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1.
Artigo em Inglês | MEDLINE | ID: mdl-35409741

RESUMO

Background: Nursing homes were particularly affected by the COVID-19 pandemic. The purpose of this study was to evaluate qualitatively and quantitatively with the use of a self-reported questionnaire as a tool for screening for mental disorders in nursing home staff. Methods: A multicenter epidemiological study was conducted in 12 nursing homes in France with 1117 nursing home staff eligible. Socio-demographic, occupational, and medical data were collected by anonymous self-reported questionnaire using validated scales to assess anxiety/depressive symptoms (HAD scale) and post-traumatic stress disorder (PCL-5). A total of 12 semi-structured interviews were conducted to assess acceptance and expectations for the use of the questionnaire. Results: The participation rate was 34.5%. Data from 373 questionnaires were included in the analysis. The questionnaire was well accepted by the participants and met their wishes for prevention action. The sample was 82% female. More than half reported a feeling of powerlessness and lack of time or staffing. The prevalence of anxiety symptoms was 22%, depressive symptoms 10%, and post-traumatic stress 7%. Conclusions: This study underlines the interest in screening for mental disorders by self-reported questionnaire and deploying preventive actions in the workplace to reduce stress and facilitate the reconciliation of family and working life in this context of the pandemic.


Assuntos
COVID-19 , COVID-19/diagnóstico , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Casas de Saúde , Pandemias , SARS-CoV-2 , Inquéritos e Questionários , Carga de Trabalho
2.
Infect Control Hosp Epidemiol ; : 1-5, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35382916

RESUMO

BACKGROUND: Exposure to infected healthcare workers (HCWs) is a source of hospital-acquired (HA) influenza. We estimated the risk of HA influenza for hospitalized patients by rate of influenza vaccine coverage (IVC) of HCWs. METHODS: A case-case negative control study nested in a prospective cohort was conducted in 2 French university hospitals during 2 influenza seasons. Each inpatient with influenza-like illness (ILI) provided a nasal swab sample that was systematically analyzed for influenza virus by polymerase chain reaction (PCR) testing. An HA influenza case was a patient with a virological confirmation of influenza with onset of symptoms ≥72 hours after admission to the ward. The IVC rate of HCWs in each participating ward was calculated from the data provided by the occupational health departments. A mixed-effect logistic regression was performed with adjustments on patient sex, age, the presence of a potential source of influenza on the ward in the 5 days prior to the start of the ILI, type of ward and influenza season. RESULTS: The overall HA influenza attack rate was 1.9 per 1,000 hospitalized patients. In total, 24 confirmed HA influenza cases and 141 controls were included. The crude odds ratio (OR) of HA influenza decreased from 0.52 (95% confidence interval [CI], 0.21-1.29) to 0.14 (95% CI, 0.03-0.63) when the IVC of HCWs increased from 20% to 40%. After adjustment, IVC ≥40% was associated with a risk reduction of HA influenza (aOR, 0.07; 95% CI, 0.01-0.78). CONCLUSIONS: Considering a limited sample size, influenza vaccination of HCWs is highly suggestive of HA flu prevention among hospitalized patients.Trial Registration: clinicaltrials.gov identifier: NCT02198638.

3.
Work ; 2022 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-35466919

RESUMO

BACKGROUND: Mental distress at work is a complex multifactorial phenomenon liable to impact health and personal life. OBJECTIVE: To assess the proportion of general practice consultations for mental distress at work and determine how general practitioners (GPs) manage these patients and the factors leading to consultation. METHODS: The frequency of consultations for mental distress at work was assessed on a self-administered questionnaire sent to the general practitioners (GPs) of the Loire administrative Département (France). Information on factors leading to consultation on management was obtained by a self-administered questionnaire in a sample of GPs and patients. RESULTS: Twenty-two patients were included by 16 GPs. 27% of patients were referred to an occupational physician. The frequency of consultations for mental distress at work was about 2% . Patients may wait several weeks or months before consulting, although a majority reported an impact on family life and health. A triggering event was often present, but no work accident procedure was undertaken. CONCLUSION: This study highlights the importance of better identifying adverse experience of working conditions and impaired mental health and reporting this to an occupational physician who can undertake preventive measures. Communication between occupational physician, employee and GP needs to be improved.

