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Introduction: The profession of pathologist exposes to various risks, notably infectious, physical and chemical. The objective of this study was to make an inventory of these occupational risks to which pathologists are subjected and to evaluate the pathologies that they presented. A particular attention was given to microscopic and screen work as they can induce musculoskeletal or ophthalmic disorders, and stress-related psychological disorders., Method: An anonymous online questionnaire containing 54 questions had been sent by mail to pathologists via the French Society of Pathology and the Syndicate of French Pathologists., Results: Five hundred and twelve pathologists responded to the survey. Thirty-eight percent reported musculoskeletal disorders in the last 6 months. Visual disturbances concerned 73.4% of respondents. In the last 12 months, 33.3% of pathologists had been injured or had had mucosal projections during macroscopic or autopsy specimens. The frequency of infectious diseases was low (6.2%) as well as that of cancers (3.9%). Psychological disorders such as depression or burnout were reported by 16.7% of respondents. Pathologists seemed happy at work and had a good overall lifestyle. Few doctors had medical follow-up and few had benefited from ergonomic advice and training on the risks of chemicals., Conclusion: The results of this study showed the interest of a medical surveillance adapted to the pathologies presented by the pathologists. Educational and preventive measures should be introduced early in the career, focusing on ergonomics and learning about chemical and biological hazards., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

The accidental loss of fingertip soft tissues, which may expose tendons and bones, is a common injury in emergency departments. If these lesions are poorly treated, they can impair fine motor skills and tactile sensitivity of the fingertips. The study was conducted on 30 patients (24 males and 6 females) with 32 soft tissue defects of the fingertip treated in emergency plastic surgery with local pedicled flap at the Plastic Surgery Department of Saint Paul Hospital Hanoi from 01/2016 to 06/2017. The most common cause of injury (21/30) was occupational accidents. At the time of the accident, 12 patients did not have personal protective equipment (PPE). Among 18 patients who had one, eight had incomplete equipment. Of 32 implanted skin flaps, 31 survived completely without necrosis or infection, only one being affected by epidermolysis. Postoperative evaluation showed excellent motor skills for 31/32 fingers and a sensitivity restoration at S4 level for 27/32. Workplace accident is the main cause of fingers soft tissue defects. Covering the fingers soft tissue defects with local pedicled flap in emergency preserves the fine motor function and the delicated tactile sensation of the fingers., Competing Interests: The authors have no conflicts of interest to declare

Introduction: Traditional gold washing traumatism during traditional gold panningfalls within the scope of occupational accidents, which are common pathologies in developing countries such as Mali. Our work aimed to study traumatism during traditional gold panning., Material and Method: A 1-year prospective study from November 2014 to November 2015 on the cases of traumatism during traditional gold washing (TOT) admitted to the emergency room(ER) of the University Hospital Gabriel Touré during the study period. Data were collected from outpatient visit records and medical charts. Data were collected on the survey sheets and analyzed with Epi-info version 7.1.1.0.fr software. Data entry was made with Windows 7 software., Results: During the study period, 21,400 patients were admitted to the ER, of whom 445 patients were victims of traumatism, a frequency of 2.08% of all outpatient visits in the ER. The age group 21-40 years old was the most represented with 64.94% of the cases. The male gender was predominant with 77.08% of the cases with a sex ratio of 3.36. Mine landslides were the most common causality in 65.39% of the cases. Dorsal spine involvement was the most common with 41.80% of cases. Medullary vertebral fracture was the most frequent diagnosis with 43.82% of cases. In total, 79.55% of patients received medical treatment. Patients or were transferred to neurosurgery department in 58.20% of cases., Conclusion: Traumatism during traditional gold panning is common. Lesions most often fit in a context of polytraumatism. The rapidity of the diagnosis and management are crucial to the prognosis of the disease., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Spinal trauma is one of the most common types of injuries among victims of traffic accidents, sports accidents, domestic accidents and workplace accidents. We conducted a 3-year retrospective study of 139 cases of spinal trauma hospitalized and treated in the Neurosurgery department of the CHUJRA, Madagascar. This study shows that 25.17% of injured patients were between 21 and 30 years of age, with a clear male predominance (69.78%; sex ratio 2.3). Falls were the dominating traumatic injury mechanism (33.09%) with risk factors including alcohol use (8.63%). Spinal injuries occurred in patients with polytrauma, of whom 34.63% had cranial trauma. Patients were admitted to the department within 1-5 hours after the trauma in 31.65% of cases, using private car as their means of transport 36.69% of cases. During the hospitalization 20 patients signed the discharge form and 6.34% of patients died. Spinal trauma is a public health problem requiring high intensity management, especially for patients with life-long disabilities. Any spine trauma requires a diligent search for cranial lesion., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts.

