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Biomedical subjects

B Cassou

Publications and source records attributed to B Cassou.

At least 19 recordsLinked to original sources
PubMed2002

[Nosocomial infections in geriatric facilities].

EPIDEMIOLOGY: In long term geriatric facilities, the prevalence of nosocomial infections (to the order of 10% in the surveys) is greater than that observed in short-term medical care centers. An endemia of methicillin-resistant Staphylococcus aureus, of between 24 and 57% of hospitalized patients, is noted in many geriatric facilities. In decreasing order, the infections that predominate are: urinary (1/3), lower respiratory tract (1/4) and cutaneous tissue infections (1/5). However, these are often manifested by misleading semiology, and orient towards an organ other that which is infected. TRANSMISSION AND PREVENTION: Nosocomial infections are frequently related to the general health of the patient and/or to transmission during handling. Invasive treatments are rarely the cause in geriatry. Preventive measures are identical to those used in short-term care centers (handwashing, source isolation and appropriate use of antibiotics). PROBLEMS: Encountered However, their application raises many problems. The living conditions (few facilities with single beds), the state of health of these elderly patients, often exhibiting multiple diseases and requiring assistance for their daily gestures, and the reduced number of staff at the bedside, require that these measures be adapted to each particularity.

Age Factors↗
PubMed2002

Chronic neck and shoulder pain, age, and working conditions: longitudinal results from a large random sample in France.

AIMS: To analyse the effects of age and occupational factors on both the incidence and the disappearance of chronic neck and shoulder pain after a five year follow up period. METHODS: A prospective longitudinal investigation (ESTEV) was carried out in 1990 and 1995 in seven regions of France. A random sample of male and female workers born in 1938, 1943, 1948, and 1953 was selected from the occupational physicians' files. In 1990, 21 378 subjects were interviewed (88% of those contacted), and 87% were interviewed again in 1995. Chronic neck and shoulder pain satisfying specific criteria, and psychosocial working conditions were investigated by a structured self administered questionnaire and a clinical examination. RESULTS: Prevalence (men 7.8%, women 14.8% in 1990) and incidence (men 7.3%, women 12.5% for the period 1990-95) of chronic neck and shoulder pain increased with age, and were more frequent among women than men in every birth cohort. The disappearance rate of chronic neck and shoulder pain decreased with age. Some adverse working conditions (repetitive work under time constraints, awkward work for men, repetitive work for women) contributed to the development of these disorders, independently of age. Psychosocial factors seemed to play a role in both the development and disappearance of chronic neck and shoulder pain. Data did not show specific interactions between age and working conditions. CONCLUSIONS: The aging of the workforce appears to contribute to the widespread concern about chronic neck and shoulder pain. A better understanding of work activity regulation of older workers can open up new preventive prospects.

Adult↗
PubMed2001

Nosocomial infections in geriatric long-term-care and rehabilitation facilities: exploration in the development of a risk index for epidemiological surveillance.

OBJECTIVE: To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities. DESIGN: Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly. SETTING: 248 geriatric units in 77 hospitals located in northern France. PARTICIPANTS: All hospital inpatients on the day of the survey were included. RESULTS: Data from 11,254 patients were recorded. The overall rate of infected patients was 9.9%. Urinary tract, respiratory tract, and skin were the most common infection sites in both rehabilitation facilities and LTCFs. Eleven risk indices, categorizing patients in 3 to 7 levels of increasing NI risk, ranging from 2.7% to 36.2%, were obtained. Indices offered risk adjustment according to NI rate stratification and clinical relevance of risk factors such as indwelling devices, open bedsores, swallowing disorders, sphincter incontinence, lack of mobility, immunodeficiency, or rehabilitation activity. CONCLUSION: The optimal index should be tailored to the strategy selected for NI surveillance in geriatric facilities in view of available financial and human resources.

Adult↗
PubMed1999

Social prognostic factors of mortality in a random cohort of Geneva subjects followed up for a period of 12 years.

STUDY OBJECTIVE: To analyse the relative risk (RR) of mortality related to social factors independent of health status and occupational category. SETTING: Subjects were Swiss men and women aged 40-65 years. DESIGN: A random sample of 820 people living in Geneva were followed up prospectively between 1984 and 1996. The social, occupational, and health data were gathered at subjects' homes in 1984 using a standardised questionnaire. Information about deaths and the corresponding dates were obtained from updated files of the Swiss Federal Office of Statistics (OFS). Risk of mortality was examined according to a Cox model. MAIN RESULTS: There were several social prognostic factors of mortality with relative risks greater than 3.0 (RR > 3.0) independent of health and occupational status. These factors were: a period of unemployment during life time, the feeling of not demonstrating initiative in the occupational setting, and not having participated in social activities. CONCLUSION: The results suggest that differential mortality determined by occupational status can be explained in part by factors that are characteristic of "life style", social dynamics, occupational context, and ruptures during the course of occupational life.

