Multidisciplnary approach applied to activity analysis within a dynamic setting: driving light vehicles for postal delivery of mail and parcels

A complex activity different from personal driving, professional light vehicle driving is becoming increasingly important in the delivery/messaging sector faced with new consumption patterns. Sparsely studied, health risks other than road accidents were approached in an exploratory multidisciplinary study conducted in collaboration with the La Poste group. Its objective was to explore, in work situation, the different components of the mail/parcel delivery activity, and particularly the driving activity as a structuring part of the distribution activity. The methodological approach combining ergonomic analyses and a medical approach has revealed postural and psychological constraints as well as complaints mainly related to the characteristics of the distribution rounds. These findings contributed to the construction of an epidemiological study aimed to analyze risk factors related to driving light vehicles for postal delivery activities.Activité complexe différente de la conduite personnelle, la conduite professionnelle de véhicule léger prend une importance croissante dans le secteur de la livraison/messagerie confronté aux nouveaux modes de consommation. Peu étudiés, les risques pour la santé autres que les accidents de la route ont été approchés dans une étude exploratoire multidisciplinaire menée en collaboration avec le groupe La Poste. Son objectif a été d’explorer, en situation de travail, les différentes composantes de l’activité de distribution de courrier/colis, et particulièrement l’activité de conduite comme partie structurante de l’activité de distribution. La démarche méthodologique alliant des analyses ergonomiques et une approche médicale a mis en évidence des contraintes ainsi que des plaintes en relation principalement avec les caractéristiques des tournées de distribution. Ces résultats ont permis d’orienter la construction d’une étude épidémiologique visant à analyser les facteurs de risque spécifiques à la conduite de véhicule léger dans les activités de distribution.Actividad compleja diferente del manejo de un vehículo personal, la conducción profesional de vehículos ligeros es cada vez más importante en el sector de entrega/mensajería frente a nuevos patrones de consumo. Poco estudiados, los riesgos para la salud diferentes a los accidentes de tráfico se abordaron en un estudio exploratorio multidisciplinario realizado en colaboración con el grupo de servicios postales La Poste. El objetivo fue explorar, en situación de trabajo, los diferentes componentes de la actividad de entrega de correo/paquetería, y particularmente la actividad de conducción como una parte estructuradora de la actividad de distribución. El enfoque metodológico que combina el análisis ergonómico y un enfoque médico pusieron en evidencia las dificultades y las quejas relacionadas principalmente con las características de las rondas de distribución. Estos resultados permitieron orientar la construcción de un estudio epidemiológico destinado a analizar los factores de riesgo específicos en el manejo de vehículos livianos en actividades de distribución

Qualitative and Semiquantitative Assessment of Exposure to Engineered Nanomaterials within the French EpiNano Program: Inter- and Intramethod Reliability Study

The relatively recent development of industries working with nanomaterials has created challenges for exposure assessment. In this article, we propose a relatively simple approach to assessing nanomaterial exposures for the purposes of epidemiological studies of workers in these industries. This method consists of an onsite industrial hygiene visit of facilities carried out individually and a description of workstations where nano-objects and their agglomerates and aggregates (NOAA) are present using a standardized tool, the Onsite technical logbook. To assess its reliability, we implemented this approach for assessing exposure to NOAA in workplaces at seven workstations which synthesize and functionalize carbon nanotubes. The prediction of exposure to NOAA using this method exhibited substantial agreement with that of the reference method, the latter being based on an onsite group visit, an expert’s report and exposure measurements (Cohen kappa = 0.70, sensitivity = 0.88, specificity = 0.92). Intramethod comparison of results for exposure prediction showed moderate agreement between the three evaluators (two program team evaluators and one external evaluator) (weighted Fleiss kappa = 0.60, P = 0.003). Interevaluator reliability of the semiquantitative exposure characterization results was excellent between the two evaluators from the program team (Spearman rho = 0.93, P = 0.03) and fair when these two evaluators’ results were compared with the external evaluator’s results. The project was undertaken within the framework of the French epidemiological surveillance program EpiNano. This study allowed a first reliability assessment of the EpiNano method. However, to further validate this method a comparison with robust quantitative exposure measurement data is necessary

Prognostic value of galectin-3, a novel marker of fibrosis, in patients with chronic heart failure: data from the DEAL-HF study

Biomarkers are increasingly being used in the management of patients with chronic heart failure (HF). Galectin-3 is a recently developed biomarker associated with fibrosis and inflammation, and it may play a role in cardiac remodeling in HF. We determined its prognostic value in patients with chronic HF. Patients with chronic HF (New York Heart Association functional class III or IV) who participated in the Deventer-Alkmaar heart failure study were studied. Galectin-3 levels were determined at baseline using a novel optimized enzyme-linked immunosorbent assay. Univariate and multivariate analyses were used to determine the prognostic value of this biomarker. We studied 232 patients; their mean age was 71 +/- A 10 years, 72% were male, and 96% were in NYHA class III. During a follow-up period of 6.5 years, 98 patients died. Galectin-3 was a significant predictor of mortality risk after adjustment for age and sex, and severity of HF and renal dysfunction, as assessed by NT-proBNP and estimated glomerular filtration rate, respectively (hazard ratio per standard deviation 1.24, 95% CI 1.03-1.50, P = 0.026). Plasma galectin-3 is a novel prognostic marker in patients with chronic HF. Its prognostic value is independent of severity of HF, as assessed by NT-proBNP levels, and it may potentially be used in the management of such patients

