Occupational health and safety in Morocco: present and future.

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.