[Discovery of occupational diseases by dentists---occupational diseases associated with oral manifestations].
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Admission of the insurance qualifying occupational skin disease (No. 5101 of Schedule 1 of the Occupational Disease Regulations = BeKV) has as its pre-requisite the availability of the medical evidence. The beginning of the period qualifying for insurance benefit shall be determined retrospectively. A hazardous activity appertains even if only a minor portion of the field of activity is the cause of the disease. Qualifying for insurance benefits requires that this activity shall have been finally given up and that the same or other hazardous activities are avoided in the future. This prognosis must have a good measure of probability. Otherwise, if the insured acts in bad faith, a pension may be withheld; if the insured acted in good faith a worsening of a syndrome by the hazardous activity (whether carried on as occupation or on one's own behalf) is not compensated for. The insurance qualifying date, furthermore, is dependent on the necessity for first-time medical treatment, medicines or therapeutic agents, or the incapacity for work, or the arising of a pension-qualifying reduction in earning power.
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The table elaborated for estimating the diminution of earning capacity has proved useful. A questionnaire programme revealed that classification of occupational dermatological disorders becomes a problem as soon as insurance-legal factors have to be considered.
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Most of the occupational diseases are related to air pollution at the work place. The distribution of gases and vapours and their human absorption are briefly described. The deposition of particles is a function of their physical properties, of the pattern of the respiratory airways and of pulmonary ventilation parameters. Several defence mechanisms also play a role. Illustrative examples are given of occupational diseases caused by solvents, carbon monoxide, metals, dusts (silicosis, asbestosis, pneumoconiosis due to dust of hard metals), allergens and carcinogens. The importance of prevention is emphasized.
In spite of the increasing industrialization no increase in tht total number of occupational diseases has been registered during the past 10 years. This fact must mainly be attributed to the improvement in the security measures taken in all occupational fields and the extension of the occupational medical care. Nevertheless, we are actually faced with a high number of occupational diseases. While the frequency of diseases diminished obviously for some occupational diseases, it increases for others partly considerably. The change in the structure of the statistics concerning occupational diseases is, amongst others and besides the continuous change of technic and the development of new products, also due to alterations of the law respective to the accident insurance right. In this connexion it is referred to the deafness due to noisy working conditions. Among the 10 most frequent occupational diseases, which are mainly manifested in internal organs, some--like pneumoconioses and lead-poisoning--are regarded as classic but still actual occupational diseases. Contrary to this, other occupational diseases--like asthma bronchiale or health injuries by halogen-hydrocarbon--became increasingly important only during the last few years. Corresponding details are given. The danger of health through working material or working methods will in most cases be recognized only after years of occupation. Very often the discovered diseases at that time are no longer reversibel. Consequently, the main task of the doctors for occupational diseases is the prevention of occupational diseases. In 1971 the professional associations put together, in cooperation with occupational medical experts, uniform principles for the necessary preventional examinations in the field of occupational medicien. The quality of the tests carried out with reference to suitability and supervision of working places as well as the extension of such tests to all fields of occupational danger will determine whether or not the number of occupational--therefore not fatal-diseases will decrease essentially.
The authors present results of analysis of occupational diseases morbidity in Poland in the past 7 years. Data included in individual occupational disease card provided information source. The analysis, apart from general coefficients of occupational diseases prevalence involved: age, sex, duration of exposure to occupational hazard inducing a disease, type of the hazard, and distribution of diseases throughout the country according to voivodeships and branches of national economy. From the material presented, the following conclusions may be drawn: 1. Occupational diseases prevalence in Poland in the years 1971--1977 was slightly decreasing. 2. The greatest coefficients of occupational diseases morbidity resulted from: occupational hearing impairments, infectious and invasing diseases, intoxications, pneumoconioses, vibration disease and diseases of skin and mucous membranes. 3. Most occupational diseases found in Poland in the years 1971--1977 resulted from long-lasting occupational exposure to a hazard. 4. The greatest occupational diseases morbidity in Poland in the period concerned, was that of persons aged 40--59.
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A 59-year-old carpenter, 44 years in his profession had an adenocarcinoma of the ethmoids. Similar cases have been described previously in foreign literature. This disease has been accepted as an occupational disease in England. The question is whether this disease, provoked by fine wood-dust may be observed in Germany too; whether the chemical wood ingredients and those being produced during fine-sanding may be carcinogenic. In gaschromatograms the wood ingredients have been demonstrated using oak and beech wood. It is proposed that comparable cases be collected in Germany in order to have a sufficient number of cases for a statistic base. This would make it possible to add this disease to the German list of occupational diseases.
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This paper does not deal with occupational diseases in the narrow legal sense of the word but as part of all public health risks. Occupational health risks of the modern large-scale animal production on intensive farms differ radically from those of the traditional mixed small production farms. The main groups of occupational diseases in intensive large-scale animal production are: 1) Zoonoses. Their occurrence obviously depends on the epizootological situation. They are divided into the following groups: classic zoonoses, zoonoses with complicated ecologic relations, zoonoses associated with soil, zoonoses with natural foci or with reservoirs outside farms. 2) Lung diseases: chronic bronchitis, farmers' and brewers' lung precancerous conditions. 3) Skin diseases and allergies: dermatites, eczema and allergies. 4) Affections due to physical and mental stress: changes in the locomotor system and CNS, contribution to the development of "civilization diseases". 5) Accidents, poisoning, noise and vibration effects.
The occupational group composed of the iron-miners working at the bottom of the mines in Lorraine makes up a high risk population for lung cancer (The carcinogenic index is 5 to 12 times as high as that of the population of non-miners). The authors report a new series of 270 cases in support of this assertion. The cancers have few particular characteristics. Their genesis appears to be related with the action of many co-factors: tobacco, various gases and noxious dust, iron particles. Our findings are similar to those of the Swedish, British and Russian authors. The occupation of iron-miner at the bottom of the mine appears then to favorize the manifestation of lung cancer. So it would be fair to consider this tumor an occupational disease, as with asbestosis.
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