Diagnosis Of Occupational Diseases Research Articles

Clinical and diagnostic features of occupational polyneuropathy in combination with damage to the locomotor apparatus in workers of harmful professions

An urgent task for the occupational pathology service of the country is the search for objective methods for the early diagnosis of occupational diseases of the peripheral nervous system, in combination with the pathology of the musculoskeletal system, often occurring among workers of hazardous industries. Based on the analysis of electroneuromyographic and radiological research methods in 60 workers performing work with the impact of local vibration and physical overload, the degree of impairment of the peripheral nervous system and the musculoskeletal system of the upper limbs was studied in comparison with persons whose labor activity excluded contact with these labor factors. A relationship has been established between the severity of clinical and instrumental data obtained with the duration of exposure to harmful factors. Identification of lesions of the peripheral nervous system and the locomotor apparatus will ensure timely prevention and adequate therapeutic measures.

Analysis on the diagnosis of suspected occupational diseases in Guangzhou from 2014 to 2019

Objective: To understand the diagnosis of suspected occupational diseases reported in Guangzhou from 2014 to 2019, so as to provide theoretical basis and technical support for the supervision of suspected occupational disease reports. Methods: By cluster sampling, the suspected occupational disease report card, occupational disease report card and pneumoconiosis report card reported by Guangzhou from January 1, 2014 to December 31, 2019 in the occupational disease and occupational health information monitoring system were collected for matching analysis to understand the diagnosis of suspected occupational disease patients. Results: From 2014 to 2019, a total of 1426 suspected occupational cases in 7 categories and 32 species were reported in Guangzhou. The average number of reported cases per year was about 240. The main diseases of suspected occupational diseases were suspected occupational noise deafness (68.44%, 976/1426) , suspected occupational chronic benzene poisoning (16.48%, 235/1426) , suspected occupational other pneumoconiosis (4.84%, 69/1426) , suspected occupational silicosis (3.23%, 46/1426) and suspected occupational welder pneumoconiosis (1.82%, 26/1426) . The diagnostic rate required to enter the occupational disease diagnostic program is 36.61% (522/1426) , and the diagnostic rate is 59.20% (309/522) . In 2019, the diagnosis rate of suspected occupational diseases was the lowest (23.92%, 61/255) , Huadu District was the lowest (8.33%, 9/108) , suspected occupational pneumoconiosis was the lowest (28.03%, 44/157) , the diagnosis rate of suspected occupational diseases reported by the Centers for Disease control and prevention was the lowest (17.43%, 19/109) , and the diagnosis rate of suspected occupational diseases reported by outpatient treatment was the lowest (22.22%, 2/9) . The suspected occupational diseases reported by institutions outside Guangzhou did not enter the occupational disease diagnosis procedure. Suspected occupational skin diseases, suspected occupational diseases caused by physical factors and suspected occupational tumors were diagnosed, and the diagnosis rate of occupational disease prevention and control institutions was the highest (94.87%, 37/39) . Conclusion: The main types of suspected occupational diseases reported during these six years are noise deafness, chronic benzene poisoning and pneumoconiosis. The overall diagnosis rate and diagnosis rate of suspected occupational diseases are not high. It is suggested to improve the network direct reporting system of suspected occupational diseases and strengthen the follow-up management and supervision of suspected occupational diseases.

Оценка и прогнозирование респираторных нарушений при заболеваниях легких, связанных с воздействием фиброгенных аэрозолей

