Work ability and mental health at return to work after COVID-19: A descriptive study among healthcare workers

BACKGROUND

Healthcare workers (HCW) may experience anxiety and prolonged work schedules during pandemics. The mental health status after a COVID-19 infection and the work ability of HCW are interesting criteria in assessing their fitness to work at the return to work (RTW) medical visit.

OBJECTIVES

To assess mental health and work ability after a COVID-19 infection among HCW at the RTW medical visit.

METHODS

An observational cross-sectional and descriptive study was carried out among HCW of Charles Nicolle Hospital of Tunisia infected with COVID-19 from September to December 2020. Anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HAD). The perceived ability to work at RTW was measured using the Work Ability Index (WAI).

RESULTS

We included 531 HCW. The median age was 40 years. HCW belonged to surgical departments (36.9%) and were nurses (32.4%). The median delay to RTW was 15 days (IQR: 13-18). At the RTW medical visit, certain anxiety and depression were found in 36.5% and 33.3% of the patients respectively. The perceived work ability was evaluated as good to very good in 37.8% of cases. The delay to RTW increased proportionally with a better-perceived work ability (p = 0.007).

CONCLUSION

Our study described the perceived work ability and the prevalence of anxiety and depression among the HCW at the RTW medical visit after COVID-19 infection in the early stages of the pandemic. Specific strategies for RTW after COVID-19 should take into consideration the mental health and work ability of HCW.

The Professional Future in Operated Carpal Tunnel Syndrome: A Cross-Sectional Study of Recognized Occupational Cases

BACKGROUND

Carpal tunnel syndrome (CTS) is frequently present among workers. This syndrome's professional and economic impact makes it a priority in occupational health. We aimed to describe the professional future of workers suffering from occupational CTS after surgery and the factors that could influence their retention at the job. -Methods: A retrospective descriptive study of workers operated on occupational CTS was conducted from 2014 to 2019. The data was collected using pre-established and phone questionnaires to determine their professional future after surgery.

RESULTS

We included 99 workers with operated CTS. They had a mean age of 45±6.5 years, were predominantly female (97%), and had two dependent children in 72.7% of cases. They worked as a seamstress in 44.4% of patients with a mean professional seniority of 18±7.2 years. The professional future was a return to work with a job transfer at 44.4% and job maintenance with ergonomic adjustments at 39.4%. A job loss was noticed in 12.2% of cases. Early retirement was noticed in 8.2%, dismissal in 3%, and resignation in 1% of cases. The factors influencing the professional future were age 50 to 59 years (p=0.01) and dependent children (p=0.02).

CONCLUSIONS

In our survey, most operated-CTS workers benefited from a job transfer and kept their job with ergonomic adjustments to their work conditions. Therefore, interventions aiming to improve the professional future of workers operated on CTS by ensuring sufficient staff and adjusting workplaces are needed.

Particularités des troubles du sommeil pendant la 6e vague de COVID-19 (Omicron) chez le personnel de soin

Objectif

Déterminer la fréquence des troubles du sommeil ainsi que les caractéristiques socioprofessionnelles et cliniques chez les professionnels de la santé (PS) ayant été atteints par la COVID-19 lors de la vague « OMICRON » de la pandémie.

Méthodes

Étude descriptive transversale ayant intéressée les PS de l’hôpital Charles Nicolle atteints de COVID-19 au cours de la période allant du 22 décembre 2021 au 31 janvier 2022. Le recueil de données a été réalisé à la visite de reprise à l’aide d’une fiche analytique relevant les caractéristiques socioprofessionnelles et médicales des PS. Le dépistage des troubles du sommeil a été fait par deux questionnaires : l’Index de sévérité de l’insomnie (ISI) pour le dépistage de l’insomnie et l’échelle Epworth pour le dépistage de la somnolence.

