7 research outputs found
Utilisation du protocole de surveillance en entreprise : expérience du programme de surveillance épidémiologique des TMS dans les Pays de la Loire
Les troubles musculo-squelettiques des membres supĂ©rieurs (TMS-MS) resteront, avec les rachialgies, lâun des enjeux majeurs de la santĂ© au travail des annĂ©es Ă venir en raison de leur augmentation probable par conjugaison dâune intensification des conditions de travail et du vieillissement de la population active. Le programme pilote de surveillance Ă©pidĂ©miologique des TMS mis en place en 2002 dans la rĂ©gion des Pays de la Loire par lâinstitut de veille sanitaire [8] a permis dâestimer les prĂ©valences des TMS et de leurs facteurs de risque en population salariĂ©e [2], [17] and [18].Ce programme utilise pour la premiĂšre fois en Europe les dĂ©finitions des TMS-MS et la dĂ©marche diagnostique standardisĂ©e proposĂ©es par le consensus europĂ©en Saltsa pour la surveillance des TMS-MS [7], [13], [15] and [20]. Lâobjectif de cet article est de dĂ©crire le protocole du programme TMS et de discuter la faisabilitĂ© de lâutilisation en France dâun protocole europĂ©en de surveillance des TMS-MS
Occupational outcome in 2007-2008 of workers suffering from musculoskeletal disorders in the French Pays de la Loire region
Aims: A French program of epidemiological surveillance implemented in 2002 in the Pays de la Loire region revealed a prevalence of 13% for the 6 most frequent upper extremity musculoskeletal disorders (UEMSDs) among a sample of salaried workers: rotator cuff syndrome, lateral epicondylitis, flexor-extensor peritendinitis of the hands and fingers, De Quervainâs disease, carpal tunnel syndrome and ulnar tunnel syndrome. The aim of this study is to describe the occupational outcome of these workers a few years later.
Methods: From 2002 to 2004, 83 occupational physicians examined 3,710 workers randomly selected [1], following the recommendations of the European consensus Saltsa [2]. 3 groups were constituted:
Group 1: workers with no upper limb pain during the past 7 days (49% of the sample)
Group 2: workers with pain during the past 7 days but without any clinical diagnosed form of UEMSDs (38%),
Group 3: workers with at least one clinically diagnosed UEMSD (13%)
In 2007 and 2008, they received by mail a questionnaire about their occupational activities.
Results: 2,332 people responded. Workers were older in group 3. After adjusting for age, we found as many retired people in the 3 groups. Among the non-retired workers (table), those who were not working were more numerous in group 3 and less numerous in group 1 (p=0.0007). Among those still at work, the percentage of workers who have changed their working station since 2002-2004 differed between groups (p=0.04): 24% have changed their working station in the same company in group 2 (vs 19% in group 1 and 21% in group 3), and 16% have moved to another company in group 2 (vs 14% and 10%, respectively).
Conclusion: This study shows that the occupational outcome varies according to the previous UEMSDs status
Relations entre facteurs organisationnels et jobstrain/déséquilibre efforts récompenses dans des centres d'appels téléphoniques en France
Objectifs : A lâinitiative de lâInVS, un rĂ©seau de surveillance Ă©pidĂ©miologique des troubles musculosquelettiques en milieu de travail a Ă©tĂ© mis en place en 2002 dans les Pays-de-la-Loire. Lâobjectif de ce travail est dâidentifier les facteurs individuels et professionnels associĂ©s au syndrome de la coiffe des rotateurs (SCR) et aux douleurs Ă lâĂ©paule.
MĂ©thodes : Au total, 3710 salariĂ©s (58 % dâhommes et Ăąge moyen de 38,7 # 10,3 ans) ont Ă©tĂ© inclus dans le rĂ©seau entre 2002 et 2004. Le SCR a Ă©tĂ© diagnostiquĂ© par 83 mĂ©decins du travail selon un examen clinique standardisĂ©. Les facteurs individuels, organisationnels, biomĂ©caniques, et psychosociaux potentiellement associĂ©s au SCR et aux douleurs ont Ă©tĂ© recueillis par autoquestionnaire. Des rĂ©gressions logistiques binaires ont Ă©tĂ© utilisĂ©es afin de modĂ©liser les facteurs associĂ©s au SCR et aux douleurs Ă lâĂ©paule. Ensuite, une rĂ©gression multinomiale a Ă©tĂ© utilisĂ©e, la variable Ă expliquer comportant trois catĂ©gories : ne pas avoir de douleur Ă lâĂ©paule (rĂ©fĂ©rence), avoir une douleur Ă lâĂ©paule sans SCR et avoir un SCR. Seules les variables significatives au seuil de 5 % ont Ă©tĂ© retenues dans le modĂšle final.