Актуальность. У лиц, работающих в условиях воздействия промышленных аэрозолей фиброгенной и/или химической природы частой проблемой является поздняя постановка диагноза профессионального заболевания бронхолегочной системы. В настоящее время наиболее достоверной и общепринятой методикой исследования функции внешнего дыхания является регистрация и анализ кривых «поток — объем», осуществляемых при помощи микропроцессорной техники. Цель исследования: оценка и прогнозирование респираторных нарушений при заболеваниях легких, связанных с воздействием фиброгенных аэрозолей.Материалы и методы.Проведено комплексное исследование функции внешнего дыхания у 153 человек с различными профессиональными заболеваниями легких в сравнении с данными 60 здоровых людей. Больным проведено бронхоскопическое исследование и компьютерная пневмотахография.Вывод. С целью ранней диагностики гиперреактивности бронхов у лиц, контактирующих на производстве с промышленными фиброгенными аэрозолями, и уточнения степени функциональных нарушений при хроническом пылевом бронхите, силикозе, пневмокониозе от воздействия сварочных аэрозолей необходимо проводить определение таких показателей форсированного выдоха, как FVC, FEV1, FEV1/FVC, PEF, MEF25 %VC, MEF50 %VC, MEF75 %VC и Rfo, изменение которых может служить первичным функциональным физиологическим маркером предболезни при профессиональных заболеваниях легких. Компьютерная пневмотахография позволяет достоверно выявлять ранние формы пылевых заболеваний легких, дифференцировать их различные клинико-функциональные типы, что повышает качество ранней диагностики, вторичной профилактики, терапии и реабилитации при данной патологии, позволяет избежать развития и прогрессирования осложнений пылевых заболеваний легких, и прежде всего хронического легочного сердца.

КОМП’ЮТЕРНА ТОМОГРАФІЧНА ДЕНСИТОМЕТРІЯ ЛЕГЕНЬ В АЛГОРИТМІ ДІАГНОСТИКИ ІНТЕРСТИЦІАЛЬНИХ ЗАХВОРЮВАНЬ ЛЕГЕНЬ, В ТОМУ ЧИСЛІ ПРОФЕСІЙНОЇ ЕТІОЛОГІЇ ТА ЕКОЛОГІЧНО ОБУМОВЛЕНИХ

DENSITOMETRY OF THE LUNGS IN THE ALGORITHM FOR THE DIAGNOSIS OF INTERSTITIAL LUNG DISEASES, INCLUDING OCCUPATIONAL AND ECOLOGICAL DISEASES A. V. Basanets, N. V. Kurdil Abstract Interstitial lung diseases are among the most common diseases of the respiratory system. A significant proportion of them are occupational diseases with pneumoconiosis as the most prevalent condition. Determination of lung density by computed densitometry (CD) allows to quantify the degree of density of lung tissue in a different lung diseases. This review focuses on world and domestic literature on the application of CD for the diagnosis and monitoring of management of interstitial lung diseases such as pulmonary sarcoidosis, pulmonary tuberculosis, idiopathic pulmonary fibrosis, pulmonary embolism, systemic sclerosis, pneumoconiosis, etc. The method of determining of lung density index, its effectiveness depending on the method of CT and the algorithm of examination of the patients are described. Peculiarities of changes in lung density index depending on the form and pathogenesis of the disease, its correlation with lung function and morphological changes have been analyzed. The most reproducible and perfect indicators of CD are those determined by inspiratory CT, which should be taken into account in the further improvement of research protocols. The standardization of the CT imaging protocol should be implemented taking into account the need for possible reduction of the radiation dose. Conclusions. The technique of CD is recognized as a revolutionary diagnostic tool for quantifying the density of the lung parenchyma, which can be effectively used to diagnose and verify the diagnosis of interstitial lung diseases, including occupational diseases. Improving methods of occupational and environmental interstitial lung diseases diagnosing, preventing their progression and development of complications will improve the quality of healthcare service for workers, decrease morbidity, reduce treatment and disability reimbursement costs. Key words: interstitial lung diseases, occupational diseases, computed lung densitometry, computed tomography

Occupational exposure to biological agents in Polish paramedics: a narrative review