Résultats

Durant la période d’étude, 86 PS ont accepté de participer à notre enquête et ont répondu au questionnaire proposé. L’âge moyen des PS était de 39 ± 10,89 ans. Une prédominance féminine a été notée (79 %) avec un sexe-ratio (F/H) de 4,53. Les PS atteints exerçaient principalement dans des services médicaux (54 %). Les infirmiers représentaient la principale catégorie professionnelle (27 %). Les principaux symptômes représentés par les PS étaient : les courbature (48 %), la toux (40 %), l’odynophagie (33 %) et les céphalées (31 %). L’insomnie a été détectée chez 44 % des interrogés (n = 38), dont 47 % présentaient une forme légère, 42 % une forme modérée et 11 % une forme sévère. La somnolence a été détectée chez 24 % (n = 21) des PS dont 80 % présentaient une somnolence diurne excessive légère et 4,7 % présentaient une somnolence diurne excessive sévère. Les PS infectés pour la première fois par le virus du SARS-CoV-2 représentaient 84 % des cas rapportant une insomnie.

Conclusion

Selon les résultats de notre étude, l’insomnie était rapportée par les PS atteints par le variant Omicron plus que la somnolence. Le dépistage précoce de ces troubles du sommeil s’avère nécessaire afin de prévenir toute détérioration de la santé mentale du personnel soignant.

Impact of atypical working hours on sleep and mood among healthcare workers

BACKGROUND

Atypical working hours have raised serious concerns about health effects, such as sleep disorders and psychological repercussions. These schedules are frequent among health professionals having the obligation to ensure the permanence of health services.

OBJECTIVE

To assess the impact of atypical working hours on sleep, sleepiness, and mood among health personnel (HP).

METHODS

Comparative descriptive cross-sectional study was carried out among HP of a regional hospital in Southern Tunisia from December 2019 to May 2020. Two groups were defined according to their work schedule: group A had a fixed-day work and group B had atypical working hours. The assessment of sleep, sleepiness, and mood was based respectively on the Spiegel questionnaire, the Epworth Sleepiness Scale, and the Hospital Anxiety and Disorder scale.

RESULTS

A total of 101 HP in group A and 135 in group B were included. We found signs of pathological sleep in group B: greater delay in falling asleep (78.1% Vs 53.5%; p = 0.002), altered sleep quality (88.1% Vs 56.4%; p = 0.039), and more frequent occurrence of dreams (37% Vs 31.7%; p = 0.033). The quality of sleep was associated with the professional seniority (p = 0.01), the workplace (p = 0.02), and having dependent children (p = 0.04). The mean score of depression was higher in group B (p = 0.02). Depression was associated with the workplace (p = 0.04) and the quality of sleep (p = 0.01).

CONCLUSION

The results of this study indicate that atypical working hours generate both sleep and mood disorders in HP. It is vital to encourage the occupational physicians to estimate sleep and mood disorders in HP.

Occupational diseases compensated in the Tunisian public sector

AIM

Describe the epidemiological characteristics of occupational diseases (OD) recognized by the Central Medical Commission (CMC) of the first ministry during the period from 2012 to 2019.

METHODS

It was a descriptive and retrospective study covering all cases of diseases declared and recognized as occupational diseases by the CMC of the first ministry in the public sector and their repair during the period from the first of January 2012 to December 31, 2019.

RESULTS

During the study period, 294 OD were declared, of which, 213 were recognized by the CMC (72.4%). The average age of the population was 45.8 ± 10.9 years. A female predominance was noted (61%). Most employees (56%) were part of the health sector. Tuberculosis was the most common occupational disease (21.1%). Cancers were present in 5.6% of cases. In this series, 99 workers had a temporary total disability (TTD) (46.5%). A partial permanent disability rate (PPD) was attributed to 20 victims of OD (9.4%) with an average rate of 29% and extremes ranging from 8% to 70%.

CONCLUSION

The OD recognized in the public sector seemed to be low. This encourages better information for workers on occupational risks and better awareness of attending physicians to report the professional nature of PD.

