Case study: particularities in occupational hearing impairment diagnosis

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Case study particularities in occupational
hearing impairment diagnosis

• Claudia Handra- MD
• Prof. Eugenia Naghi- MD, Ph D
• Chair of Occupational Medicine, UMFltCarol Davilagt
• 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

• Chronic bronchitis- work related disease
• High blood pressure
• Occupational loss of hearing
• Dorsal scoliosis
• Neurasthenic syndrome

• COPD Cor pulmonale- work related disease
• Ischemic heart disease
• Occupational loss of hearing
• Spondilarthrosys

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Professional route

• Exposure 23 years
• 1982- 1986 - excavator operator- power plant
• 1986- 1987-military service
• 1987- 2005- engine technician- power plant

• Exposure 25 years
• 1974- 1976- locksmith- steel foundry
• 1976- 1977- military service
• 1977- 1980- locksmith-steel foundry
• 1980- 2005- locksmith- steel foundry

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Medical history

• Two medical evaluations- local hospital
• 2005- complete medical evaluation, diagnosis,
  recommendations- occupational medicine clinic

• 2001- complete medical evaluation, diagnosis,
  recommendations- occupational 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 gt87 dB
• vibrations
• outdoor work conditions

• silica dust
• noise gt 87 dB
• indoor work conditions

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Expected occupational disease

• Coal miners 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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• STOP THAT NOISE!