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                  <text>Environmental - General - Exposure Assessment</text>
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                <text>&lt;h2&gt;Quantification de la variabilité biologique - Impact de la variation des niveaux ambiants de contaminants&lt;/h2&gt;</text>
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                <text>&lt;span&gt;Biomonitoring indicators serve as a complement to environmental monitoring for documenting, controlling and preventing worker exposure to chemical contaminants, and vary with factors related to the worker and his environment. In a previous study, the authors examined the individual conditions responsible for this variability. In this publication, they document the effect of variation in exposure levels on the measurement of these indicators. The objective: to propose a model for the mathematical calculation of the total variability while taking the different sources into account. As a complement to previous research in this field, this study provides Québec occupational health professionals with essential information on the total variability that can affect biomonitoring data. The results will be used to compare expected variations in environmental surveillance parameters to the variation in biological indicators, according to different exposure scenarios. This information will be added to the IRSST's biomonitoring guide. The institute's various clienteles will thus have a decision tool applicable to biomonitoring strategies. This research will also yield a computer tool that facilitates calculation of the number of samples required.&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.irsst.qc.ca/en/_publicationirsst_100327.html" rel="noreferrer noopener"&gt;http://www.irsst.qc.ca/en/_publicationirsst_100327.html&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Surveillance de l'asthme professionnel chez des travailleurs dans des secteurs à risque&lt;/h2&gt;</text>
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                <text>&lt;span&gt;Occupational asthma is the occupational respiratory disease most frequently recognized by the CSST. Sixty new cases are compensated annually, half of which are in young workers. In some industrial sectors, fewer than five years elapse between the start of exposure and the appearance of the first symptoms. To have a better understanding of this phenomenon, the researchers will evaluate instruments for measuring immunological and functional parameters for monitoring occupational asthma on three cohorts of workers. The targeted sectors are those where flour, laboratory animals and latex are found, which are among the main causal agents of Québec cases of occupational asthma. From this study, it will be possible to determine the incidence of specific immunological sensitization, of respiratory symptoms or occupational rhinoconjunctivitis, of bronchial hyperreactivity and occupational asthma in these groups at risk. Its results will promote better prevention of occupational asthma and its long-term sequellae, while increasing scientific knowledge about its natural history.&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.irsst.qc.ca/en/_publicationirsst_100279.html" rel="noreferrer noopener"&gt;http://www.irsst.qc.ca/en/_publicationirsst_100279.html&lt;/a&gt;</text>
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                  <text>Environmental - General - Exposure Assessment</text>
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                <text>&lt;h2&gt;Impact of lowering of the permissible exposure value for formaldehyde - Health impact of an occupational exposure to formaldehyde&lt;/h2&gt;</text>
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                <text>&lt;span&gt;Following a request from the review committee for Schedule A of the Regulation respecting occupational health and safety, and following a preliminary feasibility study, this project aimed to evaluate the health and socioeconomic impacts of lowering the current permissible exposure value of 2 ppm ceiling to one of the values of 1.0, 0.75 or 0.3 ppm ceiling or weighted for eight hours. The authors evaluated the gains for workers' health and the costs and economic advantages for companies. To achieve this, they adopted a mixed approach that combined expertise and a classic industrial hygiene approach, in order to produce a matrix linking economic activity sectors and formaldehyde exposure concentrations. The addition of data on workstations and emission sources made it possible to consolidate the results obtained by sector, manpower and distribution of exposed workers. This project has also resulted in the acquisition of knowledge on a large number of economic activity sectors in Québec as well as expertise on the evaluation of occupational health and safety impacts. The results are published by industrial sector, and overall, in 13 publications, including the comprehensive report.&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.irsst.qc.ca/en/_publicationirsst_100178.html" rel="noreferrer noopener"&gt;http://www.irsst.qc.ca/en/_publicationirsst_100178.html&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Emergency Preparedness &amp;amp; Response Fundamentals&lt;/h2&gt;</text>
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                <text>&lt;span&gt;This course is available in English, and contains 2 modules which are intended for all levels of environmental health professionals (EHP). The modules are divided into sections each being 10-30 minutes in length. Included are lessons on communication for emergency situations and response scenarios regarding mercury contamination, chemical spills and tornados. The first module is titled Emergency Preparedness and Response Fundamentals, with four distinct, but related lessons. Lesson #1 presents an overview of environmental health principles. Lesson #2 focuses on communication, which is a key role for EHP. Lesson #3 describes responding to emergency events and presents potential emergency response actions (i.e., roles) associated with different situations that an EHP may face in the future. Lesson #4 addresses minimizing health implications. The second module is titled Putting Principles into Practice. The intent of this module is for EHP to apply the principles they learned in Module I to each scenario presented in Module II. It consists of three real world emergency incidents. Scenario #1 presents elemental mercury contamination. Scenario #2 focuses on an ammonia release. Scenario #3 describes a natural disaster (i.e., a tornado).&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.umncphp.umn.edu/preparedness/site/index.htm" rel="noreferrer noopener"&gt;http://www.umncphp.umn.edu/preparedness/site/index.htm&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Indoor smoke from solid fuels: Assessing the environmental burden of disease&lt;/h2&gt;</text>
