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

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

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

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

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

Évaluation de la performance d'un outil d'assurance qualité des protocoles institutionnels

Objectif : L'objectif de cette étude est d'évaluer la performance d'un outil sur l'amélioration de la qualité des protocoles promus par les centres hospitaliers universitaires (CHU). Méthodes : Une étude prospective, en groupes parallèles, contrôlée, avec randomisation collective, a été conduite au sein des directions de recherche clinique (DRC) pendant quatre mois. Soixante-quatre protocoles ont été analysés. Résultats : Avant intervention, il n'existait aucune différence significative des scores qualité entre les groupes intervention et contrôle. Entre les deux périodes, le score méthodologique et réglementaire s'est amélioré significativement (81,7 ± 13,7 vs 90,4 ± 9,2 ; p = 0,040) dans les DRC intervention uniquement. La différence d'évolution des deux groupes n'a pas été significative dans le modèle d'analyse de variance (p = 0,501). Conclusion : Dans une observation limitée à 12 CHU, la qualité des protocoles promus a été jugée sous-optimale et perfectible. L'implication des DRC dans une démarche assurance qualité, telle que cette étude, a amélioré "spontanément" celle-ci. L'application systématique de notre outil n'a pas amélioré significativement le résultat

Low Back Pain and Upper-Extremity Musculoskeletal Disorders in French Postal Workers Driving Light-Duty Vehicles for Mail and Parcel Delivery

Occupational driving of light-duty vehicles (LDVs) became increasingly important in parcel delivery faced with the explosive growth of e-commerce. Since musculoskeletal disorders (MSDs) represent the most reported driving-related health problem, we aimed to analyze the risk of low back pain (LBP) and upper-extremity musculoskeletal disorders (UEMSDs) associated with driving LDVs for parcel delivery. In 306 postal workers exposed to driving and 100 unexposed workers, information on occupational driving, physical/psychosocial constraints, and work organization were collected via a questionnaire. MSDs were assessed using the Nordic Questionnaire, 14 additional questions regarding LBP, and a standardized clinical examination for UEMSDs. Statistical modeling consisted of multivariable logistic regression for UEMSDs and the item response theory approach for LBP. UEMSDs were associated with the distance of rural rounds and inversely associated with urban/mixed delivery rounds. Handling heavy loads was associated with LBP, and high physical demands during delivery rounds were related to MSDs. Karasek dimensions and mobbing actions were associated with MSDs. Work recognition, driving training, using an automatic gearbox, and the utilization of additional staff during peak periods were inversely associated with MSDs. Our results suggest that the distance driven in rural settings and high physical demands were associated with MSDs, while some organizational factors could protect from MSDs

Occupational health and hazards in construction and civil-engineering workers handling engineered nanomaterials : challenges in designing epidemiological studies in france

Engineered nanomaterials (ENMs) induce groundbreaking impacts by endowing unique properties to materials. However, uncertainties remain on their biological aftereffects. Entrusted by health and labour ministries, the French Public Health Institute launched since 2014 the EpiNano epidemiological surveillance program of workers potentially exposed to ENMs. The 2016–2020 national occupational health (OH) action plan inscribed the ENMs topic as of priority, with an enlargement to the construction and civil-engineering (CCE) sector. A scientific consortium was therefore established in order elaborate a standardised methodology to identify ENMs-exposed CCE workers. A comprehensive, structured PubMed review and web-search of technical documents was undertaken, complemented by in-depth experts’ interviews to collect contextual information regarding CCE nanoproducts. Several methodological challenges were primarily revealed, pertaining primarily to : (i) Demarcating the target population: Involvement of a large number of companies (400,000) of all sizes and activities; Massive delegation to subcontractors; Heterogeneity of socioprofessional categories (from engineers to operators) and occupations (around 22); (ii) Unknown exposures’ circumstances: no CCE nanoproducts inventories neither detailed composition information; Unawareness of CCE actors of nanoproducts’ use; Heterogeneity of ENMs incorporated in various matrices (cement, coatings, paints…) with unknown ENM release/exposure potential; Potentially passive occupational exposures; Myriad of confusion factors with interactions with other risks at workplace; (iii) Capturing and following the eligible population: a complex topic to be addressed with a lot of pedagogy for adhering workers; epidemiological follow-up hampered by high turnovers, duration of construction sites and language barrier. Discussions are ongoing to overcome these methodological challenges. As a first step, an awareness campaign and the establishment of CCE nanoproducts’ inventory will be launched soon. An increase in CCE nanoproducts’ use is expected in the context of sustainable development and energy saving. This underscores the urgency to implement a specific surveillance system, by circumventing designing complexity

Surveillance of occupational health in construction and civil-engineering workers handling engineered nanomaterials

Rationale: Entrusted by the Ministries of Health and of Labour, the French Public Health Agency have established, since 2014, the Epinano epidemiological surveillance system of workers potentially exposed in industries to engineered nanomaterials (ENMs) released during their synthesis or incorporation in matrices. The governmental national occupational health action plan 2016–2020 has dedicated a special attention to the question of ENMs exposure in workers in the construction and civil-engineering (CCE) sector. Thus, a steering committee was established to adapt the methodology to efficiently capture exposed workers on sites. Objectives: Beforehand, epidemiological and contextual components were collected in order to apprehend the methodological challenges in designing longitudinal studies on the topic of exposure to ENMs on CCE sites. Methods: A structured PubMed review and web-search of scientific and technical documents regarding ENM-based CCE products was undertaken, completed by in-depth experts’ interviews. Results: Three groups of methodological challenges were primarily identified: (i) Definition of the scope of the population, with involvement of enterprises of all sizes and activities; Heterogeneity of the population occurring on sites. (ii) Circumstances of exposures: No inventory identifying all the products incorporating ENMs; Lack of detailed information on product composition; Heterogeneity of ENMs incorporated in various matrices; Diversity of activities generating exposure variability in terms of product types, duration and intensity of exposure; Passive exposures of workers operating nearby activities involving ENMs and generating dust and aerosolisation; Possible interactions with other risk exposures in light of the multitude of chemicals used on construction sites. (iii) Defining the organizational arrangements to capture efficiently the study population and optimize data collection and monitoring procedures: Lability of the population, influenced by the duration of projects, a known high turnover generated mainly by the engagement of temporary, independent or foreign labourers, and intervention of multiple subcontractors; Regarding small, medium or micro-sized businesses, no service Health Safety Environment (HSE) and relocation of the occupational medicine. Conclusions: Implementing of such a study can be deeply influenced by the political context as well as the product marketing strategies along with the industrial secrecy. The use of ENM-based products would be probably increased in the current green economy context. This underscores the need to implement a specific surveillance system, despite the methodological complexity. Discussions are underway within the steering committee in order to find out strategies