Diagnosis Of Occupational Diseases Research Articles

Plasma Brain-Derived Neurotrophic Factor (BDNF) Levels and BDNF Promoters’ DNA Methylation in Workers Exposed to Occupational Stress and Suffering from Psychiatric Disorders

Introduction: Decreased plasma BDNF (pBDNF) levels have been proposed as a biomarker in the illness phases of mood disorders. This cross-sectional study aimed to evaluate the pBDNF and BDNF promoters’ DNA methylation levels in workers exposed to occupational stress and suffering from work-related stress disorders. Methods: the pBDNF and BDNF exon I and IV promoters’ methylation levels were measured by specific immunoassays and methylation-sensitive high-resolution melting (MS-HRM) in 62 patients with adjustment disorders (AD), 79 patients with major depressive disorder (MDD) and 44 healthy controls. Occupational stress was evaluated in the patients and controls using the Job Content Questionnaire (JCQ). Results: the pBDNF levels were significantly higher in the MDD (p < 0.001) and AD (p < 0.0001) patients than in the controls. The MDD patients showed significantly lower pBDNF levels than the AD ones (p = 0.01). The BDNF exon I and IV promoters’ methylation levels were significantly higher in the MDD patients than in the AD ones (exon I promoter: p = 0.0001, exon IV promoter: p < 0.0001) and controls (exon I promoter: p = 0.0001, exon IV promoter: p < 0.0001). In the patients, but not in the controls, the BDNF promoters’ methylation levels showed significant negative correlations with occupational stress. Conclusions: BDNF could play a key role in the pathophysiology of stress-related disorders and the peripheral elevation of it observed in patients exposed to occupational stress could suggest a protective mechanism for neurons from stress-mediated damage. The elevation of the pBDNF levels, even in MDD, may characterize a “reactive” subtype of depressive episode, while the significant elevation of the BDNF promoters’ methylation levels in depressed patients could indicate a predisposition to more severe illness under stress. Further research is needed, focusing on biomarkers for stress-related disorders as a potential tool for the diagnosis and prevention of occupational diseases.

Diagnosis and management of work related musculoskeletal disorders as occupational diseases in Germany

This article introduces the occupational disease diagnosis of work-related musculoskeletal disorders such as lumbar and spinal injuries in Germany, and focuses on the research and standard values of the maximum pressure tolerance of intervertebral discs. This article mainly introduces the dose model limits and their applications proposed by the Mainz Dortmund Dosis model (MDD), the judgment of the German Social Court (Bundessozialgericht, BSG), and the German Spinal Research Re evaluation (Deutsche Wirbels ulentudieⅡ, DWSⅡ) ; X-ray manifestations and measurements of intervertebral disc injury; Problems in actual cases and diagnosis. In order to provide reference and inspiration for the occupational diseases diagnosis of work related musculoskeletal disorders in China.

Macrophage hyperfunction as a cellular trigger for fibroplastic changes in internal organs in pneumoconiosis among miners

