Occupational Pathologies Research Articles

Современные методы исследования безопасности и физиологической эффективности применения промышленных экзоскелетов

Occupational morbidity caused by physical overloads and certain organs and systems being overstrained ranks second among occupational pathologies depending on an influencing adverse occupational factor. Given that, it seems vital and promising to develop industrial exoskeletons as they are able to protect a worker’s musculoskeletal system from excessive physical loads. And absence of a relative regulatory and technologic base is a challenge here as it imposes substantial limitations on industrial exoskeletons implementation in productions both in Russia and in other countries. A significant role in creating regulatory and technological base belongs to a possibility to accomplish an objective medical and biological examination of industrial exoskeletons safety and physiological efficiency. Developed and properly tested procedures for examining physiological and ergonomic properties of industrial exoskeletons will make a substantial contribution into a system of complex ergonomic tests accomplished at stages when exoskeletons are developed, created, and put into trial operation. The present paper dwells on up-to-date medical and biological procedures for examining safety and physiological efficiency of industrial exoskeletons. There are examples on using a «movement seizure» procedure performed with inertial sensors, ergospirometry, electromyography, and myotonometry for estimating physiological and ergonomic properties of industrial exoskeletons at a modeled working place. Results obtained via this research involving all the above mentioned procedures confirmed that it was safe and quite efficient to apply industrial exoskeletons for workers who had to deal with physical labor when performing work tasks similar to those used in developed models. Applied procedures can substantially enhance approaches to examining a worker’s functional state and obtained results will make a significant contribution into development of a regulatory and technological base for promising individual protection means used to protect the musculoskeletal system within the existing System of occupational safety standards.

Occupational health of midwives.

The midwifery profession varies greatly from one country to another. There are, however, a number of common features such as exposure to biological risks through contact with pregnant women and women in labor, exposure to postural stresses during examinations and medical acts, but also, increasingly, exposure to organizational constraints (work schedules, shift work, etc.). This article aims to give an overview of what is known about the occupational health risks of midwives (MWs). A review of the literature on Medline, from January 1, 2006 to December 31, 2017, was carried out. Articles focused principally on burnout (BO) and post-traumatic stress disorder. Several BO questionnaires were used. For the Copenhagen Burnout Inventory, the prevalence of personal BO ranged 20-57%; the percentage of work-related BO fell between 15-57%; and the prevalence of client-related BO ranged 5-15%. For the Maslach Burnout Inventory, the prevalence of emotional exhaustion varied between 23-60.7%; the prevalence of depersonalization ranged 3.3-30.3%; and the pervasiveness of personal accomplishment varied between 5-30.3%. There was little data concerning musculoskeletal problems or accidental exposure to biological fluids. The literature review on occupational pathologies demonstrates high levels of BO. Several gaps exist on the evolution of the impact of their work on the health of MWs, like the effect of shift work, postural stresses, etc. This review will make it possible to better focus future research on the occupational health of this population. Med Pr. 2020;71(4):473-81.

EMG-Assisted Algorithm to Account for Shoulder Muscles Co-Contraction in Overhead Manual Handling

Glenohumeral stability is essential for a healthy function of the shoulder. It is ensured partly by the scapulohumeral muscular balance. Accordingly, modelling muscle interactions is a key factor in the understanding of occupational pathologies, and the development of ergonomic interventions. While static optimization is commonly used to estimate muscle activations, it tends to underestimate the role of shoulder’s antagonist muscles. The purpose of this study was to implement experimental electromyographic (EMG) data to predict muscle activations that could account for the stabilizing role of the shoulder muscles. Kinematics and EMG were recorded from 36 participants while lifting a box from hip to eye level. Muscle activations and glenohumeral joint reactions were estimated using an EMG-assisted algorithm and compared to those obtained using static optimization with a generic and calibrated model. Muscle activations predicted with the EMG-assisted method were generally larger. Additionally, more interactions between the different rotator cuff muscles, as well as between primer actuators and stabilizers, were predicted with the EMG-assisted method. Finally, glenohumeral forces calculated from a calibrated model remained within the boundaries of the glenoid stability cone. These findings suggest that EMG-assisted methods could account for scapulohumeral muscle co-contraction, and thus their contribution to the glenohumeral stability.

