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Biomedical subjects

P Frimat

Publications and source records attributed to P Frimat.

16 recordsLinked to original sources
PubMed2006

Prospective evaluation of the impact of organizational change on perceived stress and health in assembly-line workers in an automobile plant.

BACKGROUND: Although the competitive climate of the automobile industry is modifying the organization of work in French plants, the health consequences of these changes have not been investigated. The objective of this study was to determine the health impact on employees of an automobile manufacturing plant in northern France of a change to a "Total Quality Management" type of organization. METHODS: This before-and-after study concerned 80 factory employees. The health impact of their work was measured before the change and then 4 and 12 months after the reorganization began, with a French version of the Job Content Questionnaire, which assesses stress at work, a self-rated health scale, and the rate of infirmary visits. Paired comparisons were used to assess before-and-after changes. RESULTS: Scores for psychological and physical demands increased significantly at 4 and 12 months after the organizational changes began, while the self-rated health score diminished significantly during both follow-ups. Decision latitude and social support scores remained unchanged during follow-up, and the number of subjects under stress in the study group (high psychological demands and low decision latitude) did not increase significantly. Finally, the rate of infirmary visits increased significantly during the study period. CONCLUSION: These results show that employees'reaction to these organizational modifications differed according to the scale studied and that their overall perceptions were more complex than expected in view of the changes that occurred.

Adult↗
PubMed2001

Long-term assessment of a sanitary education and lumbar rehabilitation program for health care workers with chronic low back pain at the University Hospital of Lille.

A back school was established in 1992 at the University Hospital of Lille (France) for employees with low back pain. We report its medical and socioeconomic benefits with a mean time to follow-up of 4 years. Our retrospective study included 108 health care workers and provides objective data (absenteeism, use of health care) and subjective information (progression of pain and disorder, social and professional impact) before training and a mean of 4 years after training. We found that 92% of the participants were satisfied with the training and that back pain had regressed or resolved for 55% of them. Both the frequency and duration of pain had decreased significantly. Seventy percent continue to apply the advice they received in their everyday life. Dealing with the problems specific to professional activities contributed to reduce the strain experienced on the job by the health care workers and improved their satisfaction at work. Global absenteeism was reduced by 57.8%, whereas it was reduced by 33% for back pain alone 4 years after implementing this program. Our study provides evidence of the positive impact of this type of training on the way back pain is perceived and on everyday life. The assessment of the cost/efficiency ratio completes the list of durable benefits reported here.

Adult↗
PubMed2000

Acute respiratory effects of exposure to stainless steel and mild steel welding fumes.

Over the past few years, many studies, including one on our previous work, have examined the chronic effects of fumes from stainless steel (SS) welding on the health of welders. These chronic effects have been related to concentrations of chromium and nickel in SS welding fumes. The present study examined the acute respiratory effects of welding fumes in the workplace by measuring the across-shift changes in a population of 144 SS and mild steel (MS) welders and 223 controls. Manual Metal Arc, Metal Inert Gas, and Tungsten Inert Gas welding processes were studied. Pulmonary function tests were performed at the start (ante, or A) and at the end (post, or P) of the work shift. The study of sensitization to harmful respiratory effects of welding was based on the study of the (P-A)/A ratio (%) of the spirometric variations during the shift. The means of these ratios in the control subjects were used to account for the circadian effect. In SS welders we observed a significant decrease in forced vital capacity (FVC) during the shift. Significant across-shift decrements in forced expiratory volume in 1 second (FEV1) and FVC were related to the SS welding exposure compared with MS welding. Moreover, the across-shift decreases in FEV1, FVC, and peak expiratory flow (PEF) were significantly related to the Manual Metal Arc welding process, compared with Metal Inert Gas techniques (respectively, PEF = -2.7% of baseline values [SD, 11.9] vs 2.0% of baseline values [SD, 7.7] P = 0.04; FVC = -1.5% of baseline values [SD, 4.8] vs 0.2% of baseline values [SD, 4.5] P = 0.05). We also demonstrated the influence of duration of SS welding exposure on the course of lung function during the work shift. After 20 years of SS welding activity, SS welders had more significant across-shift decreases than MS welders with a similar MS exposure duration (respectively, FEV1 = -2.7% of baseline values [SD, 5.9] vs 0.7% of baseline values [SD, 4.2] P = 0.008; PEF = -3.8% of baseline values [SD, 9.6] vs 2.3% of baseline values [SD, 6.5] P = 0.04). We concluded that welding-related lung function responses are seen in SS compared with MS welders and in those with a longer lifetime welding history.

