Purpose. To screen the symptoms and to evaluate the prevalence of obstructive sleep apneas syndrome (OSAH) among health professionals. Method. This transversal epidemiological study concerned 1622 subjects. A questionnaire was submitted. The subjects with a positive Berlin questionnaire benefited from ventilatory polygraphy (VP). Results. The prevalence of positive Berlin was 13.2%. It increased with age, BMI, and also with the lack of regular sport activities use cannabis, alcohol or psychotropic drugs. It was more important in subjects suffering from metabolic, neuropsychiatric, cardiovascular and and/or respiratory pathology. The average sleep duration was more important in subjects having positive Berlin with earlier bedtimes and later wake-up. The prevalence of positive Berlin was higher among those who felt tired and sleepy and those who complained from headaches in the morning. It was higher among subjects reporting insomnia and among those with vigilance disorders: sleepiness at the work place, sleepiness while driving, Epworth > 10. It was important in subjects who had a road accident and/or work accident during the last twelve months. Prevalence of OSAH was 50.9% among subjects with positive Berlin who benefited from a VP. It has been estimated between 5.4% and 7.9% in the total population. Among subjects with positive Berlin having benefited from a VP, OSAH was more frequent among those over 50, suffering from obesity, cardiovascular, neuropsychiatric, metabolic and\or respiratory diseases. Conclusion. Occupational health physicians must play an important role in the early detection of this pathology and in education. (C) 2013 Elsevier Masson SAS. All rights reserved.

Purpose of the study. During the month of Ramadan, healthy adult Muslims refrain from eating and drinking between sunrise and sunset. Their habits of life change because of late meals and evenings gatherings. The aim of the study was to assess the influence of Ramadan observance on alertness at work.Method. This cross-sectional epidemiological study concerned 2171 health care workers in hospital facilities of the cities of South, Center and West Morocco. An anonymous self-administered questionnaire was submitted before and during Ramadan.Results. During Ramadan, The changes in eating habits concerned the frequency of meals (2.1 meals a day versus 2.7) and food schedule. Drug consumption (sedatives analgesics, antispasmodics and antacids) had increased. Headaches and dyspeptic disturbances were more frequent (respectively 37.8 versus 25.3% and 35.8 versus 18.5%). The mean of length of total sleep (6.8 +/- 1.2 h versus 7.7 +/- 1.4 h) and that of nocturnal sleep (6.1 +/- 0.9 h versus 7.6 +/- 1.3 h) decreased while that of siestas increased (1.3 +/- 0.9 h versus 0.5 +/- 0.3 h). Bedtime and wake up time were significantly delayed. Insomnia was more frequent (48 versus 33%). The prevalence of alertness disturbances was more important: Epworth greater to 10 (46 versus 18.1%), sleepiness at work (49.8 versus 19.4%), and sleepiness while driving (17.3 versus 9.8%).Conclusion. Sleep, daytime alertness and health were affected. The occupational health physician should act as a mediator of the religious authorities and sensitize the workers to the harmful effects on their health of the adopted practices during this holy month. (C) 2012 Published by Elsevier Masson SAS.

Cette étude avait pour but l’évaluation de la prévalence des symptômes respiratoires, des troubles ventilatoires et des sensibilisations cutanées chez les boulangers pâtissiers. Elle a intéressé 582 sujets (354 directement exposées [ED] à la farine et 258 indirectement exposées [EI]) travaillant dans 59 boulangeries artisanales. Elle a consisté en une analyse des conditions de travail et une enquête médicale (questionnaire, examen clinique, spirométrie et tests cutanés allergologiques). La prévalence des sujets symptomatiques était plus élevée chez les ED (38,7 %) que chez les EI (28,9 %). L’exposition professionnelle a été incriminée dans la survenue des symptômes par 22 % des personnes. Chez les ED, les symptômes respiratoires étaient plus fréquents chez les fumeurs et anciens fumeurs (58,4 %) que chez les non-fumeurs (26,3 %). Chez les non-fumeurs, la prévalence des signes respiratoires était plus élevée chez les ED (26,3 %) que chez les EI (16,8 %). La prévalence des anomalies fonctionnelles était plus élevée chez les ED (27,7 %) que chez les EI (13,6 %). Chez ceux ayant des troubles fonctionnels respiratoires, 85,7 % avaient uniquement un syndrome des petites voies aériennes ou un trouble ventilatoire obstructif léger. Chez les ED, les anomalies spirométriques étaient plus fréquentes chez les fumeurs et anciens fumeurs (33,6 %) que chez les non-fumeurs (17,5 %). Chez les non-fumeurs, une augmentation des anomalies fonctionnelles a été notée chez les ED (17,5 %) par rapport aux EI (9,2 %). Pour les allergènes professionnels, le pourcentage de prick-tests positifs à au moins un acarien de stockage était plus élevé chez les ED (21,7 %) que chez les EI (10,5 %). La prévalence de la sensibilisation à la farine était de 20,1 % dans le groupe ED versus 9,6 % dans le groupe EI. Les tests cutanés étaient positifs à la farine chez 52,8 % des asthmatiques et chez 26,2 % des rhinitiques. Des mesures préventives adéquates techniques et médicales réduiraient ce risque.

