Jordan Minov. COPD and the Workplace. New York: Nova Science Publishers, Inc.; 2016. 83 pages; ISBN 978-1-63484-249-5

PURPOSE: The aim of this monograph is to present a role of the workplace exposures on the development and progression of chronic obstructive pulmonary disease (COPD), the joint effect of the workplace exposures and tobacco smoke in its development and progression, the diagnostics of the COPD related to occupational exposures, as well as its management and prevention.CONTENTS: The publication consists of seven chapters supplemented by a list of abbreviations and index of terms. The cited literature at the end of the monograph obtains scientific support to the elaborated professional knowledge.CONCLUSION: The monograph COPD and the Workplace presents a comprehensive literature dedicated to this problem and a serious effort for improvement of detection and management of COPD related to workplace exposures by medical professionals and its prevention

Specific work activities and exposure to respiratory hazards - predictors of lung function impairment among crop farmers

OBJECTIVE: The objective of the study was to evaluate the specific work activities and occupational exposure to respiratory hazards as predictors of chronic respiratory symptoms development, lung function decline, and respiratory health impairment among crop farmers. METHODS: A cross-sectional survey was performed, including 87 crop farmers (mean age: 53.4 ± 7.8 years; and mean exposure duration: 22.9 ± 7.8 years) and 80 office workers as a control group (mean age: 52.7 ± 8.2 years) matched for age, smoking habits, and socioeconomic status. Subjects were evaluated by a questionnaire on respiratory symptoms in the past 12 months and spirometry testing. RESULTS: Crop farmers had a significantly higher prevalence of cough (41.4), phlegm (28.7%), and dyspnea (21.8%), than controls (p < 0.05). All mean baseline spirometric parameters were lower in crop farmers, but statistical significance was confirmed only for MEF25, MEF50, and MEF75 (p = 0.003, p = 0.000, and p = 0.001, respectively). Most of the respiratory symptoms were significantly associated with common work activities of crop farmers and all-day exposure to certain respiratory hazards. Age, exposure duration, and their combined effect with smoking habit had a significant effect on forced expiratory volume in one second FEV1 and FEV1/forced vital capacity. CONCLUSION: The results confirm that occupational exposure among crop farmers is associated with higher prevalence of respiratory symptoms and lung function decline and, together with specific workflow activities, may not only be a predictors of respiratory health impairment, but also a key tool in the creation of preventive strategies

Occupational Exposure and Co-Occurrence of Work-Related Skin and Respiratory Disorder in Cleaner: A Case Report

BACKGROUND: Despite the connection between skin and respiratory system in occupational disease is growing area of research interest, there is still a limited evidence for the effects of both airborne and skin exposures together with skin and respiratory outcomes.CASE PRESENTATION: This report describes a 32-years old female with no previous history of atopy, asthma or skin disorders working as an office cleaner for three years. About two years after entering the actual workplace she developed episodic wheezing, shortening of breath and chest tightness. At the same time, she noticed eczematous lesions on the skin of both hands. She reported work-relatedness of both respiratory and skin symptoms, i.e. the symptoms improved during weekends and holidays and worsened when she returned to work. The patient was referred to Institute for Occupational Health of R. Macedonia for assessment of possible occupational asthma (OA) and occupational contact dermatitis (OCD). Diagnosis of asthma was confirmed by standard diagnostic procedure, while the diagnosis of sensitizer-induced OA was established by positive result of serial peak expiratory flow rate (PEFR) measurements at and away from work. Diagnosis of allergic OCD was confirmed by positive patch test to formaldehyde. The management of both diseases included complete removal from the harmful workplace exposure, as well as pharmacological treatment according to the actual recommendations.CONCLUSIONS: This case report represents a description of a co-occurrence of work-related skin and respiratory symptoms in a female working as an office cleaner. Formaldehyde is found to be a causative factor of allergic OCD, and it also may be a causative factor of sensitive-induced OA in the same patient, but other occupational sensitizers cannot be excluded

Case Study of Analysis and Targets Setting in Workplace Health Promotion: Pilot Implementation of Health Environment and Safety Management in Enterprises (HESME) Program in the Republic of Macedonia