INTRODUCTION: Research into occupational exposure to biological pathogens during medical personnel work is to a small degree concerned with paramedics. Coming in contact with biological pathogens, like HIV, HCV and HBV viruses, tubercle bacilli, or recently the SARS-CoV-2 virus in the workplace is a contamination risk. This study aims to analyze the occupational exposure of paramedics to biological pathogens at work, the possibilities of paramedics developing contagious diseases as occupational illnesses, and the prophylaxis this involves. MATERIAL AND METHODS: The publication was prepared on the basis of a literature review of works available in the PubMed, SCOPUS, and Google Scholar databases, and on websites of institutions functioning in the area of public health. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: In Poland, in 2020, there were 1 255 625 cases of SARSCoV- 2 registered, 3020 of which are cases found in paramedics, and 12 524 cases of Lyme borreliosis, 990 HBV cases, 942 HCV cases, 934 HIV cases. In 2020, there were 1861 occupational diseases, 504 of which were contagious or parasitic. Approximately 37 000 needlesticks are estimated to happen every year in medical facilities. 40% to 80% of the people who got injuries or cut in the workplace did not report the incident. CONCLUSIONS: There is a need to implement prophylactic and preventative measures to prevent occupational needlestick injuries and blood-borne infections amongst paramedics. Paramedics show insufficient knowledge of their ability to apply for an occupational disease diagnosis caused by exposure to biological pathogens present in the work environment.

Процедура розслідування захворювання на COVID-19 медичних працівників у контексті реалізації державної політики щодо безпеки праці

Розглянуто основні положення норм чинного законодавства щодо розслідування випадків захворювання на COVID-19 медичних працівників у контексті реалізації державної політики щодо безпеки праці, проаналізовано сучасний стан вітчизняного державного регулювання у цій сфері, досліджено його організаційно-правові механізми, а також запропоновано пріоритетні напрями удосконалення процедури розслідування гострих професійних захворювань.

On occupational diseases in medical workers in the Republic of Bashkortostan

Introduction. The work of medical workers belongs to the most complex, responsible types of human activity. It is associated with the impact of a complex of adverse factors: chemical, biological, physical, the severity and intensity of labour. Due to the high occupational risk, the problem of the formation and preservation of the health of medical workers is urgent. The aim of the work is to determine the dynamic characteristics of occupational morbidity and its structure among medical workers of the Republic of Bashkortostan for 2013-2020. Materials and methods. The occupational morbidity rate among medical workers during 2013-2020 was studied with the materials of the professional centre of the Republic: a notification on the establishment of a final diagnosis of chronic occupational disease and a consolidated annual report on the activities of central occupational pathology. Statistical processing of the results was carried out using the «Statistika 8» application software package. Results. The average annual incidence of occupational morbidity is 0.92±0.12 cases per 10 thousand health workers. They occupied an average of 7.0% of all occupational diseases established over the years in the Republic. The incidence rate tends to decrease. Among occupational patients of health workers, 73.9% are nurses, 15.3% are healthcare staff, 10.8% are doctors. Allergic diseases dominate the nosological structure of occupational diseases. They make up 63.3% of the total pathology, half of which is in bronchial asthma. Discussion. In medical workers, infection occurs through direct contact with a sick patient or biological material. Allergic responses occur to the presence of drugs and disinfectants. Occupational disease tuberculosis was diagnosed at the age of 43.3±6.4 years and experience of 16.6 years; hepatitis at the age of 38.2 years and experience 15.0 years; bronchial asthma - at the age of 49.4 years and an experience of 26.4 years; allergic reactions - at the age of 47.6±6.3 years and the experience of 25.8±3.7 years. Conclusion. There were identified features in incidence and its structure among doctors and paramedical workers. The basis of the concept of prevention of occupational diseases among health workers should be a system of primary prevention measures to reduce the impact of adverse factors of the working environment and the labour process, maintaining occupational and general health.

Allergic Contact Dermatitis Among Healthcare Workers Exposed to Glutaraldehyde

Background: One of the health problems that can be caused by glutaralaldehyde is allergic contact dermatitis (ACD). However, the causal relationship between glutaraldehyde and DKA is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence is also equipped with a seven-step assessment of occupational diseases therefore it can assist occupational medicine doctors who find patients with ACD and have a history of exposure to glutaraldehyde. Methods: Literature search using Pubmed, Scopus and JSTOR databases. The keywords used are ‘healthcare worker OR healthcare personnel’, ‘glutaraldehyde’ and ‘allergic contact dermatitis. Article selection was performed using the defined inclusion and exclusion criteria. Selected articles will be critically reviewed based on etiological studies from the Oxford Center of Evidence-Based Medicine. Result: It was in six selected articles that met the inclusion and exclusion criteria. The main finding after a critical review was that glutaraldehyde may increase the risk of ACD. Conclusion: There is a relationship between 1% glutaraldehyde exposure and the incidence of ACD in health workers. To establish the diagnosis of occupational diseases in health workers who are exposed to glutaraldehyde, seven steps of diagnosis of occupational diseases are used.