Qualité de vie chez le personnel hospitalier rétabli de COVID-19

Introduction

Objectif

Méthodes

Résultats

Conclusion

Capacité au travail chez les professionnels de santé COVID-19 positifs

Introduction

Le personnel de santé est particulièrement exposé au risque de contamination par le SARS-CoV-2. Par ailleurs, cette infection peut être à l’origine d’une limitation de la capacité au travail. Différents outils sont utilisés pour mesurer cette capacité. Parmi les outils les bien connus, l’indice de capacité au travail (WAI) qui est un outil d’auto-évaluation valide et largement utilisé.

Objectif

Évaluer la capacité au travail chez les professionnels de santé atteints de COVID-19.

Méthodes

Étude transversale descriptive ayant intéressé le personnel de santé de l’hôpital Charles Nicolle de Tunis atteint de COVID-19 pendant la période allant du septembre 2020 jusqu’au mars 2021. Le recueil de données a été réalisé lors de la visite médicale de reprise effectuée après la période de confinement à l’aide d’une fiche préétablie contenant les données sociodémographiques et l’indice de capacité au travail (Work Ability Index [WAI]).

Résultats

Pendant cette période nous avons recensé 669 cas d’infection COVID-19 chez les professionnels de santé de l’hôpital Charles Nicolle de Tunis dont 550 personnes ont accepté de répondre au WAI avec un taux de réponse évalué à 82,2 %. L’âge moyen était de 40,5 ± 10,3 ans avec une prédominance féminine de 77,5 %. La catégorie professionnelle la plus représentée était celle des infirmiers (32 %). La majorité des personnels appartenaient à des services chirurgicaux (37,5 %) et travaillaient à horaire fixe le jour (76 %). L’ancienneté professionnelle moyenne était de 10 ans avec des extrêmes allant de un an à 38 ans. La présence d’antécédents pathologiques était observée chez 51,5 % des personnels. La plupart des patients avaient une évolution favorable de l’infection COVID-19. La durée moyenne d’isolement était de 15 ± 7,5 jours. La persistance des symptômes à la reprise du travail était notée chez 69,8 % des interrogés. Parmi les répondants au WAI, 41,1 % avaient une capacité ressentie au travail moyenne. Cette capacité était perçue comme bonne dans 27,3 % des cas et excellente dans 11,6 % des cas. Vingt pour cent de la population étudiée avaient une capacité faible au travail. La capacité au travail évaluée par le WAI était statistiquement liée à la présence d’antécédents pathologiques (p < 0,001), à la persistance des symptômes à la reprise du travail (p < 0,001), à la catégorie professionnelle des infirmiers (p < 0,001) et au sexe féminin (p = 0,025).

Conclusion

Dans la majorité des cas, la capacité au travail chez les personnels de santé était altérée en post-COVID-19. Ceci suggère des recommandations préventives afin d’améliorer le retour au travail des malades COVID-19.

Persistance de la dyspnée à la reprise du travail chez le personnel de soins

Introduction

Le syndrome post-COVID, également appelé COVID long, englobe des symptômes persistant après la phase aiguë de la maladie. L’asthénie est le symptôme le plus fréquemment rapporté dans le post-COVID, suivi par la dyspnée résiduelle. Celle-ci peut avoir des conséquences sur le retour au travail.

Objectifs

Déterminer la prévalence de la dyspnée post-COVID à la reprise du travail du personnel soignant et décrire leurs caractéristiques socioprofessionnelles et cliniques.

Méthodes

Il s’agissait d’une étude descriptive rétrospective portant sur le personnel de l’hôpital Charles Nicolle ayant gardé une dyspnée post-COVID à la reprise du travail durant la période allant de septembre 2020 à décembre 2020.

