One of the side-effects of the COVID-19 pandemic is a global change in work ergonomic patterns as millions of people replaced their usual work environment with home to limit the spread of the severe ...acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection. The aim of our cross-sectional pilot study was to identify musculoskeletal pain that may have resulted from this change and included 232 telecommunications company workers of both genders 121 (52.2 %) men aged 23–62 (median 41; interquartile range 33–46 yrs.) and 111 (47.8 %) women aged 23–53 (median 40; interquartile range 33–44) who had been working from home for eight months (from 16 March to 4 December 2020) before they joined the study. The participants were asked to fill in our web-based questionnaire by self-assessing their experience of hand, lower back, and upper back/neck pain while working at home and by describing their work setting and physical activity. Compared to previous work at the office, 90 (39.1 %) participants reported stronger pain in the lower back, 105 (45.7 %) in the upper back/neck, and 63 (27.2 %) in their hands. Only one third did not report any musculoskeletal problems related to work from home. Significantly fewer men than women reported hand, lower back, and upper back/ neck pain (p=0.033, p=0.001 and p=0.013, respectively). Sixty-nine workers (29.9 %) reported to work in a separate room, 75 (32.4 %) worked in a separate section of a room with other household members, whereas 87 (37.7 %) had no separate work space, 30 of whom most often worked in the dining room. Ninety-five participants (40.9 %) had no office desk to work at, and only 75 (32.3 %) used an ergonomic chair. Of those who shared their household with others (N=164), 116 (70.7 %) complained about constant or occasional disturbances. Over a half of all participants (52 %) said that they worked longer hours from home than at work, predominantly women (p=0.05). Only 69 participants (29.9 %) were taking frequent breaks, predominantly older ones (p=0.006). Our findings clearly point to a need to inform home workers how to make more ergonomic use of non-ergonomic equipment, use breaks, and exercise and to inform employers how to better organise working hours to meet the needs of work from home.
Occupational and sports medicine (OSM) education is poorly represented in Croatian university undergraduate medical curricula. Zagreb University medical students are required to take OSM classes for ...a week on their final year of studies. The classes are organised around team-based learning (TBL). Given that students who attend TBL classes have significantly higher exam scores than students who take lectures
, the aim of this study was to assess students’ knowledge and attitudes immediately after TBL OSM classes. This cross-sectional study included 162 final-year Zagreb University School of Medicine students taking TBL classes in OSM in the academic year of 2019/2020. They were recruited from 30 September 2019 to 4 March 2020. Participants filled in a 20-item questionnaire compiled by the authors and adapted to the Croatian legislation. Their answers demonstrated positive attitude toward OSM classes and negative attitude toward occupational medicine practice and OSM specialty. They showed moderate interest only for the job of sports physician. Even though they showed sufficient knowledge of OSM immediately after the course was completed, they were moderately satisfied with their knowledge. Our findings call for rethinking the practical aspects of teaching OSM classes in order to promote OSM practice among medical students or at least raise awareness about the importance of prevention of numerous work or sport-related disorders.
Maintaining adequate working ability of construction workers is of considerable importance for society, as the construction sector is burdened with high prevalence of work-related diseases and ...health-issues.
To determine the number and age of construction workers in Croatia with temporary or permanent work limitation status, as well as to identify the most common health causes of such work limitation.
A retrospective cross-sectional study was performed using the data from 2534 construction workers, aged between 18 and 65 years, who underwent standardized routine occupational health examinations between 2011 and 2015. Thorough medical history and medical record reviews, blood and urine analyses, vision parameters and hearing range evaluation, as well as mental health assessment were conducted on every study participant.
A total of 210 construction workers (8.29%) received occupational/work limitation status (either temporary or permanent). Four main categories of work limitation were high blood pressure, disorders of the liver and digestive system, hearing loss and amblyopia, comprising 61.69% of all diagnoses. A total of 37.62% of workers with work limitation status had two or more different diagnoses (i.e. co-morbid conditions). Those with work limitation (either temporary or long-term) were significantly older than those fit enough to work (p-value <0.00001).
This type of organized screening represents a significant preventative effort in the construction industry, as workers may become more cognizant of the conditions that may affect their work ability.
