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Objetivo: Analisar a visibilidade de trabalhadores/as de Enfermagem através de imagens, que circularam na mídia durante a pandemia da Covid-19. Métodos: Análise cultural que visa articular a imagem e seus efeitos com teorizações de autores do campo dos Estudos Culturais. Resultados: Foram selecionadas seis figuras nas quais enfermeiras são retratadas como heroínas para combater a Covid-19 e são promovidas de coadjuvante à personagem principal, aliando a estratégia de cuidado ao discurso científico da defesa do distanciamento social. As imagens as retratam enquanto mulheres que enfrentam sofrimento laboral por executarem trabalhos extenuantes e uso prolongado de equipamentos de proteção individual. Considerações finais: A pandemia tem colocado em evidência discursos referentes ao trabalho em saúde, onde vemos imagens de enfermeiras como heroínas que organizam o caos e trazem a ordem à “linha de frente”, ficando visível a idealização da Enfermagem. Objective: To analyze the visibility of Nursing workers through images, which circulated in the media during the Covid-19 pandemic. Methods: Cultural analysis that aims to articulate the image and its effects with theories from authors in the field of Cultural Studies. Results: Six figures were selected in which nurses are portrayed as heroines to fight Covid-19 and are promoted from supporting actor to main character, combining the care strategy with the scientific discourse of defense of social isolation. The images portray them as women who face labor suffering from strenuous work and prolonged use of personal protective equipment. Final considerations: The pandemic, has highlighted speeches related to health work, where we see images of nurses as heroines who organize the chaos and bring order to the “frontline”, making the idealization of Nursing visible. Objetivo: Analizar la visibilidad de los trabajadores/as de Enfermería a través de imágenes, que circularon en los medios durante la pandemia del Covid-19. Métodos: Análisis cultural que tiene como objetivo articular la imagen y sus efectos con teorías de autores en el campo de los Estudios Culturales. Resultados: Se seleccionaron seis figuras en las que se retrata a las enfermeras como heroínas de la lucha contra el Covid-19 y se promocionan como complemento del protagonista, conjugando la estrategia asistencial con el discurso científico de la defensa del aislamiento social. Las imágenes las retratan como mujeres que enfrentan el sufrimiento laboral por realizar un trabajo arduo y el uso prolongado de equipo de protección personal. Consideraciones finales: La pandemia ha destacado discursos relacionados con el trabajo en salud, donde vemos imágenes de enfermeras como heroínas que organizan el caos y ponen orden en la “primera línea”, visibilizando la idealización de la Enfermería.

Background Reducing health inequalities involves the identification and characterization of social and exposure factors and the way they accumulate in a given area. The areas of accumulation then allow for prioritization of interventions. The present study aims to build spatial composite indicators based on the aggregation of environmental, social and health indicators and their inter-relationships. Method Preliminary work was carried out firstly to homogenize spatial coverage, and secondly to study spatial variation of environmental (EI), socioeconomic (SI) and health (HI) indicators. The aggregation of the different indicators was performed using several methodologies for which results and decision-makers’ usability were compared. Results Four methodologies were tested: 1) A simple summation of normalized HI, EI and SI indicators (IC), 2) the sum of the normalized HI, EI and SI indicators weighted by the first principal component of a Principal Component Analysis (IC PCA), 3) the sum of normalized and weighted indicators of the first principal component of Local Principal Component Analysis (IC LPCA), and 4) the sum of normalized and weighted indicators of the first principal component of a Geographically Weighted Principal Component Analysis (IC GWPCA). Conclusion The GWPCA is particularly adapted to taking into account the spatial heterogeneity and the spatial autocorrelation between SI, EI and HI. This approach invalidates the basic assumptions of many standard statistical analyses. Where socioeconomic indicators present high deprivation and where they are associated with potential modifiable health determinants, decision-makers can prioritize these areas for reducing inequalities by controlling the socioeconomic and health determinants.

