Ayse Coskun Beyan

Call centers and noise-induced hearing loss.

Noise is defined as unwelcome sound. It has been estimated that 16% of adult hearing loss in the world is due to noise exposure at the workplace. This report offers a case that diagnosed with hearing loss of whom working as a call center operator at home. Home agent operators should be explored.

21 Assessment of job-related asthma cases: our three-year experience

Introduction Work-related asthma (WRA) is one of the most common occupational diseases. There is no reliable statistical data for WRA in Turkey. In this study, we aimed to review diagnosing procedures and the characteristics of patients who were diagnosed with WRA at our clinic. Methods Global Initiative for Asthma guideline was used to establish the diagnosis of asthma. Spirometric measurement, reversibility test and BPT were performed according to ATS criteria.Detailed occupational history was gained with questioning the job(s) starting from the first job, used material(s), duration, time, place properties chronologically and extensively. The relation of the complaints with job was defined. PEF measurements were performed for at least four times, for at least two weeks in working environment and at least two weeks during resting period. A graphic was createdusing the Microsoft Office Excel program taking the highest measurement of daily four sessions into account separately for resting and working periods. The PEF assessment graphic and job history were interpreted as; compatible with OA, compatible with WEA and technically not approved. Result Two hundred and fourteen patients admitted to our clinic with WRA suspicion between November 2013 and June 2016. They were referred by an occupational health specialist, personal application, second- or third-line chest disease specialists [61 (28%), 51 (23%), and 102 (47%) respectively]. Fifty-four patients (25%) were diagnosed with occupational asthma (OA), and 24 (11%) with work exacerbated asthma (WEA), total 78 workers diagnosed with WRA. Twenty five (32,1%) had allergic rhinitis. The most commonly used test were PEF monitoring and BPT respectively. Discussion PEF monitoring, non-specific BPT and skin prick test for suitable cases would be sufficient besides occupational history and clinical properties for the diagnosis of WRA. PEF assessment, one of the most important tests for the diagnosis of WRA, must be performed.

20 Stigma towards workers diagnosed with occupational diseases

Introduction Stigma has been defined as ‘the situation of the individual who is disqualified from full social acceptance or social ‘disgrace’ arising within social relations’ or biassed acts or behaviours. Stigma related to chronic health conditions have been known for a long time. Especially, internal and external (perceived and experienced) stigmatisation have been described among the patients with communicable diseases. Despite a growing awareness of chronic diseases, there is not yet enough research about patients with occupational diseases (OD) with regards to stigmatisation. This research aimed to investigate the scope and types of stigmatisation among OD patients in an outpatients clinic. Methods This is a qualitative research. Semi-structured in-depth interviews conducted by two interviewers. 13 patients who diagnosed OD between November 2013-February 2016 recruited to the study. The interviews conducted with tape-recorded accompanied by note-taking. The tape records resolved and evaluated by content analysis methods. Result In our study, we found that at least one theme of internal or external stigmatisation was found in all employees after OD diagnosis. In particular, employees who are symptomatic have been shown to be embarrassed by the complaints and distracted from their social environment due to their illness, and their illnesses are considered as communicable diseases. It was seen that patients were tended to hide their diseases because of the fear of job loss and thinking they were being exposed to discrimination in the workplace. Discussion After OD diagnosis, external stigmatisation is an important and prominent issue. Ensuring job security of the workers with OD and keeping them in working life (return to work and rehabilitation) should be prioritised to prevent stigmatisation. There is a need for investigations to explore the prevalence and causes of the stigmatisation in the workplaces due to chronic diseases including occupational diseases.

27 Ergonomic risk factors in intensive care unit and musculoskeletal symptoms

Introduction Musculoskeletal disorders (MSD) represent a significant occupational problem in intensive care unit (ICU) workers. This study aimed to determine ergonomic risk factors and the musculoskeletal symptoms in ICU workers in university hospital. Methods Ergo team was created by the occupational health department in the hospital. The socio demographic data were obtained by a questionnaire. The clinical assessments were performed by a physiatrist. Cornell Musculoskeletal Discomfort Questionnaire was used for musculoskeletal symptoms assessment. Walk-through survey performed to determine main jobs and tasks in ICUs. The Rapid Entire Body Assessment (REBA) scale was used to assess the ergonomics risks for the nurses. Results There were 30 patient‘ bed in both intensive care units. Twelve doctors(10.7%), sixty four nurses (62.7%) and twenty seven staff members (26.2%) worked in two ICUs included in the study. Each nurse was responsible for two patients while the doctors and staff members were responsible entire units. 102 workers of those 56 from internal medicine ICU (IMICU) (56%) and 46 from anaesthesia ICU (AICU) (46%) workers were participated to the study. 60.7% of the study group was female and the mean age was 32±6.4 in IMICU and 33.1+5.7 in AICU (p=0.3). According to the Cornell scale, 52 (50.9%) had neck pain, 58 (56.8%) had back pain and 25 (24.5%) had wrist pain. Two ergonomically high risk tasks (patient positioning and working with monitor) were identified. The nurses’ mean REBA score was 9.7+1.6 in anaesthesia ICU and 8.7+2.0 in internal medicine ICU (p=0.8) for patient position taks. The mean REBA scores for anaesthesia ICU were 6.1+1.6 and 4.8+1.4 (p=0.7) respectively. Conclusion More than half of ICU workers had neck, back and wrist pain. ICU nurses had high ergonomics risks. In these units, ‘ergonomic risk prevention programmes’ should be implemented by occupational health teams.

