Abstract Context. It has been decades since the circadian variation of the secretion of the thyroid stimulating hormone (TSH) was proven in humans. Even so, there are few studies on human beings that explored the relationship existing between night shift circadian rhythm deregulation and thyroid disorders. Methods. We have revised the occupational medicine files of all employees in a single speciality hospital to conduct an observational study on the prevalence of thyroid disorders in night shift compared to day shift workers. Age, gender, occupational history, body mass index and specialist diagnosed thyroid disorders were recorded. Numerical variables were compared with ANOVA test, and categorical ones with chi test (StatPlus for Mac version v6). Results. Obesity was slightly more prevalent in night shift workers, but not statistically significant. Instead, we found a significant increase in the prevalence of thyroid disorders in night shift workers (X= 7.424, p = 0.006). As this is a mere observational study, our results only contribute to the pool of data concerning the relationship between thyroid dysfunction and night shifts. Conclusions: These results should raise awareness, particularly among occupational physicians and endocrinologists, about the influence of sleep and circadian rhythm deregulation on the raising incidence of thyroid disorders.
抽象的上下文。促甲状腺激素(TSH)分泌的昼夜变化在人类中得到证实已经有几十年了。尽管如此，很少有关于人类的研究探索夜班昼夜节律失调与甲状腺疾病之间存在的关系。方法。我们对某专科医院所有员工的职业医学档案进行了修订，对夜班与白班工人甲状腺疾病的患病率进行了观察性研究。记录年龄、性别、职业史、体重指数和专家诊断的甲状腺疾病。数值变量比较采用ANOVA检验，分类变量比较采用chi检验(Mac version v6的StatPlus)。结果。肥胖在夜班工人中更为普遍，但在统计上并不显著。相反，我们发现夜班工人甲状腺疾病患病率显著增加(X= 7.424, p = 0.006)。由于这仅仅是一项观察性研究，我们的结果仅有助于有关甲状腺功能障碍与夜班之间关系的数据池。结论:这些结果应该引起人们，特别是职业医生和内分泌学家对睡眠和昼夜节律失调对甲状腺疾病发病率上升的影响的认识。
{"title":"Circadian rhythm deregulation and thyroid dysfunction: results of an observational study on night shift workers","authors":"M. Oțelea, Lavinia Călugăreanu","doi":"10.2478/rjom-2018-0009","DOIUrl":"https://doi.org/10.2478/rjom-2018-0009","url":null,"abstract":"Abstract Context. It has been decades since the circadian variation of the secretion of the thyroid stimulating hormone (TSH) was proven in humans. Even so, there are few studies on human beings that explored the relationship existing between night shift circadian rhythm deregulation and thyroid disorders. Methods. We have revised the occupational medicine files of all employees in a single speciality hospital to conduct an observational study on the prevalence of thyroid disorders in night shift compared to day shift workers. Age, gender, occupational history, body mass index and specialist diagnosed thyroid disorders were recorded. Numerical variables were compared with ANOVA test, and categorical ones with chi test (StatPlus for Mac version v6). Results. Obesity was slightly more prevalent in night shift workers, but not statistically significant. Instead, we found a significant increase in the prevalence of thyroid disorders in night shift workers (X= 7.424, p = 0.006). As this is a mere observational study, our results only contribute to the pool of data concerning the relationship between thyroid dysfunction and night shifts. Conclusions: These results should raise awareness, particularly among occupational physicians and endocrinologists, about the influence of sleep and circadian rhythm deregulation on the raising incidence of thyroid disorders.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133094124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective. This study aimed to provide the true picture of a ten-year absenteeism survey with regard to work-related illnesses and injuries in medical-social workers, and to develop an analytical model for the occupational health practitioner to facilitate record linkage between health outcomes and occupational data. Methods. Severity indicator and specific weight indicator were calculated on the basis of sick leaves evidence from seven care facilities, as well as the average lost days per year within the period 2008-2017. Four types of work-related illnesses, non-reported accidents and five occupational groups accounted for statistic modeling of data. Results. According to the specific weight indicator for occupations, nurses ranked the first place for musculoskeletal disorders, respiratory and cardiovascular diseases, and traumatic injuries, followed by medical-social-educational staff. Severity indicator for musculoskeletal disorders was high correlated with the number of employees (r=0.66). Conclusions: This analytical method is reliable to be applied in risk assessment procedures and occupational health expertise.
