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Manfredo, Irena
Arhiv za higijenu rada i toksikologiju, 9/2015, Volume: 66, Issue: 3Journal Article
Unemployed persons are often on the margins of the healthcare system and under the radar of safety and health organisations, as no systematic records are kept of occupational diseases caused by exposure at previous work place. Law in Slovenia requires that asbestos-related occupational diseases are verified by establishing the causal relationship between exposure at work and its effect on the worker. This report describes a case of verifying occupational pleural disease in an unemployed carpenter who was referred for consultation with occupational health specialist as part of the regular procedure for the unemployed registered at the Employment Service of Slovenia. At the consultation it turned out that the carpenter had been exposed to asbestos when he worked as a teenage apprentice. The diagnosis of the bilateral pleural disease and asbestosis was confirmed by X-ray and high-resolution computed tomography. Because he had no record of exposure in that period, we analysed his past working environment for minerals and found chrysotile in all asbestos board samples. The case was presented to an interdisciplinary committee, which verified his disease as occupational. This case points to the need of adopting guidelines for occupational health specialists providing counsel to the national employment service so that the number of unrecorded occupational diseases is minimised and their treatment is covered by the state. Nezaposleni so pogosto na robu zdravstvenega sistema in izven dosega varnosti in zdravja pri delu. Poklicnih bolezni zaradi izpostavljenosti na prejšnjih delovnih mestih v Sloveniji ne spremljamo. Zakonodaja predpisuje upravičence, vrste azbesta in azbestnih izdelkov, bolezni, ki se štejejo kot bolezni zaradi izpostavljenosti azbestu in postopek priznanja poklicne bolezni zaradi izpostavljenosti azbestu. Pri dokazovanju poklicnega izvora bolezni je potrebno objektivizirali vzročno zvezo med izpostavljenostjo azbestu na delovnem mestu in reaktivnostjo delavca. Opisan je primer verifikacije poklicne bolezni zaradi izpostavljenosti azbestu pri nezaposlenem mizarju, ki je bil predstavljen zdravnici- svetovalki na zavodu za zaposlovanje v sklopu zaposlitvenega svetovanja. Azbestu je bil izpostavljen kot vajenec v mizarski delavnici. Diagnoza bilateralnih plevralnih plakov je bila postavljena z RTG p.c. in HR-CT. Ker ni bilo nobenih pisnih dokumentov iz obdobja izpostavljenosti azbestu, smo opravili natančno delovno anamnezo, izvedli mineraloško analizo na enem od delovišč in dokazali krizotil v vseh odvzetih vzorcih. Interdisciplinarna komisija je potrdila poklicno bolezen zaradi izpostavljenosti azbestu. Primer opozarja na potrebo po sprejetju smernic za delo zdravnikov-svetovalcev, s čimer bi se zmanjšala verjetnost spregledanih poklicnih bolezni. V primeru suma na poklicno bolezen pri nezaposlenih bi morala stroške dokazovanja prevzeti država.
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