Prevalence of Musculoskeletal Disorders among Dentists in Casablanca’s Dental Center

Introduction: Musculoskeletal disorders (MSDs) are the most common occupational pathologies among dentists around the world but studies are quite limited. The present study was carried out to investigate the prevalence of MSDs among dentists in Casablanca, Morocco.Methods: This was a cross-sectional descriptive study conducted among the medical staff (120 dentists) of Casablanca's Dental Center, part of the Ibn Rochd University Hospital, Morocco, over a period of 3 weeks from July 24, 2017, to August 11, 2017. The study was based on a self-administrated questionnaire which comprises two parts: the first part included physical characteristics, academic life, clinical practice, ergonomics, and work methods; and the second part consists of the “Standardized Nordic Questionnaire” (SNQ) or Nordic style questionnaire.Results: The prevalence of musculoskeletal disorders in our sample was 71.67%, predominately affecting the neck, the upper, and the lower back.Conclusion: Prevalence of MSDs was high among Moroccan dentists and the prevention of these disorders requires the adoption of a correct posture, good working habits, and ergonomic organization of the workspace, as well as the integration of regular physical activities in order for the dentist to maintain a good quality of life.

Ocular chemical burns in the workplace: Epidemiological characteristics.

Epidemiological studies focusing on occupational pathologies can be an important medium through which to bring about change with respect to workplace accidents, both in terms of prevention planning and management as well as the appropriate care following an accident. Ocular chemical burns benefit from urgent attention as, if not treated early and appropriately, the tissue of the eye and its functionality can be seriously compromised. The objective of this study was to collate epidemiological data on workplace ocular chemical burns which could in turn serve to identify key action points in terms of occupational health. Cohort study with 604 cases of chemical burns to the eye occurring in the workplace between 2014 and 2015. Criteria inclusion were diagnosis of chemical burn, patient seen at the medical centre of the mutual society, workplace acquired ophthalmic pathology leading to the issuing of a sickness certificate. No exclusion criteria were defined. Ocular chemical burns were the second most common workplace eye injury (12.68%) behind foreign bodies in the eye (43.42%). Men accounted for 68.54% of cases of ocular chemical burns. In around 75% of cases, sickness certification was for less than 7 days, although 6 patients suffered permanent disability. The occupational sector which was most affected particularly the industry service industry. The economic costs with these workplace injuries were extracted. Appropriate early medical assistance is essential. The production and distribution of clinical guides for health care workers could optimise first line assistance and mitigate possible training deficiencies.

Antioxidants level assessment in the diet of workers contacting with heavy metals at industrial enterprise

The main occupational pathologies in the Sverdlovsk region are diseases induced by the exposure to industrial aerosols containing heavy metals. One of the reasons of the toxic effect of the heavy metals is oxidative stress induced by the latter, namely, the process of damaging the body cells as a result of the oxidation reactions. The quantitative assessment of the antioxidant consumption in foods composing the diet of heavy metal industry workers was performed. The diet was revealed to be not various in terms of the foods containing antioxidants and the main quantity of the latter was administered into the body from the brown bread, tea, apples, chocolates and sweets having low activity according to the ORAC index but consumed in the great amounts. In the meantime, foods with the high level of the antioxidant content and bio-correction properties (fruits, vegetables, spices) were lacking in the diet and this fact could probably influence on the decline of the body’s reserve of detoxification.

New insight in beryllium toxicity excluding exposure to beryllium-containing dust: accumulation patterns, target organs, and elimination.

There is much contradiction between different experimental studies on beryllium (Be) toxicity. The majority of studies focus on occupational pathologies, caused by the exposure to Be dust. However, Be pollution may affect wide population groups through other exposure routes. The discrepancies between experimental studies may be attributed to the lack of adequate Be toxicity model since conventional administration routes are hampered by high acidity and low solubility of Be compounds. This study was aimed to develop a novel way to implement Be toxicity avoiding side effects, related to high acidity or low solubility of Be salts. Intraperitoneal injection of Be-glycine composition (containing BeSO4, glycine, purified water, pH adjusted to 5.5 with NaOH) was tested in the dose range 238-7622 µmolBekg-1 (body weight, b/w) in full-grown Wistar male rats. The model provided reliable uptake of Be from the peritoneum into general circulation for at least 48h. LD50 was found to be 687 µmolBekg-1 (b/w). The established LD50 value differed from previous data on gastrointestinal, intramuscular or intravenous administration of Be compounds. The liver was found to act as a primary elimination route for Be and related to the highest Be content in the animal. However, it had no signs of morphological damage, which was observed only in the testes (deterioration of germinal epithelium). At the same time, the lungs, stated as a primary target tissue for Be in the models of chronic beryllium disease, did not show strong Be accumulation nor morphological changes. Survived animals showed behavioral changes, including increased motor activity and aggressive reactions in some cases, and complete spasticity in other. The obtained data show the applicability of the established modeling protocol and testified for the independence of chronic beryllium disease on Be2+ ion toxicity per se.

