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Sources of Occupational Disease
Among the environmental causes of occupational disease are subjection to extremes of temperature (leading to heatstroke or frostbite), unusual dampness (causing diseases of the respiratory tract, skin, or muscles and joints) or changes in atmospheric pressure (causing decompression sickness, or the bends), excessive noise (see noise pollution), and exposure to infrared or ultraviolet radiation or to radioactive substances. The widespread use of X rays, radium, and materials essential to the production of nuclear power has led to an especial awareness of the dangers of radiation sickness; careful checking of equipment and the proper protection of all personnel are now mandatory.
In addition there are hundreds of industries in which metal dusts, chemical substances, and unusual exposure to infective substances constitute occupational hazards. The most common of the dust- and fiber-inspired disorders are the lung diseases caused by silica, beryllium, bauxite, and iron ore to which miners, granite workers, and many others are exposed (see pneumoconiosis) and those caused by asbestos.
Fumes, smoke, and toxic liquids from a great number of chemicals are other occupational dangers. Carbon monoxide, carbon tetrachloride, chlorine, creosote, cyanides, dinitrobenzene, mercury, lead, phosphorus, and nitrous chloride are but a few of the substances that on entering through the skin, respiratory tract, or digestive tract cause serious and often fatal illness.
Occupational hazards also are presented by infective sources. Persons who come into contact with infected animals in a living or deceased state are in danger of acquiring such diseases as anthrax and tularemia. Doctors, nurses, and other hospital personnel are prime targets for the tuberculosis bacillus and for many other infectious organisms.
a disease caused by occupational hazards.
Occupational diseases are brought on by dust and certain kinds of toxic substances, such as benzene, lead, and mercury, or by physical factors in the place of employment, for example, vibration, loud noise, high or low air temperatures, high or low atmospheric pressure (decompression sickness, altitude sickness), and various types of ionizing radiation (radiation sickness). Persons whose work involves contact with infectious patients or infected animals, materials, or products may contract a contagious or parasitic disease, for example, brucellosis, anthrax, and tularemia. The clinical forms of occupational diseases vary; the factor responsible for the disease largely determines the organs and systems affected, which may include the respiratory, nervous, cardiovascular, or hematopoietic systems or the bones, joints, liver, eyes, ears, or skin.
In the USSR, workers and employees who suffer from occupational diseases are eligible for such benefits as social security and insurance. Temporary disability payments are always paid at the rate of 100 percent of the wages previously earned. Pensions for invalidism or the loss of a breadwinner are granted without requiring a minimum length of time on the job or a minimum age and are paid at the rate of more than 100 percent of the wages previously earned. Workers or employees disabled by a form of pneumoconiosis (silicosis, anthracosis, silicosiderosis) receive especially large disability pensions. Victims of occupational disorders, except pneumoconioses, may present their claims to the enterprise and receive compensation for damages.
Occupational therapy is concerned with the causes, mechanism of development, symptoms, and treatment of occupational diseases. Occupational hygiene is the study of the prophylaxis of these diseases.
References to the effects that poor working conditions have on the body can be found in the writings of ancient Greek and Roman authors, such as Aristotle, Hippocrates, Pliny the Elder, and Galen. The first studies specifically on occupational diseases appeared in the 16th century; the occupational diseases of miners were discussed in Agricola’s De re metallica (1556) and in Paracelsus’ On Miner’s Phthisis and Other Mining Diseases (1567). B. Ramazzini was the founder of occupational therapy and hygiene as an independent branch of medicine. The Russian physician A. N. Nikitin published Workers’ Diseases and Means of Prevention (1847), the first original Russian textbook on the subject. F. F. Erisman’s Occupational Hygiene, or Hygiene of Mental and Physical Work (1877) dealt with the effects of working conditions on the physical development of workers.
In the USSR, the incidence rate of many occupational diseases and poisonings has declined sharply. A network of research institutes specializing in occupational hygiene and disorders has been established; the first such institute was founded in Moscow in 1923. In 1974 there were 15 functioning research institutes in the USSR, in such cities as Moscow, Leningrad, Gorky, Sverdlovsk, Angarsk, Kiev, Kharkov, and Karaganda. Research in occupational therapy is carried on in many clinical and hygiene subdepartments of medical institutes and in institutes for the advanced training of physicians.
Important contributions to the study of occupational diseases have been made by I. G. Gel’man, V. A. Levitskii, N. A. Vigdorchik, E. M. Tareev, A. A. Letavet, E. Ts. Andreeva-Galanina, K. P. Molokanov, and E. A. Drogichina. Discussions on the subject are held at meetings of the Problem Commission of the Academy of Medical Sciences of the USSR on the Scientific Bases of Occupational Hygiene and Therapy. Medical societies, whose membership includes internists, hygienists, and health officials, have meetings on preventive medicine, where occupational diseases are also discussed. The journal Gigiena truda i professional’nye zabolevaniia (Occupational Hygiene and Occupational Diseases) has been published since 1957.
In 1910, Europe’s first specialized clinic for occupational diseases was founded in Milan. By 1974 there were institutes of industrial medicine with occupational disease clinics in such countries as France, Great Britain, the USA, Finland, Spain, and the Federal Republic of Germany. Research is also conducted in university departments, clinics, and special centers subsidized by private companies. Specialized scientific clinical institutes, modeled after those in the USSR, have been established in other socialist countries.
Among those whose research in occupational diseases is well known are L. Teleky, A. Lehman, and F. Koelsch (Germany), T. Oliver and A. Hill (Great Britain), E. Vigliani (Italy), A. Hamilton and C. Drinker (USA), H. Schlipköter and J. Hagen (Federal Republic of Germany), E. Holstein (German Democratic Republic), and W. Zakorsky (Polish People’s Republic). More than 30 specialized journals on occupational diseases are published abroad.
REFERENCEProfessional’nye bolezni, 3rd ed. Moscow, 1973. (Bibliography.)
N. N. SHATALOV