The role of occupational medicine in assessing work limitation: A cross-sectional study on construction workers over a five-year period in Croatia.

BACKGROUND: Maintaining adequate working ability of construction workers is of considerable importance for society, as the construction sector is burdened with high prevalence of work-related diseases and health-issues. OBJECTIVE: To determine the number and age of construction workers in Croatia with temporary or permanent work limitation status, as well as to identify the most common health causes of such work limitation. METHODS: A retrospective cross-sectional study was performed using the data from 2534 construction workers, aged between 18 and 65 years, who underwent standardized routine occupational health examinations between 2011 and 2015. Thorough medical history and medical record reviews, blood and urine analyses, vision parameters and hearing range evaluation, as well as mental health assessment were conducted on every study participant. RESULTS: A total of 210 construction workers (8.29%) received occupational/work limitation status (either temporary or permanent). Four main categories of work limitation were high blood pressure, disorders of the liver and digestive system, hearing loss and amblyopia, comprising 61.69% of all diagnoses. A total of 37.62% of workers with work limitation status had two or more different diagnoses (i.e. co-morbid conditions). Those with work limitation (either temporary or long-term) were significantly older than those fit enough to work (p-value <0.00001). CONCLUSIONS: This type of organized screening represents a significant preventative effort in the construction industry, as workers may become more cognizant of the conditions that may affect their work ability.

Characteristics and Distribution of Penile Lesions in Croatian Men with Laboratory-Confirmed Low-Risk and High-Risk Human Papillomavirus (HPV) Infection.

BACKGROUND: Studies that compare penoscopic evaluation with the results of molecular human papillomavirus (HPV) testing are scarce. This study assessed and compared both type and distribution of various penile lesions using penoscopy (peniscopy) technique in Croatian men with different, laboratory-confirmed HPV status. METHODS: From a large cohort of men attending an outpatient STD clinic for HPV testing, a total of 120 patients were randomly selected and grouped into those positive for low-risk HPV, high-risk HPV, both low-risk and highrisk HPV, and those with negative results. Samples for HPV-DNA detection were taken by penile brushing and tested with the hc2 HPV DNA Test using Hybrid Capture 2 technology. Lesions were observed by photocolposcope after the application of aqueous 5% acetic acid, and classified as flat (macular), papular, papillary, classical condyloma, PIN-suspicious and non-specific lesions. RESULTS: The results have shown that flat and non-specific acetowhite lesions were the most common overall. All groups differed significantly with respect to papular and papillary lesions. A combination of heterogeneous lesions (i.e., a mixed penoscopic pattern) was commonly observed in all HPV-positive groups, but was significantly lower in the HPV-negative group. A majority of lesions were located in the coronal sulcus, and the four groups differed with respect to the location only considering the lesions of the penile shaft. Distribution of lesions in different sites did not appear to be significantly different with respect to the group, although differences within the high-risk HPV group and the group with both low-risk and high-risk HPV were detected. CONCLUSIONS: Penoscopy is relevant, but not a conclusive diagnostic tool for differentiating HPV from non-HPV findings in men - thus combining it with an HPV DNA test represents a more reliable approach.

Prevalence of HPV Infection in Croatian Men during a 12-year Period: a Comparative Study of External Genital and Urethral Swabs.

AIM: The aim of the study was to compare the prevalence and distribution of both low-risk and high-risk HPV infection of the urethra and outer genital region in Croatian men. Thus far there is a consensus that sampling the coronal sulcus and glans of the penis is essential for adequately assessing HPV status in men but less agreement is noted for urethral sampling. METHODS: External genital brushing and urethral swabs were taken from 1,342 men during a 12-year period and tested with the hc2 HPV DNA Test using Hybrid Capture 2 technology. RESULTS: The overall prevalence of male HPV infection in this study was 36.66%. Infection with high-risk HPV types (44.72%) was significantly more frequent than infection with low-risk HPV types (28.86%) or co-infection with both low-risk and high-risk HPV types (26.42%). HPV was more frequently demonstrated in the outer genital area (58.33%) when compared to the sole infection of the urethra (17.89%) or infection of both genital sites (23.78%). CONCLUSIONS: Results from this study indicate high prevalence of HPV infection in men and suggest that optimal sampling method for the testing of men is the combination of external genital and urethral swabs. Further research about the proper collection of biological samples and testing methods for HPV detection in men is necessary since our future end-goal is to implement standardized guidelines on sampling and diagnostic testing of males.