First and Second Waves of Covid-19: A Comparative Study of the Clinical Presentation and Outcome among Hospitalized Patients in Lagos Nigeria.

OBJECTIVE: Nigeria experienced many waves of the COVID-19 pandemic. This study compared the clinical presentations and mortality among hospitalized patients during the first and second waves of the pandemic in Lagos State, Nigeria. METHODS: A retrospective cohort study was conducted. Deidentified medical records of laboratory-confirmed COVID-19 patients admitted into 15 isolation centers in Lagos, Nigeria between February 27, 2020, and September 30, 2020 (first wave) and October 1, 2020, and April 30, 2021 (second wave) were reviewed. IBM Statistics version 25 was used for data analysis. RESULTS: More patients were hospitalized during the first wave of the pandemic. The mean age of patients was higher during the second wave (54.5±15.8 years vs. 42.2±15.5 years, p <0.001). More patients admitted during the second wave had comorbidities (56.0% vs 28.6%, p <0.001), were symptomatic (90.8% vs 52.0%, p <0.001), had severe COVID-19 disease (58.9% vs 25%, p <0.001) and died (14.9% vs 6.4%, p<0.001) compared with the first wave. The odds of death increased with age and severity of COVID-19 disease during the first and second waves. CONCLUSION: A higher proportion of the patients admitted in Lagos, Nigeria during the second wave were older, had comorbidities, and had severe COVID-19 disease than the first wave. Despite the fewer hospitalized patients, there were more deaths during the second wave.

OBJECTIF: Le Nigeria a connu plusieurs vagues de la pandémie de la COVID-19. Cette étude a comparé les présentations cliniques et la mortalité chez les patients hospitalisés lors des première et deuxième vagues de la pandémie dans l'État de Lagos, Nigeria. MÉTHODES: Une étude de cohorte rétrospective a été réalisée. Les dossiers médicaux déidentifiés des patients atteints de la COVID-19 confirmée par laboratoire, admis dans 15 centres d'isolement à Lagos, Nigeria, entre le 27 février 2020 et le 30 septembre 2020 (première vague) et entre le 1er octobre 2020 et le 30 avril 2021 (deuxième vague), ont été examinés. IBM Statistics version 25 a été utilisé pour l'analyse des données. RÉSULTATS: Un plus grand nombre de patients ont été hospitalisés lors de la première vague de la pandémie. L'âge moyen des patients était plus élevé lors de la deuxième vague (54,5±15,8 ans vs. 42,2±15,5 ans, p <0,001). Un plus grand nombre de patients admis lors de la deuxième vague avaient des comorbidités (56,0% vs. 28,6%, p <0,001), étaient symptomatiques (90,8% vs. 52,0%, p <0,001), avaient une forme grave de la maladie à la COVID-19 (58,9% vs. 25%, p <0,001) et sont décédés (14,9% vs. 6,4%, p<0,001) par rapport à la première vague. Les chances de décès ont augmenté avec l'âge et la gravité de la maladie à la COVID-19 lors des première et deuxième vagues. CONCLUSION: Une proportion plus élevée des patients admis à Lagos, Nigeria, lors de la deuxième vague étaient plus âgés, avaient des comorbidités et présentaient une forme grave de la maladie à la COVID-19 par rapport à la première vague. Malgré un nombre moindre de patients hospitalisés, il y a eu plus de décès lors de la deuxième vague. MOTS-CLÉS: Présentation Clinique, Covid-19, Première Vague, Mortalité, Nigeria, Deuxième Vague.

Knowledge and Attitude of Fathers towards Childhood Vaccination in Ogun State, Nigeria: A Comparative Study.

