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International audience; SETTING: Asthma is the most common chronic respiratory disease among adolescents; however, very little is known about asthma in this age group. OBJECTIVE: To explore asthma in adolescence using cross-sectional and retrospective representative data. DESIGN: A population-based sample of adolescents was selected from 578 classes in 186 schools of eight metropolitan educational districts in France and invited to complete a self-administered questionnaire (National Adolescent Health Survey [NAHS]). RESULTS: Of 14,278 adolescents selected, 12,466 (87%) participated in the survey. Prevalence of 'ever asthma' was higher among boys, among those in the south and west, among those from French overseas departments, in active smokers, and in those with other allergies, including food allergy. It was lower in adolescents whose mother was a housewife. Puberty was not associated with 'ever asthma'; however, asthmatic boys without signs of puberty usually had more attacks than those with. Severe asthma was associated with early onset and female sex. Asthma medications and consultations did not depend on socio-economic status. Asthmatic adolescents were found to need more health care in terms of medication use, consultations and hospitalisations other than for asthma than other adolescents; this relationship was strongest among severe asthmatics.

International audience; Background : Physical job demands (PJD), age, disability and lifestyle may influence the risk of occupational injury.Aim : To assess the relationships between PJD, lifestyle and injury in workers of various ages.Methods A total of 2888 randomly selected workers from northeastern France, aged ≥15, completed a postal questionnaire. The PJD score was defined as the total number of the following reported job demands: using pneumatic tools, other vibrating hand tools, hammers, machine tools or vibrating platforms and exposure to manual handling tasks, awkward postures, high pace of work, high physical workload, work at heights, work in adverse climates or exposure to noise, cold or heat. Data were analysed using logistic regression.Results Nine per cent of subjects reported an injury during the previous 2 years. The PJD score was related to the injury rate for workers aged ≥45: crude odds ratio (OR) 3.5 (95% confidence interval = 1.5-8.0) for PJD = 1, 5.0 (2.2-11.3) for PJD = 2-3 and 14.5 (6.5-32.2) for PJD ≥4, versus PJD = 0. Lower ORs were found for those aged

International audience; This study assessed the relationships of lifetime smoking and initiating smoking with job demands among 2,888 randomly selected workers, aged 15 yr or over, using a post-mailed questionnaire. Cumulated job demands (CJD) was defined as the number of: using pneumatic tools, other vibrating hand tools, hammer, tasks at height, working in adverse climate, pace of working, cold, heat, and noise exposure. Lifetime smoking was reported by 63.8% of subjects, and 5.9% initiated smoking during present job. Logistic model shows that lifetime smoking related to the CJD: OR adjusted for years with job 2.47 (95%CI 1.69-3.60) for CJD> or =4, 1.50 (1.21-1.85) for CJD2-3, and 1.20 (1.00-1.44) for CJD1, vs. CJD0. Initiating smoking also related to the CJD: ORs 3.72 (1.95-7.11), 1.51 (0.96-2.39) and 1.47 (0.97-2.24), respectively. These associations were partly confounded by gender, income, obesity and job. Smoking related to job demands and their limitation should help preventing smoking.

Summary Objective To assess occupational disparities with regard to the occurrence of occupational, traffic, domestic and sports accidents, and the role of factors such as smoking, excessive alcohol consumption, obesity, psychotropic drug intake and disability in mediating these disparities. Methods The sample included 3368 economically active subjects aged 18–64 years, selected at random in north-eastern France. Subjects completed a postal questionnaire about sociodemographic and lifestyle information, and recorded the occurrence of accidents by type during the previous 2 years. Data were analysed using a logistic regression model with different sets of independent variables and covariates in order to describe the disparities and investigate the role of personal factors. Results During the 2 years preceding the survey, 11.8% of men and 5.4% of women had an occupational accident, 3.7% of men and 4.5% of women had a traffic accident, 4.1% of men and 1.5% of women had a domestic accident, and 6.1% of men and 1.9% of women had a sports accident. Personal factors were strongly related to the occurrence of accidents, with different patterns in men compared with women, and according to the type of accident. Men in intermediary occupations, clerks, craftsmen and tradesmen and, to an even greater extent, manual workers and farmers had a much higher occurrence of occupational accidents than men in the upper occupations, while craftsmen and tradesmen had a much higher occurrence of traffic accidents. Manual workers had a lower occurrence of sports accidents. After adjustment for lifestyle factors and disability, estimated odds ratios were reduced slightly but remained significant. Occupational disparities in accidents were virtually non-existent among women. Conclusion Occupational disparities in accidents mainly concern men and are predominantly observed in occupational and traffic accidents. Lifestyle factors do play a role in explaining these disparities, but are fairly limited. Improved work conditions, equipment, health behaviours, safe driving practices and accommodation of people with disabilities are needed to reduce the risk of accidents.

