The relation of birth weight and gestational age to biological, occupational and socioeconomic factors.

The data of the 2,040 single births, born during 1987 at the "Saint Antoine" Hospital in Paris, were analysed in order to identify the impact of various biological, occupational, and socioeconomic factors on gestational age and birth weight. Birth weight is associated with the height of the mother and the weight gained during pregnancy. It is lower for mothers with preeclampsia during the current or previous pregnancies or with urogenital infections during the current pregnancy and for mothers with one or more induced abortions. Girls weigh less than boys. Parity has a positive relation to the baby's weight, while manual work seems to have a negative one. APGAR score and duration of the pregnancy are associated with the birth weight. Placenta previa, preeclampsia and urinary infections affect the gestational age. A short pause period in work is related to a shorter gestational age. Weight gain is associated with a prolonged duration of the pregnancy. Gestational age and birth weight are associated with the nationality of the mother, especially in some ethnic groups, and with marital status.

Cardiac arrhythmias during the combined use of intravenous aminophylline and terbutaline in status asthmaticus.

The purpose of this study was to evaluate prospectively the occurrence of cardiac arrhythmias during the combined therapy with intravenous aminophylline and terbutaline in 29 consecutive patients with status asthmaticus. The 24-hour Holter recordings were performed during continuous intravenous infusions of aminophylline (0.56 +/- 0.20 mg/kg/h) and terbutaline (0.034 +/- 0.014 microgram/kg/min). Serum theophylline concentration was 12.1 +/- 3.8 micrograms/ml and never reached the toxic level (greater than 20 micrograms/ml). Premature ventricular contractions (PVCs) were absent in 35 percent of patients and 48 percent had rare unifocal PVCs (less than 10/h). Only 17 percent of patients (five of 29) exhibited severe ventricular arrhythmias: PVCs greater than 10/h (n = 3), multifocal PVCs (n = 1); and a short run of ventricular tachycardia (n = 1). Serious supraventricular arrhythmias occurred in only 7 percent of patients (two of 29) who developed sustained runs of atrial tachycardia. These arrhythmias were always clinically well tolerated and spontaneously resolved without any antiarrhythmic treatment. We conclude that severe arrhythmias are rarely observed during combined therapy with aminophylline and terbutaline in status asthmaticus.

Epidemiologic investigation of respiratory effects related to environmental exposure to asbestos inside insulated buildings.

The respiratory effects of environmental pollution by asbestos inside university buildings were studied by comparing radiographic, clinical, and functional parameters among three groups of workers with different levels of exposure. Eight hundred and twenty-eight (828) people who worked for at least 15 yr in asbestos-insulated buildings and who were without known occupational exposure to asbestos (environmentally exposed group [EE]) were compared to a group of 252 workers with occupational exposure (occupationally exposed group [OE]), used as positive control; and to a group of 350 people with no known exposure to asbestos (nonexposed group [NE]), within the same university. After adjustment for confounding variables, no differences could be seen between groups EE and NE. Group OE exhibited a higher prevalence of pleural changes and lower lung functions than groups EE and NE.

[Respiratory pathology induced by inhalation of hair lacquer]. / Pathologie respiratoire induite par l'inhalation de laque capillaire.

On the basis of a critical analysis of the literature, the authors review the various respiratory lesions imputed to the inhalation of hair lacquers. Pulmonary thesaurismosis is alleged to result from accumulation in the pulmonary parenchyma of non-biodegradable macro-molecules, such as PVP. Only isolated cases have been published and the true existence of this disease remains to be confirmed, in the absence of convincing epidemiological data as well as the lack of experimental reproducibility. Chronic inhalation of hair lacquers may, however, be responsible for bronchial irritative manifestations and obstruction of the small airways, in particular in hairdressers. Increase in the relative risk of bronchopulmonary carcinoma has not been proven.

[French legislation concerning vibration-induced disease and vinyl chloride poisoning]. / La législation française concernant la maladie des vibrations et l'intoxication au chlorure de vinyle.

Discussion is limited to an analysis of texts directly concerned with safety, hygiene and the industrial physician. After a review of features related to poisoning with the vinyl chloride monomer, the problems of vibration-induced angioneurotic disorders are outlined. Medical prevention and technique and then compensation for these occupational nuisances are then described.

[Is annual X-ray examination of the chest still justified in industrial medicine?]. / L'examen radiologique annuel du thorax est-il encore justifié en médecine du travail?

Between 1975 and 1979, 137.526 annual X-ray examinations of the chest were performed among the employees of a large Paris administration. Fifty-four cases of tuberculosis, 28 cases of sarcoidosis, 10 cases of bronchial carcinoma and 26 miscellaneous chest diseases were detected. This study confirms the inadequacy of radiological examination for detecting chronic obstructive bronchopulmonary conditions. The small proportion of tuberculosis (0.39 p.1000) and bronchial carcinoma (0.07 p.1000) revealed by this method suggests that it should be reserved to high risk patients.