["One can not call it progress". Interview by Francoise Taillens].
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Biomedical subjects
Publications and source records attributed to D Ramaciotti.
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Processes linking individual situations and behaviours, as disclosed by the ergonomic analysis of job, to populations' epidemiological characteristics are discussed here. Epidemiology proposes deterministic models of general significance, reflecting stable phenomenons within wide populations. Ergonomics proposes cybernetic (or systemic) models of time- and space-limited significance, reflecting the variety of adapting and assimilating behaviours in homogeneous groups of workers. Regarding prevention, both approaches complement one another.
In Switzerland, employers and employees are requested to settle together the amount of risk and priorities for each industrial activity, for the needs of a federal commission in charge of occupational health specialists. After our results, this aim will be difficult to achieve, since the feelings of employers and employees on similar safety problems vary widely. In particular, chemical risks did not evoke similar reactions in employers and employees of the French and of the German-speaking regions. In order to help employers and employees to reach a consensus, a method will be developed in a near future.
In this paper, observations are presented to show the role played by the ergonomic analysis of working procedures, when detecting, measuring and preventing chemical hazards. At first, unsuspected hazards can be detected, when watching real operative practices. Secondly, the knowledge of each activity may question the validity of general standards. Finally, with ergonomic analysis, prevention can be designed to fit the worker's well-being, without impairing the productive process.
The methodology and first results of a research on night-work management, carried out by the PNR 15, are presented. We show that the effects of night-work and the way it is experienced by the workers, varies from one person to another, and mainly depend on the type of activity concerned and on work conditions. With the aim of prevention, we try to define risk-populations.
An ergonomic research performed in 16 plants of various activities shows that 47.2% of the workers are complaining on noise. We prove that the annoyance is not only related to the exposure level in db(A), but also to task performance and essentially mental load.
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Some results on occupational health are presented, based on a questionnaire named "Integration of occupational health in the Swiss sanitary system", which was mailed to every industrial societies employing more than 100 persons and unions in Switzerland. The results show differences between societies and unions as well as between the two main linguistic areas and that the largest societies are more in favour of the expansion of occupational health than the smallest.
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Sound levels measured during 6 music-exhibitions are situated, for the equivalent level (Leq), between 92 and 105 dB(A), and peaks of 120 dB(A) have been measured. Audiograms recorded before and after the exhibitions show a great auditive fatigue. Musicians and usual spectators present in comparison with nonexposed subjects of the same age a lightly impaired sensibility of hearing.
A randomized sample of 1392 girls and boys, 16 to 20 years old and living in the canton of Geneva have been studied through their own history, clinically and radiologically in 1970-72 during an epidemiological and socio-economical study. The rate of alveolar bone resorption (radiographic method of Marshall-Day and Shourie, with Schei grid), the degree of gingival inflammation (PM index), the oral health (OHI-S index) and the carious frequency (DMFS index) have been determined. For the same sample, an indication of the duration of caries prevention through fluoride tablets, the frequency of daily toothbrushing and the dento-facial anomalies (Angle classes) were known. Through statistical analysis, it was shown that the mean rate of alveolar resorption was 0.85 (standard deviation 1,99) for the whole sample, that 24,16% of the subjects had a zero rate, 90% of the children having a rate of no more than 3,74 and that the maximum observed rate was 20. On the other hand, this bone resorption rate was statistically significantly correlated with the PM index and the OHI-S index. However no significant correlation has been shown between alveolar resorption and the other oral characteristics such as carious attack, toothbrushing, duration of caries prevention, dento-facial anomalies.
In this paper, the design and testing of the control of a new visual screener are described. The equipment is composed of a push-pull lever, an electronic digitalizer and a display on which Landolt rings are presented. The problem to be solved was to check whether the eight directions in which the lever could be oriented were equally reliable. For this purpose, 24 untrained subjects were required to respond to 108 by-chance oriented optotypes. This experiment demonstrated that the device was reliable in this respect that it produced very few errors; however, fiability was unequally distributed over the eight orientations. Suggestions for improvement were made.
In 1970/72, a random sample of 1392 adolescents of the population irrespective of nationality and sex has been drawn, using computer equipment, from the Geneva (Switzerland) resident population, ages 16 to 20 years. The sampling fraction was 13%. These adolescents were interviewed for case history, and then underwent clinical, radiological and photographic examination by a medically trained team including a dentist and a dental hygienist. The sampling had been designed so as to avoid selection regarding the adolescents' sex and occupation (student/apprentice/young labourer) or the parents' socio-professional category. Comprehensive epidemiological data concerning the main dental and periodontal diseases are thus recorded to allow estimation of the individual cost for a complete functional restoration of the dentition and the periodontium (orthodontic treatments not included). The estimating arithmetic is performed on the computer by means of an original program worked out especially for cost estimation referring to an approved list of fees for medico-dental treatments. The first part of the article, as published below, reports the relative frequency distributions of estimated cost depending on age, sex and occupation separately as well as jointly. Moreover, these distributions are summarized by their basic descriptive statistics (medians, quartiles, ranges, extreme values, etc.). At first sight, it seems that by and large the median cost is higher for boys than for girls, and that there is evidence for an increasing trend with respect to age; young labourers rank somehow between students and apprentices. The data seem to exhibit a decreasing trend of median cost as regards ascending socio-professional category. Besides this trend is maintained when duration of caries prophylaxy by means of fluorine tablets intake is accounted for. Average number of daily tooth brushings also positively correlates with median cost, whereas the latter does not seem to depend very closely on time elapsed since the latest appointment with the adolescent's dentist. In another connection, the present paper indicates the overall cost (as well as cost for certain treatment subgroups) estimated for the sample on the one hand, for the whole population on the other hand.
Using a 10,000 square meter partition of the Geneva area, a computer mapping was developped for the geographical distribution of variables such as population density or pollutants emissions. An example is given in which the method is applied to epidemiological date (age and respiratory performance of a population sample).
The costs for a complet functional restoration of the dentition and the parodontium (orthodontics not included) in a sample of 1392 adolescents aged 16-20 (Geneva, 1970-1972) have been estimated on the basis of an approved scale of fees (1). These costs are analyzed with respect to age, sex, occupation and socio-professional status of the parents.
Discriminant analysis and its corresponding classification procedures are illustrated by means of two practical applications pertaining to a dental health survey. The discriminating variables refer to dental caries, oral hygiene, periodontal diseases and fracture of anterior teeth. Their relative discriminating power is discussed.
The prevalence of chronic bronchitis (according to the BMRC questionnaire on respiratory symptoms) for 1182 male smokers, as well as their peak flow rate, are related to age (18-65 years), cagarette consumption (1-55 cig./day) and exposure to atmospheric SO2 pollution (20-65 microgram/m3).