Mr AMOUDRU thanked the chairman for taking the initiative of
this symposium. He stated that the statistics on pneumoconioses in France
are mainly based on risk management (pensions created, entitlement to
survivors' pensions, etc.); he observed the scarcity of detailed epidemiologic
data (except for a few studies on collieries). This shortage is particularly
detrimental as regards the development of new or revised tables on occupational
diseases.
He recalled the longevity of the biopersistence of silica particles
in the pulmonary parenchyma. In effect these particles keep their cytopathogenic
power even when the subject is no longer exposed, which forms a specific
difficulty as regards the preventive or therapeutic actions envisaged.
Mr COCUDE, speaking to Dr PUJET, wished to know the proportion
of men and women concerned by respiratory rehabilitation and if différent
behaviours appear.
Mr PUJET: The proportion of men is higher concerning occupational
and tobacco-caused diseases but women are beginning to catch them up
regarding tobacco. Readaptation motivation is limited, firstly because
of the low number of centres and doctors experienced in the therapy,
and, secondly because some patients are both tobacco and alcohol addicts
and must previously lose their addiction.
Regarding the therapy programme, women are seen to be stricter than
men, but all progress normally when motivated. As for pneumoconiotics,
rehabilitation proves the best therapy compared with drugs or oxygen,
with an iraprovement of, for instance, fifty per cent of the distance
covered in a six minute walk.
Mrs MINGAM: When Dr PUJET describes the respiratory rehabilitation
of pneumoconiotics and the eloquent results he obtains, that makes me
think exactly about the readaptation of chronic patients in pain: currently,
in France, several functional reeducation centres or services propose
effort re-training or physical reactivation programmes for chronic lumbago
sufférers allowing thern to rediscover an acceptable quality
of life despite their paînful handicap.
1 am pleased to see that for two différent types of pathologies
the therapeutic approach. to be adopted follows the same guideline.
Mr COCUDE asked Dr MARQUET to draw the conclusions of this first
part regarding miners sufféring from pneumoconiosis.
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