Papers by Dominique Choudat
Occupational and Environmental Medicine, 1987
The relation between occupational exposure to cattle and prevalence of antibodies against Pasteur... more The relation between occupational exposure to cattle and prevalence of antibodies against Pasteurella multocida was evaluated in 680 workers. Three groups of exposed workers in abattoirs and slaughterhouses (S), in industrial breeding (I), and in traditional breeding (T) were compared with control workers not exposed to cattle or chicken (C). The prevalence of antibodies against capsular antigen A determined by
Allergy, 2004
Our aims were to compare the doses of wheat and rye flour that induce early bronchial responses i... more Our aims were to compare the doses of wheat and rye flour that induce early bronchial responses in occupationally exposed asthmatic subjects and to assess the effects of the dose of inhaled flour, the duration of exposure and the dose rate. Ten patients underwent tests with lactose, wheat flour and rye flour. We compared the decrease in forced expiratory volume in 1 s (FEV(1)) observed during the challenge with flour and with lactose. We also calculated the amount of flour that was instantaneously active. Seven subjects had significantly decreased FEV(1) values following exposure to wheat and rye flour and two subjects only did so for rye flour. The provocative dose (PD, dose required to reduce FEV(1) by 15%) of rye was lower than that of wheat flour (geometric mean; PD(15) rye: 95 microg; wheat: 368 microg). The calculated doses of rye and wheat flour were better correlated with the change in FEV(1) than were the cumulative doses. The bronchial response was greater with rye than with wheat flour. The response was related to the dose of allergen inhaled and to the dose rate.
Archives Des Maladies Professionnelles Et De L Environnement, 2005
La sous-estimation des maladies d’origine professionnelle en France est due à de multiples déterm... more La sous-estimation des maladies d’origine professionnelle en France est due à de multiples déterminants, notamment à la méconnaissance par le corps médical de l’origine professionnelle des maladies et de la réglementation. L’objectif de cette étude est de préciser le niveau de formation, quantitatif et qualitatif, des étudiants en médecine en cours dans le cursus de deuxième cycle des études médicales en France.Cette étude transversale nationale a été réalisée en 2004 par questionnaire, envoyé à l’ensemble des facultés métropolitaines (n = 37).Trente-cinq facultés (95 %) ont répondu au questionnaire. La durée moyenne d’enseignement théorique reçu par un étudiant de deuxième cycle au cours de son cursus est de 9,1 heures ± 4,4 heures (minimum : 2 h, maximum : 18 h). Bien que la définition des notions d’accident de travail et de maladies professionnelles soient abordées dans l’ensemble des facultés, les autres thèmes varient quantitativement et qualitativement d’une faculté à l’autre. L’assiduité des étudiants est également fluctuante et environ 30 % des étudiants arrivent en fin de cursus sans avoir reçu aucun enseignement de médecine du travail.L’enseignement de la médecine du travail lors du deuxième cycle des études médicales apparaît réduit et inadapté aux enjeux de santé publique posés par la santé au travail.Over the past 10 years, national governmental bodies have strengthened the under recognition of occupational diseases and have reiterated the desirability of training in the discipline at medical undergraduate level. The purpose of this study was to assess the level and content of the teaching of occupational medicine in the French undergraduate medical curricula.A questionnaire survey of the teaching of occupational medicine to undergraduates sent in 2004 to all the French medical schools (n = 37).Thirty five French medical schools returned a completed questionnaire, giving a response rate of 95 %. All of them had specific occupational medicine lectures but hours of lectures and seminars ranged from 2 to 18 hours with a mode of 9 hours. Lectures on the definitions of occupational diseases and workplace injuries were provided in all the medical schools, but the other topics varied widely between them. Due to a low level of attendance to the courses, nearly 30 % of students finish their undergraduate studies without having followed any lecture in occupational medicine.Despite the prominence given to issues related to occupational health in recent French government policy, this study suggests a declining commitment to occupational medicine on the part of French medical schools. Urgent action needs to be taken to address the lack of training in occupational medicine for future medical doctors.
