Background. - Despite a large media coverage of the phenomenon, the number of work-related suicides is currently unknown in France. There are nevertheless some data available to document this important issue. The aim of this study was to explore the feasibility of an epidemiological surveillance system for work-related suicides designed to quantify and describe work-related suicides mainly according to economic sectors and occupational categories.Methods. - Existing data sources in France were identified and evaluated for their relevance and their potential use in a multi-sources surveillance system. A regional pilot study was performed using the main relevant sources identified to investigate different aspects of the system design.Results. - Four major data sources were identified to be used to describe work-related suicides: death certificates, social insurance funds, data collected by the officers of the labor inspectorate and data collected from autopsy reports in forensic departments. The regional pilot study gave an estimate of 28 cases of work-related suicide in two years.Conclusion. - The findings point out the difficulties involved and the criteria for successful implement of such a system. The study provides some solutions for carrying out this system, the achievement of which will depend upon particular resources and partners' agreements. Recommendations for the next steps have been made based on this work, including possible collaboration with forensic departments, which collect essential data for surveillance. (C) 2016 Published by Elsevier Masson SAS.

L'Institut de veille sanitaire, en partenariat avec la société de pneumologie de langue française et la société française de médecine du travail, a conduit le projet ONAP II entre 2008 et 2014. L'objectif était d'estimer l'incidence de l'asthme professionnel (AP) dans 6 départements, globalement et par secteur d'activité et profession. La présentation porte sur la période 2008–2011. Le recueil de données a été réalisé grâce à un réseau de pneumologues et allergologues hospitaliers et libéraux et de spécialistes de consultations de pathologies professionnelles. En Alsace, des médecins du travail y ont également participé. Les fiches de signalement remplies par les déclarants ont été validées par des experts qui se prononçaient sur le diagnostic de l'AP et sur le lien étiologique avec une ou plusieurs nuisances. Pour la période 2008–2011, 330 fiches ont été retenues. L'incidence annuelle moyenne de l'AP estimée dans les 6 départements pilotes était de 36 cas par million. Concernant les catégories professionnelles, le taux d'incidence standardisé sur le sexe et l'âge était plus élevé, que le taux moyen, chez les ouvriers (116/million), les agriculteurs exploitants (97/million) et les travailleurs indépendants (45/million). Pour les secteurs d'activités, les taux les plus élevés ont été observés dans l'industrie alimentaire (279/million) et dans la catégorie « agriculture, sylviculture, pêche » (160/million). Pour les agents étiologiques, la farine occupait la première place (20 %). Les ammoniums quaternaires venaient en seconde place (15 %) reflétant la part de plus en plus importante des produits de nettoyage dans la survenue de l'AP.

BACKGROUND The surveillance programme for uncompensated work-related diseases (UWRDs) in France relies on a network of occupational physicians (OPs) who volunteer to report all UWRDs diagnosed during a biannual 2-week observation period. AIMS To describe this programme and the usefulness of its results. METHODS During the observation period, OPs record job title and employment sector for each worker. For each potential UWRD, they complete a one-page report form. RESULTS Between 2007 and 2012, the number of reporting OPs ranged from 705 to 965 and they saw between 78884 and 114154 employees annually. The UWRD incidence rate reports varied from 5 to 5.3% for men and from 6.5 to 7.7% for women, with musculoskeletal disorders (MSDs) being most frequent, followed by mental ill-health. Incidence rates, except for hearing loss, were higher for women than men in all categories and, in 2012, were twice as high for women (3.1%) as for men (1.4%) for mental ill-health. Incidence rates in every category increased with age up to 54 years. The highest rates for MSDs were observed among blue-collar workers (6.9% in women and 4% in men in 2012) and the lowest rates in professionals/managers (1.1 and 0.4%, respectively). Conversely, the latter had the highest incidence of mental health disorders (5.9 and 3.3%). CONCLUSIONS This 'Fortnight' protocol provides useful data on the frequency of diseases linked to employment and allows us to estimate the incidence of UWRDs, whether recognized as compensable or not, as well as their trends over time.

