UTICAJ MALIGNIH TUMORA NA RADNU SPOSOBNOST
Karic S 1, Sadikovic H 2, Karic Z 3, Alomerović I 1, Pozderac- Memija M 2.
1 Institut za ocijenjivanje radne sposobnosti, Tuzla, Bosna i Hercegovina
2 Institut za ocjenjivanje radne sposobnosti, Sarajevo, Bosna i Hercegovina
3 Dom zdravlja Tuzla, Dispanzer za Medicinu rada, Tuzla, Bosna i Hercegovina

CILJ: Cilj je istraživanje trenda malignih tumora, kao uzroka invalidnosti, osiguranika tuzlanskog regiona, u prijeratnom i poslijeratnom periodu. Jedan od posebnih ciljeva je rangiranje malignih tumora prema štetnom uticaju na radnu sposobnost.

MATERIJAL I METODE: Izvori podataka su bili nalazi, ocjene i mišljenja o invalidnosti osiguranika, tuzlanskog regiona, doneseni na Institutu za ocjenjivanje radne sposobnosti u prvostepenom postupku u Tuzli, u prijeratnom periodu (1987-1991) i poslijeratnom periodu (1996-2000). Od ukupno oko 40.000 u oba perioda za užu analizu izdvojena su 1062 ispitanika koji su ispunjavali sve uslove za istraživanje (535 muškaraca i 527 žena). Korištene su slijedeće varijable: pol, dob, stručna sprema, šifre bolesti, vrsta ocjene, periodi ocjenjivanja (prije rata i poslije rata).

REZULTATI: Nije postojala statistički značajna razlika prema polu u prijeratnom i poslijeratnom periodu (P>0,05). Udio ispitanika raste sa povećanjem godina života, od 2,66% u mlađih, do preko 40 % u starijih pacijenata. 1) KV radnici imaju veći udio u prijeratnom periodu (25,21%), taj udio je znatno veći samo u radnika sa VŠS u poslijeratnom periodu. 2) Distribucija pacijenata prema stažu osiguranja pokazuje veliku heterogenost. 3) Maligni tumori kao uzrok invalidnosti u cijelini ne pokazuju tendenciju porasta, neočekivana je tendencija značajnog smanjenja malignih tumora organa za reprodukciju (17,17%:10,62%) u prijeratnom i poslijeratnom periodu . Promjena zakonskih propisa iz 1998 godine, značajno je uticala na frekvenciju gubitka radne sposobnosti i promjenjene radne sposobnosti (39,54:65,93%), kod gubitka radne sposobnosti (47,94%:21,54%), kod promjenjene radne sposobnosti. Dominantni uzroci invalidnosti-gubitka radne sposobnosti u petogodišnjim periodima su: maligni tumori dojke, maligni tumori bronha i pluća, grlića i tijela materice. Isti participiraju sa preko 50 % broja ocjenjenih sa malignim tumorima. VSS radnici znatno su zastupljeni u poslijeratnom periodu u kategoriji gubitka radne sposobnosti (3,33% prijeratni do 5,67% u poslijeratnom periodu). Promijenjena radna sposobnost u znatno većem procentu je utvrđivana kod NK i VŠS radnika u prijeratnom periodu. (6,78%:2,04%, 12,20%:4,08%).

ZAKLJUČAK: Visoka je prevalencija gubitka radne sposobnosti kod VSS radnika u poslijeratnom periodu u najproduktivnijem segmentu radnog vijeka. Neočekivana je tendencija značajnog smanjenja broja žena sa malignim tumorima organa za reprodukciju.

CANCER INFULENCE ON WORK ABILITY
Karic S 1, Sadikovic H 2, Karic Z 3, Alomerovic I 1, Pozderac -Memija M 2.
1 Institute for Medical Research and Ocupational Health Tuzla, Bosnia and Herzegovina
2 Institute for Medical Research and Ocupational Health Sarajevo, Bosnia and Herzegovina
3 Service of Ocupational Medicine, Centre of Public Primary Health Care, Tuzla, Bosnia

AIM: The aim of this study is to research cancer rate, as reason of work disability, in Tuzla region, before and after war. The special aim was to rank cancers toward harmful influence on work ability.

MATERIAL AND METHOD: Main sources are evaluations and judgements about disability of insured people in Tuzla region, which are made in "Institute for Medical Research and Occupational Health Tuzla" on the first degree proceedings, before war (period (1987-1991) and after war (period 1996-2000). On the base of 40.000 examines, we separated aside 1062 insured people which are satisfy all condition for researching. We took next variables, age, sex, educational, and disability degree, time of processing (before or after war disability).

RESULTS. Results are presented using charts and tables. There is no statistic significant difference in sex, before and after war. The number of participants are growing with grow of life age, from 2, 66% (younger patients) till over 40% (older patients). - Qualified workers have higher part in before war period (25, 21%), that part is significant higher in workers with advanced school (2 year degree) in after war period. - Patients distribution by time of working show high constancy. - Cancers as reason for disability, in basics do not show percent of growing, it is unexpected tendency of falling down cancers (of reproduction organs) in percentage (17,17%: 10,62%) before and after war. Change of low regulations on 1998, had significant influence on percentage of losing and changing work ability, (39,54:65,39%) losing work ability, (47,94%: 21,54%) in changing status of work ability. The main reasons for losing work ability in five years periods has: breast cancer, cancer of lung, female reproduction organ cancer. Those kinds of cancers are participating with 50%. The workers with college (4 or 5 year faculty degree) are participating in lousing work ability with 3, 33% (in before war period) and 5, 67% in (after war period). Changed work ability is more preferred in estimations (less qualified persons and high school persons), in before war period (6,78%: 2,04%, 12,20%: 4,08%).

CONCLUSION: There is high number of lousing work ability of people with high or higher school in their most efficient part of working age. Also there is unexpected falling down number of females with reproduction organ cancers.