This is a prospective study conducted in December 2012 among 128 at the Nianankoro Fomba Hospital in Segou in order to assess their knowledge and practices on Blood Exposure Accidents (BEA). The average age of caregivers was 35.4 ± 9 years (range: 22-59 years). The nurses were predominant with 37.5%. The definition of BEA was mastered by 43.8%. The main transmissible infectious agents (HIV, HBV and HCV) were ignored by 76.6%. Questioning revealed that during the treatment, 78.9% wore gloves and 36.0% recapped needles after use. The concept of washing and disinfection after BEA was known by 68.8%. The disinfectant applied was correct for 21.9% of the cases, the time of application for 69.5%. Consulting a referring physician after BEA was mandatory for 32% of them. The time limit of 48 hours delay for the declaration of BEA was experienced by 51.3%. Among staff interviewed 82 caregivers (64.1%) experienced at least one BEA. Students and nursing students were most at risk. Needle pricks were the most frequent (73.2%). BEA is a major problem in the Segou Nianankoro Fomba Hospital. Compliance with standard precautions is not of common practice. Post-exposure care is not widely known. The experienced cases show poor management of BEA in the structure.

The authors report in the treatment of fractures of the proximal phalanx of the fingers, the use of Eiffel Tower pinning, a relatively simple method, fast and stable, associated to a protection and early rehabilitation. The objective of this method is to offer to the patient a pollici-digital grip. Our study is a retrospective study of 45 patients treated for fractures of the proximal phalanx of the fingers by percutaneous pinning according to Eiffel Tower method. We detail this simple and economic technique and examine the functional and radiological results of this series of patients. The amplitude of the active total motion of the proximal interphalangeal joint is on average 94.16 degrees (78.5 % of the normal active mobility of the proximal interphalangeal joint), and the amplitude of the active total motion of the metacarpo-phalangeal joint is on average 90.05 degrees (75 % of the normal active mobility of the metacarpo-phalangeal joint)., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

Fifteen to 20 % of fatal work-related accidents would be connected to the use of alcohol, psychotrops or narcotics. Many constraints restrain the systematic detection of addictive behaviour at work. The restraints can be financial, ethical, technical or laid down in the regulations. The occupational physician remains the main actor in the prevention of the risks caused by those behaviours. In 2004, the firm SNCF engaged a long-term action of drugs information and detection. It has been well-understood by the agents and all the firm's operators achieved in appropriated conditions, with a strict respect of the medical secret. In four years, the number of detected consumers decreased by half.

Objective: The aim of this study was to assess care and preventive measures for accidental exposure to blood (AEB) in Abidjan., Methods: A retrospective study of all AEB reported in the Infectious and Tropical Diseases Center of the Treichville University Hospital was made between January 2000 and December 2005. Epidemiology, management, clinical and biological post-exposure follow-up were analyzed., Results: One hundred eighty-two AEB were managed over 6 years (151 needlesticks, 14 ocular projections of blood, 12 cuts, and 5 mucocutaneous exposure to blood). 94 men (51.6%) and 68 women (48.4%) were included [sex ratio 1.4] mean age 33.8 years+/-7.4 years. Physicians (29.1%), nurses (19.8%), assistant nurse (12.1%), and medical students (11.4%) were the professional categories which declared most accidents. Among them, only 51.1% was correctly vaccinated against hepatitis B. The average delay of consultation was 26.5 hours (1-240 hours), and 82.9% of victims consulted before the 48th hour. Antiretroviral prophylaxis was prescribed to 151 patients among whom 45% with bitherapy (Zidovudine and Lamivudine), and 55% with HAART including an antiprotease. Only 60 patients had one actual month of treatment. Despite the weak follow-up, no case of HIV seroconversion was reported 6 month after exposure., Conclusion: This work underlines once again the high frequency of AEB in Abidjan despite a under reporting, and calls for the implementation of a policy to train health care workers on AEB preventive measures.

