Nearkasen Chau

Prevalence of impairments, disabilities, handicaps and quality of life in the general population: a review of recent literature.

OBJECTIVE To determine the prevalence rates of morbidity in the general population through bibliographic research. METHODS Articles relating to impairment, disability, handicap, quality of life and their prevalence in the general population, published between January 1990 and March 1998, were selected on the MEDLINE database. FINDINGS The 20 articles retained out of 433 used 41 different indicators. Indicators of impairment, disability, handicap and low quality of life showed prevalence rates of 0.1-92%, 3.6-66%, 0.6-56% and 1.8-26% respectively, depending on age and the accuracy of indicators. The heterogeneity of the conceptual framework and insufficient recognition of the importance of indicator accuracy, the age factor and the socioeconomic characteristics of the studied populations impede reliable international comparison. CONCLUSION Further standardization of indicators is therefore required. The revision of the International Classification of Impairments, Disabilities and Handicaps may make it possible to resolve some of the difficulties encountered.

Relationships of job and some individual characteristics to occupational injuries in employed people: a community-based study.

Relationships of Job and Some Individual Characteristics to Occupational Injuries in Employed People: A Community‐Based Study: Ashis Bhattacherjee, et al. Department of Mining Engineering, Indian Institute of Technology, Kharagpur, India—This study assessed the associations of job and some individual factors with occupational injuries among employed people from a general population in north‐eastern France; 2,562 workers were randomly selected from the working population. A mailed auto‐questionnaire was filled in by each subject. Statistical analysis was performed with loglinear models. The annual incidence rate of at least one occupational injury was 4.45%. Significant contributing factors for occupational injuries were job category (60.8%), sex (16.2%), regular psychotropic drug use (8.5%), age groups (7.5%), and presence of a disease (7.0%). The men had higher risk than the women (adjusted odds‐ratio 1.99, 95% CI 1.43.2.78). Compared to executives, intellectual professionals and teachers, labourers had the highest risk (6.40, 3.55. 11.52). They were followed by farmers, craftsmen and tradesmen (6.18, 2.86.13.08), technicians (3.14, 1.41. 6.70), employees (2.94, 1.59.5.48) and other subjects (3.87, 1.90.7.88). The young (.29 yr) showed an increased risk. Similar odds‐ratios were observed for regular psychotropic drug use (1.54, 1.16.2.05) and the presence of a disease (1.50, 1.11.2.02). Univariate analysis showed that smoking habit, overweight and excess alcohol use were also associated with injuries. The loglinear model results showed that there were associations between some of these independent factors. It was concluded that job, sex, young age, smoking habit, excess alcohol use, overweight, psychotropic drug use, and disease influenced the occupational injuries. Preventive measures concerning work conditions, risk assessment and job knowledge should be conducted in overall active population, especially in men, young workers, smokers, alcohol users, overweight workers and in individuals with a disease or psychosomatic disorders.

Relationships of working conditions and individual characteristics to occupational injuries: a case-control study in coal miners.

Relationships of Working Conditions and Individual Characteristics to Occupational Injuries: A Case‐Control Study in Coal Miners: Apurna Kumar Ghosh, et al. Department of Mining Engineering, National Institute of Technology, India—This study assessed the relationship of age, poor perception of working condition, poor safety environment, poor management and supervision, risk‐taking behavior, emotional instability, negative job involvement, job dissatisfaction, job stress, and poor safety performance of workers to occupational injuries. This case‐control study was conducted on 202 male coal miners with at least one occupational injury during a five‐year period and 202 male controls with no occupational injury, matched on the job. A standardized questionnaire administered by individual interviewers was used. Data were analysed by the logistic regression method. For all workers combined, the factors with significant adjusted odds ratios (ORs) found were: 30–45 and >45 yr age groups (OR vs. <30 yr age group: 1.80, 95% CI 1.02–3.17 and 2.59, 1.38–4.85 respectively), poor perception of working conditions (1.61, CI 1.00–3.18), emotional instability (2.33, 1.04–5.22), job stress (1.83, 1.00–3.46) and poor safety performance of workers (3.10, 1.45–6.63). No significant interaction was found between these risk factors and the job. It was concluded that older age, poor perception of work conditions, poor work environment, and human behavioral factors played significant roles in occupational injuries. This information would help in implementing preventive programs to improve working conditions and management quality and to help the workers to develop positive psychological traits, but workers with negative traits such as emotional instability and older workers should be employed in less demanding jobs.

Correlates of occupational injuries for various jobs in railway workers: a case-control study.

