Occupational allergic contact dermatitis and major allergens in France: temporal trends for the period 2001-2010.

BACKGROUND: Occupational allergic contact dermatitis (OACD) is one of the most common occupational skin diseases in developed countries, but data about its temporal trends in incidence remain sparse. OBJECTIVES: The aim of this study is to describe OACD trends in terms of industrial activities and main causal agents in France over the period 2001-2010. MATERIALS AND METHODS: Data were collected from the French National Network of Occupational Disease Vigilance and Prevention (RNV3P, Réseau National de Vigilance et de Prévention des Pathologies Professionnelles). All OACD considered probably or certainly associated with an occupational exposure were included in the study. Trends were examined (i) on annual crude numbers of OACD and (ii) on reported odds ratios of OACD calculated using logistic regression models. RESULTS: Overall, 3738 cases of OACD were reported and the mean age of OACD cases was 35 years, 52% being women. The most frequent occupations were hairdressers, health care workers, cleaning staff and masons. The total number of OACD cases remained stable over the study period, but increases in OACD related to isothiazolinones (P = 0·002), epoxy resins (P = 0·012) and fragrances (P = 0·005) were observed. Conversely, decreases were noted for cement compounds (P = 0·002) and plant products (P = 0·031). These trends highlight specific sectors and exposures at risk of OACD. CONCLUSIONS: Trends in OACD depend on the nature of exposure. Observed decreases were consistent with prevention measures taken during the study period, and the increases observed serve to highlight those areas where preventative efforts need to be made to reduce skin allergies in the workplace.

[Is electrical stimulation with voluntary muscle contraction of physiologic interest in aging women?]. / L'électrostimulation surimposée à la contraction musculaire volontaire présente-t-elle un intérêt physiologique chez les sujets âgés?

OBJECTIVE: To analyze the physiological effects of electrical stimulation with voluntary muscle contraction exercise in postmenopausal women. MATERIALS AND METHODS: Thirty-two females aged 62 to 75 years were randomly assigned to three groups to perform four activity sessions for six weeks: group ME (N =11) climbed up and down stairs, group ES (N =11) practised electrostimulation, and group ME + ES (N = 10) undertook both activities. Physiological adaptations of body composition (lean and fat masses and bone mineral density), muscular strength (isometric and dynamic), vertical jump and posturokinetic activities (balance and gait) were analysed. RESULTS: For the three groups, the isometric strength at angle 100 degrees (average increase right and left legs, ME: 19 N.m; ES: 4.5 N.m; ME + ES: 11.5 N.m), the dynamic strength at speed 60 degrees.s(-1) (average increase right and left leg, ME: 15 N.m; ES: 14 N.m; ME+ES: 18.5 N.m) and the vertical jump (ME: 23 mm; ES: 16 mm; ME + ES: 34 mm) increased contrary in the body composition and posturokinetic activities. Nevertheless, the group ME + ES adapted differently on some parameters of bone mineral density (P < 0.05) and dynamic strength (P < 0.01) in relation to the groups ES and ME. CONCLUSION: Electrostimulation with voluntary muscle contraction exercise could induce different physiologic adaptations compared with electrostimulation or voluntary muscle contraction exercise alone.

[Development of the occupational carcinogen legislation in the European Community]. / Evolution de la législation sur les carcinogènes d'origine professionnelle dans l'Union européenne.

The aim of this study is to sum up the development of European Community legislation concerning occupational carcinogens. In terms of prevention, 4 periods were studied. From 1951 to 1972, only a few texts of law were promulgated. From 1972 to 1984, after the ratification of the convention 139 of the International Labour Office, more texts were promulgated. Then, from 1985 to 1992, the protection against occupational carcinogens increased for workers, especially after the specific european directive edicted in 1990. Since 1992, most of the countries in the European Union have included this directive in their legislation. In terms of compensation for occupational cancer, a recommendation of the European Commission stated in 1962 had already proposed a list of compensable diseases. Because of the diversity of compensation means, it is difficult for the European Community to impose a common status.

[Cardiovascular risk factors and shift work in men living in Haute-Garonne, France]. / Facteurs de risque cardiovasculaire et travail posté chez l'homme en Haute-Garonne.

