Lung cancer is a public health problem. In Tunisia, the incidence of these cancers is increasing, especially in women. Smoking is a universally recognized risk factor. However, the part of environmental and professional exposures is not insignificant. Therefore, it is important to determine the occupational factors involved in the genesis of primary bronchopulmonary cancers.
Methods
A case-control study of 109 histologically confirmed cases of lung cancer and 109 controls matched for gender and age group (±5 years) was conducted. We collected information on socio-demographic characteristics, medical data, and occupational history. A job-exposure matrix was used to infer exposure to lung carcinogens.
Results
Cases were older than controls (mean age: 60 and 58 respectively, p=0,45). Only11,9% of cases were never-smokers, compared with 40,4% of controls. A significant association existed between smoking and lung cancer (p<10–3, OR= 4,99 IC95%= [2,49–10]). Workers in the categories construction sector (p=0.01; OR IC95% = 1,95 [1,12–3,40] ) and hotels sectors (p=10–3; OR IC95% = 5,90[1,94–17,90] ) showed signicantly increased risks of lung cancer. When determined by job task exposure matrix, crystalline silica (p=0,03 ; OR IC95%= 3,06 [1,06–8,83]), diesel emissions (p=0,01 ; OR IC95%=0,99[0,99–1]), chromium (p=0,01 ; OR IC95%=0,99[0,99–1]) and nickel (p=0,0 ; OR IC95%=0,99[0,98–1]) were signicantly associated with lung cancer.
Conclusion
Certain occupations and industries increase lung cancer risks among workers. These occupational exposures should be identified, in order to put in place effective prevention strategies.
Background: The COVID-19 pandemic is a real global health crisis. Its clinical presentation has evolved over time with an increasing number of symptoms. Olfactory dysfunction (OD) has recently been recognized as a frequent symptom relevant to screening for COVID-19, especially in pauci-asymptomatic forms. However, the underlying mechanisms of OD are not yet fully understood. Aims: To determine the prevalence of OD in healthcare workers with SARS-CoV-2 and to identify its associated factors. Methods: This is a cross-sectional, analytical study, carried out during a period of six months and including all healthcare workers at Farhat Hached Academic Hospital (Tunisia) who were diagnosed with SARS-CoV-2 by PCR, RAT, or chest CT scan. Results: A total of 474 healthcare workers were included, representing a participation rate of 85.4%. The mean age was 41.02±10.67 years with a sex ratio of 0.2. The distribution of this population by department noted that it was mainly maternity (13.9%). The most presented workstation was nursing (31.4%). OD represented 39.2% of the reasons for consultation. Hospitalization was indicated in 16 patients (3.4%). The average duration of hospitalization was 8.87 ± 7.8 days. The average time off work was 17.04 ± 11.6 days. OD persisted for more than 90 days in 35 patients (7.4%). After multiple binary logistic regression, OD was statistically associated with female gender (p =0.001; OR 95% CI: 2.46 [1.4-4.2]) and blue-collar occupational category (p =0.002; OR IC95%:3.1 [1.5-6.5]). A significant association was also noted between OD and professional seniority and absence from work duration (p =0.019; OR 95% CI: 0.97 [0.95-0.99] and p =0.03; OR 95% CI: 0.97 [0.95-0.99]) respectively. Conclusion: OD is common in COVID-19 patients. The identification of its associated factors may contribute to enhancing the understanding of its mechanism and drive therapeutic options.
Introduction: Early childhood seems to be a critical stage for allergic diseases, since it is during this period that an intensified susceptibility to environmental antigens can be developed. Objective: Determine the relationship between contact with animals during childhood and the occurrence of occupational asthma (OA)to vegetable textile dust(VTD). Materials and methods: We carried a case-control study. Cases and controls were collected from the occupational medicine department. The group of cases included patients with OA to VTD.The control group was paired according to age and gender, and randomly selected among workers with other non-allergic occupational diseases working in the textile sector. Data collection was performed using a pre-established synoptic sheet for the assessment of the socio-demographic and occupational characteristics completed from medical records and a direct phone call with each participant. Results: We enrolled 57 cases of OA and 112 controls. A predominance of women was noticed. The majority of the controls (88.4%)had contact with animals during their childhood versus approximately one third of the cases with a statistically significant difference (p<10-3).Animal contact was a protective factor for OA(OR=0.61;IC at 95%= [0.03-0.13]).OA was significantly associated with childhood contact with: poultry (p<10-3), dogs (p<10-3),cats (p<10-3),cattle (0.033),sheep (p<10-3),and goats (p=0.016).After multiple binary logistic regression, contact with cats was an independent protective factor of OA to VTD (p=0.001; ORa=0.16; ICa at 95%= [0.05-0.46]). Conclusion: Early life contact with pets may protect from the development of allergic asthma.
Introduction: Apart from its increasingly important frequency, occupational asthma (OA) has become the most important cause of occupational respiratory disorders in developed countries. The number of etiological agents continues to grow following the constant introduction of new harmful substances in industry. Objectives: Determine the prevalence and incidence of OA in our country, the socio-occupational characteristics of asthmatics, and study the forensic and social impact of such pathology. Material and Methods: An exhaustive retrospective epidemiological study was conducted in Tunisia about charts of occupational asthma cases recognized by the competent commissions of the National Medical Care Fund (CNAM) during the period ranging from January 1st 2000 to December 31st 2008. Results: 361 occupational asthma cases, accounting for a prevalence of 7.17% of all occupational diseases, were recognized during the period of the study. Occupational asthma annual incidence was estimated to be 24.42 cases per 1000000 workers. Our study population was mainly women with a sex ratio of 0.86. More than a half (57.6%) of recognized OA cases were working in the textile industry sector. Concerning the asthmatics’ professional career, most of recognized OA cases (n = 225 i.e. 70.6% of cases) kept their jobs, whereas 58 patients did not. The professional career was linked to gender with a job loss that is 1.79 time more important in asthmatic women. Conclusion: The incidence of occupational asthma in Tunisia is comparable with that found in other Mediterranean countries. A rigorous and adequate prevention is necessary and allows reducing the importance of this occupational pathology and its serious consequences.
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