Long title: Protocol for evaluating a consultation for suffering at work in French-speaking Switzerland

Introduction: Psychosocial suffering entails human, social and economic costs. In Switzerland, 34.4% of workers report chronic work-related stress. Our medical Consultation for Suffering at Work aims to preserve—or restore—the patient's capacity to act and make decisions after a diagnosis of work-related psychological suffering; it also aims to help employees get back to or remain at work. Our hypothesis is that the dynamic of the consultation itself and adherence to its medical advice are active factors of these results. Objectives: Understand changes in patients' work and health status 12 months after a Consultation for Suffering at Work. Determine the effects of the consultation on health and working status via identified active factors: the consultation dynamic and the ability to adhere to the consultation's advice. Evaluate the consultation's effects qualitatively. Materials and Methods: This longitudinal, monocentric study with a quasi-experimental design will include patients consulting between 1 January and 31 December 2018. Changes in patients' work and health status will be analysed using data collected via questionnaires at 0, 3 and 12 months. Qualitative data will be collected via a semi-structured telephone interview 3 months after the consultation. The quantitative part will include 150–170 patients; the qualitative part will include 30. Conclusion: This exploratory research project will provide a better understanding of issues of work-related psychological suffering and effective strategies to support patients. The absence of a control group and the impossibility of applying a randomised controlled design are constraints on this study

Syndrome du canal carpien et travail sur ordinateur

Carpal tunnel syndrome (CTS) is a common ductal syndrome which is part of occupational musculoskeletal disorders (MSDs). Its occurrence in connection with computer work remains debated.To review this issue, we conducted a review of the literature and a meta-analysis on the possible link between CTS and computer work, compared the result to that obtained in two large cohorts, one European and the other North American and detailed exposures to certain biomechanical factors in the French cohort in participants with pain in the hand.The literature review and meta-analysis show no association between CTS and computer work with a meta-OR at 1.67 (95% CI, 0.79 to 3.55). However, few longitudinal studies, with standardized CTS definitions were included in this analysis.To circumvent these limits, we used the French COSALI cohort and the American cohort PrediCTS study. Multivariate analyzes adjusted for age, gender, obesity and medical history did not show that computer exposure was a risk factor for CTS as it has long been relayed.The exploratory analysis of the relationship between hand pain and computer work adjusted to the biomechanical exposures in the COSALI cohort show in some groups a possible link between hand pain and computer work, under certain conditions, which will require further analysis.Le syndrome du canal carpien (SCC) est un syndrome canalaire fréquent, qui fait partie des troubles musculo-squelettiques (TMS) d’origine professionnelle. Sa survenue en lien avec le travail sur ordinateur reste débattue.Pour faire le point sur la question, nous avons effectué une revue de la littérature et une méta-analyse sur l’éventuel lien entre le SCC et le travail sur ordinateur, confronté le résultat à celui obtenu dans deux grandes cohortes, l’une européenne et l’autre Nord-américaine et détaillé les expositions à certains facteurs biomécaniques chez les participants de la cohorte française présentant une douleur de la main.La revue de la littérature et la méta-analyse n'ont pas montré d'association entre le travail sur ordinateur et le SCC, avec un méta-OR à 1,67 (IC 95%, 0,79 à 3,55). Cependant, peu d’études longitudinales, avec des définitions standardisées du SCC, faisaient partie de cette analyse.Pour contourner ces limites, nous avons utilisé la cohorte française COSALI et la cohorte américaine Predi CTS study. Les analyses multivariées ajustées sur l'âge, le sexe, l'obésité et la présence d'antécédents médicaux n’ont pas montré que l'exposition au travail sur l’ordinateur était un facteur de risque de SCC.Ces deux études montrent que le travail sur ordinateur n’apparait pas comme un facteur de risque du SCC, contrairement à ce qui a pu être longtemps relayé.L’analyse exploratoire de la relation entre douleur de la main et travail sur ordinateur, ajustée sur les expositions biomécaniques dans la cohorte COSALI, montre dans certains groupes un possible lien entre douleur de la main et travail sur ordinateur, sous certaines conditions qui vont nécessiter des analyses ultérieures

