[Evaluation of work capacity and/or disability in patients with overuse injury syndromes of the locomotor system]. / Ocjena radne sposobnosti i/ili invalidnosti u bolesnika sa sindromima prenaprezanja sustava za kretanje.

Clinical picture and subject's occupation are the main points of reference in the evaluation of work capacity in subjects with overuse syndrome. Particular attention is paid to the degree and the location of pain, as well as functional limitations with respect to demands of the workplace. If the diagnosis is right and therapy and rehabilitation intensive, overuse syndrome usually does not entail long sick leaves. Exceptions are the athletes and certain jobs which require longer periods of rehabilitation. Furthermore, untimely diagnosis and inadequate treatment may extend the period of incapacity. If the therapy and medical rehabilitation cannot completely remedy the functional deficit in performing the regular job, application of pension policy regulations may be necessary. This applies to the immediate danger of disability with the possibility to change the job for a more adequate one, as well as to the disability due to occupational or general incapacity to work. If the health condition predisposes younger persons to disability, they may exercise their right to professional rehabilitation. This review gives a list of occupational diseases and causes which may be applied to the disability generated by the overuse syndrome.

[Respiratory function in confectionary workers]. / Respiratorna funkcija radnica na proizvodnji slastica.

Respiratory symptoms and ventilatory capacity were studied in 259 female confectionary workers and in 65 non-exposed controls. Most of the chronic respiratory symptoms appeared more frequently among the exposed workers, particularly if they worked in exposure to flour, talc, starch, acids and alcohol. There was a high prevalence of acute symptoms that developed during work shift. This was true especially of cough, dyspnea, burning and dryness of the throat and eye irritation. The exposed workers exhibited statistically significant acute reductions of ventilatory capacity. Those were particularly pronounced for FEF50 (range: 4.6-13.0%) and FEF25 (range: 4.7-22.3%). The measured preshift values of ventilatory capacity were significantly lower than the predicted normal values. The administration of disodium chromoglycate (DSCG 40 mg) significantly diminished mean across-shift reductions in all ventilatory capacity tests. Data suggest that sensitive confectionery workers may develop acute and chronic respiratory symptoms accompanied by acute and/or chronic changes in ventilatory capacity.

[Respiratory function in fur-processing workers]. / Ventilacijska funkcija radnika u preradi krzna.

Forty women employed as furriers in the fur processing industry and a group of 31 control workers were examined. A higher prevalence of chronic respiratory symptoms was found among the furriers than among the controls. The differences were statistically significant for chronic cough and sinusitis (P less than 0.01). The highest prevalence in furriers was found for chronic cough (50%), sinusitis (30%), followed by dyspnea (25%), nasal catarrh (20%) and occupational asthma (5%). A large number of workers complained of acute symptoms during work shift. Statistically significant mean acute reductions in ventilatory capacity over the workshift were recorded for FVC (-4.1%), FEV1 (-5.2%) and FEV50 (-6.3%). The furriers demonstrated significantly lower mean measured pre-shift values for FVC and FEV25 (P less than 0.05) when compared with the predicted. Pre-shift administration of 40 mg of Intal considerably diminished acute ventilatory capacity over the work shift.

[Immunologic status, respiratory symptoms and ventilatory function in soybean-processing workers]. / Imunoloski status, respiratorni simptomi i ventilacijske funkcije radnika na preradi soje.

Immunological and respiratory findings were studied in a group of 19 male soy-bean workers. A group of 31 control workers were examined for the prevalence of respiratory symptoms and 20 control workers were included in the immunological study. All soy-bean workers had positive immediate skin reaction to soy-bean dust, 18 to soy antigen after separation from oil, three to lecithin antigen and only one to soy oil. Only three soy-bean workers had increased levels of specific IgE. Among 20 control workers, 19 reacted to soy-bean dust, 20 to soy after separation of oil and none to soy oil. One demonstrated increased specific IgE. The prevalence of chronic respiratory symptoms was considerably higher in exposed than in control workers, being statistically different for dyspnea (P less than 0.01). The statistically significant acute reductions in ventilatory capacity were particularly pronounced for FEF50 (-4.7%) and FEF25 (-9.4%). The mean ventilatory capacity values before shift on Monday were significantly lower than those on the following Friday for FVC, FEF50 and FEF25. There was no difference in ventilatory capacity between soy-bean workers with positive and those with negative skin tests to house dust or between those with increased and those with normal IgE serum levels. A water soluble extract of soy-bean dust was also assayed in organ bath containing guinea pig trachea. This model showed the extract to be highly reactive causing a dose-related constriction of airway smooth muscle. Our data suggest that immunologic sensitization to soy-bean products is very frequent. In addition to possible humoral contribution to respiratory disorders, soy dust seems to directly affect airway smooth muscle.

[Respiratory function in rubber-processing workers]. / Respiratorna funkcija radnika na preradi gume.

