Work-related diseases and risk factors associated with work-related musculoskeletal disorders among unionized metal industry workers: a cross-sectional study.

Objectives. This study aimed to determine the prevalence of work-related diseases (WRDs) and work-related musculoskeletal disorders (WR-MSDs), as well as investigate WR-MSD-associated risk factors, among metal industry workers in Turkey. Methods. The cross-sectional study was conducted with 1374 members of the Birlesik Metal Is Union from 121 companies. Data were collected using a self-administered 30-item questionnaire. Results. The survey response rate was 81.4% (1374/1686). Almost one out of every six workers (14.8%) stated that they had been diagnosed with a WRD, 3.6% reported that they had been diagnosed with an occupational disease and 38.6% of them indicated that they had suffered an occupational accident (OA) at least once. The prevalence of WR-MSDs was 10.7%, of work-related lung diseases was 1.8% and of occupational hearing loss was 0.6%. Quitting smoking, smoking, OA, heavy lifting, time pressure and working in the automotive industry were all associated with WR-MSDs. Conclusions. Interventions aimed at reducing musculoskeletal disorders (MSDs) should focus on smoking cessation, training workers in proper techniques and equipment for lifting and pushing/pulling heavy loads, preventing OAs and injuries, and reducing the time pressure in the workplace in the metal industry.

Serum Specific Antibodies Do Not Seem to Have an Additional Role in the Diagnosis of Hypersensitivity Pneumonitis.

BACKGROUND: We aimed to investigate the contribution of serum IgG testing to the history of exposure in the diagnosis of fibrotic hypersensitivity pneumonitis. METHODS: A single-center, retrospective, cross-sectional study including 63 patients pathologically diagnosed with fibrotic hypersensitivity pneumonitis in line with the guidelines of the American Thoracic Society. Descriptive statistics were presented and Kappa statistic was performed to evaluate the compatibility between panel and the history of exposure. RESULTS: The median age was 63 (22-81) years and 34 (54%) were male. Forty-six patients (73%) had a positive history of exposure. Thirty-nine patients (61.9%) had a positive HP/Avian panel. The most common exposure agent was mold (34.9%), followed by parakeet (31.7%). The antibody detected the most was penicillium chrysogenum lgG (36.5%), followed by aspergillus fumigatus (31.8%). There was no compatibility between HP/Avian panel and history of exposure (kappa coefficient= 0.18, p= 0.14). When the exposure was only assessed based on the history, 4 (6.35%) patients were diagnosed as fibrotic hypersensitivity pneumonitis with low confidence, 6 (9.52%) with moderate confidence, 11 (17.46%) with high confidence and 42 (66.67%) with definite confidence; whereas 4 (6.35%) patients were diagnosed as fibrotic hypersensitivity pneumonitis with low confidence, 6 (9.52%) with moderate confidence, 9 (14.29%) patients with high confidence and 44 (69.84%) patients with definite confidence if exposure was evaluated with history and/or panel. CONCLUSIONS: Serum specific precipitating antibody panel does not seem to provide additional value to the history of exposure in the diagnosis of fibrotic hypersensitivity pneumonitis.

Occupational diseases among call center operators needing vocal rehabilitation.

BACKGROUND: Work related diseases (WRDs) and occupational diseases (ODs) greatly affect call center operators (CCOs) who experience demanding work expectations and adverse working conditions in their workplace. The aim of this study was to evaluate the sociodemographic and job characteristics of CCOs diagnosed with OD, and to describe the changes in employment status after diagnosis. METHODS: This descriptive study is based on the electronic data records of Istanbul Occupational Diseases Hospital available from February 2007 to March 2018. RESULTS: According to the health board reports, 122 of the 173 (70.5%) CCOs had a confirmed OD diagnosis, 85.2% were females and the mean age was 27.5 years. Vocal cord disorders were the most frequent ODs (64.8%), followed by hearing loss (12.5%), dysphonia (10.2%) and temporomandibular disorders (4.7%). Vocal cord nodules (VCN) were found to be more frequent among females compared to males (92.9% vs 62.4%, p<0.001). Although not statistically significant, the frequency of VCN was also higher in subjects working overtime (14.6% vs 6.3%), having gastroesophageal reflux disease (82.3% vs 73.9%) or thyroid nodules (100% vs 73.7%) and being current smokers (41.7% vs 13.3%). Following the OD diagnosis, 43.8% of the cases were dismissed, 18.7% quit their job, and 9.4% still held the same job position. Only 28.1% changed unit within the workplace. CONCLUSION: Including the CCOs who were diagnosed with an OD at a very young age and at an early stage of their working life into vocational rehabilitation programs and employing them under appropriate conditions is essential to proper health and safety protocol.

