Klinika Pracovneho Lekarstva A Klinickej Toxikologie

Košice, Slovakia

Klinika Pracovneho Lekarstva A Klinickej Toxikologie

Košice, Slovakia

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Perecinsky S.,Klinika pracovneho lekarstva a klinickej toxikologie | Jancova A.,Klinika pracovneho lekarstva a klinickej toxikologie
Pracovni Lekarstvi | Year: 2016

Bronchial asthma belongs to most frequent diseases with estimated 300 million patients in the world. About 2-15% of cases originate in the occupation, but the data are not homogeneous. Occupational asthma is the most frequent occupational disease of respiratory tract in industrially developed countries and the second most frequent ion the developing countries. Occupational asthma differs from the non-occupational one in various aspects, for instance in etiology, pathogenesis and diagnostic methods. The differences in clinical picture and prognosis of the disease are not clear yet. The aim of our investigation was to find out, whether are any differences in the seriousness of occupational asthma and the response to therapy as compared with the non-occupational asthma. Methods: The patients with acknowledged occupational asthma (27 patients) were retrospectively compared with patients with asthma of non-occupational etiology who were monitored at our workplace for other diagnoses (28 patients). Differences in seriousness of asthma among individual groups were compared according to degree pf bronchial asthma. The degree of asthma was classified as light (including an intermittent and light persisting asthma (mild asthma)), moderate asthma and severe persistent asthma. Moreover, we followed pharmacotherapy and occasional changes in treatment in the meaning of intensification. In the group of patients with occupational asthma patients with moderate asthma were predominant. The occurrence of severe persistent asthma was relatively frequent in this group. In patients with non-occupational asthma the moderate asthma was also most frequent, but severe persistent asthma was not encountered Results: In the group of patients with occupational asthma as well as the non-occupational asthma, patients with moderate asthma predominated. The occurrence of severe persistent asthma was relatively frequent in the occupational asthma (26%). In the patients with non-occupational asthma, however, the severe persistent asthma did not occur in any case. In the standard treatment of asthma (bronchial dilatation, inhalation corticosteroids, antileukotrienes and theophylline), both groups were not markedly different. In contrast, oral corticosteroid (15%) and biological treatment (7.5%) were applied in patients with occupational asthma only. Conclusions: Results of this study demonstrated a higher seriousness of occupational asthma as compared with non-occupational etiology. It is documented by relatively high frequency of severe persistent asthma in the group with occupational etiology and the need of permanent treatment with oral corticosteroids. The study made it clear that occupational asthma is an important, often progressing disease with uncertain prognosis.


Svihrova V.,Ustav Verejneho Zdravotnictva JLF UK Martin | Buchancova J.,Ustav Verejneho Zdravotnictva JLF UK Martin | Paluch A.,Vseobecna Zdravotna Poistovna | Turska A.,Vseobecna Zdravotna Poistovna | And 3 more authors.
Pracovni Lekarstvi | Year: 2011

In their paper, authors analyzed average direct and indirect costs on diagnostics and treatment of acute tick encephalitis in Slovakia in economically active hospitalized patients (52 cases). Average direct and indirect costs on a single patient during hospitalization due to the diagnosis of tick encephalitis were 1 353.95 EUR. Authors pointed at possible financial impact on employers when rewarding the occupational disease in comparison to the costs related to active prevention of employees using vaccination. Basic rates of point evaluation related to pain in occupational diseases due to tick encephalitis are currently from 30 to 150 points and from 300 to 3000 points for impaired social engagement. 1 point correlated to 14.46 EUR in 2009. It is more beneficial for the employer to cover vaccination of the employee from 18 years until retirement (269.40 EUR) instead of rewarding the pain at lower rates of 30 points (433.80 EUR).


