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Occupational exposure to organic solvents can have multiple health effects for exposed employees.Neuropsychic effects represent an important part of these effects and have a significant impact on patients’ ability to work
Objectives
- To describe the socio-professional and medical characteristics of workers exposed to organic solvents
- To screen among the study population for neuropsychological effects related to an organic psychosyndrome using the Q16 questionnaire.
Methods
A retrospective descriptive study of workers exposed to organic solvents, who were referred to the occupational medicine department of Charles Nicolle Hospital in Tunis for a medical assessment of their fitness for work over the period from 2016 to 2022. The socio-professional data were collected from the medical records. The Swedish Q16 questionnaire in its French version was used to screen for neuropsychological signs of organic psycho-syndrome.
Results
A total of 37 workers were included. The mean age was 45.38 ± 8.63 years with a clear male predominance (77%). The mean occupational seniority was 21.39 ± 11.11 years. The average duration of the occupational exposure to organic solvents was 18.25 ± 11.29 years. The most represented sectors of activity were the plastics industry (11%), the automotive industry (19%), the carpentry sector (14%) and the aeronautics sector (9%). Our population was represented by polyvalent workers in 49% of cases and by painter in 24% of cases. Psychiatric history was noted in only one case. The main functional signs reported by the workers were wheezing dyspnea with breathing difficulties (13%) and headaches (11%).
The Q16 questionnaire was found to be positive in 65% of the cases, with a higher rate of positivity for the items relating to unusual fatigue (73%), irritability for no particular reason (67%), short memory (64%) and headaches (58%). Acquired dyschromatopsia detected by a Lanthony test was found in 39% of the cases, 23% of which was associated with a positive Q16 questionnaire. Additional exploration by specific psychotechnical tests was carried out in five cases, all of which came back positive with significant attentional and cognitive impairment.
A declaration of an occupational disease according to the Table n°23 (Halogenated derivatives of aliphatic hydrocarbons) and Table n°40 (other liquid organic solvents for professional use) of the Tunisian list of occupational diseases eligible for compensation was made in three and two cases respectively. A definitive exemption from exposure to organic solvents was indicated for all workers with a positive Q16 questionnaire.
Conclusions
Exposure to organic solvents is a risk encountered in various occupational sectors. Thus, education of the employees to the dangers encountered with a reinforcement of the collective and individual technical protection means are essential in order to avoid their detrimental effects on health.
Exposure to organic solvents (SO) is a significant occupational hazard in industrial settings. This can lead to neurobehavioural and physical effects that can affect the quality of life of workers
Objectives
To assess, using a validated questionnaire, the quality of life of workers exposed to SO.
Methods
Cross-sectional descriptive study conducted at the occupational medicine department of the Charles Nicolle Hospital in Tunis, which interested patients exposed to SO who had consulted for a medical opinion on fitness for duty during the period from January 1, 2017 to August 31, 2022. The data collection was carried out by a telephone call using the SF12 questionnaire. Socio-demographic and medical data were completed from medical records.
Results
We identified 51 workers exposed to OS. Thirty-three employees agreed to answer the SF12 questionnaire, for a response rate of 65%. The average age was 44 8 years with a clear male predominance of 75%. The most represented sectors of activity were the automobile industry (34%), followed by the leather and footwear industry (15%) and the plastics industry (12%). The jobs most exposed to SO were manual workers (54%) and painters (9%). The median occupational seniority was 15[10; 23] years. Comorbidities were observed in 72% of employees. The average physical composite score was 48%. The average mental composite score was 49%. The average overall score was 49%. Average quality of life (overall SF12 score above 50) was noted in 60% of the population. Moderate disability (overall SF12 score between 30 and 39) was found in 18% of respondents. Twenty-one percent of workers had a severe disability (overall SF12 score below 30).
Conclusions
In addition to socio-professional conditions, exposure to SO may be implicated in altering the quality of life of exposed workers. This implies the need to strengthen preventive measures in order to preserve the mental and physical health of these workers.
The COVID-19 pandemic had a considerable psychosocial impact on healthcare workers (HCWs) who were constantly requested during this era with an increased risk of infection. This implies behavioural changes, especially in smoking behaviour.
Objectives
To study smoking behaviour in HCWs with COVID-19.
Methods
A cross-sectional descriptive study conducted in the department of occupational pathology of Charles Nicolle Hospital in Tunis involving the smoking HCWs affected by COVID-19 during the period from September 1, 2020, to February 28, 2021. The data collection was carried out by a telephone call using a standardized questionnaire.