Medical laboratory technician professional pathologies: a 2006-2016 literature review.

The trade of laboratory technician (TL) exposes to many risks to health, because of biological or chemical or physical exposures. But the TL occupation is constantly evolving, the techniques are constantly changing. The purpose of this article is to take stock of the occupational TL pathologies which were recently described in the literature. This is a literature review, based on Medline® and Scopus® medical databases, on publications between 01/01/2006 and 31/12/2016. The research was conducted in French and English. Only articles about TL in Hospital or Teaching Hospital were selected. Twenty-eight articles were studied. The main infectious pathology described was brucellosis and a case of meningitis was studied. The cutaneous allergies reported concerned sensitization to certain solvents. There was no allergy to latex. Musculoskeletal disorders (MSD) were studied in 4 articles. The main MSDs were low back pain and neck pain. Several articles have alerted on the occurrence of burnout syndrome (BO). However, no prevalence studies were conducted over the period studied. In conclusion, TL can present many occupational pathologies. Few articles studied the prevalence of MSD and BO.

Influence of end-effector on the risk of shoulder pathologies after forearm amputation: Use of the active shoulder abduction measurement

After upper limb amputation, the use of prosthesis usually causes compensation movements for trunk and stump. These compensations can lead to musculoskeletal pain or overuse syndromes. In the context of occupational pathologies, stress levels were defined as at risk for shoulder concerning abduction amplitude (60°) and duration of exposure (2/24 h or 8.5% of the time beyond 60°). The objective of this study is to evaluate the risk of shoulder complications in a population of below-elbow amputees when using different myoelectric prosthetic end-effectors. Eight below-elbow amputees fitted with tridigital myoelectric prosthetic hand potential users of non-morphometric end-effectors in professional or leisure time are evaluated. Shoulder abduction (mean abduction and percentage of time spent beyond 60° of abduction) is measured during a Box and Block Test in a sitting position with a VICON optoelectronic system. The measurements are performed for amputated limb in 2 or 3 conditions: non-morphometric end-effector with or without wrist flexion-extension ± with tridigital myoelectric prosthetic hand (for 3 amputees) and for healthy limb. There is no significant difference in dexterity between end-effectors but significant difference between all end-effectors and healthy limb. The mean shoulder abduction is greater than 60° and the median percentage of time beyond 60° abduction is greater than 8.5% only when using a non-morphometric end-effector without wrist flexion-extension. Moreover, there is a significant difference between the 2 limbs for the mean abduction only with the non-morphometric effector without wrist flexion-extension. There are no differences between the other end-effectors and healthy limb, nor between the end-effectors between them. Prosthetic grip and mobility capacity of prosthetic wrist also influence shoulder kinematics. For some amputees, shoulder abduction is not at risk for musculoskeletal disorders but other compensation movements (internal shoulder rotation, trunk torso…) remain to be studied. The quantification of stresses on residual limb and trunk related to these compensations could allow to detect risk of musculoskeletal complications. A personalized analysis of compensations during common task could guide the choice of prosthetic end-effector and its adjustment and allow to quantify the influence of rehabilitation techniques on these compensations.

Fundamental and applied aspects of preventing the adverse effects of aviation noise

In the article, aviation noise is discussed as a harmful physical factor with ecological, hygienic, clinical and social implications. Noise contributes to development of general and occupational pathologies, chronic diseases, and reduction of professional longevity. The present-day knowledge of aviation noise sources and dynamics, and effects on environment, population, and aviation personnel is overviewed, as well as strategies to prevent noise consequences, muffling techniques being the key ones.

MODERN PROBLEMS OF PERIODIC MEDICAL EXAMINATIONS HOLDING AND ASSESSMENT OF HEALTH OF WORKING POPULATION ACCORDING TO EXAMINATION RESULTS

Periodic medical examinations (PME) of working population exposed to impact of harmful and dangerous factors of working environment do not provide timely detection of occupational pathologies, what results in progress of persistent loss of occupational capacity in the period of occupational activities. Among the reasons of the situation, there is absence of lists of persons subjected to PME, data on working conditions for assessment of antecedent risk of occupational disease progress, as well as approved methods for assessment of their health indicators according to PME results and establishment of cause-effect relations of disease progress with working conditions. The study of the results of PME of population working in the Arkhangelsk industrial complex has allowed to determine indicators of PME completeness, quality, to calculate medical-biological health indicators for examined contingents, to establish cause-effect relations between disease progress and working conditions.

