Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

Development of an intervention program to reduce whole-body vibration exposure based on occupational and individual determinants among dumper operators

Objectives. Studies related to a systematic approach for intervention design to reduce whole-body vibration (WBV) exposure are scarce. This study presents a systematic approach to identifying, selecting and prioritizing safety interventions to fulfill that research gap. Methods. A total of 130 vibration readings for dumper operators were taken from two surface iron ore mines to identify significant determinants of WBV exposure. Initially, age, weight, seat design, awkward posture, machine's age, load tonnage, dumper speed and haul road condition were hypothesized as determinants. Data were collected through standardized questionnaires and field-based observation. A multivariate statistical approach was applied for the practical use of the intervention program. Results. As some of the hypothesized factors were correlated, exploratory factor analysis (EFA) followed by multiple linear regression (MLR) was used to investigate their association with WBV exposure. As per EFA results, hypothesized factors were clubbed under individual, ergonomics and occupational factors. Occupational and ergonomics factors were found to be significantly associated with WBV exposure through MLR and used to form safety interventions to reduce WBV exposure. Conclusions. Our methodological approach is original in the occupational health research area and can be helpful to tailor the safety interventions for the unit level with minimum effort.

Untreated Allergy Among Middle School Students: Associations with Socioeconomic Adversities and Academic, Behavior, and Health Difficulties

BACKGROUND

Many adolescents with allergy do not receive physician treatment (allergyuntreated ). We explored its association with socioeconomic adversities and academic-behavior-health difficulties, which remain unaddressed.

METHODS

This cross-sectional school-based-population study compared the above factors of middle-school adolescents with allergyuntreated and those with treated allergy (allergytreated ) (mean age = 13.5 ± 1.2) from north-eastern France. Participants completed a questionnaire collecting socioeconomic adversities (nonintact family, low parents' education, insufficient family income, poor social support, suffered verbal/physical violence, and sexual abuse), low academic performance, excessive screen time, substance use, sleep difficulty, poor physical health, depressive symptoms, suicide attempt, poor quality of life, and allergytreated /allergyuntreated .

RESULTS

Logistic regression models showed that allergyuntreated was associated with all the factors considered (sex-age-class-level-adjusted odds ratio (saclOR) reaching 3.94, p < .001) and the risk score (number of main criteria: suffered sexual abuse, excessive screen time, poor quality of life, cannabis use, low parents' education, and poor social support): saclOR 4.75, 9.23, 15.64, and 31.73 (p < .001) for risk scores 1, 2, 3, and ≥4, versus risk score = 0 (pseudo-R2  = 11.1%).

CONCLUSIONS

Socioeconomic adversities and academic-behavior-health difficulties may be used to detect adolescents with allergyuntreated for care.

Substance Use Among Middle School Adolescents: Association with Family Members' and Peers' Substance Use and the Mediating Role of School and Mental Difficulties

OBJECTIVE

We assessed the associations of substance (alcohol, tobacco, cannabis, and other illicit drugs) use of adolescents with that of their family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers, and the mediating role of school and mental difficulties (SMDs) which remained insufficiently addressed.

METHODS

This cross-sectional population-based study included 1,559 middle-school adolescents in France (mean age = 13.5 ± 1.3, 778 boys, 781 girls). They completed a questionnaire including socioeconomic features (nationality, family structure and parents' education, occupation, and income), substance use, cumulative number of substance use of family members (father, mother, step-parent, brothers/sisters, and grandparents) and peers (noted familySUcn and peerSUcn), SMDs (grade repetition, suffered physical/verbal violence, sexual abuse, lack of family/peer support, depressive symptoms, suicide attempt, and age at onset). Data were analyzed using logistic regression models and Kaplan-Meier estimates.

RESULTS

Most adolescents had familySUcn 1-2, 3-5, and ≥ 6 (39.1%, 23.0%, and 4.5%, respectively) and peerSUcn 1-2 and ≥ 3 (36.1% and 13.0%, respectively). Strong dose-effect associations were found between all substance use and familySUcn and peerSUcn (odds ratio adjusted for sex, age, and socioeconomic features reaching 13.44 and 9.90, respectively, most with p < .001). SMDs explained more the associations of all substance use with familySUcn than with peerSUcn (contributions reaching 69% and 34%, respectively). The proportion of subjects without each substance use decreased with age more quickly among the adolescents with higher familySUcn or peerSUcn.

CONCLUSIONS

Early prevention reducing familySUcn, peerSUcn and SMDs among adolescents and their families may reduce efficiently initiation and regular use of substances during adolescents' life course.

Associations of Postural Activities and Knowledge for Voice with Breathing Issues and Voice-Physical-Disorders Among Lyric Singers

OBJECTIVES/HYPOTHESIS

The purpose of this research was to study the associations of postural activities and knowledge of the voice of opera singers, recognized in the literature for the specificity of their posture. Additionally, the link between vocal pathologies and body pains on one hand, and posture control on the other hand was investigated.

METHODS

A questionnaire including 90 questions was distributed to singers in France and overseas during 6 months. Ninety-eight opera singers participated in the survey. Data were analyzed using Excel and Stata software.

RESULTS

The results showed that the singers who paid more attention to posture, postural work while singing, had knowledge of anatomy and postural role in singing voice, healthy lifestyle, and good body habits, had less vocal discomfort and pathologies, a better vocal preservation, and used more costo-abdominal breathing. On the other hand, knowledge of postural role and postural work was linked with pain and vocal fatigue. Furthermore, a preventive need was revealed concerning the providing of knowledge and skills to singers, but also to singing teachers, speech therapists, and stage workers.

CONCLUSION

Our study shows that benefits were found in the voice quality of opera singers with anatomical and postural knowledge and who work on posture as part of their vocal work compared to others. Postural work and knowledge increase attention to body pain and vocal fatigue. These results can inform health care providers, opera singers, and their teachers and performers of the benefits of posture on operatic voice quality. Accordingly, this study sparks new ideas for postural work and therapy in lyric voice.

Reducing musculoskeletal disorders in iron ore mine operators: A fuzzy-based intervention approach

BACKGROUND

This study focuses on evaluating the exposure to whole-body vibration (WBV) and association of musculoskeletal disorders (MSDs) with various risk factors among dumper operators in the mining industry. Despite the issue's significance, prior research has been limited.

OBJECTIVE

The study introduces a novel fuzzy-based approach for identifying, selecting, and prioritizing safety measures to mitigate MSD risks.