OBJECTIVE: The goal of this study was to examine the relationship between shift work and cardiovascular risk factors in a cross sectional survey. MATERIAL AND METHODS: 2 610 men of the PRIME study, aged 50-60 years, residing in Haute-Garonne (France) and selected from health centers and various firms were screened. White-collar workers, retired and disabled men at the time of the study were excluded so the analysis was performed on a sample of 1,341 subjects. Work was categorized as day work (n = 1,161) and three types of shift work: 2 x 8 (n = 108), 3 x 8 (n = 41) and night (n = 31). A comparison of cardiovascular risk factors was performed in the different types of work. RESULTS: Univariate analysis showed that systolic blood pressure was significantly higher among 2 x 8 workers (132.7 +/- 17.4 mmHg) than in other shift workers and day workers (126.9 +/- 15.1 mmHg). The same difference was observed for diastolic blood pressure. Plasma triglycerides were significantly higher among night workers (1.60 +/- 0.76 g/l) than among day workers (1.29 +/- 0.81 g/L). Logistic regression analysis showed that the risk of hypertension, defined as systolic (> or = 140 mmHg) and diastolic (> or = 90 mmHg) blood pressure and/or antihypertensive drug, was 2 times higher among 2 x 8 shift workers (OR: 2.14, 95% CI [1.42-3.23]) than among day workers after adjustment for BMI, alcohol and tobacco consumption and plasma triglyceride levels. The same result (OR: 1.99, 95% CI [1.28-3.12] was obtained with a different definition of hypertension (systolic > or = 160 mmHg and/or diastolic > or = 95 mmHg blood pressure and/or antihypertensive drug). Among night workers the risk of triglycerides > 2 g/L was higher (OR: 2.52, 95% CI [1.06-6.01] than among day workers. The risk of both hypertension (140/90 mmHg) and hypertriglyceridemia in comparison to day workers was (OR: 2.01, 95% CI [1.33-3.03]) and (OR: 2.44, 95% CI [1.14-5.21]) for 2 x 8 shift workers and night shift workers respectively. CONCLUSION: The results of this study, putting into evidence a relationship between shift work, hypertension and high level of triglycerides, justify a careful screening by occupational physicians of cardiovascular risk factors among shift workers.

Job stress and occupational status in a French cohort.

BACKGROUND: The goal of this study was to examine a large, varied occupational French cohort for possible relationships between various dimensions of occupational stress, on the one hand, and the occupational status and socio-demographic characteristics of workers on the other. METHODS: Data was taken from the first, cross-sectional phase of the VISAT study (aging, health, and work), which took place in 1996. Participants were randomly drawn from the patient lists of about one hundred occupational physicians in three regions of southern France. The current study concerned 2,768 wage earners born in 1944, 1954, or 1964. The material consisted of 59 questions aimed at assessing a broad set of working conditions, some of which were proxy measures of the dimensions described in the Karasek and Siegrist models. RESULTS: From a principal component analysis, three main factors were extracted that accounted for 40% of the total variance. The first factor (a=0.79) included items that referred to the decision latitude in the Karasek model and items that referred to the reward dimension in the Siegrist model. The second factor (a=0.77) was made up of items tapping physical stressors, while the third factor (a=0.71) pooled items that corresponded fairly well to psychological demands in the Karasek model. Highly significant relationships (p<10(-4)) were found between the mean factor scores and both occupational status and educational level, with a lower occupational status and educational level being associated with greater lack of job control and rewards, higher physical stress, but lower psychological demands. Less job control and fewer rewards were also found to be greater in older workers (p<10(-3)) and females (p<10(-4)). CONCLUSION: Our results thus confirm the existence of a strong association, in a French cohort, between occupational status and dimensions of job stress known to be associated with adverse health outcomes.

Neuromuscular effects of three training methods in ageing women.

AIM: The present study aimed to compare the effects of 3 strength development methods on muscular mass and muscular strength in healthy ageing women. METHODS: Thirty-two healthy women, 62 to 75 years old were randomised into 3 groups. The 3 groups performed 4 sessions a week of strength development for 6 weeks. The 1(st) group (SC) climbed up and down 300 stairs per session. The 2(nd) group (ES) followed an electrostimulation programme on the quadriceps muscles. The 3(rd) group (SC+ES) combined stair climbing with electrostimulation. Before and after the 3 programmes, the muscular mass of the leg was assessed using a biphotonic absorptiometry machine. Isometric (angle 20 degrees and 100 degrees ) and isokinetic (60 degrees /s and 240 degrees /s) knee extension torque was measured using an isokinetic dynamometer. RESULTS: None of the programmes changed the muscular mass. All 3 groups increased isometric (angle 20 degrees, p<0.001; angle 100 degrees, p<0.003) and isokinetic (60 degrees /s, p<0.0001; 240 degrees /s, p<0.0001) knee extension torque. None of the programmes appeared more efficient than the others for muscular mass or muscular strength. CONCLUSION: Six weeks of activity (SC, ES or SC+ES) improved the isometric and dynamic muscular strength in ageing healthy women. However, this period was too short to change the muscular mass. None of the activities presented a real advantage over the others in ageing women.

[Anaphylactoid shock due to metabisulfites during cesarean section under peridural anesthesia]. / Choc anaphylactoïde aux métabisulfites au cours d'une césarienne sous anesthésie péridurale.

Sulfiting agents are antioxidants widely used in both food and pharmaceutical industries. They have been identified as responsible for adverse severe reactions. A case is reported of anaphylactoid shock during epidural anaesthesia for caesarean section. The responsible agent was metabisulfite, additive agent of local anesthetics containing epinephrine.