In obesity, oxidative stress is responsible for the aberrant production of adipokines such as adiponectin, plasminogen activator inhibitor (PAI)-1 and interleukin-6 (IL-6), which is causally associated with obesity-related inflammation, insulin resistance and cardiovascular disease. However, the signaling transduction pathways participating in adipokine dysregulation induced by oxidative stress are largely unknown. Thus, the aim of the present study was to identify possible involved signaling pathways.3T3-L1 cells were differentiated into adipocytes and underwent oxidative stress by exposure to extraneous H2O2. Quantitative PCR and immunoassays were performed to determine mRNA and protein levels of adipokines (adiponectin, PAI-1 and IL-6), respectively. Possible signaling pathways involved were high-throughout identified by Bioplex phosphoprotein assays and subsequently confirmed by inhibition of the targeted protein kinases such as Akt, ERK1/2, JAK/STAT, JNK, and p70 S6 K, respectively.H2O2 markedly suppressed adiponectin mRNA expression as well as protein secretion; however, it enhanced PAI-1 and IL-6 production in mature adipocytes. Akt,JAK/STAT and ERK1/2 participated in the H2O2-induced increase of PAI-1 and IL-6 expression, whereas adiponectin expression was reduced by H2O2 via Akt and JAK/STAT.Akt and JAK/STAT are congenerous pathways through which oxidative stress downregulates adiponectin and upregulates PAI-1 and IL-6 expression. ERK1/2 participates not in H2O2-induced decrease of adiponectin expression, but in the increase of PAI-1 and IL-6.

Cette étude épidémiologique, transversale et multicentrique, a pour objectif d'apprécier le niveau de stress chez le personnel médical et paramédical travaillant dans les services hospitaliers. Elle évalue les facteurs de risque et les manifestations psychosomatiques du stress et analyse la relation entre état de stress et caractéristiques socioprofessionnelles, facteurs de risque et manifestations psychosomatiques. Un auto-questionnaire anonyme, inspiré de celui de l'INRS, a été remis à l'ensemble des infirmiers et des médecins. Il comporte 50 items regroupés en quatre rubriques : données sociodémographiques et professionnelles, facteurs de protection ou de risque de stress en milieu de travail, indicateurs de stress et perception du stress. Trois mille cinq cent cinquante-quatre sujets ont répondu au questionnaire. La prévalence du stress était de 21,7 %. Le sexe féminin et les paramédicaux étaient les plus atteints. Le stress était plus fréquent dans les grandes villes (Casablanca et Rabat). Les conduites de compensation étaient plus importantes chez les sujets stressés. Les facteurs de risque de stress professionnel étaient la forte demande psychologique associée à une faible latitude décisionnelle et à un soutien social insuffisant. Les facteurs paraprofessionnels prédisposant au stress comprenaient les difficultés socioéconomiques, l'activité complémentaire d'appoint, les problèmes de transport et les personnes à charge. Les services de santé au travail, récemment institués en milieu de soins, doivent détecter la souffrance des soignants et améliorer l'environnement psychosocial. Cependant, les difficultés socioéconomiques et la précarité des professionnels de santé, notamment des infirmiers, ne peuvent être résolues qu'au niveau des décideurs qui doivent revoir les salaires et les conditions de vie des soignants. This epidemiological study, cross-sectional and multicentric, aims to assess the level of stress among medical and paramedical staff in hospital facilities. It evaluates risk factors and psychosomatic manifestations of stress and analyses the relationship between the state of stress and socioprofessional characteristics, risk factors and psychosomatic manifestations. An anonymous self-questionnaire, inspired by that of the INRS, was submitted to all nurses and physicians. It consists of 50 items grouped in four sections: sociodemographic and professional data, protection and stress risk factors in working premises, stress indicators and perception of stress. Three thousands five hundred fifty-four subjects answered the questionnaire. Prevalence of stress was 21.7%. Females and paramedics were the most affected. Stress was more frequent in the big cities (Casablanca and Rabat). Compensation behavior was more important among stressed subjects. Factors of professional risk stress were high psychological demand associated with low decisional latitude and insufficient social support. Paraprofessional factors predisposing to stress included socioeconomic difficulties, complementary supporting activity, transportation problems and dependents. Services of occupational health, recently instituted in medical facilities, should detect the suffering of the staff and improve the psychological environment. However, socioeconomic difficulties and the precarious situation of health staff, especially nurses, cannot be solved except at a higher level where decisions concerning salaries and living conditions should be made.