METHODS

Data collection comprised face-to-face interviews, anthropometric measurements, Rapid Upper Limb Assessment (RULA) scoring for posture assessment, and the Nordic Musculoskeletal questionnaire for assessment of MSD prevalence. Multiple linear and logistic regression models were used to analyse the contributing risk factors to MSDs and WBV exposure. These risk factors formed the basis for a practical approach to select appropriate safety measures based on fuzzy based aggregation method of expert's judgment aimed at mitigating the risk of MSDs.

RESULTS

The results revealed that the risk factors such as poor work posture, WBV exposure and poor seat design were significantly associated with neck (adjusted odds ratio aOR = 4.81), upper limb and shoulder (aOR = 3.28), upper back (aOR = 5.09), and lower back pain (aOR = 3.67) at p < 0.05. Using these factors to formulate safety measures to reduce MSD risk, the minimization of sharp turns and abrupt changes in elevation in designing the haul roads, scheduled maintenance practices, and ergonomic seat design were found as important safety measures in this study.

CONCLUSION

Our unique methodological approach in occupational health research could be highly beneficial for tailoring safety measures at the unit level with minimal effort.

A practical framework to develop and prioritize safety interventions to improve underground coal miners' safety performance

BACKGROUND

Improvement of workers' safety performance is an integral and essential part of safety management. Relevant safety interventions to improve workers' safety performance are generally difficult to establish when there is a wide range of occupational hazards and at-risk individuals' features.

OBJECTIVE

This study aimed at formulating a practical approach to develop and prioritize potential safety interventions based on occupational and individual risk factors perceived by workers to promote workers' safety performance.

METHODS

A simple framework developed to identify and prioritize the suitable safety interventions. This framework made use of data collected using standardized and validated questionnaire and domain experts' opinions. Pearson correlation coefficients, exploratory factor analysis, and multiple linear regression were used to identify significant risk factors associated with workers' safety performance. Data were collected by interviewing 202 coal mine workers with occupational injuries, and their immediate supervisors from three mines.

RESULTS

Safety performance was associated with the occupational factor-domain (poor working condition, poor safety environment, poor job satisfaction, and high job stress) only (regression coefficient = 2.14, p < 0.01). The following interventions were identified and prioritized to promote workers' safety performance: provide fair compensation to workers, job-specific and safety training, promotion policy, achievable targets, relevant perks/benefits, safety training awareness, workplace lighting, ventilation network, sensitize the management, associate safety performance to promotion, and develop team spirit.

CONCLUSION

Our approach helps to identify and prioritize the most relevant interventions to promote safety at work when there are multiple risk factors.

Associations between excessive screen time and school and out-of-school injuries among adolescents: A population-based study

Most adolescents spend excessive screen time (with television viewing, computer/console gaming, discussion forums/chatting online, internet surfing, doing homework, and electronic mails) which may impact the occurring of various types of school and out-of-school injuries. We assessed their associations and potential confounding factors among 1559 middle-school students from north-eastern France (mean age=13.5 ± 1.3). Participants completed a questionnaire including socioeconomic features, daily screen time for various screen-based activities (coded 1=<2, 2 = 2-4, 3=≥5 h; daily-total-screen time level (TDST) was defined as their sum, categorized into <7/7-11/≥12), various injury types during the school-year, behavior and health difficulties (BHDs; alcohol/tobacco/cannabis/other illicit drugs use, suffered physical/verbal violence, sexual abuse, poor family-peer support, sleep difficulty, depressive symptoms, suicide attempt, and time at onset). Most subjects had TDST≥7 (82.3 %). There were dose-effect associations of TDST with school-physical/sports training, school-free-time, out-of-school-sports, and single/repeated injuries (sex-age-adjusted odds ratio reaching 4.45). BHDs explained up to 39 % of these associations. The frequency of subjects without various BHDs decreased with age since age 10 more quickly among the participants with both TDST≥7 and injury than among the others. Our findings may inform health care providers, parents, schools, and public policy that reducing elevated screen time is efficient to prevent injuries and BHDs among adolescents.

Associations between School-Behavior-Health Difficulties and Subsequent Injuries among Younger Adolescents: A Population-based Study

Objective: School-behavior-health difficulties (SBHDs) may alter physical/mental capabilities and consequently increase injury risk during daily activities. This study assessed the associations of potential SBHDs and their cumulative number (SBHDcn) with various injury types among younger adolescents. Methods: The study population included 1,559 middle-school adolescents in France (10-18 years, 98% under 16,778 boys and 781 girls). They completed a questionnaire at school-year end collecting socioeconomic features (nationality, family structure, parents' education/occupation/income), school/out-of-school injuries during the school-year (dependent variables), and SBHDs starting before the school-year (low academic performance, alcohol/tobacco/cannabis/other-illicit-drugs use, physical/verbal violence, sexual abuse, perpetrated violence, poor social support, poor general health status, sleep difficulty, depressive symptoms, and suicide attempt). Data were analyzed using logistic regression models and Kaplan-Meier estimates. Results: Injuries were frequent during school-physical/sports-training (10.9%), other-school-training (4.7%), school-free-time (7.4%), out-of-school-sports-activity (16.5%), and traffic (2.2%). Single injury (one injury all injury types combined) and ≥2 injury types affected 23.3 and 7.9% of subjects, respectively. The proportion of adolescents without SBHDs decreased with age more quickly among those with each injury type than among those without injury. Various SBHDs were associated with most injury types, single injury, and ≥2 injury types (sex-age-adjusted odds/relative-risk ratios reaching 11, p < .001). A dose-effect association was found between SBHDcn 1-2/3-5/≥6 and both single injury and ≥2 injury types (sex-age adjusted relative risk ratios reaching 12.66, p < .001, vs. SBHDcn = 0). Socioeconomic features had a moderate confounding role in these associations. Conclusions: SBHDs strongly predict injuries among adolescents. Our findings may inform healthcare providers about their prominent role in detecting/reducing SBHDs and injuries.

