Post-traumatic Tietze syndrome as an occupational accident: A case report study.

Tietze syndrome is an inflammatory arthropathy of costochondral junction characterized by chest pain, tenderness and swelling. We reported the case of a 35-year-old worker with post traumatic Tietze syndrome. He had a history of two occupational chest traumas. They both occurred in the third left costo-chondral joint. Chest computed tomography showed located osteolysis. Differential diagnoses were excluded. He was treated with non-steroidal anti-inflammatory drugs and analgesics. As for partial permanent disability, we suggested 17% given the importance of the pain and its impact on mobility. Tietze syndrome diagnosis was based on eliminating differential diagnoses. This study raises knowledge about post-traumatic etiology in Tietze syndrome. A better understanding of this pathology could help practitioners with patients facing chest wall pain.

The impact of type 2 diabetes on professional activity.

AIM: To assess the impact of non-insulin-requiring Type 2 diabetes (T2D) on professional activity in terms of absenteeism, presenteeism, reduced productivity and daily activities. METHODS: We conducted a comparative cross-sectional survey of two groups of employees in the Cap Bon textile sector: 75 diabetic and 75 workers free from any endocrinological pathology, seen in the occupational medicine group of Nabeul. The study was spread over 10 months from March 2020.A questionnaire was administered containing the Arabic version of WPAI-GH « Work Productivity and Activity Impairment Questionnaire-General Health ¼ to assess absenteeism, presenteeism, decreased productivity and daily activity. RESULTS: A total of 150 workers participated in our study. Diabetes was responsible for absenteeism of 5.1 ± 8.9%, presenteeism of 4.8 ± 6,4%, a decrease in productivity of 7.3 ± 7.8% and a decrease in the daily activity of 14,6 ± 10%. The rate of presenteeism, decrease in productivity and daily activity were significantly higher in T2D (p = 0.015). Absenteeism was associated with degenerative complications (p< 0,001). Presenteeism was associated with the duration of the course of diabetes (p < 0,001). CONCLUSION: Diabetes has a negative impact in productivity and general activity. Early and multidisciplinary management of these patients improves their professional performance.

[Predictive factors of maintain of employment and return to work after cancer]. / Facteurs prédictifs de maintien en emploi et de retour au travail après un cancer.

BACKGROUND: Return-to-work after cancer depends on several factors related to the disease but also other socio-professional factors. The primary aim of this study was to identify socio-demographic, disease related and professional factors influencing the return-to-work process. METHODS: It was a prospective and descriptive study reporting the return-to-work process in 89 cancer patients, in a professional activity age, who had cancer treatment and a follow up in the Oncology department in Tahar Maamouri Teaching Hospital of Nabeul, between September 2015 to December 2019. RESULTS: Our study included 89 patients. Mean age was 45 years±8. The population was predominantly feminine (59 %). They were employees in 45 % of cases. Private professional sectors included 60 % of all patients. An open-ended contract was performed in 87 % of cases. Most frequent primary tumors were breast tumors (45 %) and colon tumors (20 %). Thirty-four patients went back to work after recovery. Seventy-nine percent of them were female patients and 70 % had breast cancer. Predictive factors identified in univariate statistical analysis and correlated to return-to-work were gender (P=0.002), occupation (P<10-3), initial duration off sick (P=0.015), fitting out measures at work (P=0.01), primary tumor origin (P=0.01), disease stage (P=0.037), treatment (P=0.014) and disease outcome after treatment (P=0.024). CONCLUSION: Our study underlined a need to create a pluridisciplinary platform unifying collaborators among oncologists and occupational health professionals in order to enhance professional reintegration process and to hold patient's professional equilibrium after cancer recovery.

A national survey of occupational exposures in Tunisia.

INTRODUCTION: The evaluation of occupational exposures allows to guide preventive strategies and to suggest adequate solutions. AIM: Identify occupational exposures and constrains among workers of private sector in Tunisia. METHODS: A descriptive study including all companies of the private sector who are adhering to a service of occupational health of 17 Tunisian governorates. The survey was exhaustive for the services having less than 500 companies and by sampling for the services with more than 500.The data collection was based on data sheet completed by the occupational physician. RESULTS: This investigation concerned 1653 companies employing 161 517 employees. The industrial sector represented 52.8 %.Small and medium-sized enterprises represented 92.6 % of the studied companies. Companies having a committee of Health and Safety at work represented 16.82 % and 22.14 % had a safety officer. Posturales constraints are the most represented exposures (56%) followed by gestural constraints (27%). Heavy lifting concerned 17% of workers. Exposure to noise represented the third professional nuisance, 23% of employees are exposed. The employees exposed to organic solvents were among 16695 (10.34 %), distributed on 685 companies. CONCLUSION: This study allowed us to identify and to rank the professional exposures and constrains in the Tunisian private sector. This could lead to improving targeted strategies of prevention occupational risks.

Fitness for work of hospital personnel in sickness absence.

INTRODUCTION: The evaluation of fitness for work can be conducted upon the employer's request even during the employee's sickness absence. AIM: Determine the contribution of conducting medical examinations to assess the working ability of Charles Nicolle hospital's workers who are on sick leave. METHODS: A descriptive and retrospective study included all the medical records, completed over a two-year period (2013-2014), of Charles Nicolle hospital's personnel who were on sick leave and who consulted the service of occupational medicine and professional pathology to undergo a fitness for work evaluation requested by the employer. RESULTS: Our study was based on a total of 170 cases of sickness absenteeism reported from a population of 133 employees. The average age of the study population was 39 years (+/- 9.5) with a sex ratio of 0.51. The category of nurses was the most represented (44.4 %). The average work seniority was 10.6 years (+/- 8.4). It is worth notifying that in 65.3% of the cases (111/170), medical examinations were conducted on the employees during the time they were off work. However, in the remaining 34.7 % of the cases (59/170), medical examinations were conducted on the employees after they go back to work. Our study showed that among the 111 employees who were subject to a medical examination during their sickness absence, 88 of them, which is the equivalent of 79.3 %, were found to be fit for work. Among those, 8 cases were fit for work but with some restrictions. A temporary unfitness for work was indicated in only 20.7% of the cases (23/111). CONCLUSION: Our study unveiled a discrepancy between sickness absenteeism and fitness for work in Charles Nicolle hospital. Employees on sick leave had the physical and the mental abilities that would allow them to work with some individualized accommodations based on their health-related needs.