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Dunkerque, France

Lafon D.,Service Medical | Mathieu-Huart A.,Anses | Grard O.,ARS Nord Pas de Calais
Archives des Maladies Professionnelles et de l'Environnement

Human Health Toxicity Values (HHTV) quantify the relationship between exposure to a chemical substance and effects on health. HHTVs are therefore key parameters for making calculations and assessing health risks. Many institutions offer HHTVs in databases on the Internet. Since 2004, France has initiated a process for the development of her own HHTVs. The search and the choice of HHTVs are complex and time-consuming. The French Institute for Public Health Surveillance (InVS) has developed an efficient search engine with free Internet access. Furêtox (facilitating the use of resources in toxicology) is designed to extend the scope and shorten the time of search on the Web. For a given chemical substance, Furêtox can provide swift access to the HHTVs, allow easy access to background documents with details on how the values were established and swift access to carcinogenicity classifications. Furêtox welcomes critical feedback from users and provides references ("fact sheets" for each database) on the methodology used to calculate the values. © 2012 Publié par Elsevier Masson SAS. Source

Grondin C.,Service de Maternite pediatrie | Duron S.,Center Depidemiologie Et Of Sante Publique Des Armees | Robin F.,Service Medical | Verret C.,Center Depidemiologie Et Of Sante Publique Des Armees | Imbert P.,Service de Maternite pediatrie
Archives de Pediatrie

Teenager sexuality is a public health issue. In teenagers attending a high school, we assessed their knowledge and behavior on sexuality, infectious transmitted diseases, human papilloma virus (HPV) vaccination, and cervical cancer. Then in girls, we estimated the anti-HPV vaccination coverage and focused on factors associated with poor knowledge of these topics. Methods: This was a knowledge, attitudes, and practices cross-sectional study conducted at the beginning of the 2010-2011 school year in the Saint-Cyr military high school, using an anonymous self-administered questionnaire. Results: Among 669 adolescents (M/F sex-ratio, 2.3; mean age, 17 years [IC 95%, 15-20]), 40% had already had sex and 92% had used contraception. Boys and girls had a poor level of knowledge on infectious transmitted diseases. Regarding knowledge on HPV and cervical cancer, a better level was significantly associated with female gender (P=10-4). In multivariate analysis, male gender, age under 18 years, lack of dialogue with parents on these subjects, low socioeconomic status of parents, and absence of health education were significantly associated with poor knowledge on these topics. Conclusion: These data should help healthcare providers better target access and content of sexual health education training. © 2013 Elsevier Masson SAS. Source

Mayet A.,Ecole du Val de Grace | Verret C.,Ecole du Val de Grace | Haus-Cheymol R.,Ecole du Val de Grace | Duron S.,Ecole du Val de Grace | And 11 more authors.
European Journal of Clinical Microbiology and Infectious Diseases

Since the start of 2010 there has been a flare-up of measles in France, following on the resurgence observed in 2008. The aim of this study was to present results of the epidemiological surveillance of measles in the French armed forces and to describe the increase in incidence. Measles was surveyed from 1992 to 2010. Criteria for report were those used for French national compulsory notification. The data, concerning active military personnel, were provided by the physicians in the armed forces using anonymous data collection forms. Between 1992 and July 2010, 689 cases of measles were notified. Since 2002, the mean incidence rate was 1 case per 100,000. A significant increase has been observed for 2010 (13.9 cases per 100,000 in 2010 versus 1.8 in 2009). The 28 cases reported in 2010 involved five clusters and three isolated cases. The mean age of affected subjects was 27 years. Only 30% of cases had been vaccinated. The epidemic resurgence of measles observed in 2010 in the French armed forces follows the same pattern as that observed nationally and at European level, and can be seen as the likely consequence of inadequate vaccination cover. © 2011 Springer-Verlag. Source

Ha-Vinh P.,Service Medical | Regnard P.,Service Medical | Huiart L.,French Institute of Health and Medical Research | Sauze L.,Agence Regionale de Sante ARS | Eisinger F.,Institute Paoli Calmettes
Sante Publique

Aim: When self-employed and small business owners are diagnosed with cancer what is the effect on their small-firm survival duration? Methods: Data Sources: secondary data for 3,587 subjects, 18-65 years, working when diagnosed with cancer in 1995-2009 and a comparison group of 27,688 subjects matched for gender, age and occupation. Study design: a comprehensive population-based longitudinal study. A Cox model described time to failures of small businesses and terminations of self-employment. Data Collection Methods: extraction from the statutory mandatory self-employed social security scheme database. Results: Findings were that age, cancer prognosis and very intense physical workload occupation were independent predictors of enterprise failure for cancer-exposed subjects. Compared with unexposed subjects, their global hazard ratio was 1.59 (95% CI = 1.50-1.70). However, the difference at five years after cancer diagnosis became non-significant: hazard ratio 1.11 (95% CI = 0.95-1.30). Conclusion: These findings demonstrate that beyond 5 years of maintenance of activity, the economic cost of cancer supported by very small businesses and self-employed is not important. However, support is required to pass through these first 5 years. The authors describe the various possible aids that could be implemented. © S.F.S.P.. Tous droits réservés pour tous pays. Source

Larreche S.,Service Medical | Mion G.,Ecole du Val de Grace | Mayet A.,Service de Sante des Armee | Verret C.,Service de Sante des Armee | And 5 more authors.
American Journal of Emergency Medicine

Background: Viperidae bites represent a public health issue in Africa and are responsible for a hemorrhagic syndrome with fatal outcome in the short term. A research on Medline database does not reveal any data definitively demonstrating the efficiency of antivenom in case of delayed administration. The aim of this study, based on a 12-year survey of viperine syndromes in Republic of Djibouti, was to compare the normalization of the hemostasis disorders with an early administration of antivenin versus a delayed administration. Methods: A retrospective study was conducted from October 1994 to May 2006 in the intensive care unit of the French military Hospital, in Djibouti. Seventy-three Viperidae-envenomed patients were included. Antivenin efficiency in correcting hemostatic disorders was analyzed in relation to time to treatment (before or after the 24th hour after the bite). Results: Forty-two patients (58%) presented with bleeding. A consumptive coagulopathy was found in 68 patients (93%). Antivenin was observed to be effective in improving hemostasis, and the time to normalization of biologic parameters was similar, whether the treatment was started before or after the 24th hour after the bite. Conclusion: Antivenin should ideally be administered as early as possible. However, in Africa, time to treatment generally exceeds 24 hours. The results of the present evidence-based study confirm an empirical concept: a delayed time to treatment should in no way counterindicate the use of antivenin immunotherapy, in the case of African Viperidae bites. © 2011 Elsevier Inc. All rights reserved. Source

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