Association of School Health Relationship Difficulties with Lack of Regular Physical Activity in Younger Adolescents: A Population Based Study

Objective: Lack of regular physical activity (LPA) and the number of days/week with physical activity >60 minutes/day (Ndw) may be associated with school-health-relational difficulties (SHRDs) during the life-course. This study assessed their associations and the confounding role of socioeconomic features (nationality, family structure, parents' education/occupation/income) among younger adolescents. Methods: This cross-sectional population-based study included 1,559 middle-school adolescents from north-eastern France (10-18 years, 98% under 16 years, 778 boys and 781 girls). They completed over one-hour teaching period a questionnaire collecting last-12-month LPA and last-7-day Ndw (dependent variables), and risk factors including socioeconomic features, SHRDs (previous grade repetitions, last-12-month poor general health status/physical health/psychological health/social-relationships, depressive symptoms (and age at onset and duration from onset); cumulated number noted SHRDcn). Data were analyzed using logistic/linear regression models. Results: LPA was common (32.5%) and associated with all SHRDs (sex-age-adjusted odds ratio saOR reaching 1.99, p < .001) and depressive-symptoms duration (saOR 1.63 (p < .05) and 2.11 (p < .001) for 1-2 and ≥3 years, respectively, vs. no depressive symptoms). A dose-effect association was found between SHRDcn and LPA (24.0, 33.7, 45.6, and 53.5%; saOR 1.59, 2.58, and 3.43; for SHRDcn 1-2, 3-4, and ≥5 respectively, vs. SHRDcn = 0, p < .001). Ndw was similarly associated with all SHRDs and SHRDcn (sex-age-adjusted regression coefficient reaching -1.10 day/week, p < .001). These results were robust when controlling for socioeconomic features (18% Collapse

Key Words Collapse

MESH Headings

• Male
• Female
• Humans
• Adolescent
• Child, Preschool
• Infant, Newborn
• Socioeconomic Factors
• Cross-Sectional Studies
• France/epidemiology
• Surveys and Questionnaires
• Exercise

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Grants Collapse

Association between untreated low back pain and injury proneness and confounding role of behavioral-health difficulties among younger adolescents: a population-based study

PURPOSE

Low back pain (LPB) is mostly left untreated (LBP_untreated) and may increase the injury risk due to associated behavioral-health difficulties (BHDs) among adolescents. This study assessed the association between LBP_untreated (vs. treated LBP (LBP_treated)) and injuries and the mediating role of BHDs among younger adolescents (10-16 years).

METHODS

This population-based study compared 328 adolescents with LBP_untreated (mean age = 13.7 ± 1.3) with 291 with LBP_treated (mean age = 13.3 ± 1.2) from north-eastern France. They completed a questionnaire collecting, at school-year end, socioeconomic features, LBP_treated/LBP_untreated, BHDs (alcohol/tobacco use, excessive screen-time, poor social support, poor physical health, depressive symptoms, and pain limiting activities), and injuries during the current school-year. Data were analyzed using multinomial logistic regression models and Kaplan-Meier estimates.

RESULTS

The proportion of subjects without alcohol/tobacco use or depressive symptoms decreased with time more quickly since age 10 among the adolescents with LBP_untreated than among those with LBP_treated. Hence, most LBP early started and the subjects with LBP_untreated had a higher risk of single injury (sex-age-class-level-socioeconomic-features-adjusted relative risk ratio RR = 1.63, p < 0.05, vs. LBP_treated) and a much higher risk of ≥ 2 injuries (RR = 2.60, p < 0.001). BHDs played a strong mediating role in the association between LBP_untreated and ≥ 2 injuries (contribution = 48%) but a modest mediating role in that between LBP_untreated and single injury (contribution = 10%) (pseudo R² = 7.6%).

CONCLUSION

LBP_untreated is common and associated with injuries partly due to BHDs (which may alter physical/mental capabilities, risk perception/awareness, and vigilance) among younger adolescents. Our results may inform healthcare providers that they can detect/treat LBP and BHDs to prevent their aggravation and injuries.

Association between screen time and cumulating school, behavior, and mental health difficulties in early adolescents: A population-based study

Early adolescents may daily spend excessive screen-time (with television viewing, computer/console gaming, discussion forums/chatting online, internet surfing, doing homework, and electronic mails) while its association with cumulating several school-behavior-mental-health difficulties (SBMDs) (poor-academic-performance, being obese, alcohol/tobacco/cannabis/other-illicit-drugs use, suffered violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms, and suicide attempt) is poorly addressed. We investigated this association among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed a questionnaire including socioeconomic features, daily screen-time for various screen-based activities (coded 1=<2/2=2-4/3=≥5 h; daily-total-screen-time level DSA_total was defined as their sum and categorized into 4 levels: 6-7/8-9/10-12/≥13), various SBMDs and the time of their onset during the life course (their cumulated number SBMD_score was categorized into 5 levels: 0/1/2/3-4/≥5). Logistic regression modeling showed that the DSA_total was strongly associated with all SBMDs (gender-age-adjusted odds ratio reaching 8.28, p < 0.001) and SBMD_score (gender-age-adjusted relative risk reaching 11.60, p < 0.001, pseudo R² = 0.039). These associations remained strongly significant when controlling for socioeconomic adversities (contributions 20-38%). The proportion of subjects without each SBMD steadily decreased with age according to DSA_total levels. These findings help to understand the impacts of high DSA_total on SBMDs in early adolescents and identify at-risk adolescents for prevention and care.

Association between Whole-Body Vibration exposure and musculoskeletal disorders among dumper operators: A case-control study in Indian iron ore mines

BACKGROUND

Dumper operators in mines worldwide are subjected to Musculoskeletal Disorders (MSDs) due to whole-body vibration exposure. This study evaluated the working-life-Whole-Body Vibration (WBV)-exposure and their association with various MSDs among dumper operators in mines which remains poorly addressed.

METHODS

This case-control study in Indian iron ore mines was conducted to compare randomly selected 65 dumper operators and 65 office workers. Data were collected through face-to-face interviews using the Nordic Musculoskeletal Questionnaire (NMQ) and were analysed using logistic regression models.

RESULTS

The study revealed that majority of the dumper operators were exposed to WBV exceeding the ISO-2631 limits. Compared with controls, the dumper operators had a much higher risk of upper back pain (age-overweight-adjusted odds ratio ORao = 5.37, 95%CI = 1.78-16.20), lower back pain (ORao = 2.72, 95%CI = 1.25-5.94), knee and leg pain (ORao = 3.68, 95%CI = 1.22-11.11), and having 2+ MSDs (ORao = 5.05, 95%CI = 1.88-13.51, vs. no MSDs). Working-life-WBV-exposure was higher among dumper operators having upper back pain (mean (SD) = 7.1 (1.91) vs. 5.7 (1.91), p <  0.01) and lower back pain (mean (SD) = 6.63 (2.10) vs. 5.55 (1.71), p <  0.01) compared to those without these MSDs. Older age was associated with higher risk of MSD pains.

CONCLUSION

Dumper operators have excess MSDs due to high working-life-WBV-exposure. Their MSDs and working-life-WBV-exposure should be regularly evaluated and reduced.

