Analyse du travail répétitif dans le secteur agro-alimentaire : apport de la démarche ergonomique

L'analyse du travail répétitif dans le secteur agro-alimentaire se fait dans le contexte de l'augmentation des problèmes musculo- squelettiques. L'approche de l'ergonome est abordée au travers d'études dans ce secteur, en particulier dans une usine de transformation de la volaille. L'intervention ergonomique axée sur l'amélioration des situations de travail nécessite l'implication et la participation des différents partenaires dans l'entreprise. L'analyse de l'activité de travail et l'implication des travailleurs dans l'interprétation des résultats fait ressortir la complexité du travail répétitif. La mise en valeur du savoir des travailleurs et la recherche d'une compréhension élargie du travail au-delà des aspects physiques apparaissent essentielles à la formulation de recommandations et à la revalorisation du métier.Increasing frequency in skeletal muscle problems in sectors of employment where the work is repetitive is the cause of growing concern. A number of agro-food businesses have participated in ergonomic studies aimed at a better understanding of repetitive work and its effects on health, as well as at improving work situations. Different issues related to the analysis of work and the contribution of the ergonomic approach were raised in these studies. In particular, the results of a study of a poultry processing plant were used to illustrate these issues. The first part of this article deals mainly with the expectations of those within firms requesting service vis-à-vis the work of ergonomists and the characteristics of their approach. Even though the field of study of ergonomists is often restricted to the biomechanical aspects of the activity, they rather seek to obtain an overall view of work situations by examining not only the physical aspects but also the cognitive, perceptive, social and subjective aspects which cannot be disassociated from work efficiency.During an intervention, the reference data of the ergonomist are limited, especially those related to skeletal muscle problems. It is observed that these references can only be used as pointers identifying occupational hazards, and only specifie knowledge of the work environment, continuously updated with each new study, can provide them with the elements of understanding and demonstration necessary for change. Furthermore, an ergonomic approach can lead to work situations being changed only if there are changes in the way that different participants, worker representatives and firm managers see their work. Thus, it is essential that various partners participate in the ergonomic study. Partners can participate through a project committee that brings together the key persons who will be trained in ergonomy, who will follow the progress of the study and who will develop recommendations and their application.The second part highlights the importance of ergonomists using data from different sources in order to better understand the complexity of the work activity. Results from the exploratory stage of a study of a turkey cutting production line are used, especially those related to the seventeen women working in rotation at several stations on this line. Results obtained from three workstations are compared, and analysis of accidents, observation of work activity, answers from individual interviews and group meetings are used to interpret results. Above all, the apparent lack of coherence of the results was surprising. This workstation, which was the one most often mentioned in accident reports, is precisely where the women workers spend the least amount of time (5 % of their working time), and where a smaller number of workers reported feeling pain symptoms. It is also the most hated workstation. On the other hand, the station which is best liked is the one with which most workers associate the development of their pain symptoms. The third station is used for the temporary assignment of injured workers, and is where many workers report problems related to maintaining a static posture. These three stations will be examined in turn in order to bring to light the demands of each one, the actual experiences of workers at these stations and the possible contributing factors to the development of skeletal muscle problems. For example, we consider the possibility that reports of skeletal muscle problems can be made more easily about a station where accident-type circumstances can be described (such as through pulling or hitting) than about a station where the work is more static (such as visual checking of quality) in spite of considerable posture constraints. We also highlight the potential significance of pride in work well-done and pushing oneself, which makes workers seek a station where, apart from the physical constraints, they could take up a challenge and derive personal satisfaction from it. We discover the creativity developed by workers in spite of the very repetitive nature of their work. In conclusion, these different, seemingly contradictory results demonstrate different aspects of the same reality and provide direction for discussions about improvements to be made. The third part is devoted to the systematic analysis of the activity and its use for improving work situations. Firstly, we describe the methods used in two work environments in order to obtain a more thorough understanding of the work activity and its determinants, and to make recommendations. These methods allow workers' know-how to be used profitably in order to better understand the work. Following the exploratory stage of the study of the turkey cutting production line, some of the stations were observed in more detall. The data are used to highlight the different operating methods developed by five workers at the same workstation, despite the fact that the work cycle only lasts twelve seconds. The differences show up in the order of operations and the movements and postures of work, thus demonstrating that on-line work which seems very stereotyped can be performed in very different ways. These differences also imply different physical demands as shown by the different skeletal muscle problems. Although the ways of doing things vary from one person to another, they can also vary in accordance with the conditions in which the work is performed. This fact was then demonstrated through the comparison of strategies of ten workers at the same workstation following two work paces. These different strategies developed by workers to cope with the demands for speed, given their physical capacity, have an impact on production. Complying with operating methods is of utmost importance since this involves the very identity of the people. However, the descriptions of these operating methods lead to the discovery of know-how which, used in training, can prevent some problems from developing. It is therefore very important to stress on know-how in these work environments where automation has resulted in the occupation being devalued. To conclude, the work of ergonomists is performed on several levels. Not only do they have to observe how people work and understand why they work in different ways, but they also have to be able to be convincing and create dynamics producing change in work. Moreover, given the importance of the approach of studying the multidimensional aspects of work activity, it is useful to bring the disciplines together in order to use current knowledge effectively thus serving to improve work safety and efficiency

