Papers by Catherine Lazor-Blanchet
Virus de la chorioméningite lymphocytaire : cas d’exposition en laboratoire
Archives des Maladies Professionnelles et de l'Environnement, Oct 31, 2023
We aimed to describe the characteristics and current practices of Swiss health professionals who ... more We aimed to describe the characteristics and current practices of Swiss health professionals who manage patients with occupational burnout (POB), namely the general practitioners (GP), psychiatrist-psychotherapists (PP), occupational physicians (OP) and psychologists. Among 3216 respondents, 2951 reported to consult POB, and 1130 (713 physicians and 410 psychologists) to treat them. The study showed that POB management constitutes 5 to 25% of health care professionals’ consultations, with an inequal distribution of POBs across professionals’ specialties and specializations, but also across geographic regions. The profile of POB consulted also differs across professionals. Work psychologists see more often POB at early burnout stage, GPs have most patients with moderate burnout, while PPs report the largest proportion of patients with severe burnout. The treatment practices depend on burnout severity. Psychiatrists and physicians with double specialty (GP-OPs and GP-PPs) treat patien...
Schweizerische Medizinische Wochenschrift, Aug 14, 2014
SETTING: A 950 bed teaching hospital in Switzerland. AIM: To describe the result of a contact inv... more SETTING: A 950 bed teaching hospital in Switzerland. AIM: To describe the result of a contact investigation among health care workers (HCW) and patients after exposure to a physician with smear-positive pulmonary tuberculosis in a hospital setting using standard tuberculin skin tests (TST) and Interferon-gamma release assay (IGRA). METHOD: HCW with a negative or unknown TST at hiring had a TST two weeks after the last contact with the index case (T0), repeated six weeks later if negative (T6). All exposed HCW had a T-SPOT.TB at T0 and T6. Exposed patients had a TST six weeks after the last contact, and a T-SPOT.TB if the TST was positive. RESULTS: Among 101 HCW, 17/73 (22%) had a positive TST at T0. TST was repeated in 50 at T6 and converted from negative to positive in eight (16%). Twelve HCW had a positive T-SPOT.TB at T0 and ten converted from negative to positive at T6. Seven HCW with a positive T-SPOT.TB reverted to negative at T6 or at later controls, most of them with test values close to the cutoff. Among 27 exposed patients tested at six weeks, ten had a positive TST, five of them confirmed by a positive T-SPOT.TB. CONCLUSIONS: HCW tested twice after exposure to a case of smear-positive pulmonary TB demonstrated a possible conversion in 10% with T-SPOT and 16% with TST. Some T-SPOT.TB reverted from positive to negative during the follow-up, mostly tests with a value close to the cutoff. Due to the variability of the test results, it seems advisable to repeat the test with values close to the cutoff before diagnosing the presence of a tuberculous infection.
Au niveau du travailleur : prévention médicale
Transplant Infectious Disease, Sep 1, 2007
[Burnout among physicians : a new related reason ?]
PubMed, Oct 7, 2020
Prevalence of burnout in physicians is increasing, affecting their health and satisfaction at wor... more Prevalence of burnout in physicians is increasing, affecting their health and satisfaction at work as well as quality and security of healthcare. Several causes have been identified, of which growing intensity of work, loss of meaning and feeling that healthcare structure reforms prevent one's job being done properly are the main reasons. New data shows an association between burnout and use of the yet widespread electronic health record. It has a proven impact on the multiple aspects of physician's work, and users' satisfaction is often mediocre. Hence, among the broad prevention field of physicians' burnout, specific measures related to the digital domain are needed.