Association between cumulating substances use and cumulating several school, violence and mental health difficulties in early adolescents

Multiple substances (alcohol, tobacco, cannabis and other illicit drugs (OID)) have been frequently used in early adolescents maybe due to school, violence and mental-health difficulties. We investigated the associations between substance-use patterns and related difficulties among 1559 middle-school adolescents from north-eastern France (mean age 13.5 ± 1.3). They completed a questionnaire including socioeconomic features, school, violence and mental-health difficulties (school grade repetition, sustained physical/verbal violence, sexual abuse, perpetrated violence, poor social support, depressive symptoms and suicide attempt; cumulated number noted SVMD_score) and the time of their first occurrence during the life course. Data were analyzed using logistic and negative binomial regression models. Alcohol, tobacco, cannabis and OID use affected 35.2, 11.2, 5.6 and 2.8% of the subjects respectively. The risk of using tobacco only, alcohol and tobacco, alcohol plus tobacco and cannabis, or all alcohol, tobacco, cannabis and OID strongly increased with the SVMD_score (socioeconomic features-adjusted odds ratio reaching 85). The risk began in early years in middle schools and then steadily increased, more markedly for elevated SVMD_score. Exposure to several SVMDs may be a transmission vector towards the substance use, starting mostly with alcohol/tobacco, and then shifting to cannabis/OID. These findings help to understand substance-use risk patterns and identify at-risk adolescents.

Association between Suicide Ideation and Attempts and Being an Immigrant among Adolescents, and the Role of Socioeconomic Factors and School, Behavior, and Health-Related Difficulties

The risk of suicide behaviors in immigrant adolescents varies across countries and remains partly understood. We conducted a study in France to examine immigrant adolescents' likelihood of experiencing suicide ideation in the last 12 months (SI) and lifetime suicide attempts (SA) compared with their native counterparts, and the contribution of socioeconomic factors and school, behavior, and health-related difficulties. Questionnaires were completed by 1559 middle-school adolescents from north-eastern France including various risk factors, SI, SA, and their first occurrence over adolescent's life course (except SI). Data were analyzed using logistic regression models for SI and Cox regression models for SA (retaining only school, behavior, and health-related difficulties that started before SA). Immigrant adolescents had a two-time higher risk of SI and SA than their native counterparts. Using nested models, the excess SI risk was highly explained by socioeconomic factors (27%) and additional school, behavior, and health-related difficulties (24%) but remained significant. The excess SA risk was more highly explained by these issues (40% and 85%, respectively) and became non-significant. These findings demonstrate the risk patterns of SI and SA and the prominent confounding roles of socioeconomic factors and school, behavior, and health-related difficulties. They may be provided to policy makers, schools, carers, and various organizations interested in immigrant, adolescent, and suicide-behavior problems.

Associations between school difficulties and health-related problems and risky behaviours in early adolescence: A cross-sectional study in middle-school adolescents in France

Health-related problems and risky behaviours (substance use) are frequent in adolescents, may alter their physical and mental capabilities, and may thus generate school absenteeism, low academic performance, and school dropout ideation. This study assessed their associations and the contribution of socioeconomic factors among 1559 middle-school adolescents (mean age 13.5+1.3) from north-eastern France. They completed a questionnaire including socioeconomic characteristics, health-related problems (poor physical health, psychological health, social relationships, and living environment) assessed with the World Health Organization's quality of life measure (score<25th percentile), risky behaviours, school absences during the present school year, last-trimester academic performance, and school dropout ideation. Data were analysed using logistic regression models. School absenteeism was frequent (12.6% of subjects for 8-14 days, and 6.0% for ≥15 days); 8.2% of subjects had low academic performance (average school-mark <10/20) and 3.9% school dropout ideation. All school difficulties were strongly associated with all health-related problems (gender-age-school-level-adjusted odds ratios gasOR between 1.5 and 4.2), and with risky behaviours (gasOR between 1.4 and 14). Socioeconomic factors differently contributed to these associations (contribution reaching 77%). Policy makers, schools, physicians and parents should be more aware of the problems and help adolescents to reduce health-related problems and risky behaviours and to increase resilience.

From cannabis initiation to daily use: educational inequalities in consumption behaviours over three generations in France

AIMS

The diffusion of cannabis initiation has been accompanied by a reversal in the educational gradient: contrary to older generations, the less educated in recent generations are more likely to initiate than the more educated. We tested whether the educational gradient for the transition from initiation to daily use evolved in the same way.

DESIGN/SETTING

A French telephone random survey conducted in 2010 (21 818 respondents aged 15-64 years), asking interviewees about their ages at initiation to daily use, if any.

PARTICIPANTS

A total of 6824 cannabis initiators aged 18-64 years at data collection. Three birth cohort groups (generations) were compared: 1946-60 (n = 767), 1961-75 (n = 2632) and 1976-92 (n = 3425) with, respectively, 47, 42 and 45% of women.

MEASURES

Risks of transition to daily use from ages 11-34 were compared through time-discrete logistic regressions and educational gradients were quantified through a relative index of inequality (RII). Control variables include age and time-varying variables (ages at tobacco daily use, at first drunkenness and at first other use of an illicit drug in a list of 13 products).

FINDINGS

Twenty-four per cent of the initiators reported daily use before age 35, the proportions tripling from the oldest to the youngest generation (from 11.7 to 38.6% in men, from 7.7 to 22.2% in women). Whatever the generation, the less educated initiators more often shifted to daily use than the most educated: from the oldest to the youngest generation, RII = 2.13, 95% confidence interval (CI) = [0.65, 7.02]; 2.19 95% CI = [1.33, 3.63]; and 2.24, 95% CI = [1.60, 3.15] in men; RII = 3.31, 95% CI = [0.75, 14.68]; 3.17, 95% CI = [1.49, 6.76]; and 3.56, 95% CI = [2.07, 6.14] in women, respectively.

CONCLUSION

In France, the risk of transition from cannabis initiation to daily use has remained consistently higher among less educated cannabis initiators over three generations (1946-60, 1961-75, 1976-92), in contrast to what is observed for initiation.

The Gateway Hypothesis, Common Liability to Addictions or the Route of Administration Model A Modelling Process Linking the Three Theories

BACKGROUND

The aim of this study was to describe the transitions between tobacco (T), cannabis (C) and other illicit drugs (OIDs) initiations, to simultaneously explore several substance use theories: gateway theory (GT), common liability model (CLM) and route of administration model (RAM).

METHODS

Data from 2 French nationwide surveys conducted in 2005 and 2010 were used (16,421 subjects aged 18-34). Using reported ages at initiations, we reconstituted a retrospective cohort describing all initiation sequences between T, C and OID. Transition probabilities between the substances were computed using a Markov multi-state model that also tested the effect of 2 latent variables (item response theory scores reflecting propensity for early onset and further substance use) on all transitions.