4.
Artigo em Inglês | MEDLINE | ID: mdl-34948791

RESUMO

Isocyanate, whose disease-inducing mechanism is poorly understood, with poor prognosis, is widely used. Asthma is the most frequent manifestation of prolonged exposure. We assessed the evolution of the incidence of isocyanate-induced occupational asthma over time. PubMed and Cochrane databases were systematically searched for studies published since 1990 that assessed the relationship between occupational exposure to isocyanates and asthma. We identified 39 studies: five retrospective cohort studies, seven prospective cohort studies, three of which were inception cohorts), seven observational cross-sectional studies, five literature reviews, two case series, and 13 registry studies. The incidence of occupational asthma secondary to isocyanate exposure has decreased from more than 5% in the early 1990s to 0.9% in 2017 in the United States. Despite the wide use of optimal collective and individual protection measures, the risk of occupational asthma has stabilized. Occupational asthma risk can be assessed with good sensitivity using self-questionnaires and pulmonary function tests. Occupational avoidance should be implemented as soon as possible after the first symptoms appear because the prognosis becomes increasingly poor with the persistence of exposure. It is now necessary to study specifically cutaneous sensitization to isocyanates and to define what protective equipment is effective against this mode of exposure.


Assuntos
Asma Ocupacional , Doenças Profissionais , Exposição Ocupacional , Saúde do Trabalhador , Asma Ocupacional/induzido quimicamente , Asma Ocupacional/epidemiologia , Estudos Transversais , Humanos , Isocianatos/toxicidade , Exposição Ocupacional/estatística & dados numéricos , Estudos Prospectivos , Estudos Retrospectivos
5.
Artigo em Inglês | MEDLINE | ID: mdl-34948562

RESUMO

BACKGROUND: The purpose of this study was to assess the prevalence of psychological distress in medical students during the COVID-19 health crisis and to identify factors associated with psychological distress. METHODS: A cross-sectional observational study was presented to 1814 medical students (from first to sixth year) in a French university hospital center. Sociodemographic, occupational and medical information (psychological distress measured on the French GHQ12 scale) were collected via an online anonymous self-administered questionnaire. Variables associated with psychological distress were investigated using univariate analysis and multivariate analysis (modified Poisson regression). RESULTS: In total, 832 medical students responded (46%) and 699 completed the questionnaire in full (39%); 625 (75%) showed signs of psychological distress and 109 (15%) reported suicidal ideation. Female gender, psychological trauma during the COVID-19 health crisis, change in alcohol consumption, and difficulties with online learning emerged as risk factors for psychological distress, whereas a paid activity, a feeling of mutual aid and cooperation within the studies framework, and recognition of work appeared to be protective factors. CONCLUSIONS: Mental health care or suicide prevention should be provided to students at risk in the aftermath of the pandemic. Knowing the educational and medical factors associated with psychological distress enables areas for prevention to be identified.


Assuntos
COVID-19 , Angústia Psicológica , Estudantes de Medicina , Estudos Transversais , Feminino , Humanos , SARS-CoV-2
6.
Artigo em Inglês | MEDLINE | ID: mdl-34639732

RESUMO

BACKGROUND: The COVID-19 pandemic led to a change in work organization with the development of telework. The purpose of this study was to assess the prevalence of anxiety and depressive symptoms in teleworking staff in a university hospital center in France during the first lockdown, and to identify personal, medical and occupational factors associated with anxiety disorder. METHODS: A cross-sectional observational study was conducted in 474 hospital staff working from home during the first lockdown. The sociodemographic, occupational and medical information (anxiety and depressive disorders measured on the Hospital Anxiety and Depression (HAD) scale) was collected by an anonymous online self-administered questionnaire. The variables associated with anxiety disorder were investigated by a univariate analysis (chi² and Fisher tests) and a multivariate analysis (logistic regression model). RESULTS: Three hundred and forty hospital staff participated in the study (72% response rate). Of the participants, 106 subjects (32.1%) showed signs of an anxiety disorder and 26 (7.65%) of a depressive disorder. An anxiety disorder was significantly associated with mental workload, changes in working hours, difficulties in teleworking due to issues of internet connection or due to noise, difficulties in combining family and occupational life, sleep disturbance, worry about media information and worry about the health of a loved one. An anxiety disorder remained associated with occupational stress and personal stress during lockdown after a multivariate logistic regression. CONCLUSIONS: This study highlighted the association between an anxiety disorder and perceived occupational and personal stress levels in hospital staff teleworking during the first lockdown. Stress management workshops could be proposed to hospital staff. Prevention of anxiety requires reinforced medical monitoring and reduced stress.