Glycol ethers (GE) are chemicals used since the 1930s as solvents in paints, inks, varnishes, and cleaning agents, mainly in water-based products, cosmetics, and drugs. World production approximates 1 million tons. Nineteen GE are produced or imported each year; over 1000 tons in European Union (EU) have been classified as high production volume chemicals (HPVCs). First animal data were published in 1971 and 1979 showing severe reprotoxicity for some GE. Two alerts were launched in the United States in 1982 and 1983, but the first partial GE regulation only occurred in 1993 in the EU. Although these chemicals may expose a very large population, basic toxicity data, more especially carcinogenicity, are still lacking (3/32 GE). However, experimental data were sufficient to lead developmental toxicity risk assessment since the early 1980s. Risk indices over 1000 have been calculated for consumers and workers exposed to reprotoxic GE in domestic and industrial activities. The first ban was decided in 1999 in France, but was only for drugs and cosmetics. Not surprisingly, since the late 1980s, human studies have found results similar to those in animal data: spontaneous abortions, malformations, testicular toxicity, and hematotoxicity. Despite this highly coherent set of data, and although substitution products are available, reprotoxic GE have been and still remain widely used in the world. The case of GE shows the failure of the present system based on a posteriori risk assessment. This pleads for the change of paradigm through the European REACH regulation based on the "No data, no market" principle. Ethics in REACH management should also be considered.

International audience; Spatial health inequalities have often been analyzed in terms of socioeconomic and environmental factors. The present study aimed to evaluate spatial relationships between spatial data collected at different spatial scales. The approach was illustrated using health outcomes (mortality attributable to cancer) initially aggregated to the county level, district socioeconomic covariates, and exposure data modeled on a regular grid. Geographically weighted regression (GWR) was used to quantify spatial relationships. The strongest associations were found when low deprivation was associated with lower lip, oral cavity and pharynx cancer mortality and when low environmental pollution was associated with low pleural cancer mortality. However, applying this approach to other areas or to other causes of death or with other indicators requires continuous exploratory analysis to assess the role of the modifiable areal unit problem (MAUP) and downscaling the health data on the study of the relationship, which will allow decision-makers to develop interventions where they are most needed.

International audience; Analyzing the relationship between the environment and health has become a major focus of public health efforts in France, as evidenced by the national action plans for health and the environment. These plans have identified the following two priorities: - identify and manage geographic areas where hotspot exposures are a potential risk to human health; and - reduce exposure inequalities. The aim of this study is to develop a spatial stochastic multimedia exposure model for detecting vulnerable populations and analyzing exposure determinants at a fine resolution and regional scale. A multimedia exposure model was developed by INERIS to assess the transfer of substances from the environment to humans through inhalation and ingestion pathways. The RESPIR project adds a spatial dimension by linking GIS (Geographic Information System) to the model. Tools are developed using modeling, spatial analysis and geostatistic methods to build and discretize interesting variables and indicators from different supports and resolutions on a 1-km(2) regular grid. We applied this model to the risk assessment of exposure to metals (cadmium, lead and nickel) using data from a region in France (Nord-Pas-de-Calais). The considered exposure pathways include the atmospheric contaminant inhalation and ingestion of soil, vegetation, meat, egg, milk, fish and drinking water. Exposure scenarios are defined for different reference groups (age, dietary properties, and the fraction of food produced locally). The two largest risks correspond to an ancient industrial site (Metaleurop) and the Lille agglomeration. In these areas, cadmium, vegetation ingestion and soil contamination are the principal determinants of the computed risk.

The exposure of workers to methylene chloride and phenol in an aeronautical workshop was measured during stripping of paint from a Boeing B 747. Methylene chloride exposure was measured during two work days by personal air sampling, while area sampling was used for phenol. During paint stripping operations, methylene chloride air concentrations ranged from 299.2 mg/m3 (83.1 ppm) to 1888.9 mg/m3 (524.7 ppm). The exposures to methylene chloride calculated for an 8-h work day ranged from 86 mg/m3 (23.9 ppm) to 1239.5 mg/m3 (344.3 ppm). In another aeronautical workshop, exposure to organic solvents, especially ethylene glycol monoethylether acetate (EGEEA), was controlled during the painting of an Airbus A 320. The external exposure to solvents and EGEEA was measured by means of individual air sampling. The estimation of internal exposure to EGEEA was made by measuring its urinary metabolite, ethoxyacetic acid (EAA). Both measurements were made during the course of 3 days. The biological samples were taken pre- and post-shift. During painting operations, methyl ethyl ketone, ethyl acetate, n-butyl alcohol, methyl isobutyl ketone, toluene, n-butyl acetate, ethylbenzene, xylenes and EGEEA were detected in working atmospheres. For these solvents, air concentrations ranged from 0.1 ppm to 69.1 ppm. EGEEA concentrations ranged from 29.2 mg/m3 (5.4 ppm) to 150.1 mg/m3 (27.8 ppm). For biological samples, the average concentrations of EAA were 108.4 mg/g creatinine in pre-shift and 139.4 mg/g creatinine in post-shift samples. Despite the fact that workers wore protective respiratory equipment during paint spraying operations, EEA urinary concentrations are high and suggest that percutaneous uptake is the main route of exposure for EGEEA.(ABSTRACT TRUNCATED AT 250 WORDS)

