IntroductionBipolar disorder or manic-depressive psychosis is a severe recurrent psychiatric disorder that, if left untreated, can lead to severe social harm, disability and neurotrophic changes in the brain. However, social and psychological factors play a key role in the onset and progression of the disorder. Therefore, a bio-psycho-social therapeutic approach in the form of an integrated model of “Collaborative Care” is recommended.ObjectivesDetermining the main factors interfering with the decision of fitness to work in bipolar disorders according to work requirements.MethodsClinical cases including health professionals (HP) was carried out. Cases were examinated at a specialized occupational health Clinics including HP between 2018 and 2022. Data was collected from medical records and by questioning patients directly in case of missing data.Results Four HP were included in the study. All suffering from bipolar disorder. The average age was 37 years [28,49]. All were women. Two were divorced and one single. Two anesthesia technicians, a nurse and a cleaner. Two were smokers. Two were transferred to another department because non psycho-education of colleagues at work, dealing with patients, verbal and physical agressivness and cognitive disorders. The two anesthesia technicians were judged unfit for work because of their work responsability and the need for the integrity of all cognitive faculties in the workplace.ConclusionsIn order to decide the fitness to work, occupational physician must consider both bipolar disorder impact and workplace exigency. The adequacy between disease stability and others security is iteratively revised.Disclosure of InterestNone Declared

IntroductionThe COVID 19 pandemic had a significant psychological impact worldwide. Health care workers (HCWs) were the most affected because of the pandemic burden and occupational exigencies.ObjectivesTo describe epidemiological characteristics of HCWs with post COVID19 anxiodepressive disorders.MethodsA descriptive cross-sectional study was carried out. It included HCWs of a university hospital who consulted the Occupational Medicine Clinics for the three-month post-COVID‘s medical visit. The study was carried out during the period March 2020 to January 2022. The data was collected using a questionnaire including socio-occupational and medical characteristics. Psychometric evaluation was carried out using « the Hospital Anxiety and Depression Scale »ResultsWe have collected 164 HCWs. The sex ratio (M/F) was 0.29. The average age was 41±9.8 years. They belonged to the pneumology (27%), intensive care (11%) and biology laboratory (11%). The prevalence of anxiety and depression was 34% and 30% respectively. We found an association between sleep disorders and anxiety (p=0.000), OR=5 IC95%[2.4-10.3] and depression (p=0.000), OR= 4 IC 95%[2.0-9.3]. We found an association between anxiety and persistent fatigue (p=0,000), OR=4[2,0-8,6], anxiety and concentration and memory difficulties (p=0,000), OR=3 IC 95%[1,7-6,9]. Referral to psychiatric consultations were done in 16% of the cases.ConclusionsPost-COVID anxiety disorders were frequent among HCWs and associated with neurocognitive disorders. Psychiatric support and early treatment are necessary to prevent mental deterioration.Disclosure of InterestNone Declared

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Introduction Exposure to organic solvents (OS) represents an occupational hazard in industrial settings, which may be responsible for several neurosensory effects, including ototoxicity. The assessment of hearing function in workers exposed to SO is of great value. Aim To assess, using a validated questionnaire, the hearing function of workers exposed to SO. Methods Descriptive cross-sectional study conducted in the occupational medicine department of Charles Nicolle Hospital in Tunis, having interested patients exposed to SO who consulted for a medical opinion of fitness for work during the period from January 1, 2017 to August 31, 2022. The quality of hearing function was assessed using the 12-item Speech, Spatial, and Qualities of Hearing Scale (SSQ12). Results Thirty-four workers exposed to SO participated in the study. The average age was 44±8 years with a clear male predominance of 75%. The most represented sectors of activity were the automotive industry (34%), followed by the leather and shoe industry (15%) and the plastics industry (12%). The jobs most exposed to SO were manual workers (54%) and painters (9%). The median job tenure was 15 [10; 23] years. The presence of comorbidities was noted in 70% of the employees, three of whom were being followed up for unilateral deafness. Co-exposure to noise was noted in 18% of the workers. The mean global SSQ12 score was 7. The average speech subscale was 7.3 and the average spatial subscale was 7.5. The quality subscale had the lowest score at 6. Employees reporting a hearing impairment were scheduled for a pure tone audiometry assessment. Conclusion The effect of exposure to OS on the quality of hearing function appears to be considerable. Monitoring with a combination of a validated questionnaire and pure tone audiometry is necessary in exposed workers to detect hearing loss at an early stage.

Methods Retrospective descriptive study of doctors referred to the occupational medicine consultation of the Charles Nicolle hospital in Tunis for a medical opinion on fitness for work during the period from January to November 2022. Results A total of 22 patients were included. The mean age was 49.68 ± 8.78 years. A female predominance was noted with a sex ratio (M/F) of 0.38. The doctors included, all of whom practised in the public sector, were general practitioners in 11 cases. The average professional seniority was 17.4 ± 8.74 years. The main reasons for consultation were psychiatric (12 cases) and neurological (three cases) pathologies. At the end of the medical aptitude consultation, eight patients were considered fit to continue their usual professional activity. Temporary unfitness was pronounced for ten of the patients, and permanent unfitness for four patients. Two patients were recommended for professional reclassification to an administrative position. One doctor was proposed for disability retirement (IPP=80%) and one radiologist was proposed for remote work. Conclusion The physician's job is subject to specific professional constraints. In order to guarantee a good quality of care and services, it is essential to periodically re-evaluate the practitioners' ability to work.