Assuntos
COVID-19 , Ansiedade/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Depressão/epidemiologia , Humanos , Pandemias , Recursos Humanos em Hospital , SARS-CoV-2 , Estresse Psicológico , Teletrabalho
7.
Toxics ; 9(9)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34564355

RESUMO

The biomonitoring of nanoparticles in patients' broncho-alveolar lavages (BAL) could allow getting insights into the role of inhaled biopersistent nanoparticles in the etiology/development of some respiratory diseases. Our objective was to investigate the relationship between the biomonitoring of nanoparticles in BAL, interstitial lung diseases and occupational exposure to these particles released unintentionally. We analyzed data from a cohort of 100 patients suffering from lung diseases (NanoPI clinical trial, ClinicalTrials.gov Identifier: NCT02549248) and observed that most of the patients showed a high probability of exposure to airborne unintentionally released nanoparticles (>50%), suggesting a potential role of inhaled nanoparticles in lung physiopathology. Depending on the respiratory disease, the amount of patients likely exposed to unintentionally released nanoparticles was variable (e.g., from 88% for idiopathic pulmonary fibrosis to 54% for sarcoidosis). These findings are consistent with the previously performed mineralogical analyses of BAL samples that suggested (i) a role of titanium nanoparticles in idiopathic pulmonary fibrosis and (ii) a contribution of silica submicron particles to sarcoidosis. Further investigations are necessary to draw firm conclusions but these first results strengthen the array of presumptions on the contribution of some inhaled particles (from nano to submicron size) to some idiopathic lung diseases.

8.
Front Psychol ; 12: 645092, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34354626

RESUMO

Introduction: The COVID-19 pandemic implied a period of lockdown for the general population, increasing the risk to develop some physical or mental disorders. In fibromyalgia patients, these disorders are part of the large clinical picture of the syndrome. Fibromyalgia management is especially based on a regular practice of physical activity. Lockdown imposed a break in rhythms, requiring a restructuring of scheduling. Thus, the present study aimed to investigate the experiences of fibromyalgia patients during COVID-19 lockdown using a qualitative analysis. Method: 19 patients (52 ± 9 years old) who completed a 3-month therapeutic education and/or supervised physical activity program were invited to participate (Fimouv study, Trial registration: ClinicalTrials.gov NCT04107948). A sociologist collected data by means of semi-structured interviews and analyzed them using thematic content analysis. Results: Lockdown exacerbated the main symptoms of fibromyalgia, but adjusting the rhythms of life to fluctuations of these symptoms allowed a better quality of life. Patients felt the lack of physical activity and 68% found alternatives to remain physically active. The reduction of social constraints allowed them to better contend with their pathology. Fibromyalgia stopped being a main priority. Conclusion: Lockdown was positively experienced by fibromyalgia patients. They linked the absence of physical activity with increased pain and fatigue. Nevertheless, reducing social constraints could be a key for fibromyalgia management, where symptoms seemed to take less space in everyday life. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT04107948.

9.
Front Public Health ; 9: 554291, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34113593

RESUMO

Introduction: Fibromyalgia (FM) is characterized by multiple symptoms including pain, fatigue, and sleep disorders, altering patient's quality of life. In the absence of effective pharmacological therapy, the last European guidelines recommend a multidisciplinary management based on exercise and education. Thus, our main objective was to measure the effectiveness of a healthcare organization offering a specific program of adapted physical activity combined with a therapeutic education program for FM patients. Methods and Analysis: The From Intent To Move (FIMOUV) study will recruit 330 FM patients randomized into two groups: test and control. The test group will benefit from a 1-month mixed exercise training program supervised at the hospital, followed by 2 months in a community-based relay in a health-sport structure. In addition, each of the two groups will benefit from therapeutic patient education sessions. The main endpoint is the measurement of the level of physical activity by accelerometry at 1 year. The secondary endpoints concern adherence to the practice of physical activity, impact on lifestyle, state of health, and physical capacity, as well as an estimate of the budgetary impact of this management strategy. Discussion: This interventional research will allow us to assess the evolution of behaviors in physical activity after an FM syndrome management based solely on patient education or based on a supervised and adapted practice of physical activity associated with this same therapeutic education program. It seems to be the first study evaluating the impact of its intervention on objective data for measuring physical activity and sedentary behavior via accelerometry among FM patients. Trial registration: ClinicalTrials.gov NCT04107948.