Correlates of Occupational Injuries for Various Jobs in Railway Workers: A Case‐Control Study: Nearkasen Chau, et al. National Institute for Health and Medical Research (Inserm), Unit 420, Faculté de Medicine, France—Few studies have simultaneously addressed the role of occupational factors, individual characteristics and living conditions in occupational injuries, and to the best of our knowledge none on railway workers. This survey assessed the roles of these factors in various types of injuries and for various jobs in French railway workers. This case‐control study was conducted on 1,305 male workers with an occupational injury during a one‐year period and 1,305 male controls. A standardized questionnaire was administrated by an occupational physician. Data were analyzed by the logistic regression method. The significant factors found for all the injuries combined were: young age (<30 yr) (adjusted odds ratio 1.47, 95% CI 1.01–2.14), 5 yr or less in present job (1.43, 1.15–1.78), sleep disorders (1.30, 1.08–1.57), current smoker (1.27, 1.08–1.50), and no do‐it‐yourself or gardening activity (1.23, 1.02– 1.48). Young age, sleep disorders, and smoking were common for several types of injuries. The role of these factors differed between various job categories. Among injured workers sick leaves of eight days or over were more frequent in current smokers and overweight subjects. In conclusion, young age, lack of experience, job dissatisfaction, sleep disorders, smoking, and lack of physical activity increase the risk of occupational injuries. The risks induced were related with jobs. Preventive measures concerning work conditions and these factors could be conducted in railway workers generally, and especially in workers most at risk. The occupational physician could make workers more sensitive to these risks and help them to improve their living conditions during medical examinations.

Suicidal ideation among young French adults: Association with occupation, family, sexual activity, personal background and drug use

BACKGROUND To assess associations among young adults between suicidal ideation in the previous year and adverse childhood events, occupation, education, tobacco use, alcohol abuse, cannabis use in the previous month, illicit drug use, sexual orientation and activity, depression, physical violence in the previous year, and lifetime forced sexual intercourse. METHODS A subsample of 4075 French adults aged 18-30 years was drawn from a random national telephone survey in 2005. Major depressive episode and alcohol abuse were assessed using CIDI-SF and AUDIT-C (score above 4). Data were analysed with logistic regressions. RESULTS Suicidal ideation affected 5.7% of men and 4.9% of women. Among men depression had the highest adjusted odds ratio (ORa=8.06, 5.07-12.79), followed by homosexual intercourse (3.37, 1.62-7.04), absence of sexual activity (2.83, 1.80-4.44); ORa between 1.6 and 2.0 were observed for living alone, daily tobacco smoking, being unemployed, serious health event concerning the father, age 26-30 and bad relationships between parents. Among women, depression had the highest ORa (7.60, 4.70-12.29), followed by lifetime experience of forced sexual intercourse (5.37, 2.89-9.96), having consumed illicit drugs other than cannabis (4.01, 1.48-10.89); ORa between 1.7 and 2.5 were observed for living alone, being unemployed, bad relationship between parents and age 26-30. LIMITATIONS Cross-sectional survey, sexual orientation inferred from sexual activity. CONCLUSION Suicide prevention should integrate the fact that besides depression, unemployment, family history, age, and sexual activity and orientation are specific risk factors among men, whereas illicit drug use, violence and forced sexual intercourse are more important among women.

Cannabis use stages as predictors of subsequent initiation with other illicit drugs among French adolescents: use of a multi-state model.

The aim of this study was to confirm the influence of cannabis use patterns on the probability of initiation with other illicit drugs (OID). A French nationwide retrospective cohort on drug use was reconstituted on 29,393 teenagers. A Markov multi-state model was fitted, modelling all possible pathways from initial abstinence to cannabis initiation, daily cannabis use and OID initiation. The model was adjusted for tobacco and alcohol use. The risk for OID initiation appeared 21 times higher among cannabis experimenters and 124 times higher among daily cannabis users than among non-users. Tobacco and alcohol use were associated with a greater risk of moving on to cannabis initiation (hazard ratio (HR)=1.2 for tobacco initiation, HR=2.6 for daily tobacco use and HR=2.8 for drunkenness initiation). The results of this study provide a confirmation of a stage process in drug use, mediated by cannabis and liable to lead to OID experiment. This is compatible with the literature on the gateway theory, but goes further by modelling the entire sequence of use. OID experiment could be a consequence of initial opportunity to use the more accessible illicit drug, cannabis.

