Régis Colin

Effect of occupational safety and health education received during schooling on the incidence of workplace injuries in the first 2 years of occupational life: a prospective study

Objectives This study aimed to determine the effect of occupational safety and health (OSH) education during formal schooling on the incidence of workplace injuries (WIs) in young people starting their careers. We hypothesised that young people who had received OSH education during their schooling would have fewer WIs than those who received no OSH education. Secondary objectives focused on the effect of ‘first aid at work’ training during schooling and the conditions encountered on arrival in the company (occupational hazard information, safety training and job task training) on WI occurrence. Design Prospective cohort study. Participants From 2009 to 2012, French apprentices and students at the end of their schooling and starting their careers were included. Outcomes Occurrence of WIs. Methods At the time of inclusion, information about school courses and personal characteristics were collected, and subsequent half-yearly contacts gathered information relating to work and personal data. During the 2-year follow-up, WIs were directly reported by participants and were identified by searching the French National Health Insurance Funds’ databases listing compulsory WI declarations. Results 755 participants reported holding 1290 jobs. During follow-up, 158 WIs were identified, corresponding to an incident rate of 0.12 (0.10 to 0.14) WIs per full-time worker. Subjects who reported having received OSH education at school had two times less WIs than those declaring not having received OSH education (incidence rate ratio (IRR) 0.51, 0.00 to 0.98). A lower WI risk was observed for participants who received the ‘first aid at work’ training (IRR=0.68, 0.00 to 0.98). The conditions on arrival in company were not associated with WIs occurrence. Conclusion In France, the OSH education provided to apprentices and students is mostly broader than the specific risks related to future jobs. Our results highlight the advantages of reinforcing this approach.

0111 Mortality study among Paris sewage workers

Objectives To describe the mortality of sewage workers from Paris (France). Method The cohort of 1594 Paris sewage workers since 1970 was set up in 2010 and followed-up on mortality from 1970 to 2010. Vital status and causes of death were determined by matching with national databases. Standardised Mortality Ratios (SMRs) were computed using local death rates by causes of death and 10-year employment duration classes. Data are currently analysed using relative survival techniques. This study was approved by the national ethic comity. Results Statistically significant mortality excess was observed for all causes (SMR=1.34, 778 cases) and for cancer (SMR=1.49, 337 cases). SMRs were also statistically greater than 1 for malignant (SMR=1.74, 22 cases) and non-malignant (SMR=1.77, 43 cases) liver diseases, lung cancer (SMR=1.59, 97 cases), oesophagus cancer (SMR=2.35, 28 cases), all alcohol-related diseases (SMR=1.78, 128 cases), and suicide (SMR=3.64, 22 cases). Greater than 1 but not statistically significant SMRs were observed for infectious diseases and respiratory infectious diseases. The mortality from several diseases (all causes, all cancer, oesophagus cancer, lung cancer, chronic liver diseases, all alcohol-related diseases, and infectious diseases) increased with employment duration as a sewer worker. Except for lung cancer, the SMR for smoking-related diseases was not statistically greater than 1. Results of survival analysis are in progress. Conclusions The increase mortality observed for lung cancer and infectious diseases with employment duration suggests possible occupational health effect among sewer workers. Conclusions will be completed from the survival analysis.

Bladder cancer and occupational exposure to metalworking fluid mist: a counter-matched case–control study in French steel-producing factories

Objectives To assess the relationship between occupational exposure to metalworking fluids (MWFs) in the steel-producing industry and bladder cancer incidence. Methods A nested case–control study on bladder cancer was set up in a cohort of workers from six French steel-producing factories. Three controls were randomly selected for each incident bladder cancer case diagnosed from 2006 to 2012. Controls were matched to cases on age at diagnosis and counter-matched on a surrogate measure of exposure to MWFs derived from a job-exposure matrix. Cases (n=84) and controls (n=251) were face-to-face interviewed. Experts assessed occupational exposure to MWFs (straight, soluble and synthetic) using questionnaires and reports from factory visits. Occupational exposures were based on three metrics: duration, frequency-weighted duration and cumulative exposure index. Conditional multiple logistic regressions were used to determine ORs and 95% CIs, taking non-occupational and occupational exposure into account. Results In the 25 years before diagnosis, ORs increased significantly with duration of exposure to straight MWFs (OR=1.13 (1.02–1.25)) and increased with frequency-weighted duration of exposure to straight MWFs (OR=1.44 (0.97–2.14)). These results remained valid after adjusting for duration of smoking, average number of cigarettes smoked per day, time since smoking cessation and exposure to polycyclic aromatic hydrocarbons (PAHs). ORs also increased with soluble MWFs but not significantly. No significant association was found with older exposures to MWFs or with exposure to synthetic MWFs. Conclusion The increased risk of bladder cancer observed among workers exposed to straight MWFs and to a lesser extent to soluble MWFs may be explained by the presence of carcinogens (such as PAH) in mineral oils component of straight and soluble oils. Prevention therefore remains necessary in sectors using MWFs.

