The aim of this study is to estimate the association between night work and health-related quality of life (HRQoL) among French workers. The association between cumulative duration of night work and HRQoL was also investigated. Three career-long night work exposure groups were defined at inclusion in the CONSTANCES cohort: permanent night workers, rotating night workers and former night workers. Day workers with no experience of night work were the reference group. HRQoL was assessed using the Short Form Health Survey (SF-12), in particular the physical component summary (PCS) and mental component summary (MCS) scores, with a higher score indicating better HRQoL. Several linear regression models were built to test the association between night work exposure and HRQoL. The relationship between cumulative duration of night work and HRQoL scores was analyzed using generalised additive models. The sample consisted of 10,372 participants. Former night workers had a significantly lower PCS score than day workers (β [95

Objectives To apply correction in life tables in mortality analyses to address selection effect with respect to the reference population in a cohort of sewer workers. Methods We used excess hazard model to assess the excess mortality from all-cause and from all-cancer in an historical cohort of 1898 sewer workers between 1960 and 2011. National and regional life tables were available to assess the all-cause and the all-cancer background mortality. The corrections of these life tables were modeled by spline functions in the logit of survival scale. The excess hazard was modeled using splines functions with the time since hiring as the time scale. The parameters of the model were estimated by maximizing the likelihood. The expected excess number of cases were estimated using both regional and national model-based corrected tables and compared to those obtained without correcting the life tables. In a simulation study estimates were obtained using the corrected life table with a known model of correction (i), using the uncorrected life table but applying the model of correction (ii), and without model of correction (iii). Results The simulation study showed that applying the model of correction reduces the estimation bias in the excess rate model. In the cohort study, for all-cause mortality, the difference between the excess numbers of cases estimated reduced from 28.0 using the original life tables to 1.5 when a model of correction was applied. For all-cancer mortality, the difference reduced from 24.3 to 11.8. However, the standard error was doubled. Conclusions The differences between estimates obtained using two reference life tables decreased when the model of correction was applied at a cost of larger confidence intervals. Correction in life tables can be applied in mortality analyses when the life tables available are not fully suitable to the cohort studied.

Investigations regarding AgBr-based photocatalysts came to the center of attention due to their high photosensitivity. The present research focuses on the systematic investigation regarding the effect of different alkali metal cation radii and surfactants/capping agents applied during the synthesis of silver-halides. Their morpho-structural and optical properties were determined via X-ray diffractometry, diffuse reflectance spectroscopy, scanning electron microscopy, infrared spectroscopy, and contact angle measurements. The semiconductors' photocatalytic activities were investigated using methyl orange as the model contaminant under visible light irradiation. The correlation between the photocatalytic activity and the obtained optical and morpho-structural properties was analyzed using generalized linear models. Moreover, since the (photo)stability of Ag-based photoactive materials is a crucial issue, the stability of catalysts was also investigated after the degradation process. It was concluded that (i) the photoactivity of the samples could be fine-tuned using different precursors and surfactants, (ii) the as-obtained AgBr microcrystals were transformed into other Ag-containing composites during/after the degradation, and (iii) elemental bromide did not form during the degradation process. Thus, the proposed mechanisms in the literature (for the degradation of MO using AgBr) must be reconsidered.

OBJECTIVE:The objective was to evaluate the association between age-related comorbidities (ARCs) and 5-year HIV-related excess mortality in people living with HIV aged ≥60 years.DESIGN:Cohort study using relative survival analysis (Estève's model).SETTING:The French multicentre prospective Dat'AIDS cohort that involves 12 French hospitals.PARTICIPANTS:Inclusion of 1415 HIV-1 infected patients actively followed aged ≥60 years on January 2008, with a 5-year follow-up period in the late combination antiretroviral therapy era.RESULTS:Among 1415 patients included, 154 died. By multivariable analysis, factors predictive of 5-year HIV-related excess mortality were non-AIDS-related cancer (adjusted excess HR (aEHR)=2.94; 95% CI 1.32 to 6.57), cardiovascular disease (aEHR=6.00; 95% CI 2.45 to 14.65), chronic renal disease (aEHR=4.86; 95% CI 2.24 to 10.53), cirrhosis (aEHR=3.58; 95% CI 1.25 to 10.28), hepatitis C co-infection (aEHR=3.63; 95% CI 1.44 to 9.12), body mass index<18.5 kg/m² (aEHR=4.10; 95% CI 1.61 to 10.48) and having a CD4 cell count ≤200/mm3 (aEHR=5.79; 95% CI 2.28 to 14.69).CONCLUSIONS:ARCs, particularly cardiovascular disease and chronic renal disease, are predictive of HIV-related excess mortality, with an increase in hazard similar to that of CD4 cell count.TRIAL REGISTRATION NUMBER:NCT02898987.

