Effects of a short residential thermal spa program to prevent work-related stress/burnout on stress biomarkers: The thermstress proof of concept study

Objective Work-related stress is a public health issue. Stress has multiple physical and psychological consequences, the most serious of which are increased mortality and cardiovascular morbidity. The ThermStress protocol was designed to offer a short residential thermal spa program for work-related stress prevention that is compatible with a professional context. Methods Participants will be 56 male and female workers aged 18 years or above. All participants will undergo a 6-day residential spa program comprising psychological intervention, physical activity, thermal spa treatment, health education, eating disorder therapy and a follow-up. On six occasions, participants’ heart rate variability, cardiac remodelling and function, electrodermal activity, blood markers, anthropometry and body composition, psychology and quality of life will be measured using questionnaires and bone parameters. Results This study protocol reports the planned and ongoing research for this intervention. Discussion The ThermStress protocol has been approved by an institutional ethics committee (ANSM: 2016 A02082 49). It is expected that this proof of concept study will highlight the effect of a short-term specific residential thermal spa program on the prevention of occupational burnout and work-related stress. The findings will be disseminated at several research conferences and in published articles in peer-reviewed journals. Trial Registration: ClinicalTrials.gov (NCT 03536624, 24/05/2018

Self-employment in joinery: An occupational risk facor?

Objectives: Only a few studies have analyzed the health of self-employed workers. This cross-sectional study is the first to compare health status among craftsmen joiners and paid joiners. Material and Methods: Clinical and paraclinical data for self-employed craftsmen and employees were collected by occupational health doctors according to a standardized protocol and compared. Health data and professional status relationships were analyzed by logistic regression. Results: A total of 171 craftsmen and 196 paid workers were included. Craftsmen had more dermatologic pathologies (odds ratio (OR) = 2.67, p < 0.05), ear/nose/throat symptoms (OR = 3.38, p < 0.001), pulmonary symptoms (OR = 2.46, p < 0.05), musculoskeletal symptoms (OR = 3.09, p < 0.001), and abnormal audiogram (OR = 3.50, p < 0.001). The FEV1 was significantly lower among craftsmen (p < 0.01), independently of tobacco smoke exposure. Conclusions: This survey highlights a high morbidity rate among self-employed craftsmen, suggesting that among woodworkers, professional status can be a risk factor for health. The preventive medical system for craftsmen has to be rethought to guarantee better safety for this population

Genotype–phenotype correlation in PRKN- associated Parkinson’s disease

Bi-allelic pathogenic variants in PRKN are the most common cause of autosomal recessive Parkinson’s disease (PD). 647 patients with PRKN-PD were included in this international study. The pathogenic variants present were characterised and investigated for their effect on phenotype. Clinical features and progression of PRKN-PD was also assessed. Among 133 variants in index cases (n = 582), there were 58 (43.6%) structural variants, 34 (25.6%) missense, 20 (15%) frameshift, 10 splice site (7.5%%), 9 (6.8%) nonsense and 2 (1.5%) indels. The most frequent variant overall was an exon 3 deletion (n = 145, 12.3%), followed by the p.R275W substitution (n = 117, 10%). Exon3, RING0 protein domain and the ubiquitin-like protein domain were mutational hotspots with 31%, 35.4% and 31.7% of index cases presenting mutations in these regions respectively. The presence of a frameshift or structural variant was associated with a 3.4 ± 1.6 years or a 4.7 ± 1.6 years earlier age at onset of PRKN-PD respectively (p < 0.05). Furthermore, variants located in the N-terminus of the protein, a region enriched with frameshift variants, were associated with an earlier age at onset. The phenotype of PRKN-PD was characterised by slow motor progression, preserved cognition, an excellent motor response to levodopa therapy and later development of motor complications compared to early-onset PD. Non-motor symptoms were however common in PRKN-PD. Our findings on the relationship between the type of variant in PRKN and the phenotype of the disease may have implications for both genetic counselling and the design of precision clinical trials

Genotype-phenotype correlation in PRKN-associated Parkinson's disease

Bi-allelic pathogenic variants in PRKN are the most common cause of autosomal recessive Parkinson's disease (PD). 647 patients with PRKN-PD were included in this international study. The pathogenic variants present were characterised and investigated for their effect on phenotype. Clinical features and progression of PRKN-PD was also assessed. Among 133 variants in index cases (n = 582), there were 58 (43.6%) structural variants, 34 (25.6%) missense, 20 (15%) frameshift, 10 splice site (7.5%%), 9 (6.8%) nonsense and 2 (1.5%) indels. The most frequent variant overall was an exon 3 deletion (n = 145, 12.3%), followed by the p.R275W substitution (n = 117, 10%). Exon3, RING0 protein domain and the ubiquitin-like protein domain were mutational hotspots with 31%, 35.4% and 31.7% of index cases presenting mutations in these regions respectively. The presence of a frameshift or structural variant was associated with a 3.4 ± 1.6 years or a 4.7 ± 1.6 years earlier age at onset of PRKN-PD respectively (p &lt; 0.05). Furthermore, variants located in the N-terminus of the protein, a region enriched with frameshift variants, were associated with an earlier age at onset. The phenotype of PRKN-PD was characterised by slow motor progression, preserved cognition, an excellent motor response to levodopa therapy and later development of motor complications compared to early-onset PD. Non-motor symptoms were however common in PRKN-PD. Our findings on the relationship between the type of variant in PRKN and the phenotype of the disease may have implications for both genetic counselling and the design of precision clinical trials