As of the mid-19th century, most infectious disease epidemics have been fought and slowed down by taking action on the environment (water, housing, waste) and education. This constitutes the 1st public health revolution paradigm. As we face the current epidemic of chronic diseases and the failure of the dominant biomedical model to stop them, a 2nd public health revolution is needed. The vision for this 2nd public health revolution requires a new paradigm built upon an eco-systemic definition of health and the recognition of the legitimacy for citizen participation based on the precautionary principle., À partir du milieu du XIXe siècle, la plupart des épidémies de maladies infectieuses ont reculé grâce à une action sur l'environnement (eau, habitat, déchets) et l'éducation, ce qui a constitué le paradigme de cette 1re révolution de santé publique. Face à l'épidémie actuelle de maladies chroniques et l'incapacité de l'actuel modèle biomédical pour l'arrêter, une 2e révolution de santé publique apparaît nécessaire construite sur un paradigme reposant sur une définition écosystémique de la santé et la reconnaissance de la légitimité de la participation des citoyens fondée sur le principe de précaution

The term volatile organic compounds includes a wide variety of chemical substances with the common feature of being carbon compounds that are volatile at ambient temperature. They can be classified into different families defined by their chemical formulae, each of which possesses common properties, although there may be major differences in terms of toxicity. For that reason the effects of VOC on health have to be considered both in an individual way and also from a global viewpoint on account of their common toxic properties and the role they play in the formation of environmental photo-oxidative pollutants, both outdoors and indoors.

SUMMARYAims– To highlight the major discrepancies that emerged between evidence and routine practice in the framework of the SIEP-DIRECT's Project (DIscrepancy betweenRoutine practice andEvidence in psychiatricCommunityTreatments onSchizophrenia). The Project was conducted in 19 Italian mental health services (MHS), with the aims of: a) evaluating the appropriateness of the NICE Guidelines for Schizophrenia in the Italian context, b) developing and testing a set of 103 indicators that operationalised preferred clinical practice requirements according to the NICE Guidelines, and c) evaluating their actual application in Italian MHSs.Methods– The indicators investigated five different areas: common elements in all phases of schizophrenia; first episode treatment; crisis treatment; promoting recovery; the aggressive behaviour management.Results– The NICE recommendations examined were judged in most instances to be appropriate to the Italian MHS context, and the indicators fairly easy to use. The more severe and frequently encountered evidence-practice discrepancies were: lack of written material, guidelines, and information to be systematically provided to users; lack of intervention monitoring and evaluation; difficulty in implementingspecific and structured forms of intervention; difficulty in considering patients' family members as figures requiring targeted support themselves and who should also be regularly involved in the patient care process.Conclusions– The key actions to be undertaken to favour implementation of evidence-based routine practices are: focussing on mental illness onset and family support/involvement in care; planning training activities aimed at achieving specific treatment goals; encouraging MHS participation in evaluation activities; identifying thresholds for guideline application and promoting specific guideline implementation actions; and activating decision making and resource allocationprocesses that rely more strictly on evidence and epidemiological assessment. These considerations are of value for rethinking the model of community psychiatry in Italy as well as in other countries.Declaration of Interest: None.