Adult↗
PubMed1998

Relation between locomotion impairment, functional independence in retirement, and occupational strain resulting from work carried out during working life. Study of a sample population of 350 miners in the Loire valley in France.

STUDY OBJECTIVES: To analyse long term effects of working conditions experienced at an advanced age, and after retirement by quantifying occupational strain, impairment, and disability to establish their interrelation. DESIGN: Retrospective study. PARTICIPANTS: Retired miners from The French Coal Board who had worked in the coal fields of the Loire valley. From a potential population of 507 retired miners, 350 were completely evaluated. MEASUREMENT: The study examines the occupational strain experienced by each subject, measured using both auto-evaluation and evaluation by experts and the locomotion impairment and the functional independence. MAIN RESULTS: A significant relation between the evaluation of occupational strain and functional independence and locomotion impairment of the low back was found and also a significant relation between locomotion impairment of the low back and the length of time spent working at the coal face. CONCLUSIONS: This study confirms other studies as regards the effects of occupation on health status and on the aging process, but it goes further to show the consequences of this relation on functional independence.

Activities of Daily Living↗
PubMed1998

[Control of nosocomial infections by multiresistant bacteria in geriatric services].

Geriatric wards have a higher prevalence of infection than surgical or acute medical wards, and multiresistant organisms contribute a nonnegligeable proportion of infections in elderly inpatients. The measures used to prevent nosocomial infections in geriatric wards are the same as in other types of wards. They include identifying and ensuring the technical and geographic isolation of colonized and infected patients. Health care providers should be informed of the situation, and antimicrobials used with discernment to avoid the selection of multiresistant organisms. Implementation of these measures is made difficult by architectural factors, the fact that many geriatric patients require assistance in all the activities of daily living, and the long duration of stays in geriatric wards. Additional measures are probably essential to achieve long-term control of nosocomial infections. Insufficient attention has been given to health care providers' perceptions of nosocomial infection and to defining the tasks actually performed by these providers.

Bacteria↗
PubMed1997

Risk factors of early menopause in two generations of gainfully employed French women.

OBJECTIVES: Numerous studies have been focused on the detection of factors which can act on the age of menopause. Little is known about the factors related to the occurrence of an early menopause. Some factors such as occupational work factors and generational effects have not been taken into account as yet. METHODS: We examined the risk factors of early natural menopause (before age 45) in a large random sample of gainfully employed French women born in the years 1938 (n = 1743) and 1943 (n = 1959). The subjects were selected from files of an occupational physician. A woman was considered to be post-menopausal when at least 12 consecutive months had passed without menstruation at the time of the survey. Subjects were questioned and examined during their annual visit by the occupational physician. Occupational history, working conditions, living conditions, smoking habits and reproductive history were explored. RESULTS: The prevalence of early natural menopause, before age 45, was higher in the generation of 1938 (5.3%) than in that of 1943 (3.3%) with P < 0.01. After multivariate regressions, significant relationships existed statistically between the occurrence of early natural menopause and marital status, educational level, age at first childbirth and breast-feeding of children. CONCLUSIONS: Our results show important generation effects. There was no evidence of a significant relationship between early natural menopause at 45 years of age and factors relative to heavy physical work conditions.

Adult↗
PubMed1997

[Survival after 60 years of age among elderly retired miners].

This study analyses long term effects of working conditions at an advanced age and post retirement. A longitudinal study was done among 63,000 retired miners between 60 to 65 years old. The standardised mortality ratio (SMR) in the cohort was above that expected on the basis of concurrent mortality in the reference population (SMR = 111; 95% confidence interval (CI): 108-114). The excess mortality was observed in occupational groups with exposure to underground tasks (10 years of underground tasks: RR = 2; 95% CI: .1.7-2.5), but there was sign of a healthy worker effect after 25 underground years. The effects of modern technologies and of medical progress have changed working conditions and care has reduced mortality for retired manual workers: exposure to underground tasks before 1950: RR = 1.7; CI 95%: 1.4-2.0; after 1950: RR = 1.2; CI 95%: 1.1-1.2.

Aged↗
PubMed1997

[Predictive factors of physical disability in a cohort of retired persons in Paris followed during 10 years].