Introduction. The significant prevalence of anthracosilicosis and silicosis, characterized by the rapid development of pneumofibrosis in coal mine workers, is a serious socially significant problem worldwide. A key component of the pathogenesis of pneumoconiosis is the macrophage reaction to fibrogenic dust, which is a complex immunological response, with prolonged and intense exposure leading to chronic inflammation in various organs and systems, fibrosis and a progressive decrease in their functions. A deep understanding and evaluation of the macrophage reaction as a potential biomarker for the diagnosis of lung damage in miners will allow us to develop more effective strategies to combat dust damage to organs and systems. The study aims to consider macrophage hyperfunction as a trigger mechanism for fibroplastic changes in internal organs in pneumoconiosis in miners. Materials and methods. Using light microscopy, specialists conducted extended cytological, histological and immunohistochemical studies of bronchial smears and autopsy material (fragments of bronchi, lungs, heart, liver and kidneys) of 50 miners of Kuzbass coal enterprises who died simultaneously as a result of a man-made disaster. Morphometric analysis of histological structures with measurement of linear dimensions was used for a comprehensive assessment of pathomorphological changes. Results. There was a sharp increase in the number and size of actively phagocytic alveolar macrophages loaded with dust particles in the lungs of miners. Pathological changes in internal organs were characterized by pronounced fibrosis in the peribronchial and perivascular zones, stroma with deposition of dust particles and a pronounced macrophage reaction. In a group of miners with more than 15 years of experience in the central and distal parts of the lungs, in the intermuscular zones of the myocardium, the portal tracts of the liver, and the central segments of the kidneys, there was a constant increase in the expression of immunohistochemical markers CD14, CD34, actin and vimentin, which can be used as diagnostic markers for the identification of macrophage inflammation and fibrosis, will allow to assess the degree of severity of the pathological process. A characteristic feature of the miners' long experience of dust exposure was the presence of progressive pronounced perivascular sclerosis extending beyond the vascular histione. Experts found fibroblastic cells with positive expression of CD14, CD31 and CD34 in the sclerotic zones. Limitation. The absence of cytogenetic and electron microscopic examination, which is expected in the future in conjunction with the expansion of the range of immunohistochemical research methods. Conclusion. The results of extended pathomorphological and cytological studies emphasize the importance of an integrated approach to the diagnosis of occupational diseases in the coal industry. The use of a combination of these methods will allow timely detection of macrophage inflammation and fibrous process in dust pathology, specific changes at the cellular and tissue levels, as well as to assess the severity of the pathological process. Ethics. The study of autopsy material was based on a secondary examination of blocks and ready-made histological micro-preparations (glasses) of the material of the Bureau of Forensic Medical examination of Novokuznetsk, Osinniki, Prokopyevsk. The studies of pathomorphological material were carried out strictly on the basis of Federal Law No. 323-FZ dated 11/21/2011 "On the Basics of Protecting the Health of Citizens in the Russian Federation", in particular Article 67 "Conducting pathological anatomical autopsies", Federal Law No. 8-FZ dated 12.01.1996 "On Burial and Funeral Business" (Article 5, pp. 1, 2), as well as in accordance with the Order of the Ministry of Health of the Russian Federation dated 06.06.2013 No. 354n "On the procedure for conducting pathological anatomical autopsies", Order of the Ministry of Health of the Russian Federation dated 03/24/2016 No. 179n "On the Rules for conducting pathological anatomical studies".

Delphi method investigation and research on the revision of Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013)

Objective: To explore the expert opinions on the revision of the Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) . Methods: In March 2023, the improved Delphi expert consultation method was adopted, in the first round of consultation, a pre-survey was conducted on 20 experts, and the questionnaire was improved according to the experts' opinions. Then, a second round of expert consultation questionnaire was formed to conduct a questionnaire survey and consultation of 50 experts engaged in occupational disease diagnosis and related work. The feedback of experts was collected and analyzed. Results: The average score for the scientificity and progressiveness of the main technical content of the original standard was 3.33, and the average score for the rationality and operability of the main technical content of the original standard was 3.25. The importance of individual indicators with specific connotations were ranged from 4.20 to 4.45, with coefficients of variation <0.25, and the experts' opinions were relatively concentrated. The experts have provided feedback indicating that the original standard had issues such as lack of continuity in diagnostic gradation, the need to integrate biomarkers with urinary and hair arsenic levels, a scarcity of objective diagnostic indicators, the removal of exposure response from the main text, and a low level of consistency in standard usage. These issues need to be revised urgently. Conclusion: The Diagnosis of Occupational Arsenic Poisoning (GBZ 83-2013) should be revised based on experts' feedback and suggestions to meet the current real demand for occupational arsenic poisoning diagnosis.

Investigation on the current situation of occupational disease hazards in stone processing enterprises in Weihai City

