Search Results (40)

Pesticides are compounds of major use in agriculture worldwide. Nevertheless, many pesticide chemicals are classified as endocrine disruptors and potentially carcinogens. Farmers and farmworkers are particularly exposed and are at high risk of developing health-related impairments. In Morocco, the lack of awareness towards pesticide hazards and the inappropriate application of safety measures might increase the exposure as well as the risks of health concerns. In this paper, we present the framework of a study designed to assess pesticide exposure among Moroccan farmers and farmworkers and to evaluate potential health effects, namely endocrine and epigenetic impacts. Human biological monitoring will be conducted to determine pesticide levels in urine following the development and validation of sensitive chromatography methods (SPE, UPLC-MS/MS). Biomarkers of exposure include a set of parent and metabolite pesticide compounds (organophosphates, pyrethroids, triazines and urea-based pesticides). Thyroid and reproductive hormones (TSH, T₃, T₄, FSH and LH) as well as global and specific DNA methylation markers (5-mC, 5-hmC, N⁶-mA, THRB and LHR) are selected as biomarkers of effects. This provides guiding steps and methods to perform reliable exposure evaluation and health impact assessment. This study aims to expand the current knowledge on the endocrine and epigenetic risks related to pesticides, especially in low- and middle-income countries. Full article

The use of face masks has proven to be an effective preventive measure during the COVID-19 pandemic. However, concerns have emerged regarding the safety of metal (nano)particles incorporated into face masks for antimicrobial purposes. Specifically, this review examines the risks associated with TiO₂ nanoparticles (NPs), which are classified as a possible human carcinogen. The inhalation of TiO₂ NPs can cause multiple adverse effects, including oxidative stress, pulmonary inflammation, histopathological changes, and (secondary) genotoxicity. Different aspects are discussed, such as the composition and filtration efficiency of face masks, the antimicrobial mode of action and effectiveness of various metals, and the hazards of TiO₂ NPs to human health, including exposure limits. A conservative risk assessment was conducted using different worst-case scenarios of potential (sub)chronic TiO₂ exposure, derived from published leaching experiments. Most face masks are considered safe, especially for occasional or single use. However, the nanosafety of a minority of face masks on the European market may be inadequate for prolonged and intensive use. Important uncertainties remain, including the risks of combined exposure to TiO₂ NPs and silver biocides, and the lack of direct exposure measurements. Considering the potential safety issues and the limited added protective value of TiO₂ NPs, it is recommended to ban all applications of TiO₂ in face masks based on the precautionary principle. Full article

Background: Vitamin D and iron deficiencies are prevalent among Moroccan women of reproductive age (WRA). Research suggests that Vitamin D deficiency (VDD) may impair iron bioavailability, potentially leading to iron deficiency (ID) and anemia. Objectives: This study investigates associations between vitamin D status, iron levels, and anemia risk in WRA, aged 18–49, from Meknes, Morocco. Methods: A cross-sectional study was conducted among 463 participants, measuring serum 25(OH)D, blood count parameters, iron, ferritin, C-reactive protein, and creatinine. Lifestyle factors, including dietary intake, sun exposure, and physical activity, were assessed through validated questionnaires, and anthropometric data were collected. Linear and logistic regression models analyzed associations, while ROC analysis evaluated VDD’s predictive accuracy for ID and anemia. Results: VDD (25(OH)D < 20 ng/mL) was significantly associated with reduced hemoglobin, hematocrit, red blood cells, and ferritin (all p < 0.01), indicating vitamin D’s role in erythropoiesis and iron storage. Multivariate logistic regression showed that VDD increased the risk of anemia (OR: 7.17, 95% CI: 3.19–19.28, p < 0.001), ID (OR: 2.20, 95% CI: 1.32–3.77, p = 0.007), and IDA (OR: 4.10, 95% CI: 1.73–12.08, p = 0.004). Dietary iron intake was inadequate, showing minimal protective effects against anemia and ID (β(SE): −0.08(0.03), p = 0.030 and β(SE): −0.05(0.02), p = 0.037). Conclusions: VDD is a significant risk factor for impaired iron status and anemia in Moroccan WRA, highlighting the need for targeted nutritional interventions and further research. Full article