The working shoulder: assessing demands, identifying risks, and promoting healthy occupational performance

Background: Occupational shoulder injuries are a concern for society and clinicians. To best treat and assess the influence of physical work tasks on shoulder health, it is necessary to first understand shoulder function and dysfunction, common occupational pathologies, and existing methods to assess and prevent work-related shoulder injuries.Objectives: The objectives of this paper are to present fundamental shoulder biomechanics, discuss known occupational risk factors for shoulder injury, review assessment and prevention techniques for shoulder injuries, and describe the range of tools available to evaluate work tasks for potential physical shoulder stressors.Major findings: The complex shoulder mechanism has a unique role for performing work. Recognition of the delicate balance between creating arm mobility and maintaining joint stability is crucial to understanding how the region can be injured during work. Tools exist to aid clinicians in thinking critically about occupational shoulder injury, and can provide information about both specific and general physical exposures.Conclusions: The shoulder is a complicated assembly of many neuromusculoskeletal elements, and these tissues can be injured in a variety of ways. This paper provides background on the nature of these injuries and discusses preventative strategies available to pragmatically assist clinicians.

Evaluation of Changes in Immune System of Operating Room Personnel by Measurement of Urinary Neopterin Concentrations

Abstract Today it is known that neopterin is mainly produced by activated macrophages and a marker of immune activation and macrophage activity. Increased neopterin concentrations are observed in diseases related to cellular immunity including occupational pathologies. The major goal of the present study was to evaluate the possible alteration of neopterin levels in operating room personnel, and also to show whether screening of neopterin may be useful to monitor the effect of occupational anesthetic exposure on the cellular immune system. Therefore, urinary neopterin to creatinine levels in both, exposed workers (n = 40) and healthy volunteers (n = 30), were measured by using high-performance liquid chromatography. At the same time, the correlation among urinary neopterin levels and working years, age, and smoking status were evaluated. Compared to controls, urinary neopterin levels in the exposed group were increased (controls: 85 ± 16 μmol/mol creatinine, workers: 151 ± 39 μmol/mol creatinine; p <0.05). The findings suggest that the follow up of neopterin levels may have diagnostic value in possible occupational exposure-related immune system disorders. Moreover, its biological monitoring should be performed in workplaces for clinical diagnosis and prognosis.

Encombrantes victimes. Pourquoi les maladies professionnelles restent-elles socialement invisibles en France ?

Except for wage-earners suffering from asbestos-related forms of cancer, the casualties of work-related accidents and illnesses are still invisible in public health discussions in France. This is even more surprising since the victims of collective risks in many other sectors have mobilized to draw public attention to their cause and seek legal redress. To shed light on the reasons for the invisibility of occupational pathologies, the difficulties are presented that an association of the victims of a toxic substance very frequently used in occupational settings (glycol ether) encountered. The integration of this organization's actions in the broader framework of the labor movement spawned contradictions that were resolved by “marginalizing” the victims.

Diagnostic value of voice acoustic analysis in assessment of occupational voice pathologies in teachers

It has been shown that teachers are at risk of developing occupational dysphonia, which accounts for over 25% of all occupational diseases diagnosed in Poland. The most frequently used method of diagnosing voice diseases is videostroboscopy. However, to facilitate objective evaluation of voice efficiency as well as medical certification of occupational voice disorders, it is crucial to implement quantitative methods of voice assessment, particularly voice acoustic analysis.The aim of the study was to assess the results of acoustic analysis in 66 female teachers (aged 40–64 years), including 35 subjects with occupational voice pathologies (e.g., vocal nodules) and 31 subjects with functional dysphonia. The acoustic analysis was performed using the IRIS software, before and after a 30-minute vocal loading test. All participants were subjected also to laryngological and videostroboscopic examinations.After the vocal effort, the acoustic parameters displayed statistically significant abnormalities, mostly lowered fundamental frequency (Fo) and incorrect values of shimmer and noise to harmonic ratio. To conclude, quantitative voice acoustic analysis using the IRIS software seems to be an effective complement to voice examinations, which is particularly helpful in diagnosing occupational dysphonia.