Diabetes Mellitus Among Workers Exposed to Perfluorooctanoic acid

Background: One of the health problems that can be caused by Perfluorooctanoic acid (PFOA) is Diabetes mellitus (DM). However, the causal relationship between Perfluorooctanoic acid and DM is still unclear, so it is necessary to look for some evidence regarding this relationship. The search for evidence is also equipped with a seven-step assessment of occupational diseases therefore it can assist occupational health doctors who find patients with DM and have a history of exposure to glutaraldehyde. Methods: Literature search using Pubmed, Cochrane and JSTOR databases. The keywords used are “PFOA” OR “perfluoroalkyl substances” OR “perfluorooctanoic acid” AND “diabetes mellitus”. Article selection was performed using the defined inclusion and exclusion criteria. Selected articles will be critically reviewed based on etiological studies from the Oxford Center of Evidence-Based Medicine. Result: It was in 5 selected articles that met the inclusion and exclusion criteria. The main finding after a critical review was that PFOA may increase the risk of DM. Conclusion: There is a relationship between PFOA and the incidence of DM in health workers. To establish the diagnosis of occupational diseases in health workers who are exposed to PFOA, seven steps of diagnosis of occupational diseases are used.

Discussion on the evaluation of occupational disease diagnostic criteria

Occupational disease diagnosis standards are an important basis for occupational disease diagnosis, occupational health surveillance, occupational health supervision, occupational disease treatment, occupational disease disability assessment, and handling of occupational disease diagnosis disputes in conjunction with the "Occupational Disease Prevention and Control Law of the People's Republic of China". With the successive promulgation of the "Standardization Law of the People's Republic of China" and the "Administrative Measures on Health Standards", the establishment of a mandatory standard implementation evaluation mechanism has gradually been paid attention to. However, there is still a lack of systematic research on the evaluation of diagnostic criteria for occupational diseases. Therefore, this article combines the current status of the diagnostic standards for occupational diseases in China, and proposes reasonable suggestions on how to carry out the evaluation of the implementation of this type of standard in terms of evaluation methods and content.

Analysis on the status of occupational health of medical radiation workers in China in 2019

Objective: To grasp the occupational health monitoring of radiation workers in medical institutions across the country, and to discover weak links in the prevention and treatment of occupational radiation diseases. Methods: In 2020 January, according to the monitoring data of the "National Radiation Health Information Platform" (Occupational Radiation Disease and Occupational Health Monitoring Subsystem and Occupational Radiation Disease Reporting Subsystem) , the national occupational health monitoring data from January 1 to December 31, 2019, including the number of radiation workers in medical institutions, occupational health examinations, personal dose monitoring and occupational radiation disease diagnosis, were descriptive analyzed. Results: There were a total of 394436 radiation workers in medical institutions across the country. The number of radiation workers in various provinces was quite different, with a median of 10206, which was positively correlated with the number of permanent residents in each province (r=0.947) . There were 376 personal dose monitoring institutions nationwide, and the personal dose monitoring rate of radiation workers in medical institutions was 96.61% (381045/394436) . There were 419 occupational health inspection institutions for radiation workers across the country, and 269 (64.20%) used software to print physical examination forms. A total of 334455 radiation workers in medical institutions had been subjected to occupational health examinations. The rate of occupational health examinations for radiation workers in medical institutions was 84.79% (334455/394436) . The abnormal rate of chromosomal aberrations in peripheral blood lymphocytes of radiation workers in medical institutions was 0.33% (776/233571) , the detection rate of posterior posterior subcapsular turbidity was 0.63% (2093/334455) , and the abnormality rate of thyroid color ultrasound was 28.49% (14946/52464) . In 2019, a total of 16 cases of occupational radiation diseases were reported. Conclusion: The personal dose monitoring rate and occupational health examination rate of medical radiation workers nationwide are relatively high, but the quality of lymphocyte chromosome aberration analysis, eye lens examination and thyroid color photograph examination needs to be further improved.