Adult↗
PubMed2000

Prevalence of cytomegalovirus infection among health care workers in pediatric and immunosuppressed adult units.

The prevalence of cytomegalovirus (CMV) infection varies not only from one country to another, but also with social, economic, and environmental conditions and with professional activity. Health care workers in contact with the main vectors of the CMV (i.e., children and immunosuppressed patients) are particularly exposed to the infection. We assessed the prevalence of the virus among health care personnel in light of CMV epidemiology and the recent shift in living conditions and family size. Our study was included in a broader program evaluating the risk of infection among female hospital workers of childbearing age. The goal of the program was to implement appropriate preventive measures for personnel who were not immune to the infection. Consequently, we included only female caregivers who worked with children or immunosuppressed patients. The study was based on a clinical examination, a medical and occupational questionnaire, the assessment of tasks performed; and CMV serologic testing. The overall seroprevalence was 44.25% in our population (n = 400) and was comparable regardless of the place of work. Prevalence differed significantly with age and parity, and we also found that it was higher among personnel who worked in closer contact with the patients (nurse's aides, pediatric nurse's aides) than among those whose tasks required more technical skills (nurses, pediatric nurses) (57.3% vs 34.5%, P < 0.01). The logistic regression analysis between prevalence of CMV antibodies, age, parity, and type of job showed that "contact job" was as significant a factor as parity to explain immunization in our population (odds ratio, 2.2). We also determined a correlation between the prevalence of CMV antibodies and tasks performed. In addition, we found a non-negligible group of non-immune personnel (55.75%) and young workers (mean age: 33.4) who were potentially exposed to infection. This points to the need to establish a prevention program.

Adult↗
PubMed1999

Working conditions and health effects of ethylene oxide exposure at hospital sterilization sites.

Ethylene oxide (EtO) is a powerful disinfectant and sterilant for heat-sensitive surgical items and instruments. Its use in hospitals constitutes an important source of occupational exposure that is sometimes underestimated, such as in cases of EtO device malfunction when the safety rules of procedure are not strictly followed or when individual or collective protective equipment is lacking. We carried out a descriptive study of the health care workers who were assigned to EtO sterilization units of the Lille University Hospital Centre in Lille, France (n = 16). Before the modification of the sterilization units in the development of a single, central sterilization site, we studied the workplaces, occupational conditions, and work procedures of the health care workers exposed to EtO. The aim was to assess the risk of EtO overexposure of the workers in order to improve workers' health and security in the future sterilization center. The study was based on a physical examination, a questionnaire covering each subject's personal and occupational history, and a complete ocular examination. For occupational conditions, the studies of each workplace were also performed by the occupational physician. Area and personal breathing air samplings were performed at each exposure site. Fourteen of the 16 operators had posterior and anterior subcapsular lens opacities, three of which seemed to be directly and primarily related to occupational exposure; the other ten seemed to be rather common and compatible with age. High levels of EtO exposure were reported in the oldest site (90 parts per million [ppm] during the changing of the gas bottle), where exposure often exceeded French threshold limits (permissible exposure limit: 1 ppm 8-hour time-weighted average (TWA) in air; short-term excursion limit: 5 ppm 15-minute TWA in air), or the current US recommended and legal exposure limits for EtO advocated by the Occupational Safety and Health Administration and the American Conference of Governmental Industrial Hygienists (permissible exposure limit: 1 ppm 8-hour TWA in air; excursion limit: 5 ppm 15-minute TWA in air), and the National Institute for Occupational Safety and Health standard (recommended exposure limits: 0.1 ppm 8-hour TWA in air; 5 ppm 10-minute TWA in air). The faults in the work processes, such as interruption of the sterilization cycle and disregard for the use of protective devices, were very common.

Adult↗
PubMed1999

[Prevention programs for people exposed to asbestos: results of the ongoing activities].

Programs of prevention concerning the populations exposed or having been exposed to asbestos include on the one hand, specific programs of medical surveillance and on the other hand, interventions of primary prevention. The latter were essentially anti-smoking campaigns and chemo-prevention trials of lung cancer through taking of vitamin A derivatives. In the first part of this review, the results of the experiments of the medical follow, up organized in France and abroad will be shown. These studies allow particularly to appraise both the usual latency of appearance of lung pathologies due to asbestos and the contribution of thoracic scanography in their diagnosis. The interest of the new techniques, such as the autofluorescence fiberscopy, is tackled too. The studies on primary prevention, detailed in the second part, underline the necessity to stop of tobacco consumption among the smokers exposed to asbestos. Moreover, this study concludes that the chemo-prevention of lung cancer through vitamin A derivatives is not yet effective. Some general principles which may be useful to the setting up programs of prevention are put forward in conclusion.

