[Occupational low back trauma in Tunisia]

In Tunisia, eight researches works, dealing with low back trauma [LBT], have been achieved in some occupational sector activities and only 2 of them have been published. To synthesize data provided by these 8 works realized between 1998 and 2007, in order to estimate the disorder magnitude and to describe LBT victims profile in Tunisia. The global population of study is made of 1357 LBT victims [977 belonging to the private sector and 380 to the public sector]. The data collection was carried out according to an uniformed model for the 8 studies. In the public sector, Commission M‚dicale Centrale data show that LBT account for 4 to 5% of occupational accidents [OA] and that their annual incidence is from 32 to 36/100000. In the private sector, Caisse Nationale d'Assurance Maladie data reveal that LBT account for 7.7% to 9.5% of OA. LBT victim is a male [83%], with an age ranging between 36 and 43.5 years, married [84%], educated up to the secondary educational [91%] with a vertebral disorders history [34%]. He belongs to the general-purpose workmen category in 1/2 of cases with an average seniority ranging between 7.8 and 16.2 years. LBT almost subjects, get at least of a sick leave. Work days lost is around 210 days for the private sector and 18 days for the public. The per annum amount versed for each LBT case, within the framework of the Total Temporary incapacity, is of 1449.319 DT and 45% of the subjects profit from a professional reclassification. Our results join those of international studies having dealt with LBD in professional environment. In spite of some limiting methodological issues, they allowed us to provide to professionals in occupational health useful data for this occupational risk management

[Occupational Carpal tunnel syndrome [Concerning 27 cases]]

Carpal tunnel syndrome is the most frequent of tunnel syndromes in the field of the professional sphere. It is related to repetitive movements of flexion-extension of the wrist and fingers or to a support on the heel of the hands. To determine the posts in a risk and to specify the modalities of guaranteed reimbursement of professional carpal tunnel syndrome. A retrospective and descriptive study of 27 medical files of employees indemnified for professional carpal tunnel syndrome registered in the medical control services of the social security office in charge of medical insurance of Tunis and Sousse during a period of 10 years [1995 - 2004]. There were 24 women and 3 men with the average age of 40 years all occupying posts in a risk. Their average time of service is 15 years. Two-thirds of them work in the clothing and textile industry. The attack is bilateral in 13 cases. Nightly acroparaesthesia rules the clinical rate [44.44% of cases]. Motor disorders are noted in the quarter of cases. The electromyogram had confirmed diagnosis in all of cases. The previous state study put in evidence the antecedent of carpal tunnel syndrome in 5 cases and diabetes in one case. Twenty-one patients had profit of permanent partial incapacity with a rate varying from 3 to 25%. Five had got a transfer of working place and one stayed in the same post with a half-time work. The professional origin of carpal tunnel syndrome must be called up in front of an activity in a risk. The reparation is done according to picture 82 of occupational diseases

[Place of the functional treatment and the multidisciplinary approach in the coverage of occupational accidents lumbar vertebra]

The chronic affections of the rachis lumbar vertebra are a challenge for XXI-th century. Epidemiological observations have to incite us to think about new modalities of coverage. The objective of our work is to discuss the place of the functional treatment in the coverage of occupational accidents lumbar vertebra [ATL] and to analyze new multidisciplinary therapeutic practices. Our study is retrospective concerning 242 files of occupational accidents lumbar vertebra examined by the medical commission of Tunis of the national social security [private sector] authorized to fix the partial permanent incapacity resulting from occupational accidents and from professional diseases during 5 years. We convened subjects having a global rest superior to one year [44 patients], 27 of them are present [61.3%]. These last ones were examined after an average duration of 7, 2 years from the initial ATL. The characteristics of this group of 27 insurants will be compared with those of the 242 victims of ATL. the functional treatment in the two groups is lower than those of the literature. Subjects which did not benefit from rehabilitation leave more in the pension and keep less the same job after occupational accident. Functional rehabilitation is important in the evolution of the ATL and in the improvement of the professional preview