Objective: To analyze the occupational disease hazards in stone processing enterprises in Weihai City to provide scientific basis for occupational disease prevention. Methods: From January 2021 to December 2022, 107 stone processing enterprises in Weihai City were selected to collect the detection status of occupational hazard factors in the workplace through on-site investigation and on-site monitoring of occupational hazard factors. The diagnostic reports on occupational diseases and suspected occupational diseases of 780 workers were collected through the Occupational Diseases and Hazard Factors Monitoring Information System of the Chinese Center for Disease Control and Prevention, the occupational health monitoring files of the occupational health examination institutions and the information data of the occupational disease diagnosis institutions. The differences between the measurement data were analyzed by Chi-square test or Fisher exact probability method. Results: 107 stone processing enterprises were mainly focused on granite processing, and the average free silica content in granite was 32.92% (12.78%-47.84%). The over-standard rate of silica dust was 0.31% (6/1920), and the over-standard rate of noise was 86.20% (1324/1536). Among them, the noise intensity of cutting position was the highest[120.5 dB (A) ]. The over-standard rates of noise in cutting, water grinding, dry grinding (polishing) and material preparation (forklift transportation) were 98.05%, 89.55%, 70.00% and 42.62%, respectively, and the differences were statistically significant (P<0.05). Among 780 workers, 31 cases (3.97%) of suspected silicosis were detected, and 13 cases (1.67%) were diagnosed with silicosis. 51 cases (6.54%) of suspected occupational noise deafness were detected, and 11 cases (1.41%) were diagnosed with occupational noise deafness. Conclusion: Silicon dust and noise in some positions of stone processing enterprises in Weihai City exceed the standard, and supervision should be strengthened, prevention and control measures should be implemented to protect the occupational health of workers.

Medical and legal diagnoses comparison of the occupational diseases: A nationwide study in Turkey.

The underreporting of occupational diseases in many countries significantly hampers the development of intervention programs, posing a significant public health problem. Our study aimed to contribute to the occupational diseases surveillance by examining the data of hospitals authorized to issue reports throughout Turkey. This cross-sectional study was conducted using medical diagnoses of occupational diseases reported to the General Directorate of Public Health from 81 provinces in Turkey between 1 January 2018 and 31 December 2022. The study evaluated hospitals that made medical diagnoses of occupational diseases and compared age groups, genders, occupational disease diagnosis groups and provinces of work regarding legal and medical diagnoses. The top three disease groups in terms of medical diagnosis are musculoskeletal disorders with 38.8%, respiratory diseases with 14.4% and hearing defects with 10.9%. Regarding legal diagnoses, respiratory system diseases ranked first with 26.4%, followed by musculoskeletal disorders with 8.2% and hearing defects with 5.5%. While the provinces where most cases of medical occupational diseases are diagnosed share similarities, the majority of affected individuals in Karabük and Batman have not received a legal recognition of the occupational disease. Two-thirds of Turkey's medical occupational disease diagnoses were made in two hospitals. This study is reflecting national data in Turkey and is the country's first nationwide study. The number of occupational diseases in Turkey is lower than expected. It would be more accurate to express the data in a way that includes medical diagnoses instead of using the number of compensated files corresponding to legal diagnoses.

Analysis of the epidemiological traits of occupational pneumoconiosis in Qinhuangdao between 1961 and 2020

Objective: To study the prevalence of occupational pneumoconiosis in Qinhuangdao from 1961 to 2020 and offer a foundation for developing occupational pneumoconiosis prevention and control methods. Methods: In December 2020, the data of occupational pneumoconiosis cases diagnosed by medical institutions with occupational disease diagnosis qualifications in Qinhuangdao City from 1961 to 2020 were collected Anova or kruskal-Walls tests and chi-square tests were used for inter-group comparisons of continuous and categorical variables, and LSD tests or Tamhane T2 tests were used for multiple comparisons. Results: Between 1961 and 2020, 384 cases of pneumoconiosis were documented in Qinhuangdao, of which 382 (99.5%) patients were men and 2 (0.5%) were women. The average dust service duration is 15 (9, 25) years, with a minimum duration of 0.5 years and a maximum duration of 49 years; Cases were primarily distributed in Qinglong Manchu Autonomous County (187 cases, 48.7%) and the Haigang district (160 cases, 41.7%) ; Type of pneumoconiosis was silicosis (340 cases, 88.5%), mainly 273 cases (71.1%) of stage I, 88 cases (22.9%) of stage II, and 23 cases (6.0% of stage III) ; Cases of Phase II and III and with short lengths of service are mainly concentrated in medium-sized, small, private limited liability companies and collective enterprises. Rrock work (166 cases, 43.2%), and loading kiln workers (42 cases, 10.9%) were the main types. Conclusion: Because the distribution of pneumoconiosis cases in Qinhuangdao city is concentrated and the length of service is decreasing, it is important to enhance the oversight of important area, businesses, industries, and job categories in line with the growth of the region's mineral resources.