Occupational diseases are diseases directly induced by work and working conditions. In the Republic of Croatia, according to the procedure set out by law, occupational diseases are reported and ...recognized by the Croatian Health Insurance Fund and registered and monitored in the Registry of Occupational Diseases kept by the Croatian Institute for Public Health – Department of Occupational Health. Diagnoses are under responsibility of occupational medicine specialists and are carried out according to modern occupational health criteria, which include determining the clinical picture of the disease and the damage caused by the work process. The recognition of COVID-19 as an occupational disease is extremely important for the worker considering the financial and pension benefits according to the applicable laws and regulations. Most workers who have had COVID-19 as a professional disease do not get the disease recognized as an occupational disease while they are sick. The length of the acute disease is shorter than the process of application and evaluation of occupational disease. However, the recognition of COVID-19 as an occupational disease may be important for the future. Should any of the complications (e.g. post COVID-19 syndrome) arise in the future, the worker holds their rights under health insurance. The scientific and healthcare community is still in the process of evaluating and recognizing complications of COVID-19 disease and their long-term impact on health and work ability. Key words: occupational disease, legislation, public health, occupational medicine
Pandemija izazvana širenjem koronavirusa teškog akutnog respiratornog sindroma 2 dovela je do značajnih promjena u globalnoj ergonomiji rada. Naime, tisuće zaposlenika iznenada su uobičajene radne ...prostore zamijenile kućnim prostorom ne bi li se smanjilo širenje virusa i obuzdala pandemija. Kako bi se opisale mišićno-koštane tegobe u uvjetima rada od kuće te analizirali novonastali uvjeti rada od kuće, ovo presječno pilot-istraživanje obuhvatilo je 232 zaposlenika telekomunikacijske tvrtke: 121 muškarca (52,2 %) u dobi od 23 do 62 godine i 111 žena (47,8 %) u dobi od 23 do 53 godine, koji su radili od kuće osam mjeseci, tj. od 16. 3. 2020. do 4. 12. 2020. Za potrebe ovog istraživanja autori su izradili virtualni upitnik u kojem su ispitanici samostalno procijenili intenzitet bolova u šakama, donjem dijelu leđa te u vratu i gornjem dijelu leđa tijekom rada od kuće, uvjete rada od kuće te razinu vlastite tjelesne aktivnosti. U odnosu na vrijeme prije rada od kuće, 90 ispitanika (39,1 %) prijavilo je jače bolove u donjem dijelu leđa tijekom rada od kuće, pri čemu je pogoršanje bola u vratu i gornjem dijelu leđa prijavilo 105 ispitanika (45,7 %), a bola u šakama njih 63 (27,2 %). Samo trećina zaposlenika nije prijavila mišićno-koštane tegobe tijekom rada od kuće. Muškarci su značajno rjeđe prijavili bol u šakama, donjem dijelu leđa te u vratu i gornjem dijelu leđa (p=0,033; p=0,001 odnosno p=0,013). Posebnu prostoriju za rad od kuće imalo je 69 ispitanika (29,9 %), odvojeni radni prostor njih 75 (32,4 %), a njih 87 (37,7 %) nije imalo radni prostor, pa su najčešće radili u blagovaonici (njih 30). Pisaći radni stol za rad nije imalo 95 ispitanika (40,9 %), a ergonomsku radnu stolicu imalo je njih tek 75 (32,3 %). Od ispitanika koji žive s ukućanima (N=164), njih 116 (70,7 %) smatralo je da ih ukućani ometaju u radu stalno ili povremeno. Više od polovice ispitanika (52 %) smatralo je da radi dulje kod kuće nego na poslu, i to značajno više žene (p=0,05). Samo je 69 ispitanika (29,9 %) uzimalo češće predahe, i to značajno češće stariji zaposlenici (p=0,006). Naši rezultati upućuju na to da, radi sprječavanja mišićno-koštanih tegoba, zaposlenike treba educirati o metodama i načinima prilagodbe neergonomske opreme, korištenju pauza, potrebi tjelovježbe, a poslodavce treba educirati o potrebi organizacije radnog vremena u novim uvjetima rada od kuće.