PURPOSE:To determine the short-term, lagged, and cumulative effects of psychosocial factors (PSF) on the incidence of depression and anxiety.METHOD:Major depressive disorders (MDD) and generalized anxiety disorders (GAD) were diagnosed in 2006 and 2010 using the Mini International Neuropsychiatric Interview among 5684 workers from the French SIP cohort. The outcome considered here was diagnosis of MDD and/or GAD (MDD/GAD) in 2010. The frequency of 17 PSF, covering labour intensity and working time, emotional demand, autonomy, social relationships, conflict of values, and job insecurity, was self-reported in 2006 and 2010. For each PSF, four groups (A-D) were considered: exposed neither in 2006 nor in 2010 (A as the reference), exposed in 2010 but not in 2006 (B as a short-term association), exposed in 2006 but not in 2010 (C as a lagged association), exposed in both 2006 and 2010 (D as a cumulative association).RESULTS:In men, short-term and cumulative-and to a lesser extent lagged-associations of four labour-intensity factors with MDD/GAD occurrence were observed (high volume of work, pressure at work, high complexity, and long working hours). In women, the short-term and cumulative associations of five PSF were observed, mostly emotional demand factors, lack of reward and work-family imbalance. Job insecurity had strong, short-term, cumulative and lagged associations in both men and women.CONCLUSION:According to PSF and gender, the results suggest that the relationships between PSF exposure and MDD/GAD were mostly short-term and cumulative rather than lagged.

Objectives To assess the relationship between occupational exposure to metalworking fluids (MWFs) in the steel-producing industry and bladder cancer incidence. Methods A nested case-control study on bladder cancer was set up in a cohort of workers from six French steel-producing factories. Three controls were randomly selected for each incident bladder cancer case diagnosed from 2006 to 2012. Controls were matched to cases on age at diagnosis and counter-matched on a surrogate measure of exposure to MWFs derived from a job-exposure matrix. Cases (n=84) and controls (n=251) were face-to-face interviewed. Experts assessed occupational exposure to MWFs (straight, soluble and synthetic) using questionnaires and reports from factory visits. Occupational exposures were based on three metrics: duration, frequency-weighted duration and cumulative exposure index. Conditional multiple logistic regressions were used to determine ORs and 95% CIs, taking non-occupational and occupational exposure into account. Results In the 25 years before diagnosis, ORs increased significantly with duration of exposure to straight MWFs (OR=1.13 (1.02-1.25)) and increased with frequency-weighted duration of exposure to straight MWFs (OR=1.44 (0.97-2.14)). These results remained valid after adjusting for duration of smoking, average number of cigarettes smoked per day, time since smoking cessation and exposure to polycyclic aromatic hydrocarbons (PAHs). ORs also increased with soluble MWFs but not significantly. No significant association was found with older exposures to MWFs or with exposure to synthetic MWFs. Conclusion The increased risk of bladder cancer observed among workers exposed to straight MWFs and to a lesser extent to soluble MWFs may be explained by the presence of carcinogens (such as PAH) in mineral oils component of straight and soluble oils. Prevention therefore remains necessary in sectors using MWFs.

En 2004, plusieurs experts reunis par la Commission Europeenne estimaient par consensus que les risques potentiels des nanomateriaux manufactures ne pouvaient etre predits ou derives des proprietes connues de la meme matiere sous une forme plus grossiere. Selon leur estimation, fabriquer un nanomateriau revenait a creer un nouvel agent chimique different de l’agent chimique originel et un numero d’identification specifique (CAS) etait necessaire. La mise en œuvre d’une telle decision aurait permis d’initier des mesures incluant la determination de valeurs limites d’exposition professionnelle (VLEP). En 2005, l’INRS avait egalement rapporte la necessite de reevaluer les VLEP des poussieres totales et alveolaires, estimant qu’une reflexion relative aux particules ultrafines devrait par ailleurs etre entreprise, en raison de leurs proprietes toxicologiques particulieres. Depuis, en France du moins, aucune valeur limite d’exposition professionnelle relative aux nanomateriaux manufactures n’a ete determinee. Tel n’est pas le cas des Etats-Unis ou le National institute for occupational safety and health (NIOSH) a produit des 2011 une monographie dans laquelle est recommandee une VLEP pour le dioxyde de titane (TiO2) nanometrique. A partir de l’analyse fine des travaux existants, cette note a pour objectif d’engager des reflexions sur la necessite de definir des VLEP pour les nanomateriaux et plus precisement pour le dioxyde de titane nanometrique en proposant une demarche pour l’evaluation de l’exposition aux aerosols contenant du TiO2 ainsi que les principales mesures de prevention a recommander. Enfin, la necessite de reevaluer les valeurs limites d’exposition professionnelle des poussieres reputees « sans effet specifique » sera egalement abordee.