RESULTS

T initiation was associated with increased likelihood of subsequent C initiation, but the reverse relationship was also observed. While the most likely initiation sequence among subjects who initiated the 3 groups of substances was the 'gateway' sequence T x2192; C x2192; OID, this pattern was not associated with substance use propensity more than alternative sequences. Early use propensity was associated with the 'gateway' sequence but also with some alternative ones beginning with T, C or OID.

CONCLUSION

If the gateway sequence appears as the most likely pattern, in line with GT, the effects of early onset and substance use propensities were also observed for some alternative sequences, which is more in line with CLM. RAM could explain reciprocal interactions observed between T and C. This suggests shared influences of individual (personality traits) and environmental (substance availability, peer influence) characteristics.

Whole-body Vibration Exposure of Drill Operators in Iron Ore Mines and Role of Machine-Related, Individual, and Rock-Related Factors

Background

This study aimed to assess the whole-body vibration (WBV) exposure among large blast hole drill machine operators with regard to the International Organization for Standardization (ISO) recommended threshold values and its association with machine- and rock-related factors and workers' individual characteristics.

Methods

The study population included 28 drill machine operators who had worked in four opencast iron ore mines in eastern India. The study protocol comprised the following: measurements of WBV exposure [frequency weighted root mean square (RMS) acceleration (m/s²)], machine-related data (manufacturer of machine, age of machine, seat height, thickness, and rest height) collected from mine management offices, measurements of rock hardness, uniaxial compressive strength and density, and workers' characteristics via face-to-face interviews.

Results

More than 90% of the operators were exposed to a higher level WBV than the ISO upper limit and only 3.6% between the lower and upper limits, mainly in the vertical axis. Bivariate correlations revealed that potential predictors of total WBV exposure were: machine manufacturer (r = 0.453, p = 0.015), age of drill (r = 0.533, p = 0.003), and hardness of rock (r = 0.561, p = 0.002). The stepwise multiple regression model revealed that the potential predictors are age of operator (regression coefficient β = −0.052, standard error SE = 0.023), manufacturer (β = 1.093, SE = 0.227), rock hardness (β = 0.045, SE = 0.018), uniaxial compressive strength (β = 0.027, SE = 0.009), and density (β = –1.135, SE = 0.235).

Conclusion

Prevention should include using appropriate machines to handle rock hardness, rock uniaxial compressive strength and density, and seat improvement using ergonomic approaches such as including a suspension system.

Roles of age, length of service and job in work-related injury: a prospective study of 63,620 person-years in female workers

BACKGROUND

The roles of age, length of service and job in various work-related injury types are unknown and deserve investigations among female workers. This study assessed their roles in the occurrence of injury.

METHODS

Three-year prospective study of all 22,952 permanently employed women at the French national railway company: 63,620 person-years, 756 injuries with working days lost, coded using the company's injury classification derived from that of the French health insurance scheme. We investigated the incidence of four types of injury: fall on same level, fall to lower level, materials/equipment/objects handling, and other injuries. Data were analyzed using negative binomial regression.

RESULTS

Workers aged <25 were subject to a higher risk for all types of injuries. Older workers (45-55 years) were subject to a higher injury risk for fall on same level and fall to lower level. For fall on same level as for fall to lower level the relative risk decreased steadily with increasing length of service with the company, from 1.60 for 1 year to 0.50-0.60 for ≥30 years. For injuries due to materials/equipment/objects handling the relative risk decreased from 1.05 for one year to 0.49 for 5-9 years, and then increased to about 1.50 for 20-29 years and ≥30 years.

CONCLUSIONS

Younger and shorter lengths of service were at risk for various types of injuries. Higher length of service was at risk for injury due to materials/equipment/objects handling. Preventive measures should consider the respective risks associated with age, years of employment and job.

Mortality gradient across the labour market core-periphery structure: a 13-year mortality follow-up study in north-eastern France

PURPOSE

This study explores mortality related to temporary employment, about which very little is known to date.

METHODS

In 1996, a health survey was carried out in the French region of Lorraine, and all members of 8,000 randomly chosen households were followed up for mortality over a 13-year period. Mortality of subjects in relation to their employment situation at baseline was analysed using a Cox survival regression.

RESULTS

In comparison with permanent workers, for unemployed men, we found age and occupation-adjusted hazard ratios (HR) of 4.1 for all-causes of death and 3.9 for non-violent causes, and for male temporary workers a HR of 2.2 for both all-causes and non-violent causes of death. Bad health, tobacco smoking and alcohol misuse explained 17 % of the excess risk for the unemployed and 41 % of that for temporary workers.

CONCLUSION

The observation of large mortality inequalities across the labour market core-periphery structure has important policy implications, particularly in terms of prevention focused on unhealthy behaviours among male unemployed and temporary workers.

Self-reporting and measurement of body mass index in adolescents: refusals and validity, and the possible role of socioeconomic and health-related factors

Background

Body mass index assessment using self-reported height and weight (BMIsr) can encounter refusals and under/over-reporting while for assessment with measured data (BMIm) refusals can be more frequent. This could relate to socioeconomic and health-related factors. We explored these issues by investigating numerous potential factors: gender, age, family structure, father’s occupation, income, physical/sports activity, subjective weight perception, school performance, unhealthy behaviours, physical/psychological health, social relationships, living environment, having sustained violence, sexual abuse, and involvement in violence.

Methods

The sample included 1559 adolescents from middle schools in north-eastern France. They completed a questionnaire including socioeconomic and health-related data, self-reported height/weight, measured height/weight, and weight perception (participation rate 94%). Data were analysed using logistic regression models.

Results

BMIsr encountered under-reporting (with change in BMI category, 11.8%), over-reporting (6.0%), and reporting refusals (3.6%). BMIm encountered more numerous refusals (7.9%). Reporting refusal was related to living with a single parent, low school performance, lack of physical/sports activity, sustained violence, poor psychological health, and poor social relationships (gender/age-adjusted odds ratios 1.95 to 2.91). Further to these factors, measurement refusal was related to older age, having divorced/separated parents, a father being a manual worker/inactive, insufficient family income, tobacco/cannabis use, involvement in violence, poor physical health, and poor living environment (1.30 to 3.68). Under-reporting was related to male gender, involvement in violence, poor psychological health, and overweight/obesity (as assessed with BMIm) (1.52 to 11). Over-reporting was related to male gender, younger age, alcohol consumption, and underweight (1.30 to 5.35). Weight perception was linked to reporting refusals and under/over-reporting, but slightly linked to measurement refusal. The contributions of socioeconomic and health-related factors to the associations of weight perception with reporting refusal and under/over-reporting ranged from −82% to 44%. There were substantial discrepancies in the associations between socioeconomic/health-related factors and overweight/obesity assessed with BMIsr and BMIm.

