Med Lav
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Case Reports Comparative Study
[Health surveillance of health care workers suffering from neurological, psychiatric or behavioural disorders].
Health care workers (HCWs) suffering from psychiatric or neurological disorders, alcohol or drug addiction, may pose a risk for the health and safety of patients. The occupational health specialist charged of medical surveillance of hospital workers (the so-called "Competent Physician") often needs to recognize functional impairment in HCWs. ⋯ Critical key-points are identified, and suggestions for management of functionally impaired HCWs are given.
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The epidemiological features of mesothelioma among women differ from those observed among men. ⋯ In contrast with other series of mesothelioma among women, all the present cases were attributable to asbestos. The detection of objective signs of exposure (pleural plaques, lung asbestos bodies) played a key role in attribution.
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Occupational exposure to hand-transmitted vibration in forestry workers is associated with an increased risk for vascular, neurological and musculo-skeletal disorders of the upper limbs. ⋯ The results of this study suggest a tendency for a decrease in the occurrence of VWF among forestry workers, and this finding seems to be associated with the use of anti-vibration chain saws, the reduction of exposure duration, and the improvement of work organization. On the other hand, the forestry workers showed an increase in the occurrence of peripheral sensory neuropathies, carpal tunnel syndrome, and upper-extremity musculo-skeletal disorders. This finding seems to support the view that there is epidemiological evidence for a positive association between exposure to a combination of risk factors (segmental vibration, forcefulness, awkward posture) and the occurrence of soft-tissue disorders of the upper limb in working populations.
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Pulmonary function testing is widely accepted as an integral part of medical surveillance of occupational lung diseases. There are several cross-sectional studies evaluating lung function among asbestos-exposed workers, but only few longitudinal surveys have been performed. ⋯ The results of this follow-up study showed that smoking and previous asbestos exposure were associated with a mild, but statistically significant, loss of lung function. Radiological findings of pleural plaques were not related to deterioration of lung function over the follow-up period.
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The report of transmission of viruses, such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV), from health care workers (HCWs) to patient has alarmed public opinion with potential repercussions on health organisation. ⋯ Efforts to prevent surgeon-to-patient transmission of blood-borne infections should focus not only on ascertaining the infection status of the HCW but principally on eliminating the cause of blood-borne exposures, for example by the use of blunt suture needles, improved instruments, reinforced gloves, changes in surgical technique and the use of less invasive alternative procedures. These measures should be implemented in order to minimize the risk of blood exposure and consequently of virus transmission both to and from HCW to patients.