Peggy Krief

Assessment of Nasal Fibroscopy to Explore Olfactory Cleft

Objective. To assess whether flexible nasoendoscopy can be used to visualize all parts of the olfactory cleft (OC) without morbidity. Study Design. Single-center, prospective, observational study. Setting. French tertiary referral center. Subjects and Methods. 100 consecutive patients were divided in 2 groups of 50. Group 1 underwent nasal fibroscopy without vasoconstriction or local anesthesia with an endosheath- protected endoscope. Group 2 was examined by a fiberscope without an endosheath after application of naphazoline Xylocaine. Each OC was divided in 16 items recorded as visualized or not. Four scores were compared between both groups: out of 16 (1 side), out of 32 (both sides), out of 12 concerning only the narrowest and highest bilateral spaces, and out of 4 to divide these specific areas in anterior, middle, and posterior parts. Length of procedure, pain, epistaxis, blood mark on the endosheath, sneezing, rhinorrhea, and causes of failure were recorded. Results. There was no significant difference between both groups concerning score out of 16 or 32. The visibility of the narrower and higher spaces was better in group 2: scores out of 12 were significantly different between the groups (P = .025), as were scores out of 4 for the anterior and middle parts of the OC (P = .02 and .01 respectively). Morbidity was low without differences between the groups. Deviated nasal septum was the only cause of failure and increased the patients’ pain during the examination (P = .045). Conclusion. Nasal fibroscopy could be used to explore the different portions of the OC efficiently and with low morbidity.

Implementation, mechanisms and effects of maternity protection legislation: a realist narrative review of the literature

PurposeMost industrialized countries have introduced maternity protection legislation (MPL) to protect the health of pregnant workers and their unborn children from workplace exposure. This review aimed to assess this legislation’s level of implementation, barriers and facilitators to it, and its expected or unexpected effects.MethodsA realist narrative review was conducted. Keyword searches of the PubMed, CINAHL, PsycINFO, MIDIRS, Sociological abstracts and Google Scholar electronic databases were performed in March 2018.ResultsThe 42 publications included show that the implementation of MPL is deficient in most countries. Allowing pregnant women to withdraw from work on preventive leave or sick leave is favored over workplace adaptations or worker reassignments. The publications highlight mechanisms which encourage or obstruct the enforcement of legislation at the levels of the individual, the physical and social environment, and the macrosocial context. The delay between the conception and implementation of maternity protection measures appears to be a major barrier to the efficacy of MPL. The literature also suggests that unexpected adverse effects, such as degradation in working relationships or discrimination can obstruct the implementation of protective measures.ConclusionsThis study showed the need for a better implementation of MPL during pregnancy. Further research and recommendations for improvements in MPL should consider the diverse mechanisms and effects of its implementation. Barriers and adverse effects of this implementation do not only ensure a lack of information or awareness about MPL, but are also linked to contradictions between requirements to protect employment and protect pregnancy.

Facial leucoderma following eczema: a new case induced by spectacle frames

Conflicts of interest: The authors have declared no conflicts. As well as being widely used as casting resins in the production of plastic materials, phenol formaldehyde resins are also present in lacquers, varnishes, and adhesives. p-tert-Butylcatechol (PTBC) is a strong contact sensitizer that is a component of p-tert-butylphenol formaldehyde resins (PTBF). PTBC is also used as an antioxidant to stabilize other monomers in the production of plastics and rubber. Here, we describe a case of allergic contact dermatitis followed by leucoderma caused by the use of spectacle frames, with sensitization and exposure to phenolic

Protection of pregnant women at work in Switzerland: practices, obstacles and resources. A mixed-methods study protocol

Introduction Like most industrialised countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace exposure. This legislation provides for a risk assessment, adaptations to workplaces and, if the danger is not eliminated, preventive leave (prescribed by a gynaecologist). This study’s first objective is to analyse the degree to which companies, gynaecologists and midwives implement the law. Its second objective is to understand the obstacles and resources of this implementation, with a focus on how relevant stakeholders perceive protective measures and their involvement with them. Methods and analysis Data will be collected using mixed methods: (1) online questionnaires for gynaecologists and midwives; telephone questionnaires with company human resources (HR) managers in the healthcare and food production sectors; (2a) case studies of 6–8 companies in each sector, including interviews with stakeholders such as women workers, HR managers and occupational health physicians; (2b) two focus groups, one involving occupational physicians and hygienists, one involving labour inspectors. Quantitative data will be analysed statistically using STATA software V.15. Qualitative data will be transcribed and thematically analysed using MaxQDA software. Ethics and dissemination The Human Research Ethics Committee of the Canton Vaud (CER-VD) has certified that this research study protocol falls outside of the field of application of the Swiss Federal Act on Research Involving Humans. The publications and recommendations resulting from this study will form the starting point for future improvements to the protection of pregnant women at work and their unborn children. This study started in February 2017 and will continue until January 2020.

Nasal fibroscopy as a routine screening procedure of sinonasal adenocarcinoma of woodworkers: French longitudinal case study

The purpose of this study was to assess the relevancy of flexible nasoendoscopy as a routine screening procedure of sinonasal adenocarcinoma among people occupationally exposed to wood dust.

Protection of Pregnant Women at Work in Switzerland: Implementation and Experiences of Maternity Protection Legislation

Objectives. Like most industrialized countries, Switzerland has introduced legislation to protect the health of pregnant workers and their unborn children from workplace hazards. This study aims to assess legislation’s degree of implementation in the French-speaking part of Switzerland and understand the barriers to and resources supporting its implementation.

0150 Respiratory effects of an exposure to wheat dust among grain workers and farmers: a longitudinal study

Objectives Agriculture is considered one of the occupations most at risk of acute or chronic respiratory problems. The aim of our study was to determine from which level of exposure to organic dust the respiratory function is chronically affected in workers involved in wheat grain or straw manipulation and to test if some of these working populations can recover their respiratory function after an exposure decrease. Method 87 workers exposed to wheat dust: farmers, harvesters, silo workers and livestock farmers and 62 non exposed workers, were included into a longitudinal study comprising two visits at a six months interval with lung function measurements and symptom questionnaires. Cumulative and mean exposure to wheat dust were generated from detailed work history of each worker and a task-exposure matrix based on task-specific exposure measurements. Immunoglobulins (IgG and IgE) specific of the most frequent microorganisms in wheat dust have been determined. Results FEV1 decreased significantly with the cumulative exposure and mean exposure levels. The estimated decrease was close to 200 mL per year of high exposure, which corresponds roughly to levels of wheat dust higher than 10 mg/m3. Peak expiratory flow and several acute symptoms correlate with recent exposure level. Recovery of the respiratory function six months after exposure to wheat dust and evolution of exposure indicators in workers blood (IgG and IgE) will be discussed. Conclusions These results show a chronic effect of exposure to wheat dust on bronchial obstruction. Short term effects and reversibility will be assessed using the full study results.