0342 Perception of psychosocial factors at work according to age

The objective was to explore the effects of age on the perception of psychosocial factors (PSF) SUMER, a cross-sectional survey, was designed to characterise occupational exposures in a large representative sample of French employees. In 2010, 26 762 males and 20 019 females, aged 18 to 65, filled in the Karasek (skill discretion and decision authority, job demands, social support from colleagues and supervisors) and Siegrist (esteem, job security, job promotion) questionnaires. Additionally, participants were interviewed by occupational physicians about their work situation and occupational exposures. Graphical representations were used to characterise the PSF scores according to age. Then, breakpoints were identified using multiple change-point models. Finally, seniority, and working conditions were included as dependent factors in piecewise linear models with age, separately in men and women. The graphical representations highlighted that perceptions were different for young and old workers compared to the middle-range age in both genders. These trends were confirmed statistically for young (breakpoint at 30 years) and for older workers (breakpoint at 55 years) mostly for the Siegrist scores. When seniority was taken into account, the effect of age on PSF scores was intensified for young newly hired (less than 3 years of experience) for the Karasek scores. Results confirmed that young, and to a lesser extent, senior workers have different perceptions of PSF compared to middle-age group. Particularly, the effect of age was strengthened in young newly hired workers. Given the well-known impact of the PSF on health, OSH prevention should pay attention to these groups of workers.

O22-1 Bladder cancer and occupational exposure to metalworking fluid mist: a nested case-control study in french steel-producing factories

Objective To assess possible relationships between occupational exposure to metalworking fluid (MWF) mist and bladder cancer risk. Methods A nested case-control study was conducted within a cohort of workers from 6 steel-producing factories. Cases were diagnosed with bladder cancer in 2006–2012. Three controls per case were randomly selected from the cohort, matched to cases by age at diagnostic and counter-matched according to 4 strata of surrogate measure of exposure to MWF mists, assessed using a job-exposure matrix. Cases (n = 84) and controls (n = 251) provided information during personal interviews on occupational history, including the type of MWF used (straight oils, soluble oils, synthetic fluids), and smoking habits. Experts estimated intensity, frequency and probability of exposure to each MWF mist. Conditional logistic regression, adapted to counter-matching, was used to calculate Odds-Ratios (OR) and 95% confidence intervals (95% CI), taking into account the 3 types of MWF mist, and adjusting for smoking and other occupational factors. Results A statistically significant OR for bladder cancer was observed for workers exposed to MWF mist, for over 20 years during occupational history (OR 3.32, 95% CI: 1.48–7.46). ORs were statistically significant for workers ever exposed to straight oils (OR 2.14, 95% CI: 1.05–4.36), for over 20 years during occupational history (OR 5.49, 95% CI: 1.75–17.2). ORs statistically not greater than 1 were observed for workers ever exposed to soluble oils (OR 1.46, 95% CI: 0.71–3.02), for over 20 years during occupational history (OR 2.43, 95% CI: 0.88–6.70). OR was not statistically significant for workers ever exposed to synthetic fluids (OR 1.2, 95% CI: 0.31–3.30). Dose-response relationships were observed with cumulative exposure to MWF mist and straight oils in the last 20 years before diagnosis. Conclusion This study highlighted association between recent exposure to straight oils and bladder cancer risk, but did not detect any relationship concerning soluble oils or synthetic fluids.

Relationships between organizational workplace characteristics and perceived workplace strain in call-centers in France.

BACKGROUND Our objective was to study the associations between organizational workplace characteristics (OC) reported by call-center (CC) managers and workplace stressors reported by call-handlers. METHODS The managers of 107 CCs were interviewed by their occupational physicians using a questionnaire designed to specifically explore OC in the CCs. Four thousand two call-handlers from these CCs completed a self-report questionnaire including the Karasek and Siegrist work stressor questionnaires and two specific items on other workplace stressors. RESULTS Around one-third of the OC examined were associated with the demand/control ratio, the perception of demanding work and ethical conflicts, however, far fewer OC were associated with the effort/reward ratio. Most OC were associated with higher levels of job stressors. Some had strong, systematic negative associations with stressors (e.g., highly formatted instructions for the client relationship). CONCLUSIONS These findings could help in targeting job stressor prevention and health improvement strategies in CCs.