Osnovni ciljevi ovog istraživanja bili su utvrditi povezanost samoprocjene radne sposobnosti procijenjene Upitnikom za određivanje indeksa radne sposobnosti sa sastavnicama zdravstvenog fitnesa, sa ...samoprocjenom razine tjelesne aktivnosti procijenjenom Međunarodnim upitnikom o tjelesnoj aktivnosti, te istražiti povezanost radne sposobnosti s pokazateljima rizika metaboličkog sindroma. Također, pokušala se utvrditi povezanost metaboličke sastavnice zdravstvenog fitnesa s ostalim sastavnicama (morfološkom, mišićno-koštanom i srčano-dišnom). Svrha ovog istraživanja bila je procijeniti razinu radne sposobnosti, tjelesne aktivnosti te stanje zdravstvenog fitnesa zaštitara. Jednako tako, pokušali su se utvrditi čimbenici koji pozitivno ili negativno utječu na razinu radne sposobnosti. Uzorak ispitanika činilo je 120 zaštitara, dobi od 25 do 45 godina, zaposlenih u jednoj privatnoj zaštitarskoj tvrtki iz Zagreba. Prije samog testiranja svi su ispitanici potpisali izjavu o dobrovoljnom pristanku na testiranje. Istraživanje je uključivalo samo zaštitare koji, uvidom u njihov medicinski karton kod izabranog specijaliste obiteljske medicine, nisu bolovali od nikakvih težih kroničnih bolesti, te nisu imali nikakva tjelesna ograničenja za pristup ispitivanju. Sva ispitivanja su se provodila u sklopu periodičnog preventivnog liječničkog pregleda zaštitara u ordinaciji medicine rada i sporta Ustanove za zdravstvenu skrb „Profozić„ u Zagrebu, te po potrebi na Kineziološkom fakultetu Sveučilišta u Zagrebu. Svi ispitanici su bili ocijenjeni sposobnima za radno mjesto zaštitar u privatnoj zaštiti. Samoprocjena radne sposobnosti provodila se putem Upitnika za određivanje indeksa radne sposobnosti (WAI-upitnik), a samoprocjena razine tjelesne aktivnosti putem kratke verzije Međunarodnog upitnika o tjelesnoj aktivnosti (IPAQ). Mjerenje zdravstvenog fitnesa provodilo se putem mjerenja njegovih pojedinih sastavnica. Procjenjivanje morfološke sastavnice fitnesa uključivalo je mjerenje tjelesne visine i težine, opsega struka, opsega bokova, te potom izračunavanje indeksa tjelesne mase, omjera opsega struka i opsega bokova te omjera opsega struka i tjelesne visine. Procjenjivanje mišićno-koštane sastavnice fitnesa uključivalo je mjerenje jakosti šake, mjerenje visine vertikalnog skoka, mjerenje broja dinamičkih pretklona u 60 sekundi, te mjerenje fleksibilnosti u ramenom zglobu, fleksibilnosti lumbalnog dijela leđa i istezljivosti stražnje lože mišića natkoljenice. Procjenjivanje srčano-dišne sastavnice fitnesa uključivalo je mjerenje aerobnog kapaciteta submaksimalnim testom opterećenja te mjerenje arterijskog krvnog tlaka i frekvencije srca. Procjenjivanje metaboličke sastavnice fitnesa uključivalo je mjerenje razine glukoze, lipida i lipoproteina, kao i jetrenih enzima u krvi ispitanika natašte. Za sve statističke analize korištena je programska podrška IBM SPSS Statistics verzija 24. Izračunati su Pearsonovi koeficijenti korelacije kako bi se uvidjela povezanost pojedinih sastavnica metaboličkog sindroma i zdravstvenog fitnesa s indeksom radne sposobnosti, maksimalnim primitkom kisika te razinom tjelesne