Respiratory symptoms and pulmonary function impairment among textile industry workers in Alexandria, Egypt.

Occupational exposure to cotton dust is still an important cause of respiratory problems in textile workers particularly in less developed countries like Egypt. Evaluate respiratory symptoms and diseases, and pulmonary function pattern among Egyptian textile workers. Cross sectional comparative study was conducted from December 2019 to September 2020 in a textile factory in Egypt; 364 male workers (184 cotton dust exposed workers, and 180 unexposed workers) were included. Participants were subjected to an interviewing questionnaire, British Medical Research Council questionnaire, anthropometric measurements, pulmonary function tests, and byssinosis grading format. Descriptive and analytic statistics were conducted. Chronic cough, phlegm production, and shortness of breath grade I, II and III were more reported in cotton dust exposed workers than unexposed workers (P#x003C;0.01, P#x003C;0.01, and P=0.02, respectively). Prevalence of chronic bronchitis was significantly higher among cotton dust exposed workers (12%) than unexposed workers (3.9%) (P#x003C;0.01). The mean percent predicted values of lung function indices reflecting large-1irway function (VC, FVC, FEV1, FEV1%, PEFR, and FEF75) were significantly lower in cotton dust exposed workers (P#x003C;0.01). Prevalence of byssinosis was 22.8%. Workers with byssinosis had significantly higher prevalence of respiratory symptoms, chronic bronchitis, cross-shift reduction in PEFR and significant decrease in mean percent predicted values of FVC, FEV1, PEFR, FEF75, and FEF50 than workers without byssinosis. This study revealed a substantial association between cotton dust exposure at work and respiratory symptoms and morbidity. Regular measurement of cross shift change in PEFR is recommended among exposed workers for early diagnosis of byssinosis.

Prevalence and correlates of occupational noise-induced hearing loss among workers in the steel industry.

BACKGROUND: The steel industry is one of the noisiest industries, which can predispose workers to hearing loss. In Egypt, the demand for steel is increasing due to the construction of new infrastructures as bridges, flyover roads, buildings, and towers; however, little is known about the prevalence of occupational noise-induced hearing loss (NIHL) among steel workers. Understanding the distribution of the affected workers is crucial for planning prevention strategies. This study aimed to estimate the prevalence of occupational NIHL among Egyptian steel workers and identify its correlates. METHODS: This study was conducted at two steel factories in Egypt in November 2021. It involved an initial retrospective review of the factory medical records of the latest periodic medical examination conducted on workers from July to September in the year 2021 representing workers' health status in that year. Then, a case-control approach analysis was carried out. Eligible workers (n = 606) were enrolled and divided into two groups: noise-exposed workers (n = 396) and unexposed workers (n = 210). Univariate and multivariate regression analyses were performed. RESULTS: Occupational exposure to hazardous A-weighted equivalent noise level (> 85 dB) was associated with higher hearing thresholds at all frequencies (highest at 4 kHz followed by 6 kHz), particularly in younger workers below the age of 40 years. Nearly 71% of noise-exposed workers had hearing impairment, and 47% had NIHL compared with unexposed workers (45.7% and 11.9%, respectively). The probability of NIHL in noise-exposed workers was 6.55 times higher than that in unexposed workers (OR = 6.55, 95%CI = 4.13, 10.40; p < 0.001). In noise-exposed workers, age and tinnitus were independent predictors of hearing thresholds, while tinnitus was found to be an independent predictor of NIHL after adjusting for age and job duration (OR = 2.06, 95%CI = 1.01, 4.20; p = 0.045). CONCLUSION: Almost half of noise-exposed workers had NIHL. Tinnitus was found to be an independent predictor of NIHL. Decreasing noise exposure levels in steel plants is recommended to reduce hearing loss. Future research is required to study the effect of tinnitus on audiometry measurements among workers with NIHL.

Relationship Between Rotating Night Shift Work and Anthropometric Markers of Overall and Central Adiposity.

