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PROFESSIONAL PATHOLOGY IS THE SECTION OF CLINICAL MEDICINE. History of occupational diseases. Bodnar R.Ya . PLAN of lecture. General issues on occupational pathology Notion of occupational pathology as a clinical discipline Classification of occupational diseases
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PROFESSIONAL PATHOLOGY IS THE SECTION OF CLINICAL MEDICINE. History of occupational diseases.Bodnar R.Ya.
PLAN of lecture • General issues on occupational pathology • Notion of occupational pathology as a clinical discipline • Classification of occupational diseases • History of occupational disrases. • Pecularities of diagnosis of professional diseases. • Organization of previous and periodical medical examinationof workers of industrial factories and agriculture. Examination of working capacity. • Benzene poisoning
NOTION ABOUT PROFESSIONAL DISEASES • Professional pathology is the section of clinical medicine that studies the question of etiology, pathogenesis, clinic, diagnostics, medical treatment and prophylaxis of professional diseases.
Professional harmfulness • Professional harmfulness - it is the factors of production environment or labor process, which cause an unfavorable action to the organism of working and at certain force and duration of their action are able to cause the pathological states or nosologic forms of diseases.
Professional harmfulness Professional harmfulness: • I. Chemical toxic substances. • ІІ. Industrial dust. • ІІІ. Physical factors (industrial noise, ultrasound, vibration, electromagnetic, laser and ionizing radiation, excessive or reduces atmospheric pressure, high and low temperature of external environment etc.) • ІV. Biological industrial factors (antibiotics, fungi, micro- and macro organisms). • V. Overstrain of separate organs and systems (physical, static and dynamic overload of locomotor system, muscles, nervous system, organs of eyesight, hearing, hypodynamia and others).
History of professional diseases • Information about the influence of work conditions to a health and about the existence of peculiarities of professional diseases meet yet in the works of Egyptian, ancient Greek and the Roman scientists (Aristotle, Hippocrates, Pleniy, Lucretsiy, Galen and others. - VI-IV century B.C.). In works of Hippocrates, that lived approximately in 577-450 B.C., described disease of miners, that proceeded with the severe breathlessness.
In the ХVІ century the works, in which was indicated to the professional diseases of that time, were known. In 1556 there was known the work of Agricola, devoted to disease of miners. In 1567 there was issued the work of Pretzels "About mountain scab and other mountain diseases". In the ХVІІ century the works of Martin Pans and some more late of Stockhausen were published, which described the diseases of miners, and also the poisoning, that met at smelting of metals, including the intoxication by the mephitis of lead. However, the first work, in which systematically were laid out the questions of occupational hygiene of people of different professions with the description of the proper professional diseases, was the book of Italian scientific Bernardino Ramazzini, published in 1700 under the name "About diseases of artisans".
Bernardino Ramazzini (16331714)De Morbis Artificum (Diseases of Workers)Padua, 1713
In the second half ХІХ and in the ХХ century, in relation with development of great industry, professional morbidity grows sharply. • Among the researchers that worked in the branch of professional pathology and authors of the most known manuals we can mark Shevale, Tankerel de Planshet, Cussmaul, Zenker, Galfort. • In 1910 in Milan on a motherland of Ramazzini, the first specialized clinic of professional diseases, which exists to presently, was created
Examination of working capacity and question of rehabilitation at the professional diseases • The purpose of periodic medical examination is the early detection of initial signs of professional diseases, and also timely detection of early forms of unprofessional diseases, at which subsequent work in the conditions of influence of the proper harmful factors of industrial environment is contra-indicated.
General medical contraindications to admittance on the work related to the dangerous harmful substances and harmful industrial factors, following: • 1. Inherent anomalies of organs with the evident insufficiency of their functions. • 2. Organic diseases of the central nervous system with the stable evident dysfunction. • 3. Chronic psychical diseases. • 4. Diseases of the endocrine system with the expressed violations of functions. • 5. Malignant neoplasm.
6. All diseases of the system of blood and hematosis. • 7. Arterial hypertension of the ІІІ stage. • 8. Cardiovascular diseases with heart insufficiency. • 9. Respiratory diseases with the evident pulmonary-heart insufficiency. • 10. Bronchial asthma of severe form with the evident disturbance of breathing and blood circulation. • 11. Active forms of tuberculosis of any localization. • 12. Stomach and duodenal ulcer with chronic recurrent course and susceptibility to complications. • 13. Cirrhosis of liver and active chronic hepatitis.
14. Chronic diseases of kidney with the kidney insufficiency. • 15. Collagenosis. • 16. Diseases of joints with the stable dysfunction. • 17. Pregnancy and period of lactation. • 18. Ordinary miscarriage and anomalies of fetus in anamnesis of women, which plan child-bearing. • 19. Disturbance of menstrual function that is accompanied by the uterine bleeding. • 20. Decompensated glaucoma.
The diagnosis of professional disease is determined according to the generally accepted nosologic forms of pathology and must represent a stage and course of pathological process, its expressiveness and localization, degree of functional disorders, peculiarities of clinical course, presence of complications and concomitant diseases.
Examination of working capacity at professional diseases includes three basic questions: determination of diagnosis, determination of relation of disease with the influence of professional factors, estimation of patient’s working capacity.