ACKGROUND/OBJECTIVES: Vaccine-preventable diseases (VPDs) have been shown to account for one-fifth of deaths among under-fives. Father's knowledge and attitude greatly influence the approval and uptake of childhood vaccination in patriarchal communities. This study aimed to assess and compare fathers' knowledge and attitude to childhood vaccination in urban and rural communities of Ogun State, Nigeria. METHODS: Four hundred and forty men each were interviewed in rural and urban areas. An interviewer-administered questionnaire was used to elicit data which were analyzed with IBM SPSS version 20. Mean ages of respondents were compared using T-test while chisquare was used in testing association between categorical variables. Results were presented in tables and P < 0.05 was considered statistically significant. RESULTS: There was no statistically significant difference in the mean ages of residents in the urban and rural areas (t = -1.82, p= 0.07). A greater proportion of rural participants (51.4%) had an overall good knowledge of childhood vaccination as against 45.2% of urban men but this difference was not statistically significant with p = 0.069. A greater percentage of participants in the urban area (58.0%) had an overall positive attitude to male participation in childhood vaccination compared to 54.1% of rural men. However, this difference was not statistically significant (p= 0.204). CONCLUSION/RECOMMENDATION: There was better knowledge of childhood vaccination among rural participants. In contrast, attitude towards childhood vaccination was better among urban residents. There is a need for educational interventions that may positively influence the attitude of men towards childhood vaccinations, particularly in rural areas to be conducted by the government, health workers, and other stakeholders through various communication media and adopting diverse health education methods.

CONTEXTE/OBJECTIFS: Il a été démontré que les maladies évitables par la vaccination (MEV) sont responsables d'un cinquième des décès chez les moins de cinq ans. Les connaissances et l'attitude du père influencent grandement l'approbation et l'adoption de la vaccination des enfants dans les communautés patriarcales. Cette étude visait à évaluer et à comparer les connaissances et l'attitude des pères vis-à-vis de la vaccination des enfants dans les communautés urbaines et rurales de l'État d'Ogun, au Nigeria. MÉTHODES: Quatre cent quarante hommes ont été interrogés dans les zones rurales et urbaines. Un questionnaire administré par un enquêteur a été utilisé pour obtenir des données qui ont été analysées avec IBM SPSS version 20. Les âges moyens des répondants ont été comparés à l'aide du test T, tandis que le test du carré a été utilisé pour tester l'association entre les variables catégorielles. Les résultats ont été présentés sous forme de tableaux et P < 0,05 a été considéré comme statistiquement significatif. RÉSULTATS: Il n'y a pas de différence statistiquement significative entre l'âge moyen des résidents des zones urbaines et rurales (t= -1,82, p= 0,07). Une plus grande proportion de participants ruraux (51,4 %) avait une bonne connaissance générale de la vaccination infantile contre 45,2 % des hommes urbains, mais cette différence n'était pas statistiquement significative avec p = 0,069. Un pourcentage plus élevé de participants de la zone urbaine (58,0 %) avait une attitude globalement positive à l'égard de la participation masculine à la vaccination des enfants, contre 54,1 % des hommes en milieu rural. Toutefois, cette différence n'était pas statistiquement significative (p = 0,204). CONCLUSION/RECOMMANDATION: Les participants rurauxavaient une meilleure connaissance de la vaccination des enfants. En revanche, l'attitude envers la vaccination des enfants était meilleure chez les citadins. Il est nécessaire que le gouvernement, les agents de santé et les autres parties prenantes mènent des interventions éducatives susceptibles d'influencer positivement l'attitude des hommes à l'égard des vaccinations infantiles, en particulier dans les zones rurales, par le biais de divers moyens de communication et en adoptant diverses méthodes d'éducation sanitaire. Mots clés: Connaissance, attitude, rural, urbain, vaccination des enfants, État d'Ogun.

Epidemiology of Coronavirus Disease (COVID-19) in Nigeria

In late December 2019, there was an outbreak of a new Coronavirus infection in Wuhan, Hubei Province, China, which caused acute respiratory syndrome of unknown aetiology. The World Health Organization (WHO) named the virus Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV2) or COVID-19 and declared the infection a pandemic on the 11th of March 2020. The first case of COVID-19 in Nigeria was reported on the 27th of February 2020 and since then the numbers of confirmed cases has been on the increase, at least in Nigeria. With no vaccine or cure in sight, only public health measures that include personal protective measures, physical distancing, environmental and travel-related measures have been recommended to mitigate and contain the spread of the disease. There is need to make testing for COVID-19 widely available so that the true burden of the infection will be described. This step should assist policy makers in making evidence-based decisions in the prevention and control of the disease

MODIC CHANGES IN ADULTS WITH CHRONIC LOW BACK PAIN IN NORTH CENTRAL NIGERIA.

