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Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

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Document pages: 10 pages

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.

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