[Fire department nursing, a different way of practising nursing]. / Infirmier de sapeurs-pompiers, exercer sa profession de soignant autrement.

Still unknown by his peers, the firefighter nurse is a magnificent link between the hospital world and civil security. A health professional with versatile activities, he symbolizes in his own way the innovation and emancipation of the nursing profession notably through the para-medicalisation of pre-hospital rescues. Putting into perspective the role and missions of the Seine and Marne firefighter nurses.

[Emotional distress and trauma at the threshold of death: health issues and levers for action]. / Pénibilité émotionnelle et trauma au seuil de la mort : enjeux de santé et leviers d'action.

The emotional load and the confrontation with the end of life and death that health professionals regularly endure are occupational health and public health issues. Understanding their deleterious effects on the health of caregivers is only a first step, which must be followed by the identification of the various levers of action that can be mobilized.

[Ressources, activité et dynamique d'équipe du travail infirmier de nuit]. / Ressources, activité et dynamique d'équipe du travail infirmier de nuit.

Night work takes on different aspects for nurses, from a regulatory, individual, physiological, collective and organizational point of view. It is important to be able to rely on the resources that make night work bearable by taking these different elements into account. Exploration of the personal, groupal and organizational variability observed in a university hospital and propositions to facilitate the management of night work while preserving the interest of the tasks and physiological rhythms.

[Weight gain in caregivers during night work]. / Travail de nuit et prise de poids chez les soignants.

Night work is common in hospitals. Weight gain with its metabolic complications is one of its well known effects. The presented study reports that night shift workers have an average weight gain of 5kg compared to day shift workers. They also have an insufficient cardioprotective diet. Occupational health nurses have an important role to play in identifying this warning indicator and developing primary prevention actions.

[Impact of the Covid-19 pandemic on the health of nurses in a university hospital]. / Impact de la pandémie de Covid-19 sur la santé des infirmiers d'un CHU.

In a university hospital in Brittany, health monitoring of the staff was set up at the beginning of the Covid-19 pandemic. The first results of the studies carried out in this context showed that nurses showed a greater deterioration of their physical health than other professionals. However, thanks to psychological balancing measures, nurses did not appear to be more affected in terms of psychological health and well-being at work than the other hospital workers.

[Occupational health nurse: prevention of workplace risks in a multidisciplinary team]. / L'infirmier de santé au travail : prévention et sécurité en équipe pluridisciplinaire.

The presence of nurses within occupational health care teams is now mandatory. Their role, centred on prevention, health protection and employees' safety, is practised under the authority and in close collaboration with the occupational health doctor, within a multidisciplinary team. Over recent years, their scope of practice has been expanded to include the individual monitoring of employees' health. It could be further expanded in future.

[Factors related to the one-month retention of 8507 employees declared medically unfit in Hauts-de-France companies between 2014 and 2018]. / Facteurs liés au maintien dans l'entreprise à un mois chez 8507 salariés déclarés médicalement inaptes en Hauts-de-France entre 2014 et 2018.

BACKGROUND: Given the low rate of retention in a company after an employee has been found unfit for the job, our aim was to determine the factors related to employees being kept by their company one month after being declared unfit for the job due to either a musculoskeletal disease (MSD) or a mental health disorder (MHD). METHODS: This study was based on all employees declared unfit for the job by the occupational physicians in the "Unfitness" survey in the French "Hauts-de-France" region between 2014 and 2018. For each of the two groups of workers, factors related to the employees being kept by their company one month after being declared unfit for the job were studied by logistic regression. RESULTS: Only 6.9% of the 5352 workers declared unfit for the job due to MSD were kept in their company whereas 3.6% of the 3155 workers declared unfit for the job due to MHD were kept in theirs. For the two groups of workers, the proportion of employees kept by their company decreased with female gender (OR=0.63 95%CI [0.47-0.84] for MSD and OR=0.50 [0.32-0.78] for MHD for female vs. male), long sick-leave (OR=0.26 [0.18-0.40] for MSD and OR=0.22 [0.11-0.45] for MHD for sick-leave>6 months vs. no sick leave), small size of the company (<50 employees) and working in the construction field or services sector (vs. industry or administration). Concerning the employees declared unfit due to MSD alone, the proportion of employees kept by their company decreased for seniors (>50 years old) and for those with low seniority (<5 years). CONCLUSION: "Retention in a company" as a tool for "maintenance of employment" is a little-discussed subject, lending further credence to the current recommendations for reduction of inequalities in working conditions and vocational training of employees according to age and socio-occupational category, and also for reduction of inequalities in occupational pathways according to gender.

