RESUMEN
There are 8 cement works in Morocco employing 3 600 people and producing 8 million tons annually. The aim of our study is to determine the prevalence of respiratory symptoms and to propose some preventive measures. The study involved a group of workers of whom 280 were exposed to cement dust (who were further subdivided into three categories according to the intensity of exposure) and 73 who were not. It included a medical history with a standardised questionnaire, a clinical examination and spirometry. 65% of those exposed had clinical symptoms as opposed to 34.2% of the non-exposed. Cough, expectoration rhinitis, chronic bronchitis and asthma were significantly more common with incidences of 56.1%, 52.5%, 49.3%, 29.3% and 14.3% respectively in the exposed against 19.2%, 24.6%, 26%, 9.6% and 6.8% in the non-exposed. Among the exposed the prevalence of chronic bronchitis increased significantly with the degree of exposure, from 11.4% in category 1 to 41.6% in category 3. Age did not seem to influence the development of chronic bronchitis but on the other hand a smoking history of more than 10 years did. Exposure is responsible for the development of respiratory problems because among non smokers the exposed (55.6% are more symptomatic than the non-exposed (13.3%). Tobacco smoking potentiates the effects of occupational airborne contamination because exposed smokers (73.6%) and ex-smokers (67.8%) have more respiratory problems than exposed non-smokers (55.6%). The incidence of abnormalities of respiratory function is significantly higher in the exposed than in the non-exposed (32.5% against 13.7%). Among the exposed workers presenting disorders of ventilatory function 72.5% have no more than a disorder of the small airways or a slight deficit. Among the exposed the prevalence of impaired respiratory function is greater in smokers and ex-smokers (47.9% than in non-smokers (10.4%). Tobacco smoking augments the impairment of respiratory function. Prevention depends therefore on a programme of technical (collective and individual) and medical protection of the workforce.
Asunto(s)
Materiales de Construcción/efectos adversos , Polvo , Enfermedades Profesionales/inducido químicamente , Enfermedades Profesionales/epidemiología , Trastornos Respiratorios/inducido químicamente , Trastornos Respiratorios/epidemiología , Adulto , Estudios Transversales , Humanos , Incidencia , Marruecos , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/diagnóstico , Prevalencia , Trastornos Respiratorios/complicaciones , Trastornos Respiratorios/diagnóstico , Fumar/epidemiologíaRESUMEN
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.