Omar Laraqui

Évaluation des risques respiratoires chez les puisatiers de la région d’Agadir, Maroc

Resume But de l’etude L’objectif de ce travail etait d’evaluer les risques professionnels respiratoires chez 346 puisatiers a Agadir et dans sa region. Methode L’enquete epidemiologique transversale comprenait une etude des conditions de travail avec une analyse physico-chimique du sol et un bilan medical (questionnaire, examen clinique, spirometrie et radiographie pulmonaire). Resultats Les puisatiers etaient exclusivement de sexe masculin, avec un âge moyen de 42,8 ans ± 10,5 et une anciennete d’exposition moyenne de 14,5 ans ± 6,9. Les symptomes respiratoires etaient notes chez 50 % des sujets et domines par la dyspnee (43,1 %) et la toux (35 %). La spirometrie etait anormale chez 64,2 % ; les anomalies portaient aussi bien sur les debits que sur les volumes. Les radiographies pulmonaires avaient revele 32,9 % d’images thoraciques anormales dont 78,9 % etaient des petites opacites, et 21,1 % de grandes opacites parenchymateuses. Les symptomes cliniques et fonctionnels respiratoires et les anomalies radiologiques apparaissaient precocement et leurs prevalences augmentaient avec l’anciennete de l’exposition. Il n’a pas ete observe de correlation entre les anomalies spirometriques et les images radiologiques. Discussion Peu d’etudes ont ete consacrees au risque professionnel respiratoire chez les puisatiers. A. Holanda avait mis en evidence chez ces derniers une relation significative entre l’indice d’exposition a la poussiere et l’apparition des opacites parenchymateuses et leur profusion. La valeur mediane de l’indice pour l’apparition des lesions radiologiques etait de 391 jours. Conclusion Le travail de puisatier apparait tres silicogene, l’instauration d’une surveillance medicale speciale et d’une prevention technique adequate sont necessaires pour reduire ce risque respiratoire tres invalidant.

Risques professionnels respiratoires chez les marchands d'épices au grand souk de Casablanca

Resume But de l’etude Le but de l’etude a ete de comparer a un groupe de controle la prevalence des risques professionnels respiratoires, des troubles ventilatoires et des sensibilisations cutanees chez les marchands d’epices a Casablanca. Methode Cette enquete epidemiologique transversale de type cohorte retrospective a inclus 175 marchands d’epices et 175 sujets non exposes. Elle comprenait une analyse des conditions de travail et une enquete medicale (questionnaire, examen clinique, spirometrie et tests cutanes allergologiques). Resultats Le terrain atopique a ete retrouve chez 14,8% des exposes contre 9,7% des non exposes. Les prevalences des symptomes cliniques etaient significativement plus elevees chez les exposes (41,1%) que chez les non exposes (21,7%). Chez les exposes, les fumeurs et les anciens fumeurs (63,8%) etaient plus symptomatiques que les non fumeurs (29,9%). Chez les non fumeurs, les exposes ont ete plus symptomatiques (29,9%) que les non exposes (12,3%). L’exposition semblait jouer un role important dans la genese des troubles respiratoires. Le tabac etait un facteur aggravant. Une alteration de la fonction respiratoire, de degre variable, etait retrouvee chez 61,1% des exposes. Chez ces derniers, les prevalences des tests cutanes positifs aux allergenes courants seuls, aux allergenes professionnels seuls et a l’association des deux etaient respectivement de 24,6%, 29,7% et 18,3%. La sensibilisation cutanee a au moins une epice native etait notee chez 11,4% des marchands d’epices, dominee par le piment chez 5,7% des sujets. Discussion Peu d’etudes epidemiologiques transversales de cohorte portant sur les risques respiratoires aux epices ont ete retrouvees dans la litterature. Cependant, nos resultats concernant la symptomatologie clinique, les troubles fonctionnels ventilatoires et la sensibilisation aux allergenes professionnels etaient concordants avec ceux observes dans les milieux cerealier, minotier, boulanger, epicier et agricole. Conclusion L’instauration d’une prevention medicale et technique adequate pourra reduire ce risque.

Prevalence of chronic obstructive respiratory diseases amongst fishermen

BACKGROUND The objective was to screen and evaluate the prevalence of respiratory diseases and obstructive ventilatory defects among fishermen in Morocco. MATERIALS AND METHODS This observational and cross-sectional epidemiological study involved 924 men over 20 years old and with at least two years of seniority. It included a questionnaire and a spirometry. The questionnaire is composed of four sections: sociodemographic and occupational characteristics, toxic habits, medical history and respiratory clinical symptoms. RESULTS The prevalence of symptoms of tracheobronchial irritation was 9.2% for cough, 8.2% for sputum 7.8% for dyspnoea and chest wheezing 8.1%. The frequency of rhinitis was 17.1%, asthma 6.8%, chronic bronchitis 5.6% and chronic obstructive pulmonary disease (COPD) 4.1% (5.4% for current and former smokers versus 1.1% for non-smokers). The prevalence was reaching 6.8% among those who smoked more than 10 pack-years and 17.9% among those who smoked more than 20 pack-years. Among subjects over 40 years old who had smoked more than 10 pack-years, the prevalence of COPD was 8.1%. The comorbidities were frequent. CONCLUSIONS Smoking was very common among fishermen. Symptoms and respiratory diseases remain underdiagnosed and undertreated. Prevention and early detection must be a priority in this sector.