OBJECTIVE: The objective of the present study was to examine predictors of physical disability in a survey of retired men and women living in the Paris area followed-up longitudinally for 10 years. METHODS: Subjects were randomly selected in a supplementary retirement pension fund. In all 627 subjects took part in the first phase of the survey (1982-83) and 392 in the follow-up phase (1992-93). At the 10-year follow-up, there were 185 confirmed deaths and 50 subjects refused to participate or could not be traced. Physical disability was measured by difficulties reported by the subjects for seven basic activities of daily life. Possible predictors, socio-demographic, impairments, physical activities, working conditions during working life were explored at T1. RESULTS: The incidence of physical disability was 41.4% for men and 57.6% for women. For disability in mobility, the incidence was 37.1% for men and 54.7% for women. In multivariate analysis, predictors of physical disability were social category (clerks), no physical activities, use of medicine, mental impairment. The predictors of disability in mobility were sex (women), social category (clerks), use of medicine, cardio-respiratory and sensory impairments. On the contrary, subjects with mental impairment had a lower incidence of disability in mobility than subjects without mental impairment. CONCLUSION: The results confirm the two poles of disability: biomedical and social. Working conditions during working life do not seem to play a direct part in incidence of disability at ten years follow-up.

Activities of Daily Living↗
PubMed1997

[Age, work and spinal pain].

BACKGROUND: To examine whether the relationship between age and musculoskeletal disorders in the spine is specific to one localization (cervical, dorsal, lumbar) or due to the accumulation of lesions with age. METHODS: Data were gathered from the ESTEV study among a randomly selected sample of 21,378 French workers, followed by 390 occupational physicians during the year 1990. The subjects, males or females, were born in 1938, 1943, 1948, 1953. Participation rate (88%) did not depend on age and sex. Data were collected during annual medical examination for medical variables, and using standardized self questionnaires for occupational exposures and work constraints for actual or past jobs. RESULTS: Data on musculo-skeletal disorders, defined as pains during the last 6 months before examination, were recorded by occupational physician. Each painful localization was associated with the main factors described in the literature, particularly heavy physical work factors and psycho-social factors of work. There was no interaction between age and any of these. At the opposite, in male as female subjects, there was a statistically significant interaction between age, multiple exposures to heavy physical work factors and the frequency of multiple localizations of pain in the spine. CONCLUSION: Results suggest that accumulation of pain in the different localizations of the spine might account for accelerated aging process of the musculo-skeletal structure of the spine which can reflect effects of environmental work factors.

Adult↗
PubMed1996

Predictors of life satisfaction amongst retired people in Paris.

BACKGROUND: The objective of the present study was to examine predictors of life satisfaction in a survey of retired men and women living in the Paris Metropolitan area. METHODS: In all 627 subjects took part in the first phase of the survey (1982-1983, T1), and 464 in the follow-up phase (1987-1988, T2) during which life satisfaction was evaluated, using the Life Satisfaction Index A (LSIA). Possible predictors were explored among the factors characterizing subjects at T1 and among those related to their occupational history. RESULTS: In the multivariate analyses, significant relationships were found between life satisfaction and the number of physical impairments and leisure activities, marital and mental health status and family relations. Taking into account the changes in these factors between the two phases of the survey increased the predictiveness of the regression models. CONCLUSIONS: These results confirm the links between life satisfaction and the factors generally recognized as its determinants. On the other hand, no effect of past occupational characteristics on life satisfaction long after retirement was shown.

Aged↗
PubMed1994

[Occupational cancers: notification, compensation and prevention].

Less than 140 occupational cancers (OC) are compensated every year in France although the incidence is estimated for at least 6,000 new cases, as estimated by the epidemiologists (4% of the mortality by cancers). This situation can be explained by different factors: few compensation claims by the patients or families, frequent lack of interest from medical doctors for relation between cancer and work, occurrence of the OC after retirement, difficulty to distinguish the role of occupational factors from individual comportmental factors in many OC (for ex. a lung cancer hitting a smoker). The consequences of such a situation are multiple: no compensation for more than 95% of patients or relatives, taking for granted that OC is a minor problem, insufficient prevention of the carcinogenic factors on the work place, prevention of cancers restricted to individual comportmental changes. Physicians working in cancerology units have to incite their patients in notifying the OC and help them in compensation claims. They have also to ask for epidemiologic and toxicologic research when clusters of OC are identified in a plant, in order to get better prevention, compensation and regulations.

