Strain-based work-to-family conflict as a predictor of lumbar and cervical pain in Tunisian nursing staff.

Objective. This study aimed to examine the association of the different dimensions and forms of work-family conflict with the occurrence of neck and lower back pain (LBP) in Tunisian nurses. Methods. We conducted a cross-sectional study on nurses assigned to a district hospital in Tunisia. The work-family interface was assessed with the work-family conflict scale of Carlson et al. Psychosocial and organizational constraints at work were assessed through the nursing work index - extended organization in its specific version designed for nurses. Assessment of neck and lumbar pain was carried out with the standardized Nordic musculoskeletal questionnaire. Results. Seventy-two nurses participated in the present study (participation rate = 100%) with a mean age of 42.38 ± 10.85 years. Binary logistic regression analyses retained strain-based work-to-family conflict as a significant determinant of both LBP (p < 10-3; odds ratio [OR] = 5.07; 95% confidence interval [CI] [2.1, 11.7]) and neck pain (p = 0.001; OR = 6.8; 95% CI [2.13, 22]). Conclusions. Strain-based work-to-family conflict was found to predict lumbar and cervical pain more than the other types of conflict in nursing staff. Thus, reducing strain in health-care settings should be a central component of the preventive approach of musculoskeletal disorders in nursing staff.

[Occupational asthma compensation in the Tunisian Center: cross-sectional study over a period of eight years]. / Asthme professionnel indemnisé dans le centre tunisien: étude ransversale sur huit ans.

INTRODUCTION: Our study aimed to highlight the epidemiological profile of patients compensated for occupational asthma in the Tunisian Center, to identify their professional characteristics and to determine compensation practices for this occupational disease. METHODS: We conducted an exhaustive retrospective study over a period of eight years. This case study included workers with occupational asthma diagnosed and compensated in the Tunisian Center by the only two medical commissions empowered to set rates for permanent partial disability caused by either a work-related injury or an occupational diseases in the seven central governorates. RESULTS: A total of 129 workers, with average age of 40.6 ± 7.75 years were compensated for occupational asthma during the study period. Sex ratio was 0.66. The most incriminated etiologic agents were vegetable dust pollution in the textile industry (75.2%), wood dust, flour and isocyanates. Nonspecific bronchial hyperreactivity was found in 38% of cases, a high rate of IgE in 14% of cases and positive skin prick test in 10.9% of cases. The average rate of permanent partial disability was 25.6 ± 14.2%. On the basis of the analytical study, this rate was related to patient's age and to the medical commission which had set this rate. CONCLUSION: This study of workers compensated for occupational asthma provides relevant data about epidemiological and clinical features of diagnosed patients and committee practices in particular, in term of application of the voluntary indicative scale, but it does not allow an assessment of the prevalence of this pathology which is often underestimated.

The Quality of Life and Professional Future among Tunisian Workers Suffering from Occupational Asthma.

OBJECTIVE: To identify the factors influencing the quality of life and professional future of patients suffering from occupational asthma. METHOD: A cross-sectional study of patients compensated for occupational asthma in Tunisian center during 2004-2011. The study of quality of life was based on the Asthma Quality of Life Questionnaires (AQLQ). Some related patents were also discussed. RESULTS: One hundred twenty-nine patients were compensated and the mean age was 40.8 ± 7.6 years. The global score of quality of life was 3.65 ± 0.75. The group of employees having a "bad quality of life" included 82 patients (77.3%), 73 patients kept the same job (56.6%), 20.9% had an occupational reclassification, 13.9% were dismissed, 6.2% abandoned their job and 2.3% were put in disability. The analytical study of the quality of life showed that: - The global score was correlated with the fact of keeping the same job and the application of preventive measures. - The score in the "symptoms" area was correlated with working in the textile sector and the association with an occupational rhinitis. - The score in the "activity limitation" area was correlated with age. The analytical study of the professional future revealed that maintaining the same job was correlated with low rates of permanent partial disability. CONCLUSION: Our study revealed the need to implement early preventive measures and to establish a systematic review of the permanent partial disability rate attributed to workers suffering from occupational asthma before the end of the legal period of five years.

[Career concerns among occupational physicians serving on the Institutes for Occupational Safety and Health in Tunisia]. / Préoccupations de carrière chez les médecins de travail des groupements de Médecine de travail en Tunisie.