[Substance use disorders and addictions among carers]. / Troubles de l'usage de substances et addictions chez les soignants.

Carers also use psychoactive substances and sometimes at work. The risks of use and especially the misuse of psychoactive substances at work take characteristics in health area. Often silent or concealed, substance use disorders of health professionals justify identifying, screening, care and prevention through comprehensive institutional programs involving supervision team.

Trabalhar e adoecer: temporalização de trabalhadores(as) da agroindústria / Work and disease: temporalization of agro-industry workers / Trabajar y enfermarse: temporalización de trabajadores(as) de la agroindustria / Travailler et tomber malade: temporisation des travailleurs de l'industrie agroalimentaire

Por meio da compreensão da relação entre o processo de trabalho e o projeto de ser trabalhador(a), discriminamos três dimensões da temporalização de trabalhadores(as) de uma unidade frigorífica do Oeste catarinense que adoeceram pelo trabalho. As investigações foram realizadas utilizando-se de entrevistas narrativas com trabalhadores(as) e sindicalistas. Como resultados parciais desta pesquisa, encontramos três dimensões da experiência que incidem na temporalização ou personalização, quais sejam: trabalhar com dor, sofrer e trabalhar, e antes e depois do adoecimento. A partir da experiência dos trabalhadores ressaltamos que trabalhar com dor implica numa mudança da corporeidade e na temporalização em que o adoecimento pelo trabalho se torna o projeto de ser trabalhador(a).

By understanding the relationship between the work process and the project of being a worker, we categorize three dimensions of the temporalization of workers from a refrigeration unit in the west of Santa Catarina who got sick from work. The investigations were conducted using narrative interviews with workers and union members. As partial results of this research, we find three dimensions of experience that focus on temporalization or personalization, namely: working with pain, suffering and working, and before and after an illness. From the experience of the workers, we emphasize that working with pain implies a change in the corporeality and the temporalization in which the illness due to work becomes the project of being a worker.

Por medio de la comprensión de la relación entre el proceso de trabajo y el proyecto de ser trabajador(a), discriminamos tres dimensiones de la temporalización de trabajadores(as) de una unidad frigorífica del Oeste catarinense que se enfermaron por el trabajo. Las investigaciones fueron realizadas utilizando entrevistas narrativas con trabajadores(as) y sindicalistas. Como resultados parciales de esta investigación, encontramos tres dimensiones de la experiencia que inciden en la temporalización o personalización, son ellas: trabajar con dolor, sufrir y trabajar, y antes y después de enfermarse. A partir de la experiencia de los trabajadores pusimos en relieve que trabajar con dolor conlleva en un cambio de la corporeidad y en la temporalización en que enfermarse por el trabajo se convierte en el proyecto de ser trabajador(a).

En comprenant la relation entre le processus de travail et le projet d' être travailleur, on a distingué trois dimensions de la temporisation des travailleurs d'une unité de réfrigération qui sont tombés malades à cause de leur travail dans l'ouest de Santa Catarina, Brésil . Les enquêtes ont été menées à l'aide d'entretiens narratifs avec des travailleurs et des membres du syndicat. Comme des résultats partiels de cette recherche, on a trouvé trois dimensions de l'expérience qui se concentrent sur la temporisation ou sur la personnalisation, à savoir: travailler avec la douleur, souffrir et travailler, et avant et après la maladie. À partir de l'expérience des travailleurs, on souligne que travailler avec la douleur implique un changement du corps et une temporisation dans laquelle la maladie à cause du travail devient le projet d'être travailleur.

[Tobacco and work]. / Tabac et travail.