A retrospective investigation of new cases of pneumoconiosis from 1958 to 2018 in Guangzhou City

Objective: To describe the characteristics and the survival status of pneumoconiosis cases reported in Guangzhou City from 1958 to 2018, and to investigate the epidemiological trends of pneumoconiosis. This study is aiming to provide basic data for formulating the guidelines and policies for control of pneumoconiosis, and for evaluating the control effects of pneumoconiosis. Methods: From July 2019 to January 2020, based on the data collected in the pneumoconiosis case cards and database as well as the retrospective follow-up investigate of pneumoconiosis cases, we conducted a descriptive analysis for all the new cases of pneumoconiosis reported from 1958 to 2018 in Guangzhou City. The statistical indices included the number of new pneumoconiosis cases in each decade, types of pneumoconiosis, regional and industrial distributions, survival status, and the change tendency of the diagnosis age and the dust exposure time of pneumoconiosis cases. Results: From 1958 to 2018, a total of 1194 new cases of pneumoconiosis were reported in Guangzhou City, including 1147 males (96.1%) and 47 females (3.9%) . Silicosis (60.1%, 718/1194) and welder's pneumoconiosis (21.5%, 257/1194) were the main types of pneumoconiosis. The top three districts for reporting new cases were Huangpu District (29.0%, 346/1194) , Nansha District (12.6%, 151/1194) and Baiyun District (11.1%, 132/1194) , respectively. The top three industries for reporting new cases were civil engineering construction industry (25.0%, 298/1194) , railway ship aerospace and other transportation equipment manufacturing industry (16.1%, 192/1194) and non-metal mining industry (15.7%, 187/1194) . The diagnosis age for new cases was 47.8 (23.6-79.1) years old, and the dust exposure time was 12.3 (0.4-49.1) years. Both of these two statistical indicators rose first and fell later from 1958 to 2018. As of December 31, 2019, a total of 963 new cases of pneumoconiosis were followed up, of which 467 (48.5%) survived, mainly silicosis (41.3%, 193/467) and welder's pneumoconiosis (43.3%, 203/467) . 496 cases (51.5%) died, and the age of death was 69.9 (32.4-96.9) years old. Conclusion: According to the epidemiological characteristics of pneumoconiosis in Guangzhou, we should focus on key districts and industries in the prevention and control of pneumoconiosis. Besides, the staffs in the occupational disease diagnosis institutions should try the best to collect the complete dust exposure data of new cases of pneumoconiosis. Moreover, the health administrative departments should pay more attention to the management of pneumoconiosis death case reports.

Selecting informative biomarkers for early diagnosis of occupational neurological diseases

