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BACKGROUND: The Oxford shoulder score (OSS) questionnaire for measuring patient perception of shoulder disability, has not tested specifically in a non-surgical population and no study has assessed the OSS with modern psychometrics based on Rasch model (RM). OBJECTIVE: To assess the psychometric properties of the OSS using RM among health-care workers with shoulder disorders and to verify its interest in a non-surgical population. METHODS: In an occupational health department of a French hospital center, a retrospective review was performed of the medical records from June 2019 to October 2020. Responses to 110 questionnaires were examined from 55 subjects (97% of women). A polytomous Rasch model based on the Partial Credit Model was used. RESULTS: Overall fit was satisfactory, the reliability coefficient was high and an ascending order was observed with the 5 categories of the scale. Analysis of the residuals supports unidimensionality and the local independence assumption. Item performance remained stable across the subgroup examined (DIF measures). Scale to-sample targeting indicated a substantial floor effect, and the mildest impairments were not well discriminated. CONCLUSIONS: OSS presents good psychometric qualities. However, it does not clearly discriminate subjects presenting the lowest levels of impairment. Its use in a non-surgical population is questionable.

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Night work is common in hospitals. Weight gain with its metabolic complications is one of its well known effects. The presented study reports that night shift workers have an average weight gain of 5kg compared to day shift workers. They also have an insufficient cardioprotective diet. Occupational health nurses have an important role to play in identifying this warning indicator and developing primary prevention actions.

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OBJECTIVE: The objective of the article is to describe the follow-up of pregnancies at work and occupational exposure to potential risks for pregnancy. METHODS: A descriptive cross-sectional study was performed from April 1, 2017 to October 31, 2017 in the occupational health departments of French hospitals. After delivery and at the time of returning to work, 1,165 eligible workers were interviewed by occupational health physicians (OHPs). Socio-demographic information was self-reported. Occupational exposures were assessed by an OHP. Birth weight, gestational age, and sick leaves were also collected. RESULTS: Among recruited workers, 51.8% were exposed to more than 5 occupational hazards. Biological and physical hazards were the most common hazards at the workplace. Note that heavy lifting ≥ 15 kg concerned 9.5% of workers. Only 20.1% of workers had a specific "pregnancy at work" medical visit with OHP during pregnancy; 26.8% benefited from workstation adjustments. In contrast, the level of sick leaves was high (86.7%). CONCLUSIONS: Our data suggest that pregnant workers in hospitals must be strictly supervised.

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OBJECTIVE: The objective of the study was to examine the effects of occupational exposure to diisononyl phthalate (DINP) on serum testosterone levels in male workers. METHODS: From 2015 to 2018, 97 male workers were recruited from six French factories in the plastics industry. In a short longitudinal study, changes over 3 days in the level of total or free serum testosterone and DINP exposure were measured. DINP exposure was measured by urinary biomonitoring: mono-4-methyl-7-oxo-octyl phthalate (OXO-MINP), mono-4-methyl-7-hydroxy-octyl phthalate (OH-MINP) and mono-4-methyl-7-carboxyheptylphthalate (CX-MINP). We further analysed changes in follicle-stimulating hormone, luteinising hormone, total testosterone to oestradiol ratio and two bone turnover markers (procollagen-type-I-N propeptide, C terminal cross-linking telopeptide of type I collagen), and erectile dysfunction via standardised questionnaires (International Index of Erectile Function, Androgen Deficiency in Aging Males). Linear mixed models were used with the variables 'age' and 'abdominal diameter' included as confounder. RESULTS: Increased urinary OXO-MINP was associated with a significant decrease in total serum testosterone concentrations, but only for workers who exhibited the smallest variations and lowest exposures (p=0.002). The same pattern was observed for CX-MINP but was not significant; no association with OH-MINP was detectable. More self-reported erectile problems were found in workers exposed directly to DINP at the workstation (p=0.01). No changes were observed for the other biological parameters. CONCLUSIONS: Short-term exposure to DINP is associated with a decrease in total serum testosterone levels in male workers. Our results suggest that DINP could present weak antiandrogenic properties in humans, but these need to be confirmed by other studies.