INTRODUCTION: Health indicators published over more than 15 years in France show differences in the prevalence of smoking in relation to activity status and socio-professional categories. However, the relationship between smoking and work is not limited to this. BACKGROUND: Smoking by employees is traditionally regarded as entailing additional costs for businesses, but the actual costs of smoking in the workplace are difficult to assess. Co-exposure to tobacco and the toxic substances encountered in work areas carries an increased risk of developing lung disease, broncho-pulmonary cancer and chronic obstructive pulmonary disease in particular. The workplace can also be an area of exposure to passive smoking that affects employees unequally. In France, the use of tobacco and e-cigarettes in the workplace has been regulated since 2006 and 2016, respectively. OUTLOOK: Workplace smoking cessation programs and smoking bans seem to encourage cessation of smoking. Smoking cessation advice by occupational physicians could work in the same manner. Subjects exposed to occupational carcinogens and tobacco could benefit from low-dose CT screening after a trial period to validate this approach. CONCLUSION: Workplaces can be areas for the prevention and cessation of smoking.

[Trends of lung cancer mortality among employed men according to their occupation]. / Mortalité par cancer du poumon chez les hommes salariés selon l'activité professionnelle.

The objective of this article is to describe the changes in lung cancer mortality among employed men over the period 1976-2005, according to their activity sector and socio-professional categories. This work was done as part of the Cosmop monitoring program. The socio-professional data come from the DADS panel constituted by INSEE. For each person of the panel, the vital status was searched until 2005 by matching the national file of medical causes of death managed by Inserm's CépiDC (Epidemiological Center for Mortality by Medical Causes). The results show large disparities in mortality among male employees by activity sector. Over the period 1976-2005, the rates vary twofold between the sector with the highest rate (Construction, 98 p.100,000 person-years) and the sector with the lowest rate (Education, 43 p.100,000 person-years). For most of the activity sectors, mortality rates increased between the periods 1976-1985 and 1986-1995 before decreasing over the period 1996-2005. Some activity sectors stand out by an increase in mortality over the study period. This is the case for construction, education and public administration. It is essential to continue the surveillance of cancers by social category and activity sector. This will permit us to identify sectors in which specific preventive actions should be carried out, particularly on smoking for lung cancer.

Cuestionarios de valoración funcional en traumatología / Trauma functional assessment questionnaires

RESUMEN Introducción: Las enfermedades musculoesqueléticas son dolencias de alta prevalencia, impacto y repercusión. La historia clínica y las pruebas complementarias son las primeras pautas para diagnosticarlas. Se recomienda el uso de cuestionarios para la valoración de las limitaciones e impacto en la calidad de vida de los pacientes. Objetivo: Valorar el uso y eficacia de los cuestionarios en traumatología. Métodos: Se revisaron las bases de datos Medline, Pubmed. Se obtuvieron 32 publicaciones, fundamentalmente, en inglés, aunque también en español y otros idiomas, realizadas entre 2001-2018, que recogen la experiencia de los investigadores con el uso de los cuestionarios. Los términos de búsqueda empleados fueron: Musculoskeletal Disorders, Musculoskeletal pain; and Foot and Ankle, hip and knee, Upper Extremity, low back pain; and disability, quality of life questionnaires and assessment tool. Resultados: Se han revisado 46 cuestionarios: 4 de calidad de vida, 16 de miembro superior (1 general y 15 por localización de la lesión), 19 de miembro inferior (4 generales y 15 por localización de la lesión) y 7 para raquis. Conclusiones: No hay acuerdo en los autores sobre cuál es el mejor cuestionario para la valoración de impacto y repercusión, y se combinan varios de ellos. La elección del cuestionario y el que sea genérico (de calidad de vida) o específico (de miembro superior, inferior o raquis), está en consonancia con el objetivo buscado en la investigación, la experiencia del investigador, su uso clínico y tiempo necesario para cumplimentarlo(AU)

ABSTRACT Introduction: Musculoskeletal diseases are ailments of high prevalence, impact and impact. The medical record and the complementary tests are the first guidelines to diagnose them. The use of questionnaires is recommended to assess the limitations and impact on the quality of life of patients. Objective: To assess the use and effectiveness of traumatology questionnaires. Methods: Medline, Pubmed databases were reviewed. We recovered 32 publications mainly in English, but also in Spanish and other languages, made from 2001 to 2018. These publications collect the experience of researchers with the use of questionnaires. The search terms used were Musculoskeletal Disorders, Musculoskeletal pain; and Foot and Ankle, hip and knee, Upper Extremity, low back pain; and disability, quality of life questionnaires and assessment tool. Results: Forty six questionnaires were reviewed. Four on quality of life, 16 on the upper limbs (one general and 15 by location of the lesion), 19 on the lower limbs (four general and 15 by location of the lesion) and 7 on spine. Conclusions: There is no consensus among the authors on which is the best questionnaire for assessing of the impact and repercussion. Several of them are combined. The choice of the questionnaire and the one that is generic (on quality of life) or specific (on upper, lower limbs or spinal) is in line with the objective sought in this research, the researcher´s experience, clinical use and the time needed to fill it out(AU)

