ZANIMANJE KAO FAKTOR RIZIKA U RAZVOJU KARDIOVASKULARNIH OBOLJENJA
Halilović J. 1, Fijuljanin-Fazlović M. 1, Pranjić N. 2.
1 Univerzitetsko klinički centar Tuzla
2 Medicinski fakultet Univerzitet u Tuzli, Katedra za Medicinu rada, Tuzla, Bosna i Hercegovina

Radnici s posebnim uslovima rada oboljeli od kardiovaskularnih (KVS) oboljenja predstavljaju poseban problem u ocjeni radne sposobnosti, jer uglavnom postaju invalidi rada, a njihovo zanimanje kojim su se bavili, uglavnom sadrži sve od poznatih profesionalnih rizika u razvoju kardiovaskularnih oboljenja (KVS): težak fizički rad, buka i hladnoća, izloženost hemikalijama i stres. Razvoju koronarne bolesti doprinosi i rad pri povišenoj temperaturi.

CILJ: Cilj ovog rada je identificirati učestalost bolesti KVS u odnosu na zanimanja, dob, spol i penzijski staž.

MATERIJAL I METODE: Ispitivana je skupina od 292 radnika (dobi od 49,2±6,0 godina, raspona od 26- 64 godina, 90 muškaraca i 102 žene; ukupan radni staž 27,2±7,01godina), oboljelih od kardiovaskularnih oboljenja, koji su proglašeni invalidima rada u odnosu na zanimanja, osobito zanimanja s posebnim uslovima rada, te profesionalne KVS rizike. U statističkoj analizi korišten je deskriptivni metod i hazard statistika po Cox-u.

REZULTATI: Prema zanimanjima najviše KVS oboljelih pacijenata je iz reda zanimanja s posebnim uslovima rada 219 (43 nekvalificiranih radnika s pretjeranim fizičkim opterećenjima, 160 kvalificiranih izloženih pretjeranim fizičkim opterećenjima, buci, lošim mikroklimatskim uslovima i hemikalijama, 8 zdravstvenih radnika, 9 radnika izloženih prekomjernoj toploti i 8 radnika zaštitara), 60 s zanimanjem koje zahtijeva stalni kontakt s ljudima, i 4 nezaposlena radnika. Relativni rizik prema zanimanja za oboljevanje od KVS je RR= 4, 67; CI = 1,15-2,83; P<0,001; oboljenja KVS i ukupan radni staž RR = 3, 37; CI 1,6- 3,3,P< 0,001; oboljenja KVS i spol RR= 3,13; CI 4,81-9,36, P< 0,001.

ZAKLJUČAK: Radnici s posebnim uslovima rada imaju visok rizik oboljevanja od KVS oboljenja, mjere prevencije i ergonomska procjena opterećenja radnog mjesta su na niskom nivou, a ova skupina invalida rada se ne može vratiti prethodnom zanimanju. Poslodavac nije u mogućnosti ponuditi im radno mjesto bez rizika, tako da su ovi radnici ili na popularnom čekanju ili novonastala situacija intenzivno stresno djeluje na oboljelog (loš socio-ekonomski status) i za kratko vrijeme ga uvodi u potpunu radnu nesposobnost u dobi od 49,2±6,0 godina.

OCCUPATION AS RISK FACTOR FOR INVOLVEMENT OF CARDIOVASCULAR SYSTEM DISEASES

Halilovic J 1, Fijuljanin-Fazlovic M 1, Pranjic N 2.
1 University Clinical Centre, Tuzla, Bosnia and Herzegovina
2 Department of Occupational medicine, Medical faculty University of Tuzla, Tuzla, Bosnia and Herzegovina

Workers with special work conditions diseased of cardiovascular system disease present special problem in assessment of work ability because they are being invalids of work. Their occupations consist in the most cases all known occupational risk in involvement of cardiovascular (KVS) diseases: difficult physical work tasks, noise, and coldness, exposure to chemicals and stress. In the involvement of cardiovascular disease the important place presented work exposed to high temperature too.

AIM: The aim of this work is to identify frequency of cardiovascular disease in relation to occupation, age, gender and work duration time.

MATERIAL AND METHODS: The group of 292 workers diseased of cardiovascular system disease (aged 49,2±6,0 years, between 26- 64 years, 90 men and 102 women; average of work duration time 27,2±7,01years), was examined. They assessed as invalids of work in relation to occupation, particularly workers with special work conditions. We made investigate KVS risks. In statistical analyses we used descriptive method and hazard risk statistic- Cox model.

RESULTS: On the basis of occupation the most KVS diseased patients were workers with special work conditions 219 (75%): 43 unqualified with excessive physical loaded, 160 qualified exposed to excessive physical loaded, noise, and worse microclimatic conditions, 8 healthy workers, 9 workers exposed to high temperature and 8 protector workers. Only 60 workers of them were with tasks carried permanent contact between persons and 4 unemployed workers. The relative risk for KVS diseases and occupation is RR= 4,67; CI = 1,15-2,83; P<0,001; KVS diseases and duration work time RR = 3, 37; CI 1,6- 3,3,P<0,001; KVS diseases and gender RR= 3,13; CI 4,81-9,36, P< 0,001.

CONCLUSION: The workers with special work conditions have high risk for KVS diseases. The preventive procedures and ergonomic measuring of work places are on lower level, and this group of invalids may not cam beck to early occupation. The employers-management has not possibility to offer work place without risks and workers come away on popular work-waiting places or new situation influences to diseased patients with intensive stress (worse social-economic state). On short time they became permanent inability for work in age of 49,2±6,0 years.