Risques professionnels liés à la pratique de l’anesthésie

Evaluation of anesthesiologists' knowledge about occupational health: Pilot study

BACKGROUND

An anesthesiologists' work presents with numerous occupational risks owing to the large amount of time spent inside the operating room where constant noise, anesthetic vapors, ionizing radiation, infectious agents, and psychological stress are present. Herein, we evaluated anesthesiologists' knowledge about occupational health.

METHODS

A cross-sectional study was conducted to assess 158 anesthesiologists from a tertiary hospital on their knowledge about occupational health using a structured questionnaire.

RESULTS

The survey revealed a lack of knowledge on the forms of prevention of occupational accidents (74.6% did not know how to act in case of a fire during surgery, 56% failed to identify the post-anesthesia care unit as the place with the highest contamination by inhalation anesthetics, and 42.7% failed to identify all personal protective equipment) and a surprisingly high rate of lack of observance of preventive measures (30.3% washed their hands before touching every patient, 52.5% did not use gloves during intravenous access, and 88.6% used protective equipment against ionizing radiation).

CONCLUSIONS

Despite improvements in safety standards in healthcare facilities, our research showed lack of knowledge about major topics on occupational health by physicians. Improving safety awareness is an important goal of training programs and continued medical education.

[Burnout in Tunisian medical residents: About 149 cases]

BACKGROUND

Burnout is a professional psychological chronic stress-induced syndrome defined by three dimensions: emotional exhaustion, depersonalization, and low personal accomplishment. This syndrome concerns all professions but especially healthcare staff. Numerous studies have attempted to document the impact of work activities on the doctor's mental health. According to the literature, junior doctors are more vulnerable to develop this syndrome.

AIMS

Are to determine the prevalence of severe burnout among residents of different specialties: anesthesiology, general surgery, emergency medicine, psychiatry, basic sciences. The secondary end points are to analyze risk factors, causes and consequences associated with burnout.

METHODS

A cross-sectional study conducted among medical residents working in hospitals located in the governorates of Tunis. Three instruments were used: an anonymous self-administered questionnaire, Maslach Burnout Inventory (MBI) to assess burnout, and Abstract Beck Depression Inventory to evaluate the intensity of depression. Severe burnout was defined as a severely high level of both emotional exhaustion and depersonalization associated with a severely low level of personal accomplishment.

RESULTS

A total of 149 participants (response rate=76.8%) participated in the survey. Among participants, 17.14% (n=26) had a severe burnout. The emergency medicine residents had the highest rate of emotional exhaustion and depersonalization and severe depression. Overall, resident respondents, 31% (n=46), had moderate to severe depression. Among stress factors, those significantly correlated to burnout were: lack of hobbies (P<0.001), bad job conditions (P=0.031), poor conditions of the workplace (P=0.046), relationship problems in workplace (P=0.01), work-family conflicts (P<0.001). The consequences of occupational stress associated with burnout were: Antecedents of specialty change (P=0.017) and desire for a specialty change (P<0.001). A significant correlation between depression and severe burnout was not found.

CONCLUSION

Medical residents in all specialties are at risk of burnout. Nevertheless, this study revealed that some specialties are more exhausting, which is consistent with the results reported in the literature. Moreover, it is shown that several stress factors as well as many consequences are related to severe burnout, which is in agreement with numerous studies. However, results between different studies are disparate.

Epidemiological and occupational profile of anesthesiologists practicing in Belo Horizonte, Minas Gerais--Brazil, in 2010

BACKGROUND AND OBJECTIVES

Exposed to many occupational risk factors, the anesthesiologist should know how to experience situations related to work and everyday life, so that illness is not part of his reality. Knowledge of work through the worker himself is one way to look deeper into the universe surrounding health professionals in order to seek effective solutions that increase satisfaction and minimize damage. The objective of this paper was to outline an epidemiological and occupational profile of the anesthesiologist in Belo Horizonte, Minas Gerais.

METHODS

Quantitative, cross-sectional randomized study conducted among members of the Society of Anesthesiology of Minas Gerais. Data collected through a questionnaire, including the CAGE, for evaluation of alcoholism and Self-Report Questionnaire (SRQ-20) to evaluate the prevalence of common mental disorders (CMD).

RESULTS

There was predominance of male (62.4%) working on-call schedule (91.1%), both day and at night. The average number of night shifts was 5.4% in the last 30 days. Most of them (88.3%) working in emergency departments. Most professionals reported being very tired and overloaded or very overloaded, but satisfied with the work. There was statistical association between CAGE positive and work overload and between CAGE and SRQ-20.

CONCLUSIONS

The population studied indicates that the anesthesiologist is a professional rather overloaded, which corroborates trends seen in the medical field. Major attention should be given to these professionals who live surrounded by harmful occupational hazards.

Job Satisfaction, Life Satisfaction and Burnout in French Anaesthetists

The present study aimed to examine the prevalence of burnout, levels of life satisfaction and job satisfaction in anaesthetists in France. A cross-sectional study was conducted among 193 anaesthetists from eight French public hospitals. The results indicated low levels of emotional exhaustion and depersonalization scores, but high levels of reduced accomplishment. The results also revealed differences between subgroups: physician anaesthetists reported higher levels of depersonalization and reduced accomplishment than nurse anaesthetists, female and junior anaesthetists reported higher levels of emotional exhaustion and job dissatisfaction than male and senior anaesthetists. The results and the implications to reduce burnout symptoms in anesthesia teams are discussed.

Monitoring antioxidant defenses and free radical production in space-flight, aviation and railway engine operators, for the prevention and treatment of oxidative stress, immunological impairment, and pre-mature cell aging

Degenerative diseases, immune impairment, and premature ageing commonly affect professional categories exposed to severe environmental and psychological stress. Among these, cosmonauts routinely experience extreme conditions due to microgravity, space radiation, altered oxygen supply, physical and mental fatigue during training, spaceflight, and post-flight. Long route aviation pilots display elevated oncogenic risk, connected with cosmic radiation overexposure, and high mortality rates for cardiovascular causes. Engine drivers, like pilots, are affected by health consequences of psycho-emotional stress, and burnout syndrome. The free radical (FR)/antioxidant (AO) imbalance is a common feature in all these pathological conditions. To assess the effective relevance of oxidative stress, we analyzed blood and urine reliable markers of FR production and AO defenses in 12 Russian cosmonauts, 55 airline pilots, 63 train engine drivers, and 50 age-matched controls by measuring the following: (a) lipophilic/hydrophilic low-molecular weight AO and AO enzyme activities, (b) nitric oxide, superoxide anion, hydroperoxide production, and (c) urinary catecholamine/serotonine metabolites and lipoperoxidation markers. Cosmonauts showed elevated granulocyte superoxide and nitric oxide production, increased erythrocyte superoxide dismutase activity and glutathione oxidation, and drastically decreased plasma/leucocyte lipophilic AO levels (P < 0.001-0.01). Aviation pilots, like train drivers, displayed a mild but constant oxidative stress, more pronounced in intercontinental routes pilots, and consistent with lymphocyte chromosomal alterations, DNA oxidation, and cardiovascular malfunction. Results obtained on these selected professionals operating under wearing conditions offer a solid molecular basis for advising the regular monitoring of clinical biochemistry laboratory markers of AO/FR status, to tailor individually specific AO supplementation and diet regimen, and monitor treatment outcomes.