Worker's Compensation Injury and Illness Care: A Global Round Table.

BACKGROUND: Work-related injuries and diseases have a significant impact on workers and their families, society, and the economy. There is a gap in the literature regarding the structures, content, quality, and outcomes of international occupational health systems serving injured and ill workers. This global round table was an attempt to elucidate, evaluate, and identify areas needing improvement. METHODS: International occupational health professionals were identified via chain/snowball sampling and asked to answer five questions designed to evaluate the structures, processes, and outcomes of the workers' compensation systems in each country. FINDINGS: Areas for improvement identified during this round table included timely access, reducing the impact of liability and eligibility determinations on access to medical care, equitable access to care, and the accuracy of reporting. Canada had successfully utilized a virtual approach to care for the geographically remote worker. CONCLUSIONS: International workers' compensation structures are designed to ensure timely access to quality care and services. Financial incentives optimize the safety of the working environment. There remain areas for improvement. Resources are limited, especially within the public health systems, which may delay care and affect quality. Informal and remote workers often do not have the same access to care. Occupational Health Services (OHS) and national reporting databases exist throughout the world but may not accurately capture data on informal, self-employed, small business, migrant, and remote workers.

Self-Esteem Trajectories After Occupational Injuries and Diseases and Their Relation to Changes in Subjective Health: Result From the Panel Study of Workers' Compensation Insurance (PSWCI).

BACKGROUND: Occupational injuries and diseases are life events that significantly impact an individuals' identity. In this study, we examined the trajectories of self-esteem among victims of occupational injury and disease and their relation to health. METHODS: The Panel Study of Workers' Compensation Insurance conducted annual follow-ups on workers who had experienced occupational injury or disease. A total of 2,000 participants, who had completed medical care, were followed from 2013 to 2017. Growth mixture modeling was utilized to identify latent classes in the self-esteem trajectory. Additionally, logistic regressions were conducted to explore the association between trajectory membership, baseline predictors, and outcomes. RESULTS: Three distinct trajectory classes were identified. Total 65.8% of the samples (n = 1,316) followed an increasing self-esteem trajectory, while 31.1% (n = 623) exhibited a constant trajectory, and 3.1% (n = 61) showed a decreasing trajectory. Individuals with an increasing trajectory were more likely to have a higher educational attainment (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.20-2.88), an absence of a moderate-to-severe disability rating (OR, 0.49; 95% CI, 0.25-0.96), no difficulty in daily living activities (OR, 0.81; 95% CI, 0.75-0.88), and were economically active (re-employed: OR, 2.46; 95% CI, 1.52-3.98; returned to original work: OR, 4.46; 9% CI, 2.65-7.50). Those with a decreasing self-esteem trajectory exhibited an increased risk of poor subjective health (OR, 1.89; 95% CI, 0.85-4.85 in 2013 to OR, 3.17; 95% CI, 1.04-13.81 in 2017), whereas individuals with an increasing trajectory showed a decreased risk (OR, 0.54; 95% CI, 0.43-0.68 in 2013 to OR, 0.44; 95% CI, 0.33-0.57 in 2017). CONCLUSION: Our findings emphasize the diversity of psychological responses to occupational injury or disease. Policymakers should implement interventions to enhance the self-esteem of victims.

Application strategy of the Principles and Guidelines for Human Factors/Ergonomics (HFE) Design and Management of Work Systems in China / 中国职业医学

To provide in-depth information and guidance on ergonomics, the International Labour Organization (ILO) had issued a series of conventions, recommendations, and resolutions on human factors/ergonomics (HFE) and had published HFE guides and toolkits. In 2021, the ILO and the International Ergonomics Association released an international guideline on HFE entitled Principles and Guidelines for Human Factors/Ergonomics (HFE) Design and Management of Work Systems (hereinafter referred to as the HEF Guidelines), aiming to improve the occupational safety, health, and the well-being of workers from the perspective of work system sustainability. There are currently 112 national health standards in China related to HFE, of which 79 (accounting for 71%) are equivalent to relevant standards from the International Organization for Standardization. Most of the recommended standards do not meet the applicability requirements of HFE for the Chinese workforce, as they are different from the national occupational health standard system. At present, China's HFE capability cannot meet the needs of the workforce, and there is still a gap between occupational diseases related to HFE included in the Occupational Disease List of China and those compared to the ILO. In the future, China needs to pay attention to the application of the HEF Guidelines, further improve the technical services for occupational health, include diseases caused by poor ergonomics in the national occupational disease list, strengthen the HFE standard system in the national occupational health standard system, actively promote the application of action-oriented HFE tools, enhance “human-machine coordination” and “person-job matching”, and focus on physical and cognitive HFE design to promote equality in workplace and reduce the occurrence of occupational and work-related diseases.

