Bertrand Wadoux

French Institute of Health and Medical Research, Paris, Ile-de-France, France

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Publications (5)2.11 Total impact

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    ABSTRACT: The medical follow-up of individuals who have had occupational exposures to potential respiratory hazards is little known and under-utilised. The Spirale program aims to deliver this intervention effectively to all potential beneficiaries. Spirale was introduced in two stages; i) identification of occupational exposures to asbestos or wood dust through a postal questionnaire; ii) for those initially identified, confirmation of exposure through attendance at a health centre for examination and further medical follow-up as necessary. In 2007, Spirale contacted 50,662 men born between 1942 and 1943, living in 13 departments in France. The initial response rate was 24%, rising to 50% after reminders. Seventy-two percent of people were identified as possibly having been exposed; 50% to asbestos, 3% to wood dust and 19% reporting a mixed exposure. Among the 8641 people located, 3843 (44.5%) benefited from an evaluation of their exposure. In total, 73.4% of people had their exposure to asbestos confirmed and in 1751 (64.2%) this was at a level to justify follow-up. TheSpirale program largely achieved its objective of location and initiation of medical monitoring of people who have been exposed through their work to respiratory carcinogens. It should now be implemented throughout the country.
    Revue des Maladies Respiratoires 10/2011; 28(8):1000-7. · 0.62 Impact Factor
  • Revue des Maladies Respiratoires 10/2011; DOI:10.1016/j.rmr.2011.09.001 · 0.62 Impact Factor
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    ABSTRACT: In France, 15 000-20 000 cancers attributable to occupational exposure occur each year. These cancers appear most often after the worker has retired. Since 1995, a system of post-retirement medical surveillance (PRMS) has been set up for former workers, but it remains largely underused. The SPIRALE program is a public health intervention aimed at identifying the former workers having been exposed to asbestos or wood dust during their working life and to propose them a PRMS. Additionally, it is also an epidemiologic research on the longterm effects of occupational exposure.We report the results of first years of the program conducted in 2006-2008, in 13 districts. a self-administered questionnaire was sent to 50 000 newly retired men, to identify potential past occupational carcinogen exposure. For respondents detected as possibly exposed, exposure was assessed in Health Screening Centres and a PRMS was recommended if necessary. Participation rate, rate of confirmed exposure, increased rate of PRMS, satisfaction about the program. The participation rate was 24%. From 12 002 questionnaires analysed, 72% of respondents were identified as possibly exposed: 3%to wood dust, 50%to asbestos and 19%to both exposures. Exposure to asbestos was confirmed for 73.4%, and according to the level of exposure, PRMS was recommended for 47.1%. Wood dust exposure was confirmed for 56.7%. In these districts, PRMS for asbestos increased by 45% and for wood dust by 600%. Additional surveys showed that participants showed a high degree of satisfaction about the program. The results are positive in terms of detection, information and medical surveillance of exposed workers.
    Epidemiologia e prevenzione 09/2011; 35(5-6):315-23. · 0.78 Impact Factor
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    ABSTRACT: Summary The estimation of new cancers due to professional exposures each year in France is between 15,000 and 20,000; about 25% of retired males have been professionally exposed to asbestos, and 8% to wood dust. Since 1995, a post-professional medical followup (SPP) exists, but is widely unknown. The Spirale program follows two aims: of public health, identifying eligible persons for SPP and taking them to it, and of epidemiological research on professional exposures long time effects and advantages from SPP. Spirale is leaded by the Inserm/CNAMTS 687 Unit which locates former employees exposed to carcinogens during their professional life course, using a self questionnaire, and the Assurance maladie (National Health Insurance) Health care centers (CES) which evaluate and confirm exposures and help people to obtain SPP. The Spirale pilot period took place in 13 CES in 2006 and 2007, targeting about 50000 new retired males; it identified 1,751 asbestos professional exposures and 684 wood dust ones. It raised asbestos SPP requests by 45% and wood dust ones by 600%. Besides, about 85% of exposed persons have agreed for an epidemiological follow-up. Looking for a whole territory spread order, the Assurance maladie decided to continue Spirale in 2008 in the 13 pilot CES.
    01/2009; 40(1). DOI:10.3917/pos.401.0009
  • Archives des Maladies Professionnelles et de l Environnement 05/2006; 67(2):162-162. DOI:10.1016/S1775-8785(06)78035-3 · 0.09 Impact Factor