Tuberculosis as an occupational disease

Health workers are exposed to numerous infectious diseases from which the patients they attend are suffering and that have been recognised as occupational infectious diseases. Those most frequently reported are acquired by the haematogenous path, especially hepatitis due to virus B. Numerous infectious diseases are transmitted through airways and until the coming of acute severe respiratory syndrome caused by a coronavirus, tuberculosis was one of the most dreaded. In this paper we analyse the reasons why tuberculosis is considered to be an occupational disease in health personnel; which activities entail most risk and the measures that should be adopted to reduce nosocomial transmission.     

Schneeberg lung disease and uranium mining in the saxon ore mountains (Erzgebirge)

The so-called Schneeberg lung disease is a form of bronchial or alveolar carcinoma caused by the effects of the radioactive gas radon and of its radioactive short half-life daughter products. This type of radiation-induced occupational cancer is the most common and the most important radiation injury among workers occupationally exposed to ionizing radiation. There have been many deaths from lung cancer, especially in the Soviet uranium mines in the Erzgebirge of Saxony in the former German Democratic Republic. The history of disease in these miners extends over five centuries; the first observations of their health hazard start in the Middle Ages. The discovery of the lung cancer component was made toward the end of the nineteenth century, and the suspicion that a connection might exist between this cancer type and exposure to ionizing radiation was voiced at the beginning of the twentieth century. In the first half of this century, further research was carried out on this disease in the Schneeberg area of the Erzgebirge. Before the end of World War II, guidelines were set up to define the acceptable limits of radon exposure in the ore mines of Saxony. After World War II, the American uranium mines in the Colorado Plateau used the German research results as a basis for working out their own radiation protection standard. The uranium mines under Soviet occupation in the former GDR, on the contrary, paid no attention to these research findings. For many years, no precautions were taken for the miners' working conditions. The consequence of this serious omission was an estimated 9,000 fatal cases of lung cancer among these underground miners. High concentrations of radon are to be found in indoor air of homes in some districts of the Erzgebirge, suggesting an increasing lung cancer risk for the local inhabitants. The significance of this finding is evaluated. © 1993 Wiley-Liss, Inc.     

Carpal tunnel syndrome as an occupational disease

BACKGROUND: Symptoms related to carpal tunnel syndrome (CTS) represent common patient complaints for many primary care physicians. However, there is a surprising lack of guidelines on diagnosing occupational CTS readily accessible to primary care physicians. This article aims to fill part of that void by reviewing historical aspects of occupational CTS, leading up to more current epidemiologic studies of the association of CTS with occupational ergonomic risk factors. METHODS: The English medical literature was reviewed on the relationship between CTS and occupational ergonomic risk factors. Recent legislative initiatives are discussed. Guidelines of diagnosing and managing occupational CTS are outlined. RESULTS: Many studies are divided regarding whether CTS is associated with highly repetitive/forceful/vibration work. However, a subset of patients presenting with symptoms related to CTS probably has occupational CTS. These patients can be objectively diagnosed and successfully treated and are able to return to work. CONCLUSIONS: By being armed with knowledge regarding the background of CTS and by following simple diagnosis and treatment guidelines, the family practitioner should be able to manage many patients presenting with work-related CTS.     

The unexpected result of an investigation of an outbreak of occupational lung disease

The author describes the discovery of a cluster of cases of interstitial lung disease among employees of a textile manufacturing plant and the difficulties he and his university-hospital occupational medicine team encountered in attempting to identify the cause of the disease. At first accepted in a consultant capacity by the plant's management, the team met increasing resistance to its efforts as it uncovered evidence of a work-related cause of the disease and attempted ientists to communicate findings important to the health of the public, and the physician's overarching professional responsibility to his or her patients.     

Essential hypertension as an occupational disease in engine crew members

The paper raises the question as to whether essential hypertension should be included into a list of occupational diseases (intellectual, sensory, and emotional workloads and working conditions) in engine crew members. In the engine crew members of the South-Eastern Railway, the cases and days lost because of illness and temporary disability are higher than those in the whole railway. 32% of the engine drivers (assistants) are followed up for diagnosed essential hypertension. Hypertension (49.7%) is the main reason for suspending engine crew members from work as evidenced by train pre-trip medical examinations. The working conditions (noise, infrasound, mcroclimate) in train engineer's cabs do not meet the sanitary requirements; in this connection the occupational disease sensorineural hearing loss is also registered.     

MRSA as an occupational disease: a case series

Objectives  

Occupationally acquired infection with methicillin-resistant Staphylococcus aureus (MRSA) is an issue of increasing concern. However, the number of cases of occupational disease (OD) due to MRSA in healthcare workers (HCWs) and the characteristics of such cases have not been reported for Germany.