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PubMed1989

[Adenocarcinoma of the paranasal sinuses: the situation in Switzerland and Geneva].

Eight cases of adenocarcinoma of the nasal cavity and sinuses were diagnosed in the ENT Clinic in Geneva during the period 1965-87. Five of these patients were carpenters and are the object of a detailed clinical and epidemiological analysis. From a review of the literature, it appears that the incidence of the disease in Switzerland is underestimated and that the professional risk for certain types of work is still unclear. Evaluation of the scope of this problem on a national scale and an increased awareness of the medial profession seem worthwhile.

Adenocarcinoma↗
PubMed1988

[Biological monitoring of fluoride-exposed workers in Switzerland: development of the internal fluoride burden in the last 10 years].

In Swiss plants a risk of industrial fluorosis exists only for workers in the aluminum industry (electrolysis of Al2 O3, raffination of aluminium). Exposure to fluorides is assessed by ambient monitoring, by health surveillance (early detection of fluorosis) and by biological monitoring (urinary fluoride determinations, pre-shift und post-shift). The results of biological monitoring in the 4 plants in Switzerland are presented (1976/77-1986; 1977 264 workers, 1986 242 workers). During the period from 1976/77-1986 a significant reduction of the urinary fluoride excretion in exposed workers was observed. This reduction was correlated in time with technical measures to reduce external fluoride exposure of workers. Urinary fluoride excretion was within limits of biological exposure indices at the end of the observation period in all plants (on group base). Therefore the risk of industrial fluorosis seems to be eliminated in newly engaged workers and significant lowered in the other workers of the Swiss aluminium industry.

Body Burden↗
PubMed1996

Trauma-related disorders in psychiatrists' and general practitioners' private practice in Switzerland.

A questionnaire addressing traumatic stress related issues was mailed to every third psychiatrist in private practice and to every fifth general practitioner in Switzerland (N = 1406, number of returns 517 (37%). Trauma-related disorders seem to be underdiagnosed. Patients suffering from rape, accidents and war related trauma were most often mentioned. Psychiatrists knew more about specific treatment possibilities than general practitioners. Only 14% of the responding clinicians were satisfied with the existing therapeutic services for trauma victims; more psychiatrists voiced a need for their improvement. A majority suggested interdisciplinarity and the cooperation of institutions and therapists in private practice for the treatment of trauma-related disorders. It is proposed that further education should be tailored according to the target professional group.

Adult↗
PubMed1986

[Extent and evaluation of air pollution in Switzerland].

The measurements of atmospheric pollution carried out in Switzerland during the last years revealed that high concentrations are not only found in city centers but in suburbs as well. The emission limits which should be respected in order to protect health and environment are very often exceeded. The pollution through nitrogen dioxide is specially crucial as well as that of sulfur dioxide during the winter months. Ozone concentrations are remarkably high in summer--ozone being formed by photochemical reactions of nitrogen oxides and hydrocarbons--and can be transported far away, even in rural areas. It is urgent to take the necessary steps now to reduce the atmospheric pollution in order to protect the population against possible health damages.

Air Pollution↗
PubMed1995

Hip fracture incidence in the canton of Vaud, Switzerland, 1986-1991.

The objective of this study was to estimate the incidence of hip fracture in the canton of Vaud, Switzerland (total population 584,000), for the period 1986-1991 using routine hospital discharge data collected by the Cantonal Service of Statistical Research and Information (SCRIS). For the survey period, the estimated average annual crude incidence rate of hip fractures was 167 per 100,000 persons aged 20 or older (241 for women and 84 for men). For the population aged 50 years or older, the crude incidence rate was 388 per 100,000 persons (546 for women and 185 for men). The average annual age-specific rates rose exponentially by successive 5-year age groups. The median age of patients at the time of the fracture was 82 years in women and 74 years in men. There was no significant difference between the total number of cervical and trochanteric fractures. Between the ages of 20 and 84 years, the cumulative risk for a woman to be admitted to hospital with a hip fracture was twice that of a man (15.8% vs 7.8%). From 1986 to 1991, the age- and sex-adjusted incidence, like the ratio of cervical to trochanteric fractures, did not show any significant trend, although it was consistent with an increase in men (p = 0.09). However, the annual number of fractures rose from 644 to 776, particularly among very aged men. The mean length of stay in the acute care hospital fell from 38 days in 1986 to 25 days in 1991.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Occupational medicine in Switzerland: wishes and reality].

Some results on occupational health are presented, based on a questionnaire named "Integration of occupational health in the Swiss sanitary system", which was mailed to every industrial societies employing more than 100 persons and unions in Switzerland. The results show differences between societies and unions as well as between the two main linguistic areas and that the largest societies are more in favour of the expansion of occupational health than the smallest.

