Diagnosis Of Occupational Diseases Research Articles

Employment status of workers with a diagnosed occupational disease in Croatia: a 10-year trend (2005-2014).

Occupational diseases (ODs) often have a chronic, progressive course, resulting in reduced work capacity and quality of life, prolonged sick leaves, unemployment, early retirements, and disability claims. The aim of this retrospective study was to see how diagnosed ODs affected the employment of 95 Croatian workers between 2005 and 2014. To do that, we reviewed archived data and made a telephone survey. The lowest age at which an OD was diagnosed was 20 years in women and 22 in men, while the shortest duration of work before OD diagnosis was one year for both genders. The most common ODs were overuse syndromes on the arms, carpal tunnel syndrome in particular, diagnosed mostly in textile and office workers. Of the 95 participants, 12 lost their jobs since the OD diagnosis, 46 retired, and 37 continued to work. Significantly more participants became unemployed after OD diagnosis in the period 2010-2014 than 2005-2009 (9 out of 43, 21 %, vs. 3 out of 52, 6 %, P<0.05). Only five participants were included in an occupational rehabilitation programme. Our findings warn against the deterioration in care for workers diagnosed with OD in Croatia.

Concepts of occupational morbidity formation in miners of Rostov coal basin

The authors analyzed informational statistic materials of Occupational pathology center in Rostov region over 1960–2016 and information on retrospectively formed cohort of coal miners (1990–2015). Medical and demographic characteristics of the cohort covered work conditions, age at occupational disease diagnosis in the miners, structure and dynamics of occupational morbidity in various occupational groups. Over the stated time interval, unfavorable work conditions of the coal miners were associated with high risk of occupational disease development. The miners of the studied cohort appeared to have respiratory diseases and vibration disease at able-bodied age (70.4%) prevalent in occupational diseases structure.

Perceived barriers and facilitators in the assessment of occupational diseases.

Information is collected worldwide on the diagnosis and assessment of occupational diseases (ODs) by occupational physicians (OPs). However, information on perceived facilitators and barriers to assessment is scarce. To evaluate the perceived barriers and facilitators in the assessment of ODs by OPs. We conducted a qualitative study, using interviews and focus groups. We held 12 interviews and two focus groups with Dutch OPs, to identify barriers and facilitators in the assessment of ODs. Case definition, exposure assessment, attribution to work, guidelines and decision tools, external expertise, individual motivation and consequences were identified as themes. Barriers and facilitators were mainly reported regarding assessing work attribution, e.g. how to assess multifactorial causes or the need for training, and individual motivation such as the perceived lack of usefulness or the need for monitoring suspected OD cases. Within the theme of consequences, only barriers to the assessment of ODs were reported, including the liability of employers. Perceived facilitators in the assessment of ODs were practical assessment tools, multifaceted education, ability to assess work exposures and professional independence. Perceived barriers were lack of usefulness, lack of urgency, complexity of assessment and concerns about liability issues.

The diagnosis of occupational disease in one non-freezing frosbite case

The diagnosis of occupational disease in one non-freezing frosbite case

Update on metal-induced occupational lung disease.

Occupational and environmental exposures to metals can result in multiple pulmonary conditions. This article will review recent epidemiologic and mechanistic studies that have enhanced our understanding of the association between particular lung diseases and exposure to specific metals. Recent studies have broadened our understanding of the mechanisms of lung diseases such as CBD in established industries and drawn attention to conditions that may arise from exposure to metals such as indium in developing technologies. New diagnostic techniques such as elemental tissue analysis may help establish a diagnosis of metal-induced occupational lung disease. Electronic cigarette devices, environmental pollutants, and the growing use of nanoparticle-sized metals pose additional risks to workers and consumers. Recognizing the risks of pulmonary disease in workers exposed to metals and performing a thorough occupational history and diagnostic work-up in patients with unexplained respiratory findings is necessary to promote understanding and prevention of metal-induced lung disease.