Conclusions

BMIsr and BMIm were affected by numerous biases related to vulnerability which were also obesity risk factors. BMIsr encountered under/over-reporting which were related to some socioeconomic and health-related factors, weight perception, and BMIm. BMIm was more affected by refusals than BMIsr due to socioeconomic and health-related factors. Further research is needed.

Socioeconomic inequities patterns of multi-morbidity in early adolescence

BACKGROUND

Multi-morbidity such as cumulating mental health, behavioral, and school difficulties (consumptions of alcohol, tobacco, cannabis, and hard drugs, obesity, depressive symptoms, suicide attempts, involvement in violence, and low school performance) is common in early adolescence and can be favored by a number of socioeconomic factors (gender, age, nationality, family structure, parents' education, father' occupation, and income). This study assessed the concurrent roles of various socioeconomic factors in multi-morbidity defined as cumulated number of difficulties (CD) which has been partially documented.

METHODS

Adolescents from middle schools in north-eastern France (N = 1,559) completed a questionnaire measuring socioeconomic characteristics and mental health, behavioral, and school difficulties. Data were analyzed using logistic regression models.

RESULTS

Alcohol use affected 35.2% of subjects, tobacco use 11.2%, cannabis use 5.6%, hard drugs use 2.8%, obesity 10.6%, depressive symptoms 13.3%, suicide attempts 9.9%, involvement in violence 10.3%, and low school performance 8.2%. Insufficient income and non-intact families impacted most mental health, behavioral, and school difficulties with adjusted odds ratios (ORa) between 1.51 and 3.72. Being immigrant impacted illicit drugs use and low school performance (ORa 2.31-4.14); low parents' education depressive symptoms (1.42) and school performance (3.32); and manual-worker/inactive offspring low school performance (2.56-3.05). Multi-morbidity was very common: CD0 44.1%, CD1 30.8%, CD2-3 18.4%, and CD ≥ 4 6.7%. Insufficient income, divorced/separated parents, reconstructed families, and single parents played impressive roles with strong ORa gradients (reaching 4.86) from CD1 to CD ≥ 4. Being European immigrant, low parents' education, and low fathers' occupations had significant gender-age-adjusted odds ratios for CD2-3 and CD ≥ 4, but these became non-significant when adjusted for all socioeconomic factors. Older adolescents had higher risks for multi-morbidity which did not change when adjusting for all socioeconomic factors.

CONCLUSIONS

Multi-morbidity including a wide range of mental health, behavioral, and school difficulties was common in early adolescence. Insufficient income and non-intact families played impressive roles. Being immigrant, low parents' education, and low fathers' occupations also played strong roles but these were explained by insufficient income and non-intact families. Prevention against multi-morbidity should be designed to help adolescents to solve their difficulties, especially among adolescents with socioeconomic difficulties.

Life satisfaction two-years after stroke onset: the effects of gender, sex occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg

Background

Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective influences remain unclear. This study assessed, two years post-stroke onset, the effects of these factors on patients’ LS and family caregivers’ LS in Luxembourg.

Methods

All stroke patients admitted to all hospitals in Luxembourg were identified by the ‘Inspection Général de la Sécurité Sociale’ using the only national system database for care expenditure reimbursement. Their diagnosis was confirmed by medical investigator. The sample included ninety four patients living at home having given consent (mean age 65.5 years) and sixty two main caregivers (mean age 59.3 years). Questionnaires were completed during face-to-face interviews. LS was assessed via European single question (range 1–10), survivors’ QoL via Newsqol (11 dimensions), and caregivers’ QoL via Whoqol-bref (4 domains) (range 0–100). Data were analysed using multiple regression models.

Results

Two years after stroke onset, 44.7% of patients suffered from impaired sensory function, 35.1% from impaired motor function, and 31.9% from impaired memory function. Mean patient’ LS was 7.1/10 (SD 1.9). It was higher in women (+12.4) and lower among unemployed socioeconomically active patients (−13.1, vs. retired people). Adjusted for sex, occupation, impaired motor and memory functions, LS positively correlated with scores of Newsqol feelings, sleep, emotion, cognition and pain dimensions (slopes 0.20 to 0.31), but did not correlate with those of caregivers’ Whoqol-bref domains. Family caregiver’ LS was 7.2 (SD 1.7). It was lower in those with patients suffering from impaired memory function (−12.8) as well as from feelings and emotion issues (slopes 0.22). It was associated with all caregivers’ Whoqol-bref domains (physical health, psychological health, environment, and social relationships) (slopes 0.53 to 0.68).

Conclusions

Two-year post-cerebrovascular disease patient’ LS was associated with gender, occupation, and impaired memory function. It correlated with feelings, sleep, emotion, cognition, and pain issues. Family caregivers of patients with impaired memory function had lower LS. Family caregiver’ LS correlated with dimensions of patients’ feelings (less independent, yourself, life changed, depressed, useless, less control because of stroke) and emotion (get more emotional, fear of another stroke or to become dependent on others), and with their own QoL. LS, Newsqol, and Whoqol appeared to be appropriate tools. Our findings may be useful for policy makers in relation to family and medical-social issues of stroke home-based rehabilitation.

School difficulties in immigrant adolescent students and roles of socioeconomic factors, unhealthy behaviours, and physical and mental health

BACKGROUND

School is a multi-cultural setting where students need social, material, physical, and mental resources to attain school achievement. But they are often lacking, especially for immigrant students. In an early adolescence context, this study assessed risk for school difficulties among European and non-European immigrants and the roles of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours.

METHODS

This cross-sectional study included 1,559 middle-school adolescents from north-eastern France, who completed a self-administered questionnaire including socioeconomic characteristics (gender, age, family structure, father's occupation, and family income), WHO-Quality of life (measuring the four dimensions physical health, psychological health, social relationships, and living environment), unhealthy behaviours (last-30-day uses of tobacco, alcohol, cannabis, and other illicit drugs and no regular sports/physical activities), grade repetition, low school performance (<10/20), and school dropout ideation at 16 years. Data were analyzed using logistic models.