242 Pneumoconiosis among dental technicians

Introduction Dental technicians are exposed to various chemicals, including silica particles and metals. The aim of this study is to explore the pneumoconiosis risk among dental technicians. Methods This is a cross-sectional study. We reviewed medical records of patients diagnosed with pneumoconiosis who were admitted to outpatient occupational disease centre between 2013 and 2015. Pneumoconiosis was diagnosed by X-ray radiograms in accordance to ILO procedures and with High Resolution Computarized Tomography (HRCT). Result Pneumoconiosis was diagnosed in 46 (65.7%) of the 70 dental technicians who were referred to our hospital. There were 45 (97.8%) male and 1 (2.2%) female cases. Radiologically, 16 cases were defined as 2/3 or more of profusion and 11 cases had large opacity. In 3 (6,5%) cases who had profusion 0/1, The most frequent findings are micronodules and lymphadenopathy in HRCT. Consolidation, conglomerate masses and ground glass opacities are also described alongside the reticular opacities. There was a poor correlation between pulmonary function tests and profusion, (correlation coefficient were between: −0,18 and −0,058). There was no correlation observed between profusion and age started to work and exposure duration. Discussion The study showed that pneumoconiosis among dental technicians is a great risk. Especially sandblasting procedures is raise the risk of pneumoconiosis. This shows that there are serious limitations in control measures and employee’ health monitoring.

THERMAL RISKS and OCCUPATIONAL HEALTH

Thermal comfort is defined as provision of comfortable working enviroments in terms of ambient temperature and humidity. Thermal risks which cause many health problems even deaths, have been little known or ignored. In this paper, thermal physiology, related diseases and occupational health will be evaluated. Recognition of occupational risks in the work enviroment is the most important factor to prevent occupational diseases, workrelated diseases or work accident. National guidelines about thermal risks and their management are needed.

Assessment of Work-Related Asthma Cases: our three-year experience

Objective: Work-related asthma (WRA) is one of the most common occupational diseases. In this study, we aimed to review diagnosing procedures and the characteristics of patients who were diagnosed with WRA. Methods: Between November 2013 and June 2016; 214 patients were referred to our clinic with WRA suspicion by an occupational health specialist, personal visit, chest disease specialists [61 (28%), 51 (23%), and 102 (47%) respectively]. Occupational history, functional and radiological assessment, skin prick test, PEF monitoring were done. Results: Fifty-four patients (25%) were diagnosed with OA, and 24 (11%) with WEA, total 78 workers were diagnosed with WRA. Twenty-five (32.1%) had allergic rhinitis, 13 (16.7%) had allergic dermatitis, and 8 (10%) had both diseases. Conclusion: WRA can be seen in many areas. Complaints are the basic route for admission to physician, and the diagnosis can be delayed for a long time as one year. Lower rates of referral by occupational health physicians are the signs of limitations on management of cases. Non-specific BPT and skin prick test for selected cases would be sufficient besides occupational history and clinical examination for the diagnosis of WRA. PEF assessment, one of the most important tests for the diagnosis of WRA, must be performed.

Skydiving and the risk of cervical disc herniation

The skydiving/parachuting sport which has recently gained popularity is also known for its accidents and injuries. However, there are a few studies related to its occupational ergonomic risks and occupational musculoskeletal diseases. It has been reported that the sudden hyperextension of the neck during the parachute opening, so called opening shock results in neck pain. It has been found that the jumpers are subjected to an average deceleration of 3-5 times the earths gravitational acceleration (3-5 G) during parachute opening shock. It is considered that the spinal cord is destabilized by the impact of this force. This study presents the occupational cervical disc herniation occurring in the case of a subject who has been working as a skydiving/parachuting instructor for 25 years, and the ergonomic risks specific to the sports of skydiving. There is a requirement for systematic and representative studies related to the administrative measures to be taken in order to prevent the occupational diseases that may occur in the case of skydivers, the personal protective equipment to be used, and the employee. Int J Occup Med Environ Health 2018;31(2):243-249.