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. Des indicateurs en santé travail : les troubles musculo-squelettiques du membre supérieur en France Julien Brière, Natacha Fouquet, Catherine Ha, Ellen Imbernon, Julie Plaine, Stéphanie Rivière, Yves Roquelaure, Madeleine Valenty

Objectives To estimate the proportion of pleural mesothelioma cases that can be attributed to asbestos exposure in France including non-occupational exposure. Methods A population-based case-control study including 437 incident cases and 874 controls was conducted from 1998 to 2002. Occupational and non-occupational asbestos exposure was assessed retrospectively by two expert hygienists. ORs of pleural mesothelioma for asbestos-exposed subjects compared to non-exposed subjects, and population-attributable risk (ARp) of asbestos exposure were estimated using a conditional logistic regression. Results A clear dose-response relationship was observed between occupational asbestos exposure and pleural mesothelioma (OR=4.0 (99% CI 1.9 to 8.3) for men exposed at less than 0.1 f/mL-year vs 67.0 (99% CI 25.6 to 175.1) for men exposed at more than 10 f/mL-year). The occupational asbestos ARp was 83.1% (99% CI 74.5% to 91.7%) for men and 41.7% (99% CI 25.3% to 58.0%) for women. A higher risk of pleural mesothelioma was observed in subjects non-occupationally exposed to asbestos compared to those never exposed. The non-occupational asbestos ARp for these subjects was 20.0% (99% CI −33.5% to 73.5%) in men and 38.7% (99% CI 8.4% to 69.0%) in women. When considering all kinds of asbestos exposure, ARp was 87.3% (99% CI 78.9% to 95.7%) for men and 64.8% (99% CI 45.4% to 84.3%) for women. Conclusions Our study suggests that the overall ARp in women is largely driven by non-occupational asbestos exposure arguing for the strong impact of such exposure in pleural mesothelioma occurrence. Considering the difficulty in assessing domestic or environmental asbestos exposure, this could explain the observed difference in ARp between men and women.

Mesothelioma is a rare disease less than 0.3% of cancers in France, very aggressive and resistant to the majority of conventional therapies. Asbestos exposure is nearly the only recognized cause of mesothelioma in men observed in 80% of case. In 1990, the projections based on mortality predicted a raise of incidence in mesothelioma for the next three decades. Nowadays, the diagnosis of this cancer is based on pathology, but the histological presentation frequently heterogeneous, is responsible for numerous pitfalls and major problems of early detection toward effective therapy. Facing such a diagnostic, epidemiological and medico-legal context, a national and international multidisciplinary network has been progressively set up in order to answer to epidemiological survey, translational or academic research questions. Moreover, in response to the action of the French Cancer Program (action 23.1) a network of pathologists was organized for expert pathological second opinion using a standardized procedure of certification for mesothelioma diagnosis. We describe the network organization and show the results during this last 15years period of time from 1998-2013. These results show the major impact on patient's management, and confirm the interest of this second opinion to provide accuracy of epidemiological data, quality of medico-legal acknowledgement and accuracy of clinical diagnostic for the benefit of patients. We also show the impact of these collaborative efforts for creating a high quality clinicobiological, epidemiological and therapeutic data collection for improvement of the knowledge of this dramatic disease.

Despite the lack of data on the human health potential risks related to the engineered nanomaterials (ENM) exposure, ENM handling spreads in industry. The French government officially charged the InVS to develop an epidemiological surveillance of workers occupationally exposed to ENM. An initial surveillance plan was proposed on the basis of literature review and discussions with national and international ENM and occupational safety and health (OSH) experts. In site investigations and technical visits were then carried out to build an adequate surveillance system and to assess its feasibility. The current plan consists of a multi-step methodology where exposure registry construction is paramount. Workers potentially exposed to carbon nanotubes (CNT) or nanometric titanium dioxide (TiO2) will be identified using a 3-level approach: 1-identification and selection of companies concerned with ENM exposure (based on compulsory declaration and questionnaires), 2-in site exposure assessment and identification of the jobs/tasks with ENM exposure (based on job-expose matrix, further supplemented with measurements), and 3-identification of workers concerned. Data of interest will be collected by questionnaire. Companies and workers inclusion questionnaires are designed and currently under validation. This registration is at the moment planned for three years but could be extended and include other ENM. A prospective cohort study will be established from this registry, to pursue surveillance objectives and serve as an infrastructure for performing epidemiological and panel studies with specific research objectives.

Web search engines (WSEs) are basic tools for finding and accessing data in the Internet. However, they also put the privacy of their users at risk. This happens because users frequently reveal private information in their queries. WSEs gather this personal data and build user profiles which are used to provide personalized search (PS). PS improves the users’ search results and, hence, it is a key element for the successfulness of WSEs: the entity that offers the best searching experience should attract more users. Nevertheless, profiles can also be used in an improper way by WSEs or they can be stolen by attackers. This situation requires privacy-preserving schemes able to handle from simple queries (one single term) to complex queries (several words with or without relation). Generally, these systems generate and submit inaccurate queries in order to provide privacy, but these queries must be carefully built in order to keep the usefulness of the user profiles. Current literature does not address the generation of privacy-preserving and useful complex queries. Therefore, this paper presents a new scheme that generates distorted user queries from a semantic point of view in order to preserve the usefulness of user profiles. Besides, linguistic analysis techniques are used to properly interpret complex queries performed by users and generate new semantically-related ones accordingly. The performance of the new scheme is evaluated in terms of semantic preservation of new queries, privacy level and runtime. A set of query logs taken from real users and compiled by AOL is used as test data.