BACKGROUND: Modic changes in the endplates of the vertebral bodies have been associated with low back pain. There is however paucity of information on the pattern of Modic changes in the lumbosacral spine in Nigerians with low back pain. AIM: To determine the prevalence of Modic changes in patients with chronic low back pain in our environment. DESIGN OF STUDY: Cross-sectional longitudinal study. SETTINGS: University of Ilorin Teaching Hospital, Ilorin, Nigeria. METHODOLOGY: A total of 147 consecutive adults who had MRI of the lumbosacral spine for chronic low back pain were examined for the presence of Modic changes. RESULTS: 35(23.8%) individuals had Modic changes present out of I47 patients with low back pain evaluated.Out of the 735 lumbar vertebral endplates evaluated, 90(12.2%) had Modic changes present. Among the endplates with Modic changes, 36(40%) were type I, been the most common in our sample, while 27(30%) were type II and type III each. CONCLUSION: This study has shown that Modic changes occurred more frequently at the end plates of lower lumbar vertebrae(L4/L5, and L5/S1) and Type I was the most common while Type II and III had equal prevalence; the changes occurred more frequently with increasing age suggesting these changes are degenerative in nature.

Hygiene Practices among Workers in Local Eateries of Orolu Community in South Western Nigeria.

BACKGROUND: Activities of local food premises and monitoring of food handlers are usually not regulated. AIM: The objective of this study was to determine food hygiene (FH) practices among food handlers in rural communities in South Western Nigeria. SUBJECTS AND METHODS: Descriptive cross-sectional study was carried out among 235 food handlers; data collection was by interviewer administered questionnaires. Using the SPSS software, multivariate analysis in two separate models was done to explore the predictors of correct knowledge and good hygiene practices. The model fit was assessed as good using the Hosmer and Lemeshow test. RESULTS: Mean age of respondents was 31.8 (10.8) years. Of the respondents (134) that had training, 17.2% (23/134) had formal training, and 82.8% (111/134) had apprenticeship; about 31.5% (74/235) of respondents maintained a good level of hygiene in their practices. Significant predictors of correct knowledge were found to be being trained (significant 0.01, odds ratio [OR] 2.4, 95% confidence interval [CI] 1.2-4.8) and receiving the training as an apprentice (significant 0.01, OR - referent group); or in a formal setting (significant 0.01, OR 3.3, 95% CI 1.6-7.0) and having no formal education (significant 0.04, OR - reference group). CONCLUSION: Good knowledge and attitude but low level of good practices toward FH characterized food handlers under study.

Determinants of utilization of traditional bone setters in Ilorin, north central Nigeria.

BACKGROUND: Traditional bone setting (TBS) practice is an important part of health care delivery in many developing countries and has been in Nigeria for long. Despite the complications that arise from the cultural practice, TBS services is still in high demand by a significant number of people. This study was conducted to determine the factors that influence the utilization of TBS practice. METHODS: A descriptive cross-sectional study was carried out using a semi structured questionnaire to gather information from 400 randomly selected residents of ilorin West LGA in north central Nigeria. Multistage sampling technique was used in selecting the respondents. RESULTS: The respondents were between the ages of 18-72 years with a mean age of 36.3 +/- 12.3. Three hundred and three (77.3%) of the respondents know of TBS practice as a way of getting treatment for bone injuries. More than two third 210 (69.3%) of the respondents who know TBS practice as a form of treatment for bone injuries think that TBS therapy is preferable to Orthodox medicine in handling bone injuries. Reasons for preference are that it is cheap 134 (63.8%), acceptable 123 (58.6%) and accessible 109 (51.9%) to them. More than half(52.3%) of the respondents had patronized TBS treatment at one time or the other. Main reason for patronage of TBS was influence from family members and friends (53.6%). However, factors that influence the respondents decision to utilize TBS treatment include attitude of health workers 310 (77.5%), delay in hospitals 284(71.0%) fear of amputation 272 (54.35) and fear of operation 217(54.3%) in hospitals. There was a statistically significant (p < 0.05) relationship between respondents age, sex, marital status, occupation, ethnicity as well as the income level of the respondents and the utilization of TBS. CONCLUSIONS: Utilisation of TBS is quite popular among the studied population because it is believed to be cheap, acceptable and accessible to them and a high proportion of the respondents utilize TBS notwithstanding that they live in a community where they have better access to orthodox medical care. Influence from family and friends is the main reason for consulting TBS. Regulations should be made concerning the advertisement of TBS practice by relevant agencies and the public should be made aware through health education on the dangers of TBS treatment.