Occupational Allergic Airway Disease

The purpose of this paper was to review recent advances on causal agents, diagnosis and management of occupational allergic airway diseases. Food-derived products are a major cause of occupational asthma (OA) and occupational rhinitis (OR), and flour and seafood are the most important allergen sources. In recent years, farmers, cleaners, veterinarians, swimming pool workers and waste workers have been shown as novel categories at higher risk. Molecular diagnosis may greatly improve the diagnostic workup of allergic OA and OR. The use of immunotherapy and biologics may ameliorate the treatment of allergic OA. Occupational allergies are a burden for society and surveillance of exposed workers may identify new categories at risk. Cessation of exposure is the best treatment option for OA and OR. An accurate environmental control is needed to reduce asthma exacerbations in work-exacerbated asthma. The management of occupational allergic airway diseases should include a follow-up programme providing close collaboration between health care providers and patients, and ad hoc educational tools aimed at ameliorating patient’s knowledge should be developed.

Spatial distribution of occupational disease prevalence in Guangzhou and Foshan city by geographic information system

Objective: To explore the occupational disease spatial distribution characteristics in Guangzhou and Foshan city in 2006-2013 with Geographic Information System and to provide evidence for making control strategy. Methods: The data on occupational disease diagnosis in Guangzhou and Foshan city from 2006 through 2013 were collected and linked to the digital map at administrative county level with Arc GIS12.0 software for spatial analysis. Results: The maps of occupational disease and Moran's spatial autocor-relation analysis showed that the spatial aggregation existed in Shunde and Nanhai region with Moran's index 1.727, -0.003. Local Moran's I spatial autocorrelation analysis pointed out the "positive high incidence re-gion" and the "negative high incidence region" during 2006~2013. Trend analysis showed that the diagnosis case increased slightly then declined from west to east, increase obviously from north to south, declined from? southwest to northeast, high in the middle and low on both sides in northwest-southeast direction. Conclusions: The occupational disease is obviously geographical distribution in Guangzhou and Foshan city. The corresponding prevention measures should be made according to the geographical distribution.

Current and new challenges in occupational lung diseases.

Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.

Comprehensive guide to the diagnosis and management of occupational lung diseases

Comprehensive guide to the diagnosis and management of occupational lung diseases

A role of molecular analysis for diagnosis and prevention of occupational lung diseases

Morbidity of occupational respiratory diseases depends on workplace environmental and individual genotype as well. The aim of our study was to investigate molecular biomarkers of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD) in workers exposed to toxic aerosols. The second aim was to develop preventive measures for these diseases. Methods. This was a randomized prospective cohort study that involved workers of food industry. Results. The study involved 159 food industry workers. Lung function abnormalities (29.3%) and hyperresponsiveness to workrelated factors (20.6%) were found in 126 of 159 workers who were at risk of occupational respiratory diseases and were exposed to biological active aerosols. BA and COPD were diagnosed in 17.4% and 11.9% of workers, respectively. Hyposecretory variants (PiMS, PiMZ) of alfa-1-protease inhibitor (API) gene were found in 5.5% of workers. Proportions of workers with deficit of GSTM1 and GSTT1 enzymes were 65% and 60%, respectively. Risk alleles (ID, DD) of the angiotensin converting enzyme (ACE) gene that indicate the susceptibility to cardiovascular diseases and are typical for subjects exposed to dust particles and other hazardous agents were found in 20% of workers. Conclusion. Our results have demonstrated the role of molecular biomarkers of individual susceptibility to occupational factors. Molecular biomarkers could define the risk of occupational respiratory diseases, predict their course and help to choose therapeutic and preventive measures. Identifying the susceptible workers could underlie personalized approach to prevention of respiratory diseases.

Mental health status of patients of occupational disease diagnosis and its affected factors

目的： 了解职业病诊断患者的心理健康状况，探讨其主要影响因素。 方法： 于2015年11月至2016年4月，收集127例职业病诊断患者，采用12项一般健康问卷（GHQ-12）及自编相关因素问卷进行心理健康状况及影响因素调查。 结果： 职业病诊断患者GHQ-12平均得分为（6.74±3.98）分，心理障碍高危人群（总分≥4分者）占74.0%。客观病情较重、已婚、患病后收入减少、单位主观和客观支持评分低及家庭人均年收入低是职业病诊断患者自评心理障碍的危险因素（P<0.05）。logistic逐步回归分析结果显示，患病后工资档次比患病前降低是心理健康的危险因素（OR=7.411，95%CI：2.302~23.860）；患病所从事工种年限（现工龄）长是心理健康的危险因素（OR=1.149，95%CI：1.030~1.282）；单位主观支持评分高是心理健康的保护因素（OR=0.737，95%CI：0.596~0.911）。 结论： 职业病诊断患者心理健康状况问题较严重，应重点关注患病前后收入变化大、从事工种年限长的患者。.