Purpose of the study. This epidemiological study, cross-sectional and multicentric, aims to assess the level of stress among medical and paramedical staff in hospital facilities. It evaluates risk factors and psychosomatic manifestations of stress and analyses the relationship between the state of stress and socioprofessional characteristics, risk factors and psychosomatic manifestations.Method. An anonymous self-questionnaire, inspired by that of the INRS, was submitted to all nurses and physicians. It consists of 50 items grouped in four sections: sociodemographic and professional data, protection and stress risk factors in working premises, stress indicators and perception of stress.Results. Three thousands five hundred fifty-four subjects answered the questionnaire. Prevalence of stress was 21.7%. Females and paramedics were the most affected. Stress was more frequent in the big cities (Casablanca and Rabat). Compensation behavior was more important among stressed subjects. Factors of professional risk stress were high psychological demand associated with low decisional latitude and insufficient social support. Paraprofessional factors predisposing to stress included socioeconomic difficulties, complementary supporting activity, transportation problems and dependents.Conclusion. Services of occupational health, recently instituted in medical facilities, should detect the Suffering of the staff and improve the psychological environment. However, socioeconomic difficulties and the precarious situation of health staff, especially nurses, cannot be solved except at a higher level where decisions concerning salaries and living conditions should be made. (c) 2008 Elsevier Masson SAS. All rights reserved.

They are many risks relating to the wood; they are caused by natural components of wood, products of conservation, chemical agents and parasites of wood. We have carried out a retrospective survey which concerned exposed workers and controls in twenty small handicraft workshops in the joiners’ souk of Marrakesh, it has enabled us to evaluate the prevalence of the clinical symptoms and disorders of respiratory function in 242 exposed subjects to the wood dust and 121 controls. This enquiry consisted of a questionnaire (European Coal and Steel Community: ECSC and the World Health Organisation: WHO), a clinical examination and a spirometry. Sixty-one point nine % of those exposed had clinical respiratory symptoms versusonly 21.5% of controls. Rhinitis, asthma, conjunctivitis, chronic bronchitis and dermitis were significantly more frequent in those exposed than among the non-exposed, with respectively 55.8%, 14.5%, 24.8%, 21.1% and 12.8% versus 16.5%, 6.6%, 8.3%, 5.8% and 4.9%. Exposure was the cause of respiratory symptoms because among non-smokers, exposed workers were more symptomatic than controls. Smoking exhibited a potentializing effect on airborne occupational contaminants because among exposed workers disorders were 1.8 times more frequent in smokers than non-smokers. A variable degree of respiratory obstruction was found among 30.1% of the exposed individuals versus 12.4% of the unexposed subjects. The effect of exposure was certain because among the non-smokers, 15% of exposed subjects had altered respiratory function versus 4% of unexposed persons. It is imperative to implement an occupational health service and to develop means for collective and individual prevention to maximally reduce the risk.

