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Biomedical subjects

D Brille

Publications and source records attributed to D Brille.

At least 19 recordsLinked to original sources

Occupational exposure and 12-year spirometric changes among Paris area workers.

A follow-up study over 12 years was conducted among 556 men aged 30 to 54 in 1960 and working at that time in factories around Paris (France). Various occupational exposures were recorded at the time of the 1960 survey after a technical study of each workplace. The annual rate of decline of FEV1 during 12 years was estimated for each subject from the measurements in 1960 and 1972. This rate (the FEV1 slope) was related independently of FEV1 level (which reflects the loss since the beginning of adult life) and of smoking habits to occupational exposure to dust, gases, and heat. FEV1 slope was significantly related to inhalation of mineral dust (even in the absence of silica) as well as to grain dust, and the slope was steeper with increased intensity of exposure to dust. Analysis of job changes showed that among heavily exposed subjects, those who changed jobs had a less steep slope than those who did not. Our results support the hypothesis of a causal role of exposure to dust in the development of chronic airflow obstruction and of a benefit when exposure to dust ceases. Exposure to dust, gas, and heat usually occurred together so data on gas and heat were analysed after taking account of exposure to dust. The influence of heat on FEV1 decline showed a clear trend. Results suggest that exposure to gases associated with exposure to dust or heat or both had a deleterious effect. After adjusting for age, smoking, and FEV1 level (ASLA) the following average slopes were obtained: 44 ml/a (for exposure to none or to only a slight amount of dust, or to gases alone), 51 ml/a (heat), 53 ml/a (noticeable dust), 55 ml/a (noticeable dust and heat), 60 ml/a (noticeable dust, heat, and high concentration of gases). Independently of the occupational exposures, ASLA FEV1 slopes among manual workers were related to skill, being 44 ml/a for skilled and 51 ml/a for unskilled men. Independently of social class and occupational exposures recorded, there were differences in FEV1 slopes by factory, suggesting that one should not rely on using one factory as the control of studies of occupational exposure to another.

Chemical Industry↗

Bronchial hypersecretion, chronic airflow limitation, and peptic ulcer.

Men with and men without a history of peptic ulcers were compared using respiratory symptoms and spirographic measurements taken from data recorded in an epidemiologic study. Among the 1,049 men examined, 7% reported a history of peptic ulcer. A clear relationship appeared between bronchial hypersecretion and peptic ulcers. It persisted after adjustment for age, smoking habits, social class, and country of origin. Men with ulcers inhaled tobacco smoke more often. Ulcers, smoking, and chronic phlegm were independently related to a lower body build index. It seems that the relationship between smoking and ulcers was greater among men with chronic phlegm, and it is postulated that peptic ulcers and "chronic bronchitis" might be related to a "common secretory disorder." After adjustment for age, men with a history of peptic ulcers had, not a lower FEV1, but a higher vital capacity. A slightly lower FEV1/VC ratio cannot in such cases be considered as an index of chronic airflow limitation.

Adult↗

Twelve years spirometric changes among Paris area workers.

The effects of smoking habits, socio-occupational factors and respiratory symptoms in the development of airflow obstruction have been studied in a working population of 575 men aged 30-54 in 1960 and surveyed in 1960 and 1972. On average, FEV1 decreased by 47 ml/annum. Apart from FEV1 level, which reflects loss since the beginning of adult life, three factors were independently related to FEV1 slope: tobacco consumption, occupational exposure and social class. The decrease of FEV1 with smoking was dose related and decelerated among those who stopped smoking. This follow-up study ruled against phlegm as a causal factor of early stage airflow obstruction, although its role is not excluded at later stages.

Adult↗

[Chronic obstructive bronchitis: definitions, risk factors and prevention (author's transl)].

Chronic obstructive bronchitis is defined as persistent diffuse airways obstruction frequently associated with chronic expectoration. This disease is particularly disabling and its medico-social burden implies that measures be taken. Risk factors of chronic obstructive bronchitis can be classified according to their presently known importance: tobacco, professional exposure, air pollution, viral and bacterial respiratory infections, poor socio-economic and cultural conditions, upper and lower airways infections during childhood, other environmental factors, genetic factors. Prevention needs that research be developed, in particular for factors, as hereditary ones, relations between childhood and adult respiratory diseases and characteristics of the "susceptible smokers". Knowledge of risk factors previously quoted allows to propose public-health actions. Firstly, true preventive action of general nature: fight against tobacco consumption, reduce atmospheric pollution, improve work and life conditions. Secondly, in order to prevent the disabling state of chronic bronchitis, it would be necessary to take care of patients at the initial state. A control trial is proposed to determine the level of symptoms and of reduction of ventilatory values at which an action is needed and the best "preventive therapeutical" protocol to be applied to these patients.

Air Pollution↗

[A method for studying social security records in epidemiology. Use in a study on the prognosis of chronic bronchitis (author's transl)].

A method is presented to study, in an epidemiological research, the social security records. This study is based upon records of workers affiliated to the french social security general system. To obtain data which may be compared, it was necessary to take the legislation as a basis; this legislation gives the data which must be in the records. A study of laws and rules has been done to find out these data in the medical record and in the administrative one. A questionnaire is presented. This basic questionnaire should be modified according to the precise objectives of each study and to the characteristics of the population sample. To illustrate this method, some results of a study of chronic bronchitis risk factors are presented in the second part. These results concern 950 men, born in France, aged 30 to 59 in 1960 an still alive in 1972. The study of the long reductions of the ability to work, happened from 1960 to 1971, confirm the disabling character of the group "chronic bronchitis, asthma, emphysema, respiratory insufficiency" which follows immediately cardiovascular and rheumatic diseases. The total number of beneficiaries of the social security is already very important and the whole population will be soon concerned. The use of the social security records as data source could give very interesting informations about morbidity. So, it is possible to study representative samples of the general population or of some particular groups, which has up to now, been done only in a slight extent.

Adult↗