L'état de santé des Lausannois: premiers résultats de l'étude CoLaus. [Health examination survey of the Lausanne population: first results of the CoLaus study].

Cardiovascular diseases (CVD) remain the main cause of morbidity and mortality in our society. CoLaus is a population-based health examination survey started in 2003 in Lausanne in order to assess: 1. Prevalence of cardiovascular risk factors, 2. New genetic determinants of cardiovascular risk factors such as hypertension, 3. Association of mood disorders with incidence of cardiovascular events and 4. Trends in prevalence of cardiovascular risk factors. In order to do so, over 6000 subjects (ages 35-75 years) provided data on CVD risk factors. Herein we provide preliminary results of this study, in particular on classical risk factors such as hypertension, obesity and diabetes. Implications and perspectives of this population based-study for public health and genetic studies are also discussed.

Droits du patient: ce que le nouveau Code civil va modifier dans les soins aux enfants [Patients' rights: what the new swiss civil code will change in the health care of children].

Recent progress in medicine allow to provide treatment, to cure or to extend the lifespan of people that would have not survived before. Doctors and healthcare providers have become indispensable actors in Western societies. This is particularly true for children's health issues. With the new information technologies, knowledge is now available to everyone, which enables patients to dialog on an equal footing with the physician. Nowadays, therapeutic choices are discussed and negotiated. The new tensions caused by this relationship between therapist and patient have created the need for new regulations. The Swiss Confederation has modified its Civil Code with the objective of a better protection of vulnerable individuals. This article summarizes the consequences of the new regulations with regard to the care and treatment provided to children.

Complexité, médecine générale et réformes des systèmes de santé [Complexity, general practice and reforms of health systems].

The family doctor facing complexity must decide in situations of low certainty and low agreement. Complexity is in part subjective but can also be measured. Changes in the health systems aim to reduce health costs. They tend to give priority to simple situations and to neglect complexity. One role of an academic institute of family medicine is to present and promote the results of scientific research supporting the principles of family medicine, taking into account both the local context and health systems reforms. In Switzerland the new challenge is the introduction of managed care.

Santé, travail, retraite: pour le meilleur ou pour le pire?

Cet article se penche sur la santé des personnes de plus de 50 ans au travail et à la retraite, et présente quelques points forts d'une étude menée dans le cadre de la fondation Charlotte Olivier, dont les résultats complets ont été publiés sous forme de brochure accessible à un large public. Notre propos principal ici n'est pas de mettre en évidence "ce que les employé-e-s agé-e-s peuvent faire pour l'entreprise", mais bien un état des lieux en termes de santé publique de l'alternative "travail versus retraite", qui faisait encore défaut.

Installations de compostage industriel : exposition aux bioaérosols et effets sur la santé des travailleurs

La quantité de déchets ménagers et industriels ne cesse d'augmenter. Le tri sélectif des ordures est devenu systématique dans beaucoup de municipalités européennes et le compostage industriel des matières organiques par maturation accélérée en système clos a acquis une place prépondérante. Cependant, ce type de compostage nécessite une forte concentration de divers micro-organismes. Il en résulte un risque microbiologique aéroporté encore mal évalué pour les travailleurs exposés à ces atmosphères chargées en bioaérosols (bactéries, champignons et endotoxines en suspension dans l'air). [Auteur]

Santé buccale: déterminants sociaux d'un terrain majeur des inégalités [Oral health: social determinants of a health inequality]

The oral health of disadvantaged social groups is worse at all the ages than that of the favored groups. If tooth decay prevalence decreases, this disease is still unequally distributed: 20% of the children, those with the weakest socio-economic statute (SES), concentrate 60% of the decays. Edentulism strikes significantly more people with weak SES. The inequalities of oral health reflect those of general health. Evidence of the inequalities in oral health is exposed even in the developed countries. Different models of intervention are presented: risk groups identification and targeting by specific programs; oral health community approach which includes socio-economic and public health measures aiming all the population; insurance approach to be combined with the preceding ones.

Comment faire de la surveillance sanitaire? L'exemple de l'Observatoire Valaisan de la Santé en Suisse [How to conduct public health surveillance? The example of the Observatoire Valaisan de la Santé in Switzerland].

OBJECTIVE: To describe the goals and methods of contemporary public health surveillance and to present the activities of the Observatoire Valaisan de la Santé (OVS), a tool unique in Switzerland to conduct health surveillance for the population of a canton. METHODS: Narrative review and presentation of the OVS. RESULTS: Public health surveillance consists of systematic and continuous collection, analysis, interpretation and dissemination of health data necessary for public health planning. Surveillance is organized according to contemporary public health issues. Switzerland is currently in an era dominated by chronic diseases due to ageing of the population. This "new public health" era is also characterized by the growing importance of health technology, rational risk management, preventive medicine and health promotion, and the central role of the citizen/patient. Information technologies provide access to new health data, but public health surveillance methods need to be adapted. In Switzerland, health surveillance activities are conducted by several public and private bodies, at federal and cantonal levels. The Valais canton has set up the OVS, an integrative, regional, and reactive system to conduct surveillance. CONCLUSION: Public health surveillance provides information useful for public health decisions and actions. It constitutes a key element for public health planning.

Effets du travail de nuit sur la santé

Dans les pays industrialisés, 20% des salariés sont concernés par le travail de nuit. Pourtant, les effets du travail de nuit sur la santé sont peu traités par les revues médicales générales, alors que le travail de nuit a des conséquences non négligeables sur les systèmes cardiovasculaires et digestifs entre autres, comme l'ont démontré de nombreuses études ces dernières décennies. Le travail de nuit a encore récemment attiré l'attention quand il a été déclaré cancérigène probable (catégorie 2A) par le Centre international de recherches sur le cancer. Ainsi dans cet article, seront passés en revue les troubles de la santé qui peuvent être générés ou aggravés par le travail de nuit. Deux cas pratiques illustreront la problématique et permettront d'aborder la conduite à tenir. 20% of employees in industrialized countries are concerned by shift work. Nevertheless, there is very little information in general medical journals about the effects of shift work on health. Shift work can have several major effects on health such as cardiovascular and digestive disorders among others, as demonstrated by several studies in recent decades. Shift work has attracted considerable attention recently when it was declared probable carcinogen by the International Agency for research on cancer. We review the health disorders that may be generated or aggravated by shift work and illustrate the problem by two case studies of occupational medicine and discuss the appropriate attitude to take