Occupational Disease (Asthma)

Occupational Asthma
Reality of Turkey

Çımrın Arif H.
Dokuz Eylul University Faculty of Medicine, Department of Chest Diseases, Istanbul Keywords: Occupational asthma, Turkey
While occupational asthma is the most important respiratory occupational disease in industrialized societies, official data in our country still shows dust diseases such as silicosis as the most common occupational lung diseases. In our country, however, a significant number of people are employed in the risky sectors of occupational asthma and it is shown that there is a significant proportion of occupational asthmatic patients in these studies. These results suggest that occupational asthma may be an important occupational disease in our country.
In developed countries, in general health service units, musculoskeletal and psychosocial disorders as well as respiratory disorders constitute the most important occupational health problems [1]. On the other hand, while pneumoconiosis has been decreasing since 1980s in the UK, occupational asthma has a tendency to increase and it has been reported that occupational asthma is the leading cause of work-related respiratory diseases in 1994 [2]. This situation supports the judgment that occupational asthma is the most important respiratory occupational disease in industrialized societies.
To evaluate the situation in our country in terms of occupational asthma: a. Risky businesses and populations at risk, b. Work accidents, c. Data on occupational diseases, d. The results of the research should be reviewed.
Approximately 40% of the population of our country works actively. The growth and spread of industrialization in different areas increases the likelihood that more chemicals will be met by a larger number of people. According to official statistics, Agriculture-Forestry-Hunting, Mining, Petroleum-Chemical-rubber, food, weaving, leather, wood, paper, Press-Publication, metal, ship, Energy, which is known to be risky in terms of occupational asthma in our country over two million workers and the number of workplace is 200 000 level [3]. As you can see, there are risky business areas in our country, and quite a large number of people work in these business areas. Therefore, it can be said that occupational asthma is a disease that is very likely to be seen in the employees of our country.
Table 1: distribution of work accidents according to reasons.
Table 2: distribution of occupational diseases between 1946-1993.
Table 3: types of occupational diseases (1973-1977).
Table 4: types of occupational diseases (1978-1984).
The effect of inhaled substances on the airway and its relation with asthma is an indisputable fact in the workplace. It is the main factor affecting technology exposure at work. In addition, as in reactive airway Dysfunction Syndrome (RADS), a high concentration of irritan inhalant may be the cause of Occupational airway disease. Data show that accidents with such potential occurred in our country (Table 1).
Since the 1940s, occupational disease has been diagnosed in our country. According to statistics, silicosis is one of these diseases. In the following years, a small number of other occupational diseases, other than silicosis, have started to be seen (Table 2), (Table 3), (Table 4) [4,5]. The prevalence of asthma in our society is 5-10% in different studies were revealed [6]. Again, we know that the occupational asthma is 2-3% of all asthmatics, although larger numbers are given in different series [7.8]. In our country, occupational asthma has entered official records since the 1970s (Table 4). Occupational asthma cases are defined in outpatient clinics belonging to different clinics. Kızgan and his colleagues, plastic, bakery products, leather, electronics, carpentry and furniture workers consisting of 9 workers, Çimrin and colleagues, two furniture workers and a health worker; kılıçaslan and his colleagues 4 bakırcıda vocational asthma has been defined [9-11].
In our country, there are many studies aimed at investigating the effects of occupational factors on workers working in risky business branches. Research focuses on weaving, bakery products, spray painting, forest products, health workers, detergents, hairdressers, agricultural products. Their common characteristics are cross-sectional. When we look at the methods of the studies, it is observed that the evaluation of Respiratory Questionnaire, PEF follow-up, nonspecific bronchial hyperreactivity is used in the diagnostic algorithm. However, there are only results obtained based on survey data. Therefore, in addition to the effect of healthy workers, it is compulsory to evaluate the results obtained by taking into account the sensitivity of diagnostic methods used in the researches.
When we look at the studies, the incidence of occupational asthma was found at 0.6-2% in this branch [12-18] while the incidence of acute airway response was 2-22% in the weaving sector. The incidence of occupational asthma among spray painters was at 0-10% [19-21], 1.72% in hairdressers [22-24], 2.5% in Forest Products workers [25], 14% in health workers [26], 11.6% in dust morphine workers [27], 7% in detergent workers [28], 3.3% in furnace workers [11], 7.3% in glass decoration workers [29], 30.4% among flower sellers [30].
In some other studies, findings suggest that exposure to occupational factors may increase the frequency of respiratory symptoms or an acute airway response [25,31-34]. This indicates that occupational factors have a significant airway effect, and also indicates that long-term studies are needed to determine the extent to which this effect relates to occupational asthma.
In line with the data obtained, it should be expected that the occupational asthma in our country is much higher than that reflected to official figures. In order to identify the cases, appropriate professional care should be taken in asthma clinics and suspected cases should be investigated in detail. Risky business segments should be evaluated with long-term follow-up programs and real case frequency should be determined.
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