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OBJECTIVE: The objective of the article is to describe the follow-up of pregnancies at work and occupational exposure to potential risks for pregnancy. METHODS: A descriptive cross-sectional study was performed from April 1, 2017 to October 31, 2017 in the occupational health departments of French hospitals. After delivery and at the time of returning to work, 1,165 eligible workers were interviewed by occupational health physicians (OHPs). Socio-demographic information was self-reported. Occupational exposures were assessed by an OHP. Birth weight, gestational age, and sick leaves were also collected. RESULTS: Among recruited workers, 51.8% were exposed to more than 5 occupational hazards. Biological and physical hazards were the most common hazards at the workplace. Note that heavy lifting ≥ 15 kg concerned 9.5% of workers. Only 20.1% of workers had a specific "pregnancy at work" medical visit with OHP during pregnancy; 26.8% benefited from workstation adjustments. In contrast, the level of sick leaves was high (86.7%). CONCLUSIONS: Our data suggest that pregnant workers in hospitals must be strictly supervised.

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A study was conducted with occupational health services to describe the progress of occupational pregnancies in the health sector. Compared to female administrative employees and workers, health sector employees were particularly exposed to more than five risks for pregnancy. Workplace adaptations observed are infrequent and work stoppages are particularly numerous. This justifies effective monitoring of pregnancies for personnel in this sector.

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BACKGROUND: This study aimed to investigate the association between exposure to occupational hazards for pregnancy and sick leave (SL) in pregnant workers. METHODS: A cross-sectional study was performed in French occupational health services in 2014. Occupational hazards for pregnancy were assessed by occupational health physicians (OHPs). After delivery and at the time of returning to work, 1,495 eligible workers were interviewed by OHPs. Information on SL was self-reported. Risk ratios (RRs) were calculated from multivariable analyses based on a generalized linear model with a Bernoulli distribution and a log link adjusted for selected confounders for binary outcomes or zero-inflated negative binomial regression for count outcomes. RESULTS: Among recruited workers, 74.9% presented "at least one SL" during pregnancy. After adjustment, the cumulative index of occupational hazards (0, 1-2, 3-4, ≥ 5 risks) for pregnancy was significantly associated with "at least one SL" during pregnancy in a dose-response relationship. This gradient was also observed with "early SL" (<15 week gestation): from 1 to 2 risks, RR = 1.48 (95% confidence intervals (CIs): 0.92-2.38); from 3 to 4 risks, RR = 2.03 (95% CI: 1.25-3.30); equal to or higher than five risks, RR = 2.90 (95% CI: 1.89-4.44); with "duration of absence" (adjusted mean): from 1 to 2 risks, m = 38.6 days; from 3 to 4 risks, m = 46.8 days; equal to or higher than five risks, m = 53.8 days. We also found that deprivation, pregnancy at risk, assisted reproductive therapy, work-family conflicts, home-work commuting felt as difficult and young age are associated with a higher risk of SL. CONCLUSIONS: Our results support the assertion that pregnant workers exposed to occupational hazards for pregnancy without medical complications are also at risk of taking SL during pregnancy. More prevention in the workplace for pregnant workers exposed to occupational hazards could reduce SL.

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Aim: To examine the quality of manual job coding carried out by occupational health teams with access to a software application that provides assistance in job and business sector coding (CAPS). Methods: Data from a study conducted in an Occupational Health Service were used to examine the first-level coding of 1,495 jobs by occupational health teams according to the French job classification entitled "PSC- Professions and socio-professional categories" (INSEE, 2003 version). A second level of coding was also performed by an experienced coder and the first and second level codes were compared. Agreement between the two coding systems was studied using the kappa coefficient (κ) and frequencies were compared by Chi2 tests. Results: Missing data or incorrect codes were observed for 14.5% of social groups (1 digit) and 25.7% of job codes (4 digits). While agreement between the first two levels of PCS 2003 appeared to be satisfactory (κ=0.73 and κ=0.75), imbalances in reassignment flows were effectively noted. The divergent job code rate was 48.2%. Variation in the frequency of socio-occupational variables was as high as 8.6% after correcting for missing data and divergent codes. Conclusions: Compared with other studies, the use of the CAPS tool appeared to provide effective coding assistance. However, our results indicate that job coding based on PSC 2003 should be conducted using ancillary data by personnel trained in the use of this tool.