Introduction. At present, the patterns of changes in the levels of biomarkers and the relationship of changes in their values with the pathogenesis of diseases caused by the impact of adverse factors of labour activity are not sufficiently studied. The most unresolved issues are the choice of informative laboratory indicators and diagnostic test systems in investigating the impact of physical factors on the working environment (vibration and physical overload) neurohumoral regulation: pituitary-adrenal pituitary-thyroid, pituitary-gonadal system and hormonal indicators of carbohydrate metabolism. The aim of the study was to determine diagnostic hormonal markers and integral indices to identify early changes in the neurohumoral status in the body of workers under the influence of working environment factors. Materials and methods. 330 workers of mining and machine-building enterprises were examined. Of these, 128 people with vibration disease, 45 people - with lumbosacral radiculopathy, combined pathology (vibration disease and lumbosacral radiculopathy) was detected in 60 persons. The preclinical stage (initial signs of diseases) was noted in 97 workers. Laboratory studies included hormones and integral indices of the pituitary-adrenal, pituitary-thyroid, pituitary-gonadal system, carbohydrate metabolism. To select the diagnostic significance of laboratory biomarkers, diagnostic sensitivity, prenosological value, pathognomonicity, direction, severity, and selectivity of changes in biomarker levels were evaluated. Results. The combined effect of vibration and physical overload on the body of workers was found to have a unidirectional and systemic impact on the levels of hormones of the pituitary-adrenal, pituitary-thyroid and pituitary-gonadal systems, increases insulin resistance. The severity of changes in neurohumoral regulation indicators depends on the nature and severity of the occupational neurological disease. The highest diagnostic sensitivity (Df = 72-74%) in vibration disease and its combination with lumbosacral radiculopathy was obtained for pituitary-gonadal hormones and indicators of insulin resistance. The lowest values of Dh are typical for the hormones of the pituitary-thyroid system (no more than 14%). To identify early changes in neurohumoral regulation in the body under the influence of vibration and physical exertion, it is most informative to determine the concentration of total testosterone, luteinizing hormone and insulin, as well as the integral pituitary-adrenal index, insulin resistance indices. To identify hidden disorders of the pituitary-thyroid system, the definition of the essential thyroid index can be used. Discussion. The results obtained allowed us to assess the nature of changes in the levels of hormones of the pituitary-adrenal, pituitary-thyroid and pituitary-gonadal systems and carbohydrate metabolism and to propose informative laboratory biomarkers reflecting early changes in neurohumoral regulation under the influence of physical factors of the working environment. Conclusions. To identify early changes in neurohumoral regulation in the body of workers under the influence of vibration and physical exertion, the most informative is the determination of the concentration of total testosterone, luteinizing hormone and insulin, the integral pituitary-adrenal index, and insulin resistance indices. To identify hidden disorders of the pituitary-thyroid system, the definition of the integral thyroid index can be used.

Prevalence of occupational morbidity among healthcare workers in the Russian Federation and abroad (literature review)

This article presents a literary review devoted to one of the urgent topics affecting the occupational morbidity of medical workers - as one of their socially significant occupational cohorts. The proposed assessment is based on the publications of many domestic and foreign authors’ studies. The structure of the primary nosological forms typical for healthcare workers, such as extralegal and pulmonary tuberculosis, parenteral viral hepatitis, bronchial asthma, contact dermatitis, etc., is considered. The leading role of a biological factor in the formation of occupational pathology in the considered cohort is noted. Many publications provide information on the reasonably widespread prevalence among physicians of diseases caused by occupational stress and the role of the psychophysiological factor. Numerous international studies show that doctors have a high incidence of mental health problems, including depression and anxiety, which may be associated with overuse in the workplace. Specializations in which medical workers are most susceptible to high occupational risk are noted. A comparative analysis of the prevalence of occupational diseases in individual constituent entities of the Russian Federation with an indication of regional characteristics in terms of the majority of occupational diseases and foreign countries is presented. Special attention is paid to the formation of the trade union service and its historical aspects. The professional activity of medical workers is one of the most challenging and responsible, which is because the conditions of their work, as well as the state of health, are interconnected with the quality of the care they provide and determine the final result of their activity - the patient’s health. Despite the achieved results in identifying harmful production factors, the diagnosis of occupational diseases remains relatively low. Despite the growing interest in occupational diseases among health workers, studies on the incidence of this contingent in Russia are still insufficient, and an analysis of the few available sources indicates the absence of official data and complete information regarding occupational morbidity.

Below the tip of the iceberg: A qualitative perspective of psychological and social aspects of occupational diseases

Objective: The inadequacy of preventative measures to combat the harmful effects of the working environment leads to circumstances where workers develop occupational diseases. Workers lose their good health and also experience other challenges in various aspects of their daily lives such as being forced to quit their jobs or showing poor performance at work. This study was carried out to observe, understand and analyse the psychological and social consequences that occupational diseases may give rise to. Methods: It is a quaWlitative study and involves in-depth interviews with workers who were diagnosed with occupational diseases. Interviews, that were conducted with 20 participants through the use of a voice recorder, cover both medical and legal aspects. A targeted sample, chosen to represent the full spectrum of illness, was taken from those who had received medical or legal confirmation of occupational disease. The data was generated manually by the researchers and generated through the thematic analysis technique, again, by the researchers without the use of a software.Results: We found that the process of diagnosing occupational disease was in itself a stressor and workers experienced negative effects on their mental health, family relationships, gender roles as well as their individual, social and daily living skills.Conclusion: These effects were manifested in the lives of participants suffering from occupational diseases as stigmatization, depression, social adjustment disorders, concerns about the future, fear of unemployment, impaired gender role and loss of status. The main contribution of this study to the available studies is to demonstrate the necessity to include “stigma related information” in the diagnosis and treatment processes of occupational diseases.