Objective. - This study had for aim to evaluate practices and knowledge of infectious hazards, to determine the prevalence of viral infections related to occupational blood exposure among health care workers. and to propose a preventive policy.Design. - This descriptive multicentric and transversal epidemiological survey was carried out from 2003 to 2004 in 10 Moroccan cities. Two thousand eight hundred and forty four persons were contacted and 2086 accepted to answer the questionnaire (73.3%).Results. - The mean age was 40.8 +/- 7.8 years and seniority 15.6 +/- 7.4 years. Blood was the most incriminated product (96.1%), followed by dirty linen and hospital waste. Instruments most often mentioned as dangerous were hollow needles (80.3%). The most feared infections were viral hepatitis (77.5%) and HIV (89.3%). Only 40.6% of the personnel were adequately vaccinated against hepatitis B. Post-vaccine serology was performed on only 1.8% of the vaccinated staff. During the last 12 months, 58.9% of the personnel underwent at least one occupational blood exposure 5.8% of which was reported. Universal precautions appeared poorly used as only 65.6% wore gloves for invasive acts and 61.5% correctly disinfected their hands. Re-sheathing used needles was frequent (51.2%).Conclusions. - Infectious hazards in healthcare facilities are not sufficiently taken into account: the recent creation of occupational health services in hospital facilities should contribute to improve working conditions, make hepatitis B vaccination available and mandatory, and lead to more information and education on hazards related to occupational blood exposure for healthcare personnel. (C) 2008 Elsevier Masson SAS. Tous droits reserves.

L’objectif était d’évaluer les pratiques et les connaissances sur le risque infectieux, de déterminer la prévalence des infections virales liées aux accidents d’exposition au sang chez le personnel de santé et de proposer une politique de prévention. Cette enquête épidémiologique descriptive, multicentrique et transversale a été menée durant les années 2003 à 2004 dans dix villes marocaines. Sur 2844 personnes contactées, 2086 ont répondu au questionnaire (participation 73,3 %). L’âge moyen était de 40,8 ± 7,8 ans et l’ancienneté professionnelle moyenne de 15,6 ± 7,4 ans. Le sang était le produit le plus incriminé (96,1 %) suivi du linge souillé et des déchets hospitaliers. Le matériel cité comme dangereux comprenait les instruments piquants (aiguilles creuses = 80,6 %). Les affections les plus redoutées étaient les hépatites virales (77,5 %) et le VIH (89,3 %). Seuls 40,6 % du personnel étaient correctement vaccinés contre l’hépatite B (sérologie postvaccinale réalisée chez 1,8 % des vaccinés). Durant les 12 mois précédents, 58,9 % des personnes avaient été victimes d’au moins un accident exposant au sang (AES) dont 5,8 % déclarés. Seuls 65,6 % des soignants portaient toujours des gants pour les gestes invasifs, 61,5 % se désinfectaient correctement les mains. Le recapuchonnage des aiguilles était retrouvé dans 51,2 % des cas. Les services de santé au travail en milieu de soins doivent contribuer à l’amélioration des conditions de travail, à la vaccination obligatoire et généralisée contre l’hépatite virale B et à des actions d’information et d’éducation sur les risques liés aux AES. This study had for aim to evaluate practices and knowledge of infectious hazards, to determine the prevalence of viral infections related to occupational blood exposure among health care workers, and to propose a preventive policy. This descriptive multicentric and transversal epidemiological survey was carried out from 2003 to 2004 in 10 Moroccan cities. Two thousand eight hundred and forty four persons were contacted and 2086 accepted to answer the questionnaire (73.3 %). The mean age was 40.8 ± 7.8 years and seniority 15.6 ± 7.4 years. Blood was the most incriminated product (96.1%), followed by dirty linen and hospital waste. Instruments most often mentioned as dangerous were hollow needles (80.3%). The most feared infections were viral hepatitis (77.5%) and HIV (89.3%). Only 40.6% of the personnel were adequately vaccinated against hepatitis B. Post-vaccine serology was performed on only 1.8% of the vaccinated staff. During the last 12 months, 58.9% of the personnel underwent at least one occupational blood exposure 5.8% of which was reported. Universal precautions appeared poorly used as only 65.6% wore gloves for invasive acts and 61.5% correctly disinfected their hands. Re-sheathing used needles was frequent (51.2%). Infectious hazards in healthcare facilities are not sufficiently taken into account: the recent creation of occupational health services in hospital facilities should contribute to improve working conditions, make hepatitis B vaccination available and mandatory, and lead to more information and education on hazards related to occupational blood exposure for healthcare personnel.

