Search

Through a national cohort of more than 4000 nurses and nursing assistants in 14 university hospital centres, a study has developed a tool to assess the health of nursing staff within nursing units. This tool enables the general health condition of caregivers, as well as their working conditions, to be gauged. On this basis, preventative measures in terms of work organisation can be drawn up.

A Meta-analysis was conducted on 107 original epidemiological papers published between 1980 and 1993 on the respiratory health impact of suspended particles, sulfur dioxide, ozone and nitrogen dioxide. These are the usual air quality indicators that are monitored in urban ambient air. The range of exposures that were studied (averages and 90th percentiles are respectively up to 88, 83, 124 and 53 mu/m3 (averages) and 180, 147, 234 and 131 micrograms/m3 (90th percentile) for each of the four pollution indicators) allowed assessment of dose-response functions for irritative pulmonary conditions (cough and/or asthma episodes) and respiratory function (FEVI and peak expiratory flow). The dose-response functions seem linear in the range of observed concentrations, with nitrogen dioxide showing the least consistent association across different health indicators. When applied to exposures measured as a 100 micrograms/m3 increase of pollutant's concentrations compared to low background values, the average relative risks of airway irritation (cough and/or asthma épisodes) range, according to the pollutant, from 1.08 to 1.47; average relative decreases of respiratory function amount to 1.1 to 2.2%. The effects are most often stronger among young subjects. The results of this study, when applied to air pollution concentrations in the range of values that were observed in this study, should foster health risk assessment studies in places where population air pollution exposures are available.

The POLAIR software is designed to guide the user along a methodological approach to assess the health consequences of an accidental or chronic point source atmospheric pollution. This article presents the two components of the software, i.e. the gaussian modelization of the pollution contour lines on the territory around the emission source that allows to calculate an exposure index for every individual with a space-time ponderation factor, and the implementation, by using the EPI-INFO software, of a case-control or historical cohort epidemiological study among the population living in the vicinity of the source. Standardized questionnaires for the collection of data in the field are proposed, and the steps of the data analysis are commented upon, on the basis of an illustrative example.

Fifty nine scientific papers had been published in english or french literature, by 1988, on the matter of respiratory health effects of environmental tobacco smoke exposure (ETS). Fifteen dealt with lung cancer. An original meta-analytical approach was used in order to assess the consistency of these results, where the quality of the papers contributes to the weighing scheme, along with the traditional precision parameters. Lung cancer studies converge towards a point estimate of the relative risk (RR) near 1.5, contrasting non smokers exposed during a long time to ETS (mostly at home) and non exposed non smokers (95% confidence interval = 1.3-1.6). Important methodological difficulties did not allow, to date, to show consistent dose-effect relationship with duration or intensity of exposure. Chronic infections of lower respiratory tract related to ETS have been frequently observed (RR = 1.3; 1.2-1.4) as well among adults as among children. Wheezing and asthma are likewise more frequent among children exposed to ETS at home (RR = 1.2; 1.1-1.4). A modest, although statistically significant decrease of Forced Expiratory Volume at One Second is associated with passive smoking among children (mean effect = -0.5%). Health risk related to passive smoking are much lower than those caused by active smoking. However, this hazard should not be underlooked, since ETS is universally present in everyday life and since anyone may be exposed, including children, the elderly and those who suffer from chronic respiratory diseases. Many research needs are underscored by this meta-analysis. It remains that the current state of knowledge on health risks associated with passive smoking warrants that strong preventive action, educative or statutory, be promoted.

A retrospective follow-up study was conducted among 5,737 tourists in 8 holiday camps, during the 1986 summer, in the Ardèche river basin, in order to study the relationship between the bacteriological water quality and the morbidity that occurred to swimmers. Total morbidity was more frequent among bathers than non-bathers (Risk Ratio = 1.7 [95% confidence interval = 1.4-2.1]); gastro-intestinal illness was the major type of morbidity (RR = 2.8 [1.8-4.4] for "objective gastro-intestinal diseases). After screening for the germs that were best correlated with gastro-intestinal and skin diseases, using simple linear regression, logistic regression models allowed confirmation that fecal streptococci best predicted gastro-intestinal morbidity; it significantly exceeded the risk observed among non-bathers above a concentration of 20 SF/100 ml ("objective" gastro-intestinal morbidity). The relationship with fecal coliforms was less clear. However, they are good indicators of skin diseases risk. These results should help re-evaluation of the current microbiological standards concerning recreational waters.