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Environmental surveillance is one part of a comprehensive approach for minimizing hazardous exposures in healthcare. This study highlights a low level of contamination of three hazardous drugs amongst 66 Canadian centers. Regular environmental monitoring is a good practice to maintain contamination as low as reasonably achievable.

Increases in terrestrial primary productivity across the Arctic and northern alpine ecosystems are leading to altered vegetation composition and stature. Changes in vegetation stature may affect predator-prey interactions via changes in the prey's ability to detect predators, changes in predation pressure, predator identity and predator foraging strategy. Changes in productivity and vegetation composition may also affect herbivores via effects on forage availability and quality. We investigated if height-dependent effects of forage and non-forage vegetation determine burrowing extent and activity of arctic ground squirrels (Urocitellus parryii). We collected data on burrow networks and activity of arctic ground squirrels across long-term vegetation monitoring sites in Denali National Park and Preserve, Alaska. The implications of height-specific cover of potential forage and non-forage vegetation on burrowing behaviour and habitat suitability for arctic ground squirrels were investigated using hierarchical Bayesian modelling. Increased cover of forbs was associated with more burrows and burrow systems, and higher activity of systems, for all forb heights. No other potential forage functional group was related to burrow distribution and activity. In contrast, height-dependent negative effects of non-forage vegetation were observed, with cover over 50-cm height negatively affecting the number of burrows, systems and system activity. Our results demonstrate that increases in vegetation productivity have dual, potentially counteracting effects on arctic ground squirrels via changes in forage and vegetation stature. Importantly, increases in tall-growing woody vegetation (shrubs and trees) have clear negative effects, whereas increases in forb should benefit arctic ground squirrels.

<p><strong>RÉSUMÉ</strong></p><p><strong>Contexte : </strong>Il existe de plus en plus de données sur la présence de traces de médicaments dangereux dans l’urine des professionnels de la santé exposés à ces médicaments.</p><p><strong>Objectif : </strong>Présenter une revue de la littérature scientifique concernant la surveillance urinaire de professionnels de la santé exposés aux anti - néoplasiques dans le cadre de leur travail.</p><p><strong>Sources de données : </strong>Recherche sur PubMed avec les <em>Medical Subject Headings </em>(MeSH) « <em>occupational exposure </em>» et « <em>antineoplastic agents </em>» ainsi que sur Google Scholar avec les termes « <em>antineoplastic </em>», « <em>urine </em>» et « <em>occupational exposure </em>».</p><p><strong>Sélection des études et extraction des données : </strong>L’examen a porté sur tous les articles en anglais et en français ayant trait aux professionnels de la santé exposés à des médicaments dangereux dans le cadre de leur travail, publiés entre le 1er janvier 2010 et le 31 décembre 2015. Les articles ne comportant pas de résultats urinaires et ceux  concernant les vétérinaires ainsi que les revues de littérature, les éditoriaux, les lettres à la redaction et les résumés de congrès ont été exclus.</p><p><strong>Synthèse des données : </strong>Vingt-quatre articles ont été retenus. Les études ont été menées dans 52 établissements de santé provenant de sept pays. Elles regroupaient 826 travailleurs exposés à des médicaments dangereux et 175 témoins, notamment des infirmiers (<em>n </em>= 16 études), des pharmaciens (<em>n </em>= 10), des assistants techniques en  pharmacie (<em>n </em>= 8), des médecins (<em>n </em>= 7), des aides-soignants (<em>n </em>= 2) et autres (<em>n </em>= 8). Différentes méthodes analytiques ont été utilisées pour quantifier la présence de 13 médicaments dangereux, principalement le  cyclophosphamide (<em>n </em>= 16 études), les platines (<em>n </em>= 7) et l’alpha-fluoro-béta-alanine, un métabolite urinaire du 5-fluorouracile (<em>n </em>= 3). La proportion de travailleurs qui ont étés déclarés positifs s’étendait de 0 % (<em>n </em>= 10 études) à 100 % (<em>n </em>= 4). Si l’on ne retient que les études permettant de calculer le taux de travailleurs comportant au moins un prélèvement urinaire positif (<em>n </em>= 23), la proportion totale était de 21 % (173/809 travailleurs, toutes méthodes et tous médicaments confondus).</p><p><strong>Conclusion : </strong>Vingt-quatre études de surveillance urinaire ont été réalisées au sein de sept pays entre 2010 et 2015. Dans plusieurs études, aucune trace de médicaments n’a été mesurée dans l’urine.</p><p><strong>ABSTRACT</strong></p><p><strong>Background: </strong>There is increasing evidence that traces of hazardous drugs occur in the urine of health care professionals who are exposed to these drugs.</p><p><strong>Objective: </strong>To review the scientific literature regarding urinary monitoring of health care professionals exposed to antineoplastic drugs through their work.</p><p><strong>Data Sources: </strong>A search of PubMed using the Medical Subject Headings “occupational exposure” and “antineoplastic agents” and of Google Scholar using the terms “antineoplastic”, “urine”, and “occupational exposure”.</p><p><strong>Study Selection and Data Extraction: </strong>The analysis covered all articles in English or French pertaining to health care professionals exposed to hazardous drugs in the workplace, published from January 1, 2010, to December 31, 2015. Articles that did not discuss the results of urine tests and those concerning veterinarians, as well as literature reviews, editorials, letters to the editor, and conference abstracts, were excluded.</p><p><strong>Data Synthesis: </strong>Twenty-four articles were retained. The studies were conducted in 52 health care institutions in 7 countries. They included 826 workers exposed to hazardous drugs and 175 controls, specifically nurses (<em>n </em>= 16 studies), pharmacists (<em>n </em>= 10), pharmacy technicians (<em>n </em>= 8), physicians (<em>n </em>= 7), health care aides (<em>n </em>= 2), and others (<em>n </em>= 8). Various analytical methods were used to quantify the presence of 13 hazardous drugs, primarily  yclophosphamide (<em>n </em>= 16 studies), platinum based drugs (<em>n </em>= 7), and alpha-fluoro-beta-alanine, a urine metabolite derived from 5-fluorouracil (<em>n </em>= 3). The proportion of workers with positive results ranged from 0% (<em>n </em>= 10 studies) to 100% (<em>n </em>= 4). Considering only those studies that allowed calculation of the rate of workers with at least one positive urine sample (<em>n </em>= 23), the total proportion was 21% (173/809 workers, for all methods and drugs combined).</p><p><strong>Conclusion: </strong>Twenty-four studies on urine monitoring were conducted in 7 countries between 2010 and 2015. In several studies, no traces of drugs were detected in urine.</p>