Female↗
PubMed1993

Evolution of osteoarticular disorders as a function of past heavy physical work factors: longitudinal analysis of 627 retired subjects living in the Paris area.

The relations between osteoarticular disorders and occupational exposure to heavy physical work factors were studied in a random sample of retired subjects living in the Paris area, all of whom had contributed to the same retirement pension fund. 627 subjects were originally seen in 1982-3 and 464 of them were seen again five years later. On both occasions, the same questionnaire was completed during a home interview. Osteoarticular disorders were evaluated by the presence of pain, with or without restricted joint movement, for at least six months before interview. The heavy physical work factors were those reported by the subject at the first interview, and only subjects who stated that they had been exposed to these factors for more than 10 years were considered as exposed persons. For those who were seen twice, the frequency of osteoarticular pain increased during the five years between the two interviews, from 52% to 65% in the men and 72% to 82% in the women. Among both sexes, these frequencies were significantly higher in those who stated that in the past they had to carry heavy weights and work in tiring positions. The increases in frequency of pain during the five year study period were also related to these occupational factors. In general, the frequencies for subjects not exposed to occupational factors caught up with those found for the exposed group. This interaction of age with the relation between exposure to heavy physical work factors and osteoarticular disorders does not seem to be explained by confounding factors, including age at the first interview, the fact of living alone, of being a former manual worker, of having a cardiorespiratory disorder, and smoking habits. The results of the survey suggest that working conditions are an important cause of osteoarticular disorders that last well beyond the end of working life.

Aged↗
PubMed1992

Physical diability after retirement and occupational risk factors during working life: a cross sectional epidemiological study in the Paris area.

STUDY OBJECTIVE: The aim was to examine the relationship between exposure to occupational risk factors during working life and physical disability after retirement. DESIGN: The study was a cross sectional epidemiological survey of a representative sample of retired subjects belonging to a supplementary pension fund in the Paris area. SETTING: The study took place in the general community. PATIENTS: 307 men and 320 women (63.1% of those approached) answered a questionnaire during home interviews. Their average age was 69 (SD4) years at the beginning of the survey. Whether or not subjects had been exposed to occupational risks was determined from their statements concerning the presence or absence of eight harmful environmental conditions while at work. Physical disability was defined as difficulty in carrying out seven basic activities of daily life. MAIN RESULTS: The results of univariate analyses showed significant relationships between exposure during working life to occupational risks including noise, heat, dust, carrying heavy loads, and awkward postures on the one hand, and the presence of a physical disability after retirement on the other. Multivariate analysis based on logistic regression models that took account of age, sex, and health impairments revealed a specific link between exposure to carrying heavy loads and physical disability after retirement. CONCLUSIONS: These results suggest that occupational risk factors might be important in determining such disability in retired people.

Activities of Daily Living↗
PubMed1992

[Development in health status of a group of retired subjects in the Paris region according to their practice of physical activity].

The relation between physical activity and health among retired people aged 65 and over was studied in a sample of 993 subjects, men and women, living at home in the Paris area and randomly selected from a pension fund roll. In 1982-1983 (T1), 627 subjects were interviewed. Five years later (T2), 464 subjects participated in the survey. Health was measured by the number and types of impairments and disability. The incidence of cardiorespiratory impairment and the incidence of disability were weaker among subjects with physical activity in T1 than among subjects without physical activity. These findings were unchanged after adjustment for age, sex, socioeconomic status, cigarette smoking, body mass index, uncomfortable housing, living alone and hard physical conditions during working life. This result suggests the beneficial effect of physical activity in promoting health among retired people aged 65 and over.

Aged↗
PubMed1991

Relation between job mobility during working life and health state after retirement: a cross sectional study of 627 subjects living in the Paris area.

The relation between job mobility during working life and health state after retirement was studied in a random sample of 627 retired men and women living in the Paris area who were beneficiaries of an interprofessional supplementary pension fund. State of health was evaluated by the number of health impairments that these subjects reported at the time of interview. Job mobility was defined by a dichotomic variable based on the number of different companies and branches of economic activity in which the subjects had worked. This information was obtained from the individual records supplied by the pension fund. For both sexes, a significant relation was found between the number of health impairments and job mobility: for men, the mean number of impairments was 1.7 in the high mobility group and 1.3 in the low mobility group, and for women these numbers were respectively 2.1 and 1.7. This finding seemed independent of the effects of selection and of the effects of factors such as age at the time of interview, age at retirement, previous diseases, past work accidents, and previous occupational exposures. These results suggest that a high job mobility during working life might be a risk factor for health after retirement.

Aged↗