Accidents, Occupational↗
PubMed1999

[Organ pathology causing sudden death in athletes. International study of autopsies (Germany, Austria, Switzerland)].

BACKGROUND: Accordance of all studies concerning the distribution of causes of cardiovascular sports deaths can only be registered in the dominating role of coronary heart disease and myocardial infarction among athletes > 35 years. In North America a predominance of hypertrophic cardiomyopathy among younger sportsmen (< or = 35 years) is described. This study investigates the conditions in the German speaking countries in central Europe. PATIENTS AND METHODS: The present prospective and retrospective 1.5-year (July 1996 to December 1997) study is based on post-mortem examinations of 28 institutes of pathology and forensic medicine in Germany, Austria and German speaking Switzerland. RESULTS: Twelve out of 113 cases (10.6%) were females, their age being significantly lower (27.8 years, sd = 15.2) than the age of the males (37.5 years, sd = 16.5). Eighty sports deaths (70.8%) were caused by cardiovascular reasons, 33 sports deaths (29.2%) were traumatic in origin. The main cause of cardiovascular deaths of the older athletes (> 35 years) was the coronary heart disease (84.1%). The main reasons for cardiovascular deaths of younger athletes (< or = 35 years) were the coronary heart disease (36.1%) and myocarditis (30.6%). A case of hypertrophic cardiomyopathy was not registered. Most of sports deaths happened in soccer (28), jogging (15), walking (8), cycling (7) and skiing (7). Most of traumatic sports deaths were registered in aerial sports. Four ball players (soccer n = 3, handball n = 1) and 1 motor cyclist suffered from a thrombosis after an orthopedic injury and died due to a consecutive pulmonary embolism. CONCLUSIONS: The distribution of cardiovascular sports deaths displays astonishing regional differences. In contrast to North America anatomical-pathological studies of German speaking countries do not show any dominance of hypertrophic cardiomyopathy among younger athletes, although the pathologists in recent investigations knew the results of Maron. Possible explanations for this phenomenon might be varying selections of patients (top-performance athletes and hobby sportsmen) or a different genetical background.

Adult↗
PubMed2000

Forensic evaluation of mtDNA in a population from south west Switzerland.

The polymorphism of the two hypervariable segments (HVI and HVII) of the control region of mtDNA was analyzed in a population of 154 unrelated individuals from south west Switzerland using a fluorescent based capillary electrophoresis sequencing method. In our population data of 154 random individuals, 137 mtDNA types were observed. Of these, 124 sequences were observed only in one individual whereas 10 sequences were observed in 2 individuals, 2 sequences in 3 individuals and 1 sequence in 4 individuals. The probability of two unrelated individuals having the same sequence was 0.84%. The results were compared with four other Caucasian populations. Furthermore, the usefulness of the mtDNA sequencing was tested, for exclusion and inclusion, in 18 forensic cases including 69 evidence samples and 44 reference samples. Despite the fact that 55% of the evidence samples yielded a negative result for the nuclear DNA with the human dot quantitation system, the success rate of the mtDNA sequencing was 71.0%. This validation study proves the great usefulness and sensitivity of the mtDNA sequencing technique using nested PCR and fluorescent capillary electrophoresis.

DNA, Mitochondrial↗
PubMed2003

Provision and remuneration of psychotherapeutic services in Switzerland.

OBJECTIVES: To establish the number of psychotherapists with professional backgrounds; psychotherapeutic provision and its cost; change in cost in case of integration of non-medical psychotherapy into the mandatory minimum health care benefit. METHODS: A population-based survey using computer-assisted telephone interviews in a randomly selected sample of medical and non-medical psychotherapists (NMP), stratified by professional status and language regions. RESULTS: 1,633 psychiatrists, 2,332 general practitioners and 2,616 NMP provide psychotherapy in Switzerland. NMP by training: 1,674 (64%) hold a university degree in psychology; 539 (21%) hold a professional school degree in psychology; and 403 (15%) have various backgrounds. In 2000, 146,000 patients utilised 4.52 million hours of medical psychotherapy, which cost CHF 579 million, CHF 396 million of which were reimbursed by mandatory health insurance (MHI). Reimbursement of NMP by MHI would result in additional expenditures of CHF 102-252 million. CONCLUSIONS: NMP provide 46% of psychotherapy which is currently partly reimbursed by the MHI. An integration of NMP into the MHI benefit package would incur additional costs to MHI of CHF 102-252 million.

Cross-Sectional Studies↗
PubMed2006

The prevalence of symptoms attributed to electromagnetic field exposure: a cross-sectional representative survey in Switzerland.