[An unusual foreign body in the esophagus]. / Observation d'un corps étranger inhabituel de l'oesophage.

This is a case of oesophageal penetration by dental prosthesis probably brought on by alcoholism. No other classical complication occurred for three weeks. It was increasing dysphagia that led the patient to hospital. Endoscopy revealed an unfamiliar object and its nature, but did not enable it to be extracted. The object was taken out afterwards by cervicotomy.

Symptoms and serum precipitins in workers exposed to dry sausage mould: consequences of exposure to sausage mould.

OBJECTIVE: Hypersensitivity pneumonitis due to dry sausage mould has been reported in workers who brush off the excess mould which coats dry sausage. Prevalence of symptoms and sensitization to mould among these pork-butchery workers is unknown. The aim of the study was to assess the clinical, radiographic, functional, and immunological features in exposed and non-exposed workers in semi-industrial pork butcheries. PATIENTS AND METHODS: Symptoms, and serum precipitins against mould extracts, were studied in workers in semi-industrial pork butcheries. Of 600 workers asked to participate, 123 (20.5%) were included. Fifty-nine workers, exposed to dry (raw) sausage mould and Penicillium nalgiovense were compared with 64 non-exposed subjects, for symptoms, chest X-rays, spirometry and CO-transfer measurements. Precipitating antibodies were detected by immunoelectrophoresis and electrosyneresis. RESULTS: Sneezing, cough, dyspnoea, nasal obstruction, headache, and discomfort were significantly more frequent in the exposed group at work and after work than in the control group (P < 0.05). The prevalence of precipitating antibodies for sausage mould was higher in the exposed group (37%) than in the non-exposed group (9%) (P < 0.01). The mean number of precipitating lines measured by electrosyneresis was higher in exposed workers than in non-exposed workers for mould extract (1.09 vs 0.28, P < 0.05) and for Penicillium nalgiovense (1.77 vs 0.33, P < 0.05). No specific X-ray opacity or lung function impairment was found in either group. CONCLUSIONS: Clinical symptoms and sensitization to Penicillium nalgiovense are frequent among workers exposed to mould during brushing in dry sausage plants.

High-resolution computed tomography abnormalities in ex-insulators annually exposed to asbestos dust.

BACKGROUND: characterize To the effects of high asbestos exposure during annual periods of insulation. METHOD: 170 ex-workers underwent clinical examination, spirometry, standard chest X-rays and high-resolution computed tomography (HRCT). Asbestos exposure was retrospectively assessed for latency, duration, and intensity. RESULTS: Sixty-six percent of these workers were annually exposed to high concentrations of asbestos dust. Respiratory symptoms were mild. One hundred and nineteen subjects had pleural or pulmonary changes on HRCT, compatible with asbestos exposure. Localized pleural thickening was found in 113 subjects (66.5%); pulmonary nodules or lines in 35 (20.6%). The presence of pleural plaques was linked to intensity of asbestos exposure (P <.01), and length of employment (P <.05). Parenchymal lesions were related to intensity (P <.05) and duration of exposure (P <.05). Lung function of subjects with X-ray changes was not significantly altered. CONCLUSIONS: Annual asbestos exposure led to a high prevalence of pleural plaques and to mild parenchymal anomalies.

Distinct signal transduction pathways for activation of rabbit alveolar macrophages in vitro by cotton bract tannin.

These experiments were designed to study signal transduction pathways in alveolar macrophages stimulated by condensed tannin or zymosan. Condensed tannins, present in cotton mill dust, alter the host-defense function of alveolar macrophages and may contribute to the pathogenesis of byssinosis. We tried to determine the early steps in signal transduction mechanisms of cell activation by tannin. With the quantification of 51Cr release, we determined that tannin was cytotoxic for the cells after 30 min activation with 130 micrograms for 2 x 10(6) cells. 51Cr release was similar for control cells and zymosan- or 30 micrograms tannin-activated cells. Using the luciferine luciferase reaction, we showed that tannin markedly depleted ATP cell content. In inositol-labeled cells, tannin increased inositolphosphate release in a dose-dependent manner. In lysoPAF-labeled cells, tannin induced synthesis of phosphatidic acid and diglycerides. In the presence of ethanol, the level of tannin-induced phosphatidic acid was slightly reduced, and phosphatidylethanol was synthesized. No phosphatidylethanol was found in alveolar macrophages stimulated by zymosan in the presence of ethanol. GF 109203X, a specific inhibitor of protein kinase C decreased only tannin-induced phosphatidylethanol synthesis. In conclusion, tannin (at 30 or 130 micrograms/ml) activated an inositol phospholipase C in alveolar membranes. Phosphatidylcholine phospholipases C and D were found only at the higher concentration of tannin.