[Epidemiological study of a tuberculosis case in a large manufacturing enterprise in Quebec]. / Enquête épidémiologique sur un cas de tuberculose dans une grande entreprise manufacturière québécoise.

OBJECTIVES: To determine the prevalence of tuberculosis infection related to a case of pulmonary and laryngeal tuberculosis in a workplace and to study PPD predictors. METHODS: The Mantoux skin test (PPD) was offered to all potentially infected contacts. Participants were asked to answer a questionnaire. RESULTS: Among 112 exposed employees, 92 (82.1%) were tested. At the 5 mm level, 65.2% of employees had positive tuberculin skin test (PPD). By controlling prior BCG and the degree of exposure, it showed a positive association between age and PPD (RC: 3.5; 95% CI: 1.25-10.03). When age and BCG were controlled, high exposure was statistically associated with PPD results (RC: 5.6; 95% CI: 1.25-24.68). CONCLUSION: The observed prevalence rate is probably related to the fact that the index case was very infectious and had contact in an enclosed area over a long period of time before withdrawal from work.

[The professional life and the health of nurses since the transformation of the Québec health system.]. / La vie professionnelle et la santé des infirmières depuis la transformation du réseau de la santé

Over the last years, the Quebec health system has gone through a period of transformation aimed at cost reduction and better efficiency. The present study describes the effects of the transformation on the professional life and on the health of nurses in the Quebec City urban area. Despite a cross-sectional study not allowing links from cause to effect and despite the fact that the study only includes nurses who were still employed by institutions, the research shows an increase of the prevalence of a higher level of psychological distress in nurses since the beginning of the transformation. Interventions in the work place should be geared to professional factors that nurses identify as problematical.

Hepatitis A among workers from a waste water treatment plant during a small community outbreak.

OBJECTIVE: This is a case report describing the occurrence of hepatitis A in three workers at a waste water treatment plant during a small community outbreak involving 16 cases. CASE REPORT: The first case was a 26 year old operator who had worked in the plant for two years, the second was a 23 year old employee hired to add new biolite in the secondary treatment area. These two cases never worked together and only met two or three times before the onset of disease in the second case. The third case occurred three months later in a 34 year old ventilation mechanic. All three cases were confirmed by IgM serology and virus was recovered by polymerase chain reaction in the stools of the last two cases. Despite an extensive search for other risk factors for hepatitis A in these workers none was found. CONCLUSION: This report confirms that hepatitis A is an occupational hazard for sewage workers. The numerous potential sources of contamination associated with that occupation support the use of vaccine to provide effective prevention.

[Hockey injuries: consultations in a hospital center in Quebec]. / Blessures liées à la pratique du hockey: consultations dans un centre hospitalier de la région de Québec.

OBJECTIVES: Assess the context and characteristics of hockey injuries, and evaluate the probable effects of regulations concerning mandatory use of head and neck protective equipment. DESIGN: Descriptive study of 247 patients suffering from hockey injuries. Cases were recorded at the emergency room of the Hôpital de l'Enfant-Jésus, in Quebec City, from October 1 1991 to April 30 1992. Injury characteristics are presented by categories, and "Organized hockey on skates" (HPO) is the only category where protective equipment is mandatory. RESULTS: Nearly 42% of consultations were related to non-HPO. In the HPO injuries 15.4% were head injuries whereas in other categories, head injuries represented 31.4%, 33.3% and 44.0% of total injuries. DISCUSSION: Data suggest that regulation imposing mandatory head and neck protection should be maintained in the HPO category because of its apparent preventive effect. Accordingly, implementation could also be considered in other categories.

Need for vaccination of sewer workers against leptospirosis and hepatitis A.

OBJECTIVES: This study compared the prevalence of Leptospira interrogans and hepatitis A virus (HAV) antibodies in serum samples from sewer workers and controls. METHODS: A blood sample was obtained from 76 of the 101 municipal sewer workers (75%) of Quebec City and from two controls matched to each for age and sex. Testing was done for antibodies against serovars of Leptospira icterohaemorragiae, bratislava, hardjo, grippotyphosa, and kennewicki (pomona) and hepatitis A. RESULTS: Sewer workers had a greater prevalence of antibodies against leptospirosis than controls (12% v 2%, P = 0.003). In contrast, antibodies to HAV were not significantly more prevalent among workers than among controls (54% v 49%, P = 0.51). Prevalence of HAV antibodies increased significantly with age both among workers and controls (chi 2 for trend, P < 0.001). In contrast with younger workers, prevalence of HAV antibodies was greater among workers > or = 40 years than among their controls (81% v 65%, P = 0.04). CONCLUSION: Leptospirosis continues to be a problem to sewer workers but hepatitis A is apparently no longer a risk. The likely explanation is that leptospira are still abundant in the sewage system in contrast with HAV, which is only rarely to be found in sewage as a result of the generalised decrease in incidence of hepatitis A in the past three decades. The decision to vaccinate sewer workers against hepatitis A should take into account that it is impossible to avoid all contact with sewage fluid and, despite the fact that the actual incidence of hepatitis A is low, there is a real possibility of sporadic exposure during a future outbreak.