{"title":"Absenteeism metrics for risk assessment concerning illness and injury in the medical-social assistance units","authors":"Mihaela Stoia, Doina Merlă","doi":"10.2478/rjom-2018-0010","DOIUrl":"https://doi.org/10.2478/rjom-2018-0010","url":null,"abstract":"Abstract Objective. This study aimed to provide the true picture of a ten-year absenteeism survey with regard to work-related illnesses and injuries in medical-social workers, and to develop an analytical model for the occupational health practitioner to facilitate record linkage between health outcomes and occupational data. Methods. Severity indicator and specific weight indicator were calculated on the basis of sick leaves evidence from seven care facilities, as well as the average lost days per year within the period 2008-2017. Four types of work-related illnesses, non-reported accidents and five occupational groups accounted for statistic modeling of data. Results. According to the specific weight indicator for occupations, nurses ranked the first place for musculoskeletal disorders, respiratory and cardiovascular diseases, and traumatic injuries, followed by medical-social-educational staff. Severity indicator for musculoskeletal disorders was high correlated with the number of employees (r=0.66). Conclusions: This analytical method is reliable to be applied in risk assessment procedures and occupational health expertise.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115476673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Over the last thirty years, the pathogenesis of obstructive sleep apnea syndrome (OSAS) has begun to be elucidated worldwide due to the presence of standardized diagnostic and treatment. In adults, the clinical diagnosis may be suggestive of OSAS when symptoms like fatigue, lack of concentration, poor work performance, absenteeism, daytime sleepiness, insomnia, snoring, nocturnal respiratory distress or apnea episodes witnessed by others are present. Some medical conditions found in employees’ personal history such as craniofacial abnormalities, some endocrine diseases, arterial hypertension, especially resistant arterial hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, stroke, obesity, diabetes mellitus, cognitive dysfunction or mental disorders may be the alarm signal for OSAS. The assessment of all risk factors, clinical presentation and diagnosis must become an important part of occupational medical examinations and performed in all workers due to its major public health potential and impact on survival. The early identification of OSAS among workers performed by the occupational physician can potentially reduce the risk of work injuries and fatalities. In conclusion, OSAS is a complex entity and an important public health problem. The delay in diagnosis and treatment contributes to the increase of healthcare services demand and implicitly to general mortality.