Risks for adverse pregnancy outcomes and infections in daycare workers: an overview of current epidemiological evidence and implications for primary prevention

Childcare providers are overwhelmingly women of childbearing age. Occupational risks in this sector include exposure to biological (infectious) or physical (standing, carrying loads) hazards, many of which are associated with adverse pregnancy outcomes such as children with congenital infections, low birth weight or prematurity. Here, the authors examined literature on pregnancy outcomes and infectious hazards related to employment in daycare settings. Overall, 33 original studies (10 reporting pregnancy issues, 23 focusing on infectious risks) published in 1980–2018 were retained following a Medline search. Pregnancy issues in daycare workers have rarely been studied, and inconsistent risks of spontaneous abortion, congenital malformations and fetal growth retardation have been reported. Literature pertaining to infectious risks in daycare settings is extensive. The risk of a primary cytomegalovirus infection during pregnancy was increased for daycare workers caring for >6 children and younger children, changing diapers ≥3 days/week, not wearing gloves when changing diapers, and having employment in daycare for ≤2 years. Personal factors (nulliparity, ethnicity) were also independent risk factors. Parvovirus B19 (B19V) infections appear to be related to employment in daycare, but also to having one’s own children and an increased number of siblings. Consequently, the risk of a primary B19V infection during an outbreak is of most concern among younger nulliparous workers caring for large numbers of young infected children. Since the main occupational hazard is viral infection, feasible prevention strategies include improving workers’ awareness, serological monitoring during pregnancy, educating on appropriate preventive measures, and ensuring age-appropriate immunization of children and staff in childcare facilities

Assessment of insulin sensitivity from plasma insulin and glucose in the fasting or post oral glucose-load state

International audienc

Proposition d'un outil de transmission au patient des résultats globaux de la recherche biomédicale

Contexte : La réglementation de la recherche clinique subit actuellement un remaniement profond principalement initié par l'harmonisation européenne. Les textes de loi doivent en effet être adaptés au contenu de la directive 2001/20/CE applicable en France le 1er mai 2004. Une des quatre modifications principales de la loi Huriet-Sérusclat datant du 4 mars 2002 concerne la transmission des résultats globaux de la recherche aux patients. Nous avons constaté l'absence totale de directives précises sur ce point et le manque d'information des investigateurs et promoteurs institutionnels. Objectif : Notre objectif a donc été la création d'un outil d'aide aux investigateurs pour transmettre aux patients les résultats globaux d'études institutionnelles. Matériels et méthodes : Nous avons consulté les différents acteurs de la recherche biomédicale : CCPPRB (comités consultatifs de protection des personnes dans la recherche biomédicale), CIC (centres d'investigation clinique), promoteurs institutionnels, patients et juristes. Conclusion : Après analyse des réponses, nous avons élaboré un outil de transmission des résultats globaux. Cet outil est proposé pour être testé en pratique par les investigateurs

Démarche multidisciplinaire appliquée à l’analyse d’une activité dans un environnement dynamique : la conduite de véhicules légers à La Poste pour la distribution du courrier et des colis

Activité complexe différente de la conduite personnelle, la conduite professionnelle de véhicules légers prend une importance croissante dans le secteur de la livraison/messagerie confronté aux nouveaux modes de consommation. Peu étudiés, les risques pour la santé autres que les accidents de la route ont été approchés dans une étude exploratoire multidisciplinaire menée en collaboration avec le groupe La Poste. Son objectif a été d’explorer, en situation de travail, les différentes composantes de l’activité de distribution de courrier/colis, et particulièrement l’activité de conduite comme partie structurante de l’activité de distribution. La démarche méthodologique alliant des analyses ergonomiques et une approche médicale a mis en évidence des contraintes ainsi que des plaintes en relation principalement avec les caractéristiques des tournées de distribution. Ces résultats ont permis d’orienter la construction d’une étude épidémiologique visant à analyser les facteurs de risque spécifiques à la conduite de véhicules légers dans les activités de distribution.A complex activity different from personal driving, professional light vehicle driving is becoming increasingly important in the delivery/messaging sector faced with new consumption patterns. Sparsely studied, health risks other than road accidents were approached in an exploratory multidisciplinary study conducted in collaboration with the La Poste group. Its objective was to explore, in work situation, the different components of the mail/parcel delivery activity, and particularly the driving activity as a structuring part of the distribution activity. The methodological approach combining ergonomic analyses and a medical approach has revealed postural and psychological constraints as well as complaints mainly related to the characteristics of the distribution rounds. These findings contributed to the construction of an epidemiological study aimed to analyze risk factors related to driving light vehicles for postal delivery activities.Actividad compleja diferente del manejo de un vehículo personal, la conducción profesional de vehículos ligeros es cada vez más importante en el sector de entrega/mensajería frente a nuevos patrones de consumo. Poco estudiados, los riesgos para la salud diferentes a los accidentes de tráfico se abordaron en un estudio exploratorio multidisciplinario realizado en colaboración con el grupo de servicios postales La Poste. El objetivo fue explorar, en situación de trabajo, los diferentes componentes de la actividad de entrega de correo/paquetería, y particularmente la actividad de conducción como una parte estructuradora de la actividad de distribución. El enfoque metodológico que combina el análisis ergonómico y un enfoque médico pusieron en evidencia las dificultades y las quejas relacionadas principalmente con las características de las rondas de distribución. Estos resultados permitieron orientar la construcción de un estudio epidemiológico destinado a analizar los factores de riesgo específicos en el manejo de vehículos livianos en actividades de distribución