EVALUATION OF EFFECTIVENESS OF ACLIDINIUM BROMIDE FOR PATIENTS WITH OCCUPATIONAL CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

Aim - evaluation of effectiveness and safety of the innovative medicinal product aclidinium bromide for patients with occupational COPD (chronic obstructive pulmonary disease). Materials and methods. The research was performed during 2015-2016 in the Samara Regional Center for Occupational Pathology. The study included 44 patients with the diagnosis of occupational chronic obstructive pulmonary disease. The diagnosis was based on the history of professional data, sanitary characteristics of working conditions, and complete clinical, functional and instrumental examination of the patients. The patients were randomly divided into two groups: 22 patients were given 322 micrograms of aclidinium bromide via inhalation twice a day during 24 weeks, while 22 patients from the comparison group were given 50 micrograms of glycopyrronium bromide once daily. The respiratory function test was carried out both before and after the treatment; the dynamics of dyspnea was measured and the quality of patients’ life was estimated. The following aspects were examined: the quantity of days when emergency medicinal treatment was not required; the quantity of required daily inhalations of rescue medications; the frequency of exacerbations; the period before the first exacerbation happens; compliance; adverse drug reactions. Statistical processing of the data was performed using SPSS 21 software package. Results. Aclidinium bromide has advantages over glycopyrronium bromide concerning the following aspects: functional indices (FEV1 forced expiratory volume during the first second), clinical data (dyspnea), quality of patients’ life, frequency of exacerbations, the period before the first exacerbation happens, and patients’ compliance. Conclusion. Aclidinium bromide has proven to be an effective and safe medication for medical treatment of patients who suffer from moderately severe occupational COPD.

Occupational diseases in the automotive industry in Czechia - Geographic and medical context.

The automotive industry represents the most important industrial sector in Czechia. The objective of this study has been to analyze the occurrence of occupational diseases (OD) in the automotive industry during the period from 2001 till 2014. Data on OD cases was retrieved from the National Registry of OD. Further, we conducted a survey in automotive companies with focus on occupational health services and positions of the companies in global production networks (GPNs). An analysis of OD distribution in the automotive industry was performed (age, gender, company size and its role in GPNs, regional distribution of studied companies, and regional unemployment rate), and was accompanied by assessment of the quality and range of occupational health services. Employees older than 40 years old have nearly 2.5 times higher probability of OD occurrence as compared with employees younger than 40 years old (odds ratio (OR) = 2.41, 95% confidence interval (CI): 2.05-2.85). Occupational diseases occurrence probability was 3 times higher for women than for men (OR = 3.01, 95% CI: 2.55-3.55). Occupational diseases incidence rates increased with the size of the company (0 OD/10 000 employees in micro enterprises to 57 OD/10 000 employees in large enterprises). A particularly steep rise in OD incidents in the automotive industry was observed in the Plzeň Region between 2001 and 2011. An association between OD incidents and the unemployment rate was not statistically confirmed. A statistically significant increase in OD incidents dependent on company size may be arguably attributed to a higher quality of occupational medical services in bigger companies, which ensures better detection and diagnosis of OD. In the Plzeň Region, the rapid increase in OD incidents was mainly caused by a change in the production process of automobile textiles in one factory due to the introduction of a glue containing isocyanates, which are potent allergising agents. This led to an increase in occupational allergic diseases - bronchial asthma in particular. Int J Occup Med Environ Health 2017;30(3):455-468.