Bridge to the stars: A mission concept to an interstellar object

Exoplanet discoveries since the mid-1990’s have revealed an astounding diversity of planetary systems. Studying these systems is essential to understanding planetary formation processes, as well as the development of life in the universe. Unfortunately, humanity can only observe limited aspects of exoplanetary systems by telescope, and the significant distances between stars presents a barrier to in situ exploration. In this study, we propose an alternative path to gain insight into exoplanetary systems: Bridge, a mission concept design to fly by an interstellar object as it passes through our solar system. Designed as a New Frontiers-class mission during the National Aeronautics and Space Administration (NASA) Planetary Science Summer School, Bridge would provide a unique opportunity to gain insight into potential physical, chemical, and biological differences between solar systems as well as the possible exchange of planetary materials between them. Bridge employs ultraviolet/visible, near-infrared, and mid-infrared point spectrometers, a visible camera, and a guided impactor. We also provide a quantitative Monte Carlo analysis that estimates wait times for a suitable target, and examines key trades between ground storage and a parking orbit, power sources, inner versus outer solar system encounters, and launch criteria. Due to the fleeting nature of interstellar objects, reaching an interstellar object may require an extended ground storage phase for the spacecraft until a suitable ISO is discovered, followed by a rapid response launch strategy. To enable rapid response missions designed to intercept such unique targets, language would need to be added to future NASA announcements of opportunity such that ground storage and rapid response would be allowable components of a proposed mission

Timing and Abundance of Clathrate Formation Control Ocean Evolution in Outer Solar System Bodies: Challenges of Maintaining a Thick Ocean within Pluto

Clathrate hydrates may represent a sizable fraction of material within the icy shells of Kuiper Belt objects and icy moons. They influence the chemical and thermal evolution of subsurface oceans by locking volatiles into the ice shell and by providing more thermal insulation than pure water ice. We model the formation of these crystalline compounds in conditions relevant to outer solar system objects, using Pluto as an example. Although Pluto may have hosted a thick ocean in its early history, Pluto’s overall heat budget is probably insufficient to preserve liquid today if its outer shell is pure water ice. One previously proposed reconciliation is that Pluto’s ocean has a winter jacket: an insulating layer of methane clathrate hydrates. Unfortunately, assessments of the timing, quantity, and type of clathrate hydrates forming within planetary bodies are lacking. Our work quantifies the abundance of clathrate-forming gases present in Pluto’s ocean from accreted ices and volatiles released during thermal metamorphism throughout Pluto’s history. We find that if Pluto formed with the same relative abundances of ices found in comets, then a buoyant layer of mixed methane and carbon dioxide clathrate hydrates may form above Pluto’s ocean, though we find it insufficient to preserve a thick ocean today. In general, our study provides methodology for predicting clathrate formation in ocean worlds, which is necessary to predict the evolution of the ocean’s composition and whether a liquid layer remains at present

Effects of dietary interventions on neonatal and infant outcomes: a systematic review and meta-analysis

