M. Telle-Lamberton

Work-related asthma in France: recent trends for the period 2001–2009

Objective Knowledge on the time-course (trends) of work-related asthma (WRA) remains sparse. The aim of this study was to describe WRA trends in terms of industrial activities and the main causal agents in France over the period 2001–2009. Method Data were collected from the French national network of occupational health surveillance and prevention (Réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P)). Several statistical models (non-parametric test, zero-inflated negative binomial, logistic regression and time-series models) were used and compared with assess trends. Results Over the study period, 2914 WRA cases were included in the network. A significant decrease was observed overall and for some agents such as isocyanates (p=0.007), aldehydes (p=0.01) and latex (p=0.01). Conversely, a significant increase was observed for cases related to exposure to quaternary ammonium compounds (p=0.003). The health and social sector demonstrated both a growing number of cases related to the use of quaternary ammonium compounds and a decrease of cases related to aldehyde and latex exposure. Conclusions WRA declined in France over the study period. The only significant increase concerned WRA related to exposure to quaternary ammonium compounds. Zero-inflated negative binomial and logistic regression models appear to describe adequately these data.

Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012

Objectives The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries. Methods OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of ‘centres’, requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules. Results Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries. Conclusions This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods.

Occupational contact urticaria: lessons from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P)

Occupational contact urticaria (OCU) is an occupational contact dermatitis that can cause serious health consequences and disability at work.

Occupational allergic contact dermatitis and major allergens in France: temporal trends for the period 2001–2010

Occupational allergic contact dermatitis (OACD) is one of the most common occupational skin diseases in developed countries, but data about its temporal trends in incidence remain sparse.

A review of occupational disease surveillance systems in Modernet countries.

BACKGROUNDnTo improve occupational health public policies and to facilitate coordinated research within the European Union to reduce the incidence of occupational diseases (ODs), it is important to know what OD surveillance systems exist and how they compare. Monitoring trends in occupational diseases and tracing new and emerging risks in a network (Modernet) participants are well placed to provide this information as most either contribute data to and/or are involved in the management of OD systems.nnnAIMSnTo identify and describe OD surveillance systems in Modernet countries with the longer-term objective of identifying a core template to be used on a large scale.nnnMETHODSnA questionnaire sent to Modernet participants, seeking structured information about the OD surveillance system(s) in their country.nnnRESULTSnOverall 14 countries (70%) provided information for 33 OD systems, among them 11 compensation-based (CB) systems. Six countries provided information for non-CB systems reporting for any type of OD. The other systems reported either only ODs from a prescribed list, or specific diagnoses or diagnostic groups, with reports to most schemes being physician-based. Data collected varied but all systems collected diagnosis, age, gender, date reported and occupation (and/or industry) and most collected information on exposure.nnnCONCLUSIONSnThis review provides information beneficial to both policy makers and researchers by identifying data sources useable to measure OD trends in European countries and opening the way to future work, both on trend comparisons within Europe and on the definition of a core template to extend OD surveillance on a larger scale.

Effectiveness of the European Chromium VI Directive for cement implementation on occupational allergic contact dermatitis occurrence: Assessment in France and UK

Hexavalent chromium is the main sensitizer in wet cement and a common cause of occupational allergic contact dermatitis (OACD), especially among workers in the construction industry.1,2 The European Chromium VI directive3 transposed into national regulations in France and UK respectively on May and January 2005, prohibits selling or using of hydrated cement with more than 0.0002% of chromium. This was achieved through the addition of ferrous sulphate to the dry product, allowing to reduce chromium VI to chromium III which is less sensitizing. n nThis article is protected by copyright. All rights reserved.

Trends in work-related mental disorders by sector in France

BackgroundnNotifications of work-related mental disorders (WRMDs) are increasing while little data are available on trends by industrial sector.nnnAimsnTo assess WRMD notifications and trends from 2001 to 2011 by industrial sector using data collected by the French National Network for Occupational Disease Vigilance and Prevention (RNV3P) network.nnnMethodsnWe calculated standardized notification ratios (SNRs) per sector. To analyse trends over time, we used odds ratios, analysed by logistic regression, including time as a discrete variable or as a continuous variable.nnnResultsnWe found higher than expected WRMD notifications in manufacturing; paper and book (SNR = 2.16; 95% CI [1.88-2.48]), chemical and pharmaceutical (SNR = 1.79; 95% CI [1.58-2.03]), textile and clothing (SNR = 1.27; 95% CI [1.04-1.54]). In the trade sectors, retail (SNR = 1.60; 95% CI [1.52-1.68]), motor vehicle and cycle trade and repair (SNR = 1.19; 95% CI [1.05-1.34]). In the services sector personal (SNR = 2.09; 95% CI [1.83-2.38]), information technology (SNR = 1.54; 95% CI [1.36-1.74]), financial and insurance (SNR = 1.42; 95% CI [1.31-1.53]), post and telecommunication (SNR = 1.44; 95% CI [1.30-1.60]), human health and social work (SNR = 1.29; 95% CI [1.24-1.34]). We found an increase in notifications in agriculture, post-telecommunication services and the human health/social work sectors and a decrease in chemical/pharmaceutical, metal, and paper and book manufacturing sectors (P < 0.05).nnnConclusionsnThese results reveal trends in notifications for WRMDs by industrial sector. This highlights the importance of monitoring trends in WRMDs in specific worker subsets, using specialized networks such as the RNV3P.