INTRODUCTION:Geographical variation in the prevalence of multiple sclerosis (MS) is controversial. Heterogeneity is important to acknowledge to adapt the provision of care within the healthcare system. We aimed to investigate differences in prevalence of MS in departments in the French territory.METHODS:We estimated MS prevalence on October 31, 2004 in 21 administrative departments in France (22% of the metropolitan departments) by using multiple data sources: the main French health insurance systems, neurologist networks devoted to MS and the Technical Information Agency of Hospitalization. We used a spatial Bayesian approach based on estimating the number of MS cases from 2005 and 2008 capture-recapture studies to analyze differences in prevalence.RESULTS:The age- and sex-standardized prevalence of MS per 100,000 inhabitants ranged from 68.1 (95% credible interval 54.6, 84.4) in Hautes-Pyrénées (southwest France) to 296.5 (258.8, 338.9) in Moselle (northeast France). The greatest prevalence was in the northeast departments, and the other departments showed great variability.DISCUSSION:By combining multiple data sources into a spatial Bayesian model, we found heterogeneity in MS prevalence among the 21 departments of France, some with higher prevalence than anticipated from previous publications. No clear explanation related to health insurance coverage and hospital facilities can be advanced. Population migration, socioeconomic status of the population studied and environmental effects are suspected.

Objective To demonstrate the benefits of relative survival analysis to historical cohort studies in occupational epidemiology. In historical cohort studies, it is never known whether each death observed during the follow-up is attributable to the risks specific to the cohort or to the general population risk. SMR analysis is the most widely employed technique for quantifying the excess risk in the cohort compared to an external reference population. SMR assumes that the rate in the cohort is proportional to the rate in the reference population, at any time within predefined strata. Methods As SMR analysis, relative survival analysis can be used to separate the excess mortality rate from the mortality due to the population risk. This approach requires the same data as SMR analysis (a reference life table and the death history of the cohort) and manages the death history much like right censored survival data. The time scaled used in the analysis is defined from a well-defined time origin (employment date, date of the first exposure, birthday) to the occurrence of the event (death day in mortality studies). Contrarily to SMR analysis, the excess rate is not supposed to be proportional to the population death rate but is a function of the time scale independently of the population death rate. Relative survival analysis is based on the estimation of the excess mortality rate function, the cumulative excess rate function and the net survival function. Patterns in these functions may reveal excess mortality during specific periods of the time scale. Results The proposed approach will be illustrated using data from several mortality studies. Conclusion Relative survival analysis is a relevant methodology for mortality analysis which allows for a dynamic analysis of the possible excess mortality rate.

Objective: To analyze the effects of occupational exposure to poorly soluble forms of beryllium (Be) on biomarkers of pulmonary inflammation using exhaled breath condensate (EBC) in workers employed in machining industries.Methods: Twenty machining operators were compared to 16 controls. The individual exposure to Be was assessed from the work history with several indices of exposure calculated on the basis of task-exposures matrices developed for each plant using historical air measurements. Clinical evaluation consisted in a medical questionnaire, measurements of biomarkers in EBC (tumor necrosis factor alpha (TNF-alpha), total nitrogen oxides (NOx)), measurement of the fraction of exhaled nitric oxide (FeNO) and resting spirometry. Adjusted multiple linear regressions were used to study the effect of the exposure to Be on inflammatory biomarkers.Results: Levels of TNF-alpha and NOx in EBC were not statistically different between exposed and controls. We found a statistically significant relationship between levels of TNF-alpha in EBC and both index of cumulative exposure and duration of exposure to Be. No other statistically significant relationships were found between exposure to Be and pulmonary response.Conclusion: Our results suggest that machining-related exposure to Be is related to pulmonary inflammation involving TNF-alpha. These findings must be confirmed by larger studies. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