aktivnosti. Načinjen je multivarijatni linearni regresijski model predikcije indeksa radne sposobnosti u kojem su se kao prediktorske varijable koristile one koje su na univarijatnoj razini bile značajne. Temeljem dobivenih rezultata zaključuje se da je razina radne sposobnosti zaštitara samoprocijenjena putem indeksa radne sposobnosti vrlo dobra i izvrsna, a razina tjelesne aktivnosti samoprocijenjena putem IPAQ–a je visoka, no s dugim periodom dnevnog sjedenja. Ispitanici su pokazali povišene vrijednosti u pokazateljima rizika metaboličkog sindroma: povišenu tjelesnu masu, povišene indekse abdominalne pretilosti (WC, WHR, WHtR), povišeni krvni tlak, te prisutnost nekog od oblika dislipidemije. Ispitanici su pokazali prosječne i ispod prosječne rezultate u testovima snage i fleksibilnosti te vrlo slabe rezultate u testu maksimalnog primitka kisika. Indeks radne sposobnosti značajno je pozitivno korelirao s razinom tjelesne aktivnosti te dohvatom u sjedu, a negativno s omjerom opsega struka i opsega bokova, omjerom opsega struka i tjelesne visine, dijastoličkim tlakom, te dnevnim sjedenjem. Od svih prediktorskih varijabli, samo dohvat u sjedu značajno predviđa bolji indeks radne sposobnosti. Razina tjelesne aktivnosti značajno je pozitivno korelirala s HDL-kolesterolom, VO2 max, a negativno s omjerom opsega struka i tjelesne visine, dobi, te dnevnim sjedenjem. Maksimalni primitak kisika kao mjera aerobnog kapaciteta značajno je negativno korelirao sa svim sastavnicama metaboličkog sindroma (ITM-om, opsegom struka, opsegom bokova, omjerom opsega struka i opsega bokova, omjerom opsega struka i tjelesne visine, arterijskim krvnim tlakom, lipidima, GUK-om, ALT-om, GGT-om, frekvencijom srca u mirovanju), a pozitivno s HDL-kolesterolom, visinom vertikalnog skoka i dinamičkim pretklonima u 60 s. Prilikom usporedbe čimbenika metaboličkog fitnesa (GUK, ukupni serumski kolesterol, LDL-kolesterol, HDL-kolesterol, trigliceridi) s ostalim sastavnicama zdravstvenog fitnesa pronađene su značajno pozitivne korelacije svih čimbenika metaboličkog fitnesa s ITM-om, opsegom struka, opsegom bokova, omjerom opsega struka i opsega bokova, omjerom opsega struka i tjelesne visine, dijastoličkim tlakom, osim HDL-kolesterola koji je značajno negativno korelirao s istima. Pronađene su značajno pozitivne korelacije jetrenih transaminaza (biljega nealkoholne masne bolesti jetre) sa sastavnicama zdravstvenog fitnesa (ITM-om, opsegom struka, opsegom bokova, omjerom opsega struka i opsega bokova, omjerom opsega struka i tjelesne visine, dijastoličkim tlakom, fleksibilnosti u ramenu i jakosti šake). Kroz ovo istraživanje pokušalo se utvrditi koji su to tjelesni čimbenici koji utječu na radnu sposobnost muškaraca u životnoj dobi (25 – 45 godina) u kojoj bi radna sposobnost trebala biti na najvišoj razini. Kombinacija dvaju upitnika (WAI-upitnika i IPAQ-a), kao i kombinacija WAI-upitnika i mjerenja sastavnica zdravstvenog fitnesa (morfološke, mišićno-koštane, srčano-dišne, metaboličke) može postaviti temelje za stvaranje dobrog instrumenta za određivanje čimbenika koji utječu na indeks radne sposobnosti odnosno radnu sposobnost u cjelini.