Overview of work-related diseases and occupational injury surveillance system in the UK / 环境与职业医学

The UK's work-related diseases and occupational injury surveillance system consists of Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), Labour Force Survey (LFS), The Health and Occupation Research network in General Practice (THOR-GP), and Reporting to The Health and Occupation Research network by specialist physicians. This article briefly described the scope, content, and methods of each surveillance programme in the UK work-related diseases and occupational injury surveillance system, and summarized their advantages and disadvantages. Among them, employers are required to report to relevant law enforcement authorities by RIDDOR, data are highly accessible but with a concern of serious underreport, and it is the only data source of fatal occupational injuries; LFS, a representative national household sample survey, covering occupational injuries and work-related diseases, is the primary data source of non-fatal occupational injuries and work-related diseases such as stress, anxiety, and depression, but collects non-clinically proven data based on self-perception; general practitioners report clinically confirmed work-related diseases, which is more scientific in attribution and is a good secondary source of work-related diseases; specialist physicians report clinically confirmed cases of higher severity, which is the primary source of data on conditions such as asthma and dermatitis, but may underestimate morbidity. Each surveillance programme of the system has its own characteristics, intersects, and complements each other, which can provide reference for the construction of occupational injury surveillance system in China.

COVID-19 in the Czech Republic 2020 and 2021: comparative analysis of probable work-related transmission of the coronavirus SARS-CoV-2.

OBJECTIVES: The aim of the analysis was to determine the probable places of coronavirus transmission in association with the work and compare the situation between 2020 and 2021. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period from March 2020 - December 2021. RESULTS: 2,483,219 COVID-19 cases were officially confirmed (732,202 during 2020 and 1,338,790 in 2021), from them 140,368 (6%) represented work-related disease, 520,830 cases (21%) work-related contact, and 1,822,021 (73%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (458,341 cases), in descending order - clerk, machinist, teacher, craftsman, worker/agency worker, driver, sales worker/cashier, warehouse worker/expediter, nurse, manager, food worker, paramedic, and social worker. Comparing 2020 and 2021, there was a difference in the ranking of occupations by incidence of disease. In 2021, the risk of infection acquiring increased for the occupations clerk, machinist, craftsman, worker/agency worker, manager, and food worker, while it decreased for the health professions (nurse, other paramedic, physician) and for social worker; 5,514 cases of COVID-19 were recognized as an occupational disease in 2020 and 2021, from them 5,483 cases (99.4%) in the health and social care economic activity sector. CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which 27% cases of COVID-19 are related to work (cases of work-related disease and work-related contact represented together the closest relationship to work). Different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control. The use of personal protection of the mouth and nose with respirators/muffs is essential to reduce the risk of airborne transmission.

Work-related disease symptoms and occupational injuries among coffee processing industry workers in Bench-Sheko and Kaffa Zones Southwest, Ethiopia: A mixed-method study.

Background: Occupational injuries have become one of the most critical rooting causes paying to infirmities and life-threatening conditions in developed and developing countries. Workers in the coffee industry face some occupational health and safety issues. However, there is limited evidence on this important public health issue. Hence, this research was conducted to assess work-related disease symptoms and occupational injuries among coffee processing workers in Southwest, Ethiopia. Methods: A cross-sectional study supplemented with a qualitative method was done. A total of 721 workers were involved in the study for quantitative information. In addition, we performed a total of 22 in-depth and five key informant interviews for generating qualitative evidence. Quantitative data was collected by an interview-based questionnaire which is adapted from similar studies. We conducted descriptive, binary logistic, and multivariable regression analysis as necessary, to ascertain the factors affecting occupational injuries. We collected qualitative data guided by an interview guide, transcribed verbatim, and analyzed using ATLAS ti version-8 by applying a content analysis approach. Finally, quotes from participants that had exemplary ideas were triangulated along with quantitative findings. Result: The overall prevalence rate of work-related symptoms and occupational injuries among coffee processing workers were 21.7 and 13.4% respectively. Age group 30-39 and 40-49 (Adjusted odds ratio (AOR) 1.95, 95% CI 1.37, 2.79, (AOR 3.28, 95% CI 1.89, 5.69, respectively, income level (AOR 0.24, 95% CI 0.16, 0.36, p = 0.000), experience (AOR 1.64, 95% CI 1.04, 2.60, p = 0.034), and smoking cigarette (AOR 5.59, 95% CI 2.78, 11.26, p = 0.000) were significantly associated with the work-related symptom. In addition, training related to the job (AOR 11.88, 95% CI1.34, 105.57, p = 0.026) was significantly associated with occupational injuries among coffee processing industry workers. Conclusion: The prevalence of work-related symptoms and occupational injuries was high among coffee processing industry workers in southwest Ethiopia. Therefore, there is a need for regulations for both government and industry owners to advance the occupational conditions and ergonomic structure of coffee processing industries.