Occupational and Environmental Medicine, 1990
Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a... more Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a control group comprising 90 workers of equivalent socioeconomic state in the same plant. Flow volumes were determined, blood gas concentrations were measured at rest and during exercise, chest radiographs were obtained, and data about respiratory symptoms were collected by questionnaire. A dust exposure index was calculated
European Respiratory Journal, 2002
Specific bronchial challenges provide information about the relationship between inhaled dose of ... more Specific bronchial challenges provide information about the relationship between inhaled dose of allergen and change in lung function, but the intermediate pathways remain largely obscure. The aim of this study was to investigate the relationships between the early asthmatic response and 1) the inhaled dose of wheat flour, 2) the concentration of wheat flour, 3) the duration of the exposure,
Archives Des Maladies Professionnelles Et De L Environnement, 2009
ABSTRACT
Archives Des Maladies Professionnelles Et De L Environnement, 2009
ABSTRACT
Archives Des Maladies Professionnelles Et De L Environnement, 2010
Archives Des Maladies Professionnelles Et De L Environnement, 2009
Centre du sommeil et de la vigilance et consultation de pathologie professionnelle, hôpital Hôtel... more Centre du sommeil et de la vigilance et consultation de pathologie professionnelle, hôpital Hôtel-Dieu, AP-HP, faculté de médecine, université Paris Descartes, 1, place du Parvis-Notre-Dame, 75181 Paris cedex 04, France Disponible en ligne sur www.sciencedirect.com
Journal of Sleep Research, 2009
Occupational and Environmental Medicine, 1988
Respiratory manifestations have been reported after exposure to hydroquinone and to methionine. O... more Respiratory manifestations have been reported after exposure to hydroquinone and to methionine. One hundred and three men in the same chemical plant were divided into three groups according to their exposure and compared by questionnaire, respiratory functional tests with methacholine then salbutamol challenges, and measurements of serum immunoglobulins G and E. Group H included 33 workers exposed to hydroquinone, trimethyl-hydroquinone,
European Respiratory Journal, 1997
The aim of this study was to describe changes in employment and income following a diagnosis of o... more The aim of this study was to describe changes in employment and income following a diagnosis of occupational asthma, and to determine what factors might affect these changes.
Sleep Medicine, 2005
Background and purpose: To design a new quality of life (QoL) instrument specifically for insomni... more Background and purpose: To design a new quality of life (QoL) instrument specifically for insomnia. Patients and methods: Based on severe insomniacs' interviews, we have built a new quality of life scale that has been tested in one group of 240 severe insomniacs, in one group of 422 mild insomniacs and in one group of 391 good sleepers. Ten steps led to the construction of a specific QoL scale. Results: Five dimensions have been validated as both relevant and independent from each other. Sixteen items out of the 43 initially tested were retained and significantly different within the groups in each dimension. Based on the 16 items selected, we called the scale Hotel Dieu 16 (HD-16). We have therefore verified the score's specificity (correlation score of C0.36) and the reliability of the scale (Cronbach coefficient aZ0.78). Conclusion: HD-16 may be used as a focused instrument to better assess an insomniac's quality of life. q Sleep Medicine 6 (2005) 191-198 www.elsevier.com/locate/sleep 1389-9457/$ -see front matter q
Rheumatology, 2010
Objective. To assess employment status and socio-economic burden in SSc patients.
Occupational and Environmental Medicine, 1993
From the registry of self employed workers living in Paris, a group of 105 dental technicians was... more From the registry of self employed workers living in Paris, a group of 105 dental technicians was studied to evaluate occupational exposure, to determine respiratory manifestations, and to investigate immune disturbances. Seventy one dental technicians (age range 43-68: group D), 34 dental technicians younger than 43 or older than 68 (group d), and 68 control workers (age range 43-66: group C) were investigated. The demographic characteristics and the smoking habits of the groups D and C did not differ significantly. The dental technicians often worked alone (43.7%) or in small laboratories without adequate dust control. The mean duration of their exposure was long (group D 34.0 (SD 8.4) years). The prevalence of respiratory symptoms did not differ between groups D and C except for the occurrence of increased cough and phlegm lasting for three weeks or more over the past three years (group D 16.9%, group C 2.9%, p < 0.007). The effect of cigarette smoking on respiratory symptoms and lung function was obvious. All mean values of lung function for dental technicians and controls were within normal limits. Significant decreases in all mean lung function values were found among smokers by comparison with non-smokers, however, and a positive interaction with occupational exposure was established. The x ray films of dental technicians (n = 102, groups D and d) were read independently by four readers and recorded according to the International Labour Office classification of pneumoconioses. The prevalence of small opacities greater than 1/0 was 11.8% with a significant increase with duration of exposure. The prevalence among dental technicians with 30 years or exposure or more was significantly higher (22.2%) than those with less than 30 years (3.5, p < 0.004). The prevalence of autoantibodies (rheumatoid factors, antinuclear antibodies, and antihistone antibodies) was not significantly different in the groups D and C. When positive, autoantibodies only occurred at low concentrations. This finding contrasts with previous reports on the occurrence of autoantibodies and even of connective tissue diseases in dental technicians. In conclusion, the study confirms an increased risk of pneumoconiosis among dental technicians. Moreover, there may be other lung disorders such as impairment of lung function especially in association with cigarette smoking.