HESME program concept is based on building and strengthening existing national structures and practices for health promotion at workplace, occupational health and safety, and environmental health. As part of the global HESME program, which includes different activities in the Republic of Macedonia, HESME pilot projects in two enterprises in 2003/2004 were aimed at analysis and setting targets of workplace health promotion. The analysis was made by the Institute of Occupational Health, WHO Collaborating Center and conclusions and recommendations to all stakeholders were presented. Workplace health promotion needs and priorities were defined: control of work environment hazards, smoking and alcohol consuming, encouragement of sport activities. Dealing with health problems (specific indications on stress, muscle pains, injuries at work, respiratory and allergy problems) and addiction problems (alcohol consuming, smoking), application of self-protection measures, education of managerial team on workplace hazards and ergonomics. HESME pilot implementation in both enterprises is centered on encouraging the integration of workplace health promotion issues at enterprise level as preparation for further steps

Health Promoting Workplaces

Workplace health promotion is a process of actively achieving health at workplace by changing working and living conditions. As a key concept it includes measures aimed both at individual and at environmental level from different areas. Good practice in workplace health promotion demands statutory requirements and strong motivation. Increasing consciousness and responsibility for health, identification and dissemination of models of good practice, development and incorporating adequate policies are priorities in workplace health promotion. The basic principles on which workplace health promotion has to be developed are: awareness raising, setting up infrastructure and service management. Beneficial effects can be achieved on individual, enterprise and society levels. The Institute of Occupational Health, WHO Collaborating Center, plays a major role in launching the first workplace health promotion activities in the Republic of Macedonia (education programs for stress managing at workplace, tobacco free workplaces), but the strongest impulse for workplace health promotion in the country is created by the implementation of the WHO’s Health, Environment and Safety Management in Enterprises (HESME) program

Violence and Injury Prevention – Challenges For Health Promotion in Macedonia

World Health Organization estimated 5.1 million deaths from injuries in 2002 in the world or 9% of all deaths, disproportionately affecting the young. These are a leading cause of premature death and DALYs at age of 5 to 45 years. In Europe injuries are third leading cause of death, after cardiovascular diseases and cancers with 800,000 or 8.3%. Injuries can be avoided and prevented. Many effective strategies can be used to target high risk groups and to reduce health consequences for victims of injuries. The health sector can play a key role in injury and violence prevention and control, by providing care and services to victims, prevention and advocacy, and engaging in partnerships with other sectors and across all levels of government and society. Decreasing the burden from injuries will require political commitment across all government levels and with this the allocation of adequate resources to take these activities forward. Future challenges for injury and violence prevention and health promotion, that the countries including Macedonia would face are: developing national action plans for unintentional injury and violence prevention, forming an intersectoral injury prevention committee, improving national surveillance system, strengthening national capacity to respond to the burden of injuries and violence through both primary prevention and care, promoting evidence-based practice by facilitating the exchange of knowledge and experience across the Region, recognize gaps in knowledge and prioritize research and development in both primary prevention and care, as well as studies on costs

Level of Work Related Stress among Teachers in Elementary Schools

BACKGROUND: Teaching is considered a highly stressful occupation, with work-related stress levels among teachers being among the highest compared to other professions. Unfortunately there are very few studies regarding the levels of work-related stress among teachers in the Republic of Macedonia.AIM: To identify the level of self-perceived work-related stress among teachers in elementary schools and its relationship to gender, age, position in the workplace, the level of education and working experience.MATERIAL AND METHODS: We performed a descriptive-analytical model of a cross-sectional study that involved 300 teachers employed in nine elementary schools.  Evaluation of examined subjects included completion of a specially designed questionnaire.RESULTS: We found that the majority of interviewed teachers perceive their work-related stress as moderate. The level of work-related stress was significantly high related to the gender, age, position in workplace, as well as working experience (p < 0.01), while it was significant related to level of education (p < 0.05). Significantly greater number of lower-grade teachers perceives the workplace as extremely stressful as compared to the upper-grade teachers (18.5% vs. 5.45%), while the same is true for female respondents as compared to the male ones (15.38% vs. 3.8%). In addition, our results show that teachers with university education significantly more often associate their workplace with stronger stress than their colleagues with high education (13.48% vs. 9.4%). We also found that there is no significant difference of stress levels between new and more experienced teachers.CONCLUSION: Our findings confirm that the majority of interviewed teachers perceived their work-related stress as high or very high. In terms of the relationship between the level of teachers’ stress and certain demographic and job characteristics, according to our results, the level of work-related stress has shown significantly high relation to gender, age, levels of grades taught as well as working experience, and significant relation to the level of education