Assuntos
Fibromialgia , Exercício Físico , Terapia por Exercício , Fibromialgia/terapia , Humanos , Intenção , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Arch Environ Occup Health ; 76(1): 45-51, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-32544004

RESUMO

Firefighters' activities increase the risk of sudden cardiac events. The main objective of this study was to describe the Loire firefighters' cardiovascular risk factors according to their cardiovascular risk and to their professional status. A retrospective study of the entire population of firefighters of the Loire department was conducted. Risk factors derived from the data collected during the occupational health follow-up medical examinations were described and the cardiovascular risk was assessed for 417 firefighters. The most frequent cardiovascular risk factors were: overweight and obesity (62.1%), high blood pressure (27.8%) and active smoking (16,1%). There were no significant differences between career firefighters and volunteers. The prevalence of risk factors for cardiovascular diseases is less than in the general population. Obesity remains the most common risk factor, especially among firefighters with high cardiovascular risk.


Assuntos
Bombeiros/estatística & dados numéricos , Fatores de Risco de Doenças Cardíacas , Adulto , Pressão Sanguínea , Peso Corporal , Fumar Cigarros/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Sobrepeso/epidemiologia , Prevalência , Estudos Retrospectivos
12.
J Nurs Manag ; 29(5): 962-970, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33305408

RESUMO

AIM: To describe the progression of vigilance and sleepiness over the shift and the coping strategies of nurses working 12-hr day or night shifts. BACKGROUND: The spread of 12-hr shift work in nursing raises the question of whether sufficient vigilance can be maintained to ensure quality of care. METHOD: 18 nurses working 12-hr shifts filled out a Karolinska Sleepiness Scale questionnaire and a Brief Psychomotor Vigilance Test, at the beginning of the shift and then every 3 hr. Coping strategies and quality of care were assessed on self-administered questionnaires, filled out at 3 hr, 6 hr, 9 hr and 12 hr after the start of the shift. RESULTS: The present investigation did not show significantly excessive sleepiness or vigilance impairment or poor self-perception of quality of work during 12-hr nursing work shifts, although Psychomotor Vigilance Test results gradually deteriorated slightly over duty time (from start to end of shift). Certain coping strategies were preferred such as 'having a nap' later in the night shift. CONCLUSION: Attention needs to be paid to the health status of nurses working 12-hr shifts, with regular medical monitoring by the occupational health service. IMPLICATIONS FOR NURSING MANAGEMENT: Coping strategies to maintain sufficient vigilance to ensure quality of care should be facilitated.


Assuntos
Enfermeiras e Enfermeiros , Transtornos do Sono do Ritmo Circadiano , Adaptação Psicológica , Fadiga , Humanos , Sonolência , Tolerância ao Trabalho Programado
13.
Expert Rev Vaccines ; 19(10): 937-947, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33107353

RESUMO

Introduction: The world is now facing the COVID-19 pandemic. Experience with SARS-CoV and MERS-CoV, and early reports about SARS-CoV-2 infection suggest that health-care settings and health-care workers (HCWs) are vulnerable in the context of the emergence of a new coronavirus. Areas covered: To highlight the need for prophylactic strategies particularly for HCWs, we identified SARS-CoV, MERS-CoV, and SARS-CoV-2 outbreaks in health-care settings and the incidence of infections in HCWs by a search on MEDLINE and MEDxRIV (for SARS-Cov-2). To identify prophylactic strategies against, we conducted a search on MEDLINE and clinicaltrials.gov about studies involving SARS-CoV, MERS-CoV, and SARS-CoV-2. Expert opinion: HCWs account for a great part of SARS, MERS, and SARS-CoV-2 infections, they may also contribute to the spread of the disease, particularly in health-care settings, and contribute to nosocomial outbreaks. Some preventive strategies were evaluated in previous emerging coronavirus epidemics, particularly in MERS-CoV. For COVID-19 prevention, different chemoprophylaxis with drug repositioning and new agents are under evaluation, and different vaccine candidates entered clinical development, with clinical trials. HCWs are a crucial target population for pre-exposure and post-exposure prophylaxis.