{"title":"Obstructive sleep apnea: from the beginnings, to the risk factors and to occupational medicine assessment","authors":"Mihaela Trenchea, A. Rascu, O. Arghir","doi":"10.2478/rjom-2018-0001","DOIUrl":"https://doi.org/10.2478/rjom-2018-0001","url":null,"abstract":"Abstract Over the last thirty years, the pathogenesis of obstructive sleep apnea syndrome (OSAS) has begun to be elucidated worldwide due to the presence of standardized diagnostic and treatment. In adults, the clinical diagnosis may be suggestive of OSAS when symptoms like fatigue, lack of concentration, poor work performance, absenteeism, daytime sleepiness, insomnia, snoring, nocturnal respiratory distress or apnea episodes witnessed by others are present. Some medical conditions found in employees’ personal history such as craniofacial abnormalities, some endocrine diseases, arterial hypertension, especially resistant arterial hypertension, coronary artery disease, atrial fibrillation, congestive heart failure, stroke, obesity, diabetes mellitus, cognitive dysfunction or mental disorders may be the alarm signal for OSAS. The assessment of all risk factors, clinical presentation and diagnosis must become an important part of occupational medical examinations and performed in all workers due to its major public health potential and impact on survival. The early identification of OSAS among workers performed by the occupational physician can potentially reduce the risk of work injuries and fatalities. In conclusion, OSAS is a complex entity and an important public health problem. The delay in diagnosis and treatment contributes to the increase of healthcare services demand and implicitly to general mortality.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115560093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Quality of life studies in patients with knee osteoarthritis (OA) attest to the significant impact of the disease on day-to-day activities and social interactions. The aim of this study was to assess the efficacy of a physical exercise program on functional status and quality of life in patients with work-related knee osteoarthritis. The present study included 144 participants with knee osteoarthritis, 72% women, mean age (SD) 47.2 (11.1) years. The patients were randomly assigned in two lots based on the type of kinetic treatment: lot A-with knee OA and medication (72 patients) and lot B- with knee OA, medication and exercise program (72 patients). They followed for 12 days ambulatory exercise programs based on increasing knee flexion, muscular strength and endurance, improving balance, coordination, and respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study (T0), after 2 weeks (T1) and 8 weeks after the 12 days of exercise program (T2) and was based on the following parameters: knee mobility (knee flexion), muscular strength, pain assessment on a Visual Analogue Scale (VAS), functional status (Western Ontario &McMaster Universities Osteoarthritis Index - WOMAC) and quality of life evaluation using SF-36 Questionnaire (36-Item Short Form Survey). Out of 144 participants who completed the initial evaluation, 138 also completed the 2 weeks and the 8 weeks follow-up assessments: 70 patients from the control lot and 68 patients from the exercise lot. The benefits of the kinetic programs were shown by a significant improvement in knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. Testing the linear correlations between the SF-36 score and the VAS (r=0.71, p<0.05) and WOMAC (r=0.83, p<0.05) indicators demonstrates a highly positive relationship between the quality of life expression, the pain assessment score and the functional status score in patients with knee OA. The physical exercise program improves both functional status and quality of life in patients with work-related knee osteoarthritis by increasing the range of motion and muscular strength and by reducing pain.
{"title":"Efficacy of physical exercise program in patients with work-related knee osteoarthritis","authors":"I. Marcu, Ionel Toma, A. Bighea","doi":"10.2478/rjom-2018-0007","DOIUrl":"https://doi.org/10.2478/rjom-2018-0007","url":null,"abstract":"Abstract Quality of life studies in patients with knee osteoarthritis (OA) attest to the significant impact of the disease on day-to-day activities and social interactions. The aim of this study was to assess the efficacy of a physical exercise program on functional status and quality of life in patients with work-related knee osteoarthritis. The present study included 144 participants with knee osteoarthritis, 72% women, mean age (SD) 47.2 (11.1) years. The patients were randomly assigned in two lots based on the type of kinetic treatment: lot A-with knee OA and medication (72 patients) and lot B- with knee OA, medication and exercise program (72 patients). They followed for 12 days ambulatory exercise programs based on increasing knee flexion, muscular strength and endurance, improving balance, coordination, and respiratory exercises. The patients in the control group continued their daily living activities. The evaluation was made at the beginning of the study (T0), after 2 weeks (T1) and 8 weeks after the 12 days of exercise program (T2) and was based on the following parameters: knee mobility (knee flexion), muscular strength, pain assessment on a Visual Analogue Scale (VAS), functional status (Western Ontario &McMaster Universities Osteoarthritis Index - WOMAC) and quality of life evaluation using SF-36 Questionnaire (36-Item Short Form Survey). Out of 144 participants who completed the initial evaluation, 138 also completed the 2 weeks and the 8 weeks follow-up assessments: 70 patients from the control lot and 68 patients from the exercise lot. The benefits of the kinetic programs were shown by a significant improvement in knee mobility and muscular strength for knee extensors (quadriceps muscle) and knee flexor muscles. Testing the linear correlations between the SF-36 score and the VAS (r=0.71, p<0.05) and WOMAC (r=0.83, p<0.05) indicators demonstrates a highly positive relationship between the quality of life expression, the pain assessment score and the functional status score in patients with knee OA. The physical exercise program improves both functional status and quality of life in patients with work-related knee osteoarthritis by increasing the range of motion and muscular strength and by reducing pain.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124954920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Mycosis fungoides is one of the most common forms of cutaneous T-cell lymphoma. Its diagnosis is sometimes challenging and quite difficult for the physician, because its onset clinical appearance is similar to other skin diseases. Although there are a few hypotheses about mycosis fungoides’ etiology, they aren’t fully understood and still need confirmation. We report the case of a 68 years old patient diagnosed with mycosis fungoides, who has been exposed to asbestos fibers. This case is one of the few reported cases of association between asbestos and mycosis fungoides. There is no data exploring the causal relation between asbestos exposure and mycosis fungoides but common biological mechanisms could represent an argument. If occupational exposure to asbestos will be confirmed in larger studies, a new research-field of asbestos-related diseases needs to be opened.