RESULTS

Grade repetition affected 14.8% of students, low school performance 8.2%, and school dropout ideation 3.9%. European immigrants had a higher risk for grade repetition only with a gender-age-adjusted odds ratio (OR) of 2.44, vs. French students. This odds ratio decreased to 1.76 (contribution 47%) with further adjustment for all confounders (family structure, father's occupation, family income, physical health, psychological health, social relationships, living environment, and unhealthy behaviours). Non-European immigrants had a statistically higher risk for all grade repetition, low school performance, and school dropout ideation with ORs of 3.29, 3.02, and 3.42, respectively vs. French students. These odds ratios decreased to 1.76, 1.54, and 1.54, respectively (contributions 66%, 73%, and 78%) with further adjustment for all confounders.

CONCLUSIONS

Compared with French students, European immigrant students were more affected only by grade repetition while non-European immigrant students by all grade repetition, low school performance, and school dropout ideation. The contribution of socioeconomic characteristics, physical health, psychological health, social relationships, living environment, and unhealthy behaviours was very high and much higher for non-European than for European immigrant students. Public policy should focus on these factors and services to reduce school difficulties.

The influence of socioeconomic status on cannabis use among French adolescents

PURPOSE

To investigate the influence of the family socioeconomic status (F-SES) on various intensities and frequencies of cannabis use in late adolescence.

DESIGN/SETTINGS/PARTICIPANTS

Data were obtained from a cross-sectional survey conducted in 2008, which was representative of French youth aged 17(n = 39,542). Outcomes were overall use (abstinence, lifetime use, 1-9, and 10+ uses in the past year) for all adolescents, and frequent use for those who smoked cannabis at least 10 times in the past year (≤9, 10-19, 20+ uses in the past month). Additionally, cannabis use disorders and heavy use (having smoked at least 4 joints last time) were studied among previous-year users. F-SES was the highest occupational category of both parents (in 7 categories, from managers/professionals [used as the reference category] to inactive/unemployed). Multinomial logistic regressions were computed controlling for gender; other substances use; parental separation; parental use of alcohol, tobacco, and cannabis; housing, being out of school, and sociability.

FINDINGS

For overall use, we found a strong positive social gradient: the lower the F-SES or the higher the frequency of use, the lower the odds ratio (OR) (from .85 to .52 for 10+ uses in the past year among farmers). For frequent use, we found a strong negative gradient: the lower the F-SES category, the higher the OR (from 1.02 to 2.05 among inactive/unemployed), and likewise for cannabis use disorder and heavy use (OR = 1.85 and 2.03 among inactive/unemployed).

CONCLUSIONS

Adolescents from affluent families are more prone to experimentation with cannabis and to use it at low levels but present lower levels of frequent, heavy, or problematic use than those from other SES categories. Mechanisms that hinder transition to intensive use should be investigated.

Gender differences in the association between depressive mood and mortality: a 12-year follow-up population-based study

BACKGROUND

Depressive mood has been associated with all-cause mortality in both men and women. This study aimed at exploring gender differences in the association between depressive mood and specific causes of mortality as well as factors that may account for it, including education, marital status, social support, health behaviors, and chronic diseases.

METHODS

A population-based survey including 6043 subjects (2892 men and 3151 women) was conducted in 1996 in the north-east of France with a questionnaire covering education, marital status, social support, health behaviors (smoking status, alcohol consumption, body mass index), and chronic diseases. Depressive mood was measured using the Duke Health Profile questionnaire. Cox regression models were used to examine its association with subsequent natural all-cause mortality, and cardiovascular and cancer mortality.

RESULTS

During a follow-up of 12.5 years, 406 men and 303 women died from a natural cause. Adjusting for all covariates, depressive mood predicted natural mortality in both men [Hazard Ratio (HR)=1.30; 95% confidence interval (CI): 1.00-1.69] and women (HR=1.37; 95% CI: 1.06-1.77). However, this association was significant for cardiovascular mortality in men (HR=1.63; 95% CI: 1.00-2.65) whereas it was significant for cancer mortality in women (HR=1.71; 95% CI: 1.11-2.64).

LIMITATIONS

Baseline data were self-reported and the response rate was low.

DISCUSSION

Preventive strategies aiming at reducing the increased mortality associated with depressive mood should take gender into account. Depressed men may warrant a better screening for cardiovascular risk factors and diseases, whereas depressed women may benefit from better cancer prevention measures.

Cannabis use stages as predictors of subsequent initiation with other illicit drugs among French adolescents: use of a multi-state model

The aim of this study was to confirm the influence of cannabis use patterns on the probability of initiation with other illicit drugs (OID). A French nationwide retrospective cohort on drug use was reconstituted on 29,393 teenagers. A Markov multi-state model was fitted, modelling all possible pathways from initial abstinence to cannabis initiation, daily cannabis use and OID initiation. The model was adjusted for tobacco and alcohol use. The risk for OID initiation appeared 21 times higher among cannabis experimenters and 124 times higher among daily cannabis users than among non-users. Tobacco and alcohol use were associated with a greater risk of moving on to cannabis initiation (hazard ratio (HR)=1.2 for tobacco initiation, HR=2.6 for daily tobacco use and HR=2.8 for drunkenness initiation). The results of this study provide a confirmation of a stage process in drug use, mediated by cannabis and liable to lead to OID experiment. This is compatible with the literature on the gateway theory, but goes further by modelling the entire sequence of use. OID experiment could be a consequence of initial opportunity to use the more accessible illicit drug, cannabis.

Life satisfaction of two-year post-stroke survivors: effects of socio-economic factors, motor impairment, Newcastle stroke-specific quality of life measure and World Health Organization quality of life: bref of informal caregivers in Luxembourg and a rural area in Portugal

BACKGROUND

Life satisfaction of stroke survivors is known to be associated with socio-economic factors and the survivor's and his/her caregiver's quality of life, but their respective influence remains to be fully elucidated.

PURPOSE

To analyse the stroke survivors' life satisfaction 2 years after the event and its relationships with quality of life, socio-economic and stroke-related characteristics, and with informal caregivers' life satisfaction and quality of life .

METHODS

Over 18 months, all stroke patients from Luxembourg and north-eastern Portugal who lived at home were identified from the Inspection Générale de la Sécurité Sociale and hospital records, respectively. The clinical diagnosis of cerebrovascular disease was confirmed. We excluded all patients who declared that stroke did not result in neurological impairments at the time of stroke from the statistical analysis. The samples comprised 79 patients in Luxembourg and 48 in Portugal. Patients and the people they identified as their main caregivers were interviewed using validated questionnaires measuring life satisfaction, i.e. the Newcastle Stroke-Specific Quality of Life (Newsqol - 11 subscales), which identifies the areas affected by stroke among patients, and the World Health Organization Quality of Life - bref (Whoqol-bref - 4 subscales) of informal caregivers. Survivors without neurological impairment at the time of stroke were excluded. Data were analysed via multiple-regression models.