RÉSUMÉ Introduction: Les troubles musculo-squelettiques sont des affections dont la prévalence, l'impact et le retentissement sont élevés. Le dossier médical et les examens complémentaires sont les premières orientations pour les diagnostiquer. L'emploi des questionnaires pour évaluer les limitations et l'impact sur la qualité de vie des patients est recommandé. Objectif: Évaluer l'emploi et l'efficacité des questionnaires en traumatologie. Méthodes: On a consulté les bases de données Medline et PubMed. On a obtenu 32 publications notamment en anglais, mais aussi en espagnol et d'autres langues, parues entre 2001-2018, recueillant toute l'expérience des chercheurs dans l'usage des questionnaires. Les termes de recherche utilisés ont été: Musculoskeletal Disorders, Musculoskeletal pain ; and Foot and Ankle, hip and knee, Upper Extremity, low back pain ; and disability, quality of life questionnaires and assessment tool. Résultats: Sur 46 questionnaires, on a révisé 4 concernant la qualité de vie, 16 concernant les membres supérieurs (1 de sujet général et 15 de localisation de la lésion), 19 concernant les membres inférieurs (4 de sujet général et 15 de localisation de la lésion), et 7 concernant le rachis. Conclusions: Les auteurs ne sont pas arrivés à un consensus sur le meilleur questionnaire pour évaluer l'impact et le retentissement; on a fait une combinaison de plusieurs d'entre eux. La sélection d'un questionnaire et le fait qu'il soit générique (qualité de vie) ou spécifique (membre supérieur, inférieur ou rachis) ont été en concordance avec l'objectif de la recherche, l'expérience du chercheur, l'usage clinique et le temps nécessaire pour le compléter(AU)

[State of immunization against measles among health professionals in at-risk units of the Caen University Hospital]. / État d'immunisation contre la rougeole chez les professionnels de santé au sein des services à risques du centre hospitalier universitaire de Caen.

BACKGROUND: France is facing a new resurgence of measles. Since November 2017, the number of cases has been increasing sharply. Immunization coverage in the general population, all ages combined, is below the threshold required for a rapid decline of the virus propagation. Regarding health professionals, the rate of immunization against this disease is insufficiently documented. In this context, the Occupational Health Service of the University Hospital of Caen has carried out an inventory of health personnel knowledge of immunization against measles in the units the most exposed to risk. METHODS: Knowledge of immunization against measles was studied in pediatric, imaging, and pediatric and adult emergencies departments of the University Hospital of Caen, and the Hematology Institute of Lower Normandy (IHBN). The analysis included all health professionals present within these units during the study period: March and April 2018. Data collection was carried out by consulting the medical files of the occupational health unit and considering the set of responses to postal inquiries sent to staff. RESULTS: Measured immunization status data refer to 1017 health professionals. Based on the criteria specific to the recommendations, 234 (50.6%) of the 462 professionals born before 1980 and 437 (78.7%) of the 555 professionals born in or after 1980 could be considered as immune. Of the total sample, 115 (11.3%) had positive measles serology. Among these 1017 professionals, information on the state of immunization against measles was lacking for 174 (17.1%). CONCLUSION: The state of immunization of the nursing staff remains insufficient to prevent the occurrence of measles cases and the staff is also insufficiently informed. It is essential to have knowledge of the immunization status of this population, to organize the vaccination of non-immunized personnel within the occupational health unit, to prevent the emergence of new cases of measles and to reinforce the information regarding the importance of precautions related to airborne transmission in case of measles.

[Role of the occupational health nurse]. / Rôle de l'infirmier de santé au travail.

The missions of occupational health nurses are exclusively preventive, except in the event of emergency situations. They are involved in the prevention of occupational stress, the assessment of psychosocial risks and the improvement of quality of life at work.

[Occupational health in China, an emerging issue]. / La santé au travail en Chine, une préoccupation naissante.

In Chinese factories, the prevention of occupational illness is inadequate. Public authorities have only recently started to pay attention to the issue. Individual and collective protection measures need to be developed, employees made aware of the issues and controls improved.