The basic objectives of this thesis were to determine the correlation of self-assessed work ability estimated by the Work Ability Index Questionnaire with health-related fitness components, with self-assessed level of physical activity estimated by the International Physical Activity Questionnaire, as well as with metabolic syndrome risk factors. Also, this research aimed to determine a correlation of the metabolic component of health related fitness with other components (body composition, muscular strength and endurance, flexibility and cardiorespiratory endurance). The purpose of this thesis was to evaluate the level of work ability, physical activity and health related fitness of security guards, and to determine which particular factors have a positive or negative impact on the level of work ability. The sample consisted of 120 security guards, aged 25 – 45 years old, employed in one private security company based in Zagreb. All of the participants were volunteers, as evidenced from their written consent. The research involved only security guards who, upon evaluating medical documentation from their general practitioner, did not have any chronic illness or any physical restrictions that would compromise their ability for participating. All tests were conducted as part of the periodic preventive medical examination for security guards at the Occupational Health and Sports Medicine Unit, Health Care Institution “Profozic” in Zagreb, and (if it was necessary) at the Faculty of Kinesiology of the University of Zagreb. All participants were assessed fit for duty of private security guard. Work Ability Index (WAI) Questionnaire was used for self - assessment of work ability and a short form of the International Physical Activity Questionnaire (IPAQ) was used for self-assessment of physical activity level. The level of health related fitness was evaluated by measuring its individual components. The assessment of morphological fitness component (i.e. body composition) included height/weight measurement, waist and hip circumference measurement, as well as body mass index (BMI), waist-to-hip ratio and waist-to-height ratio calculations. Muscular strength/endurance and flexibility assessment included hand grip strength measurement, vertical jump height measurement, 60-seconds sit up test, shoulder joint flexibility measurement, lumbar back flexibility and hamstring extension measurement. Cardiorespiratory endurance assessment included aerobic capacity measurement with submaximal aerobic fitness test, and also the measurement of arterial blood pressure and heart rate at rest. Metabolic fitness component assessment included blood glucose level, lipids, lipoprotein and liver enzymes level measurement from blood when fasting. For all of the statistical analyses IBM SPSS Statistics version 24 was used. Pearsons’ coefficients of correlation were calculated to correlate certain metabolic risk factors and health related fitness components with work ability index, maximum oxygen uptake level and physical activity level. Multivariate linear regression model for prediction of work ability index was made by using predictor variables that were significant on univariate level. According to results of this research, we can conclude that self-assessed level of work ability (WAI) of the respondents is very good and excellent, and self-assessed level of physical activity (IPAQ) is high, albeit with long periods of daily sedentary time. Results have shown higher values in metabolic risk factors, increased body mass index, elevated visceral obesity index (WC, WHR, WHtR), mild hypertension, and the presence of some kind of dyslipidaemia. Respondent have show
Occupational diseases are diseases directly induced by work and working conditions. In the Republic of Croatia, according to the procedure set out by law, occupational diseases are reported and ...recognized by the Croatian Health Insurance Fund and registered and monitored in the Registry of Occupational Diseases kept by the Croatian Institute for Public Health--Department of Occupational Health. Diagnoses are under responsibility of occupational medicine specialists and are carried out according to modern occupational health criteria, which include determining the clinical picture of the disease and the damage caused by the work process. The recognition of COVID-19 as an occupational disease is extremely important for the worker considering the financial and pension benefits according to the applicable laws and regulations. Most workers who have had COVID-19 as a professional disease do not get the disease recognized as an occupational disease while they are sick. The length of the acute disease is shorter than the process of application and evaluation of occupational disease. However, the recognition of COVID-19 as an occupational disease may be important for the future. Should any of the complications (e.g. post COVID-19 syndrome) arise in the future, the worker holds their rights under health insurance. The scientific and healthcare community is still in the process of evaluating and recognizing complications of COVID-19 disease and their long-term impact on health and work ability. Key words: occupational disease, legislation, public health, occupational medicine. Profesionalne bolesti su bolesti izravno izazvane radom i radnim uvjetima. U Republici Hrvatskoj, kroz postupak utvrden zakonom, profesionalne bolesti prijavljuje i priznaje Hrvatski zavod za zdravstveno osiguranje te ih se registrira i prati u Registru profesionalnih bolesti koji vodi Hrvatski zavod za javno zdravstvo--Sluzba za medicinu rada. Dijagnoze su u nadleznosti specijalista medicine rada i sporta te se provode prema suvremenim kriterijima zastite na radu, sto ukljucuje odredivanje klinicke slike bolesti i posljedica na zdravlje koji su povezani s radnim procesom. Priznavanje COVID-19 kao profesionalne bolesti izuzetno je vazno za radnika obzirom na financijske i mirovinske beneficije prema vazecim zakonima i pravilnicima. Vecini radnika koji su imali COVID-19 kao profesionalnu bolest ona nije priznata kao profesionalna bolest dok su bolesni. Duljina akutne bolesti kraca je od procesa primjene i procjene profesionalne bolesti. Medutim, priznavanje COVID-19 kao profesionalne bolesti moze biti vazno za buducnost. Ako se bilo koja od komplikacija (npr. post COVID-19 sindrom) pojavi u buducnosti, radnik ima svoja prava prema zdravstvenom i mirovinskom osiguranju. Znanstvena i zdravstvena zajednica jos uvijek su u procesu procjene i prepoznavanja komplikacija bolesti COVID-19 i njihovog dugorocnog utjecaja na zdravlje i radne sposobnosti. Kljucne rijeci: profesionalna bolest, zakonodavstvo, javno zdravstvo, medicina rada.