{"title":"Are there still other asbestos-related malignancies to be discovered?","authors":"A. Rascu, M. Neicu, A. Rascu, M. Oțelea","doi":"10.2478/rjom-2018-0006","DOIUrl":"https://doi.org/10.2478/rjom-2018-0006","url":null,"abstract":"Abstract Mycosis fungoides is one of the most common forms of cutaneous T-cell lymphoma. Its diagnosis is sometimes challenging and quite difficult for the physician, because its onset clinical appearance is similar to other skin diseases. Although there are a few hypotheses about mycosis fungoides’ etiology, they aren’t fully understood and still need confirmation. We report the case of a 68 years old patient diagnosed with mycosis fungoides, who has been exposed to asbestos fibers. This case is one of the few reported cases of association between asbestos and mycosis fungoides. There is no data exploring the causal relation between asbestos exposure and mycosis fungoides but common biological mechanisms could represent an argument. If occupational exposure to asbestos will be confirmed in larger studies, a new research-field of asbestos-related diseases needs to be opened.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114725899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract We report a case of subacute extrinsic allergic alveolitis due to occupational exposure to Penicillium spores in a 43-years old female working in a salami factory that developed a dry cough that gradually evolved to productive cough, shortness of breath, fatigue and body weight loss. Over time she complained of several episodes of flu-like symptoms that worsen around the periods in which she removed the excess mould from the surface of the salami a work. On admission, physical examination revealed crackles in both lungs on chest auscultation, pulmonary function tests showed a restrictive pattern with reduced diffusion capacity of carbon monoxide and imagistic tests identified centrilobular nodules of ground-glass opacity in both lung fields, particularly in the upper lobes. BAL showed lymphocytosis associated with neutrophilia, a pattern consistent with EAA. She was put on systemic corticosteroids and ceased exposure. The patient was compliant and after one year her medication was gradually withdrawn and in the absence of exposure, symptoms and pulmonary function normalized. The reported case had a favorable outcome due to relatively early detection and absence of exposure. Currently, the identification and removal of the causative agent remains the cornerstone of prevention, evolution and prognosis.