Bajusova I.,Klinika pracovneho lekarstva a klinickej toxikologie | Kolarcik P.,Univerzita P. J. Safarika v Kosiciach | Ihnatko M.,Nemocnica Kosice Saca | Kimakova T.,Univerzita P. J. Safarika v Kosiciach | Legath L.,Klinika pracovneho lekarstva a klinickej toxikologie
Hygiena | Year: 2013

Benzene has hematoxic effects, causes damage to the central nervous system and immune system, is classified as a Category 1 carcinogen, and a Category 2 mutagen. Benzene exposure is limited by public health legislation. A total of 99 biological samples of benzene-exposed workers and 19 biological samples of non-exposed patients in a control group were examined. Concentration determination of two selected biomarkers of benzene exposure was performed using two different analytical methods. Trans,transmuconic acid was determined by chromatography and phenol was determined by spectrophotometry. The purpose of the study was to compare their excretion rate in both monitored groups, and to prove appropriateness of chromatographic determination of trans,trans-muconic acid in urine for quick and reliable biomonitoring of the working environment. The average phenol concentration in both groups varied at physiological levels: mean (SD) was 11.07 (8.51) mg.g-1 creatinine for a benzene-exposed group, and 12.16 (11.42) mg.g-1 creatinine for a control group. As for trans,trans-muconic acid, the average concentration was 0.64 (0.95) mg.g-1 creatinine in case of benzene-exposed workers compared to 0.29 (0.24) mg.g-1 creatinine for a control group. Concentration of trans,trans-muconic acid in urine from exposed workers did not exceed a recommended concentration limit for Threshold Limit Value level for benzene, but exceeded a recommended Biological Exposure Indices value set by the American Conference of Governmental Industrial Hygienists. A statistic t-test revealed a significant difference in measured values of excreted trans,transmuconic acid between a control group of patients and benzene-exposed workers proving appropriateness of determination for quick and reliable bio-monitoring of the working environment.


Perecinsky S.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | Legath L.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | Varga M.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | Jancova A.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | And 2 more authors.
Klinicka Imunologia a Alergologia | Year: 2012

Objective: Follow sensitization to inhaled allergens in each group of patients with allergic rhinitis and demonstrate the most important allergens. At the same time observed differences in patient populations living in Košice and the countryside. Methods: 208 patients with allergic rhinitis was assessed sensitization to common inhalation allergens. Patients based on place of residence were divided into two groups -first: patients permanently resident in Košice and second: patients from other areas of eastern Slovakia living in rural areas. The incidence of sensitization to each allergen was expressed as percentages of positive and negative skin tests. Findings were compared between groups. Results: Patients living in Košice were the most commonly sensitized to allergens of grasses (60% of patients), the countryside was the most common sensitization to mites (63.49% of patients). In the group of patients living in Kosice implement significant sensitization to seasonal allergens. There was found a statistically significant difference between the two groups in the proportion of positive skin test to a mixture of grass and mugwort (p = 0.02 respectively. p = 0.04). In the group of patients living in rural areas, the proportion of positive skin test to perenial allergens was higher than in Kosice. Conclusion: Our study demonstrates the significant impact of the urban environment on the development of allergic diseases, which significantly increases the risk of sensitization to allergens mainly grasses and weeds.


Slavomir P.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie
Pracovni Lekarstvi | Year: 2013

Occupational rhinitis (OR) belongs to most frequent occupational diseases of upper respiratory tract, occurring two to four times more often than occupational asthma. Prevalence and incidence of occupational rhinitis have not been specifically investigated, though. There proved to be marked regional differences in numbers of acknowledged cases in Slovakia. Numerous studies in the Košice region followed etiology of the disease as well. However, results of a single region are not necessarily applicable for the Slovak Republic at large. The objective of this investigation was to determine and compare possible differences in etiology of OR in the Košice region, where the disease is most frequent with other Slovakian regions. The study encompassed a group of 70 patients who were the subjects of occupational rhinitis acknowledgement in Slovakia in the 1990-2011 years. The group was divided in two groups. The first group included the OR cases in the Košice region. In the second group there were patients from other regions of Slovakia. The flour proved to be the most frequent cause in both groups (44% cases in both groups). Chemical compounds figured much more frequently in the Košice region than in the other regions. On the contrary occupational allergy to moulds represented up to 18% of OR cases in the other regions, whereas in the Košice region it did not occur. A general analysis determined relatively low number of etiological agents, indicating insufficient diagnostics of the disease. The spectrum of agents in the two groups differed relatively little, most often represented by classical allergens, where hypersensitivity can be proved by classical examination by immunoallergology methods. In numerous cases identification of OR requires nasal provocation tests or exposure tests directly at the workplace, which helps to better identify numerous agents and consequently improves the diagnostics of the disease.