Occupational Hantavirus Infections in Agricultural and Forestry Workers: A Systematic Review and Metanalysis.

Hantaviruses are zoonotic pathogens that can cause serious human disorders, including hemorrhagic fever with renal syndrome and hantavirus cardiopulmonary syndrome. As the main risk factor for human infections is the interaction with rodents, occupational groups such as farmers and forestry workers are reportedly at high risk, but no summary evidence has been collected to date. Therefore, we searched two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of hantaviruses in farmers and forestry workers. Data were extracted using a standardized assessment form, and results of such analyses were systematically reported, summarized and compared. We identified a total of 42 articles, including a total of 28 estimates on farmers, and 22 on forestry workers, with a total workforce of 15,043 cases (821 positive cases, 5.5%). A pooled seroprevalence of 3.7% (95% confidence interval [95% CI] 2.2-6.2) was identified in farmers, compared to 3.8% (95% CI 2.6-5.7) in forestry workers. Compared to the reference population, an increased occurrence was reported for both occupational groups (odds ratio [OR] 1.875, 95% CI 1.438-2.445 and OR 2.892, 95% CI 2.079-4.023 for farmers and forestry workers, respectively). In summary, our analyses stress the actual occurrence of hantaviruses in selected occupational groups. Improved understanding of appropriate preventive measures, as well as further studies on hantavirus infection rates in reservoir host species (rodents, shrews, and bats) and virus transmission to humans, is needed to prevent future outbreaks.

Preventing and Monitoring Work-Related Diseases in Firefighters: A Literature Review on Sensor-Based Systems and Future Perspectives in Robotic Devices.

In recent years, the necessity to prevent work-related diseases has led to the use of sensor-based systems to measure important features during working activities. This topic achieved great popularity especially in hazardous and demanding activities such as those required of firefighters. Among feasible sensor systems, wearable sensors revealed their advantages in terms of possibility to conduct measures in real conditions and without influencing the movements of workers. In addition, the advent of robotics can be also exploited in order to reduce work-related disorders. The present literature review aims at providing an overview of sensor-based systems used to monitor physiological and physical parameters in firefighters during real activities, as well as to offer ideas for understanding the potentialities of exoskeletons and assistive devices.

[Occupational and work-related diseases in community law and in the legislature of selected EU member states - a comparative perspective]. / Choroby zawodowe oraz choroby niezawodowe zwiazane z praca w prawie wspólnotowym i wybranych krajach Unii Europejskiej ­ ujecie porównawcze.

Work-related diseases that are not included in the occupational diseases lists have become a significant social phenomenon, generating increasing costs for the EU member states and for European employers. The impact they have on workers' health and claims results in a need to implement changes in the legislation, which in Poland is currently limited to providing protection and prevention of already established occupational diseases. In the review, a formal-dogmatic approach was used, in a manner of analyzing the current state of Polish legislation and court rulings based upon it. The Polish legal framework was compared to that of the 3 EU member states selected on the basis of their regulations concerning occupational and work-related diseases (Germany, Finland and Ireland). The presented arguments indicate the purpose of the need for a change in the Polish legal framework of occupational and work-related diseases in the direction of either the Finnish or German model. The current Polish law forces people suffering from those work-related diseases which are not recognized as occupational diseases to seek legal remedies under general provisions of civil law, which demands proving not only an adequate causal link between the type of work and the disease but also the employer's culpability, which puts the affected employee in a worse legal situation than those suffering from an established occupational disease. The provisions of the statutory law implemented in the Federal Republic of Germany provides a solution for a fraction of the abovementioned problems deriving from the referred differences in occupational and work-related diseases regulation, while the Finnish model, based on causality, instead of the legal definition of occupational disease as such, practically allows for a complete elimination of the problem. Med Pr. 2021;72(5):549-60.

