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Inorganic Dust-Related Pneumoconiosis and Risk Groups in Turkey

Inorganic Dust-Related Pneumoconiosis and Risk Groups in Turkey. Prof. Dr. Arif Çımrın Dokuz Eylul Univ. Medical School, Dept of Pulmonary Diseases, İzmir. acimrin@deu.edu.tr. Content. Turkey profile Data on Working life -sectors and industries

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Inorganic Dust-Related Pneumoconiosis and Risk Groups in Turkey

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  1. Inorganic Dust-Related Pneumoconiosis and Risk Groups in Turkey Prof. Dr. Arif Çımrın Dokuz Eylul Univ. Medical School, Dept of Pulmonary Diseases, İzmir acimrin@deu.edu.tr

  2. Content • Turkey profile • Data on Working life -sectors and industries -working people by social security system -workplace distribution by workers number -job classification -workplaces and workers by risky jobs related with pneumoconiosis • Occupational diseases -official data -field study results on pneumoconiosis • Conclusion

  3. General popul. ~70million UrbanRural Young people Life expectancy 69years Labor Force =24 million(49%) -Women workers = 30% 2/3 agriculture + family -Insured people = 6 million -Informal workers = 4.5million -Unemployment = 10.5% Turkey profile Social Insurance Inst 2002 Official Statistics Inst 2004

  4. Sectoral distribution of employment (%)

  5. Main industries in Turkey as a percentage of workers Construction 15.2 Metal 11.9 Textile 11.1 Commerce office 9.5 General services 8.1 Food 7.2 _%_ Labor statistics, 2000

  6. Worker distribution by Social Security Institution The Pension Fund 14.6 % Self-employed insured 22.6 % Number of insured 52.2 % www.ssk.gov.tr/wps/portal

  7. Workplace distribution by workers number Small-scale workplaces www.ssk.gov.tr/wps/portal

  8. All mining activites -Coal(Bituminous, Lignite) -Quartz, Felspar, Clay, Stone -Asbestos, asbestos like fibre minerals Related activities Ore mill and fertilisation Ceramic, Construction, Metal, Shipyard, Dental technician Brake lining, Insulation Risk Areas for Pneumoconiosis • Other fibers • -Stone wool • -Glass wool • -Nylon flock

  9. Workplaces and the worker numbers in occupations related with pneumoconiosis -2004 www.ssk.gov.tr/wps/portal

  10. Occupational diseases,official data

  11. Occupational diseases in Turkey by year (1972-2003) Pala K, 2005

  12. Insured People and İncidence of Occupational diseases in Turkey (1972-2003) Insured Occup dis. incidence İncidence İnsured people years

  13. Small-scale workplaces and occupational environment -2004 www.ssk.gov.tr/wps/portal

  14. 1978 1979 1980 1981 1982 1983 1984 Silicosis 246 162 97 94 156 133 116 Asbestosis - - - 1 5 3 1 Asthma - 1 1 4 8 3 5 Byssinosis - 6 5 8 3 1 - Total 246 169 103 107 172 140 122 Occupational lung diseases in Turkey Social Insurance Inst, 2002

  15. The distribution of the number of occupational diseases by work groups, 2000-2004 www.ssk.gov.tr/wps/portal

  16. Occupational Diseases by Cause or Diagnosis, 2002-2004 SII Year Book, 2002, www.ssk.gov.tr/wps/portal

  17. Occupational diseases in mining sector, 2004 (*)İzmir 5 workplaces ~1500 workers www.ssk.gov.tr/wps/portal

  18. Inferences about Occupational Diseases, EU vs Turkey EU, 2002 0.3-0.5 % Occupational diaeases in Turkey (2004), n:384 ~18,000-30,000 /year (overall expected occupational disease)

  19. Outcome 1 Surveillance problem (Problem possibility for registration of suspected cases and/or final diagnosis of occupational diseases)

  20. Results of field and clinical studies about pneumoconiosis

  21. Coal Mining

  22. Outcome 2 • In coal mining (state enterprises) Dust standarts cause CWP  Correlation between dust level and CWP  Prevalence of CWP:10-15 %  >10years tenure • No data on CWP and working conditions in private enterprises • Need for better workplace hygiene standarts