Résultats

Durant la période d’étude, parmi 588 patients infectés par la COVID-19, on a colligé 81 cas (13,7 %) ayant eu une dyspnée persistante à la reprise du travail. La moyenne d’âge était de 42,9 ans ± 10,48 avec une nette prédominance féminine (73 % des femmes). Il s’agissait d’infirmier (36 % des cas), de technicien (33 % des cas), d’ouvrier (15 % des cas), de médecin (10 % des cas) et d’agent administratif (6 % des cas). Les services d’affectation étaient surtout les services médicaux (35 % des cas) et les services chirurgicaux (33 % des cas). L’ancienneté professionnelle était en moyenne de 17 ans avec des extrêmes allant de 1 à 36 ans. Des antécédents respiratoires étaient notés chez 13 % des cas (10 % d’asthme et 3 % de BPCO) et une cardiopathie était rapportée chez 9 % des cas. Le tabagisme était rapporté chez 8 % des cas et l’activité physique chez 35 % des cas. Un surpoids pondéral était retrouvé chez 50 % des cas et une obésité chez 25 % des cas. La prescription de corticothérapie était indiquée chez 14 % des cas, le recours à l’oxygénothérapie à domicile était rapporté chez 4 % des cas et une hospitalisation était rapportée chez 11 % des cas. La reprise du travail était faite en moyenne après 19 jours de la date du prélèvement avec des extrêmes allant de 8 à 152 jours.

Conclusion

La dyspnée post-COVID est fréquente et peut avoir des conséquences sur la reprise du travail. De ce fait un meilleur accompagnement de ces patients est nécessaire afin d’améliorer leur qualité de vie.

Cutaneous manifestations of COVID‐19 among healthcare workers: A Case report and literature review

Common clinical features of COVID‐19 are increasingly known but cutaneous manifestations are rarely described among healthcare workers. A review of cutaneous manifestations of COVID‐19 especially among healthcare workers (HCW) is thus required. The aim of our current study was to provide a comprehensive review of cutaneous manifestations of COVID‐19 among HCW through six case reports and a literature review. We conducted a literature search for cases reports, original and review articles using PubMed and the Google search engines. We included the written English studies that mentioned cutaneous symptoms during COVID‐19 infection. In addition to the review, 6 cases were collected among the HCW working at the Charles Nicolle Hospital of Tunis from September 2020 to January 2021. In our review, we included 17 articles in addition to our six cases. The type of papers was case series and case reports in respectively 8 and 9 studies. Skin manifestations were reported in two studies including two HCW, in addition to our series of six HCW. Skin manifestations were chilblain‐like lesions (44.5%), a generalized macular or maculopapular exanthem (32.1%), a papulovesicular rash and chicken pox‐like vesicles (11.5%), painful acral red–purple papules (4.6%), urticaria (2.8%), purpuric or petechial lesions (2.3%), and livedo reticularis lesions (0.45%). Of the 218 cases, 203 cases have reported the location of lesions. The very great majority of lesions were found on the trunk, hands, and feet. Fifty‐one patients (23.4%) experienced lesions on the trunk. The time of onset of cutaneous lesions was variable. At the diagnosis or the onset of COVID‐19 symptoms, 8.3% (18/218) of patients presented with cutaneous lesions. After the onset of respiratory symptoms or COVID‐19 diagnosis, 36.7% (80/218) of patients presented with cutaneous lesions. Of the 197 cases with reported healing times, healing times were up to 24 days. COVID‐19 has been associated with different cutaneous manifestations, likely of varying pathophysiology and severity, some preceding COVID‐19 symptomatology and others occurring during active disease or later in the course. Thus, heightened awareness and timely recognition of cutaneous manifestations in COVID‐19 are important for occupational physicians treating HCW with COVID‐19.

Impact de la pandémie COVID-19 sur le sommeil du personnel de soins

Objectif

Méthodes

Résultats

Conclusion

Intérêt de la médecine du travail hospitalière dans la promotion de la vaccination anti-COVID-19

Introduction

La médecine du travail est essentiellement une médecine préventive permettant de préserver la santé des travailleurs notamment en milieu de soins et particulièrement en cette période de pandémie COVID-19. Dans ce cadre, une campagne de vaccination a été organisée au sein des services de médecine du travail des hôpitaux, destinée pour le personnel de soins des secteurs public et privé non encore vacciné. Notre étude avait pour objectif de déterminer l’apport de la médecine du travail hospitalière dans cette mesure préventive.

Méthodes

Étude descriptive transversale ayant intéressé le personnel de soins non vacciné de deux centres hospitalo-universitaires publics (hôpital Charles Nicolle et hôpital Habib Thameur) et trois cliniques privées qui s’est présenté au service de médecine du travail de l’hôpital Charles Nicolle au cours de la campagne.