Perecinsky S.,Klinika Pracovneho Lekarstva a Klinickej Toxikologie | Jancova A.,Klinika Pracovneho Lekarstva a Klinickej Toxikologie
Pracovni Lekarstvi | Year: 2012

Asthma and rhinitis are widespread around the world and often affect the patients simultaneously. Allergic inflammation with rhinitis is isolated to nasal mucosa only, whereas bronchial mucosa in asthma is associated with affected mucosa of upper respiratory tract. This idea is the basis of the terminology of "one airway, one disease", which may also be applied to allergic rhinitis and asthma of occupational genesis. It has been published that 76-92% of patients with occupational asthma suffers from rhinitis. Less data concern associated asthma in patients with rhinitis of occupational etiology. We have investigated prevalence of rhinitis in patients with acknowledged occupational asthma or, on the other hand, with prevalence of asthma in patients with occupational rhinitis. As the same time we analyzed the relation between these two diseases, which is closely related to evaluation of the chance of oneself to assert or acquit well socially, self-fulfillment. The group included 121 patients: 89 with occupational asthma and 32 with occupational rhinitis. In the group of patients with occupational asthma, rhinitis was associated in almost 53.93%, in the group of patients with occupational rhinitis, 25% of patient were affected with asthma. An increasing trend in the occurrence of cases of associated rhinitis with occupational asthma was observed. The patients with occupational rhinitis, who also suffered from associated asthma, were classified as occupational rhinitis with transition to bronchial asthma. Frequent simultaneous occurrence of rhinitis and asthma indicate the need of a complex view of these diseases. in each patient with occupational rhinitis it is needed to perform targeted examinations to exclude bronchial hyperreactivity. in contrast, in bronchial asthma patients an otolaryngology examination is indicated as well as examination of upper respiratory tract by means of functional methods of examination at specialized institutions.


Topolovska Z.,Klinika pracovnrho a cestovnrho lekarstvr | Varga M.,Klinika pracovneho lekarstva a klinickej toxikologie
Pracovni Lekarstvi | Year: 2011

This review paper deals with differences in the field of Occupational Medicine in the Czech and Slovak Republic and presents a review of occupational legal problems in the field. The authors do not aim to evaluate which system is better but the goal was to make clear main differences in both systems and inspire the readers in the context of ongoing changes in the concept of the field of Occupational Medicine.


Perecinsky S.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | Jancova A.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | Varga M.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie | Legath L'.,Klinika Pracovneho Lekarstva A Klinickej Toxikologie
Pracovni Lekarstvi | Year: 2012

Occupational rhinitis and occupational asthma are important, often occurring diseases. Occupational asthma is the most frequent occupational disease of the respiratory system in most countries. Rhinitis also belongs to frequent health damage from work. The objective of the work was to analyze patients who were diagnosed occupational rhinitis and occupational asthma at the clinic in the years 1990-2011. In the given period of time asthma was confirmed as an occupational disease in 89 cases. Occupational rhinitis was acknowledged in 32 patients. Occupational asthma occurred most frequently in agriculture, where this sector greatly prevailed over other branches in the early 90ties. Occupational asthma also occurred relatively often in the food processing industry and textile industry, whereas the other branches were represented less. From the mid 90ties, however, occupational asthma in agriculture and textile industry completely disappeared. Occupational asthma reports completely ceased from 2007. In the last years occupational asthma rather occurred in sectors, where the employees had been exposed to chemical allergens and irritating compounds. The group of patients with occupational rhinitis proved to be different with agriculture being represented by two cases only. Food processing industry prevailed in this group with the most often occurring occupation of baker. Bronchial asthma and rhinitis belong to frequent work-related health damages, but the occupational disease status has been rarely acknowledged. It is necessary to draw more attention to these diseases and henceforth pay attention to investigation of these diseases. In view of the specificity and complicated diagnosis it is useful to centralize the patients to workplaces, which are specifically concerned with these diseases. Last but not least, physicians should be educated in related areas.