Investigation on standard application of industrial dust hazard classification

Objective: To investigate the application and effectiveness evaluation of the standard of GBZ/T 229.1-2010 in practice, and to explore the applicability, aiming to provide technical evidence for the revision of GBZ/T 229.1-2010. Methods: There were 2 questionnaire surveys carried out in the study, including general survey and specific survey. Databases were established and data were input with Excel 2010 and Epidata version 3.1 software. SPSS version 19.0 software was used for data cleaning and statistical analysis. Results: The general survey received 100 questionnaires, with 43 from facilities and 57 from professional expertise. There were 59 questionnaires from occupational health technical service organizations held by government, and 11 from colleges and universities. The leading three jobs using GBZ/T 229.1-2010 were the occupational hazards evaluation for constructive project (69.0%) , lecturing/training (55.0%) , occupational hazards monitoring (50.0%) , respectively. The high frequency used contents of GBZ/T 229.1-2010 were the fourth part "classification" (67.0%) , the fifth part "the principles of classification management" (59.0%) , annex A "the correct use instructions" (52.0%) , respectively. In the results of feasibility, scores of the fourth part "classification" , the fifth part "the principles of classification management" , annex A "the correct use instructions" were 3.07, 3.03, 3.23, respectively. The parts needed to be modified as priories were the fourth part "classification" (22.0%) , the fifth part "the principles of classification management" (13.0%) , annex A "the correct use instructions" (12.0%) . The specific survey received 15 questionnaires, with 12 from the employers and 3 from occupational health technical service organizations. The awareness rate of GBZ/T 229.1-2010 among occupational health professionals was 83.3%. Classification results in the employers were used for guidance on improvement measures (66.7%) , health surveillance and monitoring (58.3%) , certification for occupational health and safety management system (33.3%) , occupational disease diagnosis (33.3%) , and personal protective equipment issued (33.3%) , etc. In the results of feasibility, scores of the content of free SiO(2), occupational exposure ratio, physical labor intensity level, classification of industrial dust, principles of classification management, annex A "the correct use instructions" were 5.00, 4.33, 5.00, 5.00, 3.67, 3.67, respectively. Conclusion: GBZ/T 229.1-2010 indicates that the standard is feasible and practical. But there are still some problems, such as classification of different kinds of industrial dusts at workplace, and the interaction of occupational exposure to industrial dusts and other hazards at workplace, etc.

A trend analysis of the incidence of occupational diseases in Chongqing, China, from 2006 to 2014

Objective: To investigate the incidence of occupational diseases in Chongqing, China, from 2006 to 2014, and to analyze the harm, features, and trend of occupational diseases in Chongqing. Methods: The data of new cases of occupational diseases from 2006 to 2014 were collected, and the patients with a confirmed diagnosis of occupational diseases were selected as study subjects to analyze the incidence of occupational diseases in Chongqing. Results: There were 17499 cases of occupational diseases in total in Chongqing from 2006 to 2014. Among these patients, 17124 (97.86%) were male, most of whom (95.40%) had occupational pneumoconiosis, and 375 (2.14%) were female, most of whom (72.80%) had occupational chemical poisoning. There were 16400 cases (93.72%) of occupational pneumoconiosis in total, mainly coal workers' pneumoconiosis (55.87%) and silicosis (43.02%) , and the main industries involved were coal mining and washing, railway transport equipment manufacturing, and mining and washing of bituminous coal and anthracite. There were 724 cases of occupational poisoning in total; there were 281 cases of acute occupational poisoning, mainly gas poisoning (39.86%) and carbon monoxide poisoning (33.10%) ; there were 443 cases of chronic occupational poisoning, mainly poisoning caused by benzene (47.63%) , mercury and its inorganic compounds (32.74%) , and lead and its inorganic compounds (9.03%) . Conclusion: Occupational diseases in Chongqing are mainly occupational pneumoconiosis, and occupational health supervision should be enhanced in the industries of coal mining and washing and railway transport equipment manufacturing to protect workers' health.

Determinants Levels of Urinary 8-Hydroxydeoxyguanosine among Chromium Electroplating Workers

Electroplating workers were exposed by particulate and fog of chromium from electrolysis process during work. Chromium is highly carcinogenic when inhaled. Chromium can be reduced in the cells in the body. This process may generate Reactive Oxygen Species (ROS) causing lipid peroxidation and oxidative DNA damage. This research was aimed to analyse the influence of chromium to the levels of urinary 8-OHdG as an indicator to support early diagnosis of occupational disease. 66 electroplating workers in Tegal District were taken purposively as samples for this research. There were association between chromium level in urine, malondialdehyde (MDA) level, Body Mass Index, smoking habit, alcohol and supplement drink consumption and urinary 8-OHdG (p&amp;lt;0.05). There was not association between BMI and urinary 8-OHdG (p&amp;gt;0.05). Multivariate analysis using logistic regression showed the alcohol consumption had the most powerful influence to the level of urinary 8-OHdG. The levels of urinary 8-OHdG could be used as an indicator of oxidative DNA damage and early diagnosis of occupational disease among electroplating workers who were exposed by chromium.

