Surdité professionnelle dans une industrie automobile de la région du centre Tunisien reconnaissance et indemnisation

Objectif : La surdité professionnelle pose encore des problèmes de reconnaissance et d’indemnisation en Tunisie. L’objectif de notre étude est d’analyser les conditions de reconnaissance et d’indemnisation de la surdité professionnelle auprès des travailleurs d’une industrie automobile.Matériel et méthodes : Nous avons mené une étude descriptive rétrospective qui a porté sur les salariés de la Société Tunisienne d’Industrie Automobile (STIA) victimes de surdité professionnelle reconnue par la Commission Médicale du centre sur une période de cinq ans (2003 à 2007).Résultats : Un total de 81 dossiers de surdité professionnelle reconnue a été colligé durant la période d’étude. Notre population était constituée par une main d’oeuvre masculine qualifiée (50,6%) et non qualifiée (38,3%) ayant une ancienneté moyenne dans le poste bruyant de 28,7 ± 6,8 ans. Le niveau moyen d’exposition professionnelle au bruit était de 90,7 ± 3,9dB(A). Il était plus élevé dans les ateliers de presse [92,4dB(A)], de tôlerie [91,6 dB(A)] et de peinture [90 dB(A)]. La perte auditive moyenne (PAM) sur la meilleure oreille était de 65,7 ± 17,4dB. Les potentiels évoqués auditifs ont été pratiqués chez 66 patients (81,5%) et ont confirmé le diagnostic de surdité de perception dans 64 cas et d’une surdité mixte dans les 2 autres cas. L’audiométrie tonale avec prothèse auditive a été pratiquée dans 71,6% des cas et a relevé une amélioration estimée nette chez 81% des patients. Le taux moyen de l’incapacitépermanente partielle était de 21,5 ± 6,8% avec des extrêmes allant de 8 et 51%. La majorité des salariés (92,6%) avaient un taux d’IPP entre 15 et 35%. La PAM > 60 dB a été statistiquement corrélée avec la catégorie professionnelle (p=0,017) et l’ancienneté au travail (p=0,039).Conclusion : La réparation de la surdité professionnelle présente encore des limites et des imperfections liées aux critères de reconnaissances qui doivent être révisées.Mots-clés : Surdité professionnelle, Bruit, Industrie automobile, Réparation

Occupational Noise Exposure and Diabetes Risk

Introduction. Noise is one of the most common worldwide environmental pollutants, especially in occupational fields. As a stressor, it affects not only the ear but also the entire body. Its physiological and psychological impacts have been well established in many conditions such as cardiovascular diseases. However, there is a dearth of evidence regarding diabetes risk related to noises. Aim. To evaluate the relationship between occupational exposure to noise and the risk of developing diabetes. Methods. This is a cross-sectional analytical study enrolling two groups of 151 workers each. The first group (noise exposed group: EG) included the employees of a Tunisian power plant, who worked during the day shift and had a permanent position. The second group (unexposed to noise group: NEG) included workers assigned to two academic institutions, who were randomly selected in the Occupational Medicine Department of the Farhat Hached University Hospital in Sousse, during periodical fitness to work visits. Both populations (exposed and unexposed) were matched by age and gender. Data collection was based on a preestablished questionnaire, a physical examination, a biological assessment, and a sonometric study. Results. The mean equivalent continuous sound level was 89 dB for the EG and 44.6 dB for the NEG. Diabetes was diagnosed in 24 workers from EG (15.9%) and 14 workers from NEG (9.3%), with no statistically significant difference (p=0.08). After multiple binary logistic regression, including variables of interest, noise did not appear to be associated with diabetes. Conclusion. Our results did not reveal a higher risk of developing diabetes in workers exposed to noise. Further studies assessing both level and duration of noise exposure are needed before any definitive conclusion

Effects of music therapy on occupational stress and burn-out risk of operating room staff

The operating theatre staff is exposed to various constraints such as excessive working hours, severe medical conditions and dreadful consequences in case of malpractice. These working conditions may lead to high and chronic levels of stress, which can interfere with medical staff well-being and patients quality of care. The aim of this study is to assess the impact of music therapy on stress levels and burn-out risk on the operating room staff. This is a pre-experimental study including the operating rooms staff of urology and maxillofacial surgery in the academic hospital of Sahloul Sousse (Tunisia) over a period of six weeks. The study consisted of three phases. The first was an initial assessment of stress level with a predefined survey. The second included three music therapy sessions per day over one month. The third was an immediate stress level reassessment following the intervention. Stress levels were evaluated using the Perceived Stress Scale version PSS-10 and the Maslach Burnout Inventory. The overall response rate was 73.9%.The average age of the study population was 37.8 ± 7.7 years with a female predominance (64.7%). After the music therapy program, Perceived Stress Scale average score decreased from 22 ± 8.9 to 16 ± 7.9 (p = 0.006). Concerning the burnout, only the average score of emotional exhaustion decreased signifi- cantly from 27 ± 10.8 to 19.2 ± 9.5 (p = 0.004). Music therapy is an innovative approach that seems to reduce operating theatre staff stress. It must be considered as a non pharmacological, simple, economic and non invasive preventive tool

Contribution of Patch Tests with Occupational Handled Products in the Diagnosis of Occupational Contact Dermatitis: A 10-year Review

Introduction. Allergic contact dermatitis (ACD) is a common occupational disease. Its diagnosis is essentially based on interrogation and patch tests. However, commercially available batteries are sometimes not appropriate for the working conditions and the handled products, which must then be tested. In Tunisia, no previous study has focused on the contribution of patch tests with handled products in the workplace. The objective of this study is to establish the sociodemographic and occupational profile of the patients benefiting from patch tests with handled products in the workplace to identify the characteristics of these products as well as to evaluate the relevance of their positivity and their contributions in terms of aetiological diagnosis of occupational ACD. Methods. This is a retrospective descriptive epidemiological study conducted for a period of 10 years from January 1st, 2006, to December 31, 2015, among patients exercising a professional activity and consulting the Dermato-Allergology Unit of the Occupational Medicine ward of the University Hospital Farhat Hached of Sousse for the exploration of ACD. Results. During the study period, 113 patients received patch tests of handled products in the workplace with a prevalence of 7.3% of patch-tested patients during the same period. The mean age was 35.79 ± 9.45 years with a male predominance (sex ratio = 1.35). The most represented activity sectors were the health sector in 30.1% and the textile sector in 21.2%. The majority of patients were professionally active (61.9% of the study population) with an average professional seniority of 10.28 ± 8.49 months. In total, 138 patch tests with handled products were carried out of which 46 tests were positive (33.3%). After the analytical study, variables independently significantly associated with the positivity of patch tests with handled products in the workplace were the male gender and the working in the plastics industry. An occupational disease was declared to the National Health Insurance Fund for 8 patients, i.e., 7.1% of cases. Conclusion. Patch tests with handled products in the workplace can provide strong arguments for the professional origin of the ACD