Prehospital and Disaster Medicine, Feb 9, 2016
Introduction: Influenza is a major concern for Emergency Medical Services (EMS); EMS workers' (EM... more Introduction: Influenza is a major concern for Emergency Medical Services (EMS); EMS workers' (EMS-Ws) vaccination rates remain low despite promotion. Determinants of vaccination for seasonal influenza (SI) or pandemic influenza (PI) are unknown in this setting. Hypothesis: The influence of the H1N1 pandemic on EMS-W vaccination rates, differences between SI and PI vaccination rates, and the vaccination determinants were investigated. Methods: A survey was conducted in 2011 involving 65 Swiss EMS-Ws. Socio-professional data, self-declared SI/PI vaccination status, and motives for vaccine refusal or acceptation were collected. Results: Response rate was 95%. The EMS-Ws were predominantly male (n = 45; 73%), in good health (87%), with a mean age of 36 (SD = 7.7) years. Seventy-four percent had more than six years of work experience. Self-declared vaccination rates were 40% for both SI and PI (PI + /SI +), 19% for PI only (PI + /SI-), 1.6% for SI only (PI-/SI +), and 39% were not vaccinated against either (PI-/SI-). Women's vaccination rates specifically were lower in all categories but the difference was not statistically significant. During the previous three years, 92% of PI + /SI + EMS-Ws received at least one SI vaccination; it was 8.3% in the case of PI-/SI-(P = .001) and 25% for PI + /SI-(P = .001). During the pandemic, SI vaccination rate increased from 26% during the preceding year to 42% (P = .001). Thirty percent of the PI + /SI + EMS-Ws declared that they would not get vaccination next year, while this proportion was null for the PI-/SI-and PI + /SI-groups. Altruism and discomfort induced by the surgical mask required were the main motivations to get vaccinated against PI. Factors limiting PI or SI vaccination included the option to wear a mask, avoidance of medication, fear of adverse effects, and concerns about safety and effectiveness. Conclusion: Average vaccination rate in this study's EMS-Ws was below recommended values, particularly for women. Previous vaccination status was a significant determinant of PI and future vaccinations. The new mask policy seemed to play a dual role, and its net impact is probably limited. This population could be divided in three groups: favorable to all vaccinations; against all, even in a pandemic context; and ambivalent with a "pandemic effect." These results suggest a consistent vaccination pattern, only altered by exceptional circumstances.
Journal of Clinical Microbiology, Aug 1, 2010
We described the colonization dynamics of Staphylococcus aureus in a group of 266 healthy carrier... more We described the colonization dynamics of Staphylococcus aureus in a group of 266 healthy carriers over a period of approximately 1 year. We used precise genotyping methods, i.e., amplified fragment length polymorphism (AFLP), spa typing, and double-locus sequence typing (DLST), to detect changes in strain identity. Strain change took place rather rarely: out of 89 carriers who had initially been colonized, only 7 acquired a strain different from the original one. Approximately one-third of the carriers eliminated the colonization, and a similar number became newly colonized. Some of these events probably represent detection failure rather than genuine colonization loss or acquisition. Lower bacterial counts were associated with increased probability of eliminating the colonization. We have confirmed a high mutation rate in the spa locus: 6 out of 53 strains underwent mutation in the spa locus. There was no overall change in S. aureus genotype composition.
Occupational Medicine, Sep 28, 2015
We report a case of acquired lymphocytic choriomeningitis virus (LCMV) infection due to an accide... more We report a case of acquired lymphocytic choriomeningitis virus (LCMV) infection due to an accidental percutaneous inoculation of LCMV at work. The injured worker developed a flu-like syndrome, followed by pericarditis and meningoencephalitis. Seroconversion was confirmed by ELISA. The patient made a complete recovery. We review measures undertaken to prevent a similar event and propose a follow-up protocol in the event of accidental LCMV exposure.
Occupational Medicine, Aug 14, 2015
Background Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommende... more Background Vaccination of health care workers (HCW) against seasonal influenza (SI) is recommended but vaccination rate rarely reach >30%. Vaccination coverage against 2009 pandemic influenza (PI) was 52% in our hospital, whilst a new policy requiring unvaccinated HCW to wear a mask during patient care duties was enforced. Aims To investigate the determinants of this higher vaccination acceptance for PI and to look for an association with the new mask-wearing policy. Methods A retrospective cohort study, involving HCW of three critical departments of a 1023-bed, tertiarycare university hospital in Switzerland. Self-reported 2009-10 SI and 2009 PI vaccination statuses, reasons and demographic data were collected through a literature-based questionnaire. Descriptive statistics, uni-and multivariate analyses were then performed. Results There were 472 respondents with a response rate of 54%. Self-reported vaccination acceptance was 64% for PI and 53% for SI. PI vaccination acceptance was associated with being vaccinated against SI (OR 9.5; 95% CI 5.5-16.4), being a physician (OR 7.7; 95% CI 3.1-19.1) and feeling uncomfortable wearing a mask (OR 1.7; 95% CI 1.0-2.8). Main motives for refusing vaccination were: preference for wearing a surgical mask (80% for PI, not applicable for SI) and concerns about vaccine safety (64%, 50%) and efficacy (44%, 35%). Conclusions The new mask-wearing policy was a motivation for vaccination but also offered an alternative to non-compliant HCW. Concerns about vaccine safety and efficiency and self-interest of health care workers are still main determinants for influenza vaccination acceptance. Better incentives are needed to encourage vaccination amongst non-physician HCW.