Results
During the study period, 61 smoking HCWs were identified. Thirty-two patients agreed to answer the questionnaire, with a response rate of 52%. The mean age was 41±10 years. The sex ratio (M/F) was 1.46. Half of the participants had comorbidities. The most represented occupational categories were blue-collar workers (n=11) followed by nurses (n=10) and physicians (n=7). The median professional seniority was 13 [3.5; 20] years. The mean age of smoking initiation was 20±5 years. The most common mode of smoking was cigarettes (93%) with an average consumption of 19 cigarettes per day. Water pipe smoking was noted in 3 patients. All patients started smoking before the COVID-19 infection. Strong tobacco dependence was noted in 25% of patients. Twenty-one per cent of the population had moderate dependence. Half of the participants maintained the same level of smoking as before the COVID-19 infection. An increase in smoking was noted in 34% of patients. A decrease in the level of smoking was reported by 15% of respondents. Four participants stopped smoking after COVID-19 infection. The reasons for smoking cessation were COVID-19 damage (n=3) and confinement with family (n=1).
Conclusions
The change in smoking behaviour during the COVID-19 pandemic is notable, particularly in HCWs who are exposed to a high physical and mental load. The presumed association of smoking with severe forms of COVID-19 infection makes tobacco control in HCWs an obligation in order to preserve the continuity of care.
Anxiety and depressive disorders are major public health problems associated with multiple adverse occupational outcomes, including unemployment, reduced productivity, and absenteeism.
Objectives
To study the socio-professional and medical characteristics of workers with mixed anxiety -depressive disorders and to evaluate their impact on work ability.
Methods
A descriptive and retrospective study conducted in the occupational medicine department at Charles Nicolle Hospital, involving all the medical records of workers suffering from mixed anxiety –depressive disorders that were referred for a medical opinion of fitness for work from January 1, 2014, to December 31, 2020.
Results
The study included 62 females and 20 males diagnosed with mixed anxiety-depressive disorders with a mean age: 41.4± 8 years. The average professional seniority was 12.8 years±7.8 years. The most auspicious occupational sectors for these disorders were health (41%) and communication (30%). Most of these workers (62%) were fit for work with professional restrictions (10 workers to positions with a lower mental load and 20 exclusions from night shift work), though 12% were declared unfit for work temporarily. Twenty-one workers were fit to continue working and one worker was unfitted to work.
The overall prevalence of mixed anxiety –depressive disorders was found to be significantly elevated in female patients (p: <0.001).
Conclusions
The decision of medical fitness for work among workers with psychiatric disorders considers their physical and mental capacities as well as the conditions in which the work is carried out, aiming to annihilate the risk of psychic imbalance. Thus, an adjustment of workstations can be an important determinant in the prevention of psychosocial risks.
Organic solvents (OS) constitute a considerable occupational risk in industrial environment. Long-term exposure can cause several neuropsychic manifestations which are the subject of several studies conducted in Tunisia.
Objectives
To identify the main psychological disorders in workers exposed to OS in Tunisia and to determine the occupational sectors at risk.
Methods
This is a review of the Tunisian literature, focusing on studies carried out on OS in the workplace and published in the form of articles or defended in the form of theses or dissertations in medical faculties over a ten-year period.
Results
The total number of employees was 9 499 of which 4 259 were exposed to OS. The total number of companies studied was 169 with 164 occupational pathology cases. The most studied sectors were the chemical industry (20 studies) and the leather industry (21 studies). Atmospheric concentration of OS was measured in 20 studies. A mixture concentration index was calculated in 70 cases, it did not comply with the standard in 30 cases. Pathologically, the syndrome of acquired intolerance to organic solvents had a prevalence of 1.8% to 38.2%, while the syndrome of psychic dependence had a prevalence of 8.9% to 35.3%. The prevalence of organic psycho-syndrome ranged from 0.8% to 26.5%.
Conclusions
Despite the methodological differences of the studies, this work can contribute to the evaluation of the extent of the problem posed by OS in the workplace for a possible implementation of an adapted preventive approach.
Asthma is the most common allergic respiratory disease and is frequently associated with symptoms of depression and anxiety. However, this association remains poorly understood, especially in active military personnel with asthma who are particularly exposed to a high mental and physical load.
Objectives
To investigate the presence of anxiety and depression in active military personnel with allergic asthma.
Methods
This is a descriptive cross-sectional study conducted at the pneumology department of the Tunis military hospital that interested active military personnel followed for asthma and who consulted the department in the period from January 1, 2022 to October 31, 2022. The Hospital Anxiety and Depression Scale (HADS) was used to assess depression and anxiety.
Results
During the study period, 36 asthma patients were included. The mean age was 35±8 years with a male predominance of 83%. The majority of the participants were non-commissioned officers (91%), whom were in field positions in 68% of cases. The median professional seniority was 9 [6; 17] years. Active smoking was noted in 47% of the participants. Half of the patients had comorbidities. A history of major depressive syndrome was reported by 8% of patients. Current antidepressant treatment was mentioned by only one patient. Asthma was well controlled in 66.7% of cases. Definite anxiety was found in 30% of the patients while it was doubtful in 26% of the population. Depression was present in 18% of the participants. Specialist psychiatric care was recommended for patients with depression and anxiety.
Conclusions
Anxiety and depression are significant comorbidities in asthma patients. Screening for these risks is necessary, especially in the military population whose work requires mental and physical integrity.
Disclosure of Interest
None Declared
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