Health-related Quality of Life and Determinants of the Mental Dimension Among Tunisian Nurses in Public Hospitals.

BACKGROUND: The health-related quality of life (HR-QoL) has been in-creasingly investigated in health sciences. The Objectives of this study are to evaluate the HR-QoL among nurses in Tunisian public hospitals and to identify the determinants of its mental dimension. METHODS: A cross-sectional, bi-centric study was conducted within a representative sample of the 1,179 nurses assigned to 28 departments of two Tunisian public hospitals. A structured inquiry (socio-professional characteristics, occupational perceived workload) and validated questionnaires (SF12, Job Content Questionnaire of Karasek, Work Ability Index) have been completed. RESULTS: Response rate was equal to 97.34%. The mean age of nurses was 42.60 ± 21 years. Nearly half of caregivers (49.07%) had a poor mental quality of life. The multivariate analysis concluded that mental HR-QoL was correlated with the female gender (0.010), obesity and the non-practice of regular physical activity (0.027), musculoskeletal diseases (<10-3), the low ability to work (<10-3). This deterioration of the mental HR-QoL dimension was also associated with the job tenure (0.002), the perceived workload (0.015), and conflictual relationships with colleagues (0.006) the feeling of insecurity at work (0.034), and the intention to leave the profession early (0.007) Conclusion: The results of this study showed that a considerable number of nurses had a poor mental quality of life. This study also identified factors associated with this deterioration. Acting on these determining factors may improve the well-being and global health of nurses, as well as their work performance and quality of care provided.

Quality of Life of Healthcare Workers Suffering from Occupational Contact Dermatitis.

BACKGROUND: Healthcare workers are at a high risk of developing Occupational Dermatitis (OD). Affected workers often experience severe impairment of their Quality of Life (QoL). This study aimed to assess the skin-related QoL of healthcare workers with OD and to explore its related factors. METHODS: A cross-sectional and exhaustive study was conducted among healthcare personnel of four public hospitals in the central region of Tunisia. All the cases of OD declared were included. Skin-related QoL was assessed using the validated Tunisian version of the "Dermatology Life Quality Index" (DLQI). Some related patents have also been discussed. RESULTS: A total of 37 cases of OD were collected with an annual incidence of 4.2 cases per 10000 workers. The population was predominantly female (73%) and the mean age was 44.7±9.4 years. Nurses were the most represented occupational category (38%). Allergic contact dermatitis was the most frequent diagnosis (96%). The use of gloves was the most frequently reported occupational hazard (86%). The most frequently affected sites were hands (97%). The median score of DLQI was five. Multivariate analysis showed an association between the impairment of skin-related QoL and female gender (p = 0.04; OR = 19.3,84), exposure to disinfecting chemicals in the workplace (p = 0.01; OR = 17,306) and the absence of occupational reclassification (p = 0.01; OR = 21,567). CONCLUSION: About one-third of the population had an impaired quality of life. The score impairment was significantly related to the female gender, exposure to disinfecting chemicals and the absence of occupational reclassification.

When the Hijab causes death in workplace : A case series.

In eastern countries, Muslim females wear the Hijab, all the time, conforming to a moral standard of modesty and privacy. Worn in workplaces, the Hijab can causes accidents leading to death. In this context, we report three fatal work accidents related to the Hijab. In two cases, death occurred instantaneously. In all cases, death was attributed to mechanical asphyxiation.

Does Ramadan fasting affect the physical workload?

AIM: To quantify the physical workload during the Ramadan 2015 (summer season) and to verify if this load changes significantly compared with periods of non-fasting (in summer or winter seasons). METHODS: It was an18-month prospective cohort study conducted in a brickyard and a textile manufacturing company located in the governorate of Monastir (Tunisia). It was based on the results of three visits: The first one (V1) was carried out in the month of Ramadan in the hot season, the second visit (V2) took place in the hot season outside of Ramadan and the third one (V3) was in the cold season outside of Ramadan. During these visits twelve male workers from each company matched by age filled out a questionnaire and went through a heart rate recording according to the recommendations of the analysis level of the International Organization for Standardization 8996 enabling the evaluation of the physical workload. RESULTS: During Ramadan, the physical workload was rated as «Medium¼ without any significant difference between the equivalent metabolic rate means ± SD of the two groups (287.00±70.5 and 224.21±43.01W respectively in the brickyard and in the textile manufacturing company). The working metabolic rate and the percentage of use of the maximum working capacity decreased in V2 and in V3 with no significant difference between the two companies and the three measurement visits. CONCLUSION: The physical workload in the month of Ramadan measured in two different activity sectors was found to be «Medium¼ and did not significantly differ from that noted in the non-fasting periods (outside of Ramadan).

Prévalence et déterminants des troubles musculosquelettiques des membres supérieurs chez les artisans tunisiens.

Musculoskeletal disorders (MSDs) of the upper limbs are a major occupational health problem. We report the results of a cross-sectional survey of 334 craftsmen from the governorate of Monastir in Tunisia. The objectives of this study were to assess the prevalence of MSDs among these workers and determine their risk factors. A pre-established questionnaire based on the Nordic MSD questionnaires, Karassik and the one developed by Malchaire in 2000 was used. In the 12 months prior to the survey, the prevalence of MSDs was 92.0%. The risk factors identified were related to individual characteristics, psychosocial factors and work organization. Appropriate preventive measures seem necessary in this sector.

[Semi-quantitative ergonomic analysis of the biomechanical constraints within the cervical spine among screen-operators in the Tunisian universities]. / Analyse ergonomique semi-quantitative des contraintes biomécaniques du rachis cervical parmi les opérateurs sur écran dans les établissements universitaires tunisiens.

INTRODUCTION: This study aims to evaluate the biomechanical constraints associated with neck pain among screen-operators. METHODS: We conducted an ergonomic study of 325 screen-operators in 25 Tunisian universities based on an anthropometric evaluation of on-screen work and on a semi-quantitative analysis of video recordings of the activities of employees over a representative period of 30 minutes. RESULTS: The prevalence of neck pain was 72.3% in a working population who had to seat in an unsuitable chair and to use an unsuitable worktop (84.6%) and a screen too low with regard to horizontal gaze (81.2%). A semi-quantitative analysis, using video recording of the workstation, concluded that the nape flexed more than 40 degrees for 69% of overall working time. Lateral flexion was observed for 50.3% of working time and right or left rotation for 57.4% of working time. Thus, the most limiting head posture on a postural and gestural level was observed when screen-operators read on a computer screen, had an incorrect positioning of the keyboard and consulted documents. CONCLUSION: Our results highlight the importance of biomechanical constraints associated with a design of on-screen work which is not in accordance with the ergonomically recommended anthropometric dimensions. These constraints are associated with a high prevalence of neck pain, reflecting the need to ensure an ergonomic design of workstations in order to prevent this problems.

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.

[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.