Comparative study of DNA adducts levels in white sucker fish (Catostomus commersoni) from the basin of the St. Lawrence River (Canada).

The levels of DNA adducts in the hepatic tissue of the white sucker fish species Catostomus commersoni were determined by 32P-postlabelling. The fish were caught at four sites: two sites near the city of Windsor (Québec, Canada) on the St. François River, a downstream tributary of the St. Lawrence River, and two sites in the St. Lawrence River itself, near the city of Montréal (Québec, Canada). The latter sites are known to be contaminated by many pollutants including polycyclic aromatic hydrocarbons. Total adduct levels in all fish ranged from 25.1-178.0 adducts per 10(9) nucleotides. White sucker from the selected sites of the St. Lawrence River had a significantly higher mean level of DNA adducts than those of the St. François River (129.4 vs 56.8, respectively). These results suggest that the effluents of many heavy industries (e.g. from a Soderberg aluminium plant) flowing in the St. Lawrence River are more likely to produce genotoxic damage to fish than those released in one of its tributary, and mainly associated to the activities of a small town and a nearby pulp and paper mill.

Therapeutic horseback riding:.

This paper reviews the literature on the benefits of therapeutic horseback riding and the outcomes of eleven data-based studies purpoting to validate the claims that horseback riding offers therapeutic benefits. These studies have focused on physical and psychosocial variables. The literature on the benefits of riding reported obvious beneficial effects, while the outcome studies were able to document only some of these claims. The studies generally reported some significant effects from the therapeutic intervention. An examination of the outcome studies revealed weak scientific rigor, small sample sizes, and a lack of homogeneous populations. Furthermore, use of standardized measures was limited as authors frequently relied on nonstandardized observational techniques to evaluate change. This review indicates a need for further research into both the physical and psychosocial areas with both children and adults. In addition, there is a need for research which would improve the methodological rigor, homogeneity of populations, sample size, and use of standardized measurement instruments.

A study of therapeutic effects of horseback riding for children with cerebral palsy.

This article describes major findings from a study of the therapeutic benefits of horseback riding for children with cerebral palsy. Nineteen children (aged 4-12 years) with mild or moderate degrees of cerebral palsy were recruited from a children's treatment centre. Prior to randomization, the children were stratified according to their degree of disability. Ten children were allocated to a riding (experimental) group, and participated in one-hour weekly riding classes for six months. The remaining nine children were put on a waiting list for riding. The results of the study were inconclusive as so often in the case with children with cerebral palsy. Qualitative results gleaned from the weekly progress recordings of the riding instructor, reports of the on-site physical therapist, and reports from parents showed clear progressions in physical and psychosocial functioning. Results of standardized quantitative assessments showed few statistically significant changes in the children. The study clearly indicates a need for further research and for finding or developing instruments that are able to capture and reveal meaningful changes in physical and psychosocial status.

Burns associated with fondues.

OBJECTIVE: To describe the causes of burns associated with fondues. DESIGN: Descriptive case series. PATIENTS: All 17 patients admitted to a burn centre between Apr. 1, 1985, and Mar. 31, 1990, whose burns were associated with fondue. Eleven agreed to complete a telephone interview. RESULTS: The age of the 17 patients varied from 2 to 56 (mean 27) years. Two causes were identified: spilling of the contents of the fondue pot and explosion of the fondue fuel when added to the burner during a meal. The telephone interview revealed that eight people other than the respondents were burned during the same accidents. CONCLUSION: Although we identified only badly burned patients the problem may be more extensive. The knowledge of specific causes of burns from handling fondue equipment indicates that preventive action should be undertaken. More epidemiologic information is needed to obtain a precise estimate of the magnitude of this public health problem.