Mortality in Miners with Coal-Workers' Pneumoconiosis in the Czech Republic in the Period 1992-2013.

While working underground, miners are exposed to a number of risk factors that have a negative impact on their health and may be a cause of an increased mortality in miners. The aim of the study was to compare total and specific mortality in black coal miners with acknowledged coal-workers' pneumoconiosis (CWP) and without CWP, and the mortality of the general male population in the Czech Republic in the period 1992-2013. The sample consisted of 3476 coal miners with CWP and 6687 ex-coal miners without CWP, who were removed after achieving the maximum permissible exposure (MPE). The mortality risk differences were analyzed with the use of the standardized mortality ratio (SMR) and 95% confidence interval. Significantly higher total mortality (SMR = 1.10; 95% CI: 1.02-1.17), and mortality from malignant neoplasm (SMR = 1.16; 95% CI: 1.03-1.30), lung cancers (SMR = 1.70; 95% CI: 1.41-2.04), and non-malignant respiratory diseases (SMR = 2.78; 95% CI: 2.32-3.31) were found in the sample of coal miners with CWP. In this sample, the severity of CWP was assessed, and the SMR increased with the severity of CWP. The total (SMR = 0.86; 95% CI: 0.82-0.91) and specific mortality of miners without CWP were not higher compared with the general population. In the case where the miners were removed from underground work after achieving the MPE (without CWP), their mortality was not higher than that of the general population, but the mortality of miners with CWP was higher compared to the general population. This mortality was affected by malignant and non-malignant respiratory diseases.

[Ventilatory function in patients with silicosis or coal workers' pneumoconiosis]. / Výskyt ventilacní poruchy plic u osob se silikózou a pneumokoniózou uhlokopa.

OBJECTIVES: The aim of the study was to determine ventilatory function in a group of patients with silicosis and coal workers pneumoconisos (CWP) newly granted as occupational disease. METHODS: The authors have undertaken the analysis of all cases of occupational silicosis and CWP which were diagnosed in men in the South Moravia region. Information on ventilatory function, chest symptoms, age, working and smoking history was collected during the medical surveys, including spirometry testing and chest radiography. Diagnosis was based on history of occupational exposure to coal or silica dust, chest x-ray findings, using International Labour Office classification. RESULTS: In the years 1997-2014, 116 occupational silicosis and coal workers´ pneumoconiosis have been notified. There were diagnosed 42 cases of simple and 17 cases of complicated silicosis, 40 cases of the simple and 17 cases of complicated CWP. Duration of exposure to respiratory hazards, smoking history and prevalence of ventilatory impairment were not significantly different between these groups. The mean age of persons at diagnosing occupational disease was 61.0 (SD 11.2) years, the mean duration of exposure to respirable dust was 24.7 (SD 10.2) years. Abnormal spirometry results were detected in 51.7% of pneumoconiotics--8.6% with restrictive, 11.2% with obstructive, and 31.9 with mixed impairment. The prevalence of ventilatory function impairment was found to be significantly associated with chronic obstructive pulmonary disease and age. CONCLUSIONS: Testing of ventilatory function has an important role in the evaluation of lung disease in employees exposed to various respirable hazards. Although such testing was not useful for diagnosing silicosis or CWP, it was important for evaluating compensation amount for occupational disease in 51.7% pneumoconiotic patiens.

Cardio-ankle vascular index in heterozygous familial hypercholesterolemia.

AIM: The cardio-ankle vascular index (CAVI) is a new non-invasive marker of arterial stiffness and atherosclerosis. The purpose of this study was to compare CAVI in patients with heterozygous familial hypercholesterolemia (FH) and in healthy controls. METHODS: 82 FH subjects (27 males, 65 females), aged 53.7±13.6 years without clinical symptoms of cardiovascular diseases and 359 healthy controls (121 males, 238 females), aged 43.9±14.9 years, were examined. CAVI was measured using the system VaSera® 1500. RESULTS: CAVI in FH patients was significantly higher (8.0±1.4) than in healthy subjects (7.5±1.3) p = 0.002; however, age, sex and BMI adjusted CAVI did not differ significantly (p = 0.061) between the FH group (7.5, CI: 7.3; 7.7) and control group (7.7, CI: 7.6; 7.7). CONCLUSION: The study showed no significant difference in CAVI between heterozygous FH and healthy controls.

