Development and Evaluation of a Training Program on Occupational Health Research and Surveillance in Turkey.

OBJECTIVES: The aim of this study was to increase knowledge and skills regarding occupational health surveillance and research in professionals. METHODS: Following the Analysis, Design, Development, Implementation, and Evaluation model, several training modules have been designed and implemented in the course of 2016. Evaluation forms were distributed to 42 participants before the start and after each training module to measure changes in knowledge, skills, and self-efficacy. RESULTS: The majority of the participants were satisfied and found the training relevant and interesting for adult learners. The level of self-efficacy increased after the trainings. Females and occupational physicians displayed higher scores than men and other disciplines. After 1 year, the self-efficacy level decreased, but the level was still substantially higher than before the training. CONCLUSIONS: Feedback on the implemented training program was favorable. Participants were able to acquire and apply competencies in the subject matter at short and long term.

Attitudes and behaviors of family physicians regarding occupational diseases.

OBJECTIVES: The incidence of occupational diseases (ODs) is below expectations. The approaches of family physicians are very important. In this study, we aimed to evaluate attitudes and behaviors of family physicians about ODs. METHODS: The questionnaire was first sent to family physicians via e-mail. Of 3663 responders, 3090 replies were included to study. RESULTS: 44.1% of them stated they obtained detailed occupational history. In logistic regression analysis, physicians who obtained detailed occupational history, discussed their patient's health with an occupational physician, had education about ODs and those who stated that they wanted to receive training in ODs were more likely to refer their patient. CONCLUSION: In this study, it was determined that those who received education on ODs and those who have worked as workplace physician obtained occupational history, knew occupational diseases hospitals and wanted to receive further education.

Prevention of Occupational Diseases in Turkey: Deriving Lessons From Journey of Surveillance.

INTRODUCTION: To prevent and manage the societal and economic burden of occupational diseases (ODs), countries should develop strong prevention policies, health surveillance and registry systems. This study aims to contribute to the improvement of OD surveillance at national level as well as to identify priority actions in Turkey. METHODS: The history and current status of occupational health studies were considered from the perspective of OD surveillance. Interpretative research was done through literature review on occupational health at national, regional and international level. Analyses were focused on countries' experiences in policy development and practice, roles and responsibilities of institutions, multidisciplinary and intersectoral collaboration. OD surveillance models of Turkey, Belgium and the Netherlands were examined through exchange visits. Face-to-face interviews were conducted to explore the peculiarities of legislative and institutional structures, the best and worst practices, and approach principles. RESULTS: Some countries are more focused on exploring OD trends through effective and cost-efficient researches, with particular attention to new and emerging ODs. Other countries try to reach every single case of OD for compensation and rehabilitation. Each practice has advantages and shortcomings, but they are not mutually exclusive, and thus an effective combination is possible. CONCLUSION: Effective surveillance and registry approaches play a key role in the prevention of ODs. A well-designed system enables monitoring and assessment of OD prevalence and trends, and adoption of preventive measures while improving the effectiveness of redressing and compensation. A robust surveillance does not only provide protection of workers' health but also advances prevention of economic losses.

The Mersin Greenhouse Workers Study. Surveillance of Work-related Skin, Respiratory, and Musculoskeletal Diseases.

BACKGROUND: Skin, respiratory, and musculoskeletal diseases in greenhouse workers are frequently observed due to exposure to plant products and pesticides in enclosed conditions and ergonomic risks. Current studies on occupational health risks of greenhouse workers in Turkey are insufficient. OBJECTIVES: The aim of the present study was to assess work-related skin, respiratory, and musculoskeletal diseases in greenhouse workers in the Erdemli province, Mersin, an area with a workforce predominantly active as greenhouse workers. METHODS: The study population consists of adult greenhouse workers, who visited their family physician between June 12-14, 2017 and were diagnosed with dermatological, respiratory, and musculoskeletal diseases. Immediately after this consultation, occupational physicians conducted face-to-face interviews, asking questions about sociodemographic features and occupational factors including current and previous work, current exposures and relation of current symptoms with work. RESULTS: In total, 423 workers with 555 diagnoses were included in the study. Percentages of diagnoses were 30.1%, 21.6% and 48.3%, for skin, respiratory and musculoskeletal diseases respectively. Nearly half of participants had taken an absence from work due to those diseases. Mean age of onset for greenhouse working was 15.5 years. Almost all participants (96.2%) reported contact with chemicals, and usage of respiratory protection was low (17.3%). Pesticides were regarded as a risk factor by nearly two-thirds of workers with skin or respiratory system disorders. Participants' answers to questions regarding the relationship between their diseases and their work was positive for more than half of patients and patients with skin and respiratory diseases. Nearly half of the patients with musculoskeletal diseases attributed their complaints to physical overload at work. CONCLUSIONS: We found evidence of work-relatedness in almost half of the 555 greenhouse workers with dermatological, respiratory and musculoskeletal diseases. These findings are helpful in creating an awareness program. There is a need for a more detailed assessment of the cases and the related working conditions to start a tailored prevention program.