Community participation in malaria control in olorunda local government area, osun state, southwestern Nigeria.

Malaria is a major health burden in developing countries and needs multiple strategies for its control. Community participation as one of the strategies for malaria control promotes self-awareness and confidence, causes the people to examine the problems and to think positively about the solutions. The study was aimed at assessing the level of community participation in malaria control in Olorunda local government area of Osogbo, Osun state, Nigeria. The study employed a cross-sectional descriptive design. Multi-staged sampling technique was used to choose 550 respondents. An interviewer-administered semi-structured questionnaire was used to elicit information from the respondents. Most of the respondents (65.0%) fell between the age ranges 20-39 years, with a mean age of 32.85 ± 12 years. Almost all (98.4%) respondents had knowledge of malaria with most of them (88.0%) correctly aware that mosquito bite could lead to malaria fever. Respondents stated that stagnant pool (92.6%) and refuse dump (89.0%) could predispose to malaria. About two-thirds (60.6%) of the respondents participated in the control of the breeding sites of mosquitoes on specific days for environmental sanitation. The association between community participation in health talk and community participation in malaria control was statistically significant (p<0.000). Although only 23.0% use ITN to protect themselves from mosquito bites, there was statistical significant association between awareness of respondents about ITN and its usage (p=0.003). Knowledge of respondents about malaria was high with majority participating in malaria control measures. However, the use of insecticide treated nets (ITN) was low. Therefore, it is recommended that continuous awareness creation on the use of ITN, and continued efforts aimed at elimination of breeding sites of mosquitoes should be adopted to achieve long term control of malaria.

Community participation in malaria control in olorunda local government area, osun state, southwestern Nigeria

Malaria is a major health burden in developing countries and needs multiple strategies for its control. Community participation as one of the strategies for malaria control promotes self-awareness and confidence; causes the people to examine the problems and to think positively about the solutions. The study was aimed at assessing the level of community participation in malaria control in Olorunda local government area of Osogbo; Osun state; Nigeria. The study employed a cross-sectional descriptive design. Multi-staged sampling technique was used to choose 550 respondents. An interviewer-administered semi-structured questionnaire was used to elicit information from the respondents. Most of the respondents (65.0) fell between the age ranges 20-39 years; with a mean age of 32.85 + 12 years. Almost all (98.4) respondents had knowledge of malaria with most of them (88.0) correctly aware that mosquito bite could lead to malaria fever. Respondents stated that stagnant pool (92.6) and refuse dump (89.0) could predispose to malaria. About two-thirds (60.6) of the respondents participated in the control of the breeding sites of mosquitoes on specific days for environmental sanitation. The association between community participation in health talk and community participation in malaria control was statistically significant (p

Assessment of violence against women in Kano metropolis, Nigeria.

BACKGROUND: Violence against women, in its various forms, is endemic in communities and countries around the world, cutting across class, education, race, age, religious and national boundaries. AIMS AND OBJECTIVES: This descriptive cross-sectional study was conducted to identify various forms of gender based violence affecting women in Kano metropolis, determine factors responsible for gender based violence and use this to suggest ways of preventing gender based violence. SUBJECTS AND METHODS: Respondents for this study were selected from the eight metropolitan Local Government Areas of Kano State, Nigeria. Six hundred adult males and females were selected through a multi-stage sampling technique by the use of questionnaire as the data tool. RESULTS: More than three quarters 436 (75.7%) of the respondents knew that women are subjected to various forms of verbal abuse in their homes by their spouses. Deprivation of assess to health care and education was identified by 454 (78.8%) and 490 (85.15) respondents as challenges faced by women at homes. Majority of the respondents 498 (86.4%) identified financial reason, four hundred and forty (76.4%) respondents mentioned unfaithfulness and three-quarters 434 (75.3%) of the respondents said refusal of sexual advance is a reason for violence activities witnessed by women in their respective homes. There was a statistically significant relationship in opinion of male and female on coercion of wife for sexual activities when she is tired and when she is not in the mood (p-value=0.0000). CONCLUSION: Government and Non Governmental organisation should intensify activities to promote awareness and advocacy on violence against women. Involvement of males in all programmes relating to violence against women should be done especially since the perpetrators in most cases are men.