Prevalence of skin diseases amongst Moroccan fishermen

BACKGROUND The main objective was to evaluate the prevalence of skin diseases amongst fishermen, to specify the different clinical forms, associations and most frequent localisations, and to identify potential aetiological factors. The secondary objectives were to assess the knowledge, attitudes and practices of seafarers regarding occupational dermatoses to conduct information, awareness and education campaigns on risk factors and behaviours and to propose adapted prevention. MATERIALS AND METHODS This cross-sectional survey involved 1102 artisanal fishermen who attended the annual legal medical consultation at the occupational health service. All participants were men and had a regular activity for at least 2 years. It included an individual questionnaire, a clinical examination and a technical visit to the workplace Results: The skin disorders were palmar hyperkeratosis in 67.1% of fishermen, plantar hyperkeratosis in 59.4%, scares in 52.2%, facial wrinkling in 32%, and marine stings in 11.2%. The skin infections were fungal (44.4%), bacterial (8.3%), viral (5.5%) and scabies (1%). Only 192 (17.4%) fishermen did not have any dermatologic disease, 43% had one type of dermatologic diseases, 27.2% two types, 9.5% three types and 2.5% four types. Concerning personal protective equipment, only 87.4% wore protective clothing, 12.8% high visibility clothing, 52.6% safety shoes, 30.1% protective gloves, and 63.5% protective caps or hats. Only, 12% knew that mycosis were infectious origin and were contagious. Eighty-two per cent ignored the mode of contamination, 78% the means of prevention and 91% the existence of a medical treatment. Ninety-five per cent thought that pityriasis versicolor was due to sunrays especially in summer and not to fungus. CONCLUSIONS The elaboration of the prevention approach needs a cooperative spirit; it will be more accepted and applied by all fishermen, if their representatives are involved in its preparation. The realisation of information and sensitization campaigns about the skin health must be based on the results of prevalence surveys.

Exposure Risk Assessment Follow-up in an Aluminium Salvage Plant

Introduction: Workers who work in salvage plant industry are at risk of exposure to aluminum (Al). The objective of this study was to conduct a longitudinal quantitative health risk and bio monitoring assessment for workers exposed to Al. Methods: Al workers were compared to controls. A standardized medical examination and neurobehavioral tests and pulmonary assessment were achieved. The longitudinal study was based on repeated measurements (Airborne and urine Al evaluations). Results: Clinical results showed no evident adverse effects, only mild health impairings. Modification of industrial process to reduce Al exposure leaded paradoxically to increase Al peaks in airborne and urine samples. Conclusion: Hygienic and architectural measures taken to improve exposure and to reduce Al inhalation was a failure. Appropriate preventive measures should be carefully assessed before being applied to protect effectively exposed workers.

The assessment of seafarers’ knowledge, attitudes and practices related to STI/HIV/AIDS in northern Morocco

BACKGROUND The purpose of this study was to assess the knowledge, attitudes and practices of seafarers in relation to sexually transmitted infections (STI) and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS). MATERIALS AND METHODS This transversal, descriptive and behavioural study was conducted in 2014 on a representative sample of 1447 seafarers. RESULTS The rate of participation was 95%. The mean age was 36.1 ± 8.2 years. Knowledge about transmission and prevention mode was satisfactory on HIV/AIDS; however, some misconceptions still persist. The level of stigmatisation and discrimination towards people living with the virus was considered high. The prevalence of sexual high-risk behaviour was significant: 32% had at least two sexual partners and 26.3% have had sex with sex workers, 60% of them were not protected; 42.8% have never used the condom and only 15.1% used it systematically. The sailors who had sexual intercourse under the influence of alcohol or drugs are less protected. As too HIV testing, only 10.2% did it. CONCLUSIONS This study showed a gap in knowledge about transmission and prevention of HIV infection/AIDS and sexual risk behaviour. Increasing awareness and information among seafarers is of prime importance.

