Wellbeing and occupational risk perception among health care workers: a multicenter study in Morocco and France.

BACKGROUND: The study analyzes health care workers' (HCWs) occupational risk perception and compares exposure to occupational risk factors in Moroccan and French hospitals. METHOD: Across nine public hospitals from three Moroccan regions (north, center and south), a 49 item French questionnaire, based on the Job Content Questionnaire, and 4 occupational risks subscales, was distributed to 4746 HCWs. Internal consistency of the study was determined for each subscale. Confirmatory factor analysis was conducted on the Moroccan questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis was used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. A comparative analysis between Moroccan and French (Nantes Hospitals) investigations data was performed. RESULTS: In Morocco, 2863 HCWs (60 %) answered the questionnaire (54 % women; mean age 40 years; mean work seniority 11 years; 24 % physicians; 45 % nurses). 44 % Moroccan HCWs are at high strain. Casablanca region (1.75 OR; CI: 1.34-2.28), north Morocco (1.66 OR; CI: 1.27-2.17), midwives (2.35 OR; 95 % CI 1.51-3.68), nursing aides (1.80 OR; 95 % CI: 1.09-2.95), full-time employment (1.34 OR; 95 % CI 1.06-1.68); hypnotics, sedatives use (1.48 OR; 95 % CI 1.19-1.83), analgesics use (1.40 OR; 95 % CI 1.18-1.65) were statistically associated to high strain. 44% Moroccan HCWs are at high strain versus 37 % French (Nantes) HCWs (p < 0.001). CONCLUSION: Moroccan HCWs have high strain activity. Moroccan HCWs and more Moroccan physicians are at high strain than Nantes HCWs. Moroccan and French's results showed that full time workers, midwives, workers using hypnotics, and analgesics are at high strain. Our findings underscore out the importance of implementing a risk prevention plan and even a hospital reform. Further research, with an enlarged study pool will provide more information on psychosocial risks (PSR) and HCWs' health.

Psychosocial and occupational risk perception among health care workers: a Moroccan multicenter study.

BACKGROUND: International studies on occupational risks in public hospitals are infrequent and only few researchers have focused on psychosocial stress in Moroccan Health Care Workers (HCWs). The aim of this study was to present and analyze Moroccan HCWs occupational risk perception. Across nine public hospitals from three Moroccan regions (northern, central and southern), a 49 item French questionnaire with 4 occupational risks subscales, was distributed to 4746 HCWs. This questionnaire was based on the Job Content Questionnaire. Psychosocial job demand, job decision latitude and social support scores analysis were used to isolate high strain jobs. Occupational risks and high strain perception correlation were analyzed by univariate and multivariate logistic regression. RESULTS: 2863 HCWs (60%) answered the questionnaire (54% women; mean age 40 years; mean work seniority 11 years; 24% physicians; 45% nurses). 44% of Moroccan HCWs were at high strain. High strain was strongly associated with two occupational categories: midwives (2.33 OR; CI 1.41-3.85), full-time employment (1.65 OR; CI 1.24-2.19), hypnotics and sedatives use (1.41 OR; CI 1.11-1.79), analgesics use (1.37 OR; CI 1.13-1.66). CONCLUSION: Moroccan HCWs, physicians included, perceive their job as high strain. Moroccan HCWs use of hypnotics, sedatives and analgesics is high. Risk prevention plan implementation is highly recommended.

[Prevalence and risk factors of attention disorders of professional drivers in Morocco]. / Prévalences et facteurs de risque des troubles de la vigilance chez les routiers professionnels au Maroc.

We aimed to evaluate the prevalence and risk factors of professional drivers' vigilance disorders in Morocco. This transversal epidemiological multicentric study concerned 5,566 professional drivers of taxis (2,134), buses (1,158) and trucks (2,274). We used an anonymous individual questionnaire of 4 sections: socioprofessional and sanitary characteristics of drivers, working conditions, sleeping habits, symptoms of sleep problems and favouring factors. Drivers were a population at risk: high body mass index (62.2%), toxic habits (smoking: 50.6%; alcohol: 12.9%; cannabis use: 11.7%), pathological antecedents (27%) and consumption of psychotropic drugs (4%). Their working conditions were difficult and sleeping problems were frequent. The mean daily hours of work was 10.6 ± 1.6, and mean sleep duration 6.5 ± 1.3 hr. Insomnia was 40.2%, abnormally high Epworth scores 36.3% and sleepiness when driving 53.4%. Information and education on the dangers of sleepiness while driving is necessary, as is respect for regulations on work duration. The extension of the occupational health system to this type of activity would help improve road security and protect the health of professional drivers and road users.