0304 Temporo-spatial analysis of mortality from pleural mesothelioma from 1975 to 2012 in Île-de-france

Context Pleural mesothelioma surveillance, a marker of asbestos exposure, improves early detection and helps improving compensation of the disease. Few epidemiological data exist at a sub-district level in France. Objectives This study presents an analysis of mortality in Île-de-France region from pleural mesothelioma from 1975 to 2012, by sex, district and ”cantons-villes” residence. Material and methods Pleural mesothelioma deaths from 1975 to 2012 were provided by the CepiDc and the corresponding population numbers by INSEE. Mortality rates stratified by age were reported for the region and its districts. Standardised mortality ratios were calculated using the Île-de-France population as a reference at ”canton-villes” level. A ranking algorithm to order the mortality by ”canton-ville” over the period was developed and applied. Results The epidemic peaked in the mid-90s. Among men the lowest standardised rate was observed for Paris (3.4 per 100,000) and the highest in Seine-et-Marne and Seine-Saint-Denis (5.1 per 100,000). Among women the lowest mortality was observed in Paris and in the Val d’Oise (1.3 per 100,000) and the higher in the Seine-Saint-Denis (1.8 per 100,000). The temporo-spatial representation shows high mortality areas consisting of neighbouring ”cantons-villes” in Seine-et-Marne (Perthes) and Seine-Saint-Denis (Aulnay-sous-Bois), in contrast with areas of low mortality localised mainly in Paris and the Val-d’Oise. The epidemic timeline differed among ”canton-ville”. Conclusion Epidemic of pleural mesothelioma can be characterised at a fine scale over a long period. This territorial knowledge can be an aid to targeted education of health professionals and the populations concerned.

0225 Effects of change in work organisation on psychological well-being: influence of psychological demand, decision latitude and social support

Consequences of organisational choices on working conditions are complex and may influence psychosocial well-being and health either positively or negatively. Changes in work organisation have been shown to be negatively associated to psychosocial experiences or health within the last French Working Condition Survey (WCS). Here we investigated how these associations were influenced by the following potential modificators: psychological demand at work, decision latitude and social support. Psychosocial experiences examined were overwhelmed state, gratitude, internal psychological violence, meaning of work and value conflicts. Health was approached by the WHO5 scale as well as by self-perceived health status. Logistic regressions between change in organisation and psychosocial well-being and health were carried out on the 7000 market sector employees of the WCS belonging to companies with at least 10 employees. The modificator was included in the model together with an interaction term to account for the modification effect. High psychological demand increased the effect of change in organisation on the meaning of work. Low decisional latitude increased the effect of change in organisation on gratitude, meaning of work and value conflict and low social support increased the effect of change in organisation on gratitude and internal psychological violence. This analysis illustrates the complexity of relationships between organisation at work and psychological well-being. More analyses will be carried out on specific types of organisation such as quality management of just-in-time management.

P272 Work organisation, psychosocial experiences and health in the market sector. results from the french national working condition survey 2013

Work intensification increases again in France as revealed by the last National Working Condition Survey (WCS), along with organisational changes and job insecurity. Consequences of organisational choices on working conditions are complex and may influence psychosocial well-being and health either positively or negatively. Associations between work organisation and psychosocial experiences or health were analysed for market sector workers within the WCS through logistic regressions adjusted for gender, age, socioeconomic status, region and firm size. Changes in work organisation were studied as well as specific features such as versatility or quality procedures. Psychosocial experiences examined were: overwhelmed state, gratitude, internal psychological violence, meaning of work and value conflicts. Health was approached by the WHO5 scale as well as by self-perceived health status. Organisation features negatively associated with psychosocial experiences and health were: organisational change, management team change, redundancy plan within the last 12 months and adjustable versatility. Use of quality procedures were only associated with increased overwhelmed state, internal psychological violence, value conflicts and poorer self-perceived health status. These results, coherent with the international literature, illustrate once again the need to incorporate human factors when defining and introducing organisational changes. Further work will include the influence of work features such as quantity, intensity and complexity and psychological context such as latitude, social support and organisational justice. A key issue is their role in the moderation or exacerbation of organisation change consequences on psychosocial well-being and health.