Psychometric properties of the French versions of the Perceived Stress Scale

Objectives: This study was conducted to examine the psychometric properties of the French versions of the Perceived Stress Scale (PSS) and to compare the appropriateness of the three versions of this scale (14 items, 10 items, or 4 items) in a sample of workers. Materials and Methods: Five hundred and one workers were randomly selected in several occupational health care centers of the North of France during 2010. Participants completed a questionnaire including demographic variables and the PSS. The psychometric properties of this scale were analyzed: internal consistency, factorial structure, and discriminative sensibility. Results: For the PSS-14 and PSS-10, the Exploratory Factor Analysis (EFA) provided a two-factor structure, corresponding to the positively and negatively worded items. Those two factors were significantly correlated (r = 0.43 and 0.50, respectively). For the PSS-4, the EFA yielded a one-factor structure. The reliability was high for all three versions of the PSS (Cronbach’s α values ranged from 0.73 to 0.84). The results concerning the effects of age, gender, marital, parental and occupational statuses showed that the 10-item version had the best discriminative sensibility. Conclusions: The findings confirmed satisfactory psychometric properties of all the three French versions of the PSS. We recommend the use of the PSS-10 in research settings because of its good psychometric properties

Self-employment in joinery: An occupational risk facor?

Objectives: Only a few studies have analyzed the health of self-employed workers. This cross-sectional study is the first to compare health status among craftsmen joiners and paid joiners. Material and Methods: Clinical and paraclinical data for self-employed craftsmen and employees were collected by occupational health doctors according to a standardized protocol and compared. Health data and professional status relationships were analyzed by logistic regression. Results: A total of 171 craftsmen and 196 paid workers were included. Craftsmen had more dermatologic pathologies (odds ratio (OR) = 2.67, p < 0.05), ear/nose/throat symptoms (OR = 3.38, p < 0.001), pulmonary symptoms (OR = 2.46, p < 0.05), musculoskeletal symptoms (OR = 3.09, p < 0.001), and abnormal audiogram (OR = 3.50, p < 0.001). The FEV1 was significantly lower among craftsmen (p < 0.01), independently of tobacco smoke exposure. Conclusions: This survey highlights a high morbidity rate among self-employed craftsmen, suggesting that among woodworkers, professional status can be a risk factor for health. The preventive medical system for craftsmen has to be rethought to guarantee better safety for this population

Occupational Risk Factors for COPD: A Case-Control Study.

The aim of this research was to examine the occupational risk factors for Chronic Obstructive Pulmonary Diseases (COPD) in a range of occupations.Eleven occupations involving different types of exposure were observed in this multicenter case-control study. Controls and cases were matched for sex, age and smoking. Multiple logistic regression analyses were used to estimate odds ratios (ORs).A total of 1,519 participants were initially recruited between September 2004 and September 2012. After matching, 547 pairs were obtained. The mean age was 56.3 +/- 10.4 years. Smelter workers were the only ones with an increased risk of COPD in this study (OR = 7.6, p < 0.0001, 95% CI [4.5, 12.9]). Physical activity was protective (OR = 0.7), while living in the city was a risk (OR = 1.6). The main used metals were cast iron, aluminum and alloys. Molds and cores were mainly made from sand and synthetic resins. Machine maintenance (65.2%), molding (49.6%), finishing (41.1%) and casting (41.0%) were the most common activities. Almost all workers (95.1%) cleaned the floors and machines with a brush or compressed air.This study demonstrates the importance of occupational factors in the genesis of COPD, especially among smelter workers. As with the fight against smoking-related disease, the removal or substitution of recognized hazardous agents is the best way of preventing the onset of COPD. This is why it is essential to continue research on its occupational risk factors

Ill health-related job loss: A one-year follow-up of 54,026 employees

Introduction: The diagnoses of workers being unfit to work may be a relevant health indicator. Therefore, the aim of this study was to analyze the one-year incidence of an unfit to work diagnosis. Method: This one-year prospective study included all workers undergoing annual work medical examination from occupational health services in Troyes, France. Results: Twenty-one occupational physicians followed 54,026 employees. The all-cause incidence of being unfit to return to work was 0.772%. The two main causes of being unfit to work were musculoskeletal disorders (61%) and psychopathologies (24%). The relative risk (RR) of being unfit to work, independent of the cause, was higher when employees were aged over 50 years (RR = 2.51), and female (RR = 1.51). Conclusions: Prospective results from occupational physicians’ medical records may provide significant and cost-effective directions to prioritize actions and target health promotion in the workplace

Incidence of ill-health related job loss and related social and occupational factors. The "unfit for the job" study: a one-year follow-up study of 51,132 workers

Objective: The analysis of ill-health related job loss may be a relevant indicator for the prioritization of actions in the workplace or in the field of public health, as well as a target for health promotion. The aim of this study was to analyze the medical causes, the incidence, and the characteristics of employees medically unfit to do their job. Methods: This one-year prospective study included all workers followed by occupational physicians in an occupational health service in the south of France. The incidence of unfitness for work have been grouped according to the main medical causes and analyzed. We performed a multivariate analysis in order to adjust the observed risk of job loss based on the age groups, sex, occupation and the activity sectors. Results: A total of 17 occupational physicians followed up 51,132 workers. The all-cause incidence of being unfit to return to one's job was 7.8‰ (n = 398). The two main causes of being unfit for one's job were musculoskeletal disorders (47.2%, n = 188) and mental ill-health (38.4%, n = 153). Being over 50 years old (Odds ratio (OR) 2.63, confidence interval 95% CI [2.13-3.25]) and being a woman (OR 1.52, 95% CI [1.21-1.91]) were associated with the all-cause unfitness, independent of occupation and activity sector. Conclusions: Identification of occupational and demographic determinants independently associated with ill-health related job loss may provide significant and cost-effective arguments for health promotion and job loss prevention.status: publishe