of spontaneous abortion among nurses hand ling antineo plastic drugs. Scand J Work Environ Health 1990;16:102-7 . The purpo se of the study was to evaluate the frequency of spontaneous abortion in two groups of women. One group consisted of women regularly involved in the preparation of cancer chemothe rapy perfusions and therefore considered to be exposed to cytostatic agents; the other consisted of women not occupationally exposed to such agents. The study was carried out in four French hospitals. Four hundred and sixty-six women were involved; 534 pregnancies were described in which 139 were exposed and 357 were unexposed . The results showed that the frequency of spontaneous abortion was 26 % for the exposed pregnancies and 15 070 in the unexposed ones (odds ratio 2.0). These results do not seem to be due either to the classic risk factors of spontaneous abortion (age, cigarette consumption duri ng pregnancy, pregnancy order) (adjusted odd s ratio I.7) or to possible errors concerning the retrospective evaluation of prior gynecologic and obstetric history.

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Objective-To determine the eYciency of the major bibliographic databases by assessing the percentage of references among the total literature available that can be retrieved from each database. We also evaluated the best database combinations to carry out an exhaustive search. Methods-BIOSIS, EMBASE, MEDLINE, NIOSH-TIC, and TOXLINE were searched on two topics: allergy to latex and asbestos and mesothelioma, in the title, abstract, or keywords (textwords). This search was performed for the years 1994 and 1995. All the records were classified by journal and author's name and were verified for each record whether or not it was indexed in each database. Statistical analysis was performed with 2 test. Results-777 articles in 510 issues were found. The eYciency of each database (percentage of articles recovered) and of combinations varied between 11% and 63% for one database and between 42% and 86% for a combination of two databases. The reasons why these diVerences exist between databases, and within a database, between two diVerent subjects or two diVerent years are reported. Conclusion-Firstly, it is not advisable to assert that a bibliography is complete when only one database is searched. Secondly, the eYciency of the databases may be quite diVerent. Finally, it is suggested that the best way to be as exhaustive as possible is to search two or more databases-for example, in EM-BASE and TOXLINE, or to a lesser extent EMBASE and MEDLINE. This seems to be the best compromise solution between time consumed for searching and eYciency. (Occup Environ Med 1998;55:562-566)

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Work disability prevention interventions are complex innovations competing against usual care, workplace habits, and social insurance systems' complexity. The trial effectiveness of these interventions does not guarantee their implementation and sustainability. Multilevel barriers in the healthcare, workplace and insurance systems must be identified and tackled, and implementation strategies must be evaluated to monitor the implementation process and fidelity.

In case of pertussis in an HCW, all staff in the unit who have had unprotected and intensive contact with that person should be provided with macrolide treatment to stop any transmission to colleagues and to young patients. Furthermore, the possibility of providing these HCWs with acellular pertussis vaccines warrants further investigation.

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