Purpose: This study aimed to investigate possible association between rotating night shift (RNS) work and anthropometric markers of overall and central adiposity among male workers. Methods: Medical records of workers who underwent medical examination at the Occupational Medicine Unit affiliated with Alexandria Faculty of Medicine were reviewed in December 2021 to extract data about RNS, overall adiposity [body mass index (BMI) from 25 to 29.9 kg/m2 indicated overweight, while BMI ≥30 kg/m2 indicated obesity], central adiposity (waist circumference ≥94 cm). Univariate and multivariate logistic regression were done to model adiposity as a function of potential demographic, lifestyle, and occupational factors. Results: Data of 647 male workers, including daytime workers (26.9%) and RNS workers (73.1%) who spent 1-5 years, 6-9 years, or ≥10 years working RNS, were analyzed. No association was found between RNS work and overall adiposity (BMI ≥30 kg/m2). In multivariate regression, age, residence, and smoking status were predictors of an increased BMI. Compared with young workers (<30 years old), the odds of an increased BMI (BMI ≥25 kg/m2) were 2.6 and 3.01 times higher among workers who were 30-<40, and 40-<50 years old, respectively [95% CI=(1.35, 5.05) and (1.19, 7.56), respectively]. Workers who lived in urban areas were less likely to have had an increased BMI (OR=0.34, 95% CI=0.16, 0.74). The odds of an increased BMI were 2.14 times higher in workers who never smoked compared with current smokers (95% CI=1.12, 4.11). No association was found between RNS and central adiposity. In multivariate regression, age was the sole predictor of central adiposity. Conclusion: The study supports the idea that RNS work might not be associated with overall or central adiposity and highlights a possible association between central adiposity and age and association between BMI and age, residence, and smoking behavior. Longitudinal, larger studies are required to explore the relationship between RNS and adiposity.

Medical professionals' job satisfaction and telemedicine readiness during the COVID-19 pandemic: solutions to improve medical practice in Egypt.

BACKGROUND: The COVID-19 pandemic has impacted medical professionals' job satisfaction and was a call to adopt telemedicine. Finding out how far medical professionals are satisfied and ready to use telemedicine would be important to improve medical practice. METHODS: Data was collected from 959 medical professionals from both the governmental and private health sectors in Egypt in 2021 using a specifically designed online questionnaire, to evaluate job satisfaction, perception of telemedicine, and propose solutions to improve medical practice. RESULTS: The study revealed low to moderate job satisfaction at governmental (27.2%) and private (58.7%) sectors. Underpayment was the most reported challenge at both sectors (37.8% and 28.3%, respectively). Dissatisfaction with government salary was independently predicted by working at the Ministry of Health and Population (OR = 5.54, 95%CI = 2.39,12.8; p < 0.001). Wage increase (46.10%), medical training of professionals (18.1%), and management of non-human resources (14.4%) were the most proposed solutions to improve medical practice in Egypt. During the COVID-19 pandemic, 90.7% of medical professionals had practiced telemedicine with moderate level of perception of its benefits (56%). CONCLUSIONS: During the COVID-19 pandemic, medical professionals reported low to moderate job satisfaction and a moderate level of perception of telemedicine. It is recommended to analyze the healthcare financing system and provide continuous training of medical professionals to improve medical practice in Egypt.

Nurses' perception and compliance with personal protective equipment and hand hygiene during the third wave of COVID-19 pandemic.