INTRODUCTION: Career dissatisfaction among occupational physicians (OP) may affect their performance and the quality of healthcare services provided. Our study aims to assess the job satisfaction of OP serving on the Institutes for Occupational Safety and Health(IOSH) in Tunisia and to identify the determinant factors. METHODOLOGY: We conducted a national cross-sectional validated SAPHORA JOB survey among all the OP serving on 22 IOSH. RESULTS: 58% of OP serving on the IOSH were dissatisfied with their career. Career satisfaction was statistically influenced by the number of healthcare facilities for which they were responsible (p=0.016), the work organisation (p=0.010), the work impact (p=0.011), the salary (p<10-3) and knowledge on current regulation (p=0.047). CONCLUSION: The standardisation of pay scale and career ladders for OP serving on the IOSH based on a revision of legislative texts is recommended. Improving organization and working conditions may allow success in the workplace and benefit enhancement.

Determinants of Grip Strength in Tunisian Nurses: A Bicentric Study.

BACKGROUND: Grip muscle force has always been used to assess functional limitations in elderly. Its use as a tool to assess work capacity has never been described in the literature. OBJECTIVE: To describe the patent determinants of grip strength and the usefulness of its measurement in assessing workability index in the healthcare sector. METHODS: This is a cross-sectional study conducted in a sample of 293 healthcare workers representative of 1181 based on a comprehensive questionnaire about socio-professional characteristics and on an 8-item work capacity evaluation (WAI). Besides, Body mass index was measured and muscle strength was assessed by JAMAR hydraulic dynamometer. RESULTS: Handgrip Strength was stronger in male nurses (p < 0.001), with low perceived physical load (p = 0.0001) and working on a night shift (p = 0.001). It decreased with a greater duration of household work (p < 0.0001) and increased with a greater BMI (p = 0.015) and a better workability index (p < 0.0001). After removal of all the variables that were not independently associated with the muscle strength force, factors accounting for 52.6% of the variance in nurses handgrip strength were gender (p < 0.001), workability index (p < 0.001), duration of household work (p = 0.021), BMI (p = 0.002), perceived physical load (p < 0.001) and work schedule (p = 0.002). CONCLUSION: Grip Strength Test is a useful tool to assess strength and functional capacity at work in healthcare workers. Further longitudinal studies are required to confirm this hypothesis.

Work related asthma in the textile industry.

Nowadays, occupational asthma is the most common form of occupational lung disease in the world. In some countries the textile industry remains an important source of potential agents causing occupational asthma. In the textile industry several agents such as cotton dust and dyes may cause occupational asthma. In this review, we discuss the epidemiology, pathogenesis/mechanisms, clinical presentations, management and prevention specific to occupational asthma in the textile industry.Work-related asthma risk is considerable. Current understanding of the mechanisms by which many textile agents cause occupational asthma is limited, especially for low molecular-weight sensitizers and irritants. The diagnosis is generally established on the basis of a suggestive history of a temporal association between exposure and the onset of symptoms and objective evidence that these symptoms are related to airflow limitation. Early diagnosis, elimination or reduction of exposure to the offending agent and early use of convenient therapy according to disease severity may play an important role in the prevention of long-term persistence of asthma. Its prevention in the textile industry should be both technical and medical. It depends on the difficulties to reduce dust level, the limits in arranging work station or in occupational rehabilitation. These difficulties are increased in small textile industry companies. Persistent occupational asthma in this sector is often associated with substantial disability and consequent impacts on income and quality of life. Prevention of new cases is the best approach to reduce the burden of asthma attributable to occupational exposures. This review also outlines different patents on the diagnosis and treatment of asthma.

Occupational allergy in healthcare workers.

Occupational healthcare may expose to various allergens and irritants. Thus, the allergic manifestations in nursing staff are frequent and their prevalence is increasing all over the world. In fact, many new substances continuously appear in the medical practices. These allergic manifestations include a wide spectrum of clinical symptoms such as ocular, nasal and especially bronchial symptoms, which can be isolated or associated. These diseases can be a source of many problems related to the occupational aptitude. All these conditions justify prevention procedure strengthening, which mainly consist in substituting the sensitizing agents, and applying collective and individual prevention measures. This article also refers to some patents on the treatment of allergy.