RESULTS

Life satisfaction was higher among women and lower among subjects with impaired motor functions. It was lower among Portuguese respondents with low-level education (<12th grade) and higher among those at work (37.6/100). In Luxembourg, retired people had more life satisfaction than did working people (-7.9/100). Controlling for socio-economic factors, life satisfaction was associated with feelings- Newsqol (slope 0.25) among Luxembourg residents, and with feelings-, mobility- and self-care-Newsqol (slopes 0.24, 0.27 and 0.33, respectively) among Portuguese respondents. Life satisfaction of patients was strongly related to that of family caregivers among the Portuguese respondents (slope 0.66) but the relationship was moderate in Luxembourg (slope 0.28). The survivors' life satisfaction was not correlated with any Whoqol-bref domain in the Luxembourg group, but was correlated with the Whoqol-bref psychological, social relationships and environment domains among the Portuguese respondents (slopes 0.55, 0.59 and 0.51, respectively).

CONCLUSIONS

The life satisfaction scale and the Newsqol stroke instrument, which identify areas of quality of life affected by stroke, are reliable patient-centred markers of intervention outcome. They can be used within the framework of medical follow-up (such as telephone assistance, clinical practice and prevention). Depending on the stroke survivor's and the family caregiver's habitual lifestyle and material circumstances, enhancement of a caregiver's quality of life can help maintain the patient's life satisfaction, particularly in a rural setting.

Transitions between tobacco and cannabis use among adolescents: a multi-state modeling of progression from onset to daily use

Use of a given substance may follow a stage process leading from onset to regular use, and use of one substance can be strongly associated with use of another. The aim of this study was to describe the transitions between tobacco and cannabis use. Data was derived from a French nationwide survey involving 29,393 teenagers. A homogenous Markov multi-state model (MSM) was fitted. The substance use pattern modeled was: no lifetime use→1 (2) substance(s) initiation→1 (2) daily substance(s) use, with pathways between tobacco and cannabis. The likelihood of first initiating tobacco appeared 17.6 times greater than the likelihood of initiating cannabis. Once a subject has experimented with one substance, the risk of another substance experiment was much greater. Transition intensity from tobacco initiation to daily use was 4.8 times higher than that from cannabis. Our results are compatible with a process mixing the gateway theory, the reverse gateway theory and the route of administration model, but do not explore a common liability to addictions, which could be explored by using a MSM on a prospective cohort with initial collection of some explanatory factors.

Social gradient in initiation and transition to daily use of tobacco and cannabis during adolescence: a retrospective cohort study

AIMS

This study explores whether the family socio-economic status (F-SES) and school situation could have an impact on tobacco and cannabis initiation and transition to daily use during adolescence.

DESIGN AND SETTING

A French cross-sectional nation-wide survey conducted in 2005 containing retrospective data.

PARTICIPANTS

French teenagers aged 17 (n = 29 393).

MEASUREMENT

The F-SES was defined by the highest occupational category of either parent, with seven categories ranging from unemployed/inactive to managers/professionals. Ages at repeat school years, at leaving school, at the first episode of drunkenness and at initiation of illicit drug use were used to model tobacco and cannabis initiation and transition to daily use with time-discrete logistic regressions.

FINDINGS

The risk for tobacco initiation was almost equally distributed across F-SES groups, but the risk of a progression to daily use was higher in every F-SES category compared to managers/professionals [odds ratio (OR) from 1.17 to 1.90]. Compared to managers/professionals, risk of cannabis initiation was lower in all F-SES categories (OR from 0.63 to 0.87), but all categories except farmers were at increased risk of transition to daily use: the OR range between 1.29 (intermediate) and 1.98 (unemployed/inactive). Repeating school years and leaving school predicted daily use of tobacco (OR = 2.00 and 2.37) and cannabis (4.58 and 2.07).

CONCLUSIONS

Adolescents from the highest family socio-economic status categories are at risk for tobacco and cannabis experimentation but are less prone to engage in daily use. Psychological and social mechanisms that inhibit transition to daily use should be investigated, including school attainment and performance.

Gender and age disparities in the associations of occupational factors with alcohol abuse and smoking in the French working population

BACKGROUND

This study assessed the associations of short-term employment, physical and psychological occupational demands, and job dissatisfaction with alcohol abuse (using the Audit-C test) and daily smoking among working French men and women in different age groups.

METHODS

The sample included 13,241 working people, 18-29, 30-39, and 40-59-years-old, randomly selected in France and interviewed by phone. Occupation, type of employment, physical demands, psychological demands, job dissatisfaction, gender, age, educational level, and income were considered. Data were analyzed with logistic models.

RESULTS

Alcohol abuse affected 20.4% of men and 7.5% of women; smoking 32.1% and 24.2%, respectively. Their patterns of association with the occupational factors varied with gender and age. Job dissatisfaction was the leading factor among young men (adjusted odds ratio for alcohol abuse and smoking: 1.71 and 2.02), whereas short-term employment was the leading factor among young women (1.69 and 1.58), this pattern being reversed in older generations. The pattern of associations of physical and psychological demands with outcomes is more complex, but overall psychological demands were more important for women (especially the younger ones) than men, especially for smoking (OR>1.6). Smoking within 5 min after waking was much more common among male and female smokers with these occupational factors, suggesting a potential dependency.

CONCLUSIONS

Workers with short-term employment and occupational demands are subject to a higher risk for alcohol abuse and smoking with high gender and age disparities. Gender and age should be considered when designing measures to prevent substance abuse related to occupation.

Anthropometric characteristics of hospitalised elderly women: a case-control study

This study assessed the anthropometric status of 451 hospitalised female patients aged 70 or over, at their admission to hospital, in reference to 77 healthy women of the same age. The most frequent diseases were circulatory diseases (40.8%), mental disorders (29.9%), respiratory diseases (12.4%), endocrine and metabolic diseases (11.5%), osteomuscular diseases (8.4%), and traumatisms (6.9%). The differences were significantly high for mid-arm circumference (MAC), triceps skinfold thickness (TSF), weight, weight/height, and body mass index (BMI). The patients with cancers, blood diseases, mental disorders, respiratory disease, digestive diseases, or traumatisms had the lowest values. All the indicators correlated in a similarly negative way with age. The decreased TSF was more pronounced among subjects with respiratory diseases. Measurement of anthropometric indicators, TSF in particular, should be part of preventive measures aimed at reducing malnutrition and its consequences in a hospital setting.