Preferred Choice of Health Facilities for Healthcare among Adult Residents in Ilorin Metropolis; Kwara State; Nigeria

Purpose: The choice of health facilities for healthcare by an individual is largely determined by several factors. This study aims to determine predictors of preferred choice of health facility for care. Methods: In a descriptive cross-sectional study; pre-tested semi-structure questionnaire was administered to 366 adults selected through a multi-stage sampling technique in Ilorin metropolis. Data collected were analysed using Epi Info software version 3.4.1 and level of significance set at p 0.05. Results: The preferred health facility for medical care was private hospitals (35.2) followed by pharmaceutical store (27.9) and 17.0for general/teaching hospitals and only 12.3for primary health care (PHC). Quick service and availability of drugs were the major reasons for their preference which were said to be better in private hospitals. Sex; marital status; educational status; occupation and city area where the respondents dwell are all associated with the preferred choice of health facility for care. Conclusion: This study has shown that the private sector is preferred to the public ones with regards to receiving healthcare and that within the public sector; the higher levels of health facilities are preferred to the primary health care centres. Improving the image and performance of the public health facilities especially the PHC is very important for appropriate utilization of health services

Demographic profile of mothers and their utilisation of maternal health-care services in Osun State, Nigeria.

BACKGROUND: The provision of prenatal care and the promotion of institutional childbirth have the potential to reduce maternal and neonatal morbidity and mortality. Despite this, high maternal and infant mortality is still being recorded in the developing countries and researchers still report low utilisation of maternal health care services in different communities in Nigeria. OBJECTIVE: This study examined the current level of utilisation of maternal health care in some rural and peri-urban communities of Olorunda Local Government Areas of Osun State in South Western Nigeria. METHODS: A cross-sectional descriptive study was carried out. Researchers conducted a house-to-house survey using a semi-structured questionnaire to interview adult women who are either pregnant or already had a child before. Information was collected on demographic characteristics and utilisation of maternal health care services. RESULTS: Most of the respondents (94.8%) delivered in health care facilities with the supervision of trained health personnel. The study showed a strong influence of mother's education and economic status of the family respectively (p<0.05) on the use of maternal health care services. CONCLUSION: This study revealed a higher level of utilisation of maternal health care services in the communities under study than earlier reported in Southwestern Nigeria. Continuous and sustained community education and mobilisation is essential so that women and their families learn about the need for special care during pregnancy and childbirth under trained health personnel.

Knowledge and practices of poultry workers on prevention of avian flu in osogbo, osun state, Nigeria.

INTRODUCTION: Nigeria recorded its first case of avian flu among birds early in the year 2006 and by the third quarter of the year, about sixteen states of the country had been affected. Finding out the knowledge and practices of persons in close contact with birds as regards the avian flu would help to identify areas in need of focused attention and alert the coordinating agencies of the magnitude and prevalence of practices which may encourage the spread of the disease. METHODOLOGY: This was a descriptive cross-sectional survey of poultry owners and workers in Osogbo, Osun State, southwestern Nigeria. Information was obtained from 65 of the 100 registered members of the poultry association who consented to answering questions on the pre-tested semi-structured questionnaires. RESULT: In this study, 49.1% (28) of the study sample knew of avian flu, and 46.4% (13) of these knew that the disease was present in Nigeria. Only 50% (14) of those who knew about the disease felt it could affect human beings. For those who have heard of the disease before, 85.7% (24) knew it could be transmitted from sick birds to humans. Practices which favour the spread of the virus that were engaged in by the respondents included using bird droppings as manure (71.9%), and feeding fish with intestines of killed chicken (66.7%). CONCLUSION: The study shows a low level of awareness of avian flu among the poultry workers and owners. It is recommended that massive education should be embarked upon for groups occupying strategic positions in disease epidemiology, as well as all stake holders in poultry farming.

Knowledge, attitudes to HIV/AIDS and sexual behaviour of students in a tertiary institution in south-western Nigeria.