5-Fluorouracil (5-FU) is a well-known cytostatic drug, which is often used in cancer treatments. Yet, it is also a very dangerous compound for people who are occupationally exposed to it for a long time, such as pharmacy employees, nurses and cleaning staff. We aimed to improve and implement a LC-MS/MS method for 5-FU quantification on surface contamination samples collected with swabs in a pharmacy department and outpatient nursing station of a university hospital. To improve the existing methods to quantify 5-FU, we compared a LC-MS/MS method using the frequently applied electrospray ionization source (ESI) with a UniSpray ionization source (USI). To determine the contamination of 5-FU in a pharmacy department preparing 5-FU infusion bags, which are then given to patients in the outpatient nursing stations, we collected multiple surface swabs of the laminar flow cabinets and frequently touched objects, before the preparation and administration of 5-FU and afterwards. Furthermore, we sampled the protective gloves and the bare hands of employees of the pharmacy department, involved in the preparation of the infusion bags. Using the USI source, we were able to reach the lowest limit of quantification (LOQ). With this technique, we were able to detect 5-FU contamination on the laminar flow cabinets and frequently used objects in the pharmacy department and the outpatient nursing station in the very low ng/cm² range. This contamination was mostly higher after preparation or administration than before. While we also found 5-FU on the protective gloves, we almost found no 5-FU on the skin of the pharmacy technicians preparing the 5-FU infusion bags. In conclusion, our method was able to detect very low concentrations of 5-FU contamination, but the contamination we found is very unlikely to result in any issues for the personnel working in these areas. Full article

Although vitamin D insufficiency has been correlated with an increased risk of cardiovascular disease (CVD), there are few data on the association between 25-hydroxyvitamin D (25(OH)D) and atherogenic indices predictive of CVD. This study investigated the relationship of vitamin D status with lipid profile and atherogenic indices in adult women in Morocco. Three hundred women aged 18 to 50 years from Meknes were included. Fasting 25(OH)D and lipid concentrations were assayed by a one-step electrochemiluminescence-based immunoassay and an enzymatic method, respectively. Atherogenic indices (atherogenic index of plasma (AIP), atherogenic coefficient (AC), non-HDL cholesterol (non-HDL-C), Castelli risk indices I and II (CRI-I and II), and CHOLIndex (CI)) were calculated using conventional lipid parameters. Logistic regression models and operating characteristic curve (ROC) analysis were used to assess the relationship of the variables and estimate the threshold of 25(OH)D levels associated with high atherogenic indices. 25(OH) D below 20 ng/mL was significantly associated with an enhanced risk of hypertriglyceridemia and elevated values of AIP, AC, non-HDL-C, and CRI-I with an OR (95% CI) of 4.904 (1.856–12.959), 3.637 (2.149–6.158), 3.589 (1.673–7.700), 2.074 (1.215–3.540), and 2.481 (1.481–4.123), respectively. According to the ROC analysis, the likelihood of hypertriglyceridemia and high values of AIP, AC, non-HDL-C, and CRI-I were associated with 25(OH)D thresholds ≤15.15 ng/mL, ≤17.5 ng/mL, ≤19.8 ng/mL, ≤20.1 ng/mL, and ≤19.5 ng/mL, respectively, all p < 0.01. Based on the atherogenic indices, this study indicates that vitamin D below 20 ng/mL may increase the risk of cardiovascular disease in adult women. Additional health measures are essential to raise awareness among women and health professionals of preventing and controlling cardiovascular risk factors, particularly among young individuals. Full article

Chronic pain is a prevalent condition with a multifaceted pathogenesis, where epigenetic modifications, particularly DNA methylation, might play an important role. This review delves into the intricate mechanisms by which DNA methylation and demethylation regulate genes associated with nociception and pain perception in nociceptive pathways. We explore the dynamic nature of these epigenetic processes, mediated by DNA methyltransferases (DNMTs) and ten-eleven translocation (TET) enzymes, which modulate the expression of pro- and anti-nociceptive genes. Aberrant DNA methylation profiles have been observed in patients with various chronic pain syndromes, correlating with hypersensitivity to painful stimuli, neuronal hyperexcitability, and inflammatory responses. Genome-wide analyses shed light on differentially methylated regions and genes that could serve as potential biomarkers for chronic pain in the epigenetic landscape. The transition from acute to chronic pain is marked by rapid DNA methylation reprogramming, suggesting its potential role in pain chronicity. This review highlights the importance of understanding the temporal dynamics of DNA methylation during this transition to develop targeted therapeutic interventions. Reversing pathological DNA methylation patterns through epigenetic therapies emerges as a promising strategy for pain management. Full article

The shortage of healthcare workers is a growing concern. The COVID-19 pandemic and retirement wave have accelerated turnover rates. This systematic review aimed to identify and analyse the existing interventions for job retention of healthcare workers, in terms of nurses and physicians, in a hospital setting. A comprehensive search was conducted within three electronic databases, guided by the preferred reporting items for systematic review and meta-analyses (PRISMA) and synthesis without meta-analysis (SWiM) guidelines, this resulted in 55 records that met the inclusion criteria. The intervention outcomes are categorized into substantial themes: onboarding, transition program to a different unit, stress coping, social support, extra staffing, coping with the demands of patient care, work relationships, development opportunities and department resources, job environment, work organization, recruitment approach, and technological innovations. Considering the literature, onboarding programs and mentoring for nurses and physicians are recommended. Additionally, other interventions described in this review could positively affect the retention of nurses and physicians. When selecting an intervention for implementation, managers and human resources should consider the intervention that matches the determinant of intention to leave of their healthcare workers and the hospital’s mission, vision, and values. Sharing the success stories of implemented interventions may benefit healthcare organizations. Full article