  23. Workplace setting

  24. Silicosis studies and case reports Field Study Prevalans (%) • Quartz mill; -Şener S., Milli Prodüktivite Merkezi Yayınları. 1993 15.0 • Ceramik fabric; -Çımrın AH, Tüberküloz ve Toraks. 1999 6.0 -Sakar A, Tuberküloz ve Toraks 2005 6.5 • Glass and cast sandblasting; -Sevinc C, J Occup Health 2003 36.4 Case Report • Dental technician; -Kartaloğlu Z, Yosei Med J. 2003 Olgu • Denim sandblasting -Akgün M, J Occup Health. 2005; 47: 346-349 Olgu -Gur A, Eur Respir J. 2005 (suppl) 147s Olgu • Welders; Arda H, Toraks Derneği Yıllık Kongresi, 2005 Olgu grubu Fidan F, Toraks Derneği Yıllık Kongresi, 2005 Olgu

  25. Respiratory symptoms and silicosis prevalence among ceramic factory workers n:166 Age: 26.45 4.92 yrs Total working time(mean): 3.03 2.45 yrs Respirable dust containing silica: 2.5mg/m3 Respirable silica concentration : 0.05mg/m3 Silicosis prevalence %6.0 Total working time(mean) 5.5yrs Çımrın AH, Tuberculasis and thorax 1999; 47: 456-462.

  26. Silicosis prevalence among ceramic factory workers • n:626 • Silica exposed n: 365 • Mean tenure 104.40  76.44 (1-312 month) • Pneumoconiosis n=24 (6.5%) 0/1 (n=5) 1/0-1/2 (n=18) (p predominant n=15, q predominant n=3) 2/1 ve üzeri (n=1) • Pneumoconiosis workers; older age, longer tenure Sakar A. Tuberculosis and Thorax 2005

  27. Silicosis among quartz mill and glass makers • 8 workplaces • 128 male • Mean age: 32.9 years • Mean working time: 3.98±4.23 years • Mean respirable dust concentration 1.2 ±1.81 mg/m3 • Silicosis prevalence %15.6 Şener S, National Productivity Center Publ. 1993; 509: 355-360.

  28. Quartz and felspar mill workers and silicosis Silicosis prevalence 23 % Turkish Thoracic Society Annual Congress, 2006

  29. Workers by age Workers by tenure Turkish Thoracic Society Annual Congress, 2006

  30. 5 workplaces, Izmir n=11 (2 ♀) Mean age(years) 31.6 Mean tenure (years) 8.7 Mean daily working time (h/day) 6.7 Respirabl dust quartz content 85-95% Mean respirable dust level 116.415.6mg/m3 Mean respirable free silica 76.5mg/m3 Silicosis x-ray 3/11 HRCT + 1/11 Silikosis prevalence (4/11) 36.3% Sandblasting under uncontrolled and primitive conditions in Turkey Sevinc C, Cimrin A, Manisalı M. J Occup Health. 2003; 45: 66-69

  31. İzmir 12 workplaces Sandblaster: 75 To be evaluated 56 ♂ Mean tenure (month) 21.4 ay Simple silicosis n:10 Prevalence: %17.8 Silicosis prevalence among denim sandblasters in İzmir

  32. Outcome 3 • Silicosis exist • No data about workplace hygiene • Possibility for high level occupational exposure • Informal working(?) • Health surveillance ; Quality, Continuity, Inspection • Fast workers turnover (short tenure, worker dismiss) • Problematic small workplaces

  33. Clinical Setting -Case presentations

  34. Age 21 ♂ • 5 months cough and dyspnea • 8 years dental laboratory • Si, P, K, Ca, Cr, Cd, Co, Fe, Al Kartaloğlu Z. Yosei Med J. 2003; 44(1):169-73 Sandblaster Dental technician

  35. Denim sandblasters –sandblasting for 3 years Case 2: 18 years od Case 1: 19 years od J Occup Health. 2005 Jul;47(4):346-9.

  36. Mini Symposia 8 As a new job of silicosis; denim sandblasting 21.04.2006 14-15.30

  37. Outcome 4 • Complicated cases in clinical setting • Mortality due to silicosis is going on • Problems about diagnosis, registry

  38. As an important topic; M.D interest Discharge from hospital Diagnosis: Inactive Pulmonary Tuberculosis ??

  39. Case 42 years old, 17 years sandblasting, dental technician

  40. n: 214 Chest x-ray: 137 Mean age 28 Tenure (mean) present job 6.12 yrs former job 7.92 yrs Pneumoconiosis prevalence: 30.6 % Sandblasting history n:77 -x-ray evaluated n:44 -pneumoconiosis prevalence: 47.6 % Pulmonary problems among dental technicians in İzmir (preliminary data)

  41. Outcome 5 • Problems about diagnosis, registry • Risky working area is not clear -Tasks for pneumoconiosis risk -Population under the pneumoconiosis risk

  42. we still do not have data about pneumoconiosis in some occupations

  43. Metal

  44. Brake lining and other asbestos related occupations

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