RĂ©sultats : La prĂ©valence des douleurs Ă lâĂ©paule dans lâĂ©chantillon Ă©tait de 29,3 % celle du SCR de 7,4 %, et 63,3 % nâont pas souffert Ă lâĂ©paule. Les facteurs associĂ©s aux douleurs et au SCR sont le genre fĂ©minin (respectivement OR = 1,3 IC 95 % [1,1â1,5]) et 1,4 [1,1â1,9]), lâĂąge (1,6 [1,1â2,2] et 7,0 [4,1â12,2] chez les plus de 55 ans comparĂ© aux moins de 35 ans), lâĂ©picondylite (1,7 [1,0â2,9] et 3,6 [2,0â6,6]), le syndrome du canal carpien (1,9 [1,2â3,0] et 2,7 [1,5â4,9]), la rĂ©pĂ©titivitĂ© du geste (1,3 [1,1â1,6] et 1,7 [1,3â2,3] pour une durĂ©e de plus de 4 h/j comparĂ© Ă jamais), la forte demande physique (1,4 [1,1â1,6]) et 1,7 [1,3â2,3]) et le faible soutien social hiĂ©rarchique (1,4 [1,2â1,6] et 1,5 [1,1â2,0]). Lâabduction des bras comprise entre 608 et 908 (plus de 2 h/j) est associĂ©e seulement aux douleurs (1,4 [1,1â1,8]), lâabduction des bras Ă plus de 908 est associĂ©e au SCR (1,8 [1,1â2,7]) tandis que lâabduction des bras rĂ©unissant les 2 derniĂšres conditions est associĂ©e aux douleurs et au SCR (1,5 [1,1â2,1]) et 2,7 [1,7â4,4]). Enfin, le rythme de travail imposĂ© par la cadence automatique dâune machine est associĂ© aux douleurs (1,5 [1,2â1,9]).
Conclusion : Ces résultats confirment le caractÚre plurifactoriel des douleurs et du SCR, associant des facteurs individuels à des facteurs organisationnels, biomécaniques et psychosociaux
PRKDC mutations associated with immunodeficiency, granuloma, and autoimmune regulator-dependent autoimmunity.
BACKGROUND: PRKDC encodes for DNA-dependent protein kinase catalytic subunit (DNA-PKcs), a kinase that forms part of a complex (DNA-dependent protein kinase [DNA-PK]) crucial for DNA double-strand break repair and V(D)J recombination. In mice DNA-PK also interacts with the transcription factor autoimmune regulator (AIRE) to promote central T-cell tolerance. OBJECTIVE: We sought to understand the causes of an inflammatory disease with granuloma and autoimmunity associated with decreasing T- and B-cell counts over time that had been diagnosed in 2 unrelated patients. METHODS: Genetic, molecular, and functional analyses were performed to characterize an inflammatory disease evocative of a combined immunodeficiency. RESULTS: We identified PRKDC mutations in both patients. These patients exhibited a defect in DNA double-strand break repair and V(D)J recombination. Whole-blood mRNA analysis revealed a strong interferon signature. On activation, memory T cells displayed a skewed cytokine response typical of TH2 and TH1 but not TH17. Moreover, mutated DNA-PKcs did not promote AIRE-dependent transcription of peripheral tissue antigens in vitro. The latter defect correlated in vivo with production of anti-calcium-sensing receptor autoantibodies, which are typically found in AIRE-deficient patients. In addition, 9 months after bone marrow transplantation, patient 1 had Hashimoto thyroiditis, suggesting that organ-specific autoimmunity might be linked to nonhematopoietic cells, such as AIRE-expressing thymic epithelial cells. CONCLUSION: Deficiency of DNA-PKcs, a key AIRE partner, can present as an inflammatory disease with organ-specific autoimmunity, suggesting a role for DNA-PKcs in regulating autoimmune responses and maintaining AIRE-dependent tolerance in human subjects
PRKDC mutations associated with immunodeficiency, granuloma, and autoimmune regulator-dependent autoimmunity
Background PRKDC encodes for DNA-dependent protein kinase catalytic subunit (DNA-PKcs), a kinase that forms part of a complex (DNA-dependent protein kinase [DNA-PK]) crucial for DNA double-strand break repair and V(D)J recombination. In mice DNA-PK also interacts with the transcription factor autoimmune regulator (AIRE) to promote central T-cell tolerance. Objective We sought to understand the causes of an inflammatory disease with granuloma and autoimmunity associated with decreasing T- and B-cell counts over time that had been diagnosed in 2 unrelated patients. Methods Genetic, molecular, and functional analyses were performed to characterize an inflammatory disease evocative of a combined immunodeficiency. Results We identified PRKDC mutations in both patients. These patients exhibited a defect in DNA double-strand break repair and V(D)J recombination. Whole-blood mRNA analysis revealed a strong interferon signature. On activation, memory T cells displayed a skewed cytokine response typical of TH2 and TH1 but not TH17. Moreover, mutated DNA-PKcs did not promote AIRE-dependent transcription of peripheral tissue antigens in vitro. The latter defect correlated in vivo with production of anti-calcium-sensing receptor autoantibodies, which are typically found in AIRE-deficient patients. In addition, 9 months after bone marrow transplantation, patient 1 had Hashimoto thyroiditis, suggesting that organ-specific autoimmunity might be linked to nonhematopoietic cells, such as AIRE-expressing thymic epithelial cells. Conclusion Deficiency of DNA-PKcs, a key AIRE partner, can present as an inflammatory disease with organ-specific autoimmunity, suggesting a role for DNA-PKcs in regulating autoimmune responses and maintaining AIRE-dependent tolerance in human subjects