[Occupational medicine in France: the current situation in 2024]. / Médecine du travail en France, état des lieux en 2024.

OCCUPATIONAL MEDICINE IN France : THE CURRENT SITUATION IN 2024. Occupational medicine has evolved since its creation in 1946. Occupational medicine services have become Occupational health services (OHS) and medical examination in nowadays only a part of their missions, which include helping the employers to perform risk assessment, patients to stay at work, and implementing health promotion in the workplaces in order to prevent disabilities. To fulfill those missions, OHS can rely on health specialists (occupational physicians and nurses) but also on a wide range of competencies, from toxicologists to ergonomists, and from psychologists to occupational hygiene specialists, all gathered in multidisciplinary teams, leaded by the occupational physician. Optimizing cooperation between general practitioners and occupational health physicians is still needed to improve the worker journey, to facilitate his ability to return to work and to ameliorate his long-term health follow-up according to his previous occupational exposures.

MÉDECINE DU TRAVAIL EN FRANCE, ÉTAT DES LIEUX EN 2024. La médecine du travail a peu à peu évolué, depuis sa création en 1946. Les services médicaux du travail sont devenus des services de prévention et de santé au travail, et le suivi de santé ne représente désormais qu'une partie de leur activité. L'aide à l'évaluation des risques, le maintien en emploi, les actions de promotion de la santé dans une perspective de prévention de la désinsertion professionnelle ont pris une place grandissante. Cela s'est accompagné d'une évolution des compétences au sein de ces services. Outre la compétence santé représentée par le binôme médecin-infirmier, des ergonomes, psychologues et toxicologues sont désormais présents ; ils interviennent en prévention des risques professionnels et constituent des équipes pluridisciplinaires, animées et coordonnées par le médecin du travail. Une meilleure collaboration entre médecin du travail et médecin traitant reste nécessaire pour améliorer le parcours du travailleur, son maintien en emploi et son suivi de santé au long cours en fonction de ses expositions professionnelles passées.

Extended analysis of solid cancer incidence among nuclear industry workers in the UK 1955-2011: comparison of workers first hired in earlier and later periods.

To address points arising from the recent study of nuclear workers in the USA and the International Nuclear Workers Study (INWORKS), concerning the difference in solid cancer risk estimates between those first hired in earlier and later calendar years, subsidiary analyses were conducted on a cohort of 172 452 workers in the National Registry for Radiation Workers (NRRW) from the UK. A total of 18 310 incident first primary solid cancer cases were registered in the period from 1955 until 2011 in the NRRW cohort and workers accrued 5.25 million person-years of follow-up. Incidences rates of all solid cancers combined, lung cancer and solid cancer excluding lung cancer were examined in terms of external radiation doses in the full cohort and in a sub-cohort of workers who had no record of internal exposure monitoring and were defined by the periods of first hire before and after the beginning of the years 1960, 1965 and 1970. All analyses were carried out using Poisson Regression. These analyses demonstrated that only for lung cancer between the pre-1965 and post-1964 periods is there strong evidence for a difference in the risks using the NRRW full cohort. In the other calendar period breakdowns and for the other cancer groups, there is no clear evidence of differences in the risks. The NRRW estimation of risks between recent and early workers is not generally consistent with the US workers cohort or the INWORKS evaluations that later hired workers are at much higher solid cancer risk than earlier hired workers, although INWORKS contains a significant part of the latest updated NRRW cohort as well as the US data. The conclusion that the INWORKS and US study data demonstrate a real difference in excess solid cancer risk from external radiation exposure between earlier and later workers is premature. The results presented here should also be treated with caution because of the limited corroborating evidence from other published studies. Information on internal doses, neutron doses as well as non-radiation factors such as smoking and asbestos exposure would be needed to make definitive inferences.

Bernardino Ramazzini's De Morbis Artificum Diatriba on Workers' Health-the Birth of a New Discipline.

This paper provides a picture of the observations made over three hundred years ago by Bernardino Ramazzini (1633-1714) in light of current topical issues ranging from health problems related to work and lifestyle habits to the current burdensome COVID-19 pandemic. The main aspects of his work consist of descriptions of disorders linked to environmental risks, suggestions for measures for risk protection, and recommendations for healthy living. This paper focuses on Ramazzini's most relevant achievements by (1) analyzing the episodes that stimulated the composition of his main work and highlighting some observations on which current epidemiological and toxicological studies are based; (2) reviewing his work showing not only the systematic descriptions of work-related illnesses caused by occupational factors but also his sound etiological and physiopathological contributions to the field of occupational lung diseases, breast cancer, and environmental disorders; and (3) remarking on his main observations in the fields of risk prevention and health promotion, also in the light of some highly topical issues related to unhealthy lifestyle habits and the COVID-19 pandemic.

