Occupational health and safety in Morocco remain the poor link in our health system despite the existence since several decades of regulations concerning the protection of workers. This legislation is interesting but unfortunately not implemented and not updated. Our study shows failures at all levels: three occupational medical inspectorates with nine occupational inspection physicians for the whole of Morocco; 1,322 occupational medical services for 4,600 firms required to have such services. Occupational medical services cover only 7% of the urban working population; more than 9 workers out of 10 do not benefit from any medical protection. Only one occupational medical service out of four submits its annual medical report to the occupational medical inspectorate; 683 physicians practice occupational medicine while our theoretical needs are for about 3,000; among the 300 doctors holding a diploma of occupational medicine, only 100 practice in their speciality; of the 1,200 nurses employed in work environments, few hold state diplomas as provided for by legislation; safety engineers, prevention experts and ergonomists are rare; several exposed sectors do not have occupational safety and health services: civil servants, handicraft workers, small firms, rural areas, temporary and occasional workers, etc.; no serious study on occupational hazards (occupational accidents and diseases) has been undertaken. A reorganization of occupational safety and health is required: at the level of the Council of physicians and occupational medical inspectorate; a commission should control "who does what"; at the national level: extension of occupational safety and health services to all the working population (political will); meeting of the Consultative Medical Council and the establishment of a National Institute of Occupational Health; at the international level: the fight against the introduction of dangerous substances and technologies, originating in industrialized countries. Only correct and generalized occupational safety and medicine can ensure a true health protection of the population, particularly those working.

Accidents, Occupational↗

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Occupational health and safety in the mining industry in Morocco.

The mining sector is one of the pillars of our national economy. Our paper concerns safety and occupational health in the mining sector in Morocco. This sector employs 60,000 persons, more than half of them working in the phosphate sectors. There are 36 occupational medical services, with 83 practitioners 395 nurses and 91 agents, protecting 43,926 workers (73% of all personnel). The task of labour inspection in this sector is entrusted to mining engineers. The statistics of the central department of industrial inspection in mines from 1975 to 1995 show a fall in occupational injuries and a progressive increase reported in occupational diseases, 96% of which are silicosis. The improvement of prevention and health at work in the mining sector in Morocco has led to a reduction in occupational hazards and specially occupational injuries. However, an effort seems required so as to generalize occupational medical and safety services in all the mining enterprises and in the craft mining sector in particular.

Accidents, Occupational↗

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[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↗

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[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↗

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[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↗

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[The value of occupational health in the national campaign against tuberculosis in Morocco].

Tuberculosis is a major public health problem in Marocco, with an incidence of 100 cases per 100,000 people. Occupational health could make a substantial contribution to the national anti-tuberculosis campaign, as the principal aims of occupational health are to protect and to improve the physical, mental and social well-being of the workforce. Occupational health thus devotes considerable attention to the promotion of health in general, and the fight against tuberculosis in particular. Occupational health physicians can play a major in several areas: prevention, screening, management of patients, compensation and epidemiology. The generalization of medical cover in the work environment in Morocco requires the application of laws already in place, the creation of occupational health departments, the training of occupational health physicians and the raising of their awareness concerning the anti-tuberculosis, and the involvement of doctors in municipal hygiene offices in the framework of a national health program for the entire workforce.

Health Priorities↗

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[Infectious risks associated with blood exposure for traditional barbers and their customers in Morocco].

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.

Adult↗

PubMedDate not supplied

The Internet and peritoneal dialysis.

Explore the source record for details and available documents.

Computer Communication Networks↗