OBJECTIVES: To investigate health risk perception as well as to assess the prevalence of self-reported symptoms attributed to electromagnetic fields (EMF) and other environmental exposures in the general population of Switzerland. METHODS: Between May and June 2004, telephone interviews of a representative sample of the Swiss population (n=2048, >14 years old) about: (1) health symptoms attributed to five environmental factors (one of which was EMF), (2) health risk perception related to 12 environmental risk factors (five of which were different EMF sources). RESULTS: We found a prevalence of 5% (95% CI 4-6%) for electromagnetic hypersensitivity (EHS) in our study sample. The most common health complaints among EHS individuals were sleep disorders (43%) and headaches (34%), which were mostly attributed to power lines and mobile phone handsets. In addition, 53 percent (95% CI 51-55%) were worried about adverse health effects from EMF, without attributing their own health symptoms to them. CONCLUSIONS: The large proportion of the population who is concerned or attributes own symptoms to EMF may cause societal conflicts given the ubiquity of EMF in our everyday life.

Adolescent↗
PubMed2003

Mesotheliomas among Italians, returned to the home country, who worked when migrant at a cement-asbestos factory in Switzerland.

OBJECTIVES: To report the occurrence of mesotheliomas in Italy among subjects who worked, when migrant, at a cement-asbestos factory in Niederurnen, Switzerland, and had resettled to the home country. METHODS: Information about the disease and on the working history of subjects was collected by regional mesothelioma registries. Only cases diagnosed by means of histo-pathological examinations have been considered here. RESULTS: 15 mesotheliomas (13 pleural, 2 perithoneal; 12 among males, 3 among females) have been identified among Italians, who had worked at the factory. None of them had other occupational exposure to asbestos. The majority was living in the Veneto Region (North East of Italy), and in Puglia (Southern Italy). CONCLUSIONS: Exposure to asbestos at this factory has already caused an important number of occupational cancers among the employees, a large fraction being constituted of migrants. In order to avoid under-estimation of risks and to allow compensation, diseases which occur among foreign workers returned to their home country should be evaluated. Migration for work is at the genesis of asbestos-related mesotheliomas now occurring in Italy.

Adult↗
PubMed2004

[Survey on practice of regional anaesthesia in Germany, Austria, and Switzerland. Part 1: Quality assurance and training concepts].

The practice of regional anaesthesia in German speaking countries was investigated by a survey. The first part of the trilogy contains the presentation and evaluation of the data about quality assurance and training concepts. In 2002 questionnaires were mailed to 750 randomly selected departments of anaesthesia and 384 hospitals participated (51.2%). The overall proportion of regional anaesthesia was 23% and in Switzerland it was significantly higher (adults: 48%; children: 31%). Of the hospitals 19% had no person who was responsible for quality assurance. The number of puncture attempts was unlimited in 59% of the hospitals. The first training steps were observed closely (complete observation: 81%). The exact beginning (48%) and end (15%/13%) of the training were often not fixed, 80% of all anaesthesia departments requested an improvement in the training for peripheral and 53% for neuroaxial regional anaesthesia techniques. Regional anaesthesia plays a highly important role. Concepts of training and quality assurance that are backed up by evidence-based medicine should be worked out to improve the training and further education in regional anaesthesia.

Adult↗
PubMed2004

[Olfactory dysfunctions. Epidemiology and therapy in Germany, Austria and Switzerland].

INTRODUCTION: Olfactory dysfunction has been reported to affect more than 200,000 patients a year in the USA. The aim of this survey was to obtain comparable epidemiological data and treatment information on olfactory dysfunction in German speaking countries. METHODS: Questionnaires were sent to all otorhinolaryngology departments in Germany, Austria and Switzerland; 52% of hospitals completed the survey. RESULTS: An average of 46 patients with olfactory dysfunction were treated per hospital every month. Hyp- and anosmia were most commonly caused by inflammatory diseases of the nose/paranasal sinuses (53%), respiratory dysfunction (19%), or postviral conditions (11%). Steroids were used most frequently for pharmacological treatment (topically 82%; orally 65%). Approximately one third of the clinics used B vitamins, or zinc; 80% of the hospitals performed surgery to treat underlying diseases. Acupuncture and smell training was used by approximately 20%. CONCLUSION: A total of 79,000 patients per year are treated for olfactory dysfunction in German hospitals. The vast majority of these disorders (72%) is caused by sinunasal diseases. The quality control of therapeutic strategies is urgently needed.

Austria↗
PubMed2006

Patterns of inpatient care for immigrants in Switzerland: a case control study.

