Commuting Accidents among Non-Physician Staff of a Large University Hospital Center from 2012 to 2016: A Case-Control Study.

Road risks (commuting and on-duty accidents) have been responsible for 44% of work-related fatalities compensated by the French system of Social Security in 2012 and still represented 37% in 2018. Our objective was to assess risk factors for commuting accidents among the non-physician staff in a French university hospital. We conducted a case-control study of commuting accidents from 2012 to 2016. Cases were identified and controls were randomly selected from the hospital's personnel file with matches by year of the accident, gender and age. Risk factors were assessed using conditional logistic regression analysis. An increased risk was observed for 2 × 8 hour shifts, crude OR = 1.40 (95% CI = 1.05-1.86) compared to daytime schedules, but not confirmed in the multiple model. Being a duty officer and not working the day before the accident were associated with increased risk of accidents with adjusted OR = 1.9 (95% CI = 1.1; 3.3) and OR = 1.5, (95% CI = 1.1; 2.1), respectively. The risk increased as the distance between home and work increased, such as adjusted OR = 2.2 (95% CI = 1.4; 3.4) for a distance of >3.6 to 9 km, OR = 2.6, (95% CI = 1.7; 4.0) for a distance of >9 km to 19 km, and OR = 4.2, (95% CI = 2.8; 6.2) for >19 km vs. <3.6 km. The distance between home and work, not working the day before the accident, and certain categories of personnel were related to commuting accidents.

Assessment of Personal Occupational Exposure to Radiofrequency Electromagnetic Fields in Libraries and Media Libraries, Using Calibrated On-Body Exposimeters.

BACKGROUND AND OBJECTIVES: With the spread of Wifi networks, safety concerns have arisen, with complaints of somatic disorders, notably in traditional libraries and media libraries. The aim of the present study was to describe the conditions and levels of exposure to radiofrequency electromagnetic fields in the real-life occupational conditions of those working in traditional libraries and media libraries. METHODS: Dynamic measurements, using an exposimeter, were taken in 20 radiofrequency bands from 88 to 5850 MHz. The activity of 28 library workers was analyzed on a space-time budget. An audit of exposure sources and static measurements enabled the work-places to be mapped. RESULTS: In seven libraries, 78,858 samples were taken over the 20 radiofrequency bands from 88 to 5850 MHz. Exposure was described for 28 working days. The median total field was 0.071 V/m (10th percentile: 0.022 V/m, 90th percentile: 0.534 V/m) and for Wifi the median field was 0.005 V/m (10th percentile: 0.005 V/m, 90th percentile: 0.028 V/m). Median individual exposure to Wifi frequency waves ranged from 0.005 to 0.040 V/m. CONCLUSIONS: Overall, the occupational exposure in this sector was close to the exposure in the general population. Peaks were due to the use of walkie-talkies by security staff. Exposure due to external sources depended on geographic location. Exposure in this occupation is well below the general occupational exposure levels, notably as regards Wifi.

Occupational exposure to high-frequency electromagnetic fields and brain tumor risk in the INTEROCC study: An individualized assessment approach.

INTRODUCTION: In 2011, the International Agency for Research on Cancer classified radiofrequency (RF) electromagnetic fields (EMF) as possibly carcinogenic to humans (group 2B), although the epidemiological evidence for the association between occupational exposure to RF-EMF and cancer was judged to be inadequate, due in part to limitations in exposure assessment. This study examines the relation between occupational RF and intermediate frequency (IF) EMF exposure and brain tumor (glioma and meningioma) risk in the INTEROCC multinational population-based case-control study (with nearly 4000 cases and over 5000 controls), using a novel exposure assessment approach. METHODS: Individual indices of cumulative exposure to RF and IF-EMF (overall and in specific exposure time windows) were assigned to study participants using a source-exposure matrix and detailed interview data on work with or nearby EMF sources. Conditional logistic regression was used to investigate associations with glioma and meningioma risk. RESULTS: Overall, around 10% of study participants were exposed to RF while only 1% were exposed to IF-EMF. There was no clear evidence for a positive association between RF or IF-EMF and the brain tumors studied, with most results showing either no association or odds ratios (ORs) below 1.0. The largest adjusted ORs were obtained for cumulative exposure to RF magnetic fields (as A/m-years) in the highest exposed category (≥90th percentile) for the most recent exposure time window (1-4 years before the diagnosis or reference date) for both glioma, OR = 1.62 (95% confidence interval (CI): 0.86, 3.01) and meningioma (OR = 1.52, 95% CI: 0.65, 3.55). CONCLUSION: Despite the improved exposure assessment approach used in this study, no clear associations were identified. However, the results obtained for recent exposure to RF electric and magnetic fields are suggestive of a potential role in brain tumor promotion/progression and should be further investigated.

