RESUMEN
STUDY OBJECTIVE: To conduct a retrospective 15-year study to monitor trends in the number of employees at risk for occupational tuberculosis (TB) (levels III and IV) in the Slovak Republic, and in particular in the sector of economic activities Q (health care and social assistance). Furthermore, to analyze reported cases of occupational TB and to compare the incidence and sex-specific and age-specific prevalence with the data reported in the Czech Republic. MATERIAL AND METHODS: Data on the number of employees at risk of exposure to occupational TB were derived from the Automated Risk Classification System of the Slovak Republic. Data on cases of occupational TB were taken from health statistics (Institute of Health Information and Statistics/National Health Information Center in the Slovak Republic and the National Institute of Public Health in the Czech Republic). A retrospective analysis was conducted (for 1998-2012) of reported cases of occupational TB, selected from Article 24 of the List of occupational diseases (infectious and parasitic diseases except tropical infectious and parasitic diseases and diseases transmissible from animals to humans). The selection criterion was a TB diagnosis according to ICD-10. In the Czech Republic, the data were derived from Article 5.1.02 (tuberculosis), Chapter V. of the List of Occupational Diseases. The data obtained were analyzed by methods of descriptive statistics. RESULTS: The numbers of employees with a level III risk of exposure to occupational TB in the Slovak Republic declined by 30% over the 15 years of study and by 40% in category Q. In 2012, 2027 employees were classified in category III and 1442 of them belonged to group Q. Females accounted for 81-84% of employees at risk of exposure to occupational TB. Eighty-six and 181 cases of occupational TB were reported in the Slovak Republic and in the Czech Republic, respectively, in 1998-2012, with the incidence showing a downward trend in both countries. TB of the respiratory tract was reported most often (83.7% of the total of reported cases of occupational TB). As expected, more cases occurred in females than in males (1.9 times as many cases in females as in males in the Slovak Republic and three times as many cases in females as in males in the Czech Republic). The incidence of occupational TB was the highest in sector Q, with the highest absolute numbers reported in nurses. In 2012, the incidence rates of occupational TB were 0.22 cases per 100,000 sick benefit policy holders in the Slovak Republic and 0.13 cases per 100,000 sick benefit policy holders in the Czech Republic. CONCLUSION: The incidence of occupational TB has a downward trend in both countries, similarly to TB incidence in the general population. A negative aspect in both countries is the incidence of occupational TB at the middle productive age, in contrast to the population occupationally non-exposed to TB. Slovakia is surrounded by higher prevalence countries, with the exception of the Czech Republic. It cannot be ruled out that, in addition to the known factors influencing the prevalence of TB, including occupational TB, migration from eastern countries, including job search migration, can also play a role in increase in TB cases. It is vital to continue epidemiological surveillance and to reduce the risk of TB as much as possible also in healthcare settings by adhering to barrier nursing practices. Cases of active TB need early and adequately long, controlled treatment in order to reduce, among others, the incidence of multi-drug resistant TB.
Asunto(s)
Enfermedades Profesionales/epidemiología , Tuberculosis/epidemiología , Adulto , Animales , República Checa/epidemiología , Femenino , Humanos , Incidencia , Masculino , Enfermedades Profesionales/microbiología , Exposición Profesional/estadística & datos numéricos , Estudios Retrospectivos , Eslovaquia/epidemiología , Tuberculosis/microbiologíaRESUMEN
In 44 healthy males aged 18-21 years, the authors studied the effect of irritation of the trigeminal zone by ammonia vapors and by immersion of the face into water on parameters of forced vital capacity. Inhalation of ammonia immediately induced impairment of all the studied parameters of forced expiration. In the later time intervals (up to the 10th minute after inhalation) the air flow remained reduced over the whole forced expiration (FVC/FET), mainly at the expense of decreased air flow at the end of forced expiration (FEF75-85%). Inhalation of ammonia also resulted in abolition of the psychically induced higher heart rate and in its normalization. Immersion of the face into cold water caused reduction in the values of FVC, FEV1, FVC/FET, and FEF0-25%. After voluntary apnea in the air there was only a small reduction of FEF0-25%. In the light of these findings, the authors consider irritation of cold receptors of the face to be the main cause of the changes in functional parameters of the lungs during immersion reflex.