Background: Nutrition plays a fundamental role in fetal growth and birth outcomes. Objective: We synthesized effects of dietary interventions before or during pregnancy on neonatal and infant outcomes. Design: Randomized controlled trials that assessed the whole diet or dietary components and neonatal or infant outcomes were included. Two authors independently identified articles to be included and assessed the methodologic quality. A meta-analysis was conducted separately for each outcome by using a random-effects model. Results were reported by dietary intervention as follows: 1) counseling, 2) food and fortified food products, or 3) a combination (counseling plus food) intervention, and 4) collectively for all dietary interventions. Results were subanalyzed by the nutrient of interest, country income, and BMI. Results: Of 2326 abstracts screened, a total of 29 randomized controlled trials (31 publications) were included in this review. Food and fortified food products were effective in increasing birth weight [standardized mean difference (SMD): 0.27; 95% CI: 0.14, 0.40; P < 0.01] and reducing the incidence of low birth weight (SMD: −0.22; 95% CI: −0.37, −0.06; P < 0.01). All dietary interventions and those focused on macronutrient intake also increased birth weight (P < 0.01) and length (P < 0.05) and reduced the incidence of low birth weight (P < 0.01). Dietary interventions in low-income countries and underweight or nutritionally at-risk populations increased birth weight (P < 0.05) and reduced the incidence of low birth weight (P = 0.01). No effects were seen for the following other outcomes: placental weight, head circumference, macrosomia, Apgar score, small for gestational age, large for gestational age, and perinatal mortality. Conclusion: Additional high-quality randomized controlled trials that test different dietary interventions are required to identify maternal diet intakes that optimize neonatal and infant outcomes.No Full Tex

Trends in Bone Marrow Sampling and Core Biopsy Specimen Adequacy in the United States and Canada: A Multicenter Study

Objectives: To assess bone marrow (BM) sampling in academic medical centers. Methods: Data from 6,374 BM samples obtained in 32 centers in 2001 and 2011, including core length (CL), were analyzed. Results: BM included a biopsy (BMB; 93%) specimen, aspirate (BMA; 92%) specimen, or both (83%). The median (SD) CL was 12 (8.5) mm, and evaluable marrow was 9 (7.6) mm. Tissue contraction due to processing was 15%. BMB specimens were longer in adults younger than 60 years, men, and bilateral, staging, and baseline samples. Only 4% of BMB and 2% of BMB/BMA samples were deemed inadequate for diagnosis. BM for plasma cell dyscrasias, nonphysician operators, and ancillary studies usage increased, while bilateral sampling decreased over the decade. BM-related quality assurance programs are infrequent. Conclusions: CL is shorter than recommended and varies with patient age and sex, clinical circumstances, and center experience. While pathologists render diagnoses on most cases irrespective of CL, BMB yield improvement is desirable

Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010

BACKGROUND: Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. METHODS: We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. FINDINGS: In 2010, there were 52*8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24*9% of deaths worldwide in 2010, down from 15*9 million (34*1%) of 46*5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2*5 to 1*4 million), lower respiratory infections (from 3*4 to 2*8 million), neonatal disorders (from 3*1 to 2*2 million), measles (from 0*63 to 0*13 million), and tetanus (from 0*27 to 0*06 million). Deaths from HIV/AIDS increased from 0*30 million in 1990 to 1*5 million in 2010, reaching a peak of 1*7 million in 2006. Malaria mortality also rose by an estimated 19*9% since 1990 to 1*17 million deaths in 2010. Tuberculosis killed 1*2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34*5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1*5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12*9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1*3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5*1 million deaths) was marginally higher in 2010 (9*6%) compared with two decades earlier (8*8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1*3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose (HIV/AIDS, Alzheimer's disease, diabetes mellitus, and chronic kidney disease in particular), but for most diseases, death rates fell in the past two decades; including major vascular diseases, COPD, most forms of cancer, liver cirrhosis, and maternal disorders. For other conditions, notably malaria, prostate cancer, and injuries, little change was noted. INTERPRETATION: Population growth, increased average age of the world's population, and largely decreasing age-specific, sex-specific, and cause-specific death rates combine to drive a broad shift from communicable, maternal, neonatal, and nutritional causes towards non-communicable diseases. Nevertheless, communicable, maternal, neonatal, and nutritional causes remain the dominant causes of YLLs in sub-Saharan Africa. Overlaid on this general pattern of the epidemiological transition, marked regional variation exists in many causes, such as interpersonal violence, suicide, liver cancer, diabetes, cirrhosis, Chagas disease, African trypanosomiasis, melanoma, and others. Regional heterogeneity highlights the importance of sound epidemiological assessments of the causes of death on a regular basis. FUNDING: Bill & Melinda Gates Foundation