[Development of carpal tunnel syndrome after being certified and an occupational disease]. / Rozwój zespolu ciesni nadgarstka (ZCN) po stwierdzeniu choroby zawodowej.

The authors present the results of the study carried out in South Moravia, Czech Republic, in a group of 140 patients (76 women and 64 men) with occupational carpal tunnel syndrome (CTS). The time-lag between the occupational disease certification and the investigation ranged from 2 to 14 years. The mean age of persons at the diagnosis was 44.5 +/- 7.4. years, and the duration of hazardous occupational exposure was 19.8 +/- 9.8 years. Repetitive and excessive strain of upper extremities was observed in 59% of patients and locally transmitted vibrations to the hands or vibration combined with repetitive and excessive strain of upper extremities in 41% of patients. Following the CTS certification as an occupational diseases, 98% of patients were removed from exposure to etiologic factors. During a follow-up examination, 19% of patients evaluated their health condition as better or recovered, deterioration was reported by 28%, and unchanged condition by 63% of subjects. Surgery was performed on 61% of patients. The comparison of the examination outcome at CTS certification as an occupational disease with the follow-up examination indicated significant improvement of distal motor latency, but the complete recovery of the median nerve conduction was found only in 13% of patients.

Occupational respiratory diseases in the Czech Republic.

This paper presents the profile of occupational respiratory diseases in the Czech Republic. In a retrospective study the author analyzes structure, causes, occurrence, and trends of occupational diseases. Between 1996 and 2000, a total of 2,127 new cases were recorded, of which 62.0% were pneumoconioses caused by dust containing free silica, 21.0% were occupational asthma or allergic rhinitis and the rest were divided between lung cancer (10.0%), asbestos-related disorders (4.4%) and variety of other respiratory diseases (2.7%). During the period of the investigations, the decreasing trend of occupational respiratory diseases, which began in 1992, has continued.

[Occupational infectious diseases in the Czech Republic]. / Problematyka zawodowych chorób zakaznych i pasozytniczych w Republice Czeskiej.

INTRODUCTION: The authors present a survey on the incidence of occupational infectious and parasitic diseases in the Czech Republic. MATERIALS AND METHODS: Between 1996 and 2000, occupational infectious and invasive diseases were diagnosed in 1906 patients. This is about 18% of the total number of diagnosed cases in the period under study. The total number of the diagnosed diseases included 68% of those occurring due to interhuman transmission, 29% of zoonoses and 3% of tropical diseases. The majority of occupational infectious diseases developed in health care workers (66%). This was followed by agriculture, game management and forestry workers (20%). In the group of sick workers, women outnumbered men (74% vs. 26%). The mean age of those affected was 39.2 +/- 11.9, range, 16-79 years. RESULTS: Scabies, viral hepatitis and tuberculosis predominated in the group of transmitted diseases and trichophytoses, erysipeloid and Lyme borreliosis among zoonoses. During the whole period of investigation, scabies occupied the first place among occupational infectious diseases. The increased incidence of diseases is mostly due to epidemics in the general population, and its spread is attributed to a low hygiene and social standards, overcrowding, increased migration that creates a higher risk for the elderly, mentally retarded and immunocompromised subjects. In tropical and subtropical countries, contract workers suffered mostly from malaria, amebiasis and infectious hepatitis A. CONCLUSIONS: It was possible to clearly identify occupational infectious and parasitic disease in different working conditions. The results of the survey confirm that infectious and parasitic diseases still create a difficult problem especially among health care and agriculture or forestry workers.