Profile of Declared Work Accidents at the Parakou Agency of the National Social Security Fund, 2015-2021, Benin ()
1. Introduction
Current modes of production and commercial exchanges have given rise to new forms of work organization. The resulting work situations have favored occupational risk factors that were previously non-existent in the workplace, in particular occupational accidents. The Beninese social security code considers an accident at work, whatever the cause, the accident occurring to a worker: by the fact or on the occasion of work; during the journey from his residence to the place of work and vice versa or during the journey between the place of work and the place where he usually takes his meals and vice versa insofar as the journey has not been interrupted or diverted for personal or non-employment reasons; and during trips for which the costs are borne by the employer [1] . According to the International Labor Office (ILO, 2005), nearly 268 million work accidents occur each year [2] . Due to their frequency and seriousness, accidents at work constitute a real public health problem [3] . The International Labor Organization (ILO) estimated that these accidents cause more than 350,000 deaths worldwide every year. On the African continent alone, 45 million ATs occurred, causing at least 59,000 in 2014 [4] . In Senegal (2013), the cost of AT represented 4% of the gross domestic product every year [5] . The unavailability of a study on the characteristics of work accidents occurring in northern Benin motivated this study on the profile of work accidents declared to the Parakou agency of the National Social Security Fund from 2015 to 2021.
2. Methods
This was a descriptive historical cohort study. Data collection took place from February 2 to April 30, 2022. It concerned workers in the departments of Borgou and Alibori affiliated with the National Social Security Fund (CNSS) of the Parakou regional agency. The outcome sought was the occurrence of a work accident. To do this, we took into account the files of victims of work accidents (WA) declared from January 1, 2015 to December 31, 2021. This was an exhaustive sampling including the available and exploitable files of all workers affiliated with the CNSS Parakou agency. Data on accident cases were collected from AT declaration registers and worker files, using a tally sheet. The variables studied were socio-demographic (sex, age, seniority, professional category, department of location of the company), and the characteristics of work accidents. Data collection was digital with the KoBoToolbox platform and the KoboCollect application. The quantitative variables were described by their mean with standard deviation and those qualitative by the percentage. Data processing and analysis were performed using R version 4.1 software. The study received approval from the Ethics Committee of the Faculty of Medicine of the University of Parakou under the number REF: 0450/CLERB-UP/P/SP/R/SA.
3. Results
Of the 735 files, 733 were available and usable, i.e. 99.72%. The department of Borgou had counted 558 (76.1%) and 175 (23.9%) for that of Alibori. The proportion of annual incidence of AT was 2.98% varying between 5.8% in 2015 and 1.7% in 2021 (see Figure 1). The victims were 90.6% male. The average age of the subjects was 36 ± 10 years. The youngest were 16 and the oldest were 67. Those under 18 made up 0.4% of the sample. There were more subjects aged 28 to 37 (37.1%) as well as those with less than 5 years of seniority in their professional activity (66.7%). Manual workers and laborers were the most concerned with respective proportions of 46.7% and 31.2% (Table 1). Collision (32.8%) and recklessness (21.3%) were the main cause mechanisms of occurrence. Fractures (22.9%) were the most frequent traumatic lesions. The lesions were most often found in the thoracic limbs (38.5%) particularly in the hand (25%) and in the pelvic limbs (22.5%) particularly in the foot (10.5%) (Table 3). The majority of accidents occurred in the workplace (63.6%) (Table 2). The transformation industry sector was mainly concerned (52.1%) followed by that of buildings and public works (19.8%) (Table 2).
4. Discussion
The data for the study was collected from the files of all clients of the CNSS Parakou agency from 2015 to 2021 and from the AT declaration register and victim files from this same period; which seems appropriate for this retrospective study.
Annual frequency of accidents: The average annual frequency of AT was 2.98%. Fayomi et al. in 1993 in Benin, obtained a frequency of 4% [6] . A study carried out in 2000 showed that work accidents declared in Benin evolved in Sawtooth around the annual frequency of 4.8% on average [7] . In Tunisia, the evolution of WA was down from 43.2% in 1995 to 33.3% in 2005 [8] .