Purpose of the study. Road accident represents one of the main causes of death and Moroccan roads are among the most deadly in the world. Truck drivers are to blame for many of these accidents and sleepiness is a principal cause. The purpose of this study is to evaluate among truck drivers vigilance problems, their causes and consequences and to propose preventive measures.Method. This transversal epidemiological study concerned 2134 truck drivers in Casablanca. We used an anonymous individual questionnaire comprising four sections: socioprofessional and sanitary characteristics of drivers, working conditions, sleeping habits, symptoms of sleep problems and favouring factors.Results. Drivers are a population at risk: excess weight (62.9%), toxic habits (smoking: 49.6%; alcohol: 11.8%; cannabisin: 12%), pathological antecedents (28.3%) and consumption of psychotropic drugs (3.9%). Their working conditions are difficult and sleeping problems are frequent. Daily working hours over 12 (50.3%), sleep duration less than seven hours (53%). Insomnia (36.5%), abnormally high Epworth scores and sleepiness when driving (68.6%) are important factors that cause accidents (6.8%).Conclusion. Information, education and communication oil the dangers of sleepiness while driving is necessary in addition to the respect of regulations on work duration. The extension of the occupational health system to this type of activity would allow an improvement in road security and protect the health of professional drivers and road users. (c) 2008 Elsevier Masson SAS. All rights reserved.

Le but de l’étude a été de comparer à un groupe de contrôle la prévalence des risques professionnels respiratoires, des troubles ventilatoires et des sensibilisations cutanées chez les marchands d’épices à Casablanca. Cette enquête épidémiologique transversale de type cohorte rétrospective a inclus 175 marchands d’épices et 175 sujets non exposés. Elle comprenait une analyse des conditions de travail et une enquête médicale (questionnaire, examen clinique, spirométrie et tests cutanés allergologiques). Le terrain atopique a été retrouvé chez 14,8% des exposés contre 9,7% des non exposés. Les prévalences des symptômes cliniques étaient significativement plus élevées chez les exposés (41,1%) que chez les non exposés (21,7%). Chez les exposés, les fumeurs et les anciens fumeurs (63,8%) étaient plus symptomatiques que les non fumeurs (29,9%). Chez les non fumeurs, les exposés ont été plus symptomatiques (29,9%) que les non exposés (12,3%). L’exposition semblait jouer un rôle important dans la genèse des troubles respiratoires. Le tabac était un facteur aggravant. Une altération de la fonction respiratoire, de degré variable, était retrouvée chez 61,1% des exposés. Chez ces derniers, les prévalences des tests cutanés positifs aux allergènes courants seuls, aux allergènes professionnels seuls et à l’association des deux étaient respectivement de 24,6%, 29,7% et 18,3%. La sensibilisation cutanée à au moins une épice native était notée chez 11,4% des marchands d’épices, dominée par le piment chez 5,7% des sujets. Peu d’études épidémiologiques transversales de cohorte portant sur les risques respiratoires aux épices ont été retrouvées dans la littérature. Cependant, nos résultats concernant la symptomatologie clinique, les troubles fonctionnels ventilatoires et la sensibilisation aux allergènes professionnels étaient concordants avec ceux observés dans les milieux céréalier, minotier, boulanger, épicier et agricole. L’instauration d’une prévention médicale et technique adéquate pourra réduire ce risque. The aim of this study is to determine the prevalence of respiratory symptoms and the sensitisation among sellers of spices in Casablanca. This transversal epidemiological survey among 175 sellers of spices and 175 non-exposed includes an analysis of working conditions and a medical assessment (questionnaire, medical examination, spirometry and skin prick testing). Atopy was found among 14.8% of sellers of spices. 41.1% of those exposed had clinical respiratory symptoms versus only 21.7% of the non-exposed. Exposure was the cause of respiratory symptoms because among non-smokers, exposed workers were more symptomatic (29.9%) than controls (12.3%). Smoking entailed a potentiating effect on airborne occupational contaminants. Respiratory function was altered in 61.1% of those exposed. The prevalence of occupational allergens is 24.6% among exposed. The rate of positive prick tests to native spices is 11.4% among exposed versus 2.9% among non-exposed. Few cohort transversal epidemiological studies concerning spices occupational respiratory hazard were found in the literature. However, our results on clinical symptoms, functional ventilation problems and professional allergen sensitivity were concordant with those observed in cereal, mill, bakery, grocer, and agricultural environments. It is imperative to implement a medical and technical prevention to reduce the risk.