Working conditions and occupational risk exposure in employees driving for work.

INTRODUCTION: An analysis of the occupational constraints and exposures to which employees facing road risk at work are subject was performed, with comparison versus non-exposed employees. Objective was to improve knowledge of the characteristics of workers exposed to road risk in France and of the concomitant occupational constraints. The descriptive study was based on data from the 2010 SUMER survey (Medical Monitoring of Occupational Risk Exposure: Surveillance Médicale des Expositions aux Risques professionnels), which included data not only on road risk exposure at work but also on a range of socio-occupational factors and working conditions. MATERIALS AND METHODS: The main variable of interest was "driving (car, truck, bus, coach, etc.) on public thoroughfares" for work (during the last week of work). This was a dichotomous "Yes/No" variable, distinguishing employees who drove for work; it also comprised 4-step weekly exposure duration: <2h, 2-10h, 10-20h and ≥20h. RESULTS: 75% of the employees with driving exposure were male. Certain socio-occupational categories were found significantly more frequently: professional drivers (INSEE occupations and socio-occupational categories (PCS) 64), skilled workers (PCS 61), intermediate professions and teaching, health, civil service (functionaries) and assimilated (PCS 46) and company executives (PCS 36). Employees with driving exposure more often worked in small businesses or establishments. Constraints in terms of schedule and work-time were more frequent in employees with driving exposure. Constraints in terms of work rhythm were more frequent in non-exposed employees, with the exception of external demands requiring immediate response. On the Karasek's Job Demand-Control Model, employees with driving exposure less often had low decision latitude. Prevalence of job-strain was also lower, as was prevalence of "iso-strain" (combination of job-strain and social isolation). Employees with driving exposure were less often concerned by hostile behavior and, when they did report such psychological violence (inspired on the Leymann questionnaire), it was significantly more frequently due to clients, users or patients. DISCUSSION: Employees with driving exposure at work showed several specificities. The present study, based on a representative nationwide survey of employees, confirmed the existence of differences in working conditions between employees with and without driving exposure at work. In employees with driving exposure, constraints in terms of work-time and rhythm increased with weekly exposure duration, as did tension at work and exposure to hostile behavior.

A few seconds to have an accident, a long time to recover: consequences for road accident victims from the ESPARR cohort 2 years after the accident.

OBJECTIVE: The aim of the present study was to describe the consequences of a road accident in adults, taking account of the type of road user, and to determine predictive factors for consequences at 2 years. DESIGN: Prospective follow-up study. METHODS: The cohort was composed of 1168 victims of road traffic accidents, aged ≥16 years. Two years after the accident, 912 victims completed a self-administered questionnaire. Weighted logistic regression models were implemented to compare casualties still reporting impact related to the accident versus those reporting no residual impact. Five outcomes were analysed: unrecovered health status, impact on occupation or studies, on familial or affective life, on leisure or sport activities and but also the financial difficulties related to the accident. RESULTS: 46.1% of respondents were motorised four-wheel users, 29.6% motorised two-wheel (including quad) users, 13.3% pedestrians (including inline skate and push scooter users) and 11.1% cyclists. 53.3% reported unrecovered health status, 32.0% persisting impact on occupation or studies, 25.2% on familial or affective life, 46.9% on leisure or sport activities and 20.2% still had accident-related financial difficulties. Type of user, adjusted on age and gender, was linked to unrecovered health status and to impact on leisure or sport activities. When global severity (as measured by NISS) was integrated in the previous model, type of user was also associated with impact on occupation or studies. Type of user was further associated with impact on occupation or studies and on leisure or sport activities when global severity and the sociodemographic data obtained at inclusion were taken into account. It was not, however, related to any of the outcomes studied here, when the models focused on the injured body region. Finally, type of road user did not seem, on the various predictive models, to be related to financial difficulties due to the accident or to impact on familial or affective life. CONCLUSIONS: Overall, victims were affected by their accident even 2 years after it occurred. The severity of lesions induced by the accident was the main predictive factor. However, considering lesion as intermediary factors between the accident and the recovery status at 2 year post-accident, impact on health status was lower for cyclists than M4W users or M2W users.

