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Case study: particularities in

occupational hearing impairment diagnosis

Claudia Handra- MD

Prof. Eugenia Naghi- MD, Ph DChair of Occupational Medicine, UMF<Carol Davila>

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

COPD Cor pulmonale- work related disease

Ischemic heart disease

Occupational loss of hearing

Spondilarthrosys

Chronic bronchitis- work related disease

High blood pressure

Occupational loss of hearing

Dorsal scoliosis

Neurasthenic syndrome

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Professional routeExposure= 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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ConsequencesJob restrictions/ preventive measures

Irreversible loss of hearing

Severe aggravation of work related diseases

Medical retirement

Freequent hospitalizations

Job restrictions/ preventive measuresIrreversible loss of hearingAggravation diseasesFrequent hospitalizations

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Hazard

coal dust

noise >87 dB

vibrations

outdoor work conditions

silica dust

noise > 87 dB

indoor work conditions

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Expected occupational disease

Coal miner’s 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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