Determinants Levels of Urinary 8-Hydroxydeoxyguanosine among Chromium Electroplating Workers

Electroplating workers were exposed by particulate and fog of chromium from electrolysis process during work. Chromium is highly carcinogenic when inhaled. Chromium can be reduced in the cells in the body. This process may generate Reactive Oxygen Species (ROS) causing lipid peroxidation and oxidative DNA damage. This research was aimed to analyse the influence of chromium to the levels of urinary 8-OHdG as an indicator to support early diagnosis of occupational disease. 66 electroplating workers in Tegal District were taken purposively as samples for this research. There were association between chromium level in urine, malondialdehyde (MDA) level, Body Mass Index, smoking habit, alcohol and supplement drink consumption and urinary 8-OHdG (p&amp;lt;0.05). There was not association between BMI and urinary 8-OHdG (p&amp;gt;0.05). Multivariate analysis using logistic regression showed the alcohol consumption had the most powerful influence to the level of urinary 8-OHdG. The levels of urinary 8-OHdG could be used as an indicator of oxidative DNA damage and early diagnosis of occupational disease among electroplating workers who were exposed by chromium.

Occupational asthma: an analysis of two cases

To investigate the incidence of occupational asthma induced by occupational exposure to detergents and spices. The occupational history, case data, and results of auxiliary examinations were collected from patients with asthma induced by occupational exposure to detergents and spices and submitted to the expert group for diagnosis of occupational diseases to obtain the diagnostic results. Both patients with asthma were exposed to asthmogenic substances in the working environment and developed the symptoms of asthma after a certain latency period. In case 1, the patient had positive results from bronchial dilation test and peak expiratory flow test; in case 2, the patient had positive results from allergen skin prick test for spices and essence and allergen bronchial provocation test. Therefore, the possibility of asthma induced by occupational factors could not be excluded. Occupational exposure to detergents and spices can induce occupational asthma.

Field investigation of occupational disease diagnosis in Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014: an analysis of 136 cases

To investigate the characteristics of 136 patients with occupational diseases, to summarize key techniques used in field investigation, and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis. Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014. A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014, and there were 66 cases of leukemia, 18 cases of suspected occupational benzene poisoning, 12 cases of suspected occupational handarm vibration disease, and 11 cases of suspected pneumoconiosis. Of all these patients, 41.91% were engaged in at least three types of work, 70.59% were exposed to at least three types of chemicals, 25.74% experienced changes in technical processes and chemicals, and 47.06% had disputes on the chemicals they were exposed to during verification by both parties. Occupational hazard factors were detected. Most samples (358)were used to measure benzene concentration in workplace air, among which 11.7% had a benzene concentration of >6.00 mg/m(3)(exceeding standard), 13.41% had a benzene concentration of 3.26~6.00 mg/m(3), 75.42% had a benzene concentration of<0.03 to <3.25 mg/m(3). The samples of suspected occupational hand-arm vibration disease, suspected pneumoconiosis, and suspected occupational noiseinduced hearing loss had high overstandard rates (100%, 93.8%, and 83.3%, respectively). Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia, suspected occupational benzene poisoning, suspected occupational hand-arm vibration disease, and suspected pneumoconiosis. The key aspects of field investigation include confirmation of the history of occupational exposure, identification of occupational hazard factors, confirmation of the changes in technical processes and chemicals, detection of occupational hazard factors, sampling and analysis of raw materials, and epidemiological investigation of workers with the same type of work.

Current status of occupational health and related countermeasures in Guangzhou, China

To investigate the current status of occupational health and related countermeasures in Guangzhou, China. Related data were collected from occupational poisoning accident investigation, diagnosis and identification of occupational diseases, and the occupational disease hazard reporting system, and the statistical data of occupational health in Guangzhou were analyzed retrospectively. The number of enterprises reporting for occupational disease hazards in Guangzhou was 20 890, and the total number of workers was 1 457 583. The number of workers exposed to occupational hazards was 284 233, and the cumulative number of workers with occupational diseases was 1 502. There were many risk factors for occupational diseases in enterprises, and there were a large number of workers with occupational diseases, as well as newly diagnosed cases. From 2001 to 2014, the total number of cases of occupational diseases was 958. The situation for the prevention and control of occupational diseases is grim in Guangzhou. Occupational health supervision and law enforcement should be enhanced, the three-level supervision system should be established and perfected, and the occupational health supervision system with a combination of "prevention, treatment, and protection" should be established and promoted, so as to gradually establish a technical service support system for occupational health.