COVID-19 in the Czech Republic 2020: probable transmission of the coronavirus SARS-CoV-2.

OBJECTIVES: The aim of the study was to determine the probable places of coronavirus transmission in association with the work. METHODS: The work analysed data from the Information System of Infectious Diseases managed by the Institute of Health Information and Statistics of the Czech Republic in the period March-December 2020. RESULTS: 732,202 COVID-19 cases were officially confirmed, from them 64,587 (9%) represented work-related disease, 184,384 cases (25%) work-related contact, and 483,231 cases (66%) out-of-work contact. There were identified 13 occupations with the highest incidence of COVID-19 in the observed period (42,072 cases), in descending order nurse, paramedic, teacher, machinist, clerk, social worker, physician, worker/agency worker, craftsman, policeman, manager, food worker, and miner; 150 cases of COVID-19 were recognized as an occupational disease in 2020, from them 148 cases in the health and social care economic activity sector. CONCLUSION: The available data show probable exposures to an infectious agent (without proof of specific contact with the source of the infection), of which at least one third are related to work, so different relevant anti-epidemic measures in the workplace have considerable practical importance for epidemic control.

Cardiac and vascular disorders as para-occupational diseases - a Polish perspective.

INTRODUCTION: The study presents the difference between occupational and para-occupational diseases in terms of Polish law, and indicates the fact that cardiovascular diseases (CVDs) are considered to be work-related, and describes the latest reports on the prevalence of cardiovascular risk factors in workplaces. OBJECTIVE: The aim of this study is to present the difference between occupational and para-occupational diseases in terms of Polish law. Also indicated is the fact that cardiovascular diseases (CVDs) are considered to be work-related and the latest reports on the prevalence of cardiovascular risk factors in workplaces are described. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE: Polish law distinguishes two groups of diseases that may arise in connection with work: occupational diseases and work-related diseases (so-called para-occupational diseases). Despite the fact that both groups are connected with the work environment they are not equivalent in legal terms. CVDs are one of the greatest threat to human life. The pathogenesis of these diseases is highly dependent on the compilation of adverse risk factors, which are typically divided into modifiable and non-modifiable. To-date, modifiable factors, i.a. excess weight and high blood pressure, were mainly associated with an unhealthy lifestyle. However, a shift in perspective has taken place and currently researchers focus more on the work environment as a possible factor affecting people's health. It is emphasized that an unhealthy work environment increases the risk of CVD. Research shows that workplaces are rich in risk factors specifically related to work, including psychosocial, physical and chemical factors. CONCLUSIONS: Legal principles covering para-occupational diseases in Poland seem incomplete. It is suggested that providing detailed legal authorization and defining the bodies that will objectively and reliably engage in the diagnostic process of para-occupational diseases may be beneficial to employees.

Identificación y reconocimiento de enfermedades profesionales en siete hospitales públicos de España / Identification and recognition of occupational diseases in seven public hospitals in Spain

Antecedentes: La infra-notificación y reconocimiento de enfermedad profesional (EP) es un problema secular en España y demás países europeos. El proyecto de Carga de la Enfermedad Profesional en España (CEPS) pretende contribuir a resolver este problema. Objetivo: Describir el proceso de identificación y reconocimiento de EP en siete hospitales españoles entre 2017 y 2019. Material y Métodos: En los siete hospitales que participan en el estudio se creó una unidad de patología laboral (UPL) la cual estimulaba en los servicios asistenciales la identificación de posibles EP atendidas en el hospital. Los pacientes confirmados por la UPL fueron acompañados en el proceso de reconocimiento. Resultados: En este periodo fueron derivados 308 casos, y en 154 (62%) se confirmó la sospecha EP. De éstos, 78 (65%) han sido reconocidos. La tasa de confirmación (casos confirmados/ derivados) varió según hospitales (de un 25% en el Badalona Serveis Assistencials a un 100% en el Hospital Universitario Fundación Jiménez Díaz) y grupos de diagnósticos (de un 13% para trastornos musculoesqueléticos a un 100% para patologías varias). La tasa de reconocimiento (casos confirmados/casos reconocidos) varió según centro, diagnóstico, sexo y edad, siendo más alta en mujeres, con ≥ 55 años y diagnosticados con patologías varias (oculares, infecciosas, mentales, entre otras). Conclusión: Las UPL contribuyen significativamente en el proceso de identificación y reconocimiento de EP, lo que los pacientes posiblemente no hubieran obtenido de otra forma (AU)

