Abstract
Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and Methods: A cross-sectional and descriptive study was carried out in Ngaoundere Regional Hospital from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having been consented to participate in the study. Posteroanterior (PA) chest radiographs were obtained from all workers during this periodic medical check-up. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus2-Lexica-V5 Edition software. Results: 753 workers were selected for this study, of whom 88.04% were men and 11.96% were women, a sex ratio H/F is of 7.4, the average age was 39 ± 7.89 years with extremes of 24 and 56 years, the most frequent job type was the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97.47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0.13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest X-ray, including 1 case (0.13%) of evolutionary pathology, 40 cases (5.31%) of sequelae pathologies. When the results of the chest X-ray are compared with the clinical signs and the pathological history of the workers, it is found that the only case with evolutionary abnormalities on the chest X-ray showed clinical signs and that the other cases with sequelae abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest X-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3,765,000 FCFA ($6473.74) for all the X-rays performed. Conclusion: In view of the low rate of abnormalities on the chest X-ray and the sequelae nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.
Highlights
The periodic medical examination is a visit to which the employee is subjected in the course of his employment, carried out by the working doctor, on which the company depends
During these periodic medical examinations, the occupational doctor carries out an interrogation, the clinical examination, and can carry out or prescribe the additional examinations necessary for the determination of the compatibility between the job type and the state of health of the worker, including the detection of conditions that may lead to a contre-indication to this job, an occupational disease that may result from the professional activity of the worker and the detection of dangerous diseases for the professional environment of the worker
Of the workers with blunting of costophrenic angles on chest X-ray complained of chest pain (Table 3) and that one third of those patients had a history of pleurisy, 77.77% of workers with basal or apical infiltrate had a history of either tuberculosis or lung infection (Table 4)
Summary
The periodic medical examination is a visit to which the employee is subjected in the course of his employment, carried out by the working doctor, on which the company depends This is the central element of worker health surveillance. Zima-Ebeyard et al in a study entitled Interest of Systematic Diagnostic Radiology of the chest during Periodic Medical Visits (PMV) among workers in Gabon, found a high performance for screening for tuberculosis and low for lung cancer, they propose that thoracic radiography should be performed on a case-by-case basis and should be preceeded by a clinical examination including a thorough anamnesis and in particular a good interview on known occupational and environmental exposures [3]. Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. When the results of the chest X-ray are compared with the clini-
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