BACKGROUND: Migration has become a major political and social concern in West European societies. METHODS: A case-control method was used to analyse the utilisation of inpatient mental health services by immigrants from a catchment area in Switzerland over a 7-year period. RESULTS: Compared to natives, immigrants had fewer psychiatric hospitalisations, but more emergency and compulsory admissions. During inpatient treatment, they received less psycho-, ergo- and physiotherapy. Other therapies as well as compulsory measures were at comparable rates, as was the frequency of irregular discharge. They spent shorter periods as inpatients and the rate of psychiatric readmissions was significantly lower. Comparison of different countries of origin revealed that only patients from West and North Europe were comparable to natives regarding type of referral, inpatient treatment, and longitudinal measures of service utilisation. Even after accounting for effects of social class, immigrants from South Europe, former Yugoslavia, Turkey, East Europe and more distant countries spent significantly shorter time in inpatient treatment, compared to Swiss control patients. CONCLUSIONS: Results of this study clearly point to an underutilisation of inpatient facilities among immigrants with mental disorders, and to disadvantages in psychiatric inpatient care. This, however, does not pertain to all foreign patients to the same extent: inequalities of mental health service use are particularly pronounced in immigrants from more distant countries.

Adolescent↗
PubMed1998

HIV infection and suicide risk: an epidemiological inquiry among male homosexuals in Switzerland.

Conflicting results have been published about suicidality among HIV+ subjects; part of the alleged increased risk may be linked to premorbid risk factors such as drug addiction and homosexuality. In order to cope with these confounding factors, we assessed the degree of suicidal ideation in a sample of Swiss male homo- and bisexuals, comparing HIV- and HIV+ subjects. A total of 164 subjects returned a self-administered, home-completed questionnaire, which had been circulated among homosexuals in the French speaking part of Switzerland. Suicidal ideation was assessed through Pöldinger's scale. Serostatus was known for 149 subjects, among whom 65 were HIV+. A high rate of suicide attempts was found among homosexuals, both HIV- and HIV+. Scores on Pöldinger's scale are significantly, though moderately, higher among HIV+ subjects, and this finding seems to be a direct consequence of HIV infection.

Adult↗
PubMed2000

Prevalence of tracheostomy in ICU patients. A nation-wide survey in Switzerland.

OBJECTIVE: To assess the frequency, timing and technique of tracheostomy and its variation between different intensive care units (ICUs) in Switzerland. DESIGN: Retrospective, descriptive prevalence study. SETTING: A questionnaire was sent to all intensive care units formally recognized by the Swiss Society of Intensive Care Medicine. Excluded were paediatric ICUs. A total of 48 ICUs (70 %) responded. PATIENTS: In 1995 and 1996 the participating units had admitted 90,412 patients for a total of 243,921 ICU days. RESULTS: Seventy percent of the contacted ICUs answered the questionnaire. The prevalence of tracheostomy was 10% in the long-term ventilated patients (defined as > 24 h), or 1.3 % of all patients. Most tracheostomies were performed during the 2nd week of ventilation. The frequency of tracheostomy varied widely (0-60 %) and was only slightly associated with the different language regions of our country and with the policy of hospitals to accept or refuse intubated patients on their normal wards. Most units offered either conventional surgical tracheostomy (69 %) and/or percutaneous procedures (57 %). The decision to perform a tracheostomy was made mostly by the intensivist and the procedure was more often performed in the ICU (65 %) than in the operating theatre (35 %). Units where the intensivist had exclusive control used only percutaneous techniques. An overall complication rate of 13 % was reported, bleeding and infections being at the top of the scale. Only 27 % of the units performed late follow-up protocols. CONCLUSIONS: Despite its frequency, tracheostomy in Swiss ICUs is far from being standardized with regard to indication, timing and choice of technique.

Humans↗
PubMed2003

Forest perception and knowledge of hikers and mountain bikers in two different areas in northwestern Switzerland.

Recreational activities can have major impacts on vegetation and wildlife in frequently visited forests. We assessed forest perception and knowledge (state, functions, and species diversity) among hikers and mountain bikers in a frequently visited, seminatural suburban recreation forest (Muttenz) and in a more distantly situated, naturally grown excursion forest (Wasserfallen) in northwestern Switzerland. In all, 239 hikers and 126 mountain bikers were interviewed. Mountain bikers in both forests and hikers in the more intensely used recreation forest at Muttenz assessed the state of the forest less optimistically and showed a higher awareness of the negative impact of recreational activities on the flora and fauna than hikers at Wasserfallen. Furthermore, mountain bikers seemed aware of the social conflicts caused by their activity, since they appreciated neutral or positive encounters with other forest visitors. In contrast, 57% of hikers at Muttenz reported on negative experiences with other forest visitors, particularly with mountain bikers. In general, the interviewees' ecological and biological forest knowledge (forest type and function, species diversity) was rather high. A large proportion was aware of the pros and cons of different forest conditions for plants and animals, and could name or recognize at least some plant and/or animal species typical for the visited forest. The forest knowledge was neither influenced by the type of recreational activity carried out nor by any aspect of forest visit behavior (frequency and duration of forest visits, means of transportation and travel distance to forest). However, the interviewees' forest knowledge was influenced by their age and educational level.

Adult↗