Transcript Studiu de caz: particularitati in abordarea hipoacuziei si

Case study:
particularities in
occupational hearing
impairment diagnosis
Claudia Handra- MD
Prof. Eugenia Naghi- MD, Ph D
Chair of Occupational Medicine, UMF<Carol Davila>
Occupational Medicine Clinic, Hospital Colentina,
Bucharest
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Noise
Dictionary= sound or a mixture of
discordant, strong sounds, disagreeable
for the hearing
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Occupational noise
One of the most frequent hazard in
very different work places
Mechanization of the production
processes increased the intensity of
noise
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Case presentation
M.D. male, age 39
engine technician
power plant
I. G. male, age 49
locksmith
steel foundry
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Diagnosis
COPD Cor
pulmonale- work
related disease
Ischemic heart
disease
Occupational loss
of hearing
Spondilarthrosys
Chronic bronchitiswork related disease
High blood pressure
Occupational loss
of hearing
Dorsal scoliosis
Neurasthenic
syndrome
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Professional route
Exposure= 23 years
1982- 1986 excavator operatorpower plant
1986- 1987-military
service
1987- 2005- engine
technician- power
plant
Exposure= 25 years
1974- 1976- locksmithsteel foundry
1976- 1977- military
service
1977- 1980- locksmithsteel foundry
1980- 2005- locksmithsteel foundry
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Medical history
Two medical
evaluations- local
hospital
2005- complete
medical evaluation,
diagnosis,
recommendationsoccupational
medicine clinic
2001- complete
medical evaluation,
diagnosis,
recommendationsoccupational
medicine clinic
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Consequences
Job restrictions/
preventive measures
Irreversible loss of
hearing
Severe aggravation of
work related diseases
Medical retirement
Freequent
hospitalizations
Job restrictions/
preventive
measures
Irreversible loss of
hearing
Aggravation
diseases
Frequent
hospitalizations
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Hazard
coal dust
noise >87 dB
vibrations
outdoor work
conditions
silica dust
noise > 87 dB
indoor work
conditions
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Expected occupational
disease
Coal miner’s
pneumoconiosis
Occupational loss of
hearing
Occupational
musculoskeletal
disease
Silicosis
Occupational cancer
Occupational loss of
hearing
Occupational
musculoskeletal
disease
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Diagnosed occupational
disease
Occupational loss of
hearing
Occupational loss of
hearing
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Possible causes
Lack of personal
protective
equipment
Unsuitable pace and
duration of work
activities
Lifestyle
Lack of personal
protective
equipment
Unsuitable pace and
duration of work
activities
Lifestyle
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Preventive measures
Occupational risk acknowledgment
Pre-employment medical evaluation
Periodical medical examination
Education
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Occupational risk
acknowledgment
Assessment of occupational hazards
endangering hearing other than
occupational noise
Epidemiological studies
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Medical examination
Early stage diagnosis; professional
reorientation; prevention of disease
aggravations
Occupational physician in charge of
medical evaluation and follow-ups
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Education
Employer
Adequate technical
and administrative
measures of
prevention
Employee
Personal hygiene
Personal protection
equipment
First- aid measures
First symptom
acknowledgement
Awareness of the
importance of medical
follow-ups
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