The spectrosome of occupational health problems.

Given the increased prevalence of cancer, respiratory diseases, and reproductive disorders, for which multifactorial origins are strongly suspected, the impact of the environment on the population represents a substantial public health challenge. Surveillance systems have become an essential public health decision-making tool. Networks have been constructed to facilitate the development of analyses of the multifactorial aspects of the relationships between occupational contexts and health.

Ranking occupational contexts associated with risk of non-Hodgkin lymphoma.

Background: Risk factors associated with non-Hodgkin lymphoma (NHL) remain unknown, but certain occupational contexts (OCs) have been implicated. The objective of this study was to inventory, from the accumulated knowledge, associations between OCs and NHL risk.

Methods: Literature was used to identify the NHL-associated OCs.

Role of the work-unit environment in the development of new shoulder pain among hospital workers: a longitudinal analysis.

Objective: This study aimed to test longitudinal associations linking the work-unit-level psychosocial and organizational work environment and biomechanical constraints to workers' shoulder pain in the French multi-centre cohort ORSOSA study of registered nurses (RN) and nursing assistants (NA).

Methods: We analyzed 1896 female RN and NA, who were free of shoulder pain in 2006 and in the same position and work unit in 2008. Incident shoulder pain (SP) was defined as self-reported pain that persists for ≥ 4 days and/or increases during a lateral movement of the arm away from the midline of the body (abduction).

Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

Background: Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress.

[Improvement of hospital working conditions: ORSOSA, from research to preventive actions].

The health of hospital workers, nurses and nurse-aids constitutes a public health challenge for three reasons: maintenance of personnel at work in a context in which many express their desire to quit their jobs, protection of their health, and maintenance of quality of care. ORSOSA (ORganisation des SOins et SAnté des soignants) is a multidisciplinary interventional population health research programme designed to improve quality of life in the workplace of healthcare workers. This programme is designed to develop a tool to diagnose psychosocial and organisational work factors (POWFs) and mechanical constraints (MC), and then to implement this method in primary prevention interventions.

The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study.

Objectives: This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals.

Methods: We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008.

Application of pharmacovigilance methods in occupational health surveillance: comparison of seven disproportionality metrics.

Objectives: The French National Occupational Diseases Surveillance and Prevention Network (RNV3P) is a French network of occupational disease specialists, which collects, in standardised coded reports, all cases where a physician of any specialty, referred a patient to a university occupational disease centre, to establish the relation between the disease observed and occupational exposures, independently of statutory considerations related to compensation. The objective is to compare the relevance of disproportionality measures, widely used in pharmacovigilance, for the detection of potentially new disease × exposure associations in RNV3P database (by analogy with the detection of potentially new health event × drug associations in the spontaneous reporting databases from pharmacovigilance).

Methods: 2001-2009 data from RNV3P are used (81,132 observations leading to 11,627 disease × exposure associations).

[Assessing the impact of psychological and organizational constraints on caregivers].

Through a national cohort of more than 4000 nurses and nursing assistants in 14 university hospital centres, a study has developed a tool to assess the health of nursing staff within nursing units. This tool enables the general health condition of caregivers, as well as their working conditions, to be gauged. On this basis, preventative measures in terms of work organisation can be drawn up.

Blood pressure and working conditions in hospital nurses and nursing assistants. The ORSOSA study.

Background: Healthcare workers often are unsatisfied with their working conditions despite declaring to like their jobs. Psychosocial constraints in the workplace have increased recently due to changes in work organization. These psychosocial constraints are linked to cardiovascular diseases.

Occupational exposome: a network-based approach for characterizing Occupational Health Problems.

Surveillance of work-related diseases and associated exposures is a major issue of public health, in particular for identifying and preventing new threats for health. In the occupational health context, the French national occupational disease surveillance and prevention network (RNV3P) have constructed a growing database that records every year all Occupational Health Problems (OHPs) diagnosed by a network of physician specialists. The network aims to provide and develop an expertise on the disease-exposure relationships, and uses the RNV3P database for developing the surveillance of OHPs and for the detection of emerging associations between diseases and occupational exposures.

