[Attempt of correlation between the data on atmospheric pollution in Bordeaux and school absenteeism of children due to broncho-respiratory causes].
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Biomedical subjects
Publications and source records attributed to J F Tessier.
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The evaluation of the medico-social consequences of asthma in adults encounters difficulties that are inherent to a chronic disease with varying clinical pictures. Overall statistical analyses, particularly concerning mortality, provide little information in a socio-economical perspective, especially in France. However, based on the results of fragmentary but varied analyses, the study of this disease in relation to the working careers of asthmatic subjects underlines the importance of the repercussions at the very start of professional life (choice of profession, recruitement in a company). The study of absenteeism and inaptitude reveals to what degree these consequences are related to the seriousness of the disease and to the asthmatic person's social sphere. The same is true for family and social life which is more difficult to evaluate. Systematic analyses alone will be useful in determining whether asthma is considered a "social disease" with its eventual implications on a public health program.
The author proposes a study of the medico-social consequences of asthma. Having shown the impossibility of a monolithic conception of asthma, he shows how much it is conditioned in the child by his social and family surroundings. Different levels of consequences are considered: restraints linked to the therapeutics of a chronic disease, effect on physical activity and leisure, importance of the repercussions on school life (absenteeism and slowness). In conclusion, the author stresses both the importance of these consequences on the personal and professional future of the child and the need to define high risk groups corresponding to criteria based on seriousness and social environment for whom the prevention of these repercussions must have priority.
The socio-professional consequences of asthma are studied in 80 patients with more or less serious asthmatic conditions. The professional repercussions are important since 27% of the asthma patients who work have had important changes in their professional life due to their disease. Work interruptions are frequent and seem to be longer than for workers who belong to the primary and secondary sectors. The family consequences are more difficult to determine, however 17 out of 80 patients think that their disease has interfered in their relationship with their spouse.
The first results of a survey involving 1950 children from 6 to 12 years old living in Bordeaux are presented here. For 280 of them, who had attacks of asthma or showed other closely related signs, a questionnaire was filled out by the parents. On this basis, the main features of the disease, as well as the ORL bronchial and allergological course, were specified for a representative epidemiological population (with a distinction between actual asthma and disappeared asthma, distribution according to sex and age of the first attack). A functional examination by flow-volume curve for 111 of the children showed, using maximal flow measurement (particularly V 50 and V 25), the existence of modifications of the bronchial paths that were not detected by classical spirometric parameters.
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