Le metier de coiffeur-barbier traditionnel a continue a exposer les personnes qui le pratiquaient et leurs clients a de multiples maladies infectieuses. L’objectif de ce travail a ete d’etudier le risque infectieux lie au sang chez cette population et d’evaluer sa connaissance de la notion de risque professionnel. Une enquete epidemiologique transversale, menee dans la region de Casablanca durant l’annee 2001, a interesse 150 coiffeurs-barbiers exclusivement de sexe masculin. Elle a comporte un questionnaire medico-social et un bilan serologique (VIH, VHC, VHB, TPHA, VDRL). L’âge moyen etait de 36,5 ans ± 14,7, l’anciennete moyenne dans la profession etait de 17,8 ans ± 8,7, le niveau socio-economique etait pour la majorite bas. Les conditions d’hygiene etaient defectueuses. La notion du risque infectieux lie au sang etait dans la majorite des cas meconnue en particulier pour les hepatites B et C ; l’absence de vaccination etait la regle. La serologie VIH s’est revelee negative chez l’ensemble des barbiers. En revanche, la serologie syphilitique par TPHA etait positive chez 7 % et par VDRL chez 4 %. Chez 2 %, l’Ag HBs etait positif et la serologie de l’hepatite virale s’est revelee positive chez 5 % (anticorps anti-VHC positifs). La responsabilisation de tous, notamment des pouvoirs publics et l’interdiction formelle pour les coiffeurs de s’adonner a l’exercice illegal des actes medicaux associee a leur protection medico-sociale nous semblent necessaires et urgentes. Les regles universelles de prevention doivent etre utilisees pour proteger la sante de ces professionnels et celle de la population generale.

L'objectif de ce travail était d'évaluer les risques professionnels respiratoires chez 346 puisatiers à Agadir et dans sa région. L'enquête épidémiologique transversale comprenait une étude des conditions de travail avec une analyse physico-chimique du sol et un bilan médical (questionnaire, examen clinique, spirométrie et radiographie pulmonaire). Les puisatiers étaient exclusivement de sexe masculin, avec un âge moyen de 42,8 ans ± 10,5 et une ancienneté d'exposition moyenne de 14,5 ans ± 6,9. Les symptômes respiratoires étaient notés chez 50 % des sujets et dominés par la dyspnée (43,1 %) et la toux (35 %). La spirométrie était anormale chez 64,2 % ; les anomalies portaient aussi bien sur les débits que sur les volumes. Les radiographies pulmonaires avaient révélé 32,9 % d'images thoraciques anormales dont 78,9 % étaient des petites opacités, et 21,1 % de grandes opacités parenchymateuses. Les symptômes cliniques et fonctionnels respiratoires et les anomalies radiologiques apparaissaient précocement et leurs prévalences augmentaient avec l'ancienneté de l'exposition. Il n'a pas été observé de corrélation entre les anomalies spirométriques et les images radiologiques. Peu d'études ont été consacrées au risque professionnel respiratoire chez les puisatiers. A. Holanda avait mis en évidence chez ces derniers une relation significative entre l'indice d'exposition à la poussière et l'apparition des opacités parenchymateuses et leur profusion. La valeur médiane de l'indice pour l'apparition des lésions radiologiques était de 391 jours. Le travail de puisatier apparaît très silicogène, l'instauration d'une surveillance médicale spéciale et d'une prévention technique adéquate sont nécessaires pour réduire ce risque respiratoire très invalidant. This transversal epidemiological survey permitted to evaluate the respiratory hazards among 346 pit diggers in Agadir. This study included an analysis of working conditions, physico-chemical characteristics of sandstone sample and medical survey (questionnaire, medical examination, spirometry and chest X-rays). The population under study consisted of exclusively male workers with a mean age of 42.8 years ± 10.5 and a mean duration of exposure of 14.5 years ± 6.9. 50% of pit diggers had respiratory symptoms dominated by dyspnea (43.1%) and cough (35%). 64.2% had abnormal spirometry. Chest X-rays analysis revealed 32.9% of pulmonary abnormalities (78.9% are small and 21.1% large opacities). The clinical and functional respiratory symptoms and the radiological abnormalities appeared early and their prevalence increased with the duration of the exposure to dust. There was no correlation between the outcome of lung function tests and chest X-rays opacities. Few studies have been devoted to the occupational respiratory hazard among pit diggers. A. Holanda showed among these a significant relationship between the dust exposure index and the appearance of X-rays opacities and their profusion. The median value of lesion appearance was 391 days. The pit diggers work appears very silicogenic. It is imperative to implement a medical and technical prevention to maximally reduce the respiratory hazard.