Résultats

Au total, nous avons colligé 824 personnels non vaccinés. Notre population ayant reçu le vaccin anti-COVID 19 était composée de 454 personnels (55,1 %). Le personnel avait un âge moyen de 39,66 ± 10,03 ans et était à prédominance féminine (72,7 %) avec un sex-ratio H/F de 0,36. Ils travaillaient dans 72,2 % dans le secteur public et occupaient des services à caractère médical dans 34,9 % des cas. La catégorie professionnelle prédominante était celle des ouvriers (27,4 %) suivie de celle des infirmiers (20,1 %).

Conclusion

Notre étude a mis en évidence un taux de participation à la vaccination supérieur à la moitié du personnel au sein du service de médecine du travail. Ce taux pourrait refléter le rôle important que joue cette discipline dans l’information et la sensibilisation du personnel à la vaccination anti-COVID 19. Par ailleurs, un renforcement de ces actions est nécessaire afin d’aboutir à une participation quasi-totale du personnel non vacciné.

Perception of mental health and professional quality of life in Tunisian doctors during the COVID-19 pandemic: a descriptive cross-sectional study

Introduction

few research studies about mental health problems in medical staff during the first wave of the COVID-19 pandemic have been reported. The Aim of the study is to assess the prevalence of anxiety and insomnia, affecting the professional quality of life of physicians during COVID-19 pandemic.

Methods

doctors answered an online questionnaire regarding their perception of insomnia, anxiety and professional quality of life during COVID-19 pandemic with psychological parameters including the Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI) and Professional quality of life version 5 (ProQOL5).

Results

anxiety was found in 64.8% of the participants. This disorder was respectively moderate and severe in 12.4% and 6.7% of cases. Insomnia was found in 51.4% of respondents, 29.5% of whom worked in the COVID circuit (p=0.17). Insomnia was assessed as mild, moderate and severe in respectively 38.1%, 11.4% and 1.9% of cases. Compassion satisfaction was moderate in 72.4 of cases and high in 24.8% of cases. The entire population with low CS belonged to the 20-29 age group (p=0.019). Compassion satisfaction was statistically higher in married people (32.7%) (p=0.004). This entity varied significantly with occupational grade (p=0.003), seniority in grade (p=0.011) and working in the private health sector (p=0.046). Burnout was moderate in 73.3% and low in 26.7% of cases. Burnout was significantly higher among single people (p=0.03) and statistically altered in the staff working in the COVID unit (p=0.028). Secondary traumatic disorder was above moderate in 69.6%.

Conclusion

a high prevalence of psychological symptoms was found among doctors during COVID-19. Medical health workers are in need of health protection and adequate working conditions.

Peritoneal mesothelioma associated with bladder cancer and occupational exposure to asbestos: A case report

Mesothelioma is a rare tumor usually located on the pleura. In this typical location, it is closely linked to asbestos exposure. However, in other locations such as in peritoneal mesothelioma, the association to asbestos remains unusual.

Visual disorders and fitness for professional driving

BACKGROUND

The professional driver's post is a security post that requires a careful assessment of the visual functions influencing the medical fitness decision. Professional driving benefits from a codified regulation regarding vision disorders. However, it suffers from several shortfalls making the task of the occupational doctor sometimes difficult.

AIM

To identify the ophthalmological pathologies that have influenced the fitness decision for professional driving and develop a fitness approach for professional driving according to the different ophthalmological pathologies encountered.

METHODS

We conducted a retrospective, descriptive study from the files of professional drivers with visual impairment who consulted the department of occupational health at Charles-Nicolle Hospital of Tunis for medical fitness decision, during the period from January 1, 2008 to December 31, 2016.