Premature Deaths Due to Silicosis in Turkey, 2006-2017: A Twelve-Year Longitudinal Study.

BACKGROUND: Deaths due to epidemics of silicosis still continue to be reported both in developing and developed countries, and silica exposure from different sectors remains an important occupational health concern. AIMS: To identify characteristics of silicosis cases by focusing on a developing country and evaluate the frequency of and factors related to premature deaths and also reveal preventable causes of premature deaths in silicosis. STUDY DESIGN: Retrospective cohort. METHODS: We reviewed the records of 9769 patients who were diagnosed with occupational diseases in Istanbul Occupational Diseases Hospital between 2006 and 2017. According to International Classification of Diseases (ICD)-10 codes, 1473 silicosis cases were detected. The sociodemographic characteristics, job characteristics, comorbidities, serological, functional, and radiological data, and follow-up time were obtained from the medical records. Mortality data were gathered from The National Death Notification System of Ministry of Health. RESULTS: The study examined 9769 cases diagnosed with an occupational disease, and 15.0% (n = 1473) of them were diagnosed with silicosis. The median age of silicosis patients was 40.0 years, and 26.9% of them were child labor when they started to work in dusty industries. Child labor was mostly seen among dental technicians (57.7%), denim sandblasters (46.4%), and miners (37.0%). In the follow-up period, 26.3% of Teflon sandblasters, 11.1% of coal miners, 8.6% of denim sandblasters had died before their average life expectancy, and the years of loss of life was 26.0 ± 11.6 years all over the group. Premature death was associated with occupation [hazard ratio (Teflon sandblasting): 3.93, CI: 1.43-10.78; hazard ratio (marble production): 4.4, CI: 1.02-19.21]; large opacities in posterior anterior chest X-ray [hazard ratio: 2.14, CI: 1.18-3.86]; tuberculosis [hazard ratio: 2.60, CI: 1.42- 4.76]; and reduction in forced vital capacity (forced vital capacity% ≤80) during diagnosis [hazard ratio: 4.43, CI: 2.22-8.83]. CONCLUSION: More than a quarter of silicosis cases are those who start working in dusty industries at an early age. Factors associated with premature death in patients with silicosis are patient occupation, large opacities on chest X-ray, tuberculosis, and pulmonary function loss at diagnosis.

A Current Example of Historical Cases: Occupational Pulmonary Aluminosis.

Pulmonary aluminosis (PA) is a rare form of pneumoconiosis caused by aluminum powders and vapors. Although the pathogenesis is not fully elucidated, it is thought to make a number of changes in the lungs, resulting in fibrosis. Our patient, who had cough, sputum, and dyspnea and had thorax computed tomography results showing reticular density changes and symmetrical ground-glass opacity in the bilateral upper and middle zones, informed us that he had worked in aluminum casting for 20 years and was exposed to iron, aluminum, and zinc vapors, and dust in the workplace. The patient was scheduled for bronchoscopy; aluminum analysis in bronchoalveolar lavage revealed 0.256 mg/kg of aluminum. The patient, with a history of occupational exposure, was diagnosed with aluminum metal fume-induced PA. This case shows that, even if it is preventable, PA can still occur if the occupational health and safety regulations are not met and also emphasizes the importance of the detailed occupational history in interstitial lung diseases.

Rheumatological Diseases in Denim Sandblasters with Silicosis: What Should Pulmonologists Look for?

OBJECTIVE: Silica exposure is not only the cause of silicosis, also associated rheumatological diseases like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc). This report will reveal the rheumatological diseases of silicosis patients who were exposed to silica while working as denim sandblasters. Additionally, we will describe some clinical and laboratory findings that will help pulmonologist suspect, recognize and manage rheumatological diseases related to silica exposure in patients with silicosis. MATERIAL AND METHODS: We reviewed the records of 142 sandblasters diagnosed with silicosis and found ten silicosis cases who also had rheumatological diseases between the years 2009 and 2017. The occupational characteristics, serological, functional and radiological data, were collected for patients of silicosis with rheumatological diseases. RESULTS: Ten silicosis patients with concomitant rheumatological diseases were found. Six patients among our cases had diagnosed SSc (4.2%), three of them had RA (2.1%), and one of them was being monitored for SLE (0.7%). The mean silica exposure time of the cases was 4.3±1.9 years (min: 1 max: 8). We also found elevated LD, sedimentation and CRP levels in our cases. CONCLUSION: It should be kept in mind that, in silicosis cases with arthralgia, joint tenderness or sclerosis at the fingertips may be indicative of rheumatological diseases related to silica exposure, and in these cases, the unexplained elevations of sedimentation and CRP levels may also be a result of silica-induced rheumatological diseases.