Workplace mental health: Current practice and support needs of Ontario occupational therapists.

BACKGROUND.: Workplace mental health (WMH) is an important and expanding practice area for occupational therapists. PURPOSE.: This cross-sectional study explores the current practices and support needs of Ontario-based occupational therapists in WMH. METHOD.: Registrants from the provincial association who provide mental health and/or work-related services were invited to participate. Ninety-three therapists completed an online survey; 10 participated in follow-up focus groups. Analysis involved descriptive statistics of the survey data and content analysis of the focus group data. FINDINGS.: Return to work, reactivation, and functional cognitive assessment were the most commonly reported services. Key challenges were limited funding and training and lack of awareness of the occupational therapy role. Therapists emphasized the importance of raising the competence, credibility, and profile of occupational therapy in WMH. IMPLICATIONS.: Defining the role of occupational therapy, developing training and resources, and advocacy are needed to advance occupational therapy practice within this rapidly changing field.

[Occupational risks during pregnancy: Feedback from occupational medical services]. / Exposition aux risques professionnels pendant la grossesse : retour de services médicaux interentreprises.

OBJECTIVES: To describe the follow-up of pregnancies at work and exposures to pregnancy occupational hazards. METHODS: A cross-sectional study was performed between January and December 2014 in occupational health services of Languedoc-Roussillon region. Eligible workers were interviewed by occupational health physicians (OHPs) after delivery and at the time of returning to work (exposure, anticipation, prevention, communication, sick leave). Occupational skill levels were classified according to the French standard classification of occupations (version 2003) from the French National Institute of Statistics. Socioeconomic deprivation was assessed using the Evaluation of Deprivation and Inequalities in Health Examination (EPICES) individual scale. RESULTS: A total of 1347 workers were recruited. The mean age was at 30.7±4.5 years. Among pregnant workers, there were 54.2% of employees, 30.7% of intermediate occupations, 10.4% of managers and, 4.7% of manual workers. Twenty-two percent of workers were classed as deprived. Also, 43.2% of workers were exposed to three or more occupational hazards during pregnancy. Only 17.7% of workers had medical visits with OHP during pregnancy and 14.7% benefited from workstation adjustments. In contrast, the level of sick leaves was high (74.2%). CONCLUSION: Our results argue for the need to follow pregnancies at work. However, the low level of prevention activities and the high level of sick leaves raise the question of the management of pregnant women at work.

[Preventing addictive practices in the workplace thanks to occupational health services]. / Prévenir les pratiques addictives en milieu professionnel grâce aux services de santé au travail.

The workplace can be concerned by all types and all levels of addictive practices: consumption of alcohol or psychoactive substances, work addiction, internet addiction and technology addiction. Addictions can be related to multiple factors, both within and outside the workplace. With the employer, responsible for occupational health and safety, the multidisciplinary team of the inter-company occupational health service must today implement a collective and global prevention policy with regard to addictions, in addition to the traditional follow-up.

Evolution of the missions of occupational health services and follow-up of the employees / Évolution des missions des services de santé au travail et du suivi des salariés

Evolution of the missions of occupational health services and follow-up of the employees. In France, the occupationnal health system is original because it is based on dual approach, individual or medical approach and collective, directed on the working conditions. The targeted follow-up of health is split between from now on the healthcare professionals of a multidisciplinary team and has to allow a better prevention of occupationnal risk and the deployment of the numerous missions of occupational health services.

Évolution des missions des services de santé au travail et du suivi des salariés. En France, le système de santé au travail est original car fondé sur une double approche, individuelle médicale et collective orientée sur les conditions de travail. Le suivi de santé ciblé est désormais partagé entre les professionnels de santé d'une équipe pluridisciplinaire et doit permettre une meilleure prévention des risques professionnel et le déploiement des nombreuses missions des services de santé au travail.

[Occupational disorders epidemiology]. / Épidémiologie des maladies professionnelles

Occupational disorders epidemiology. The aim of this narrative review was to give some basics of occupational disorders epidemiology, compensated or not, and focusing on complementarity between data sources available in France.

Épidémiologie des maladies professionnelles. L'objectif de cette mise au point est de donner quelques repères sur l'épidémiologie des maladies liées au travail et des maladies professionnelles, en insistant sur les sources possibles de données disponibles en France et leur complémentarité.