Assuntos
COVID-19/prevenção & controle , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , COVID-19/tratamento farmacológico , COVID-19/epidemiologia , Vacinas contra COVID-19/administração & dosagem , Infecções por Coronavirus/epidemiologia , Desenvolvimento de Medicamentos , Reposicionamento de Medicamentos , Humanos , Profilaxia Pós-Exposição , Síndrome Respiratória Aguda Grave/epidemiologia
14.
Vaccine ; 38(36): 5759-5763, 2020 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-32684500

RESUMO

INTRODUCTION: Nosocomial outbreaks of seasonal influenza are frequent, and vaccination is largely recommended for healthcare workers (HCWs). Vaccine coverage in French HCWs does not exceed 20%. Decision-aids (DA) are potential useful interventions to increase vaccine coverage (VC). Our aim was to evaluate the impact of a DA on HCWs influenza vaccine coverage. MATERIAL AND METHODS: Prospective cluster-randomized trial conducted in 83 departments in two public hospitals (a teaching and a non-teaching hospital) during the 2018-2019 flu season. Distribution of the DA and of questionnaire about decisional conflict and knowledge in the departments randomized in the intervention group. RESULTS: A total number of 3 547 HCWs were concerned by the study (1 953 in the intervention group, 1 594 in the control group). Global VC was 35.6% during the 2018-2019 season, instead of 23.6% in the 2017-2018 season (p < 0.005). During the 2018-2019 season, VC was 31% (95% CI 28.7-33.3) in the control group and 38.7% (95% CI 36.5-40.9) in the intervention group (p < 0.005). Among the 158 HCWs exposed to the DA who answered the survey, 51.3% had no decisional conflict. HCWs without decisional conflict were more prone to get vaccinated before flu season. CONCLUSION: The use of the DA was associated with a 25% relative increase in VC among HCWs against seasonal influenza. This modest increase remained far from the WHO 75% target, but may have reduced the number of nosocomial. Multi-component interventions are needed to increase VC in HCWs.


Assuntos
Vacinas contra Influenza , Influenza Humana , Atitude do Pessoal de Saúde , Pessoal de Saúde , Hospitais , Humanos , Influenza Humana/prevenção & controle , Estudos Prospectivos , Inquéritos e Questionários , Vacinação
15.
Artigo em Inglês | MEDLINE | ID: mdl-30150568

RESUMO

This study aimed to evaluate the association between intention to leave work, and working conditions and health status among female care-staff in nursing homes. A multicenter cross-sectional study included female care-staff in 105 nursing homes for the elderly. We used validated questionnaires to assess occupational, psychosocial and medical data in a multicenter transverse study. Univariate analysis on chi² test was performed with stratification according to job (nurse, nursing assistant), and variables found to be significant on each dimension were included on multivariate models. 1428 nursing assistants and 342 registered nurses were included. 391 nursing assistants and 85 registered nurses intended to leave their work with the elderly. The registered nurses' intention to leave was associated with deteriorated care-team or residents relations, and with perceived elevated hardship due to the proximity of residents' death. The nursing assistants' intention to leave was associated with deteriorated management relation, with job insecurity and elevated hardship due to the residents' intellectual deterioration. Impaired physical or psychological health status also correlated with this intention. Policy to reduce voluntary turnover of care-staff in nursing homes for the elderly could be based on multifactorial management, acting on work organization and reducing psychosocial stress.