Physicians' Knowledge, Attitudes, and Practice of Occupational Diseases Diagnosis and Occupational History Taking.

This cross-sectional study assessed physicians' knowledge and attitudes toward occupational diseases, their practice of occupational history taking, and the associated factors and barriers. From January 1 to June 30, 2023, Egyptian physicians from different specialties (n = 278) completed a questionnaire including sociodemographic and occupational data, questions measuring knowledge, attitudes, practice, and barriers. The significant predictor of low knowledge was the nonuse of a standard history form. The lack of undergraduate education/postgraduate training in occupational diseases was the predictor of unfavorable attitudes and poor practice. Unfavorable attitudes also predicted poor practice. The main barriers were insufficient knowledge and busy schedules. Different specialties physicians are essential in recognizing occupational diseases. They need to be knowledgeable about occupational diseases within their specialties. Specialized undergraduate and postgraduate training in this topic can help achieve such needs.

Establishment of the quality management system for occupational diseases diagnosis

The quality management system of occupational diseases diagnosis is belonged to one part of the hospital quality management system. It must be adhered to the quality management concept of comprehensive, full staff and whole process. To establish and improve the quality management system should be included: (1) Formulated a quality management manual for occupational disease diagnosis, including organization construction, rules and regulations, responsibilities, work flow, operating procedures and clinical pathways, standard instrument, etc. (2) Managed the document of occupational diseases diagnosis. (3) The continuous improvement of quality management. The quality management of occupational diseases diagnosis focuses on the mastery and implementation of the manual by employees, which is reflected in the continuous improvement of daily work, internal assessment and external assessment.

The application of metaverse in occupational health.

The metaverse, as a new digital interactive platform, is garnering significant attention and exploration across industries due to technological advancements and societal digital transformation. In occupational health, there is immense potential for leveraging the metaverse to enhance work environments and occupational health management. It offers companies more efficient and intelligent solutions for occupational health management while providing employees with safer and more comfortable work environments. A comprehensive literature search was conducted using PubMed, Web of Science, IEEE Xplore, and Google Scholar databases to identify relevant studies published between January 2015 and March 2024. The search terms included "metaverse," "virtual reality," "occupational health," "workplace safety," "job training," and "telemedicine." The selected articles were analyzed, and key findings were summarized narratively. The review summarizes the broad application prospects of metaverse technology in immersive training, occupational risk identification and assessment, and occupational disease monitoring and diagnosis. However, applying the metaverse in occupational health also faces challenges such as inadequate technical standards, data privacy issues, human health hazards, high costs, personnel training, and lagging regulations. Metaverse offers new possibilities for addressing the numerous challenges faced in occupational health and has broad application prospects. In the future, collaborative efforts from multiple stakeholders will be necessary to promote the sustainable development of metaverse technology in occupational health and better protect workers' occupational health.

Development of rehabilitation and preventive programs for employees of "dust-hazardous" professions

Introduction. The main tasks of the occupational pathology service are early diagnosis of occupational diseases, prevention of their formation, and in case of development, slowing down the progression. Due to the timely start of rehabilitation measures, it is possible to preserve employees' ability to work, and the employer — the labor potential of qualified personnel.&#x0D; In modern enterprises, it is necessary to create programs to provide workers with medical care at the early stages of the formation of diseases, to prevent their progression, the development of complications and the preservation of professional ability to work.&#x0D; The study aims are the scientific substantiation of methodological approaches to optimizing rehabilitation and preventive programs for employees of "dust−hazardous" professions.&#x0D; Materials and methods. The scientists have examined 254 employees of KAMAZ PJSC: 164 employees of the Foundry and 90 employees of other divisions of the enterprise. The work uses a complex of hygienic, clinical and laboratory, instrumental, statistical research methods.&#x0D; Results. The authors have established the features of the a priori and a posteriori risk of the formation of occupational pathology of the respiratory organs in the departments of a large machine-building enterprise. There is specificity of the development of respiratory pathology depending on the exposure characteristics and characteristics of the physico-chemical properties of industrial aerosols in workers of a machine-building enterprise. The researchers have developed and scientifically substantiated a methodological approach to the application of a set of measures aimed at reducing risk and preventing occupational pathology of the respiratory system in employees of a machine-building enterprise, based on a personalized assessment of harmful factors of the production environment, a differentiated approach to correcting modifiable risk factors.&#x0D; Conclusions. The authors justified the use of various rehabilitation and preventive programs for interned employees of the enterprise who have a high risk of developing occupational pathology of the respiratory system, developed a differentiated approach to the use of various rehabilitation and preventive programs based on the analysis of the dynamics of clinical and functional indicators reflecting the course of respiratory pathology under the influence of industrial aerosols of various compositions (formation of obstructive-restrictive disorders, changes in exercise tolerance, the dynamics of morbidity with temporary disability).