BACKGROUNDKnee bursitis (KB) is a common disorder in specific occupations requiring frequent and/or sustained kneeling postures.AIMSTo assess the prevalence of KB in the general working population.METHODSBetween 2002 and 2005, a total of 3710 workers of a French region were randomly included in the study. A standardized physical examination of the knee was performed when knee pain was reported by the worker during the preceding 12 months. The criteria for diagnosis of KB were (i) the presence of pain and/or tenderness in the anterior face of the knee at the date of the examination (or for at least 4 days in the preceding week) and (ii) the presence of swelling and/or pressure-induced pain of the pre- or infra-patellar bursa. Occupational risk factors were assessed by a self-administered questionnaire.RESULTSThe prevalence of uni- or bilateral cases of knee bursitis was low: 0.6% [0.2-0.9] in men and 0.2% [0.0-0.6] in women. The highest prevalence was observed in the construction sector (2.3% [0.8-5.4]) and in the food and meat processing industries (1.4% [0.4-3.5)]. More blue-collar workers were affected than other occupation categories (0.8% [0.3-1.2] versus 0.1% [0.0-0.4]).CONCLUSIONSThe study showed a concentration of cases among male workers exposed to heavy workloads and frequent kneeling.

Les équipes médicales et techniques du service de protection radiologique des armées (SPRA) ont mené une étude visant à évaluer l’exposition radiologique de l’équipe de cardiologie interventionnelle de l’hôpital d’instruction des armées (HIA) de Percy. Les auteurs ont également réalisé un zonage radiologique.Les doses efficaces et équivalentes aux extrémités et au cristallin ont été évaluées à l’aide de dosimètres passifs OSL InLight® et de dosimètres nanoDot® lors de plusieurs interventions. Des mesures d’ambiance ont également été réalisées avec des radiamètres AT1123® et ont permis la réalisation d’un zonage radiologique.Les auteurs recommandent la mise en place systématique de moyens de protection collectifs pour les pieds et les cristallins des opérateurs en cardiologie interventionnelle. Ils suggèrent la catégorisation des cardiologues et des infirmiers en catégories A et B respectivement. Le zonage radiologique réalisé impose le port obligatoire d’une dosimétrie passive et opérationnelle pour l’accès à la salle lors des procédures.Medical and technical teams from the French defence radiation protection service (SPRA) conducted a study to quantify the ionizing radiation exposure to the interventional cardiology staff at the Percy military hospital. A delineation of areas is also assessed by the authors.Effective and equivalent doses have been evaluated with whole-body InLight® OSL and nanoDot® dosimeters for extremities and lens during several procedures. Ambient measurements have also been performed with AT1123® survey meters and have contributed to delineate areas.The authors propose the systematic implementation of collective protection means for the operators’ feet and lens in interventional cardiology. They suggest the categorization of cardiologists and nurses in A and B categories respectively. Area delineation requires the compulsory wearing of passive and operational dosimeters to access the operating room during procedures.

The enormous investments in nanotechnology have led to an exponential increase of new manufactured nano-enabled materials whose impact in the aquatic systems is still largely unknown. Ecotoxicity and nanosafety studies mostly resulted in contradictory results and generally failed to clearly identify biological patterns that could be related specifically to nanotoxicity. Generation of reactive oxygen species (ROS) is one of the most discussed nanotoxicity mechanism in literature. ROS can induce oxidative stress (OS), resulting in cyto- and genotoxicity. The ROS overproduction can trigger the induction of anti-oxidant enzymes such as catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidases (GPx), which are used as biomarkers of response. A critical overview of the biochemical responses induced by the presence of NPs on freshwater organisms is performed with a strong interest on indicators of ROS and general stress. A special focus will be given to the NPs transformations, including aggregation, and dissolution, in the exposure media and the produced biochemical endpoints.

