[Quality of life of silicotic former miners]. / Qualité de vie des anciens mineurs silicotiques.

BACKGROUND: The aim of this study was to assess the respiration-related quality of life (QoL) of former miners with silicosis and to determine the factors that could affect QoL (socio-demographic and professional parameters, toxic habits, co-morbidities, and degree of respiratory disability). METHODS: This cross-sectional study involved 104 people who came for routine periodic consultation and included the medical records file and a questionnaire. RESULTS: The average age was 66.3±5.4 years. Functional respiratory symptoms were exertional dyspnoea (97.2%), cough (73.1%), sputum (59.6%) and wheezing (25%). Associated respiratory illnesses were asthma (29.8%), COPD (18.3%), persistent rhinitis (13.5%) and tuberculosis (5.8%). 3/4 of the miners had at least one comorbidity. The most common were cardiovascular (43.3%), metabolic (27.9%) and musculo-skeletal (25%). The ventilatory defects were mild in 27.9%, moderate in 57.7% and severe in 14.4%. The radiological lesions exceeded four zones of the pulmonary parenchyma in 81.8%. The average scores for "symptoms", "activities ¼, « impacts" and "total" were 49.1±14%, 77.8±12%, 66.5±16% and 67±16%, respectively. Age, duration of exposure, comorbidities, moderate to severe ventilatory defects, and significant to severe impairment were correlated with altered QoL. CONCLUSION: Improvement of QoL requires comprehensive care with the management of complications, co-morbidities, better patient awareness, and better consideration of the feelings of patients.

[Assessing knowledge, attitude, and practice on occupational blood exposure in caregiving facilities, in Morocco]. / Evaluation des connaissances, attitudes et pratiques sur les accidents d'exposition au sang en milieu de soins au Maroc.

OBJECTIVE: This study had for aim to evaluate practices and knowledge of infectious hazards, to determine the prevalence of viral infections related to occupational blood exposure among health care workers, and to propose a preventive policy. DESIGN: This descriptive multicentric and transversal epidemiological survey was carried out from 2003 to 2004 in 10 Moroccan cities. Two thousand eight hundred and forty four persons were contacted and 2086 accepted to answer the questionnaire (73.3 %). RESULTS: The mean age was 40.8+/-7.8 years and seniority 15.6+/-7.4 years. Blood was the most incriminated product (96.1%), followed by dirty linen and hospital waste. Instruments most often mentioned as dangerous were hollow needles (80.3%). The most feared infections were viral hepatitis (77.5%) and HIV (89.3%). Only 40.6% of the personnel were adequately vaccinated against hepatitis B. Post-vaccine serology was performed on only 1.8% of the vaccinated staff. During the last 12 months, 58.9% of the personnel underwent at least one occupational blood exposure 5.8% of which was reported. Universal precautions appeared poorly used as only 65.6% wore gloves for invasive acts and 61.5% correctly disinfected their hands. Re-sheathing used needles was frequent (51.2%). CONCLUSIONS: Infectious hazards in healthcare facilities are not sufficiently taken into account: the recent creation of occupational health services in hospital facilities should contribute to improve working conditions, make hepatitis B vaccination available and mandatory, and lead to more information and education on hazards related to occupational blood exposure for healthcare personnel.

[Infectious risks associated with blood exposure for traditional barbers and their customers in Morocco]. / Risque infectieux lié au sang chez les coiffeurs-barbiers traditionnels et leurs clients au Maroc.

The trade of traditional barber has continued to expose its practitioners and their customers to multiple infectious diseases. The objective of this work was to study the infectious risk associated with blood exposure in this population and to assess its knowledge of this occupational risk. A cross-sectional epidemiologic survey was conducted in the Casablanca region during 2001 among 150 barbers, all men. It included a medical-social questionnaire and a serology work-up (HIV, HCV, HBV, TPHA, VDRL). The subjects' mean age was 36.5 years +/- 14.7, they had worked in the trade for an average of 17.8 years +/- 8.7, and the socioeconomic status of most was low. Hygiene conditions were deficient. The concept of infectious risk associated with blood was generally not well known, especially for hepatitis B and C; most were not vaccinated. HIV serology was negative for all barbers. On the other hand, syphilis serology was positive for 7% by TPHA and for 4% by VDRL. HBV was positive in 2% and HCV in 5%. It is essential and urgent to promote awareness of these risks among all, especially the public authorities, and to formally ban barbers from the illegal practice of medicine for their own protection. All means of prevention must be used to protect the health of these workers and of the general population.