Gestion du risque lié aux médicaments cytotoxiques dans un hôpital universitaire
Archives Des Maladies Professionnelles Et De L Environnement, 2011
Combined analysis of mycobacterium tuberculosis-specific CD4 and CD8 T-cell responses for the timely diagnosis of active TB disease
Protection de la maternité dans les laboratoires du CHUV : Risque toxique
Le burnout concerne 20 pour cent de la population active
Epuisement emotionnel, deshumanisation progressive de la relation avec l'autre et un sentimen... more Epuisement emotionnel, deshumanisation progressive de la relation avec l'autre et un sentiment d'echec professionnel. Le burnout est tout ca a la fois. La difficulte est de deceler a temps ces symptomes qui peuvent mettre parfois des mois, voire des annees a se declarer. Definition et tour d'horizon du burnout.
Importance and prevention of nosocomial infections in the outpatient setting
Revue médicale suisse, Apr 7, 2010
The concept of nosocomial infections (or healthcare-related infections) applies to the outpatient... more The concept of nosocomial infections (or healthcare-related infections) applies to the outpatients clinics. However, data are scarce and imprecise in this setting compared with hospitals. The choice of preventive measures is therefore difficult. A lower risk in the outpatient facilities does not justify the complete implementation of hospital precautions. The latter can nevertheless be adapted since infection may be acquired during an ambulatory consultation through the same mechanisms as in hospitals. We propose a preventive strategy derived from standard precautions to be applied in every case, transmission-based precautions that are more rarely needed, and asepsis in case of invasive procedure.
Journal of Occupational Medicine and Toxicology, Nov 18, 2020
Background: Vaccination is the most effective prevention of seasonal influenza. Despite its recom... more Background: Vaccination is the most effective prevention of seasonal influenza. Despite its recommendation and active promotion, vaccination coverage remains low among healthcare staff. The goal of the study was to test if a pre-employment health check is a good opportunity to promote future vaccination against influenza among healthcare workers newly hired by a university hospital. Methods: All new hospital employees active at the bedside who underwent a pre-employment health check between the end of 2016's influenza epidemic and the start of the next influenza vaccination campaign were randomly allocated to a control group or an intervention group. The intervention consisted of a semi-structured dialog and the release of an information leaflet about influenza and influenza vaccination during the checkup , and the shipment of a postcard reminder 2 weeks before the next vaccination campaign. Vaccination rates during the campaign were compared among the two groups. Results: Three hundred fifty-seven employees were included. Vaccination rates were similar in both groups: 79/172 (46%) in the control and 92/185 (50%) in the intervention group. A significantly higher rate of vaccination was noted among physicians (70/117, 60%) than among other employees (101/240, 42%, p = 0.001). In a pre-defined exploratory analysis among physicians, the vaccination rate was higher in the intervention group (36/51, 71%) than in the control group (34/65, 52%, p = 0.046). Conclusions: Promotion of the influenza vaccine during pre-employment health check did not improve the vaccination rate of newly hired hospital healthcare workers overall during the next influenza vaccination campaign. Results suggest a favourable impact on the vaccination rate of physicians. Thus, there may be an interest in using communication strategies tailored to the different categories of healthcare workers to promote the influenza vaccine during pre-employment health check.
