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Abstract: Systemic sclerosis (scleroderma) is a rare auto immune disease. Its physiopathology, based on various mechanisms, involves a predisposing genetic background and some exogenous factors. Among them, the role of toxic products is highly suggested according to several case-control studies. The aim of this study is to review the literature concerning occupational exposure associated with scleroderma. This review is completed by the results of a self-reported questionnaire on occupational exposures sent to 82 scleroderma patients followed in Marseille. Scleroderma associated with silica exposure should be declared as occupational disease. Moreover, the role of other toxic agents such as solvents is highly suspected and scleroderma occurring in case of high exposure should also be declared. Our study performed in Marseilles showed a occupational exposure in 10% of cases (five patients having an occupational exposure that could be involved in the genesis of the disease). One had an occupational silica exposure and was declared as occupational silica disease. Other cases had various toxic exposures including solvents and two were declared as disease of occupational nature. Occupational exposure (labour and leisure) must be searched for when faced with a scleroderma patient for two reasons: the possible declaration of an occupational disease and a better knowledge on toxics involved in scleroderma. [Copyright &y& Elsevier]

Background: A qualitative study was conducted in 2008 of occupational physicians (OPs) in south-eastern France to document their attitudes, opinions and practices on prevention and screening of occupational cancers. This was done to provide elements to prepare the questionnaire of a quantitative study in 2009., Methods: Semi-structured interviews were conducted using a structured interview guide with 20 OPs. The data collected were subjected to an analysis of thematic content type., Results: The analysis revealed that OPs face many difficulties when preventing occupational cancers. For most of OPs, these difficulties appeared related to "external factors": lack of involvement of employers and minimization of risks by employers and employees. Lack of time, overload and, for some OPs, perceived lack of independence towards employers, were also mentioned as barriers to cancer prevention. This study also suggested hypotheses related to OPs themselves (internal factors): perceived lack of effectiveness and, trend to minimize the risks of occupational cancer in their geographical area. Finally, the results suggest a significant heterogeneity of OPs' practices regarding occupational cancer screening., Conclusion: These results raise several hypotheses that will be addressed further in the quantitative survey. They warn about the difficulties of a profession that seems to encounter a demographic and identity crisis.

Objective: Cutaneous melanoma prevention has become a public health issue. The incidence of this cancer has been steadily growing for 50 years, and the related death ratio is not decreasing. Today, the surgical resection of a thin lesion is the only validated curative treatment. The early detection of melanoma represents a major line in the management of such tumours., Methods: Occupational physicians of the PACA area were invited to participate in a campaign for the screening of pigmented suspect cutaneous lesions for 2 years. Voluntary physicians were trained to use the ABCDEF diagnostic criterion. Lesions were detected during regular yearly consultations (1998/1999) and the data concerning the development and care of these lesions was collected during consultations over the following year (1999/2000)., Results: Two hundred and fifty occupational physicians of the PACA area participated in the campaign. Two pre-cancerous lesions and 10 cancers (5 melanoma and 5 pigmented basocellular carcinoma) were found among the 487 suspect lesions detected. Each melanoma had a Breslow score of less than 0.9 mm and were of good or even excellent prognosis., Conclusion: The cutaneous examination, although rapid, during the occupational medicine consultations, is an effective means of detecting the early onset tumoral lesions which, at that stage may potentially be cured. The ABCDEF criterion is a useful diagnostic tool and should be taught to the all the medical and paramedical staff.

DYNAMIC BALANCE: The antibiotic status of the human organism results from the dynamic balance between the antioxidant system and the production of reactive oxygen species. Oxidative stress occurs when this balance shifts in favor of pro-oxidants as can occur in several disease situations. ROS: Part of the oxygen used by cells is transformed into toxic metabolites, reactive oxygen species (ROS), which can be the cause or consequence of tissue and molecular disorders. Some of the most prominent diseases linked with oxidative stress include atherosclerosis, cancer, allergy, neurodegenerative diseases, Parkinson's disease. PERSPECTIVES FOR PREVENTION: Actions designed to prevent the environmental cause, such as eviction of a exposure to toxins or a change in eating habits, can be an effective means of reducing the lesions induced. Study of total antioxidant potential could be quite useful for detecting and monitoring environmental damage and for clinical follow-up. It could also help in determining, for each individual, the negative or positive development of a therapy on the anti-free radical action. Treatments must be personalized according to the tested response.

Unlabelled: AT RISK GROUPS: The incidence of latex hypersensitivity of latex hypersensitivity has increased over the last decade. The main at-risk groups for developing latex allergy are: health care workers and employees working in latex industries, patients with atopic diathesis and subjects with repeated surgical procedures during childhood. SENSITIZATION: The use of cornstarch powder gloves can sensitize healthy subjects and exacerbate symptoms of allergic patients as the powder spreads the latex allergens into the environment., Practical Attitude: We propose here some practical recommendations for prevention, both for the general population and for allergic subjects.