Glycol ethers (GE) are a family of solvents, the use of which has increased dramatically since the 60's, in domestic and occupational mainly water-based products, such as paintings, inks, varnishes, cleaning agents. There are two subgroups: E series and P series. EGME, among the E series, is the reference substance. This is a reprotoxic chemical causing infertility and genital apparatus atrophy on both sexes, embryofetal toxicity through maternal exposure (malformation, growth alterations and functional deficits). European Union has classified nine other GE as reprotoxic. P series, with the beta isomers exception, has no specific reprotoxicity. Epidemiological studies published from the 80's onwards, have confirmed animal data (malformation, oligoazoospermia, spontaneous abortion, hypofertility). The effects can be observed even after the end of exposure. Risk assessment studies tend to prove that this massive exposure during several decades could have had an important impact on reproductive human health. Even if this exposure has considerably decreased since the last few years, a ban of reprotoxic GE, as required by two official bodies (CSC, CSHPF), seems necessary, due to the high risk level. Classification should be completed for some GE, not classified now (EGBE). Health assessment of past exposure should be carried out. Physicians should look after a possible glycol ethers responsibility when facing this kind of reprotoxic effects.

The Finnish Institute of Occupational Health (FIOH) has received support from the World Health Organization (WHO) and the International Labor Office (ILO) to publish the African Newsletter on Occupational Health and Safety. The African Newsletter on Occupational Health and Safety should not be a medium for industry propaganda, or the source of misinformation among the workers of Africa. Instead, FIOH should provide the same level of scientific information in Africa that it does in Finland and other developed countries.

Following the wreck of the oil tanker ERIKA off the north-west coast of France in December 1999, cleaning up of the beaches involved considerable work, which in any case could not be perfect. This raised the question of the short- and long-term health risks for the future bathers related to the toxicity of the remaining oil polycyclic aromatic hydrocarbons (PAHs). This risk assessment study was conducted to help health authorities plan risk management policies and inform the public. Thirty-six beaches were selected, representing a sample of the most frequently encountered topographic and beach usage situations; seven “control” beaches, unspoiled by ERIKA, were also investigated. Samples of water and sand were taken from each site, as well as from the surface of rocks. The 16 PAHs selected by the U.S. EPA were quantified in each environment. Several scenarios of exposure were contemplated: (1) a child between 2 and 4 years accidentally ingesting a small ball of fuel, (2) a child daily exposed throughout his holiday-time stay, (3) an adult (including a pregnant woman) spending his/her holidays on the coast, (4) an adult working on the beach, (5) and an adult practicing water sports. Among the available and significant toxicological values, the most conservative ones were selected for computing risks. The sand and water, after decontamination, were slightly polluted (respectively, 7.8 μg/kg and 23.3 ng/l of total 16 PAHs), with values similar to those found in the control beaches. By contrast, the rocky areas in some places were still highly polluted (up to 23 mg/kg on the surface layer). No lethal risk was found for a young child who had accidentally ingested a small ball of fuel. The life-long excess risks for skin cancer and for all other cancers were about 10−5 in scenarios including contact with the polluted rocks. In all other cases, excess risks were considerably lower. The hazard quotient for teratogenic effects was very small, except in scenarios where pregnant women would walk among rocks containing high pollution levels. In conclusion, exposure was mainly associated with polluted water among children, and with spoiled rocks for adults. Despite uncertainties, mainly dealing with the prediction of long-term risks following a short-term exposure, this study showed that beaches where pollution was no longer visible after decontamination did not entail any significant health risks and could be opened to the public.

There is a lack of data on environmental benzene exposure in children. In this study, we compared personal benzene exposure and inhalation uptake in a group of children to those of their parents. We also compared levels of urinary benzene metabolites, trans,trans-muconic acid (MA) and hydroquinone (HQ), for those two groups, and assessed the correlation between personal benzene exposure and urinary MA and HQ concentrations. The study was performed on 21, 2-3-year-old children and their parents recruited on a voluntary basis among non-smokers from the three largest day-care centers of the town of Rouen in France. Average benzene concentrations were measured over 5 consecutive days with diffusive samplers. The following simultaneous measurements were carried out: personal exposure of the parents, concentrations inside and outside the day care centers, and inside the volunteer's bedrooms. Morning and evening urine samples were collected during the same period. Benzene personal exposure levels were 14.4+/-7.7 microg/m(3) and 11.09+/-6.15 microg/m(3) in parents and children, respectively. Benzene inhalation uptake estimates were 2.51+/-1.23 microg/kg/day in the group of parents and 5.68+/-3.17 microg/kg/day in the group of children. Detectable levels of MA and HQ were found in 85% and 100% of the samples, respectively. Intra-individual variation of urinary MA and HQ concentrations expressed as a coefficient of variation (CV) ranged from 63 to 232% and from 13 to 144%, respectively. Mean values of MA and HQ (in mg/g creatinine) were 1.6- and 1.8-fold higher in the group of children than in the group of parents (P=0.008 and P0.0001, respectively). Significant correlations between metabolites levels and benzene were not found.