The trade of traditional barber has continued to expose its practitioners and their customers to multiple infectious diseases. The objective of this work was to study the infectious risk associated with blood exposure in this population and to assess its knowledge of this occupational risk. A cross-sectional epidemiologic survey was conducted in the Casablanca region during 2001 among 150 barbers, all men. It included a medical-social questionnaire and a serology work-up (HIV, HCV, HBV, TPHA, VDRL). The subjects' mean age was 36.5 years +/- 14.7, they had worked in the trade for an average of 17.8 years +/- 8.7, and the socioeconomic status of most was low. Hygiene conditions were deficient. The concept of infectious risk associated with blood was generally not well known, especially for hepatitis B and C; most were not vaccinated. HIV serology was negative for all barbers. On the other hand, syphilis serology was positive for 7% by TPHA and for 4% by VDRL. HBV was positive in 2% and HCV in 5%. It is essential and urgent to promote awareness of these risks among all, especially the public authorities, and to formally ban barbers from the illegal practice of medicine for their own protection. All means of prevention must be used to protect the health of these workers and of the general population.

To evaluate the prevalence of respiratory symptoms, ventilatory function disorder and immediate hypersensitivity reactions in a population exposed to flour and cereal dusts in five flour mills in Morocco.The study of 373 exposed and 301 non-exposed subjects consisted of an analysis of working conditions and a medical survey.The prevalence of clinical respiratory symptoms was 64.1% among exposed subjects and 41.2% among non-exposed subjects. Cough, expectoration, rhinitis, conjunctivitis, dermatitis, asthma and chronic bronchitis were more frequent among mill-workers. Spirometry was abnormal in 31.6% of those exposed: anomalies were found in both flow and volume. Among exposed subjects with a ventilatory disorder, 77.9% had only small airways syndrome or a light deficit. Smoking was the cause of excess morbidity. Skin prick tests were positive for at least one allergen in 65.4% of exposed compared to 27.2% non-exposed subjects. The prevalence of positive skin tests to occupational allergens alone was higher among those exposed (42.4%) than among the non-exposed (9.9%). The implementation of adequate medical and technical prevention may reduce this risk.

Objective: To evaluate the prevalence of respiratory symptoms, ventilatory function disorder and immediate hypersensitivity reactions in a population exposed to flour and cereal dusts in five flour mills in Morocco.Methods: The study of 373 exposed and 301 nonexposed subjects consisted of an analysis of working conditions and a medical survey.Results and conclusion: The prevalence of clinical respiratory symptoms was 64.1% among exposed subjects and 41.2% among non-exposed subjects. Cough, expectoration, rhinitis, conjunctivitis, dermatitis, asthma and chronic bronchitis were more frequent among millworkers. Spirometry was abnormal in 31.6% of those exposed: anomalies were found in both flow and volume. Among exposed subjects with a ventilatory disorder, 77.9% had only small airways syndrome or a light deficit. Smoking was the cause of excess morbidity. Skin prick tests were positive for at least one allergen in 65.4% of exposed compared to 27.2% non-exposed subjects. The prevalence of positive skin tests to occupational allergens alone was higher among those exposed (42.4%) than among the non-exposed (9.9%). The implementation of adequate medical and technical prevention may reduce this risk.