Archives Des Maladies Professionnelles Et De L Environnement, Oct 1, 2020
Secret professionnel et maladies infectieuses
Couverture vaccinale contre la grippe parmi le personnel des Urgences d’un Hôpital Universitaire en 2009 : différences entre les grippes saisonnière et pandémique
Introduction La vaccination du personnel hospitalier contre la grippe saisonnière (GS) est recomm... more Introduction La vaccination du personnel hospitalier contre la grippe saisonnière (GS) est recommandée depuis de nombreuses années pour limiter sa transmission nosocomiale, limiter l’absentéisme et permettre le fonctionnement du système de santé en cas d’épidémie. La couverture vaccinale (CV) contre la GS plafonne à ~ 30 % dans notre hôpital, malgré une promotion active de la vaccination (information, campagnes de vaccination, présence dans les services de délégués vaccinaux durant les différents horaires). En 2009, dans notre hôpital, la CV contre la nouvelle grippe pandémique (GP) a doublé par rapport celle contre la GS à la même saison. Par ailleurs, en raison de la GP, le port d’un masque chirurgical était devenu obligatoire pour le personnel asymptomatique non vacciné lors de contacts avec les patients. Objectifs Décrire les déterminants de la CV contre la GP et la GS au sein d’un service d’urgences hospitalières (SU). Evaluer la répercussion du port du masque obligatoire sur la CV de la GP. Méthodes Distribution au personnel du SU en septembre 2010 d’un questionnaire anonyme, basé sur une revue de littérature, recueillant les données démographiques, le statut vaccinal auto-déclaré contre la GS et la GP et les motifs d’acceptation ou refus des vaccins. Résultats Le taux de réponse était de 68 % sur 187 questionnaires (79 % des 111 infirmiers et 46 % des 76 médecins, p &lt; 0,001). La moyenne d’âge était de 35 ± 9 ans ; 63 % de femmes. 49 % étaient vaccinés contre la GS et 63 % contre la GP (p &lt; 0,001). Parmi les non vaccinés contre la GS, 40 % étaient vaccinés contre la GP et seulement 15 % des vaccinés contre la GP n’étaient pas vaccinés contre la GS (p &lt; 0,001). Les principales raisons invoquées pour la vaccination contre la GP étaient : protéger sa famille (70 %), protéger les patients (64 %) et éviter le port du masque (62 %). Les principales raisons invoquées pour ne pas se vacciner étaient : préférer porter le masque (86 %), peur des effets secondaires (57 %) et doutes sur la sécurité (57 %) du vaccin. Conclusions Dans le service des urgences, la couverture vaccinale contre la GP était également supérieure à celle contre la GS. La majorité du personnel vacciné contre la GS l’a été contre la GP. Il semble que la crainte de disséminer la GP et la contrainte du port du masque durant la période épidémique aient été des facteurs incitatifs. Ces résultats sont à confronter à l’analyse des données de la même enquête conduite dans les autres services de l’hôpital
Vaccination du personnel de santé contre la grippe : comment faire mieux
Archives Des Maladies Professionnelles Et De L Environnement, May 1, 2018
Introduction Le taux de vaccination du personnel hospitalier reste bas en Europe malgre les recom... more Introduction Le taux de vaccination du personnel hospitalier reste bas en Europe malgre les recommandations officielles de vaccination (OMS, autorites de sante publique) et les etudes confirmant que la vaccination du personnel soignant est le moyen le plus efficace pour limiter les epidemies de grippe nosocomiales et le risque de desorganisation des services de soins durant la periode epidemique annuelle. Chaque annee en Suisse, le virus de la grippe est responsable de l’infection de plus d’un million de personnes et d’environ 1500 deces. Le taux de vaccination moyen chez les soignants est de l’ordre de 20 %, avec des differences importantes entre les cantons romands et alemaniques, bien inferieur a l’objectif de 70 % initialement vise par l’Office federal de la sante publique. Materiel et methodes Le centre hospitalier universitaire vaudois de Lausanne est l’un des 5 hopitaux universitaires Suisses et emploie 11 000 personnes sur differents sites, dont 68 % de personnel soignant (personnel medical, infirmier, paramedical). Depuis plus de dix ans, le service de sante au travail avec l’appui de la direction et d’autres partenaires institutionnels a developpe une approche globale combinant plusieurs strategies fondees sur les preuves pour ameliorer le taux de vaccination du personnel soignant. Nous avons conduit des etudes pour mieux connaitre les determinants individuels d’acceptation ou de refus de la vaccination antigrippale au sein de notre hopital. En parallele, nous travaillons depuis plusieurs annees avec des specialistes de la communication pour developper progressivement une culture favorisant la vaccination du personnel de sante reticent a la vaccination. Resultats Des messages cles ont ete identifies pour repondre aux attentes et interrogations du personnel, restaurer la confiance en la vaccination, vehiculer des messages issus des connaissances scientifiques. Les outils multimedia (clips, reseaux sociaux) sont utilises pour renforcer une communication d’influence visant a reduire les reticences a la vaccination et induire des changements. Le deploiement progressif de diverses actions combinees a permis d’ameliorer regulierement la couverture vaccinale du personnel de sante au sein de l’hopital, en particulier chez le personnel infirmier. Le taux de vaccination du personnel assurant des soins aupres des patients a atteint 51 % en 2016–2017. Conclusions Le challenge actuel est de reduire les reticences a la vaccination en general. Une communication efficace est donc particulierement importante. Les services de sante au travail devraient developper des collaborations avec des specialistes de la communication en vue de favoriser l’acceptation de la vaccination chez le personnel.
Uploads
Papers by Catherine Lazor-Blanchet