Marcel-André Boillat

Carpal tunnel syndrome: role of occupation

SummaryA total of 21 consecutive patients who underwent surgery for carpal tunnel syndrome in a regional hospital were analysed for their trade and serum α1-antitrypsin phenotypes. The majority of these cases were women and mostly manual trades and professions were involved. Furthermore, heterozygous antitrypsin phenotypes were more frequent among the surgical cases than among the general Swiss population. In a second stage, the incidence of carpal tunnel syndrome in Switzerland was studied for 1 year from June 1988 through May 1989 using the sentinel system developed by the Federal Office of Public Health Administration. In all, 188 cases were found, most of whom were women, which was compatible with the frequency in other countries. A complementary questionnaire that was filled out by 65 cases and their matched controls showed that housewifes and shop clerks were overrepresented among the patients. Likewise, exposure to vibrating tools and frequent extensions and/or flexions of the wrist were mentioned more often by the cases than by the controls. The present study confirms previous findings that women are at greater risk of developing carpal tunnel syndrome especially in jobs requiring repetitive movements or operation of vibrating tools. A constitutional element in pathogenesis was suggested by observations that the mothers of the cases had often also been afflicted with carpal tunnel syndrome and that the frequency of distribution of antitrypsin phenotypes in patients differed from that in the general population.

Smell or taste disturbances, neurological symptoms, and hydrocarbon exposure.

SummaryA total of 264 workers participated in a cross-sectional study concerning the toxicity of hydrocarbons. The clinical examination shows an increased prevalence of smell and/or taste disturbances in the heavily exposed group. These symptoms appear to be generally transitory and reversible. They seem to be due to concentration peaks rather than to a long exposure duration. They are associated with acute depressor effects and not with symptoms which could belong to a hydrocarbon-induced chronic toxic encephalopathy.

Effect of Alcohol on the Kinetics of Styrene and its Metabolites in Volunteers and in Workers

Abstract The reliability of mandelic acid (MA) and phenylglyoxylic acid (PGA) in urine as biological indicators of styrene exposure is impaired by the concurrent intake of ethyl alcohol. This has been verified by controlled experiments in the laboratory and in the field. Six males were exposed to styrene at 50 ppm with four concurrent levels of ethyl alcohol intake from 0 to 1 g per kg of body weight during or following exposure. Blood and urine samples were analyzed for MA, PGA, styrene epoxide (SO), and styrene glycol (SG). The MA/SG ratio in blood was found to be the most promising indicator and could be used as a metabolic “check-index.” An MA/SG ratio less than 30 is proposed as a warning level which is indicative of interference by alcohol intake. Similar studies on seven workers in a polyester plant yielded results in agreement with the controlled laboratory findings. Berode, M.; Droz, P. O.; Boillat, M. A.; Guillemin, M. Effect of alcohol on the kinetics of styrene and its metabolites in volunteer...

Neurobehavioral test performance among apprentice painters: Baseline data

In the debate on chronic effects of solvent use, it is often difficult to find information on the cerebral health status of subjects before any exposure has occurred. The objective of this study was to obtain baseline data by examination of workers at the beginning of their occupational lives. This study compares the performance of 57 apprentice painters, mean age 16.6 +/- 1.2 years, with that of 62 apprentices, mean age 16.2 +/- years, drawn from other manual trades involving no significant exposure to solvents. Their performances were compared twice over a period of 3 years using a series of behavioral tests chosen from a translated version of the Neurobehavioral Evaluation System (NES). There were no major differences in performance between the apprentices, except for the verbal ability test, which showed lower results for painters. This can be explained by factors such as socioeconomic background, previous schooling, or mother tongue, and raises the question of whether it is appropriate to use such a test to adjust for the influence of premorbid ability in elderly exposed workers.

Surveillance de l'exposition professionnelle aux solvants. Présentation d'une étude en cours

ZusammenfassungDas Expositionsrisiko kann aus drei Richtungen her erfasst werden: Luftüberwachung, biologisches Monitoring und ärztliche Ueberwachung. Es werden für diese drei Richtungen Methoden entwickelt, die dann simultan an Arbeitergruppen verschiedener Verfahren angewendet werden, nämlich Tiefdruck, Trokenreinigen, Polyesterindustrie und Serigraphie.SummaryThe risk of exposure can be assessed by three different approaches: air monitoring, biological monitoring and medical surveillance. Methods are developped for these three approaches which are then applied simultaneously to groups of workers in various industrial operations: rotogravure printing, dry clearing, polyester industry, silk-ink printing.

Problèmes de santé liés à l'activité professionnelle

Statistical data obtained from insurance companies give certainly a good picture of work effects on health in the field of accidents. This is different for occupational diseases, which are more difficult to diagnose and which are recognized on the basis of medicolegal criteria. Statistics do not involve other aspects than diseases, such as discomfort, ergonomical questions, psychophysiological consequences and situations where there is a limited role of occupation. Prevention of work related health problems has to consider these characteristics and needs to be based on risk analysis, a prospective procedure. The advantage of such an approach is the possibility of adjustment to a changing work environment and to new technologies.

Intoxication saturnine: à propos d'un cas de polyneuropathie

ZusammenfassungFall eines dreissigjährigen Malers, der während eines Monats am Entfernen alter bleihaltiger Anstriche in einem geschlossenen Raum beschäftigt wurde. Eine Bleivergiftung erfolgte, die das hämatopoetische System störte und zu einer heute kaum noch beobachteten Bleilähmung führte.SummaryCase of a thirty-year old male painter, who removed old leadpainting in a confined space for one month. It ensued a serious leadpoisoning with hematologic effects and peripheral motor palsy.

Surveillance médicale de personnes exposées aux gaz anesthésiques

ZusammenfassungOperationspersonal (65 Personen) wird mit einem Kontrollkollektiv (68 Personen, Kinderspital) verglichen. Trotz ziemlich hoher Narkotikumkonzentrationen konnten keine schädliche Wirkungen gesichert werden.SummarySixty five anesthesists are compared with 68 collaborators of a pediatric unit. Despite significant exposure to halothane and nitrogen oxide, no serious ill effect could be shown in the exposed population.