İŞYERİ HEKİMLİĞİ UYGULAMALARI VE ÇALIŞANLARIN İKİNCİ VE ÜÇÜNCÜ BASAMAK SAĞLIK KURULUŞLARINA YÖNLENDİRİLMESİ

Employees may need to be referred to health institutions for different indications, such as illness and rehabilitation. In Turkey, the procedure for referring cases from the workplace to health institutions is not fully defined. Learning the approaches of workplace physicians on employee referrals will determine the direction and content of future studies on this matter. This study aims to obtain information about the characteristics of workplace physicians working in Izmir province and their attitudes towards case referral to health institutions. The population of the descriptive study consisted of workplace physicians registered in Izmir Medical Chamber e-mail information network. The subjects were contacted through the information network of the Chamber, and an online questionnaire was sent. 58% of the participants stated that they participated in risk assessment studies and conducted field surveillance. 69.3% of the participants stated that they were able to conduct a pre-employment examination for all employees, and 78.4% stated that they were able to conduct periodic examinations on a regular basis. 52.3% of the participants stated that they referred patients with a preliminary occupational disease diagnosis one or more times. One-fourth of the participants stated that they could not act freely in terms of referring cases from the workplace. The examinations performed at the workplace and referral of the necessary cases to advanced healthcare centers are vital steps in protecting and improving employee health. It is crucial for the workplace physician to feel free to refer suspicious cases and to have job security against all possible consequences.

Synthesis of Models for Predicting and Diagnosing Occupational Diseases Based on Hybrid Fuzzy Technology

The purpose of research is to develop a method for synthesizing models for predicting and diagnosing occupational diseases based on hybrid fuzzy technology, providing an increase in the quality of decision-making in occupational pathology.Methods. It is established that most of the problems related to the topic under study (forecasting, early diagnosis, assessment of the severity and dynamics of the development of professional diseases) belong to the class of poorly formalized problems with fuzzy and incomplete data structure, which are recommended to be solved using the methodology of synthesis of hybrid fuzzy solving rules based on on the interaction of the natural intelligence of doctors and a cognitive engineer with artificial hybrid intelligence. Using the chosen mathematical apparatus, a method for the synthesis of fuzzy models of forecasting and diagnosis of occupational diseases is proposed.Results. As a concrete example, the problem of predicting and diagnosing ischemic heart disease (CHD) in electric train drivers has been solved with the allocation of such classes of conditions as: "healthy and the appearance of CHD is not expected"; "healthy, but the appearance of CHD is expected after the predicted time"; "early stage of CHD"; "CHD disease has been detected". As a result of expert evaluation, it was shown that the confidence in the correct classification is at the level of 0.9. The same result was confirmed by the results of statistical tests on representative control samples in terms of diagnostic sensitivity and specificity.Conclusion. The proposed method of synthesis of hybrid fuzzy models makes it possible to synthesize hybrid decision rules that improve the quality of prediction and early diagnosis of the studied class of diseases both in the presence of training samples and in their absence by compensating for the lack of statistical material by methods of formalization of clinical thinking. As a concrete example, the problem of predicting and diagnosing ischemic heart disease in electric train drivers has been solved. It is shown that the confidence in the correct classification is at the level of 0.9, which allows us to recommend the results obtained for practical use in occupational pathology.