Validation of an instrument for measuring psychosocial and organisational work constraints detrimental to health among hospital workers: the NWI-EO questionnaire.

Background: Quality of care, job satisfaction and the health of registered nurses (RNs) are associated with their exposure to psychosocial and organisational work factors (POWFs).

Objectives: To develop and validate an extended version of the Revised Nursing Work Index (NWI-R), the NWI-EO (Extended Organisation) tool specifically designed for occupational physicians and those involved in prevention programmes in healthcare institutions to assess the perception of POWFs, and then to determine priorities for preventive action to improve work organisation at the hospital staff level.

Methods: The tool was validated in the ORSOSA study, a multicentre French cohort of RNs and NAs (n=4085) recruited in 214 work units of 7 French university hospitals.

Linking hospital workers' organisational work environment to depressive symptoms: A mediating effect of effort-reward imbalance? The ORSOSA study.

Few studies have analysed the association between the organisational work environment and depression in hospital workers and we still have little understanding of how processes in the practice environment are related to depressive disorders. However, individual perception of an imbalance between efforts made and expected rewards has been associated with incident depression. The main goal of this study was to test the hypothesis that some organisational constraints at the work-unit level may be related to depressive symptoms in hospital workers, either directly or through individual perceptions of effort-reward imbalance (ERI).

Programmed health surveillance and detection of emerging diseases in occupational health: contribution of the French national occupational disease surveillance and prevention network (RNV3P).

Objective: The French national occupational disease surveillance and prevention network (RNV3P) includes the 30 occupational disease consultation centres in university hospitals to which patients are referred for potentially work-related diseases, and an occupational health service. The aim of this work is to demonstrate the contribution of RNV3P to national health surveillance.

Methods: Data from consultations are recorded in standardised occupational health reports and coded using international or national classifications.

[The National Occupational illness surveillance and Prevention Network (RNV3P) and health monitoring].

The National Occupational Illness Surveillance and Prevention Network (RNV3P) established in 2002 as a network of experts from 29 university hospitals as well as occupational physicians records and monitors occupational health problems (OHPs) based on Soccupational health consultations in university hospitals in mainland France and in occupational medical health services (approximately 5000 OHPs/year for patients seen in hospital consultations). The OHP data are collected systematically according to a standardised code which is attributed based on main variables of interest: disease and co-morbidity (CIM-10), 1-5 impact codes (INRS), an occupational code (ILO) and a code for the type and domain of professional activity (NAF-93). For certain problems recorded, the clinician also reports a degree of imputance for attributing the level of certainty for the problem's relationship to the S main illness (weak, probable, strong).

Reliability, validity, and health issues arising from questionnaires used to measure Psychosocial and Organizational Work Factors (POWFs) among hospital nurses: a critical review.

This systematic review assesses the validity of epidemiological questionnaires used to measure psychosocial and organizational work factors (POWFs) in nurses. Of the 632 articles published between 1980 and July 2008 identified in this review, 108 provide some data concerning analysis of the intrinsic characteristics of such instruments (content validity or conceptual basis, reliability, validation of internal construction) and their external validity with respect to health aspects (concurrent validity and predictive validity). Psychometric properties of generalist questionnaires validated among blue collar or white collar workers were also assessed in the nurse population.

Detection of emerging diseases in occupational health: usefulness and limitations of the application of pharmacosurveillance methods to the database of the French National Occupational Disease Surveillance and Prevention network (RNV3P).

Objective: To test data mining methods used in pharmacosurveillance in order to identify potential emerging disease-nuisance associations in the national occupational disease surveillance and prevention network (RNV3P) database.

Methods: Proportional reporting ratios (PRR) used in pharmacosurveillance were applied to detect disproportional reporting of disease-nuisance associations which are not compensated by the national social security system.

Results: The 24 785 reports of the RNV3P were grouped into 1344 different disease-nuisance associations reported more than twice, of which 422 did not give entitlement to compensation by the social security system.