Firefighters are exposed via multi-route exposure to a multitude of chemicals (PAHs, VOCs, flame retardants, dioxins, etc.) that may cause acute and long-term health effects. The dermal absorption of contaminants is a major contributor to the overall exposure and can be reduced by wearing appropriate personal protective equipment. As leather firefighters’ gloves cannot be decontaminated regularly by wet cleaning, many Belgian firefighters wear supplementary undergloves made of nitrile butadiene rubber (NBR) to protect against the accumulation of toxicants. However, the safety of this practice has been questioned. In this commentary, the current practice and risks are outlined for the first time, assessed by an interdisciplinary working group of the Belgian Superior Health Council. As NBR sticks to the skin more at high temperatures, the contact time on removal will be prolonged, posing an additional risk for deeper burns. However, based on the physicochemical properties of NBR and the existing experience of firefighters and burn centers, it is estimated that such incidents occur relatively rarely in practice. On the other hand, the risk of repeated exposure to contaminated gloves if no undergloves are worn is unacceptable. Despite the slightly increased risk for deeper burns, it is concluded that wearing disposable NBR gloves under regular firefighters’ gloves is an appropriate and effective preventive measure against toxic contamination. The nitrile butadiene rubber must always be fully covered to avoid any contact with the heat. Full article

Stress has been consistently linked to negative impacts on physical and mental health. More specifically, patients with chronic pain experience stress intolerance, which is an exacerbation or occurrence of symptoms in response to any type of stress. The pathophysiological mechanisms underlying this phenomenon remain unsolved. In this state-of-the-art paper, we summarised the role of the autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis, the two major stress response systems in stress intolerance. We provided insights into such mechanisms based on evidence from clinical studies in both patients with chronic pain, showing dysregulated stress systems, and healthy controls supported by preclinical studies, highlighting the link between these systems and symptoms of stress intolerance. Furthermore, we explored the possible regulating role for (epi)genetic mechanisms influencing the ANS and HPA axis. The link between stress and chronic pain has become an important area of research as it has the potential to inform the development of interventions to improve the quality of life for individuals living with chronic pain. As stress has become a prevalent concern in modern society, understanding the connection between stress, HPA axis, ANS, and chronic health conditions such as chronic pain is crucial to improve public health and well-being. Full article

Medical certification is often needed for absences of longer than one workday. The literature remains unclear as to whether this changes absenteeism. Earlier research found that the merging of two firms can augment or diminish short-term absenteeism. This study was conducted to examine whether prolonging self-certification or merging increases short-term absenteeism. Data from January 2014 to December 2021 were retrospectively collected from HR absenteeism files at two occupational health services in Belgium. Sickness periods of longer than 4 weeks were excluded. Company 1 started a merger in 2014, and company 2 prolonged of the self-certification period in 2018. The total full-time equivalents (FTEs) of company 1 increased by 6%, while company 2 had an increase of 28%. At company 1, there was a decline in absenteeism, while company 2 had an increase. The ARIMA (1, 0, 1) model provided a statistically significant local moving average (company 1: 0.123; company 2: 0.086) but no statistically significant parameters for the intervention (company 1: 0.007, p = 0.672; company 2: 0.000, p = 0.970). Prolonging the self-certification period by up to 5 days without medical certification or merging was not found to increase short-term absenteeism. Full article

This cross-sectional study aimed to develop and validate a vitamin D food frequency questionnaire (VitD-FFQ) to assess vitamin D intake in Moroccan women of reproductive age. Using the method of triads, the VitD-FFQ was validated against seven-day dietary records (7d-FR) and 25-hydroxyvitamin D (25(OH)D) as a biomarker of vitamin D status in 152 women (aged 18–45 years). Participants’ sun exposure scores (SES) were assessed using a specific questionnaire (SEQ). Predictors of vitamin D status were identified via linear regression models. Several statistical tests were applied to evaluate the criterion validity of the FFQ against two references methods (7d-FR and the biomarker-serum 25(OH)D). Median (Interquartile range) intakes were 7.10 ± 6.95 µg /day and 6.33 ± 5.02 µg/ day, respectively, for VitD-FFQ and 7d-FR. Vitamin D status was mainly determined by SES (R = 0.47) and vitamin D absolute food intakes derived by the VitD-FFQ (R = 0.56), which demonstrated a more significant prediction ability compared to 7d-FR (R = 0.36). An agreement was observed between the VitD-FFQ and 7d-FR (BA index of 3.29%) with no proportional bias (R² = 0.002, p = 0.54). <10% of participants were incorrectly classified, and weighted kappa statistics showed that VitD-FFQ had an acceptable ranking ability compared to the 7d-FR and the biomarker. The validity coefficient for the VitD-FFQ was high: ρQR = 0.90 (95%CI: 0.89–0.92), and a range from 0.46 to 0.90. Adjustment for the participants’ SES and BMI (body mass index) improved the biomarker’s validity coefficient (ρRB 0.63 (95% CI 0.39–0.82). Our results indicate that the VitD-FFQ is valid for estimating absolute vitamin D intake in Moroccan women of reproductive age. Full article

Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and validate a sun exposure score (SES) and correlate it with serum 25-hydroxyvitamin D levels in women of childbearing age. One hundred and sixty women aged 18 to 45 years residing in Meknes, Morocco, were included. A questionnaire estimating the sun exposure score and blood analysis of serum 25-OHD concentration were performed. The questionnaire’s reliability and construct validity were evaluated using Cronbach’s alpha and factor analysis. Spearman’s test was used to assess the correlation between SES and 25-OHD levels. The score’s reliability and construct validity were good, with Cronbach’s alpha values >0.70 and factorial saturation ranging from 0.696 to 0.948. Serum 25-OHD levels were significantly associated with the total sun exposure score, and all SES domains (Rho was 0.615 (p < 0.0001), 0.307 (p < 0.0001), 0.605 (p < 0.0001), and 0.424 (p < 0.0001) for total SES, indoor exposure domain, outdoor exposure domain, and sun protection practice domain, respectively). In addition, median 25-OHD levels increased significantly when sun exposure was changed from insufficient to sufficient (p < 0.0001). The results suggest that the sun exposure score could be used as a clinical tool to assess vitamin D levels in women of childbearing age. Full article

A study was conducted within the European Human Biomonitoring Initiative (HBM4EU) to characterize occupational exposure to Cr(VI). Herein we present the results of biomarkers of genotoxicity and oxidative stress, including micronucleus analysis in lymphocytes and reticulocytes, the comet assay in whole blood, and malondialdehyde and 8-oxo-2′-deoxyguanosine in urine. Workers from several Cr(VI)-related industrial activities and controls from industrial (within company) and non-industrial (outwith company) environments were included. The significantly increased genotoxicity (p = 0.03 for MN in lymphocytes and reticulocytes; p < 0.001 for comet assay data) and oxidative stress levels (p = 0.007 and p < 0.001 for MDA and 8-OHdG levels in pre-shift urine samples, respectively) that were detected in the exposed workers over the outwith company controls suggest that Cr(VI) exposure might still represent a health risk, particularly, for chrome painters and electrolytic bath platers, despite the low Cr exposure. The within-company controls displayed DNA and chromosomal damage levels that were comparable to those of the exposed group, highlighting the relevance of considering all industry workers as potentially exposed. The use of effect biomarkers proved their capacity to detect the early biological effects from low Cr(VI) exposure, and to contribute to identifying subgroups that are at higher risk. Overall, this study reinforces the need for further re-evaluation of the occupational exposure limit and better application of protection measures. However, it also raised some additional questions and unexplained inconsistencies that need follow-up studies to be clarified. Full article

Diisocyanates have long been a leading cause of occupational asthma in Europe, and recently, they have been subjected to a restriction under the REACH regulations. As part of the European Human Biomonitoring project (HBM4EU), we present a study protocol designed to assess occupational exposure to diisocyanates in five European countries. The objectives of the study are to assess exposure in a number of sectors that have not been widely reported on in the past (for example, the manufacturing of large vehicles, such as in aerospace; the construction sector, where there are potentially several sources of exposure (e.g., sprayed insulation, floor screeds); the use of MDI-based glues, and the manufacture of spray adhesives or coatings) to test the usability of different biomarkers in the assessment of exposure to diisocyanates and to provide background data for regulatory purposes. The study will collect urine samples (analysed for diisocyanate-derived diamines and acetyl–MDI–lysine), blood samples (analysed for diisocyanate-specific IgE and IgG antibodies, inflammatory markers, and diisocyanate-specific Hb adducts for MDI), and buccal cells (micronucleus analysis) and measure fractional exhaled nitric oxide. In addition, occupational hygiene measurements (air monitoring and skin wipe samples) and questionnaire data will be collected. The protocol is harmonised across the participating countries to enable pooling of data, leading to better and more robust insights and recommendations. Full article