Бронхіальна астма як професійне та екологічно-обумовлене захворювання: сучасні погляди на проблему згідно рекомендацій міжнародної організації праці 2022 року

Abstract. According to the International Labour Organization (ILO), the annual incidence of occupational bronchial asthma (OBA) ranges from 12 to 300 cases per million workers. Unlike in European countries, bronchial asthma in Ukraine remains an «under-recognised» occupational disease, accounting for less than 0.2 % of occupational pathology. The aim of the study: to analyse the algorithm for diagnosing and recognising bronchial asthma as an occupational disease according to the ILO 2022 recommendations, to compare its main provisions with the current one in Ukraine in order to adapt the system of registration of OBA to the requirements of the European Union because of the European integration process. Materials and methods. An analytical review of scientific publications using the abstract databases of scientific libraries PubMed, Medline and text databases of scientific publishers PubMed, Central, BMJ group and other VIP databases. The main legislative documents of Ukraine and the ILO regulating the process of recognising occupational diseases were analysed. The methods of system and content analysis were used. The results. Population risk assessments show that the development of 9–15 % of asthma cases in working population is directly related to exposure to harmful factors in the workplace. The risk of disease development is significantly increased due to air pollution with chemical and toxic substances as a result of hostilities in Ukraine. A comparative analysis of the international principles of diagnosis and recognition of bronchial asthma as an occupational disease with a similar system in Ukraine revealed significant differences: Ukrainian documents do not contain important information on the properties of various forms of chemical compounds, their toxicological profile, the minimum duration of exposure that causes an occupational disease, and the latency period. The lack of reference to these legally defined indicators affects the objectivity of diagnosis, the unification of diagnoses, which leads to a distortion of statistical indicators of occupational morbidity in Ukraine. Conclusions. The system of diagnosis and recording of occupational diseases, including OBA, should be improved according to the current ILO 2022 recommendations because of the reintegration processes of Ukraine’s accession to the European Union. Key words: occupational bronchial asthma, sensitizers, irritants.

Priority directions for preserving the health of underground coal mining workers

Introduction. An increase in life expectancy, a decrease in the mortality rate of the working-age population and an extension of working longevity are the most important components in the development of the human potential of the Russian Federation. We observe the most unfavorable situation with the achievement of the above-mentioned targets in coal mining.&#x0D; The study aims to substantiate the priority directions for preserving the health of workers engaged in underground coal mining in modern production conditions based on an assessment of occupational risks to prolong their working longevity.&#x0D; Materials and methods. The authors have carried out the analysis of official statistics data (state reports of Rospotrebnadzor and the annual report of Rosstat) for 2021–2022 on the state of working conditions and occupational morbidity in the coal industry. We have summarized the materials of Rosugleprof for 2006–2022 on occupational morbidity in coal industry organizations. We have presented the data of epidemiological studies in a cohort of coal miners on the example of the Rostov region.&#x0D; Results. The authors note the largest proportion of cases of occupational pathology among employees of mining enterprises — 40.3%. The most at risk are: sinkers (10.2% of all newly identified cases of occupational diseases in 2022), miners of the treatment face (6.5%), excavator drivers (4.5%). In the structure of occupational morbidity of miners, the leading place is occupied by radiculopathy — 27.0%; sensorineural hearing loss — 22.9%; vibration disease — 22.0%; respiratory diseases (occupational bronchitis, pneumoconiosis, COPD) — more than 15.5%. In a cohort of miners with an established diagnosis of occupational diseases, it was shown that the standardized relative risk (SRR) of death from diseases of the circulatory system was 1.55 times significantly higher compared with the control population.&#x0D; Mortality from malignant neoplasms in miners was 44% higher than mortality in the population (SRR=1.44). At the same time, the death rate from the subclass malignant neoplasms of the respiratory system was 2.02 (95% CI 1.85–2.20), and from malignant neoplasms of the bronchi and lungs 2.24 (95% CI 2.04–2.46). The risk of death from respiratory diseases in the cohort of miners was more than 2 times higher than the population indicator (SRR=2.18). A significantly higher frequency of deaths from this class of diseases indicates a causal relationship with dust loads. The prevalence of coronary heart disease (CHD) among coal mine workers is higher than among the unorganized population of large cities and other groups of industrial workers.&#x0D; Conclusion. Scientists have recorded the most unfavorable working conditions in underground coal mining, which is due to the technologies used and production conditions. The prevention of diseases among miners requires the creation of health groups and the improvement of medical examination methods. Development of an integrated information system for health monitoring and personalized preventive and rehabilitation measures. To solve this problem, it is necessary to study working conditions, scientifically substantiate preventive measures, harmonize special assessment of working conditions and develop criteria for severity and intensity of work, as well as improve the technology for assessing working conditions and personalized risk assessment.&#x0D; Ethics. The study did not require the conclusion of the Ethics committee.