Sino-nasal cancer and exposure to leather dust.

Background: In 1987, the International Agency for Research into Cancer classified shoemaking and cobbling as a definite human carcinogen. However, there are 10 times fewer articles published on Medline compared to wood dust which also induces sino-nasal cancer.

Aim: To improve the medical, technical and social management of this type of cancer in the shoe trades.

Impact of urban atmospheric pollution on coronary disease.

Recent epidemiological findings have suggested that urban atmospheric pollution may have adverse effects on the cardiovascular system as well as on the respiratory system. We carried out an exhaustive search of published studies investigating links between coronary heart disease and urban atmospheric pollution. The review was conducted on cited articles published between 1994 and 2005 and whose main objective was to measure the risk of ischaemic heart diseases related to urban pollution.

Prevalence and therapeutic control of hypertension in French Caribbean regions.

Objective: To describe characteristics of hypertension in French Caribbean regions.

Design: A cross-sectional worksite study.

Setting And Participants: A random sample of 6136 workers referred for annual check-up from Martinique, French Guyana and Guadeloupe.

Systemic sclerosis and occupational risk factors: role of solvents and cleaning products.

Objective: To analyze occupational and non-occupational exposure factors suspected of being associated with scleroderma (SSc), with a view to inculpating or excluding certain potentially toxic substances (e.g., solvents), thereby contributing to the recognition of such toxins in the field of occupational health.

Incidence and prevalence of methicillin-resistant Staphylococcus aureus nasal carriage among healthcare workers in geriatric departments: relevance to preventive measures.

Methicillin-resistant Staphylococcs aureus (MRSA) nasal carriage was assessed among healthcare workers caring for elderly patients in contact precautions in geriatric departments. Monthly incidence ranged from 0% to 3.3%.

Increased incidence of haematological cancer among physicians in a University Hospital.

Objectives: The oral report of eight cases of cancer over a period of 3 years among physicians working in a French University Hospital led us to conduct a retrospective cohort study to compare the incidence of cancer in these physicians with that of the general population living in the same area.

Method: The cohort consisted of 940 physicians (72% male, 28% female) who had worked for at least 1 year in this hospital between 1945 and 1994 (a total of 10,693 person-years). The incidence of cancer among physicians was compared with that of the general population using a local cancer registry which has recorded all cancer cases occurring in the Department between 1979 and 1994.

Exposure to carcinogenic air pollutants among policemen working close to traffic in an urban area.

Objective: This study evaluates individual airborne exposure to gaseous and particulate carcinogenic pollutants in a group of policemen working close to traffic in the center of Grenoble, France.

Methods: Sixty-two personal active air samples were collected during the workshifts of eight policemen in summer and in winter during the occurrence of the thermal inversion phenomenon. Seventeen stationary air samples were monitored in the policemen's work area during the same period with the same sampling devices as used for the personal samples.

Clinical evaluation of a self blood pressure monitor according to the First International Consensus Conference on Self Blood Pressure Measurement.

Background: The Calor TensioSense Bras automatic blood pressure monitor has obtained European Union certification, but the clinical validity of this new oscillometric device when handled by lay subjects has yet to be evaluated.

Design: The design employed prospective and blinded blood pressure measurements and a validation procedure according to the criteria set out by the First International Consensus Conference on Self Blood Pressure Measurement (1999).

Methods: Thirty-three subjects were recruited, 11 in each of three strata of systolic blood pressure (<130, 130-160 and >160 mmHg).

Socioeconomic inequalities in hypertension prevalence and care: the IHPAF Study.

To analyze the health disparities relative to the prevalence of arterial hypertension and its therapeutic control in the active French population, in relation to occupational categories (OC), a population of 17 359 men and 12 267 women was assessed from January 1997 to April 1998. The initial phase was a cross-sectional analysis of a cohort study designed to assess the incidence of arterial hypertension in a French working population. Information was collected by the worksite physician during the annual examination.