A SHORT HISTORY OF OCCUPATIONAL DISEASE: 2. ASBESTOS, CHEMICALS, RADIUM AND BEYOND.

Historically, the weighing out and manipulation of dangerous chemicals frequently occurred without adequate protection from inhalation or accidental ingestion. The use of gloves, eye protection using goggles, masks or visors was scant. From Canary Girls and chimney sweeps to miners, stone cutters and silo fillers, these are classic exemplars of the subtle (and in some cases not so subtle) effects that substances, environments and practices can have on individual health.

A SHORT HISTORY OF OCCUPATIONAL DISEASE: 1. LABORATORY-ACQUIRED INFECTIONS.

Laboratory-acquired infections are as old as laboratories themselves. As soon as the culture of microorganisms was introduced, so too was their transfer to laboratory workers. It is only in relatively recent history that such infections have been fully understood, and methods of spread and their prevention or avoidance developed. This paper endeavours to provide an overview of the history of laboratory-acquired infection and the steps taken, particularly in the UK, for its prevention.

Jean Rodier: History of Manganism in Morocco.

Jean Rodier (1920-2003), distinguished researcher and scientist, directed the Toxicology Department of Hygiene Institute of Rabat under the French Protectorate. From 1946, he developed numerous lines of research in occupational health, in particular on Manganism, a neurological disorder that impacted miners in his home country of Morocco. His many papers on Manganism, only one of which was published in English, describe field and laboratory research studies that focused its prevention and management.

[The Amiantus Program in Poland - 20 years of implementation]. / Program Amiantus w Polsce ­ 20 lat realizacji.

BACKGROUND: Despite the ban on the production of asbestos-containing materials, introduced in Poland over 20 years ago, new cases of asbestos-related diseases are still being recorded. Systematic control of respiratory function in people exposed to asbestos dust is, therefore, extremely important due to the biological properties of this mineral. MATERIAL AND METHODS: The Amiantus preventive medical examination program was undertaken in 2000 to implement the legal rights of former employees of asbestos processing plants for this type of examinations. People who have ever been employed in such factories have been authorized to use preventive medical examinations for the rest of their lives. The research is continuous, spread over time and focused, in particular, on the assessment of the respiratory system. RESULTS: Since the beginning of the program, throughout 20 years of its implementation, 8329 people have been examined, including 5199 (62.4%) men for whom a total of 34 454 medical examinations have been carried out. During the program period, the percentage of diagnosed pathologies increased from 8% in 2000 to 25% in 2019. Overall, 2078 asbestos-related diseases were diagnosed among former employees of asbestos processing plants under the Amiantus Program, which accounted for 25% of this group. Among all diseases caused by exposure to asbestos, the most common were: asbestosis (1880 cases - 90.5%), lung cancer (121 cases - 5.8%) and pleural mesothelioma (77 cases - 3.7%). Diseases of pleura in the form of plaques and diffuse pleural thickening were diagnosed in 40% of the examined patients, while radiological pulmonary shadows affected over 65% of former employees of asbestos processing plants. CONCLUSIONS: The Amiantus Program, thanks to the long observation period, enabled monitoring the health of former employees exposed to asbestos, and created a unique opportunity to carry out epidemiological analyzes. These studies allowed the authors to expand their knowledge of the natural history of asbestos-related diseases. Med Pr. 2020;71(5):595-601.

Analysis of Occupational Safety and Health Administration (OSHA) noise standard violations over 50 years: 1972 to 2019.

INTRODUCTION: Noise exposure has long been an occupational health concern and has been an important area of focus of the Occupational Safety and Health Administration (OSHA) since its founding. Nevertheless, it remains unclear what effects OSHA's noise standards have had on employer efforts to reduce risks. Consequently, a review of OSHA noise standard violations was performed to clarify the violation trends between 1972 and 2019. METHODS: Using the OSHA Information System, researchers identified 119 305 violations involving four noise standards between 1972 and 2019: 29 CFR 1910.95, occupational noise exposure in general industry; 1926.52, occupational noise exposure in construction; 1926.101, hearing protection in construction, and 1904.10, recording criteria for cases involving occupational hearing loss. Violation frequencies of noise standard subparagraphs and relationships to factors such as industry differences were analyzed using descriptive statistics and t tests. RESULTS: The most commonly violated noise standard was 1910.95 in manufacturing. Such violations rose between 1972 and 1985 and then declined steadily. Whether in general industry or construction, four noise standards were most-frequently cited: lack of feasible administrative or engineering controls (1910.95[b] and 1926.52[d]) and inadequate hearing conservation program (1910.95[c] and 1926.52[b]). These violations were more highly penalized (mean = $1036.50) than other subparagraph violations (mean = $915.80). Programmed and unprogrammed inspections generated similar violation quantities except between 1980 and 1985, when programmed inspections exhibited a sharp spike in violations. CONCLUSION: The study identified trends in OSHA noise standard violations and possible explanations for those trends. The study findings can support development of more practical noise-exposure protection policy.