OBJECTIVE: To determine the knowledge, attitude and sexual behaviour of students in a tertiary institution in south western Nigeria with regard to HIV/AIDS. METHODS: Descriptive cross-sectional survey conducted between January and March 2005. Information was collected from 368 students of a tertiary institution in Ede, Osun State, Nigeria. Participants were selected by a multi-stage sampling method and data obtained using a semi-structured pre-tested questionnaire. RESULTS: Most (89.4%) respondents were aware of the existence of HIV/AIDS, and knew the aetiology, routes of transmission, signs and symptoms, and preventive measures against the disease. While a little over half (59.8%) of the respondents revealed that they could hug people with HIV/AIDS, one out of four (27.2%) stated that these persons should be isolated from the community. Less than a quarter (22.3%) of the respondents believed that they were vulnerable to HIV/AIDS. More than half (58.2%) had ever had sex; the mean age at their first sexual exposure (for all respondents) was 16.7 +/- 4.4 years. Almost half (48.2%) of the 191 currently sexually active respondents had multiple sexual partners. Of the sexually active respondents, 75.9% claimed to have ever used condoms; among these, male respondents were more likely to have ever used condoms than their female counterparts (p < 0.05). CONCLUSION: The study revealed a gap in the knowledge of HIV/AIDS and an inappropriate sexual behaviour among respondents. Meaningful strategies, such as an innovative and culturally sensitive adolescent sexual and reproductive health programme that focuses on modification of sexual behaviour should be adopted to allow young people to prevent transmission of the HIV/AIDS virus.

Sociodemographic characteristics and health risk behaviours among students of a tertiary institution in south western Nigeria.

The identification of early risk factors among undergraduate students that impact on health, both mental and physical is a primary focus of this survey. This is more so since people suffering from an illness may not be currently engaging in any health risk behaviours but might have engaged in such behaviours before they developed the illness condition. Therefore the identification of health risk behaviours among this group of people would permit a better understanding of localized patterns of health risk behaviours as well as help to target intervention activities towards this particular group of people.The study is based upon data obtained from a cross-sectional survey of students in a tertiary institution in South Western Nigeria. Participants voluntarily and anonymously completed a baseline semistructured questionnaire which elicited information on demographic information, sexual behaviours and substance use among others. Of the 368 respondents, majority 225 (60.9%) are in the age group of 20-24 years. A total of 152 (41.3%) are either currently or have previously indulged in heavy drinking of alcohol and a statistically significant association (p<0.05) was found between the use of alcohol and having multiple sexual partners and use of commercial sex workers. Ninety-four (25.5%) and 52 (14.1%) are currently smoking or have smoked cigarette and marijuana before respectively; while 56 (15.2%) are currently using or have before used narcotic drugs. The relationship between hard drug use and non use of condom was statistically significant (p<0.05). Ninety-two (25.0%) have more than one sexual partners at the same given period; the male respondents indulged more in having multiple partners than the female and the result was statistically significant (p<0.05). As many as 155 (47.8%) of the 324 (88.0% of the respondents) sexually active respondents had never used condom during sexual intercourse. Also 88 (27.1%) of this group of the respondents have had sexual relationship with commercial sex workers (CSW) at one time or the other. Condom use was low among the sexually active respondents. Only 29.3% of the respondents always use condom when having any sexual relationship. This study has shown that students in this survey indulge in health risk behaviours such as "unsafe sexual practices", alcohol, cigarette smoking and other substance use. The males are more involved in having multiplicity of sexual partners than their female counterpart. The study also revealed a significant association between the use of alcohol and in having multiple sexual partners. Comprehensive health education and intervention programs are needed to influence positive behavioural change among this group of students and this will require working in partnership with schools authorities and other local community groups.

Respiratory symptoms and peak expiratory flow rates in workers of a Nigerian soap and detergent industry.

This comparative cross-sectional study was carried out to assess the respiratory symptoms and peak expiratory flow rates of the factory(study group) and office(control group) workers in a soap and detergent industry in Ilorin in relation to the occupational hazards of chemical fumes and detergent dust in the industry. Upper respiratory tract infections were found in 67.5% and 10.6% of the study group and control group respectively. The study shows that the factory workers experienced hazards (e.g. chemical fumes and detergent dust) at work more than the office workers. Personal protective devices such as boots, face masks, gloves, earmuffs and goggles were not consistently used since they were inadequate in supply, worn out and of substandard qualities. The general reduction in the mean values of peak expiratory flow rate in the factory workers than in the office workers as observed in this study may possibly, be a pointer to the effect of industrial exposure to chemical fumes and detergent dust over the years. There is the need to follow up these workers in order to detect early any possible disease and complications that may arise.