Respiratory disease

Preparatory Measures

• Postpone all elective surgeries (for at least one month) and if possible, postpone urgent surgeries until the case is no longer contagious or until a test rules out the possibility of COVID-19 for a patient with compatible symptoms.
• Prepare for all urgent surgery scenarios for suspected or confirmed cases of COVID-19 with the various teams: technical services, IPC, operating room, surgeons, anesthesiologists, etc.
• Determine whether the surgery has a high risk of generating aerosols (see below) by discussing with the surgeon.
• Favor epidural or locoregional anesthesia whenever possible a…

The recommendations presented in this document are to be implemented when the Québec national public health director declares that there has been sustained community transmission of COVID-19 in the Québec population. Community transmission may be declared locally, regionally or province-wide.

In the current context, the underlying premises for these recommendations are those issued by the public health authorities for the entire Québec population, who are required to postpone non-urgent appointments, remain at home except for essential trips (groceries, pharmacy, urgent healthcare), observe social distancing, and follow the established procedures when they present symptoms.

Since there is no effective vaccine or specific treatment for COVID-19 at the time of drafting of these recommendations, public health measures remain the best available tools to mitigate the incidence of the disease. The implementation of the “Pour une maternité sans danger” program is one such w…

The last report issued by the Comité sur l’immunisation du Québec (CIQ) concerning the Programme d’immunisation contre l’influenza du Québec (PIIQ) [Québec’s Influenza Immunization program] was published in 2007. An update became necessary, given the many scientific advances that have occurred in this field.

The primary objective of the PIIQ must be to reduce influenza-associated hospitalizations and deaths.

To attain this objective, the CIQ recommends maintaining a targeted vaccination strategy for individuals at high risk for hospitalization and death and giving priority to achieving vaccine uptake of at least 80% in these groups.

It is recommended to withdraw healthy children aged 6–23 months and healthy adults aged 60–74 years from the list of groups at high risk for influenza-associated hospitalization and death, but to maintain the other groups currently included in the PIIQ.

The CIQ recommends that all healthcare workers receive the va…

The live attenuated influenza virus vaccine (LAIV), Flumist®, administered by intranasal spray, is approved for people aged 2-59 years. The National Advisory Committee on Immunization (NACI) recommended in its statement for the 2011-2012 season that, given its efficacy and immunogenicity, LAIV should be used preferentially for healthy children and adolescents aged 2 to 17 years. NACI also indicates that LAIV can be used for children with chronic diseases, other than immune compromising conditions or severe asthma, but that there were insufficient data to recommend the preferential use of LAIV over trivalent inactivated vaccine (TIV). The Comité sur l'immunisation du Québec (CIQ) also recommended, at its June 2011 meeting, that LAIV should be used preferentially in healthy children aged 2-17 years, particularly among household contacts of people at high risk for complicated influenza infection.

At the December 2011 CIQ meeting, the question of LA…

Public health ethics (PHE) is a relatively new field of study that encourages interdisciplinary discussion of moral issues related to the theory and practice of public health and preventive medicine. Emerging over the last 15 years out of dissatisfaction with the traditional orientations of biomedical ethics, PHE involves the explicit use of concepts from ethical, social and political theory to discuss and evaluate collective interventions that aim to protect and promote the health of groups and populations rather than of individuals.

This document has two aims. The first is to serve as a timely introduction to the field of PHE as applied to policy and practice responses to what was perhaps the most visible recent global public health threat, the global influenza AH1N1 pandemic. It is based on a review of the literature on this subject carried out by the National Collaborating Centre for Healthy Public Policy (NCCHPP) between May and August of 2009. The review does not…

In the autumn of 2007, the Association des victimes de l'amiante du Québec (AVAQ – a Québec association for asbestos victims) and the Ministère du Développement durable, de l'Environnement et des Parcs du Québec (MDDEP – Québec ministry of sustainable development, the environment and parks) published studies on the asbestos concentrations measured in indoor and outdoor air in Thetford Mines. The findings motivated the public health authorities in Chaudière-Appalaches and Estrie to request the assistance of the Institut national de santé publique du Québec (INSPQ – Québec institute of public health) to conduct an assessment of the risk of lung cancer and mesothelioma of the pleura in this population.

Asbestos is divided into two families: amphiboles (crocidolite, amosite, tremolite, actinolite and anthophyllite) and serpentines (chrysotile). The three main diseases associated asbestos exposure are asbestosis, lung cancer and mesothelioma of the pleu…

In the autumn of 2007, the Association des victimes de l'amiante du Québec (AVAQ – a Québec association for asbestos victims) and the Ministère du Développement durable, de l'Environnement et des Parcs du Québec (MDDEP – Québec ministry of sustainable development, the environment and parks) published studies on the asbestos concentrations measured in indoor and outdoor air in Thetford Mines. The findings motivated the public health authorities in Chaudière-Appalaches and Estrie to request the assistance of the Institut national de santé publique du Québec (INSPQ – Québec institute of public health) to conduct an assessment of the risk of lung cancer and mesothelioma of the pleura in this population.

Asbestos is divided into two families: amphiboles (crocidolite, amosite, tremolite, actinolite and anthophyllite) and serpentines (chrysotile). The three main diseases associated asbestos exposure are asbestosis, lung cancer and mesothelioma of the pleu…

This document reports on the Québec data acquired since 2003 on asbestos exposure and asbestos-related diseases, both among workers and in the general population. However, the aim is not to update the knowledge on asbestos as such. This report also summarizes the status of the Québec surveillance system for asbestos exposures and asbestos-related diseases, which will be introduced by the Institut national de santé publique du Québec (INSPQ), as a result of the adoption of the Policy concerning the increased and safe use of chrysotile asbestos in Québec.

The most recent data (2004) on environmental exposure to asbestos in outdoor air identified no asbestos fibres in Montréal and in the city of Québec. However, in Thetford Mines, the average airborne asbestos concentration was 0.0043 fibre/ml (f/ml) by transmission electron microscopy (TEM). This concentration was 215 times higher than that obtained in the air outside buildings involved in litigation regarding the re…