Exposure to airborne pollutants can result in adverse health effects. Acute symptoms can for instance comprise of irritation of the eyes or of the respiratory tract (called sensory irritation). In a recent case, health problems were reported in a French school and supposedly attributed to the presence of airborne irritant pollutants. Based on measured concentrations, the risk of developing the described health effects was assessed.Numerous airborne sensory irritants (aldehydes, organic acids, volatile organic compounds (VOCs), SO2, NH3) were identified and quantified in the indoor air by using active and passive sampling and online monitoring techniques. Reference values based on toxicological properties of compounds (sensory irritants) were taken from the literature. If not available, tentative values were specially developed for this purpose. Concentrations of all sensory irritants remain below their corresponding guideline values and are comparable to literature data. It was concluded that the risk of developing sensory irritation due to the presence of the studied compounds is negligible. This holds both for individual compounds and for the mixture of studied compounds. Limitations of the employed sampling strategy, and of existing sampling and analytical techniques, which do not allow for analysing more reactive compounds—which are strong sensory irritants—may play a role. New sampling techniques need to be developed. Psychosocial factors (group behaviour, increased attention to sensory irritation) should also be taken into account when dealing with health complaints on sensory irritation. Keywords: Airborne sensory irritants, Exposure, Mixtures, Risk assessment, Weighted sum parameter

Glycol ethers (Ge) are a family of substances with a growing use in industrial and domestic products for the two last decades. Ge (group 1 and 2) are experimentally toxic for reproduction and development, at various levels. That begins to be found in humans. Epidemiological studies confirm toxicokinetic data showing humans are more sensitive than animals, because of a low excretion rate of the toxic metabolites. Occupational and consumer exposures are frequently higher than reference concentrations deducted from animal data. They may be involved in the growing number of genital reproductive system and reproduction anomaly, observed in most developed countries. Genetic toxicity is suspected from experimental data, but further investigations are needed.

Ethylene glycol ethers and their acetate derivatives were analyzed for their toxicity in vitro on several hemopoietic cell lines, either growth-factor-dependent or leukemic, in mouse, rat, and human species. Considering the concentrations that reduced the cell viability in culture by 50%, most of the ethylene glycol ethers and in particular ethylene glycol monoethyl ether (EGEE) or ethylene glycol monobutyl ether (EGBE) should be considered as hemopoietic toxins. EGBE was found to be the most potent toxin on the human promyelocytic cell line, NB4 (median inhibitory concentration (IC50) 5 mM at 6 h; IC50 0.1 mM at 96 h) but also on the factor-dependent cell line DA1 (IC50 80 microM at 48 h). Factor-dependent cell lines were not significantly more sensitive than leukemic cell lines. The toxicity of these compounds falls in the same range of concentration as benzene or phenol, but hydroquinone was significantly more toxic in the same assay (IC50 3-15 microM at 48 h). Toxic effects increased linearly with time. The toxicity of ethylene glycol ethers was confirmed by both assays for colony-forming units in culture medium (CFU-C) (human blood cord cells) and murine bone marrow long-term culture (IC50 5-10 mM). Stromal cells in the adherent layer were more resistant than hemopoietic cells. An all or none toxicity was found within a narrow range of concentration (2-5 mM for EGBE), and chronic exposure over two months did not show cumulative effects on the culture cellularity. The possibility that fibroblastic or macrophage cells worked at the detoxification of the culture is suggested. Results are discussed with regard to epidemiological and in vivo experimental data presently available.