[Musculoskeletal disorders of the knee of workers]. / Pathologie locomotrice du genou et travail.

50% of workers have been or will be affected by knee pains and complaints will be more frequent as the population ages and careers will be longer. The increase in prevalence depends on mechanical or morphological causes as well as psychosocial state and work organization. Lesions of the meniscus, well known for a long time, seem to be stable in the statistics of Social Security as well as the hygroma; the use of knee-pads (overalls with built-in cushions) is strongly recommended while working in kneeling or squatting position, even DIY activities. Are particularly dangerous: the squatting or kneeling position extended for longer than one hour a day, often recovering from these two positions (more than 30 times a day), lifting or carrying heavy loads, often climbing (around 30 times per day) stairs or ladders. These gestures and postures are unavoidable in some jobs; in those cases, advices given by the specialist of occupational medicine and the ergonomist may improve or alter the habits of the worker or of his entire team. The prevention of overweight and the habit of carrying heavy loads must be amplified, for all the usual positions of work. Consulting to decide about the return to work after surgery for knee replacement will be more frequent. Then, as each time work can interfere with health, it is logical that the family doctor have (via the patient) links with the specialist of occupational medicine, which holds valuable information for quality of life of employees.

[Evaluation of knowledge, attitudes and practices in the health care setting in Morocco with regard to hepatitis B and C]. / Evaluation des connaissances, attitudes et pratiques sur les hépatites virales B et C en milieu de soins au Maroc.

The purpose of this study was to evaluate practices and knowledge on infectious hazards, to determine the prevalence of viral hepatitis B and C related to occupational blood exposures among health care workers, and to propose a prevention policy. This descriptive epidemiological survey, which is multicentric and cross-cutting, was carried out in 2005 in four Moroccan cities. 1562 health care workers were contacted and 1002 accepted to reply to the questionnaire (64.1%). The mean age was 39.5 +/- 6.8 years and length of service 12.6 +/- 8.3 years. Blood was identified as the product most handled by workers (91.3%), followed by dirty linen and hospital waste. The most frequently used instruments reported were hollow needles (77.9%), followed by lancets. Re-sheathing used needles was practiced by 47.3% of the personnel. Nurses, assistants and support staff have insufficient knowledge on how viral hepatitis B and C is transmitted. Only 47.4% of personnel were adequately vaccinated against hepatitis B. Post-vaccines serology was carried out on only 2.7% of the vaccinated staff. During the last twelve months, 62.8% of the persons were victim to at least one occupational blood exposures of which 8.3% were reported. Universal precautions are not widely known or applied: only 24.4% wore gloves for invasive acts and 63% correctly disinfected their hands. Viral hepatitis B and C hazards in healthcare facilities are not sufficiently taken account. The recent creation of occupational health services in hospital facilities should contribute to improve working conditions, provide for mandatory vaccination of hospital employees against viral hepatitis B, and improve and increase information and education on hazards related to occupational blood exposures for healthcare personnel.

[Assessment of the risk of tuberculosis among health care personnel in Meknes]. / Evaluation du risque tuberculeux chez le personnel de santé à Meknès.

Tuberculosis has long been a concern for those responsible for the health of hospital personnel. Several studies of healthcare professionals who work in Morocco with patients with tuberculosis have shown annual incidence rates approximately ten times higher than those for the general population. This survey of the risk of tuberculosis among healthcare personnel (109 subjects with high and 118 with intermediate exposure to tuberculosis) and a control population (124 teachers) showed a positive correlation between the diameter of the tuberculin induration and intensity of exposure (significant difference between the highly exposed versus those with intermediate or no exposure). The risk of occupational tuberculosis was greater among the highly exposed healthcare workers. The involvement of occupational medicine units in health training in national public health programs and especially in programs combating tuberculosis must be a high-priority activity, because studies show that tuberculin conversion rates diminish significantly when programs of tuberculosis sensitization (information, education and communication), prevention (vaccination), and control (screening and treatment) are widely available to healthcare professionals, even those who have direct and constant with patients with tuberculosis.