Background: Occupational injury represents 7,7 at 69,9% of the total ocular traumatisms. They can be a major source of visuel loss and blindness. The aim is to study the epidemiology of work-related ocular injuries: objects frequencies,works most exposed., Methods: We performed a prospective study that interest 78 patients having a work-related ocular traumatism during a 4 months period. They were admitted at ocular emergeney All patients underwent an ophtalmologic examination completed with orbital radiography and echography. A medical and/or chirurgical appropriate treatment was institued., Results: Occupationnal injury frequency was 9% of the whole ocular traumatisms in the same period. The mean age was 31 years. 55% of cases were under 30 years. 91% were male. Most exposed works were industrial and mecanical sectors In 70,5% of cases work-related eye injuries were caused by projectile objects. Most common lesion was corneal superficial foreign body (58%). Open globe injury was noted in 8%. 95% of patients had no eye protection at the time of the accident. 13% were blind or unilateral partially sighted (according to the OMS classification)., Conclusion: The authors discussed the importance and different prevention strategies to prevent the risk of blindness and socio-economical cost of occupationnal accidents. There is a need for systematic periodic sensibilization to reduce these accidents and blindness.

The Mutualité Sociale Agricole (MSA--French social security agency) closely examines the circumstances and consequences of the accidents and diseases occurring in agriculture as part of the professional activity of farmers and their employees. During work as such, identified as being the first source of accidents, approximately 35,000 and 70,000 accidents occur each year, respectively to farmers and employees. In both populations, the accident frequency is around 60 out of every 1,000 insured persons. The evolution is positive for employees, but serious, non-fatal accidents remain a major area of concern. Accidents to and from work mainly involve employees. Their number has markedly decreased and the anualy frequency is close to 3 out of every 1,000 employers. The number of occupational diseases is constantly increasing, mainly as the consequence of the recognition of periarticular diseases. This article also summarizes the main conclusions of a French survey conducted in 2003 among 50,000 wage earners in the agricultural sector, as part of the medical monitoring of professional risks (SUMER).

Industrial accidents causing lumbar back strain are frequent and are of major causes of absenteeism. For this purpose, we tried in this study to assess the prevalance of such accidents, to determine the circumstances of their occurence and to point out the various risk professions. For this, we analysed 242 files of lumbar back pathology industrial accidents related. The latter files have been examined by the Tunis medical board authorized to set out the permanent disability rate resulting from industrial accidents and occupational diseases. We noticed a marked male predominance 58% of patients were aged between 41 and 50 years. We observed a predisposition in 19% of all cases. The professional category of operators is mainly concerned. These accidents most frequently occur in the morning at the site of work, often due to the handling of heavy loads. They cause lesions of variable importance, such as slipped disc hernia in 40% of cases. The average duration of absenteeism resulting from lumbar strain is of 237 days a year per patient. After-effects are frequent, notably those of spinal pains and lumbar stiffness. The average rate of permanent partial disability is of 8% (0-45%).

Radiotherapy accidents are exceedingly rare. However, they may have major negative consequences: for health (and sometimes life) of victims as well as for the trust that patients put in radiotherapy and radiation oncologists. Each accident must be pointed out, analysed and reported, in order to allow preventive actions, avoiding repetitive accidents. Through examples of majors accidents occurred all over the world in the last decades, affecting professionals, public or patients themselves, the necessity of transparency is demonstrated. The International Commission of Radiobiological Protection has drawn positive lessons from such accidents and insists on following recommendations: necessity of sufficient number and competent professionals, importance of continuous and initial education, information of professionals and, in general, a strict Quality Assurance program. It is clear that each radiotherapy center remains at risk for errors. It is essential to develop preventive procedures to avoid transformation of errors into accidents. In that context, complete and detailed description and reports of each anomaly or incident must be encouraged as it is done for sectors of aviation or nuclear industry. Radiation oncology must develop such a culture of transparency and of systematic report of all incidents.

The objectives of this study were to appreciate the magnitude of work accidents in a building construction sector, to specify their type and characteristics. A retrospective study was undergone in a big building construction industry in Senegal. Data were collected from records of accidents reported to the Social Security Administration between 1994--1996. We looked for characteristics of accidents as well as workers involved in accident. 244 accidents were collected in a three years period, i e 81.5/year, 132 work injuries involved temporaryworkers. 55.73% occurred in chantiers, and 1/3 in working room. Moving and handle objects generated most accidents (36,47%). Wounds and contusions were the most frequent lesion (51,62.%). Arms and feets were concerned in 51.63%, and ocular lesions were noticed in 13.94%. These accidents generate an overall number of 3055 days lost. Work injuries in the building construction sector in Senegal are identical to those described in othercountries. Prevention measures requires improvement of working conditions, education of workers and availability of personal protective equipment's.