Quality of life one year after a road accident: results from the adult ESPARR cohort.

BACKGROUND: There are a few studies assessing repercussions in road accident victims, which reported their results in quality of life (QoL), on an epidemiologic point of view. METHODS: ESPARR (follow-up of victims of road accident in the Rhône) is a prospective cohort study of 1,168 individuals (age ≥ 16 years) involved in road traffic accidents, having been admitted to one of the hospitals in the Rhône département (France). The World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-Bref) was used to assess QoL at the 1-year follow-up. χ(2) analysis was performed to test differences between groups, logistic regression was performed to examine predictors of global QoL and health, and linear regression was performed to examine predictors of the four functioning domains of the WHOQOL-Bref. RESULTS: Lesion severity (New Injury Severity Index ≥ 16; odds ratio, 2.6; 95% confidence interval, 1.7-3.9) and presence of head lesions (odds ratio, 1.5; 95% confidence interval, 1.1-2.2) were predictive of unsatisfactory QoL. Female sex, educational level lower than school graduation, severe injury, intention to lodge a complaint, early postaccident medical complications were predictive of health dissatisfaction. Several factors seemed to be associated to a poor QoL; notably, posttraumatic stress disorder was associated with low scores in all four WHOQOL-Bref domains. Socioeconomic factors were also significant, notably financial problems. CONCLUSION: The strong points of the present study lie in the fact that it is based on a representative cohort of road accident victims in an area in which all those treated within the hospital system after a road accident have been registered. The present study shows the strong correlation between QoL and posttraumatic stress disorder. LEVEL OF EVIDENCE: Prognostic study, level II.

Case-control study on renal cell cancer and occupational exposure to trichloroethylene. Part I: Exposure assessment.

A method for a semi-quantitative retrospective assessment of exposure to trichloroethylene (TCE) was implemented for a case-control study conducted in the Arve valley (France), an area with a widely developed screw-cutting industry, where teams of occupational physicians have collected a large quantity of well-documented measurements. A task-exposure matrix was developed to link the main working circumstances in a screw-cutting workshop to corresponding TCE-exposure levels: a 'basic level' was assigned to each task, standing for usual working procedures; exposure circumstances, such as duration or distance from the TCE source, were introduced as corrective factors. In parallel, a detailed occupational questionnaire was designed, setting subjects' descriptions of their successive jobs and working circumstances against levels assessed in the matrix. Possible exposure to TCE, plus some other occupational compounds (other solvents, oils, some metals, asbestos, welding fumes and ionizing radiations), were assessed for any job in all job histories. An average level of exposure to TCE, related to an 8 h usual working day, was attributed to each job period in turn, which was then categorized into six classes: 0; 1-35; 35-50; 50-75; 75-100; and >100 p.p.m. A total of 402 study subjects described their occupational life (average 3.7 jobs/subject, from 1924 to 2003). About 19% of the 1486 job periods described were assessed as being exposed to TCE; of these, 72.2% involved levels<35 p.p.m., 13.2% involved levels>50 p.p.m. and 5.4% above the French occupational exposure limit of 75 p.p.m. (TWA 8 h). A total of 41 job periods included exposure with peaks. Compared with levels encountered in other studies, the more severely exposed part of our study population seemed more exposed than most other populations previously studied, owing to vapor degreasing practices.