Socio-demographic characteristics of the victims: Young people between the ages of 28 and 37 represented 37.1% of the sample. Our results are also similar to those found by Diallo in Mali where the most affected age group was 25 to 34 years [9] . In Togo in 2018, Mikponhoué et al. [10] , found that the age group of 25 to 39 years was more affected. Article 459 of the Beninese Individuals and Family Code stipulates that the age of majority is 18 years [11] . In our study, 0.4% of WA victims were minors (under 18). There are therefore minors who work in companies in northern Benin. Almost all (90.6%) of the victims were male. This result is in line with those of the work of Mikponhoué et al. 2018 [10] in Togo (89%), Hami et al. [12] in 2018 in Morocco (91.8%), Mihaja et al. [13] in 2020 in Madagascar (95.81%) and Maoua et al. [14] in 2016 in Tunisia (87.5%).
Characteristics of accidents: The secondary sector of activity (industry, buildings and public works) ranks first (52.1%, 19.7%) in terms of the occurrence of declared accidents. In 2018 in Senegal, in the construction and public works sector, 22.6% of employees had been victims of AT (Dia et al.) [5] . Workers and laborers were the most victims of work accidents with respectively 46.4% and 31.2% of the whole. In 1993, Fayomi et al. [6] had already noted a strong involvement of these two categories of workers in Benin in work.
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Figure 1. Evolution of the annual incidence of WA declared to the CNSS, Parakou agency from 2015 to 2021.
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Table 1. Breakdown of reported victims of WA according to age, seniority and professional category, Parakou agency of the CNSS, 2015-2021 (n = 733).
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Table 2. Distribution of accident victims according to the place of occurrence, mechanism of accident and sector of activity, CNSS Parakou agency, 2015-2021 (n = 733).
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Table 3. Breakdown of reported WA victims according to location and type of lesion, CNSS Parakou agency, 2015-2021 (n = 733).
accidents (77%). From this observation, we can then say that there has been a regression of occupational accidents over the years in this country, as shown in Figure 1. In Burkina Faso (N’guessan et al. 2019) [15] , workers and maneuvers were also the most victims (36.68%). Those with less than 5 years of practice represented 66.7% of the accident victims. Observations of Mikponhoué et al. [10] in Togo in 2018 (78.53%), Horwitz et al. 2005 [16] in Oregon in the USA (53.2%) agree with our observation. Parakou regional agency from 2015 to 2021 occurred in the workplace (63.8%). At the CNSS of Senegal (Dia et al. 2018) [5] and that of Togo (Atitché et al. 2017) [17] , it was similar at 77.4% and 67.1% respectively. The lack of surveillance in the workplace and the lack of continuous training for workers would partly explain this. The WA occurring on the journeys was 35.2%. This reflects that the situation in Benin with regard to commuting accidents has therefore not changed since 2013. In Burkina Faso, the rate is higher (62%) (Sanon Lampo et al. 2019) [18] . This high rate of commuting accidents in Benin, as elsewhere in the sub-region, raises the issue of road safety, particularly in relation to the state of the roads and respect for the highway code. Machinery and hand tools were 19.0% and 17.2% the most common causes, respectively. The same observation was made by Diallo in Mali but at a higher frequency (44.11%) [9] . The predominant lesions were fractures (22.9%) followed by wounds (21.1%). In the series by Rahmani et al. in 2013 [19] and Sanon Lompo et al. in 2019 [18] in Ouagadougou, invoices also came first in higher proportions (25.21% and 48.88%). According to the work of Halvani et al. in Iran in 2012 [20] , wounds came first (55.9%). The hands and feet were the most affected (25% and 10.5%). These are the parts of the body most in contact with the rolling means and even with the work equipment.
The limits of the study are linked to the retrospective collection, hence the incomplete data (the number of workdays lost or the number of hours off work) and our inability to trace the history of all the information on the workers. However, it provides usable scientific information.
5. Conclusion
The average annual frequency of occupational accidents recorded at the regional agency of the National Social Security Fund of Parakou from 2015 to 2021 is decreasing but still high. Men are much more affected than women. The most concerned were young people and those who had less than five years of seniority in their profession. Recklessness was the main cause of accidents. The lesions are most frequently found at the extremities of the limbs. The secondary business sector is more at risk. It is important to assess their socio-economic impacts, and necessary concerted and adapted actions involving all the actors of health and safety at work.