Aged↗
PubMed1999

[Screening of diseases associated with asbestos. On-going activities, synthesis].

Medical screening requires always assessment. On the basis of ongoing studies on occupational health asbestos programs, we suggest some recommendations for asbestos screening after occupational exposure. The proposal for asbestos workers post-exposure surveillance should take into account the medical but also the social aspects of the problem. Post-exposure screening of asbestos workers includes an evaluation of occupational exposure, compulsory basis medical check-up, the characteristics of the radiological investigations and schedule of the medical surveillance. In conclusion, we suggest some general recommendations for asbestos screening after occupational exposure, particularly the necessity to obtain a concerted approach of asbestos screening with regional and national networks, the concern of their assessment and the implementation of specific research studies.

Asbestosis↗
PubMed1998

[Raynaud's phenomena of occupational origin].

Raynaud's phenomenon must systematically lead to the research of a professional cause, mainly if the patient is a manual worker. The most frequent professional cause is vibrations disease which involves different occupations, especially woodcutters. In this disease, Raynaud's phenomenon may be associated with neurological or rheumatic manifestations. Prevention relies on tool improvement and reduction of exposure-time. The more uncommon hammer's syndrome is characterized by the onset of a terminal cubital artery aneurysm, resulting from repeated trauma on the palm of the hand. Raynaud's phenomenon is severe, with frequent trophic complications related to embolic migration towards digital arteries. Improved prevention explains that acrosyndromes related to vinyl chloride exposure are now very rare. Finally, a Raynaud's phenomenon may be the first symptom of a systemic sclerosis induced by silicate exposure.

Aneurysm↗
PubMed1993

Circadian variation of diet-induced thermogenesis.

The objective of this study was to assess a circadian variation of diet-induced thermogenesis (DIT) that could favor weight gain among night workers used to eating a night time snack. Nine young men were given the same mean at 0900, 1700, or 0100. Energy expenditure was measured by indirect calorimetry 1 h before and during the 6 h after the snack. DIT was calculated as the 3 h of energy expenditure above basal metabolic rate. Morning DIT was significantly higher than afternoon DIT (P = 0.04) and night DIT (P = 0.002). Afternoon DIT was higher than night DIT (P = 0.06). We conclude that the time when a meal is consumed affects the thermogenic response and must be considered in the energy balance.

Adult↗
PubMed1986

[Caloric intake and weight gain according to the shift schedule of shift workers].

Survey involved 84 workers matched for age, socio-occupational and families status and divided into 3 groups : A : 27 shift workers on 3 days rotating shift, B : 47 shift workers on 5 days rotating shift, C : 20 days workers. Each subject was submitted to dietary survey by means of 24 hours recall, realised 3 times for shift workers and once for control. All workers were interviewed about caloric intake of the preceding day off caloric intake. Annual weight gain was studied through the use of occupational health service records. There was no significant difference between the 3 groups for working day caloric intake. Day-off intake was lower (p less than 0.05) in group A (day-off any day of the week). Annual weight gain was not different between the 3 groups. Shift workers with faster weight gain had a higher caloric intake on day-off and after evening meal.

Adult↗
PubMed1985

Acute carbon monoxide poisoning. Risk of late sequelae and treatment by hyperbaric oxygen.

The indications for hyperbaric oxygen therapy (HBO) in the treatment of acute carbon monoxide (CO) poisoning are discussed far too little in the literature. Depending on the author reasons for referral to a hyperbaric center include the carboxyhemoglobin level, change in state of consciousness or neurological abnormalities. In our opinion, HBO should be used on much wider indications than is usual, not only because of the rapid relief from symptoms it provides but mainly because it may prevent severe delayed sequelae. During a period of 9 months 230 patients with CO poisoning were admitted to our intensive care unit; 203 were treated with HBO and 27 with normobaric oxygen. Our indications for HBO treatment were: coma, pathological neurological findings or loss of consciousness during CO exposure irrespective of normal clinical findings on admission. Four patients died and the others were discharged 12 hours to 25 days after the incident. Seven patients had minor neurological problems within two weeks of discharge and which disappeared within one month. Two patients were re-hospitalized for neuropsychiatric sequelae and recovered in 3 and 6 months respectively. Neither the clinical status upon admission nor COHb predicted the outcome of the poisoning. Referral to a HBO center should be considered when: --the patient is comatose --there are abnormal clinical findings --patients have been unconsciousness during exposure, irrespective of whether they are conscious on admission and have normal clinical status.

Acute Disease↗