International audience; Background – Despite a decrease of tobacco use among adolescents over the last decade, few investigations have tempted to assess new patterns of tobacco consumption, like the hookah (schischa), or the impact of recent tobacco policies like the prohibition of tobacco sale to minors under 16 years old.Methods – The ESPAD survey (European School Survey Project on Alcohol and Other Drugs) is a self-administered school survey carried out every four years among 15-16 years old adolescents from the public, private and agricultural schools. The fourth data collection was carried out during spring 2007 in France and in 35 other European countries.Results – The decrease of tobacco use is confirmed by the 2007 data. Globally, the decline is important for daily smoking: in 1999, 33% of the girls and 30% of the boys versus 16 and 18% respectively in 2007. However the rate of heavy smokers (more than 10 cigarettes per day) remains stable over the same period, highlighting the difficulty for the most dependent smokers to change behaviors. Conversely, the rate of occasional smokers (less than one cigarette a day) increases significantly. In addition, one pupil in three already smokes a hookah, but the experimentation rate stands at 4% among pupils who never smoked cigarettes, while a little less than a third experienced cigarettes only. Among daily smokers aged 15 years, 86% (i.e. 19% of the age group) bought box of cigarettes during the past thirty days in spite of underage sales restriction.; RésuméIntroduction – Malgré une baisse des niveaux de tabagisme depuis près d’une décennie à l’adolescence, peu d’enquêtes ont tenté d’évaluer la pénétration de nouveaux modes de consommation du tabac, comme le narguilé, ou l’impact des dernières mesures de lutte contre le tabagisme des jeunes, notamment l’interdiction de vente de tabac aux moins de 16 ans.Méthodes – L’enquête scolaire autoadministrée Espad (European School Survey Project on Alcohol and Other Drugs) est quadriennale et cible les élèves de 16 ans du secteur public, privé et agricole. Le dernier exercice s’est déroulé au deuxième trimestre 2007 en France et dans 35 autres pays européens.Résultats – La baisse du tabagisme est confirmée par les données 2007. La diminution est importante pour le tabagisme quotidien, passant de 33 % en 1999 à 16 % en 2007 parmi les filles et de 30 % à 18 % parmi les garçons, même si la part des gros fumeurs (plus de 10 cigarettes par jour) est restée stable sur la période considérée, soulignant de la sorte la difficulté de modifier le comportement des fumeurs les plus dépendants. A l’opposé, la part des fumeurs occasionnels de moins d’une cigarette par jour augmente notablement. Par ailleurs, un élève sur trois a déjà usé d’un narguilé mais 4 % n’ont expérimenté le tabac que de cette façon, alors qu’un peu moins d’un tiers n’a expérimenté que les cigarettes. Parmi les fumeurs quotidiens âgés de 15 ans exactement, 86 %, soit 19 % de la tranche d’âge, dit avoir acheté du tabac chez un débitant au cours des trente derniers jours, soit illégalement.

International audience; BACKGROUND: Obesity is related to asthma, but factors influencing this relation have not been clearly defined. OBJECTIVE: This study was designed to assess the role of eating behaviors and weight concerns in the association between obesity and asthma. DESIGN: A population-based sample of 11,710 adolescents, recruited from 186 secondary schools of 8 educational districts in France, completed a self-administered standardized questionnaire including DSM IV (Diagnostic and Statistical Manual of Mental Disorders) questions on eating disorders. RESULTS: Obesity (body mass index >/=95th percentile according to age and sex) was associated with asthma in girls (odds ratio: 1.48; 95% CI: 1.05, 2.08) but not in boys (odds ratio: 1.07; 95% CI: 0.75, 1.54). Both obese and asthmatic adolescents were more likely to have abnormal eating behaviors and weight concerns (P < 0.05). In an adjusted polytomous logistic model with 4 categories based on the presence and/or the absence of asthma and obesity as the dependent variable, the odds ratio for weight concerns increased from a minimum value for asthmatic nonobese adolescents (odds ratio: 6.3; P < 0.001) with nonasthmatic, nonobese adolescents as the reference group. Similar patterns were observed for overweight. CONCLUSIONS: Our data suggest that, besides well-known factors such as genetic background, direct mechanical effects, and reduced physical activity, abnormal eating behaviors and weight concerns might intervene in the relation between obesity and asthma. Psychosocial dimension has to be considered to disentangle the complex relation between obesity and asthma in adolescence in view of prevention.

International audience; AIM: We investigated the relationship between sex (genetic/biological) and gender (environmental/cultural) factors in relation to adolescent tobacco smoking. METHODS: A representative sample of 11,582 students from French secondary public schools participated in the study by completing a self-administered, standardised questionnaire. RESULTS: Using the WHO classification for smoking in the youth, 15.6% of the adolescents were regular smokers, 7.7% occasional smokers, 17.9% experimental smokers and 4.8% ex-smokers, with no statistically significant gender difference. Taking non-smoking as a reference, puberty had a much greater effect on the likelihood of being a regular smoker [OR = 18.0 (95% Confidence Interval: 9.6-32)] than of being an experimental/occasional smoker [OR = 3.7 (2.9-4.6)] among girls. For boys, the effect of puberty was not as great [OR = 4.7 (3.5-6.5)] for regular vs. [OR = 2.1 (1.8-2.5)] for experimental/occasional smokers). Similarly, illicit drug use had a larger effect on the likelihood of being regular smoker vs. non-smoker [OR = 15.0 (12.0-20.0) in boys and 12 (8.8-16.0) in girls] than of being experimental/occasional smoker vs. a non-smoker [OR = 4.8 (3.7-6.1) and 2.9 (2.1-3.9) respectively]. Other factors related to regular smoking were exposure to passive smoking and regular alcohol consumption. Living with both parents was a protective factor for life and regular smoking in both genders. CONCLUSIONS: Our results show that influential factors of sex-related (puberty), gender-specific (environmental tobacco smoking, alcohol consumption, drug abuse) or sex/gender (regular sexual intercourse) are related to the smoking behaviour in French adolescents.