[Pandemic influenza A (H1N1)v vaccination status and factors affecting vaccination: Ankara and Diyarbakir 2009 data from Turkey]. / Pandemik Influenza A (H1N1)v Asilanma Durumu ve Asilanmaya Etki Eden Faktörler: Ankara ve Diyarbakir 2009 Verileri.

In this study, it was aimed to determine the frequency of the symptoms of influenza-like illness during influenza A (H1N1)v pandemic in two provinces where sentinel influenza surveillance was conducted and also to obtain opinions about H1N1 influenza and vaccination, H1N1 vaccination status and factors affecting vaccination. This cross-sectional study was conducted in the provinces of Ankara (capital city, located at Central Anatolia) and Diyarbakir (located at southeastern Anatolia). It was planned to include 455 houses in Ankara and 276 houses in Diyarbakir. The household participation rate in the study was 78.9% and 53.6% for Ankara and Diyarbakir, respectively. Our study was carried out between January-February 2010, with 1164 participants from Ankara and 804 from Diyarbakir, including every household subjects except for infants younger than 11 months and patients with primary/secondary immunodeficiency diseases. Data was collected by site teams consisting of a physician and a healthcare staff with informed consent. Of the participants 45.5% from Ankara and 35.3% from Diyarbakir stated that they had gone through an influenza-like illness. The most frequently indicated clinical symptoms were fatigue/weakness, rhinitis, sore throat and cough. The rates of admission to a physician with influenza like illness complaints were 50.6% and 58.7%; rates of hospitalization due to influenza-like illness were 1% and 1.5%, and rates of antiviral drug use were 3.8% and 1.9%, in Ankara ve Diyarbakir participants, respectively. The rate of personal precautions taken by the subjects for prevention from pandemic influenza were 59% and 53.3%, in Ankara and Diyarbakir, respectively. These precautions most frequently were "hand washing" and "avoiding crowded public areas". H1N1 influenza vaccine was applied in 9.3% of the participants in Ankara and in 3.7% of the participants in Diyarbakir. Vaccination rate was higher in both of the provinces in adults over 25 years old than children and adolescents and in patients with chronic underlying disease. None of the 25 pregnant participants were vaccinated against pandemic influenza. The educational background, employment status and quality of the job have been detected as factors affecting the status of being vaccinated with H1N1 influenza vaccine in both provinces. In addition, the percentage of having H1N1 influenza vaccination was found to be higher in subjects who had seasonal influenza vaccination previously and in 2009, than those who had not, and this difference was statistically significant in both provinces (Ankara p< 0.001, Diyarbakir p< 0.001). The mostly indicated post-vaccination adverse reactions reported by vaccinated participants were local sensitivity, muscle and joint pains, headache and malaise. The most frequent rationale for not being vaccinated against H1N1 were "I do not consider it necessary/I do not want" (Ankara 33.4%, Diyarbakir 27.4%) and "I do not believe/trust its efficacy" (Ankara 25.6%, Diyarbakir 22.6%). Those data emphasized the insufficient awareness of our population about the importance of pandemic influenza and vaccine. It is also believed that possible case definition in H1N1 case management scheme should be revised. In conclusion an important part of pandemic preparation plans is risk communication with the public to increase awareness and to prevent the missed opportunities.