Prevalence of consumption of addictive substances amongst Moroccan fishermen

BACKGROUND The prevalence of toxic habits is constantly increasing in developing countries and all professional sectors are concerned. Seafarers are a particular target because of the dangerousness and complexity of their work. However, few studies have investigated toxic habits in this population. The aim of the study was to determine the prevalence of the use and misuse of addictive substances in seafarers and to appreciate poly-consumptions according to socio-demographic and occupational characteristics. MATERIALS AND METHODS This cross-sectional study was conducted amongst 1,219 fishermen. Subjects filled a questionnaire during their medical examination. The questionnaire covered socio-demographic and occupational characteristics, toxic habits (tobacco, alcohol, cannabis and others psychotropic substances). The misuse was assessed by specific tests: dependence on smoking tobacco (Fagerstrom), Cannabis Abuse Screening Test (CAST) and Alcohol Use Disorders Identification Test (AUDIT). RESULTS The prevalence of consumption was 58.5% for smoking tobacco, 36.2% for cannabis, and 36.5% for alcohol. Amongst consumers, the prevalence of dependence or misuse was 49% for smoking tobacco, 61.2% for cannabis and 86% for alcohol. Only 115 (9.4%) people had no toxic habit. 56.4% had one toxic habit, 20.4% had two toxic habits, 11.9% had three toxic habits and 1.9% had four toxic habits. The most frequent associations were tobacco-cannabis (10.5%) and tobacco-alcohol (6.1%). CONCLUSIONS In this sector, occupational health physicians have to play a key role in raising awareness and fighting against toxic habits.

Risk-taking behaviours among fishermen in Morocco by the evaluation of “ordalique” functioning

BACKGROUND The aim was to investigate the potential fishermens psychological functioning which induces risk-taking behaviours by evaluating the ordalique functioning. MATERIALS AND METHODS This cross-sectional epidemiological study was conducted in three ports of northern Morocco in 2016 and concerned 1413 traditional fishermen working in small embarkations and 1049 administrative staff working in the maritime sector on land. Both groups were male, comparable for age and educational level. The survey support was an individual questionnaire covering socio-demographic characteristics, toxic habits and ordalique functioning questionnaire (le questionnaire de fonctionnement ordalique, QFO). It is composed of 42 items and four dimensions which are evaluated: risk-taking, transgression, positive representation of risk-taking and believes. RESULTS The prevalence of the ordalique behaviour and its four dimensions was significantly higher among traditional fishermen than administrative staff on land; 66.4% vs. 33.6% (p < 0.0001) for risk-taking, 65.2% vs. 34.8% (p < 0.0001) for transgression, 60.4% vs. 39.6% (p < 0.0001) for positive representation, 59.8% vs. 51.2% (p < 0.0001) for believes. For all range ages, the prevalence of ordalique functioning was higher among fishermen than administrative staff on land. Among fishermen, the prevalence of the was significantly higher among the under 40 years old (69.1% vs. 54.7%, p < 0.0001). The prevalence of toxic habits among ordalique fishermen was significantly greater than no-ordalique ones: tobacco (54.5% vs. 48.6%, p < 0.035), alcohol (42.8% vs. 32.4%, p < 0.0001), cannabis (34.8% vs. 26.6%, p < 0.0001), psychotropic drugs (13.8% vs. 10.4%, p < 0.081) and a combination of toxic habits (27.7% vs. 19.6%, p < 0.0001). CONCLUSIONS Ordalique behaviour among fishermen may explain the partial failure of preventive measures in this sector. Risk-taking behaviours into account in the safety system could reduce occupational hazards in the fishery.

Prevalence and Determinants of Flu Vaccination in a Working Population

Introduction: Influenza viruses are highly contagious. Frequently, new strains of influenza are identified. Influenza vaccination is the most effective way of influenza prevention. Numerous jobs experience a risk of occupational exposure to influenza; this may conduct to the transmission of the infection to other people and coworkers. The aim is to determine influenza vaccination rates and factors, which influence the vaccination decision regarding a working population exposed to variable contamination risks. Methodology: A cross sectional survey was conducted during 2015-2016’s influenza vaccination campaign. The study concerns a representative sample of a population of 50,000 workers belonging to a large distribution of occupational branches. Workers were asked, during their occupational medical examination, to complete a brief questionnaire containing a list of reasons for either being vaccinated or not. The number of contacts with people during work, which is supposedly influencing the flu contamination, was also taken into account. Results: The annual influenza vaccination rate was quite low for all groups of workers. But the intention to receive vaccination was twice higher for the most exposed group, which may be subject to contamination during work. One of their most common reasons for not being vaccinated was to have a good health and not feeling concerned by flu. The main reason given about immunization against the flu was in order to avoid contamination by family or co-workers. Discussion: The low rate of flu vaccination indicated that most of workers were susceptible to infection. International data shows highly variable vaccination rates. The most important tool regarding the decision making of performing influenza vaccination could be related to internal and external communications. The low coverage achieved is an occupational and public health problem. This finding confirms the importance of a comprehensive approach towards the influenza vaccination, ensuring that workers are correctly informed about flu vaccine.