{"title":"Extrinsic allergic alveolitis induced by spores of Penicillium in a salami factory worker","authors":"L. Moise, Bogdan-Alexandru Barbu, A. Rascu","doi":"10.2478/rjom-2018-0004","DOIUrl":"https://doi.org/10.2478/rjom-2018-0004","url":null,"abstract":"Abstract We report a case of subacute extrinsic allergic alveolitis due to occupational exposure to Penicillium spores in a 43-years old female working in a salami factory that developed a dry cough that gradually evolved to productive cough, shortness of breath, fatigue and body weight loss. Over time she complained of several episodes of flu-like symptoms that worsen around the periods in which she removed the excess mould from the surface of the salami a work. On admission, physical examination revealed crackles in both lungs on chest auscultation, pulmonary function tests showed a restrictive pattern with reduced diffusion capacity of carbon monoxide and imagistic tests identified centrilobular nodules of ground-glass opacity in both lung fields, particularly in the upper lobes. BAL showed lymphocytosis associated with neutrophilia, a pattern consistent with EAA. She was put on systemic corticosteroids and ceased exposure. The patient was compliant and after one year her medication was gradually withdrawn and in the absence of exposure, symptoms and pulmonary function normalized. The reported case had a favorable outcome due to relatively early detection and absence of exposure. Currently, the identification and removal of the causative agent remains the cornerstone of prevention, evolution and prognosis.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114555295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Ionizing radiation are classified as Class I carcinogens. The exposure to this factor increases the risk of developing cancer, and researchers aim to establish the relationship between the exposure and the risk levels, as well as guidelines which would limit exposure to it. The risks were assessed through studies related to the atomic bomb survivors, to the populations exposed to radiation for the purpose of diagnosis or therapy and to the professionally exposed populations – radiologists, radiotherapists, workers in uranium mines, operatives in the nuclear industry. The population of Japanese survivors of the atomic bombs is the largest population exposed and studied with an extremely wide age range (from the irradiation in utero to old people). This population, made up of 93.000 people, represents a major source of information used to determine the potential risk of low dose radiation exposure. Health professionals working with ionizing radiation have been studied ever since the 1890’s. After the implementation of a radiation protection system, the doses received decreased only to increase again with the technical development and its use in a wide variety of specialties. Two recent studies on large cohorts and during long periods of time brought information about the cancer risk due to occupational exposure to ionizing radiation and shed light on the need to monitor exposed staff and re-evaluate radiological safety standards. This review is focused on recent literature concerning the radiation exposure of medical professionals.
{"title":"Cancer induced by exposure to ionizing radiations in medical personnel","authors":"X. Bacinschi","doi":"10.2478/rjom-2018-0003","DOIUrl":"https://doi.org/10.2478/rjom-2018-0003","url":null,"abstract":"Abstract Ionizing radiation are classified as Class I carcinogens. The exposure to this factor increases the risk of developing cancer, and researchers aim to establish the relationship between the exposure and the risk levels, as well as guidelines which would limit exposure to it. The risks were assessed through studies related to the atomic bomb survivors, to the populations exposed to radiation for the purpose of diagnosis or therapy and to the professionally exposed populations – radiologists, radiotherapists, workers in uranium mines, operatives in the nuclear industry. The population of Japanese survivors of the atomic bombs is the largest population exposed and studied with an extremely wide age range (from the irradiation in utero to old people). This population, made up of 93.000 people, represents a major source of information used to determine the potential risk of low dose radiation exposure. Health professionals working with ionizing radiation have been studied ever since the 1890’s. After the implementation of a radiation protection system, the doses received decreased only to increase again with the technical development and its use in a wide variety of specialties. Two recent studies on large cohorts and during long periods of time brought information about the cancer risk due to occupational exposure to ionizing radiation and shed light on the need to monitor exposed staff and re-evaluate radiological safety standards. This review is focused on recent literature concerning the radiation exposure of medical professionals.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127133337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patricia Petculescu, Andrei S. Nastase, Ana-Maria Mănescu, M. Oțelea
Abstract Romania is recognized as the European country with the highest tuberculosis rate in Europe. The association of tuberculosis with silicosis determines synergistic immunosuppression of the alveolar macrophages resulting in a higher grade of pulmonary parenchymal destruction and consequently respiratory failure. The case report approaches a patient with third stage of silicosis and associated active secondary pulmonary tuberculosis disease with positive smears. The impact of the Mycobacterium tuberculosis (MTB) infection’s activation is known to be severe, worsening the prognosis of silicosis and reducing the patient’s quality of life. Regarding the high morbidity rate of tuberculosis, an early diagnosis of tuberculosis in patients with silicosis is paramount, and sometimes cannot be achieved by usual bacteriological tests. Therefore, a better strategy is to be considered in silicotuberculosis, namely to prevent the progression of the latent tuberculosis foci by testing the positive predictive value of up-to-date tests such as IFN-γ inducible protein 10 biomarker, which may allow early detection and treatment.
