Charles Boulenguez

Job stress and major coronary events: results from the Job Stress, Absenteeism and Coronary Heart Disease in Europe study.

Aims The intention of this study is to investigate the relationship of the demands/control/strain model with hard coronary events in an epidemiological, prospective, multicenter, European study. Methods and results Six cohorts (Brussels, Ghent, Lille, Barcelona, Göteborg and Malmö) from four European countries (Belgium, France, Spain and Sweden) consisting of 21 111 middle-aged male subjects participated between 1993 and 1996 in the baseline survey of the Job Stress, Absenteeism and Coronary Heart Disease in Europe (JACE) study. The Karasek strain model of psychological demands (five items)/control (nine items) was used. During a mean follow-up of 40 months 185 acute coronary events or coronary deaths were observed. Age-adjusted hazard ratios (HRs) for developing an acute coronary event were 1.46 [CI 95% confidence interval (1.08–1.97)] for high against low psychological demands and 1.53 (95% CI 1.0–2.35) for strained (high demands plus low control) against relaxed (low demands plus high control) groups. After adjustment for standard cardiovascular risk factors the HR for developing a coronary event for those above or equal to the median against those below the median of psychological demands was 1.46 (95% CI 1.08–1.97) whereas the HR for strained against relaxed groups is 1.46 (95% CI 0.96–2.25). Sensitivity analyses confirmed the robustness of the results. Conclusion In this European, multicenter, prospective, epidemiological study the Karasek job strain model was an independent predictor of acute coronary events, with the psychological demands scale emerging as the important component.

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.

Quantification of shape of flow‐volume loop of healthy preschool children and preschool children with wheezing disorders

The earliest change associated with airflow obstruction in small airways is reflected in a concave shape on the maximum expiratory flow‐volume loop (MEFVL). The shape of the MEFL changes with age but reference values for curvilinearity indices (CI) for preschool children have not been published. We aimed to describe the normal curvilinearity of healthy preschool MEFVL by CI (the β angle and the ratio of maximum expiratory flow when 50% of forced vital capacity remains to be expired/peak expiratory flow (MEF50%/PEF)) and to test their capacity in detecting concavity in preschool children with wheezing disorders.