BACKGROUND: Healthcare workers' (HCWs) compliance with infection prevention and control (IPC) measures during the COVID-19 pandemic is crucial to reducing the spread of infection to their colleagues, families, and community. This study assessed the risk perception and compliance with personal protective equipment (PPE) usage, hand hygiene, and specific IPC measures and explored the factors associated with compliance among nurses during the third wave of the COVID-19 pandemic in Egypt. METHODS: A hospital-based cross-sectional survey was conducted at the Alexandria Main University Hospital (AMUH) in Alexandria city from May to August 2021, where 354 nurses were included with a response rate of 94.9%. A structured interviewer-administered questionnaire was used for data collection. Univariate and multivariate logistic regression analyses were conducted. RESULTS: The overall compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The mean risk perception score was 40.9 ± 3.3. More than 95% of nurses were aware of the high risk of COVID-19 infection at their workplace, the serious consequences of the disease, and the risk that can be minimized by using PPE, whereas a relatively low percentage of nurses believed that the risk of COVID-19 infection could be reduced by using a surgical mask (19.2%) or gloves (50.5%). Good compliance was independently predicted by risk perception (OR = 1.25; 95% CI = 1.13, 1.39), and knowledge about PPE usage and hand hygiene (OR = 3.53; 95%CI = 2.40, 5.19). Facilitators of compliance with the PPE usage were attending suspected or confirmed COVID-19 cases in their hospital ([Formula: see text] = 9.82), comfort to use the PPE ([Formula: see text] = 9.16), availability of PPE ([Formula: see text] = 8.96), hospital policy ([Formula: see text] = 8.74), and senior compliance ([Formula: see text] = 6.5). CONCLUSIONS: Nurses at AMUH reported high risk perceptions. The rate of compliance with PPE usage, hand hygiene, and IPC measures was 81.9%. The personal risk perception and knowledge about the PPE usage and hand hygiene are the keys to improving compliance in a healthcare facility.

Epidemiological, life style, and occupational factors associated with lower limb varicose veins: a case control study.

BACKGROUND: Few data were documented about risk factors for lower limb varicose veins (LLVV) among Egyptian population. Identifying modifiable risk factors is crucial to plan for prevention. The current research aims to study the epidemiological, life style, and occupational factors associated with LLVV in a sample of Egyptian population. METHODS: A case control study was adopted. Cases with LLVV (n = 150) were compared with controls (n = 150). Data was collected using an interview questionnaire and clinical assessment. Data was analyzed using the univariate and multivariate logistic regression analyses. RESULTS: According to multivariate analysis among all participants (n = 300), the odds of LLVV was 59.8 times greater for those who frequently lift heavy objects (95% CI = 6.01, 584.36) and 6.95 times higher for those who drink < 5 cups of water/day (95% CI = 2.78, 17.33). Moreover, it was 4.27 times greater for those who infrequently/never consume fiber-rich foods (95% CI = 1.95, 9.37) and 3.65 times greater for those who stand > 4 h/day (95% CI = 1.63, 8.17). Additionally, odds of LLVV was 3.34 times greater for those who report irregular defecation habit (95% CI = 1.68, 6.60), and 2.86 times higher for those who sleep < 8 h/day (95% CI = 1.14, 7.16), and 2.53 times higher for smokers compared with ex-smokers/non-smokers (95% CI = 1.15, 5.58). In addition, a standing posture at work was an independent predictor of LLVV among ever employed participants (n = 234) in the current study (OR = 3.10; 95% CI = 1.02, 9.38). CONCLUSIONS: This study highlighted seven modifiable independent predictors of LLVV mostly related to the life style, namely, frequent lifting of heavy objects, drinking < 5 cups of water/day, infrequent/no consumption of fiber-rich food, standing more than 4 h/day, irregular defecation habit, sleeping less than 8 h/day, and smoking. These findings provide a basis to design an evidence-based low-cost strategy for prevention of LLVV among Egyptian population.

Adverse health effects among nurses and clinical pharmacists handling antineoplastic drugs: Adherence to exposure control methods.

BACKGROUND: Chronic exposure to antineoplastic drugs (ADs) may result in reproductive, liver, renal, lung, and cardiac toxicity. Moreover, bone marrow suppression, mucosal ulcers, and cancer may develop. In developing countries, adverse health effects owing to occupational exposure to ADs and adherence to safe handling guidelines are not well documented. AIM: This study was conducted to determine the health effect of occupational exposure to ADs and evaluate adherence to control methods. MATERIALS AND METHODS: A comparative cross-sectional approach was adopted. ADs-exposed nurses and clinical pharmacists (n=54) were compared with nonexposed group (n=54). Self-reported clinical manifestations. and use of exposure controls were reported via an interview questionnaire. Blood samples were collected for complete blood count and liver and kidney function tests. RESULTS: Significantly higher rate of impaired fertility (31%) and oral ulcers (36.36%) were reported by ADs-exposed nurses and clinical pharmacists compared with nonexposed group (3.8 and 7.4%, respectively; P=0.01 and P=0.00, respectively). Moreover, ADs-exposed group had significantly lower mean white blood cell count (6518±2064.79/µl) and significantly higher mean creatinine level (056±0.13 mg/dl) compared with nonexposed group (7307±2001.4/µl and 0.51±0.12 mg/dl, respectively; t=2.02, P=0.04; and P=0.04, respectively). Inadequate controls were reported, mainly lack of medical surveillance (100%), lack of training (69.1%), insufficient handling practices, and low usage of personal protective equipment, particularly among nurses. CONCLUSION: The study highlighted chronic adverse effects associated with occupational exposure to ADs and inadequate implementation of exposure control methods. Findings necessitate raising awareness among ADs-exposed nurses and clinical pharmacists to introduce engineering controls, conduct hazard awareness training, initiate medical surveillance program, and ensure adherence to safe handling practices.

