[Industrial factors in the etiology of obstructive respiratory diseases. Implications for prevention]. / Facteurs industriels dans l'étiologie des maladies respiratoires obstructives. Conséquences pour la prévention.

The statistics of occupational diseases in industrial medicine, as well as the markedly elevated incidence of chronic bronchitis amongst workers, show that there is an additional respiratory risk linked to industrial environment and the conditions of work. Epidemiological studies in industry and in particular certain occupations, such as mining and the construction industry have led to a better understanding of this industrial risk as a generator of the additional obstructive respiratory disease occurring in exposed workers. Among the unrecognised risks is the prolonged exposure to the oxides of nitrogen which are capable of affecting gas exchange, as has been shown in one of our investigations in the production of nitrogenous fertilizers, which explains the mechanism. In industrial medicine, a preventative strategy should be planned, on the one hand considering individual risks and taking account of personal and genetic factors, on the other hand monitoring of respiratory risks by the identification of new irritants and finally the organisation of respiratory function screening for the early detection of lung dysfunction, by more sensitive tests than the FEV1 (VEMS), whose validity should be studied. The priority is primary prevention by the suppression of toxic irritants and by the improvement of working conditions.

[Medico-social consequences of asthma in adults (author's transl)]. / Conséquences médico-sociales de la maladie asthmatique chez l'adulte.

The evaluation of the medico-social consequences of asthma in adults encounters difficulties that are inherent to a chronic disease with varying clinical pictures. Overall statistical analyses, particularly concerning mortality, provide little information in a socio-economical perspective, especially in France. However, based on the results of fragmentary but varied analyses, the study of this disease in relation to the working careers of asthmatic subjects underlines the importance of the repercussions at the very start of professional life (choice of profession, recruitement in a company). The study of absenteeism and inaptitude reveals to what degree these consequences are related to the seriousness of the disease and to the asthmatic person's social sphere. The same is true for family and social life which is more difficult to evaluate. Systematic analyses alone will be useful in determining whether asthma is considered a "social disease" with its eventual implications on a public health program.

[Two surveys on farmer's lung disease and bird breeder's disease in the Pyrenees region]. / A propos de deux enquêtes sur la maladie du poumon de fermier et la maladie des éleveurs d'oiseaux en Midi-Pyrénées.

Two different surveys, one strictly epidemiological in rural areas, the other retrospective and within hospitals, led to a better knowledge of the setting of the FLD and BBD in South Pyrenees region. In the country, more than 12% of patients had specific precipitins, 6% had either one or both diseases; women had anti-aviary precipitins more frequently than men. The retrospective hospital survey yielded 456 cases of patients admitted or consulting revealing numerous correlations between the different clinical, radiological and functional syndromes on the one hand and the serological positivity on the other. Serological diagnosis was most useful, as a wide variety of antigenic extracts was used (actinomycetes thermophiles, mouldy hay, bird droppings), mixed sensitizing was extremely frequent. The widely found positivity towards avian antigens seems specific to the South Pyrenees region.