Personal Protective Equipment in Health Workers during Coronavirus Disease-19 Outbreak

BACKGROUND: Coronavirus (CoV) disease (COVID)-19 pandemic has put immense pressure on the healthcare systems worldwide. AIM: The aim of the actual study was to assess the availability of personal protective equipment (PPE) in health workers (HWs) during an outbreak. METHODS: The study was conducted in April-May 2020 using an on-line questionnaire. Completed surveys were returned by 560 HWs (297 physicians, 79 nurses/technicians, 78 dentists, 9 pharmacists, and 97 other HWs). RESULTS: High proportion of HWs was using one surgery mask for two or more times or not using it at all when contacting patients who were self-isolated (35.3%) or severe acute respiratory syndrome CoV (SARS-CoV)-2 positive (19.3%). More than 90% of participants were using surgery masks and gloves every time or almost every time while working with patients who were self-isolated or SARS-CoV-2 positive. High frequency of participants reported: No isolation zones at the workplace (61.2%), no triage of patients at the entrance (33.4%), and not attended a training course about the correct usage of PPE (72%). CONCLUSION: The data obtained can be used in the creation of specific interventions in healthcare settings aimed at providing high-quality PPE through the development of a national healthcare strategy that can lead to the prevention of COVID-19 in HWs

Chronic Respiratory Symptoms and Lung Function in Agricultural Workers - Influence of Exposure Duration and Smoking

INTRODUCTION: Job exposure in agricultural workers often leads to respiratory impairment.AIM: To assess the influence of exposure duration and smoking on chronic respiratory symptoms and ventilatory capacity in agricultural workers.METHODS: A cross-sectional study covered 75 agricultural workers, compared with an equal number of office workers matched by age, exposure duration and smoking status. Standardized questionnaire was used to obtain data on chronic respiratory symptoms, job and smoking history. Lung functional testing was performed by spirometry.RESULTS: The prevalence of respiratory symptoms was higher in agricultural workers, with significant difference for cough (P = 0.034), and dyspnea (P = 0.028). Chronic respiratory symptoms among agricultural workers were significantly associated with duration of exposure (P < 0.05) and daily smoking (P < 0.01), as well as with daily smoking in controls (P < 0.01). The average values of spirometric parameters in exposed workers were significantly different for MEF50 (P = 0.002), MEF75 (P = 0.000), and MEF25-75 (P = 0.049). Obstructive changes in small airways in exposed workers were strongly related to exposure duration (P < 0.05) and smoking (P < 0.01). Agricultural workers with job exposure more than 15 years had more expressed adverse respiratory symptoms and lung function decline.CONCLUSION: The results confirmed the influence of agricultural exposure and daily smoking on chronic respiratory symptoms and airflow limitation, primarily targeting the small airways

Bronchial Hyperresponsiveness in Farmers: Severity and Work-Relatedness

OBJECTIVE: To evaluate the prevalence of respiratory symptoms, lung function and bronchial hyperresponsiveness in farmers, with emphasize to their severity and work-relatedness due occupational risk factors and farming characteristics.METHODS: A cross-sectional survey was performed including 60 cow breeders aged 21 to 65 years, compared to an equal number of agricultural farmers matched by age, job exposure duration, and smoking status. We have used a questionnaire to record the chronic respiratory symptoms, detailed work history, specific farming activities and tasks performed, and smoking history. Evaluation of examined subjects also included lung function spirometry tests, and bronchial hyperresponsiveness testing.RESULTS: We found higher prevalence of work related respiratory symptoms in the last 12 months in cow breeders with significant difference for phlegm (P = 0.039), and wheezing (P = 0.026). Mean values of all spirometric parameters were lower in cow breeders, reaching significance for MEF50 (P = 0.001) and MEF75 (P = 0.000). Significant difference was found for mild bronchial hyperresponsiveness among cow breeders with job exposure of more than 15 years. The risk of developing work-related respiratory symptoms increased significantly with full-time farming, exposure to gases and vapors, and keeping more than 10 cows.CONCLUSION: Our data suggest that workplace exposure in farmers may cause respiratory impairment which is closely related to its duration, characteristics, and intensity. The results suggest that cow breeders in general have higher rates of work-related respiratory symptoms and bronchial hyperresponsiveness than agricultural farmers, whereas their severity increases with an increase in frequency and duration of animal contact