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Biomedical subjects

J P Curtes

Publications and source records attributed to J P Curtes.

At least 19 recordsLinked to original sources

[Respiratory risk in carpenters and cabinet makers].

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 versus only 21.5% of controls. Rhinitis, asthma, conjunctivitis, chronic bronchitis and dermATitis 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.

Adult↗

[Child labor in the artisan sector of Morocco: determinants and health effects].

Despite the fact that child labour is regulated through the work code, and the convention on child rights adopted by the General Assembly of the United Nations in 1989 and ratified by Morocco in 1993, multiple surveys have shown that children are often put to work at a very early age and few employers respect the work conditions laid out in the texts. The aim of this study was to assess the different situations of child labour in the handicraft sector, the reasons and the problems surrounding it, to study its repercussions on health and to propose several preventive measures. From March to July 1997, a retrospective cohort study of working children and children in school was carried out in a small neighbourhood of Casablanca. We interviewed and examined a random sample of two hundred children working in the handicraft sector. The health status of these children was compared to that of the same sample size of children in school, from the same age group and socio-economic status. Each subject was given a standardized questionnaire that was translated into dialectal Arabic and administered by a occupational health doctor and a communications specialist. The results of the study have pointed out the small school network of the working children, the painful conditions of work and the important consequences on their health state with a wide prevalence of pathologies higher than for the children attending school. The misery in addition of the rural exodus, the no-adapted educative and socio-economic systems, the splitting of the family unit often go to generate a submissive childhood without defense and "ready to be used".

Adolescent↗

[Prevalence of respiratory systems and evaluation of sensitization levels in traditional grain market workers in Casablanca].

Our study proposes to evaluate the prevalence of clinical respiratory symptoms, spirometric abnormalities and allergy skin test sensitivities in two groups: on exposed to grain dust in a big traditional grain market in Casablanca and the other unexposed. The inquiry which concerned 277 exposed workers and 230 non exposed consisted of a questionnaire, spirometric examinations and skin prick testings. Exposed and no exposed groups are statically similar as far as physical data (sex, age, weight, heignt) and smoking habits. The atopy was found among 18% of the exposed. The prevalence of clinical respiratory symptomatology among exposed is 64.3% against 24.8% among non exposed. Respiratory symptoms (cough, expectoration), rhinitis, asthma, conjonctivitis, dermatitis, chronic bronchitis were significantly more frequent in those exposed than in the non exposed. Smoking is at the origin of additional morbidity. Atopy seems to be a potentiating factor as all the atopic people exposed are symptomatic. Respiratory function was altered in 37.1% of those exposed versus 12.8% of those no exposed. Among exposed workers with decline of lung function parameters 68.9% have only light anomalies. Tabacco interferes significantly in the alteration of respiratory function parameters. Work exposure to grain associated with smoking resulted in a reduction in respiratory function values. In grain workers, the prevalence of allergy skin test sensitivities of occupational allergens is 30.3% versus 6.9% among those no exposed. The enquiry in the workplace shows complete absence of means of protection for the work force and elevated levels of dust. It is imperative to implement an occupational health service and to develop means for collective and individual prevention to maximally reduce the risk.

Adult↗

[Hygiene, working conditions and professional risks in the Moorish "hammams++" in Marrakech].

Moorish "Hammam" baths are used by almost all of the Moroccan population. We evaluated the occupational hazards associated with these baths by studying the working conditions, hygiene and safety at ten Hammam baths in Marrakech. We carried out a descriptive, cross-sectional epidemiological study of 60 workers (30 men and 30 women). We analyzed working conditions, hygiene and safety and carried out a medical survey by means of a questionnaire, clinical tests, chest X rays and biological screening. The working environment in Hammam baths is particularly hot and humid. We found working conditions, hygiene and safety to be poor. Elementary regulations concerning environmental health were not respected and no means of protection was provided for the staff. Mycological studies showed that fungi pathogenic for humans were present in 100% of floor samples. Bacteriological analysis of the well water supplying the baths and of the residual water collected from various bath chambers showed that pathogenic bacteria resistant to multiple antibiotics were present. The medical survey identified various diseases affecting staff members, mostly infectious in nature. The most common problems observed were: problems muscular or skeletal in nature or linked to posture (28.3%), dermatological (100%), neurological (71.6%), ocular (30%), respiratory (90%), ear/nose/throat (51.6%), digestive (11.6%), oral (63.3%), gynecological (83.3%) and urinary (31.6%). Often, individual workers suffered several morbidities associated with working conditions simultaneously In light of these major occupational hazards, it is clearly important to implement special medical supervision of workers in Hammam baths, to improve hygiene and working conditions and to ensure the occupational health education and training of those concerned. As a first step, an occupational health service should be set up in the offices of the municipal health department.