The prevalence of acute and chronic respiratory symptoms and diseases as well as lung function changes were studied in 409 rubber male workers and 172 nonexposed control male workers. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves on which forced vital capacity (FVC), one second forced expiratory volume (FEV1) and flow rates at 50% and the last 25% of vital capacity were calculated (FEF50, FEF25). A significantly higher prevalence of all chronic respiratory symptoms except asthma was found in rubber workers in comparison to the controls. Smokers had significantly higher prevalence of most of the chronic respiratory symptoms than nonsmokers. Rubber workers exposed for more than 10 years had also significantly higher prevalence of chronic respiratory symptoms than those with shorter exposure. A high prevalence of acute symptoms during work shift was recorded in rubber workers. Ventilatory capacity was mostly decreased during work shift, particularly FEF50 and FEF25. All acute reductions were greater in rubber workers exposed for more than 10 years as compared to those with shorter exposure. Alupent inhaled at the end of the work shift significantly improved decreased values. Rubber workers demonstrated significantly lower ventilatory capacity tests with respect to the controls. A large number of rubber workers showed a decrease in lung functions tests less than 70% of the predicted normal values. Our data suggest that rubber workers are exposed to numerous noxious agents which may lead to acute and/or chronic impairment of lung function.

[Occupational exposure to harmful materials in artistic activities]. / Profesionalne stetnosti u djelatnosti likovnih umjetnika.

Artists' activities such as sculptures, paintings, graphic designs, photography, restoration, glassblowing, glass cutting and ceramics are described. The hazards the artists are exposed to during their professional activities with potential dangerous effects on their health are listed. Diseases which can develop as a consequence of exposure to specific noxious agents in such in environment are described. Preventive measures (personal, technical and medical) which should be applied in order to prevent the development of diseases related to these specific working conditions are stressed.

[Monitoring of pulmonary ventilation function and respiratory symptoms in cotton-processing workers]. / Pracenje ventilacijske funkcije pluca i respiratornih simptoma radnika u preradi pamuka.

A follow-up study in cotton workers (35 female and 31 male) was performed ten years after the original cross-sectional study. The prevalence of byssinosis considerably increased during the follow-up study in female (22.9%; 42.9%) and in male (25.8%; 51.6%) workers. Similarly, the prevalence of almost all respiratory symptoms was significantly higher during the follow-up study than at the time of the initial study. Significant acute reductions of FVC and FEV1 during the work shift were recorded in both surveys. The mean annual decline in ventilatory capacity was greater than expected for both female (FVC: -0.036 L/year; FEV1: -0.059 L/year) and male workers (FVC: -0.059 L/year; FEV1: -0.068 L/year). The mean total airborne dust concentration was 3.95 mg/m3 with an average respirable dust concentration of 0.97 mg/m3. Our study demonstrated an association between exposure to cotton dust and increasing prevalence of respiratory symptoms and progressive impairment of ventilatory capacity.

Respiratory findings in mail carriers.

The results of the recording of respiratory symptoms and the measurement of lung function in 136 male postal workers employed as mail carriers were studied. In addition, the prevalence of chronic respiratory symptoms in 87 male nonexposed control workers was also examined. There was a significantly higher prevalence of chronic bronchitis (25.0%) and sinusitis (38.9%) in mail carriers than in control workers (13.8%; P < 0.05 and 2.3%; P < 0.01). A logistic regression analysis performed on the results of the study of chronic respiratory symptoms of mail carriers indicated a significant (P < 0.001) effect of smoking in this cohort, with the exception of occupational asthma. Mail carriers who smoked had a significantly higher prevalence of chronic cough (45.3%), chronic phlegm (39.1%), chronic bronchitis (39.1%) and sinusitis (53.1%) than mail carriers who were nonsmokers (18.1%; 12.5%; 12.5% and 26.4% respectively.) (P < 0.01). A high prevalence of acute symptoms developing during the work-shift was recorded, in both smokers and nonsmokers, being highest for upper airway symptoms, headache (50.0%), nasal catarrh (42.6%), and eye irritation (57.4%). The results of tests for average measured ventilatory capacity (as a percentage of predicted capacity) were significantly lower than expected, particularly for maximum flow rates at the last 25% of the vital capacity (FEF25), in both smokers (68.5%) and in nonsmokers (74.2%). A multivariate analysis of lung function parameters indicated a significant effect of employment conditions. The only major identifiable occupational exposure of mail carriers was to ambient air pollution for an average of 6 h per day as well as to adverse meteorological conditions. The measured ambient concentrations of major outdoor pollutants, primarily total suspended particulates, sulfur dioxide (SO2) and black smoke exceeded considerably the recommended Croatian maximum air quality standards over the past 10 years. Our study of mail carriers demonstrated that these workers were subject to respiratory symptoms associated with their smoking habits. Lung function findings suggested that occupational exposures, possibly to atmospheric pollution in combination with adverse meteorological conditions, may have led to lung function impairment in these workers.