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OBJECTIVES: The aim of this study was to perform a systematic review and to use a meta-analytical approach to assess quantitatively the risk of adverse pregnancy outcomes in hairdressers and cosmetologists. METHODS: A systematic literature search up to 1 February 2012 was carried out using major bibliographic databases, grey literature, contacts with research teams working on the subject, review papers and reference lists of selected articles. Observational studies reporting measures of effects in relation with body care (hairdressers, cosmetologists, etc.) and reproductive disorders were included. Study quality was assessed by three reviewers. The estimated risk ratios (RR) from all studies reporting on identical outcomes were combined using an average of logarithm transformation of estimated RR weighted by their inverted variance. Statistical heterogeneity across studies was assessed using Cochran's Q test. To explore the sources of heterogeneity, several sensitivity analyses and subgroup analyses were conducted based on study quality, country, study period, alcohol consumption, smoking habit, jobs and control populations. RESULTS: Nineteen studies were selected and reviewed in-depth. The combined risk ratios (RRcs) of five reproductive outcomes were calculated and found to be significantly increased for four outcomes: time to pregnancy, which had an RRc of 1.11 (95% CI: 1.03-1.19); premature birth, which had an RRc of 1.05 (95% CI: 0.99-1.11); small for gestational age, which had an RRc of 1.24 (95 CI%: 1.10-1.41); low birth weight, which had an RRc of 1.21 (95% CI: 1.06-1.39); and embryonic and fetal losses, which had an RRc of 1.19 (95% CI: 1.03-1.38). CONCLUSIONS: This work confirms a weak increase in risk of some reproductive disorders in female hairdressers/cosmetologists. However, the evidence level is rather weak, and a causal association between job and reproductive outcomes cannot be asserted.

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OBJECTIVES: To confirm the effects of short-term exposure to ozone (O(3)) on ischaemic heart and cerebrovascular disease. METHODS: Daily levels of urban O(3) pollution, the incidence of first-ever, recurrent, fatal and non-fatal ischaemic cerebrovascular events (ICVE) and myocardial infarction (MI) were correlated using a case-crossover design. The authors analysed 1574 ICVE and 913 MI that occurred in Dijon, France (150,000 inhabitants) from 2001 to 2007. Sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)), carbon monoxide (CO) and particulate matter with an aerodiameter of ≤10 µg/m(3) (PM(10)) were used to create bi-pollutant models. Using the adjusted OR, the effects of O(3) exposure were calculated for every 10 µg/m(3) increase in pollutants in multivariate logistic models adjusted for temperature, humidity, flu outbreaks and holidays. RESULTS: The authors found a significant association between exposure to O(3) and recurrent ICVE with a 3-day lag (OR=1.115; 95% CI 1.027 to 1.209). The direction and magnitude of the association between exposure to O(3) and recurrent MI were similar but not statistically significant. For incident events, the authors detected only a non-significant association for ICVE with a 2-day lag (OR=1.041; 95% CI 0.996 to 1.089). In the subgroup analysis for ICVE, the authors observed an increased association with cardiovascular risk factors (OR=1.523; 95% CI 1.149 to 2.018). For MI, the authors found an association with O(3) when hypercholesterolaemia was present (OR=1.111; 95% CI 1.020 to 1.211), and the association became stronger with the number of cardiovascular risk factors. The authors found a marked dose-response relationship. CONCLUSION: Recurrent ICVE and MI could be triggered by short-term exposure to even low levels of O(3), especially among subjects with severe vascular risk factors.

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