There were 483 cases of occupational diseases and professional intoxications reported in the Slovak Republic in 2009. The highest proportion of occupational diseases covers the disease of bones, joints, tendons and nerves of extremities from longterm, excessive, unilateral load of upper extremities with 209 reported cases, i. e. 43.27 % of all reported professional diseases. The second was the disease of bones, joints, muscles, vessels and nerves of extremities caused by the work with vibrating instruments which represented 17.4 % of all occupational diseases in Slovakia in 2009. The third most frequent occupational diseases are infectious and parasitic diseases including tropical infectious and parasitic diseases and diseases transmitted from animals to humans (52 cases, i.e. 10.7 % reported occupational diseases). The occupational analysis showed the highest occurrence of occupational diseases (123 cases) in workers in mining and building industry in the Slovak Republic. The highest occurrence of occupational diseases according to the field classification of economic activities was in the industrial production - 246 reported cases. The most occupational diseases according to the site of organization where the occupational diseases developed were reported in the region of Banska Bystrica, the most occupational diseases according to the health care organization which reported the occupational disease were in the region of Košice in 2009.


Bajusova I.,Klinika pracovneho lekarstva a klinickej toxikologie | Kolareik P.,Ustav verejneho zdravotnictva LF | Ihnatko M.,Oddelenie pracovneho lekarstva | Legath L.,Klinika pracovneho lekarstva a klinickej toxikologie
Pracovni Lekarstvi | Year: 2011

Benzene exposure poses a serious risk to human health in the workplace. Benzene has significant hematotoxic effects, causes damage to the central nervous system and immune system, is classified as a Category 1 carcinogen, and a Category 2 mutagen. In this study, we focused on determination and comparison of two biomarkers of benzene exposure. Determination of trans,trans-muconic acid in urine by a HPLC method with UV detection is considered as suitable and acceptable biomonitoring of workplaces, and spectrophotometric determination of phenol in urine. Cigarette smoke contains relatively high concentrations of ben doporuèozene and becomes a significant additional source of benzene exposure for smokers. The aim of this study was to monitor influence of the length of occupational worker exposure on excretion rate of exposure benzene biomarkers, and to verify a hypothesis whether the amount of selected biomarker excretion is affected by active smoking of exposed workers. The result of a group testing of 105 workers being exposed to benzene was the determination of average concentration values of both excreted biomarkers of benzene exposure with a comparable and short halftime of excretion from the organism. Urine trans,trans-muconic acid concentration was 0.80 (1.34) mg . g -1 creatinine and phenol concentration was 10.64 (12.67) mg . g -1 creatinine. Concentration of trans,trans-muconic acid for workers being exposed to benzene did not exceed a recommended concentration limit of treshold limit value of benzene according to applicable legislation, but it exceeded recommended biological exposure indexes according to the American Conference of Governmental Industrial Hygienists as for samples of biological material taken from exposed workers at the end of the shift. The average phenol content in urine was even at physiologic level. Based on laboratory analyses and statistic data of the group of the exposed workers, no relationship was found between the lenght of occupational exposure and increased selected biomarker excretion. No relationship was confirmed between increased selected biomarker excretion and smoker habits that would affect evaluation of occupational load by inhalation of benzene either. Key words: benzene, trans,trans-muconic acid, phenol, smoking.

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