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                <text>&lt;span&gt;This 82-page guide is available in English and is intended for intermediate level public health professionals and environmental health specialists. It outlines a method for estimating the disease burden at a national or local level caused by household exposures to indoor smoke from solid fuels. Solid fuel use is defined as the household combustion of coal or biomass (such as dung, charcoal, wood, or crop residues). Worldwide, approximately 50% of all households and 90% of rural households utilize solid fuels for cooking or heating. Solid fuels are commonly burned in inefficient simple stoves and in poorly ventilated conditions. In such situations, solid fuel use generates substantial emissions of many health-damaging pollutants, including respirable particulates and carbon monoxide, and results in indoor air pollution exposures often far exceeding national standards and international guidelines.&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.who.int/quantifying_ehimpacts/publications/en/Indoorsmoke.pdf" rel="noreferrer noopener"&gt;http://www.who.int/quantifying_ehimpacts/publications/en/Indoorsmoke.pdf&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Sharps injuries: Global burden of disease from sharps injuries to health-care workers&lt;/h2&gt;</text>
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                <text>&lt;span&gt;This 48-page model of determining the global burden of disease from sharps injuries to health care workers is available in English. The intended audience includes intermediate level occupational safety and health specialists, in addition to health care and public health professionals. The purpose of this study is to estimate the global burden of occupational transmission of hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in healthcare personnel.&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.who.int/quantifying_ehimpacts/publications/en/sharps.pdf" rel="noreferrer noopener"&gt;http://www.who.int/quantifying_ehimpacts/publications/en/sharps.pdf&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Case Studies in Environmental Medicine (CSEM) Environmental Triggers of Asthma&lt;/h2&gt;</text>
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                <text>&lt;span&gt;This peds case study is available in English. It is intended for advanced level health care providers with the goal of increasing the primary care provider's knowledge of hazardous substances in the environment and to aid in the evaluation of potentially exposed patients. This case study provides information related to environmental triggers of asthma including: pathogenesis, differential diagnosis, diagnosis, evaluation, follow-up, factors and sources, as well as therapy and prevention. Upon completion of this case study the participant should be able to identify various environmental factors that trigger asthma exacerbations, describe interventions available to mitigate environmental factors in triggering asthma, identify sources of information on the impact of environmental factors on patients with asthma, and identify sources of information on asthma management. The CDC designates this educational activity for a maximum of 1.5 hours toward the American Medical Association (AMA) Physician's Recognition Award, 1.8 contact hours in nursing, and 0.15 Continuing Education Units (CEUs).&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.atsdr.cdc.gov/HEC/CSEM/asthma/index.html" rel="noreferrer noopener"&gt;http://www.atsdr.cdc.gov/HEC/CSEM/asthma/index.html&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Case Studies in Environmental Medicine (CSEM) Disease Clusters: An Overview&lt;/h2&gt;</text>
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                <text>&lt;span&gt;This case study is available in English. It is intended for advanced level health care providers, especially pediatricians, of the special susceptibilities of children to hazardous substances in the environment and aid in their evaluation of potentially exposed patients. This case study provides information related to clusters including: case definition, case confirmation, population denominator, exposure assessment, plausible hypotheses, risk communication, and resources. Upon completion of this case study the participant should be able to define a disease cluster, describe the components of the public health department disease cluster investigation, and describe the physician's responsibility regarding disease clusters. The CDC designates this educational activity for a maximum of 1.5 hours toward the American Medical Association (AMA) Physician's Recognition Award, 1.6 contact hours in nursing, and 0.1 Continuing Education Units (CEUs).&lt;/span&gt;</text>
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                <text>&lt;a target="_blank" href="http://www.atsdr.cdc.gov/HEC/CSEM/cluster/index.html" rel="noreferrer noopener"&gt;http://www.atsdr.cdc.gov/HEC/CSEM/cluster/index.html&lt;/a&gt;</text>
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                <text>&lt;h2&gt;Case Studies in Environmental Medicine (CSEM) Trichloroethylene Toxicity&lt;/h2&gt;</text>
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                <text>&lt;span&gt;This case study is available in English. It is intended for advanced level health care providers, especially pediatricians, of the special susceptibilities of children to hazardous substances in the environment and aid in their evaluation of potentially exposed patients. This case study provides information related to at risk populations, including peds, exposure pathways, physiologic effects, clinical and laboratory evaluation, therapy, as well as workplace and environmental standards and regulations related to trichloroethylene exposure. Upon completion of this case study the participant should be able to discuss the major exposure routes for trichloroethylene, describe two potential environmental and occupational sources of exposure to trichloroethylene, state two reasons why trichloroethylene is a health hazard, describe factors contributing to trichloroethylene toxicity, identify evaluation and treatment protocols for persons exposed to trichloroethylene, and list two sources of information on trichloroethylene. The CDC designates this educational activity for a maximum of 1.5 hours toward the American Medical Association (AMA) Physician's Recognition Award, 1.6 contact hours in nursing, and 0.1 Continuing Education Units (CEUs).&lt;/span&gt;</text>
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