Background: Under-reporting and recognition of occupational disease (OD) is a secular problem in Spain and other European countries. The burden of occupational disease in Spain project (CEPS) aims to contribute. Objective: To describe the process of identification and recognition of OD in seven Spanish between 2017 and 2020. Material and Methods: In the seven hospitals that participate in the study an occupational pathology unit (OPU) was created. The OPU encouraged the healthcare services to identify possible OD treated in the hospital. The patients confirmed by the OPU were accompanied in the recognition process. Results: 308 cases were referred in this period and 154 OD was confirmed (62%). Of these, 78 have been recognized (65%). The confirmation rate (confirmed/ referred cases) varied according to hospitals (from 25% at the Badalona Serveis Assistencials to 100% at the Hospital Universitario Fundación Jiménez Díaz) and diagnosis groups (from 13% for musculoskeletal disorders to 100% for various pathologies). The recognition rate (confirmed/ recognized cases) varied according to hospitals, diagnosis, sex and age, being higher in women, aged ≥ 55 years and diagnosed with various pathologies (ocular, infectious, mental, among others). Conclusion: OPU contribute significantly in the process of identification and recognition of OD, which the patients might not have obtained otherwise (AU)

The rights of surgeons while working with hiv-infected patients in Ukraine.

OBJECTIVE: Introduction: Surgeons that are working with HIV-infected patients in Ukraine are in a vulnerable state due to the lack of special regulation of this issue in labor, medical law and labor contract, as well as the spread of HIV among the population of the country. The aim of this article is to determine and uncover the content of the rights of surgeons while working with HIV-infected patients in Ukraine. PATIENTS AND METHODS: Materials and Methods: The research materials of the rights of the surgeons that are working with HIV-infected patients consist of national legislation, official explanations of the Social Insurance Fund of Ukraine, statistics on HIV infection. The research methods that have been used are cross-sectoral, complex statistical, analysis and synthesis. In order to obtain the results of the research the norms of medical, labor and civil law have been analyzed. RESULTS: Review: The authors of the article have emphasized and described the rights of surgeons that are working with HIV-infected patients. CONCLUSION: Conclusions: It has been proved that the current system of surgeons' rights needs to be improved. It has been offered: to establish, at the legislative level, the responsibility of the patient with HIV infection to warn a medical employee about his infection in case of surgery or other medical manipulation that leads to contact with blood or other biological materials; to revise and significantly increase the payment of obligatory insurance of surgeons, if they are infected by a patient with HIV infection.

Silicosis, then microscopic polyangiitis-antineutrophil cytoplasmic antibodies-associated vasculitis may be work-related disease in patients with silicosis.

A 74-year-old man with silicosis was admitted to the hospital because of prolonged fever. After referral to internal medicine for persistent fever and renal dysfunction, workup revealed antineutrophil cytoplasmic antibodies (ANCA) positivity. He was diagnosed with microscopic polyangiitis (MPA). After treatment with immunosuppressive therapy, his condition improved. Herein, we discuss silica exposure and the risk of ANCA-associated vasculitis (AAV), particularly in terms of work-related diseases. Silica exposure is a notorious risk factor for developing AAV, which is potentially lethal when not identified. When we see a silicosis patient with new-onset prolonged fever and generalized fatigue, AAV should be taken into consideration. This case report provides beneficial information to reliably assess patients at high risk of developing AAV in primary care settings.

Occupational health related concerns among surgeons.

The surgeon's daily workload renders him/her susceptible to a variety of the common work-related illness. They are exposed to a number of occupational hazards in their professional work. These hazards include sharp injuries, blood borne pathogens, latex allergy, laser plumes, hazardous chemicals, anesthetic gases, equipment hazards, static postures, and job related stressors. However, many pay little attention to their health, and neither do they seek the appropriate help when necessary. It is observed that occupational hazards pose a huge risk to the personal well-being of surgeons. As such, the importance of early awareness and education alongside prompt intervention is duly emphasized. Therefore, increased attention to the health, economic, personal, and social implications of these injuries is essential for appropriate management and future prevention. These risks are as great as any other occupational hazards affecting surgeons today. The time has come to recognize and address them.