Analysis of influencing factors of pneumoconiosis complicated with pulmonary tuberculosis

Objective: To investigate the influencing factors of pneumoconiosis complicated with tuberculosis in order to provide the scientific evidence for formulating the preventive strategies. Methods: From July 2019 to January 2020, all occupational pneumoconiosis patients reported in Guangzhou from 1958 to 2018 were investigated retrospectively (n=1155) . The basic data (including gender, diagnosis time, diagnosis age, dust exposure duration, period, pneumoconiosis disease type, work type and industry) were obtained from pneumoconiosis case card and network report database. The data of pulmonary tuberculosis were collected from the occupational disease diagnosis files of Guangzhou Occupational Disease Prevention and Control Hospital, and were supplemented by telephone follow-up. The distribution of pneumoconiosis and tuberculosis in Guangzhou was analyzed. Binary logistic regression analysis model was used to analyze the influencing factors of pneumoconiosis complicated with pulmonary tuberculosis. Results: Among the 1155 new cases of pneumoconiosis, 357 cases were pneumoconiosis tuberculosis, and the complication rate of tuberculosis was 30.9%. Year of diagnosis, age of diagnosis, dust exposure duration, pneumoconiosis caused by mineral dust and construction industry were influencing factors for pneumoconiosis complicated with pulmonary tuberculosis (OR=0.948, 1.048, 0.972, 3.112, 2.815, P<0.05) . After the adjustment of gender, diagnosis year, diagnosis age, dust exposure duration and diagnosis period, the risk of pulmonary tuberculosis in rock drilling workers was 1.462 times higher than that in other types of work (P<0.05) . Conclusion: The complication rate of tuberculosis in patients with pneumoconiosis is relatively high. The main influencing factors are the year of diagnosis, age of diagnosis, dust exposure duration, the type of pneumoconiosis and the industry. The importance of occupational health examination and health education on prevention and treatment of tuberculosis should be emphasized among dust-exposed workers and pneumoconiosis patients. People with susceptibility factors are the top priority.

The Importance of Occupational Medicine Outpatient Clinics; a Single Center Experience in Turkey

Objective: The specialty of occupational medicine is newly developing in Turkey and the number of specialists and the specialty clinics are very few. The aim of this study is to present the first two-year data of an occupational medicine outpatient clinic. This clinic is unique as it is the first outpatient clinic in a secondary health care center in Turkey (except dedicated occupational disease hospitals), and the first residency-trained occupational medicine specialist in Turkey was running this clinic. The data will be compared with national numbers in order to show if these clinics make a difference in diagnosis and notification of occupational diseases.&#x0D; Materials and Methods: The data is collected from the hospital database between 2017 August to 2019 August who applied to Occupational Diseases Clinic in the hospital. Only the patients who were referred by a physician or applied themselves with suspicion of an occupational disease are included to the study. The patients who applied for periodic examinations, fitness for work evaluations are not included.&#x0D; Results: A total of 491 patients were included to the study. 444 of them did not have a prior diagnosis of occupational disease. Of these patients, 162 (36.4%) were diagnosed with an occupational disease. 42.6 % of these diagnoses were pneumoconiosis.&#x0D; Conclusion: Occupational diseases are underdiagnosed and/or underreported in Turkey. A single center dedicated to occupational diseases made a substantial increase in the number of occupational diseases in two years. In conclusion, these clinics would help improving recognition of occupational diseases.