The objective of this study was to highlight the relationships between deterioration of a wide variety of psychosocial factors (PSF) and increase of mental health symptoms. About 5,500 workers from of the French cohort “Health and Career paths” were considered in this study. Mental health symptoms were assessed in 2006 and 2010 by the Mini International Neuropsychiatric Interview leading to diagnosis of Major Depressive Disorder (MDD) or Generalised Anxiety Disorder (GAD). The outcome considered here was the diagnosis of MDD/GAD in 2010. Seventeen self-reported PSF, evaluated in 2006 and 2010, explored six domains: labour intensity and working time (7 items), emotional demand (3), autonomy (2), social relationships at work (2), conflict of values (2), and job insecurity (1). For each PSF, four exposure groups were considered: exposed both in 2006 and 2010 (A), exposed in 2006 and not in 2010 (B), exposed in 2010 and not in 2006 (C), and never exposed (as reference). Changes in PSF exposure between 2006 and 2010, although small, were rather towards deterioration, in particular for the pressure at work and the lack of reward. In men without MDD/GAD in 2006, job insecurity and high volume of work were related to MDD/GAD diagnosis in 2010, whatever the exposure groups. MDD/GAD diagnosis in 2010 was associated with high complexity of work in group A, emotional discordance in group B and long working hours in group C. In women, job insecurity was highly associated to MDD/GAD diagnosis in 2010. Exposure to fear at work, work-family imbalance or lack of reward affected women, but not men. These results underlined, in the context of a 4-year follow-up, the relationships between several PSF, in addition to those of „Karasek and Siegrist models, and MDD/GAD diagnosis. Job insecurity and emotional discordance impaired mental health in both genders.

L’analyse de la mortalité de cohortes professionnelles historiques est principalement réalisée sur la base de calculs de ratios standardisés de mortalité (standardized mortality ratio [SMR]). Dans les études de population sur le cancer, les méthodes de survie relative ont été développées afin d’évaluer, chez les patients atteints de cancer, la mortalité due au cancer par rapport aux autres causes de décès. L’objectif de la présentation est de montrer comment ces méthodes d’analyse peuvent être utilisées en épidémiologie en santé au travail. Comme le calcul du SMR, ces analyses comparent la mortalité observée dans la cohorte à celle de la population prise pour référence externe. Elles s’appuient sur l’estimation de la survie nette (calculée selon la méthode de Pohar-Perme), de laquelle sont déduits le taux de mortalité relatif (TMR) et le taux de mortalité en excès (TME). Appliqué à l’épidémiologie en santé au travail, ce dernier peut être interprété en termes de taux de mortalité dû à l’exposition professionnelle de la cohorte étudiée. Le TME et le TMR peuvent être calculés en fonction du délai depuis la première exposition permettant ainsi de mettre en évidence les périodes au cours desquelles l’excès (ou le déficit) de mortalité apparaît. Le modèle du SMR suppose un TME constant au cours du temps. L’utilisation de cette méthodologie sera illustrée au travers d’exemples issus d’une étude de la mortalité dans une cohorte de 1898 égoutiers suivis en mortalité de 1970 à 2010. Le TMR par maladie de l’appareil digestif est sensiblement constant en fonction du temps écoulé depuis l’embauche, proche de la valeur du SMR. En revanche le TMR par cancer « trachée, bronches, poumon » est plus élevé que le SMR entre 35 et 45 ans après l’embauche et le TME met en évidence une surmortalité supérieure à 2 pour mille et par an après 35 ans après l’embauche. Pour les décès par maladies de l’appareil cardiovasculaire des égoutiers en activité, le SMR (19 cas, SMR = 1,13) est statistiquement non significatif mais le TME met en évidence un excès de mortalité statistiquement significatif après une vingtaine d’année d’activité. À la différence du SMR, coefficient unique caractérisant l’ensemble de la période de suivi, le TMR ou le TME permettent une lecture dynamique de la mortalité d’une cohorte. Les excès de mortalité observés doivent être interprétés en relation avec les caractéristiques de l’exposition.

In this article, we introduce a new Stata command to estimate the net survival function and the net cumulative hazard. The command includes graphic facilities. It was designed to have a similar syntax to sts, the Stata command dedicated to estimate survival and related functions. We present two examples to illustrate the use of this new command.