Carpal tunnel syndrome and computer work

Le syndrome du canal carpien (SCC) est un syndrome canalaire fréquent, qui fait partie des troubles musculo-squelettiques (TMS) d’origine professionnelle. Sa survenue en lien avec le travail sur ordinateur reste débattue.Pour faire le point sur la question, nous avons effectué une revue de la littérature et une méta-analyse sur l’éventuel lien entre le SCC et le travail sur ordinateur, confronté le résultat à celui obtenu dans deux grandes cohortes, l’une européenne et l’autre Nord-américaine et détaillé les expositions à certains facteurs biomécaniques chez les participants de la cohorte française présentant une douleur de la main.La revue de la littérature et la méta-analyse n'ont pas montré d'association entre le travail sur ordinateur et le SCC, avec un méta-OR à 1,67 (IC 95%, 0,79 à 3,55). Cependant, peu d’études longitudinales, avec des définitions standardisées du SCC, faisaient partie de cette analyse.Pour contourner ces limites, nous avons utilisé la cohorte française COSALI et la cohorte américaine Predi CTS study. Les analyses multivariées ajustées sur l'âge, le sexe, l'obésité et la présence d'antécédents médicaux n’ont pas montré que l'exposition au travail sur l’ordinateur était un facteur de risque de SCC.Ces deux études montrent que le travail sur ordinateur n’apparait pas comme un facteur de risque du SCC, contrairement à ce qui a pu être longtemps relayé.L’analyse exploratoire de la relation entre douleur de la main et travail sur ordinateur, ajustée sur les expositions biomécaniques dans la cohorte COSALI, montre dans certains groupes un possible lien entre douleur de la main et travail sur ordinateur, sous certaines conditions qui vont nécessiter des analyses ultérieures.Carpal tunnel syndrome (CTS) is a common ductal syndrome which is part of occupational musculoskeletal disorders (MSDs). Its occurrence in connection with computer work remains debated.To review this issue, we conducted a review of the literature and a meta-analysis on the possible link between CTS and computer work, compared the result to that obtained in two large cohorts, one European and the other North American and detailed exposures to certain biomechanical factors in the French cohort in participants with pain in the hand.The literature review and meta-analysis show no association between CTS and computer work with a meta-OR at 1.67 (95% CI, 0.79 to 3.55). However, few longitudinal studies, with standardized CTS definitions were included in this analysis.To circumvent these limits, we used the French COSALI cohort and the American cohort PrediCTS study. Multivariate analyzes adjusted for age, gender, obesity and medical history did not show that computer exposure was a risk factor for CTS as it has long been relayed.The exploratory analysis of the relationship between hand pain and computer work adjusted to the biomechanical exposures in the COSALI cohort show in some groups a possible link between hand pain and computer work, under certain conditions, which will require further analysis

Work-related premature ageing: old concept but emerging stakes.

International audienceno abstrac

Patients en situation de burnout ::besoins médico-sociaux et ressources

Il existe un écart entre l’offre de services actuelle et les besoins des personnes en situation de burnout. Les acteurs de terrain, des employeurs aux prescripteurs, ont un rôle à jouer pour répondre aux besoins de santé de la population cible, promouvoir les services existants et faciliter leur collaboration intégrative. C’est ce qu’une étude évaluant l’adéquation entre les besoins de santé des personnes en situation d’épuisement professionnel ou de burnout et les services offerts à ces patients, du point de vue des informateurs clés du canton de Vaud, a démontré. Une première partie a identifié, par une recherche empirique sur internet, les services axés sur l’organisation du travail, les services thérapeutiques, sociaux et de réinsertion professionnelle. La seconde partie, basée sur une méthode qualitative par focus group, a identifié 21 besoins non comblés

Renal failure and occupational exposure to organic solvents: what work-up should be performed?

International audienceThe etiological work-up of a disease with an occupational component, such as renal failure associated with exposure to organic solvents, may include several complementary investigations. The authors discussed certain elements of the etiological work-up in the light of a clinical case, particularly the individual and collective advantages and disadvantages of this work-up. Further investigations would not have provided the patient with any individual or collective benefit and were therefore not performed, whereas other investigations (environmental studies, screening of fellow workers) may provide collective rather than individual benefits, but must be decided by a multidisciplinary approach. A multidisciplinary study (general practitioner, nephrologist, occupational health physician, and specialist in toxicology) is necessary to discuss the appropriate etiological work-up, taking into account the individual and collective benefit-risk balance

Occupational exposure to plant protection products and health effects in Switzerland: what do we know and what do we need to do?

There is currently no centralised database on workers' exposures to plant protection products (PPPs) in Switzerland, nor a national register for negative health effects linking them to occupational PPP exposure. This lack of basic data makes it difficult to implement either epidemiological research or prevention campaigns for the agricultural sector. The first objective was to understand the level of information and flow of data on occupational PPP exposures and health effects in the Canton of Vaud, Switzerland. Then, to apply this information to develop recommendations for improving a vigilance system for occupational health effects related to PPP exposure. A mapping study and semistructured stakeholder interviews were conducted to better understand the flow of data on occupational PPP exposures and health effects. A clinical records investigation of workers occupationally exposed to PPPs was undertaken to understand the magnitude of this potential problem. Finally, a workshop brought together relevant stakeholders to discuss recommendations for the way forwards. A lack of data on PPP exposures and associated health effects was revealed. This highlighted important knowledge gaps at different levels of the current institutional information flow system. We found that although there were numerous stakeholders that worked efficiently in their own mandate, there was a clear need for increased collaboration and coordination in order to make use of existing data to promote safer PPP use among agricultural workers in Switzerland. Due to increasing evidence of an association between PPP exposure and health effects, increased collaboration between stakeholders is necessary to develop links between the data sources that already exist. Our study was the first to investigate the health effects linked to PPP exposure among the Swiss agricultural population. The recommendations presented in this paper would help promote a safer and healthier agricultural workforce in Switzerland, as well as the population at large