[Tobacco and work]

INTRODUCTION

Health indicators published over more than 15 years in France show differences in the prevalence of smoking in relation to activity status and socio-professional categories. However, the relationship between smoking and work is not limited to this.

BACKGROUND

Smoking by employees is traditionally regarded as entailing additional costs for businesses, but the actual costs of smoking in the workplace are difficult to assess. Co-exposure to tobacco and the toxic substances encountered in work areas carries an increased risk of developing lung disease, broncho-pulmonary cancer and chronic obstructive pulmonary disease in particular. The workplace can also be an area of exposure to passive smoking that affects employees unequally. In France, the use of tobacco and e-cigarettes in the workplace has been regulated since 2006 and 2016, respectively.

OUTLOOK

Workplace smoking cessation programs and smoking bans seem to encourage cessation of smoking. Smoking cessation advice by occupational physicians could work in the same manner. Subjects exposed to occupational carcinogens and tobacco could benefit from low-dose CT screening after a trial period to validate this approach.

CONCLUSION

Workplaces can be areas for the prevention and cessation of smoking.

[State of immunization against measles among health professionals in at-risk units of the Caen University Hospital]

BACKGROUND

France is facing a new resurgence of measles. Since November 2017, the number of cases has been increasing sharply. Immunization coverage in the general population, all ages combined, is below the threshold required for a rapid decline of the virus propagation. Regarding health professionals, the rate of immunization against this disease is insufficiently documented. In this context, the Occupational Health Service of the University Hospital of Caen has carried out an inventory of health personnel knowledge of immunization against measles in the units the most exposed to risk.

METHODS

Knowledge of immunization against measles was studied in pediatric, imaging, and pediatric and adult emergencies departments of the University Hospital of Caen, and the Hematology Institute of Lower Normandy (IHBN). The analysis included all health professionals present within these units during the study period: March and April 2018. Data collection was carried out by consulting the medical files of the occupational health unit and considering the set of responses to postal inquiries sent to staff.

RESULTS

Measured immunization status data refer to 1017 health professionals. Based on the criteria specific to the recommendations, 234 (50.6%) of the 462 professionals born before 1980 and 437 (78.7%) of the 555 professionals born in or after 1980 could be considered as immune. Of the total sample, 115 (11.3%) had positive measles serology. Among these 1017 professionals, information on the state of immunization against measles was lacking for 174 (17.1%).

CONCLUSION

The state of immunization of the nursing staff remains insufficient to prevent the occurrence of measles cases and the staff is also insufficiently informed. It is essential to have knowledge of the immunization status of this population, to organize the vaccination of non-immunized personnel within the occupational health unit, to prevent the emergence of new cases of measles and to reinforce the information regarding the importance of precautions related to airborne transmission in case of measles.

[Occupational risks during pregnancy: Feedback from occupational medical services]

OBJECTIVES

To describe the follow-up of pregnancies at work and exposures to pregnancy occupational hazards.

METHODS

A cross-sectional study was performed between January and December 2014 in occupational health services of Languedoc-Roussillon region. Eligible workers were interviewed by occupational health physicians (OHPs) after delivery and at the time of returning to work (exposure, anticipation, prevention, communication, sick leave). Occupational skill levels were classified according to the French standard classification of occupations (version 2003) from the French National Institute of Statistics. Socioeconomic deprivation was assessed using the Evaluation of Deprivation and Inequalities in Health Examination (EPICES) individual scale.

RESULTS

A total of 1347 workers were recruited. The mean age was at 30.7±4.5 years. Among pregnant workers, there were 54.2% of employees, 30.7% of intermediate occupations, 10.4% of managers and, 4.7% of manual workers. Twenty-two percent of workers were classed as deprived. Also, 43.2% of workers were exposed to three or more occupational hazards during pregnancy. Only 17.7% of workers had medical visits with OHP during pregnancy and 14.7% benefited from workstation adjustments. In contrast, the level of sick leaves was high (74.2%).

CONCLUSION

Our results argue for the need to follow pregnancies at work. However, the low level of prevention activities and the high level of sick leaves raise the question of the management of pregnant women at work.

[Evolution of the missions of occupational health services and follow-up of the employees]

Evolution of the missions of occupational health services and follow-up of the employees. In France, the occupationnal health system is original because it is based on dual approach, individual or medical approach and collective, directed on the working conditions. The targeted follow-up of health is split between from now on the healthcare professionals of a multidisciplinary team and has to allow a better prevention of occupationnal risk and the deployment of the numerous missions of occupational health services.

[Occupational disorders epidemiology]

Occupational disorders epidemiology. The aim of this narrative review was to give some basics of occupational disorders epidemiology, compensated or not, and focusing on complementarity between data sources available in France.

[Preliminary assessment of the use of portable hydrogen peroxide detectors in a centralized cytotoxic preparation unit]

INTRODUCTION

For 1 year, our unit has been equipped with portable H₂O₂ Dräger detectors contributing to protect the staff from a possible exposure to this odourless and toxic gas. This work shows the current available data about H₂O₂ toxicity, describes the organization of the implementation and the analysis of the values measured over 12 months.

MATERIAL AND METHODS

Data about H₂O₂ toxicity have been obtained through a literature review. The measured values are presented in instantaneous value and occupational exposure limit (OEL) over 8 h.

RESULTS

Over six technicians, the average percentage, of detected values superior to zero reached 1.06% in August. The detected maximum instantaneous value reached 2.2 ppm in May. These isolated exposures have little incidence when related to the 8-h exposure with an occupational exposure limit (OEL) of 0.072 ppm over 12 months.

DISCUSSION AND CONCLUSION

The implementation of this tool has allowed to highlight a technical problem of the sterilization airlock that could be resolved. This measuring device of H₂O₂ concentration in the air in real time allows to secure everyday working conditions and to alert the staff of a possible technical failure. However, literature data regarding chronic toxicity are limited and restrict the analysis of the measured values.