Nur Şafak Alıcı

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.

241 Serum prolidase activity in silicosis

Introduction Silicosis is the result of silica exposure. Many chemotactic mediators arise with toxicity resulting from exposure to silica particles and silicotic nodules occur from the formation of collagen. Prolidase catalyses the hydrolysis of oligo/dipeptides which contains proline or hydroxyproline in the carboxyl terminal position. Many studies have identified prolidase activity at varying levels in fibrotic diseases. The aim of the study is to investigate the relationship between silicosis and prolidase activity. Methods This study is a cross-sectional study. We reviewed medical records (functional status and radiological findings) and serum prolidase levels of 62 patients who were admitted to our centre between September and December 2015. Result All cases were male and silicosis was diagnosed in 37 (%) of 62 cases. Prolidase level was significantly higher in patients with silicosis than in normal (p<0.001) (4877±2324 vs 815±520). Correlation analysis showed significant positive correlation between prolidase activity and ILO classification (r:0,723, p<0,001, figure 1A) and age (r: 0,391, p:0,002). Prolidase activity was negatively correlated with FEV1 (r:−0.332, p: 0.008) and FCV (r:−0.295, p:0.020). Discussion Since prolidase is involved in collagen metabolism, its activity can be used for early diagnosis and follow-up of silicosis. Further studies are needed to clarify the etiopathogenetic mechanisms of silicotic nodule formation and early detection of vulnerable population who had silica exposure before nodule formation.

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.

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.