Assuntos
Esgotamento Profissional/psicologia , Instituição de Longa Permanência para Idosos , Satisfação no Emprego , Enfermeiras e Enfermeiros/psicologia , Assistentes de Enfermagem/psicologia , Casas de Saúde , Reorganização de Recursos Humanos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , França , Nível de Saúde , Humanos , Intenção , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
16.
J Occup Environ Med ; 60(10): e548-e553, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30095592

RESUMO

OBJECTIVE: We aim to identify cardiovascular risk factors in firefighters of Loire (French district) with a high cardiovascular risk and report results of a screening program using exercise tests. METHODS: A retrospective descriptive study was performed in a cohort of 158 career and 400 volunteer firefighters with a high cardiovascular risk who had undergone an exercise test. RESULTS: Five hundred fifty-eight exercise tests and cardiovascular profiles were analyzed. Prevalence was 18% for high blood pressure, 19% for dyslipidemia, and 48% for overweight. Exercise tests were positive in 91 cases (16.3%): sensitivity, 53%; specificity, 74%. Risk of onset of a predictive event was higher in the high-risk group: odds ratio, 3.2 (95% confidence interval 2.0 to 5.1). There were more events on exercise test in volunteer firefighters. CONCLUSION: Prevalence of cardiovascular risk factors in the cohort of firefighters was acceptable in comparison to French general population and other firefighters' cohort. Physical training of volunteer firefighters needs reinforcing.


Assuntos
Dislipidemias/epidemiologia , Teste de Esforço/efeitos adversos , Bombeiros , Hipertensão/epidemiologia , Sobrepeso/epidemiologia , Voluntários , Adulto , Arritmias Cardíacas/etiologia , Pressão Sanguínea , Dispneia/etiologia , Eletrocardiografia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
17.
BMJ Open ; 7(9): e016238, 2017 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-28939575

RESUMO

OBJECTIVES: To demonstrate that urine cytology screening can provide relevant epidemiological data for earlier detection of urothelial cancer caused by occupational exposure. DESIGN: Prospective cohort study. SETTING: Industries using urothelial carcinogens in France. Urine samples were collected on site, after a work week and were analysed at the University Hospital of Clermont-Ferrand, France. PARTICIPANTS: Participants were workers exposed to urothelial carcinogens. Women and current smokers at time of study recruitment were exclusion criteria. OUTCOMES: Urine cells atypia were ranged into three classes: negative/normal, atypical/suspicious/dysplasia or positive/malignant. RESULTS: We included 2020 workers over a period of 20 years from 1993 to 2013: 606 worked in rubber manufacturing, 692 from metal processing, 245 in chemical industry and 477 in roadwork and building industry. Workers had a mean exposure of 15.2±10.4 years before their first urine cytology screening. There was a mean of 3.4±4.3 urine cytology screenings per worker between 1993 and 2013. 6478 cytology were normal, 462 suspicious and 13 malignant. Suspicious and malignant cytology occurred in 4.8% of workers exposed for 1-10 years, 6.2% for 11-20 years of exposure, 7.6% for 21-30 years and 8.6% for >30 years (p<0.001). Using exposure for 1-10 years as reference, the adjusted OR of receiving a suspicious or malignant diagnosis increased with duration of exposure: OR=1.50 (95% CI 1.10 to 2.05, p=0.01) for 21-30 years and OR=1.78 (95% CI 1.23 to 2.56, p=0.002) for >30 years of exposure. Using metal processing as reference, the risk of pathological urine cytology results increased for rubber manufacturing (OR=1.32, 95% CI 1.05 to 1.65, p=0.02), with a trend for roadwork and building industry (OR=1.39, 95% CI 0.98 to 1.97, p=0.07) and for chemical industry (OR=1.34, 95% CI 0.94 to 1.93, p=0.11). CONCLUSIONS: Urine cytology is a useful tool in occupational medicine. We promote new guidelines with an early screening of urothelial cancer by cytology, starting with beginning of exposure.


Assuntos
Detecção Precoce de Câncer/métodos , Indústria Manufatureira/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Urina/citologia , Neoplasias Urológicas/diagnóstico , Neoplasias Urológicas/epidemiologia , Adulto , Feminino , França/epidemiologia , Humanos , Modelos Logísticos , Masculino , Indústria Manufatureira/classificação , Pessoa de Meia-Idade , Análise Multivariada , Exposição Ocupacional/análise , Estudos Prospectivos , Fatores de Tempo
18.
Geriatr Psychol Neuropsychiatr Vieil ; 13(4): 396-406, 2015 Dec.
Artigo em Francês | MEDLINE | ID: mdl-26707557