RESULTS

Sixty drivers were included in the study. The population gender was exclusively male. Mean age was 48 ± 8.43 years. A pathological medical history was found in 70% of patients, mainly represented by: Diabetes (37%) and high blood pressure (28%). Truck drivers were the most represented (45%) and the average of professional experience was 14 years with extremes ranging from zero to 33 years. In 75% of cases, patients had one or more functional complaints. The decrease in visual acuity was the common reason for consultation (55% of cases). Diabetic retinopathy was the ophthalmological diagnosis most commonly found in our study (18% of cases). Diabetic retinopathy was the leading cause of definitive disability in our study (32% of cases). Other ophthalmologic causes of definitive disability were: Glaucoma, amblyopia, homonymous haemianopia, age-related macular degeneration, blindness or functional loss of one eye, diplopia, retinal detachment and uveitis complicating Behcet's disease.

CONCLUSION

At the end of this study, we showed regulatory deficiencies for which we suggested recommendations that could help the occupational physician to take medical fitness decisions.

[Effects of day shift work on quality of life and vigilance in Tunisia]

INTRODUCTION

Alternate work is known to cause physical and mental health disorders for employees that can alter their quality of life and sleep.

OBJECTIVE

The purpose of this research was to evaluate workers quality of life and sleep in situations of alternate work.

RESULTS

In total, 391 workers answered the questionnaire. According to the type of schedule, 320 employees worked alternately on a 2×8 shift schedule and 71 worked on a permanent night shift schedule. The group of employees working at night had a better quality of life than the group of employees working in 2×8 in terms of both their physical and mental scores (P &lt; 10-3). Type 2×8 workers were found to have excessive daytime sleepiness as compared to those on fixed night schedules.

CONCLUSIONS

Shortly, we can deduce from this study that alternating day shift work causes a deterioration of workers' quality of life of and generates sleep disorders..

[Evaluation of psychosocial constraints among grocery stores workers in Tunisia]

BACKGROUND

The identification of psychosocial constraints in the sector of mass retail is necessary to set up and guide preventive strategies.

AIM OF THE STUDY

To evaluate the prevalence of psychosocial constraints among employees working in a large supermarket chains.

METHODS

A descriptive cross-sectional survey conducted in employees of grocery stores. The study was based on a questionnaire exploring their socio-professional characteristics and on the Karasek questionnaire.

RESULTS

245 workers participated in the study. The average age was 32.4±6.4 years. Sex-ratio was 0.84. Occupational seniority was 6.3 years (min=1 year; max=18 years). The category of employees was the most represented (56%); the cashiers and the executives represented respectively 24.5 and 19.5%. A job strain situation was observed in 28.2 % of cases. It varied significantly with occupational seniority (p=0.03). The employees and the cashiers represented the most exposed posts. A high job demands was observed in 48,2% of the cases. The employees working in a supermarket are more exposed than those working in a minimarket (p<0,001). A low job control was found in 61.2 % of cases. It was more important among the employees having a permanent employment contract (p=0.01). A low job suport was found in 65,3% of cases. A situation of isostrain was observed in 20%.

CONCLUSION

According our results, workers in grocery stores are exposed to psychosocial risk factor. The implementation of strategies to reduce stress factors at work is required.

A national survey of occupational exposures in Tunisia

INTRODUCTION

The evaluation of occupational exposures allows to guide preventive strategies and to suggest adequate solutions.

AIM

Identify occupational exposures and constrains among workers of private sector in Tunisia.

METHODS

A descriptive study including all companies of the private sector who are adhering to a service of occupational health of 17 Tunisian governorates. The survey was exhaustive for the services having less than 500 companies and by sampling for the services with more than 500.The data collection was based on data sheet completed by the occupational physician.

RESULTS

This investigation concerned 1653 companies employing 161 517 employees. The industrial sector represented 52.8 %.Small and medium-sized enterprises represented 92.6 % of the studied companies. Companies having a committee of Health and Safety at work represented 16.82 % and 22.14 % had a safety officer. Posturales constraints are the most represented exposures (56%) followed by gestural constraints (27%). Heavy lifting concerned 17% of workers. Exposure to noise represented the third professional nuisance, 23% of employees are exposed. The employees exposed to organic solvents were among 16695 (10.34 %), distributed on 685 companies.