Acidentes e doenças do trabalho relacionadas a trabalhadores da área de transportes de carga no Brasil no período de 2010 e 2011 / Labor accidents and diseases related to cargo-transporting workers in Brazil between 2010 and 2011

Road cargo transport is responsible for transporting 60% of cargo in Brazil according to 2011 data. In fact, it is fundamental in the production, distribution of industrial and agricultural goods.Current analysis characterizes INSS-insured laborers linked to activities in cargo transport with regard to gender, age, international disease classification. It also compares the number of benefits conceded during the last nine years to discuss the impact of accidents and diseases related to laborers in Brazil. The transversal, qualitative study deals with insurance benefits for activities involving cargo transport in Brazil. During the last nine years most INSS insurance benefits may be pinpointed for 2004, with 16.8%. Most (96.1%) were males, with age bracket between 40 and 44 years (15.3%). According to CID, benefits were distributed according to codes M.54 (dorsalgy) with 6.1%; M54.4 (lumbago with sciatic) with 4.7%, M.54.5 (low lumbar pain) with 7% and S62.6 (breaking of fingers) with 3.4%; 45.9% were classified as other diseases. Research shows that a great number of insurance benefits are provided to cargo drivers, corroborating data in the literature.

Occupational health issues amongst UK doctors: a literature review.

BACKGROUND: Around 1.1 million people suffer from occupational health diseases in the UK. Work-related conditions reported by doctors include mental health disorders, musculoskeletal problems and skin disorders. AIMS: To investigate the prevalence of occupational illness in UK doctors from different specialties. METHODS: A literature search conducted on PubMed, EMBASE, MEDLINE® and Health Management Information Consortium (HMIC) identified relevant research about doctors between the years 1990 and 2013. RESULTS: Seventy-two papers were identified. The majority of studies were cross-sectional with no random ized controlled trials or meta-analyses found. Mental health issues including burnout were widely reported and were attributed to greater job constraints, managerial issues, difficulty with clinical cases and lack of job satisfaction. Substance abuse in doctors was reported to be a risk of maladaptive coping mechanisms and was associated with early retirement. Surgeons were reported as being at greatest risk of needle-stick injuries and musculoskeletal pain. Orthopaedic surgeons were reported to be at risk of noise-induced hearing loss as a result of the use of air-powered and electric drills. There was limited research found concerning contact dermatitis and work-related malignancies amongst doctors in the UK. CONCLUSIONS: Our literature review found research on UK doctors for a variety of work-related illnesses with the prevalence varying depending on both specialty and seniority. This could have adverse effects both on the individual and the provision of patient care. Further studies are required to investigate the epidemiology of noise-induced hearing loss, nosocomial infections, skin-related disorders and work-related malignancies.

Work-Related Upper Limb Disorders: A Case Report.

In this study the complex interrelationship between physical factors, job stress, lifestyle and genetic factors on symptoms of work-related musculoskeletal disorders of the upper limbs is demonstrated by a case report and discussion of the literature. A 58 year old woman with long lasting complaints of the upper limbs with increasing intensity and duration, generalisation, combined with skin thickness, Raynaud's phenomenon, joint disorders, arterial and pulmonary hypertension, metabolic lipid dysfunctions is presented. Occupational history proves continuous duration of service at a job with occupational physical static load with numerous repetitive monotonous systematic motions of fingers and hands as a weaver of Persian rugs followed by work at an automated loom and variable labour activities. Though the complaints dated since the time she was a manual weaver, the manifestations of generalized joint degenerative changes, system sclerosis with Raynaud's phenomenon with similar upper extremities signs and symptoms discount upper limbs musculoskeletal disorder as caused only or mainly by occupational risk factors. The main principles and criteria for occupational diagnosis of musculoskeletal upper limb disorders and legislative requirements for their reglamentation are discussed.

Global estimates of the burden of injury and illness at work in 2012.