Objective: Infections transmitted by blood such as viral hepatitis B and C or human immunodeficiency virus (HIV) are a true threat to health care workers. As medical students are exposed to accidental contamination during their hospital activities, we conducted a survey among medical students in Nice France to determine the frequency and circumstances of needle prick accidents and how the risk of blood exposure is managed., Methods: A survey was conducted between December 1 and December 15, 1996 among second cycle medical students. An anonymous questionnaire was proposed to all students attending mandatory faculty classes. A blood-exposure accident was defined as a needle prick or a cut caused by another sharp object which occurred in the hospital., Results: Among the 237 students enrolled in the classes, 200 (84%) responded to the survey. Among these, one-quarter had experienced a blood-exposure accident by needle prick. For students terminating their second cycle, this rate was 37%. In 58% of the cases, the accidents had occurred when the students were on duty (excepting hospital training courses). Blood drawing for gas measurements was the most frequent circumstance (44%). Only 39% of the students had declared the accident and 51% had had a serology control within 2 months. The serological status of the source patient was unknown to the students in nearly half the cases. Only one out of two students applied elementary safety measures systematically (gloves, not recapping the needle). Only 13% of the students stated they had received information about blood-exposure accidents and their prevention and less than 50% had a correct notion of the risk of hepatitis B and C and HIV transmission by needle pricks., Conclusion: The incidence of blood-exposure accidents in hospital medical students is high and probably underestimated by official statistics due to the low declaration rate. Measures should rapidly implemented to inform and train students on prevention. Our units are currently working with students, the medical faculty and the occupational medicine unit to reach these objectives.

Sectorisation of cares leads professionals to a confrontation with violent home patients. These interventions need a maximal security for professionals. Emergency Mobile Crisis Team (ERIC) has more than 6,000 crisis home interventions' experience. The aim of this study was to assess violent situations during a 42 months experience. We present 70 situations of danger for professionals, and their consequences. Difficulties lead to procedural safety measures, which are presented. Prevention of violence during intervention needs an acute preparation, a clear evaluation of context, and passive or active securisation measures. Occurrence of acting-out is low, but situations considered as dangerous are frequent. We propose some pragmatic issues to increase security in crisis home interventions.

We present here the results of a study of 21 work-related accidents that occurred in a Brazilian manufacturing company. The aim was to assess the safety level of the company to improve its work accident prevention policy. In the last 6 months of 1992 and 1993, all accidents resulting in 15 days' absence from work, reported for social security purposes, were analyzed using the INRS causal tree method (ADC) and a questionnaire completed on site. Potential risk factors for accidents were identified based on the specific factors highlighted by the ADC. More universal trees were also compiled for the safety assessment. Three hundred and thirty specific accident factors were recorded (mean of 15.71 per accident). This is consistent with there being multiple causes of accidents rather than the assertion of Brazilian business safety departments that accidents are due to "dangerous" or "unsafe" behavior. Introducing the idea of culpability into accidents prevents the implementation of an appropriate information feedback process, essential for effective prevention. However, the large number of accidents related to "material" (78%) and "environment" (70%) indicates that working conditions are poor. This shows that the technical risks, mostly due to unsafe machinery and equipment are not being dealt with. Seventy-five potential accident factors were identified. Of these, 35% were "organizational", a high proportion for the company studied. Improvisation occurs at all levels, particularly at the organizational level. This is thus a major determinant for entire series of, if not most, accident situations. The poor condition of equipment also plays a major role in accidents. The effects of poor equipment on safety exacerbate the organizational shortcomings. The company's safety intervention policy should improve the management of human resources (rules designating particular workers for particular workstations; instructions for the safe operation of machines and equipment; training of operators, etc.) and introduce programs to detect risks and to improve the safety of machines and equipment. We also recommend the establishment of a program to follow the results of any preventive measures adopted.

Reminder of the materials used for the manufacture of corrective lenses. Belgian statistics concerning eye accidents at work and European legislation concerning the prevention of eye accidents, personal protective equipment, P.P.E. Eye protection for sports.