RESUMO

To describe training given and training desired and to assess the relation between training and perceived hard working conditions as experienced by female staff working in direct contact with the elderly in nursing homes. A transverse descriptive study was conducted with the involvement of 78 occupational physicians, and included staff in 105 nursing homes in the Rhône-Alpes Region of France. Data on training received during the previous 5 years and on training needs were collected from staff by self-administered questionnaire. 1,446 nursing assistants, 667 housekeepers and 348 nurses were included. The most frequent form of training during the previous 5 years was in handling. Staff most frequently desired training in palliative care and psychological approaches to residents. Part-time workers had less frequently had training during the previous 5 years. Staff with daytime hours significantly more often had training in the reception of and activities for the elderly and in hygiene than did night-staff. Almost half of respondents reported very hard working conditions related to physical handling of residents or to the physical deterioration of elderly persons. More than two-thirds reported very hard working conditions related to death. In all occupational categories, respondents who had had training in palliative care less often reported experiencing very hard working conditions related to death. Better adaptation of the training offer to the needs expressed by employees could improve the experience of working conditions in nursing homes. A longitudinal study could assess the impact of training in palliative care on reported hard working conditions related to death.


Assuntos
Idoso de 80 Anos ou mais/psicologia , Idoso/psicologia , Pessoal de Saúde/educação , Pessoal de Saúde/psicologia , Casas de Saúde , Adulto , Estudos Transversais , Feminino , França , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Casas de Saúde/organização & administração , Recursos Humanos
19.
J Occup Health ; 57(3): 285-96, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25864937

RESUMO

OBJECTIVES: This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. METHODS: A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. RESULTS: The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, p<0.001). Physical attack by residents was more frequently reported by NAs (59.1%) than Ns (52.8%) or HKs (38.0%) (p<0.001). Nearly 10% of employees reported clear effort/reward imbalance (10.4% of NAs, 9.2% of Ns and 7.0% of HKs, p=0.059). Great hardship related to proximity to death was reported by 40.5% of HKs (versus 37.3% of NAs and 22.6% of Ns; p<0.001). CONCLUSIONS: To prevent stress related to insufficient ability, nursing home workers should be encouraged to attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job.


Assuntos
Casas de Saúde , Recursos Humanos de Enfermagem/psicologia , Doenças Profissionais/etiologia , Estresse Psicológico/etiologia , Adulto , Estudos Transversais , Feminino , França , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Recompensa , Fatores de Risco , Estresse Psicológico/psicologia , Inquéritos e Questionários , Carga de Trabalho/psicologia
20.
Ind Health ; 52(4): 334-46, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24807124

RESUMO

This study investigated the relation between working conditions, in terms of physical and psychological demand, and upper-limb and neck musculoskeletal disorders (ULNMD) in female staff working in direct contact with the elderly in nursing homes. A cross-sectional survey was conducted in 105 nursing homes in France. Data on nursing-home working conditions were collected by questionnaire from occupational physicians and by self-administered questionnaire from staff. Psychosocial demand at work was assessed on Siegrist's questionnaire and ULNMD on the Nordic questionnaire. 2,328 employees were included: 628 housekeepers, 1,372 nursing assistants and 328 nurses. During the previous 12 months, 50% of the subjects (1,160) had presented with a musculoskeletal complaint concerning the neck, 38% (881) the shoulders, 10% (246) the elbows and 22% (520) the wrists. 9% (219) reported effort/reward imbalance on the 2004 Siegrist questionnaire and 42% were in a situation of over-commitment. ULNMD complaints were associated not only with physical occupational factors but also with psychosocial factors (effort/reward imbalance and over-commitment), both before and after adjustment on individual and occupational factors. Prospective studies are needed to clarify the causal role of occupational, including, organizational, psychosocial factors in ULNMD outcomes. Preventive approaches should take account of both physical and psychosocial occupational factors.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Doenças Musculoesqueléticas/etiologia , Casas de Saúde/estatística & dados numéricos , Doenças Profissionais/etiologia , Adulto , Braço , Estudos Transversais , Feminino , França/epidemiologia , Humanos , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/epidemiologia , Pescoço , Doenças Profissionais/epidemiologia , Fatores de Risco , Inquéritos e Questionários
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