CONCLUSION

This study allowed us to identify and to rank the professional exposures and constrains in the Tunisian private sector. This could lead to improving targeted strategies of prevention occupational risks.

Epileptic seizures and occupational exposure to solvents: a cases series

INTRODUCTION

Organic solvents (OS) are substances with well-known nervous system tropism. Long-term exposure can cause several neurological and neuropsychic manifestations (mainly toxic encephalopathy). A potential causal relation between epileptic seizures and exposure to OS remains controversial.

METHODS

We report seven cases of patients with no neurological history who had been professionally exposed to OS and who had at least one epileptic seizure after exposure. Selection of these cases was based on medical records of patients who were referred to the occupational health department of Charles Nicolle Hospital of Tunis during the period from January 1, 2010 to December 31, 2014.

RESULTS

Cases studies concerned five men and two women aged between 29 and 46. Professional seniority ranged from 2 to 31 years. In all cases, epileptic seizures occurred after exposure to a mixture of solvents. It was concluded, according to workplace inspections, that there was an important daily and direct OS exposure. Working conditions were considered as defective. Six cases had generalized seizures, one patient presented with status epilepticus. Illness onset occurred between one and nine years after the beginning of exposure to OS.

CONCLUSION

These cases suggest a possible relationship between OS exposure and onset of epilepsy.

Epileptic seizures and occupational exposure to solvents: a cases series

INTRODUCTION

Organic solvents (OS) are substances with well-known nervous system tropism. Long-term exposure can cause several neurological and neuropsychic manifestations (mainly toxic encephalopathy). A potential causal relation between epileptic seizures and exposure to OS remains controversial.

METHODS

We report seven cases of patients with no neurological history who had been professionally exposed to OS and who had at least one epileptic seizure after exposure. Selection of these cases was based on medical records of patients who were referred to the occupational health department of Charles Nicolle Hospital of Tunis during the period from January 1, 2010 to December 31, 2014.

RESULTS

Cases studies concerned five men and two women aged between 29 and 46. Professional seniority ranged from 2 to 31 years. In all cases, epileptic seizures occurred after exposure to a mixture of solvents. It was concluded, according to workplace inspections, that there was an important daily and direct OS exposure. Working conditions were considered as defective. Six cases had generalized seizures, one patient presented with status epilepticus. Illness onset occurred between one and nine years after the beginning of exposure to OS.

CONCLUSION

These cases suggest a possible relationship between OS exposure and onset of epilepsy.

Fitness for work of hospital personnel in sickness absence

INTRODUCTION

The evaluation of fitness for work can be conducted upon the employer's request even during the employee's sickness absence.

AIM

Determine the contribution of conducting medical examinations to assess the working ability of Charles Nicolle hospital's workers who are on sick leave.

METHODS

A descriptive and retrospective study included all the medical records, completed over a two-year period (2013-2014), of Charles Nicolle hospital's personnel who were on sick leave and who consulted the service of occupational medicine and professional pathology to undergo a fitness for work evaluation requested by the employer.

RESULTS

Our study was based on a total of 170 cases of sickness absenteeism reported from a population of 133 employees. The average age of the study population was 39 years (+/- 9.5) with a sex ratio of 0.51. The category of nurses was the most represented (44.4 %). The average work seniority was 10.6 years (+/- 8.4). It is worth notifying that in 65.3% of the cases (111/170), medical examinations were conducted on the employees during the time they were off work. However, in the remaining 34.7 % of the cases (59/170), medical examinations were conducted on the employees after they go back to work. Our study showed that among the 111 employees who were subject to a medical examination during their sickness absence, 88 of them, which is the equivalent of 79.3 %, were found to be fit for work. Among those, 8 cases were fit for work but with some restrictions. A temporary unfitness for work was indicated in only 20.7% of the cases (23/111).

CONCLUSION

Our study unveiled a discrepancy between sickness absenteeism and fitness for work in Charles Nicolle hospital. Employees on sick leave had the physical and the mental abilities that would allow them to work with some individualized accommodations based on their health-related needs.