Occupational Diseases in the Period of Socioeconomic Transition in Poland

Current situation in the epidemiology of occupational diseases is a resultant of many contributing factors, such as occupational exposures of the working population, social and economic conditions, medical measures, legislation, and ongoing changes in the national economy. This work is based on the information compiled from reporting forms on occupational diseases gathered in the Central Register of Occupational Diseases run by the Nofer Institute of Occupational Medicine, Lódź, Poland. A systematic downward trend in the number of occupational diseases has already been observed over several years. In 1998, as many as 12 017 cases were recorded (117.3 per 100,000 workers), while in 2005, this number was reduced to 3249 (34.8 per 100 000). In 2005, the highest incidence rates were noted for chronic voice disorders, pneumoconioses, infectious and parasitic diseases, hearing loss, and skin diseases. The observed decrease in occupational pathology is associated with continued transformations in the national economy. Changes in the nature and level of occupational exposures have influenced the profile of occupational pathologies. Medical preventive measures, such as vaccinations covering high-risk groups have contributed to the reduced incidence of occupational diseases. For example, the number of cases of occupation-related viral hepatitis was seven times lower in 2005 than in 1993. The 2005 data show that over 50% of occupational diseases were diagnosed in workers employed outside industry. Changes taking place on the labor market, new technologies and most of all transfer of the workforce from industry to the service and administration sectors, will certainly affect the profile of occupational and work-related pathologies. In the present-day environment, the work-related stress has become a dominant factor.

Pathologies pulmonaires d'origine immuno-allergique en milieu professionnel

Occupational lung disease are frequent diseases, resulting from chronic inhalation of environmental potential antigens generated in professional activities. In this article, we describe the most important lung diseases with immune mechanisms, asthma and hypersensitivity pneumonitis, their diagnosis and their imputability to professional environment. Occupational asthma, characterized by bronchial obstruction and/or hyperresponsiveness, is the most frequent respiratory occupational disease in France, with flour (19%) and isocyanates (11%) as principal etiologic agents. According to the molecular weight of the antigens involved, asthma mechanisms are IgE mediated or not. Hypersensitivity pneumonitis, less frequent than asthma, consists in a group of interstitial diseases, with complex immune mechanisms (immune complexes, lymphocytes), which develop after chronic inhalation of organic components over a long period of time. Diagnosis in acute phase involves symptomatologic clinical signs and chronology, occupational interrogation, functional respiratory exploration, and radiologic signs. Broncho-alveolar lavage showing hypercellularity and hyperlymphocytosis is characteristic of this pathology. Asthma and hypersensitivity pneumonitis may be recognized as occupational pathologies, as described in Occupational disease tables by French social security or by a Occupational disease regional committee.

Organization and activities of the International Radio Medical Centre (CIRM).

The International Radio Medical Centre (CIRM) was founded in 1935, to provide free medical assistance by radio to ships with no doctor on board and others who cannot be reached by a doctor. In 1950 CIRM was established as a non-profit-making foundation and has benefited since 1957 from an annual contribution from the Italian government. The results achieved by the Centre over 61 years include medical assistance to 42,935 patients on board ships (as well as on small islands and aircraft), with 375,264 medical messages received and transmitted. CIRM is organized into a medical service, a telecommunications service and a studies section. The 24-h continuous medical service is provided by doctors at the CIRM headquarters. The doctor on duty gives instructions for managing the case. If necessary the medical service will coordinate the patient's hospitalization at the nearest port with suitable medical facilities or arrange the patient's transfer to another ship with a doctor on board, or an airlift. The telecommunications service receives requests for assistance, locates the ship or whoever made the request, passes the call to the doctor on duty, and relays the doctor's response to those requesting assistance. The studies section, established in 1957-58, researches occupational pathologies of sailors and contributes to their prevention. This provides a scientific basis for improving medical assistance to sailors at sea.

Isoinertial functional assessment of low-back disorders in pediatric nurses: Ergonomic and rehabilitation guidelines

Low-back troubles are among the most common and most disabling occupational pathologies. It is very common in health professionals including pediatric nursing personnel. However, the problem is difficult to assess, as in many cases there is no objective origin for the complaints. Therefore, objective measures of function are of great interest. Trunk function in a population of 50 pediatric nurses was investigated with an isoinertial dynamometric device (Isostation B200). Isometric torques, unresisted ranges of motion and dynamic velocities were measured in the sagittal plane. The population was divided into three groups: those subjects with no complaints (LBP0) those with moderate low-back pain (LBP1), and those with severe low-back pain (LBP2). Forty-two (85%) of those nurses had low-back complaints, 31 moderate and 11 severe. Isometric torques and velocities enabled a good discrimination between the three groups. There were significant differences between nurses usually carrying children on right or left arm and those carrying indifferently on any arm. The latter had better performances and less low-back pain. The velocity extension to flexion ratio was significantly decreased with the existence and severity of low-back pain. Isoinertial functional assessment has a good discriminatory value in this population. It enables one to draw ergonomic guidelines for child-carrying techniques. Finally, the modifications of the extension to flexion ratio help to determine that, in this population, rehabilitation programs should focus on dynamic back muscle strengthening.