Biomedical subjects
Publications and source records attributed to S Perdrizet.
The French mesothelioma register has three objectives. The first, collection of morbidity data could not be achieved since the data collected are not exhaustive. The second, the collection of histological material for establishing diagnostic criteria, has provided interesting data; and the third, etiological research, may constitute the basis for well-defined studies.
A large survey was carried out by means of a self-administered questionnaire to the 30,000 teenagers attending school in a French "département" (Bas-Rhin) during spring 1976. This survey revealed some psychological factors about smoking in teenagers as they relate to school and family environment; 30.3% of the subjects were smokers. This proportion was higher in boys than in girls, and increased with age. Statistical analysis showed a greater number of smokers in non-mixed schools, in schools where adults were admitted or where regulations did not forbid smoking, as well as among boarders. We also found a greater number of smokers when the family smoked, when the parents lived outside the "départment" or belonged to the lower social classes.
A matched survey of 55 full-time workers probably exposed to asbestos in an electricity-generating power station (exposed group) and of 53 unexposed workers in an automobile plant has been conducted. The asbestos risk in the power station was confirmed by the presence of airborne fibers in the range 0.1--6000 X 10(-9) g/m3 in the air sampled during the survey period and by the presence of FB in the sputa of 32.7% of the workers. The following parameters were significantly related to asbestos exposure in the study group: FB in the sputa, localized rectitude of the diaphragm, pleural thickening, pleural calcification, and the chest pain. Moreover, for all persons studied, gastrointestinal symptoms and recent hoarsening of the voice were significantly related to the number of FB in the sputa.
In the French "département" of "Bas-Rhin", about 30,000 teen-agers filled in a self-administered questionnaire about respiratory symptoms, in spring 1976. The assessment of this method of data collection shows a very high response rate (99,7 p. cent). If we consider as incomplete all the questionnaires having at least one unanswered question concerning respiratory symptoms or smoking, 55,8 p. cent of them were incomplete, but for most questions non-response rate was lower than 4 p. cent. The consistency of answers was very satisfactory (mean inconsistency rate: 0,39 p. cent) and the likelihood of answers was proved.
A study of respiratory symptoms in 6918 schoolchildren aged 6-10 years was carried out in 1975, in 7 French areas having different pollution levels. The proportion of children with respiratory symptoms (cough and/or wheezing), dyspnoea, colds and colds "going to the chest" was higher in Paris than in the other areas. The frequency was related to age, allergy and some socio-economic factors. After adjustment for these factors the difference in the respiratory symptoms between those in Paris and elsewhere was still statistically significant. According to 1974 average pollution data, air was more polluted in Paris than in the other areas, particularly for black smoke.
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The important differences in the infectivity of the various forms of tuberculosis can be explained by quantitative data concerning the behaviour of the tubercle bacillus in man and the number of bacilli in the lesions and sputum. Patients in whom tubercle bacilli can be detected by direct examination of the sputum smear are the main sources of transmission. Moreover the individuals infected by them break down more often with the disease. In the individual patient, the use of antibacterial drugs completely changes the natural history of the disease: not only do patients no longer die but they are cured; their period of infectivity is considerably reduced, relapses are avoided, chronicity disappears. The drugs used prophylactically in individuals of high risk groups prevent development of the disease. The impact of chemotherapy is reflected by a two-to-three-fold increase in the speed of decline of the risk of infection, a decline which had started before the introduction of the drugs. While patients given the right combination of drugs lose their infectivity in a few weeks (probably most often in less than two weeks), treatment must of course be continued much longer and regularly in order to ensure the maintenance of conversion and the absence of relapse. This stresses the importance of providing means to ensure the taking of the drugs by all patients. The future reduction of transmission will essentially depend on the maintenance of an adequate system ensuring the early diagnosis and correct treatment of cases, which will inevitably continue to appear among the already infected portion of the population. Epidemiological surveillance is mandatory as well as the surveillance of the delivery of services, particularly of the quality of diagnosis and therapeutic services. The roles of public health authorities and perhaps still more that of the practising physician, specialized and not specialized, remain considerable both from an epidemiological point of view and from the point of view of the relief of all the suffering still created by the disease.
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