Statistical data obtained from insurance companies give certainly a good picture of work effects on health in the field of accidents. This is different for occupational diseases, which are more difficult to diagnose and which are recognized on the basis of medicolegal criteria. Statistics do not involve other aspects than diseases, such as discomfort, ergonomical questions, psychophysiological consequences and situations where there is a limited role of occupation. Prevention of work related health problems has to consider these characteristics and needs to be based on risk analysis, a prospective procedure. The advantage of such an approach is the possibility of adjustment to a changing work environment and to new technologies.

To prevent professional injuries and diseases, the need of analyzing risks at the work place from the individual as well as from collective point of view, is emphasized by law-makers. The present study shows that, using epidemiology enquiries allows one to analyse the prevalence of professional diseases in a population, without using the "LAA type" lists. One can see that these diseases, though linked to professional activity, go far beyond the limits of the insurance prescribed definitions.

The results of a series of 36 post-traumatic radio-carpal arthrodeses were compared with those of the series of resection of the first row of carpal bones reported during the round table. The advantages and disadvantages of both procedures were discussed. Arthrodesis results in: 1) loss of grip strength in all cases, averaging 41%; 2) persistent pain in 78% of cases; 3) impairment of function resulting from blocking of the wrist. After the procedure, average time off work is 15 months, level of permanent disability was 30%, and 20% of patients returned to their previous jobs. These figures could be used as arguments against arthrodesis. However, they must be taken in context: final arthrodesis, usually performed on manual workers, is often chosen when resection of the first row of carpal bones would obviously be insufficient, for example, when severe arthritis of the head of the capitate is present.

Frequency and severity of sickness absence due to back pain were studied among workers in the French National Electric and Gas Company. The results showed that the prevalence of back pain was less than 10% a year but the annual duration of absence that it involved was relatively important: 30 days in the average per disabled person. In a second part, the prevalence was studied according to individual and occupational variables. Differences according to occupational category are very important: between the occupations the most prone to absence, those of "switchboard operator", "mechanics driver" and "warehouseman" and the ones least exposed "managerial staff" and "skilled technician and upper management", the ratio for the prevalences was 10.

The situation of work accidents in the enterprises of the milk industry in the Saratov region during the period 1967-1986 is analysed. The main factors which exert an influence on the rate of work accidents are pointed out. The medical and economic efficiency achieved by the introduction of some prophylactic measures into the enterprises of the milk industry is emphasized.

From the data of a survey conducted in 1986 within the French area of Aquitaine and based on a representative sample of injuries having led to immediate death or hospitalization, different types of injuries were compared. Domestic and recreational accidents constituted the leading cause (41%) of injuries, followed by traffic accidents (28%) and suicides (13%). The overall ratio of immediate deaths to hospitalizations was 1 to 30 (1 to 10 for suicides, 1 to 20 for traffic accidents and 1 to 80 for domestic accidents). The overall annual incidence was 131 per 10,000 (respectively 20, 34 and 53 for suicides, traffic accidents and domestic accidents). The incidence by sex, age and type of accident was assessed. Among hospitalizations, about 3/4 of domestic and school accidents were falls; 45% of work accidents were cutting-piercing or being struck by an object, and 40% were falls; 90% of attempted suicides were poisonings. Using the Injury Severity Score (ISS), severity of injuries was the highest in traffic accidents. Traffic accidents also led to the highest hospital mortality within eight days (1.6%).

Hand injuries count for a 1/3 of all injuries at work, 1/3 of chronic injuries, 1/4 of lost working time, 1/5 of permanent disability. This varies from activity to activity and with the material element involved. An average of 22 working days are lost, but this varies according to lesion. The average permanent rate is 5.8% against 10% for accidents in generally. High rates are not very frequent (2% above 10%). The average cost is between 12,000 F and 15,000 F (at 1980 rates) of which more than 2/3 can be attributed to daily compensations. In 1980, the number of finger amputations can be estimated at 11,000 (3300 fo which were accidents at work) whose overall cost was 140,000,000 F, the daily compensations being 2/3 of this figure. The cost of insuring this risk is subscribed by employers, and the contributions are based on the nature of the risk. To prevent accidents and the after effects certain points must obviously be stressed. The return of patients into working life is vital, even before complete recovery from their injuries.

The authors surveyed occupational accidents in the dairy industry in Saratov district, 1967-86. The survey covered the frequency of work accidents, risk factors for accidents at work and types of lesions. Data were subjected to dispersion analysis by an "ISKRA 226" computer. Finally, the authors discussed modalities for reducing accidents at work in the dairy industry.