Profesionalne bolesti su bolesti izravno izazvane radom i radnim uvjetima. U Republici Hrvatskoj, kroz postupak utvrđen zakonom, profesionalne bolesti prijavljuje i priznaje Hrvatski zavod za ...zdravstveno osiguranje te ih se registrira i prati u Registru profesionalnih bolesti koji vodi Hrvatski zavod za javno zdravstvo – Služba za medicinu rada. Dijagnoze su u nadležnosti specijalista medicine rada i sporta te se provode prema suvremenim kriterijima zaštite na radu, što uključuje određivanje kliničke slike bolesti i posljedica na zdravlje koji su povezani s radnim procesom. Priznavanje COVID-19 kao profesionalne bolesti izuzetno je važno za radnika obzirom na financijske i mirovinske beneficije prema važećim zakonima i pravilnicima. Većini radnika koji su imali COVID-19 kao profesionalnu bolest ona nije priznata kao profesionalna bolest dok su bolesni. Duljina akutne bolesti kraća je od procesa primjene i procjene profesionalne bolesti. Međutim, priznavanje COVID-19 kao profesionalne bolesti može biti važno za budućnost. Ako se bilo koja od komplikacija (npr. post COVID-19 sindrom) pojavi u budućnosti, radnik ima svoja prava prema zdravstvenom i mirovinskom osiguranju. Znanstvena i zdravstvena zajednica još uvijek su u procesu procjene i prepoznavanja komplikacija bolesti COVID-19 i njihovog dugoročnog utjecaja na zdravlje i radne sposobnosti.
Edukacija iz medicine rada i sporta (MRIS) slabo je zastupljena u kurikulima dodiplomskih studija medicine. Studenti medicine na Medicinskom fakultetu Sveučilišta u Zagrebu obvezni su pohađati ...nastavu iz MRIS-a tjedan dana na posljednjoj godini studija. Nastava je organizirana prema načinu poučavanja u grupi (PUG). Kako studenti koji iskuse PUG imaju bolje rezultate ispita i ocjene u odnosu na studente koji samo pohađaju predavanja, cilj ovog istraživanja bio je procijeniti znanje i stavove studenata odmah nakon nastave iz MRIS-a koja je zasnovana na PUG-u. U ovom presječnom istraživanju sudjelovala su 162 studenta završne godine studija medicine na Medicinskom fakultetu Sveučilišta u Zagrebu koji su iskusili PUG tijekom nastave iz MRIS-a u akademskoj godini 2019./2020. Bili su uključeni u istraživanje od 30. rujna 2019. do 4. ožujka 2020. Sudionici su ispunili upitnik s 20 čestica koji se odnosi na znanje i stavove studenata o MRIS-u. Autori su ga sastavili i prilagodili hrvatskom zakonodavstvu. Rezultati našega istraživanja pokazali su pozitivne stavove studenata prema nastavi iz MRIS-a i negativne stavove prema poslu u medicini rada i specijalizaciji iz MRIS-a. Studenti su pokazali osrednje zanimanje za posao u sportskoj medicini. Iako su pokazali dostatno znanje odmah nakon završetka kolegija, bili su umjereno zadovoljni svojim znanjem iz MRIS-a. Praktični aspekti strategije poučavanja na nastavi iz MRIS-a trebali bi se razmotriti u budućnosti kako bi se promicao rad u MRIS-u među studentima medicine rada i sporta ili barem podigla svijest o važnosti prevencije brojnih poremećaja koji su vezani uz rad ili sport.
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