How difficult is it to diagnose and report an occupational disease in a developing country? A modified delphi study

Aim: The roles of occupational medicine specialists are very important in the diagnosis and notification of occupational diseases. In this regard, the opinions of the parties are needed to identify the problems and propose solutions. Methods: This is a Modified Delphi exercise. It was conducted through an online survey in 2 rounds in Turkey between June 4, 2021 and August 31, 2021. The population of the research consists of occupational medicine specialists and sub-branch students in Turkey and some physicians working in the central organizational units of the Ministry of Health and the Ministry of Labor and Social Security regarding the diagnosis, registration and notification of occupational diseases. In both rounds, e-mails were sent to 127 people. The survey was sent via , and the response frequency was 27.5% and 18.1% in rounds 1 and 2, respectively. A survey form was created for the second round by evaluating the open-ended information obtained as a result of the first round using the thematic analysis method and making suggestions. This form was sent to participants via e-mail and questions were asked about participation in the proposals in the second round. Proposals with 70% or more participation were accepted unanimously. Results: The most important difficulties regarding the diagnosis and details of occupational diseases are; The lack of a national occupational disease surveillance system, the fact that the current occupational disease diagnosis and summary system is focused on pricing, and the difficulties people experience in diagnosis were determined. Conclusion: In order to increase the reporting of occupational diseases, a surveillance-oriented system should be switched instead of a compensation-based system. In addition, the deficiencies in manpower, financing, technical infrastructure and legislation in the occupational disease reporting system need to be rapidly revised.

Features of the occupational prevalence in health workers in the Republic of Bashkortostan over 2017–2022

Introduction. The labour of health workers (HW) is associated with the impact of adverse factors of various nature including chemical, physical, biological, high neuro-emotional stress, physical activity. All these factors, high workload, round-the-clock working with night shifts, unpredictability of the state of health and responsibility for the life of the patient, high olccupational activity, constant psycho-emotional and intellectual stress make the labour of HW to be a complex and responsible type of human activity. Over recent (2020–2021) years, due to the emergence of a highly contagious Covid-19 viral infection, health workers have been in direct contact with patients.&#x0D; Objective. To determine the features of occupational morbidity among the HR in the Republic of Bashkortostan over 2017–2022 including the COVID-19 pandemic.&#x0D; Materials and methods. Data on occupational diseases in HW over 2017–2022 were studied on the base of the materials of the Republican Center for Occupational Pathology of the Ufa Scientific Research Institute of Occupational Medicine and Human Ecology. There were evaluated reports of the final diagnosis of an occupational disease, acts of investigation of occupational diseases, sanitary and hygienic characteristics of working conditions, a consolidated annual report on the activities of the Center.&#x0D; Results. The level of occupational morbidity increased from 0.6‱ in 2017 to 5,6‱ during 2021, i.e. increased by 9.3 times. The nosological, gender, age, occupational and experience structure of morbidity has changed. In 88.8% of cases, the diagnosis of an acute occupational disease due to coronavirus infection was established posthumously: in 2020 – 100%, in 2021 – 86.3%. There were 0.72 deaths from this infection per 1,000 health workers.&#x0D; Conclusions. To preserve the health and occupational longevity of HW, especially in the context of an epidemiological rise in infectious diseases, it is necessary to strengthen priority measures for primary and secondary prevention, provide personal protective equipment, strengthen disinfection measures, establish a special regime of work and rest, and other preventive and social protection measures.

