[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.

[Returning to work after an acute coronary syndrome: When waiting is wasting]

BACKGROUND

Return to work (RTW) after acute coronary syndrome (ACS) is an important issue for the patient's future.

AIMS

The study aim was to determine whether RTW practice complies with guidelines or is delayed by failure in patient management. We analysed the factors influencing RTW beyond the 90-day period recommended by guidelines.

METHODS

We conducted a survey of 216 self-employed workers admitted to the hospital for ACS using self-report questionnaires and medical examination. Factors influencing RTW, occupational and cardiac features, and recall and source of medical information were investigated.

RESULTS

Ninety-three of 216 patients did not return to work by 90 days, despite good cardiac performance in 30 cases (32 %). The mean sick leave duration was 93.3±103.7 days. Advice concerning return to work was completely missing for 44 % of patients. Cardiac performance was independent of sick leave duration, but was correlated with the likelihood of RTW (P<0.001). Patients assimilated about 70 % of the medical information they were provided, but only 53 % of work-related information. Recall of work-related information was better among patients admitted to a rehabilitation facility (65 %) compared to those who did not receive rehabilitation (P<0.05).

CONCLUSION

Cardiologists should assess the patient's cardiac performance within 2 months after ACS. Patient management should also include cardiac rehabilitation or therapeutic education toward improving information recall.

[Delay of professional activity recovery after implant based breast augmentation surgery: Influence of healthcare coverage]

AIM OF THE STUDY

The main goal is to determine if the delay before going back to work after implant-based breast augmentation surgery is influenced by the healthcare coverage criteria.

MEANS AND METHODS

In this retrospective, single center based study, patients who underwent implant-based breast augmentation surgery (excluding reconstructive surgery) in the past 3 years with a minimum follow-up of 1 month were questioned by telephone. Patients who had early postoperative complications, or no professional activity, were excluded. The demographic and perioperative data were collected and two groups were compared: those who were covered by the healthcare system and those who were not.

RESULTS

Sixty patients were included. The two groups were comparable concerning the demographic (age, BMI, children, work intensity, smoking status, comorbidity) and surgical data (surgical approach, type, volume and position of the implant, operative time and drainage). There was a significant difference between the groups concerning the delay of return to work (P=0.0001): 18.4 days for reimbursed patients versus 9.45 days for patients without healthcare coverage.

CONCLUSION

For the same implant-based breast augmentation surgery, and for the same population, the duration of postoperative recovery period doubles for the patients for whom surgery is reimbursed by the healthcare system.