Background In recent years, temporary work (TW) has increased in European countries due to the greater uncertainty in the economy.Aims To compare the prevalence of non-specific musculoskeletal symptoms of the upper extremities (UEMSDs) and their main risk factors in blue-collar workers employed through temporary agencies (TW) and in those in permanent employment (PE).Methods UEMSDs occurring during the preceding 7 days were assessed using a Nordic questionnaire completed by 1493 blue-collar workers randomly included in a surveillance programme for UEMSDs (171 in TW and 1322 in PE) in a large French region. Personal factors and work-related risk factors for UEMSDs were assessed by self-administered questionnaires.Results The prevalence of UEMSDs during the preceding 7 days did not significantly differ between workers in TW or PE. However, after adjustment for age and gender, TW had a higher risk of symptoms of the wrist/hand region (OR = 1.6, 95% CI 1.04-2.6). TW was characterized by higher exposure to paced work (OR = 2.0, 95% CI 1.4-3.0), repetitive work (OR = 2.3, 95% CI 1.6-3.4), awkward postures of the wrist (OR = 1.7, 95% CI 1.2-2.4) and intensive use of vibrating hand tools (OR = 1.6,95% CI 1.1-2.3). Workers in TW suffered from a lack of autonomy (OR = 2.5, 95% CI 1.7-3.6) and skill discretion at work (OR = 2.0, 95% CI 1.3-3.1) more frequently, but there was no difference in relation to psychological demands of the task or social support.Conclusions Temporary workers were more frequently exposed to working time constraints, repetitive work and biomechanical constraints of the wrist/hand region when compared to permanent workers and may represent a subpopulation at particularly high risk of UEMSDs.

Les troubles musculo-squelettiques du membre supérieur (TMS) regroupent des affections douloureuses en lien avec l’hypersollicitation des tissus mous périarticulaires. Les principaux sont les tendinopathies de la coiffe des rotateurs de l’épaule, les épicondylalgies, le syndrome du canal carpien et les syndromes douloureux non spécifiques.Les TMS affectent des millions de travailleurs européens et représentent le premier problème de santé au travail dans l’Union Européenne. Ils témoignent de l’intensification des conditions de travail qui affecte un nombre croissant de travailleurs de l’industrie et des services. Leur répercussion en termes de souffrance et d’interruption des parcours professionnels, mais aussi de coûts économiques, en font une priorité de santé au travail.Il s’agit de maladies multifactorielles faisant intervenir des facteurs de susceptibilité individuelle et des facteurs professionnels non seulement biomécaniques, mais aussi psychosociaux et liés à l’organisation du travail.La prévention des TMS nécessite une approche globale et intégrée, privilégiant la réduction des risques à la source par une action en milieu de travail, le dépistage et la prise en charge précoce des travailleurs et, si nécessaire, une intervention de maintien en emploi.Upper-limb musculoskeletal disorders (MSDs) are painful conditions related to the overuse of periarticular soft tissues. The main MSDs are rotator cuff tendinopathy, epicondylalgia, carpal tunnel syndrome and non-specific pain.MSDs affect millions of European workers and represent the first problem of health at work in the European Union. They testify to the intensification of working conditions affecting a growing number of workers in the industry and services sectors. Their impact in terms of pain and disruption of career, but also economic costs, make it a priority of health at work.MSDs are multifactorial disorders associated with individual and occupational (biomechanical, psychosocial and factors related to work organization) risk factors.The prevention of MSDs requires a global and integrated approach focusing on the reduction of the exposure to working constraints, early diagnosis and management and, if necessary, an intervention of stay at work.

The effects of reduction mammaplasty (RM) have been proved in several randomised trials. However, publications regarding cost utility are infrequent and lacking with regard to medium-term follow-up. Therefore, we decided to assess the cost utility of RM at 2–5 years’ follow-up, when later costs and possible re-operations have been incurred.A total of 73 patients had bilateral RM between January 2005 and March 2007 in the Hospital District of Helsinki and Uusimaa, Finland. Health-related quality of life was measured with the 15D. Preoperative data were collected with an interview at an appointment and follow-up data by means of a postal survey. Direct hospital costs were obtained from the Ecomed® clinical patient administration database (Datawell Ltd., Espoo, Finland).A total of 62 (85%) patients agreed to participate in the study and returned the follow-up questionnaire. The mean follow-up time was 4.0 years (SD 0.53, range 2.3–4.6 years). The mean improvement in the 15D score change was 0.083 (SD 0.081). The mean number of quality-adjusted life years (QALYs) gained was 3.052 (SD 3.167, range 2.561–17.553). The mean hospital costs of the intervention were €3601 (SD 1321), and the mean cost per QALY gained was €1180. Roughly 76% of the costs were due to the hospital stay during the operation. Eight percent of the costs were incurred more than 6 months after the hospital stay.The cost per QALY gained by RM is low, even when considering later costs caused by possible re-operations, and compares favourably with a number of other surgical procedures.