Adult↗

[Health risks study in a pottery environment in Morocco].

Morocco is famous for its potteries, the largest of which are located at Rabat, Safi, Marrakech and Fes. This cross-sectional, descriptive epidemiological survey was carried out over an eight-month period, from January to August 1997. The study population consisted of 290 male workers from 36 workshops. The study involved a social and medical survey (a questionnaire and medical examination for all workers, with biological assessment for a representative sample of 95 craftsmen) and an analysis of the working conditions in which atmospheric pollution at the pottery was evaluated. Atmospheric concentrations of zinc, copper, iron, chrome and lead were determined. Only lead levels were found to be significantly high and were analyzed on three occasions. This study demonstrates poor working conditions and a lack of respect for the regulations concerning specific prevention measures and the health rules applicable to establishments where personnel are routinely exposed to the risk of lead poisoning. Various pathological conditions were observed, with the following prevalences: skeletal muscle 67.6%, dermatological 8.3%, digestive 58%, respiratory 28% and neurological 35.5%. Several nonspecific, often minor, clinical signs were recorded for most of the potters but the toxicological analysis confirmed lead contamination in 74% of the exposed subjects (plasma lead concentration, CPU, ALAU). The potteries of Morocco are not subject to any protection. Special technical and medical surveillance should be introduced and the laws concerning exposure to lead should be applied.

Adolescent↗

[Knowledge and attitudes of health care professionals with respect to AIDS and the risk of occupational transmission of HIV in 2 Moroccan hospitals].

We carried out a survey of 266 health care workers at two hospitals, in Rabat and Casablanca, to evaluate the level of knowledge, attitudes and behavior of these individuals with respect to AIDS. We also analyzed working conditions presenting a risk of occupational transmission of HIV, with the aim of developing appropriate preventive measures. We carried out a cross-sectional study, using a standardized questionnaire. The study population consisted of 91 doctors (34.2%), 106 nurses (39.8%), 12 laboratory technicians (8. 8%) and 47 support staff (17.6%) working in various departments. The mean age was 32.7 years. This study population was young, with 83% less than 40 years old and more than half having worked in the hospital for less than ten years. We found that the personnel knew a great deal about the usual means of transmission of HIV, but much less about possible occupational contamination. One person in two was unaware of the ways in which HIV in the hospital environment can be inactivated (bleach - 70% alcohol) and only 18.4% knew that HIV is sensitive to heat. Half the study population thought that the systematic exclusion of patients with HIV was essential and two thirds suggested that every patient admitted to the hospital should undergo systematic HIV testing. Anxiety when caring for seropositive patients was expressed by 56% of doctors and 62% of paramedical workers and 85% thought that health workers were at high risk of contamination during their work. The frequency of occupational injuries was found to be high and such accidents were rarely declared (declaration rate 7%). Protection measures were not in place in more than 50% of cases and too little information and resources were available to increase the awareness of the health care workers. These data show that greater efforts should be made to educate and inform health workers by means of the occupational medicine units recently set up for the benefit of the staff.

Acquired Immunodeficiency Syndrome↗

[Responsibility of poison control center physicians].

Rennes's Poison Control Centers as a public medical department associated with an emergency care unit for poisoned patients, is also endowed with a role in toxicological information. In this regard, doctors are working as health officers in the respect of professional ethics. Administrative courts will therefore have to consider suits opposed to poison control doctors. The contract linking the doctor to his counterpart is a benevolence contract. The validity of his oral advice was defined by the Cour de Cassation. The potential evaluation of a fault will be modulated by the particular circumstances of data collection and hence its uncertainty. However, Poison Control Centers must be best organized so that their answers to queries are given by a toxicology-qualified staff. The doctor will also have to provide assistance to those people in danger by adequate help. Despite the ambiguity of some calls which he has to face, the doctor in a Poison Control Center does not seem to be involved by the Law on suicide.

Ethics, Medical↗