Prevalence and associated factors related to arm, neck and shoulder complaints in a selected sample of computer office workers.

BACKGROUND: Globally, there is an expansion in computer-related work, which may have contributed to an increased burden of complaints of the arm, neck and/or shoulder (CANS). The study was conducted to determine the prevalence and factors associated with CANS among computer office workers (OWs) in Alexandria. MATERIALS AND METHODS: Computer OWs at four banks and two telecommunication companies (n=211) were included in a cross-sectional study in 2016. Data were collected using the self-administered Musculoskeletal Upper Extremity Questionnaire-Arabic version. Potentially related factors were examined using bivariate and multivariate analyses. RESULTS: The sample comprised 95 (45.02%) males and 116 (54.97%) females. Overall, 72% aged 25-35 years. Prevalence with 95% confidence interval (CI) for CANS was 0.73 (95% CI: 0.66-0.79), 0.69 (95% CI: 0.62-0.75) and 0.70 (95% CI: 0.64-0.76), respectively. The majority of the complaints were minor (86%). Factors significantly associated with neck complaints were female sex (P=0.03), inappropriate office equipment (P=0.02), task complexity (P<0.01), break autonomy (P=0.02) and low decision authority (P=0.05). Factors significantly associated with arm/hand complaints were female sex (P=0.01), awkward body posture (P=0.05), break autonomy (P<0.01) and low break quality (P=0.04). CONCLUSION: The study revealed high prevalence of CANS and highlighted associated factors, namely, task complexity, inappropriate office equipment, low decision authority, low break quality and female sex. Improving ergonomic conditions, reducing job demands, and increasing job control are crucial to reduce CANS among computer OWs.

Study of Patterns and Markers of Human Immune Deficiency Virus -1 (HIV-1) Progression and Unemployment Rate among Patients from Alexandria, Egypt.

Middle East and North Africa (MENA) new HIV cases show the highest increase among all regions in the world. Even though Egypt has a low prevalence among the general population (< 0.02%), a national HIV epidemic occurs in certain population risk groups. The current study was conducted to asses clinical and immunological disease progression; following up viral load (VL) and detecting delta-32 CCR5 genotype polymorphism in selected cases, determining unemployment rate and identify predictors of employment for HIV-cases. A cross sectional design was adopted. HIV infected cases attending Alexandria Fever Hospital (AFH) for one year. Interview questionnaire and four CD+4 counts were done for all patients, HIV VL and delta-32 CCR5 polymorphism were done for selected cases. Sexual transmission and drug abuse are the most important risk factors. Infectious comorbidity increases the rate of HIV progression. CD4+ count at the end of the study; CD+4 (4), count was significantly higher than all other CD4+ readings among the whole cohort and among the treated group. Also, VL at the end of the study; VL(2), was significantly higher than VL(1) among the untreated group. Unemployment rate was 40%. Male gender and obtaining vocational training were significant predictors of employment. It can be concluded that having a family member living with HIV and drug abusers are high risk groups for HIV acquisition. Factors responsible for progression of HIV should be further investigated. Antiretroviral therapy is very effective in checking HIV replication rate, delaying the progression of HIV, reconstituting the immune response and should be available for all cases detected.