This article reviews the present indicators, trends, and recent solutions and strategies to tackle major global and country problems in safety and health at work. The article is based on the Yant Award Lecture of the American Industrial Hygiene Association (AIHA) at its 2013 Congress. We reviewed employment figures, mortality rates, occupational burden of disease and injuries, reported accidents, surveys on self-reported occupational illnesses and injuries, attributable fractions, national economic cost estimates of work-related injuries and ill health, and the most recent information on the problems from published papers, documents, and electronic data sources of international and regional organizations, in particular the International Labor Organization (ILO), World Health Organization (WHO), and European Union (EU), institutions, agencies, and public websites. We identified and analyzed successful solutions, programs, and strategies to reduce the work-related negative outcomes at various levels. Work-related illnesses that have a long latency period and are linked to ageing are clearly on the increase, while the number of occupational injuries has gone down in industrialized countries thanks to both better prevention and structural changes. We have estimated that globally there are 2.3 million deaths annually for reasons attributed to work. The biggest component is linked to work-related diseases, 2.0 million, and 0.3 million linked to occupational injuries. However, the division of these two factors varies depending on the level of development. In industrialized countries the share of deaths caused by occupational injuries and work-related communicable diseases is very low while non-communicable diseases are the overwhelming causes in those countries. Economic costs of work-related injury and illness vary between 1.8 and 6.0% of GDP in country estimates, the average being 4% according to the ILO. Singapore's economic costs were estimated to be equivalent to 3.2% of GDP based on a preliminary study. If economic losses would take into account involuntary early retirement then costs may be considerably higher, for example, in Finland up to 15% of GDP, while this estimate covers various disorders where work and working conditions may be just one factor of many or where work may aggravate the disease, injury, or disorders, such as traffic injuries, mental disorders, alcoholism, and genetically induced problems. Workplace health promotion, services, and safety and health management, however, may have a major preventive impact on those as well. Leadership and management at all levels, and engagement of workers are key issues in changing the workplace culture. Vision Zero is a useful concept and philosophy in gradually eliminating any harm at work. Legal and enforcement measures that themselves support companies and organizations need to be supplemented with economic justification and convincing arguments to reduce corner-cutting in risk management, and to avoid short- and long-term disabilities, premature retirement, and corporate closures due to mismanagement and poor and unsustainable work life. We consider that a new paradigm is needed where good work is not just considered a daily activity. We need to foster stable conditions and circumstances and sustainable work life where the objective is to maintain your health and work ability beyond the legal retirement age. We need safe and healthy work, for life.

Influencing Factors in Approving Cerebrovascular and Cardiovascular Disease as Work-Related Disease of Workers' in Manufacturing Sectors / 대한산업의학회지

OBJECTIVES: This study was performed to analyze the factors that have been meaningful in recognizing cerebrovascular and cardiovascular diseases in manufacturing sector workers as work-related diseases, since amendment of Industrial Accident Compensation Insurance Act on July 1st, 2008, and provide information to establish an objective standard. METHODS: We examined 359 claims of cerebrovascular and cardiovascular diseases which were presented as occupational diseases from January 1st, to December 31th, 2010, collecting Industrial Accident Compensation data from the six Provincial Committees for work-related disease decision. We analyzed the approval rate and odds ratio of the general characteristics, past medical history and work-related information, by using univariate logistic regression. In addition, we confirmed the factors that have effects on when approving work-related diseases by using multivariate logistic regression. RESULTS: Overall, 92 claims out of the 359 claims were recognized as worked-related diseases with an approval rate of 25.6%. Because of accidental situations such as altercation, cold environments, fire etc., only 12 cases were approved. In addition, due to short-term overwork such as outdoor work in cold environments, only 18 cases were approved. Sixty-two cases were approved for chronic overwork. On chronic overwork, the approval rate was not significantly different in univariate logistic regression in gender, age, claimed disease, survival or death, smoker or non-smoker, or associated disease. However, factory size and, average working time for last one week and average working time for last four weeks were significantly. In the multivariate logistic regression analyzed, adjusted for age and sex, we found that the factors in approving cerebrovascular and cardiovascular disease as work-related disease were average working time for the last four weeks and factory size. CONCLUSION: We concluded that there has been a great deal of subjective judgements when approving cerebrovascular and cardiovascular diseases to be occupational diseases. Therefore, objective criteria should be established, especially with regard to the approval of work-related cerebrovascular and cardiovascular diseases and working hours.