BACKGROUND:While chronic persecutory delusions are typically anchored into patients' everyday life situations, no investigation has ever looked at how situations associated with a feeling of persecution are recorded and later retrieved.METHOD:a diary methodology combined with a recognition task involving ten patients with schizophrenia who presented chronic persecutory delusions and ten control participants. Diaries of everyday persecutory events (Pe) and non-persecutory events (nPe) were kept.RESULTS:in both groups, 1) Pe were associated with higher anxiety scores than nPe, 2) Pe were experienced as less distinctive and more stereotyped than nPe, 3) the frequency of incorrect recognition of altered descriptions of Pe was higher than that of nPe.LIMITATIONS:because high levels of motivation are required of the diarists, our sample size was small.CONCLUSION:Memories of persecutory events were highly emotional and semanticized. they were frequently incorrectly recognized, suggesting the existence of bias resulting from interactions between their processing and persecutory delusions.

Objectives To describe the mortality of sewage workers from Paris (France). Method The cohort of 1594 Paris sewage workers since 1970 was set up in 2010 and followed-up on mortality from 1970 to 2010. Vital status and causes of death were determined by matching with national databases. Standardised Mortality Ratios (SMRs) were computed using local death rates by causes of death and 10-year employment duration classes. Data are currently analysed using relative survival techniques. This study was approved by the national ethic comity. Results Statistically significant mortality excess was observed for all causes (SMR=1.34, 778 cases) and for cancer (SMR=1.49, 337 cases). SMRs were also statistically greater than 1 for malignant (SMR=1.74, 22 cases) and non-malignant (SMR=1.77, 43 cases) liver diseases, lung cancer (SMR=1.59, 97 cases), oesophagus cancer (SMR=2.35, 28 cases), all alcohol-related diseases (SMR=1.78, 128 cases), and suicide (SMR=3.64, 22 cases). Greater than 1 but not statistically significant SMRs were observed for infectious diseases and respiratory infectious diseases. The mortality from several diseases (all causes, all cancer, oesophagus cancer, lung cancer, chronic liver diseases, all alcohol-related diseases, and infectious diseases) increased with employment duration as a sewer worker. Except for lung cancer, the SMR for smoking-related diseases was not statistically greater than 1. Results of survival analysis are in progress. Conclusions The increase mortality observed for lung cancer and infectious diseases with employment duration suggests possible occupational health effect among sewer workers. Conclusions will be completed from the survival analysis.

Few studies have addressed longer‐term survival for breast cancer in European women. We have made predictions of 10‐year survival for European women diagnosed with breast cancer in 2000–2002. Data for 114,312 adult women (15–99 years) diagnosed with a first primary malignant cancer of the breast during 2000–2002 were collected in the EUROCARE‐4 study from 24 population‐based cancer registries in 14 European countries. We estimated relative survival at 1, 5, and 10 years after diagnosis for women who were alive at some point during 2000–2002, using the period approach. We also estimated 10‐year survival conditional on survival to 1 and 5 years after diagnosis. Ten‐year survival exceeded 70% in most regions, but was only 54% in Eastern Europe, with the highest value in Northern Europe (about 75%). Ten‐year survival conditional on survival for 1 year was 2–6% higher than 10‐year survival in all European regions, and geographic differences were smaller. Ten‐year survival for women who survived at least 5 years was 88% overall, with the lowest figure in Eastern Europe (79%) and the highest in the UK (91%). Women aged 50–69 years had higher overall survival than older and younger women (79%). Six cancer registries had adequate information on stage at diagnosis; in these jurisdictions, 10‐year survival was 89% for local, 62% for regional and 10% for metastatic disease. Data on stage are not collected routinely or consistently, yet these data are essential for meaningful comparison of population‐based survival, which provides vital information for improving breast cancer control.

Une revue critique de la litterature a ete menee sur le lien entre travail poste (TP) et survenue de maladies cerebro- et cardiovasculaires (MCCV). Dans plusieurs etudes de bonne qualite, le TP est associe a une augmentation modeste mais significative du risque de maladies cardiaques ischemiques fatales et non fatales. Les conclusions sont moins claires pour le lien avec la mortalite cardiovasculaire ischemique et les pathologies cerebrovasculaires. Sur le plan de la causalite, des biais de selection difficiles a prendre en compte sur le plan methodologique ne peuvent etre ecartes pour expliquer ces associations observees. Lien causal ou marqueur socio-economique ? Cette interrogation non resolue demande de poursuivre les recherches pour demontrer que le TP, ou certaines de ses composantes, se presentent comme un facteur propre de survenue de MCCV.