Abstract
Introduction: Apart from its increasingly important frequency, occupational asthma (OA) has become the most important cause of occupational respiratory disorders in developed countries. The number of etiological agents continues to grow following the constant introduction of new harmful substances in industry. Objectives: Determine the prevalence and incidence of OA in our country, the socio-occupational characteristics of asthmatics, and study the forensic and social impact of such pathology. Material and Methods: An exhaustive retrospective epidemiological study was conducted in Tunisia about charts of occupational asthma cases recognized by the competent commissions of the National Medical Care Fund (CNAM) during the period ranging from January 1st 2000 to December 31st 2008. Results: 361 occupational asthma cases, accounting for a prevalence of 7.17% of all occupational diseases, were recognized during the period of the study. Occupational asthma annual incidence was estimated to be 24.42 cases per 1000000 workers. Our study population was mainly women with a sex ratio of 0.86. More than a half (57.6%) of recognized OA cases were working in the textile industry sector. Concerning the asthmatics’ professional career, most of recognized OA cases (n = 225 i.e. 70.6% of cases) kept their jobs, whereas 58 patients did not. The professional career was linked to gender with a job loss that is 1.79 time more important in asthmatic women. Conclusion: The incidence of occupational asthma in Tunisia is comparable with that found in other Mediterranean countries. A rigorous and adequate prevention is necessary and allows reducing the importance of this occupational pathology and its serious consequences.
Highlights
Apart from its increasingly important frequency, occupational asthma (OA) has become the most important cause of occupational respiratory disorders in developed countries
Two types of occupational asthma are distinguished based on their appearance after a latency period or not: The classical occupational asthma requiring a period of sensitization and irritant-induced asthma occurring after acute exposure to high concentrations of irritants [2]
The recognition of occupational diseases is performed by the medical boards that meet at the head office of the National Medical Care Fund (CNAM) in the cities of Tunis, Sousse and Sfax
Summary
Apart from its increasingly important frequency, occupational asthma (OA) has become the most important cause of occupational respiratory disorders in developed countries. Objectives: Determine the prevalence and incidence of OA in our country, the socio-occupational characteristics of asthmatics, and study the forensic and social impact of such pathology. Material and Methods: An exhaustive retrospective epidemiological study was conducted in Tunisia about charts of occupational asthma cases recognized by the competent commissions of the National Medical Care Fund (CNAM) during the period ranging from January 1st 2000 to December 31st 2008. Results: 361 occupational asthma cases, accounting for a prevalence of 7.17% of all occupational diseases, were recognized during the period of the study. High-molecular-weight agents are a major cause of allergic occupational asthma in the workplace. High-molecular-weight agents comprise proteins from plant, microorganism or animal origin in the 10 - 60 kDa range. The structures of antigenic determinants and mechanisms of many occupational allergens have been elucidated, whereas those of others, e.g. of platinum, recognized by immunocompetent cells are still obscure
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