Occupational and Environmental Medicine, 2011
Word count : abstract : 298 words paper : 4329 words -3 tables, 1 figure -28 references 4 keyword... more Word count : abstract : 298 words paper : 4329 words -3 tables, 1 figure -28 references 4 keywords : Healthcare worker, epidemiology, exposure assessment, disinfectant Hospital workers -EGEA 25/02/2011 2
Journal of Psychosomatic Research, 2011
Background: Light is a powerful synchronizer of the biological clock and of the sleep/wake cycle.... more Background: Light is a powerful synchronizer of the biological clock and of the sleep/wake cycle. Blind people have more sleep disturbances than people without eyesight problems. However, whether visually able people who are underexposed to bright natural light suffer from sleep wake disorders has never been examined. This study tried to assess the prevalence of sleep and wake disorders in subjects working in environments that are not exposed to natural light. Methodology: A setting-controlled cross-sectional epidemiological study was carried out. A representative sample of 13 296 French employees of a single transportation company participated in the study. During working hours, 4635 subjects (34.9%) experienced no light exposure (NLE) and 8661 were partially or completely exposed (LE) to natural light. Sleep disorders, sleep quality, and sleepiness were assessed using subjective tools: the Sleep Disorders Questionnaire-French version (SDQFV) and the Epworth Sleepiness Scale (ESS). Light exposure was estimated on workers' schedules and by objective measurements of light intensity (lux meter). Principal findings: On a univariate analysis, complaints of poor sleep and sleepiness were significantly higher in NLE workers compared to LE: nonrestorative sleep (36.8% vs. 29.5%; Pb.0001), insomnia (28.8% vs. 24.8%; Pb.0001), severe insomnia (14.1% vs. 10.9%; Pb.0001), and daytime somnolence (6.8% vs. 4.3%; Pb.0001). After multivariate analysis, NLE has shown more insomnia (OR=1.8, 95% CI 1.3-2.3, Pb.01) and hypersomnia (OR=1.9, 95% CI=1.3-2.4, Pb.01) than LE. Significance: These data suggest that underexposure to natural light at work may significantly impair sleep and wake disorders in non-lightexposed workers.
Journal of Cystic Fibrosis, 2012
Background: As a result of prolonged survival, more patients with cystic fibrosis (CF) participat... more Background: As a result of prolonged survival, more patients with cystic fibrosis (CF) participate in the labour force. The aim of this study was to evaluate their education, occupation levels and risk factors for work disability. Method: 207 patients answered a self-administered questionnaire about their educational level and work status. Independently, medical records were reviewed for illness severity indicators. Results: 39 patients (19%) were students, 117 (57%) were in the labour force, 13 (6%) were seeking employment and 38 (18%) were inactive. CF patients had a higher educational level and were more likely to hold skilled jobs and to work part time than the general population. FEV1 and educational level were the strongest predictive factors of disability. Conclusion: Many CF patients have access to professional life. Their higher educational levels improve the chances of attaining employment, which highlights the need for career counselling. Working part time helps to maintain employment despite declining health.
International Archives of Occupational and Environmental Health, 1987
Cotton and jute dust exposure is known to induce reversible airway obstruction. We compared 50 ex... more Cotton and jute dust exposure is known to induce reversible airway obstruction. We compared 50 exposed workers to 99 non exposed workers for the prevalence of respiratory symptoms and ventilatory impairment, and for variations in pulmonary function after five working days and after inhalation of salbutamol. The prevalence of respiratory symptoms was not significantly different between the two groups. Pulmonary function was not different on Monday morning, however, significant differences were observed on Friday afternoon. The exposed workers had a lower flow rate at 75% of exhaled forced vital capacity than controls (P less than 0.01). Salbutamol induced greater bronchodilatation in the exposed group. Comparison with a control group is necessary to take into account the change in pulmonary function. Repeated tests, combined with pharmacological tests, are able to differentiate the lung function pattern of exposed and non exposed workers.
Industrial Health, 2005
To determine whether insomnia impact the professional life of patients and have an economical wei... more To determine whether insomnia impact the professional life of patients and have an economical weight, this review article focused on the socioeconomic impacts of sleep related problems in working populations. The goal is to summarise the work that has been accomplished in that field. Several occupational factors have an impact on insomnia: the work schedules (shift work and night work), the physical environment at work and the occupational stressors. Insomnia is also a common problem in daytime workers. The daytime functioning of insomniacs is a key point to understand the impact of insomnia on workers. Absenteeism is one major target in the evaluation of severe insomnia at the workplace. Most of the studies find a higher rate of work accidents in insomniacs. The economic impact is severe in term of direct and indirect costs. Insomnia is a common problem at the workplace. The negative impact is not only on individual but also at the societal levels. More epidemiological studies appear warranted to demonstrate a reciprocal link between work conditions and sleep disorders.
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Papers by Dominique Choudat