{"title":"Complicated Silicosis Associated with Mycobacterium tuberculosis Infection","authors":"Patricia Petculescu, Andrei S. Nastase, Ana-Maria Mănescu, M. Oțelea","doi":"10.2478/rjom-2018-0005","DOIUrl":"https://doi.org/10.2478/rjom-2018-0005","url":null,"abstract":"Abstract Romania is recognized as the European country with the highest tuberculosis rate in Europe. The association of tuberculosis with silicosis determines synergistic immunosuppression of the alveolar macrophages resulting in a higher grade of pulmonary parenchymal destruction and consequently respiratory failure. The case report approaches a patient with third stage of silicosis and associated active secondary pulmonary tuberculosis disease with positive smears. The impact of the Mycobacterium tuberculosis (MTB) infection’s activation is known to be severe, worsening the prognosis of silicosis and reducing the patient’s quality of life. Regarding the high morbidity rate of tuberculosis, an early diagnosis of tuberculosis in patients with silicosis is paramount, and sometimes cannot be achieved by usual bacteriological tests. Therefore, a better strategy is to be considered in silicotuberculosis, namely to prevent the progression of the latent tuberculosis foci by testing the positive predictive value of up-to-date tests such as IFN-γ inducible protein 10 biomarker, which may allow early detection and treatment.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127595120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Sick building syndrome (SBS) is a complex syndrome consisting of non-specific symptoms with an onset associated with subjects’ presence in some modern building and the disappearance of symptoms shortly after they leave it. The effects of SBS may be the result of a series of protective reactions of the human body triggered by various types of surrounding environment, further suggesting that the human response could be based on a three-phase biological model: sensory perception, low degree inflammatory reactions and environmental stress reactions. Besides stress created by the discomfort of people who develop symptoms, SBS is the cause of an extensive loss of productivity, sickness absenteeism, wasted time in complaints with all the legal punitive issues that arise from them. The subjects diagnosed with SBS are hard to follow-up over time due to workers often leaving their jobs and being lost from cohort databases. Achieving a reputation of a “sick building” may prove difficult to rehabilitate even after expensive repairs and upgrades. In extreme cases closure and even demolition can occur. SBS is an evolving concept and this review we will present part of this evolution and what are the major challenges for its definition.
{"title":"Sick building syndrome, a crossroad in modern occupational medicine assessment","authors":"Bogdan-Alexandru Barbu, Z. Niculescu, L. Moise","doi":"10.2478/rjom-2018-0002","DOIUrl":"https://doi.org/10.2478/rjom-2018-0002","url":null,"abstract":"Abstract Sick building syndrome (SBS) is a complex syndrome consisting of non-specific symptoms with an onset associated with subjects’ presence in some modern building and the disappearance of symptoms shortly after they leave it. The effects of SBS may be the result of a series of protective reactions of the human body triggered by various types of surrounding environment, further suggesting that the human response could be based on a three-phase biological model: sensory perception, low degree inflammatory reactions and environmental stress reactions. Besides stress created by the discomfort of people who develop symptoms, SBS is the cause of an extensive loss of productivity, sickness absenteeism, wasted time in complaints with all the legal punitive issues that arise from them. The subjects diagnosed with SBS are hard to follow-up over time due to workers often leaving their jobs and being lost from cohort databases. Achieving a reputation of a “sick building” may prove difficult to rehabilitate even after expensive repairs and upgrades. In extreme cases closure and even demolition can occur. SBS is an evolving concept and this review we will present part of this evolution and what are the major challenges for its definition.","PeriodicalId":399083,"journal":{"name":"Romanian Journal of Occupational Medicine","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117161395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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