Pathological features and diagnostic significance of lung biopsy in occupational lung diseases

Objective: To investigate the clinicopathological characteristics of occupational lung diseases, to reduce the missed diagnoses and misdiagnoses of the diseases and to help standardize the diagnosis and treatment of these patients. Methods: A total of 4 813 lung biopsy specimens (including 1 935 consultation cases) collected at the Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, China from January 1st, 2017 to December 31th, 2019 were retrospectively analyzed. Among them, 126 cases of occupational lung diseases were confirmed with clinical-radiological-pathological diagnosis. Special staining, PCR and scanning electron microscopy were also used to rule out the major differential diagnoses. Results: The 126 patients with occupational lung diseases included 102 males and 24 females. All of them had a history of exposure to occupational risk factor(s). Morphologically, 68.3% (86/126) of the cases mainly showed pulmonary fibrotic nodules, dust plaque formation or carbon end deposition in pulmonary parenchyma. 16.7% (21/126) of the cases mainly showed welding smoke particle deposition in the alveolar cavity and lung interstitium while 15.1% (19/126) of the cases showed granulomas with fibrous tissue hyperplasia, alveolar protein deposition or giant cell interstitial pneumonia. The qualitative and semi-quantitative analyses of residual dust components in the lung under scanning electron microscope were helpful for the diagnosis of welder's pneumoconiosis and hard metal lung disease. Conclusions: The morphological characteristics of lung biopsy tissue are important reference basis for the clinicopathological diagnosis and differential diagnosis of occupational lung diseases. Recognizing the characteristic morphology and proper use of auxiliary examination are the key to an accurate diagnosis of occupational lung diseases on biopsy specimens.

Analysis of suspected occupational diseases cases and subsequent diagnosis follow-up investigation in Hubei Province from 2020 to 2021

Objective: To understand the epidemiological characteristics of suspected occupational diseases cases, and to track the subsequent diagnosis of suspected cases in Hubei Province from 2020 to 2021, and to provide theoretical basis for the supervision of suspected occupational diseases. Methods: In April 2022, the data of suspected occupational diseases cases and occupational diseases in Hubei Province from 2020 to 2021 were collected by the Occupational Diseases and Health Risk Factors Information Surveillance System. The distribution and diagnosis of suspected occupational diseases cases were analyzed. We investigated undiagnosed suspected occupational diseases by telephone. Results: From 2020 to 2021, a total of 1872 cases of suspected occupational diseases in 6 categories and 18 species were reported in Hubei Province. The top three suspected occupational diseases were suspected occupational noise deafness (36.75%, 688/1872), suspected coal worker's pneumoconiosis (33.07%, 619/1872) and suspected silicosis (20.99%, 393/1872). The diagnosis rate of suspected occupational diseases was 33.60% (629/1872). The rate of confirmed diagnosis was 63.59% (400/629). The diagnosis rate (26.86%, 456/1698) and rate of confirmed diagnosis (55.48%, 253/456) of suspected occupational diseases detected by occupational health examination were the lowest. The diagnosis rate of suspected occupational diseases detected by comprehensive medical institutions and private medical institutions were lower than disease prevention and control institutions and occupational disease prevention center (P<0.05). The main reasons for not entering the diagnostic procedure included that workers were not informed that they were diagnosed as suspected occupational diseases (31.55%, 124/393), workers were unwilling to apply for occupational disease diagnosis (18.56%, 73/393), and some workers planned to apply for diagnosis but had not yet applied (10.69%, 42/393) . Conclusion: Occupational noise deafness, coal worker's pneumoconiosis and silicosis are the main diseases of suspected occupational diseases in Hubei Province. In order to increase the diagnosis rate and confirmed diagnosis rate of suspected occupational diseases, it is suggested to strengthen management and supervision from the aspects of case management, information warning and worker notification.

A case of occupational explosive deafness caused by non explosive strong noise

Occupational explosive hearing loss is often caused by close exposure to blasting operations or the impact waves and strong pulse noise generated by explosions of flammable and explosive chemicals, pressure vessels, etc. in the workplace. This article analyzes the diagnosis of a case of occupational explosive hearing loss caused by non explosion, in order to improve the flexible application of diagnostic standards by occupational disease diagnosis physicians.