Impact of the service terms on biochemical indices in employees at the potassium ore processing enterprise

Introduction. The extraction of potash ores is developing at a significant pace. The flotation method is the way to obtain potassium chloride using chemical reagents that have a toxic effect on the respiratory and nervous system, and liver. The complex long-term impact of occupation factors of the working environment with an increase in work experience leads to a rise in the prevalence of diseases of vital organs and systems. The aim of the study is to assess the change in individual biochemical indices of unfavorable responses on the part of the health of workers at a potassium ore processing enterprise, depending on the length of work experience. Materials and methods. The working conditions of workers were assessed, the content of some aldehydes, hexane, and heptane in biological media was investigated, and changes in many biochemical parameters were established. Results. The factors of the working environment in workers at the potassium ore processing enterprise are characterized by the simultaneous exposure to chemicals (potassium chloride, formaldehyde, propionic and butyric aldehydes, hexane and heptane), physical parameters (industrial noise, the microclimate of the working area, the severity of the labor process) and are assessed as harmful (class 3.1). During long-term labor activity (more than ten years), workers have an accumulation of hexane in the urine (1.4 times) and the increased associated content of norepinephrine in blood plasma (up to 1.3 times), not established in workers with up to ten years of work experience. Workers with ten years of work experience and noise with a level of intensity at workplaces exceeding 14.4 dBA showed an increase of 1.3-2.3 times in the level of homocysteine and lipoprotein, not established in workers with a work experience duration of fewer than ten years. No dependence on the service terms was found for changes in sensitization indices of the upper respiratory tract and hepatocytes’ cytolytic activity. Conclusion. The revealed changes in indices with an increase in the length of service require special attention for the early diagnosis of occupational diseases and the development of measures to prevent emerging changes in critical organs and systems.

Analysis of Health Service Utilization and its Influencing Factors among Patients with Pneumoconiosis in China

Pneumoconiosis, an interstitial lung disease that occurs from breathing in certain kinds of damaging dust particles, is a major occupational disease in China. Patients diagnosed with occupational pneumoconiosis can avail of free medical treatment, whereas patients without a diagnosis of occupational diseases cannot not claim free medical treatment in most provinces from the government before 2019. This study aimed to analyze the priority of medical facility selection and its influencing factors among patients with pneumoconiosis. A total of 1,037 patients with pneumoconiosis from nine provinces in China were investigated. The health service institutions most frequently selected by the patients were county-level hospitals (37.5%). The main reason for the choice was these hospitals' close distance to the patients' homes (47.3%). The factors for the choice of health care institutions were living in the eastern region ( OR = 2.91), living in rural areas ( OR = 2.10), silicosis diagnosis ( OR = 2.44), employment in private enterprises ( OR = 2.91), smoking ( OR = 2.69), and quit smoking ( OR = 3.98). The diagnosis, treatment, and rehabilitation therapy of pneumoconiosis should be enhanced in primary medical institutions.

Awareness of occupational diseases among research assistants working in a medical faculty hospital: An exploratory study on a neglected area

INTRODUCTION: Occupational diseases are conditions that are preventable and that are actually frequently encountered by physicians in daily practice. The present study, involving research assistants working in a medical faculty hospital clinic where there is the potential to diagnose occupational disease measures, aimed to analyze their level of awareness of the diagnosis, treatment, and monitoring of occupational diseases. MATERIALS AND METHODS: This is a descriptive study, for which an exploratory survey was administered to 126 resident physicians in a medical faculty hospital. The survey items were related to the physicians' knowledge of the definition of “occupational disease,” whether they took work and occupational history in daily practice, the status of diagnosis of occupational diseases in their own fields of specialization and the procedure followed in the event of a diagnosis, and their opinions of the significance of diagnosing occupational diseases. RESULTS: Among the participants, 77 (62.1%) were found to ask the patients about their occupation, with the reasons given for not doing so being stated as patient load and busy schedule by 16 (12.9%) and limited time by 9 (3%) of the participants. Approximately 60% of the participants were able to define the term “occupational disease,” however, only 37.9% were aware of the laws on occupational health and safety. CONCLUSIONS: The findings indicate that there is a significant lack of knowledge on occupational disease in medical education. As such, education should be provided during both medical school and specialization training regarding the duties, powers, and responsibilities of physicians related to occupational diseases.