Sensorial organisation favouring higher visual contribution is a risk factor of falls in an occupational setting

The contribution of intrinsic balance control factors to fall mechanisms has received little investigation in studies on occupational accidents. The aim of this study was to assess whether postural regulation in falling workers might have specificities in terms of sensorimotor strategies and neuromuscular responses to balance perturbations. Nine multi-fall-victims (MF), 43 single-fall-victims (SF) and 52 controls (C) were compared on performance measurements of static and dynamic postural control. MF and SF had the worst postural performance both in the static and slow dynamic tests, particularly in eyes closed conditions, suggesting a high dependency on visual cues and a lower use of proprioception. Moreover, the sensorial analysis showed that MF and SF relied less on vestibular input in the development of balance strategy and had more difficulties in maintaining a correct upright stance when proprioceptive input was altered. Finally, MF showed longer latency responses to unexpected external disturbance. Overall, postural control quality increased in the order MF, SF and C. MF and SF adopted particular sensorimotor organisation, placing them at an increased risk of falling in specific sensory environments. Strategies incorporating visual information involve using the cognitive processes causing delayed and less accurate fall avoidance responses, in contrast to adaptative strategies based on proprioceptive and vestibular information.

Social gradient in initiation and transition to daily use of tobacco and cannabis during adolescence: a retrospective cohort study

AIMS This study explores whether the family socio-economic status (F-SES) and school situation could have an impact on tobacco and cannabis initiation and transition to daily use during adolescence. DESIGN AND SETTING A French cross-sectional nation-wide survey conducted in 2005 containing retrospective data. PARTICIPANTS French teenagers aged 17 (n = 29 393). MEASUREMENT The F-SES was defined by the highest occupational category of either parent, with seven categories ranging from unemployed/inactive to managers/professionals. Ages at repeat school years, at leaving school, at the first episode of drunkenness and at initiation of illicit drug use were used to model tobacco and cannabis initiation and transition to daily use with time-discrete logistic regressions. FINDINGS The risk for tobacco initiation was almost equally distributed across F-SES groups, but the risk of a progression to daily use was higher in every F-SES category compared to managers/professionals [odds ratio (OR) from 1.17 to 1.90]. Compared to managers/professionals, risk of cannabis initiation was lower in all F-SES categories (OR from 0.63 to 0.87), but all categories except farmers were at increased risk of transition to daily use: the OR range between 1.29 (intermediate) and 1.98 (unemployed/inactive). Repeating school years and leaving school predicted daily use of tobacco (OR = 2.00 and 2.37) and cannabis (4.58 and 2.07). CONCLUSIONS Adolescents from the highest family socio-economic status categories are at risk for tobacco and cannabis experimentation but are less prone to engage in daily use. Psychological and social mechanisms that inhibit transition to daily use should be investigated, including school attainment and performance.

Relationship between job, lifestyle, age and occupational injuries

BACKGROUND Physical job demands (PJD), age, disability and lifestyle may influence the risk of occupational injury. AIM To assess the relationships between PJD, lifestyle and injury in workers of various ages. METHODS A total of 2888 randomly selected workers from northeastern France, aged >or=15, completed a postal questionnaire. The PJD score was defined as the total number of the following reported job demands: using pneumatic tools, other vibrating hand tools, hammers, machine tools or vibrating platforms and exposure to manual handling tasks, awkward postures, high pace of work, high physical workload, work at heights, work in adverse climates or exposure to noise, cold or heat. Data were analysed using logistic regression. RESULTS Nine per cent of subjects reported an injury during the previous 2 years. The PJD score was related to the injury rate for workers aged >or=45: crude odds ratio (OR) 3.5 (95% confidence interval = 1.5-8.0) for PJD = 1, 5.0 (2.2-11.3) for PJD = 2-3 and 14.5 (6.5-32.2) for PJD >or=4, versus PJD = 0. Lower ORs were found for those aged <30 (1.4, 4.2 and 9.9, respectively) and 30-44 (1.5, 4.4 and 6.5, respectively). The differences between age groups remained when controlling for all factors studied. Obesity, smoking and musculoskeletal disorders were associated with injury risk in workers aged >or=45 (adjusted ORs 1.7-2.6). Smoking was also an injury risk factor for workers aged <30. CONCLUSIONS PJD and lifestyle have a higher impact on injury rates among older workers than among younger ones. Injury prevention should address reducing PJD and improving relevant lifestyle factors, especially for older workers.

Comparison between estimates of hand volume and hand strengths with sex and age with and without anthropometric data in healthy working people

Edema and hand strength measurements are useful for the recovery assessment of patients with a hand lesion. This work determined and compared estimates of hand volume, grip strengths (measured with a Jamar and a Collins dynamometer), and pinch strength (with a Jamar pinch gauge) in terms of sex and age with or without anthropometric indices in healthy working people. The sample included 100 subjects from within the staffs of two rehabilitation centres. For both grip strengths, multiple linear regression models including body height, weight, and arm muscle area were very good (multiple correlation coefficient R of about 0.84) and clearly better than those obtained with sex and age only. For pinch strength, the best estimate was obtained with sex and arm muscle area (R of 0.76); for hand volume, the model with sex, body height, and weight provided the best result (R of 0.93). These findings suggested that anthropometric indices easy to measure must be taken into account to estimate hand volume and hand strengths.