The health of restaurant work: A historical and social context to the occupational health of food service.

The United States currently has over one million restaurants, making food service one of the largest workforces and industry sectors in the nation's economy. Historically, concern for the health of early restaurant workers was tied largely to the hygiene of the food and thus the wellbeing of the customer rather than the individuals preparing the food. The landscape of occupational illness and injury that resulted is fraught with some of the starkest health disparities in wages, discrimination, benefits, injuries, and illness seen among US laborers. These disparities have consistently been associated with social class and economic position. Conditions identified during the early years of restaurant work, before the introduction of occupational safety and health protections, persist today largely due to tipped wages, dependence on customer discretion, and the management structure. Research and intervention efforts to control occupational health hazards should be directed toward the socioeconomic and structural roots of health problems among food service workers in the United States. Such efforts have important implications for enhancing worker protections, improving wages, and restructuring working conditions for restaurant and food service workers. They also suggest opportunities for occupational health practitioners and researchers to contribute to system-level change analysis to address centuries-old occupational health challenges still facing one of the largest sectors of workers in the country.

[Ragsorters' Disease-150 years ago a new, today a vanished occupational disease in Austria]. / Die Hadernkrankheit ­ vor 150 Jahren eine neue, heute verschwundene Berufskrankheit in Österreich.

In 1870 17 women who were engaged with shredding and sorting rags in a Lower-Austrian papermill fell ill with a highly febrile lung affection; nine of them died. Hitherto this illness was not recognised as a separate disease, the "Ragsorters' Disease". The rags were used garments and household textiles collected mostly in eastern countries as well as used contaminated bandages of hospitals. The manipulation with the rags produced much dust which was inhaled by the women, provoking some different illnesses, including the Ragsorters' Disease. Mostly without prodromes a heavy lobar or lobular pneumonia with atelectasis and oedematous softenings of the lung tissue. Histologically impressive were masses of bacteria on and between the epithelia cells and inside the walls of the alveoli. The bacteria were diagnosed as Bac. anthracis.The Ragsorters' Disease could be restrained by technical improvements and disinfection. Finally, it was extinguished by the replacement of rags by woodpulp.

Sibyl Horner, Sydney Alexander Henry, and occupational skin disease.

Occupational skin disease was, and remains, a major cause of morbidity, accounting for many thousands of hours lost from work each year. Investigating the causes, and seeking preventive measures, occupied much of the time of the early Medical Inspectors of Factories. Two of the inspectors, Sydney Henry and Sibyl Horner, became specialists in certain types of skin disease.

Bernardino Ramazzini: un pionero de la medicina del trabajo / Bernardino Ramazzini: a pioneer of work medicine

Bernardino Ramazzini (1633-1714), médico italiano, es considerado el padre de la medicina del trabajo por su tratado sobre las enfermedades de los trabajadores, publicado en latín hace más de 300 años. Su fecha de nacimiento, 4 de octubre, se ha tomado como el Día de la Medicina del Trabajo. Fue un precursor de la salud pública y de la seguridad y salud laborales. Se recuerda en este artículo la vida y obra de este eminente clínico, que poseía una amplia formación humanística. (AU)

Bernardino Ramazzini (1633-1714), an Italian doctor considered the father of occupational medicine, for his treatise about workers' diseases, published in Latin more than 300 years ago. His date of birth, October 4, is the Day of Occupational Medicine. It was a precursor to public health and occupational health and safety. This article recalls the life and work of this eminent clinician, who had an extensive humanistic training. (AU)

"A Widespread Superstition": The Purported Invulnerability of Workers of Color to Occupational Heat Stress.

This study explores the history of the denial of the vulnerability of non-White workers to risks of heat illness. Defenders of chattel slavery argued for the capacity of workers of African descent to tolerate extreme environmental temperatures. In Hawai'i, advocates of racial segregation emphasized the perils to Whites of strenuous work in tropical climates and the advantages of using Chinese immigrants. Growing reliance on Mexican immigrants in agriculture and other outdoor employment in the early 20th century brought forth claims of their natural suitability for unhealthful working conditions. These efforts to naturalize racial hierarchy fell apart after 1930. The Great Depression subverted the notion that people of European descent could not endure hot work. More rigorous investigation refuted contentions of racial difference in heat tolerance.