Retrospektivní pohled na profesionální nemoci z přetížení v královéhradeckémregionu

A Retrospective View on Occupational Diseases from Overburden in the Region of Hradec Králové

The paper focuses on retrospective evaluation of professional diseases caused by the one-sided excessive and long-term overburdenof extremities from seven former districts of the Hradec Králové region between 1987 and 1996. 88 patients (49 women and 39men) were included in the follow up. The average age in the time of the evaluation of the occupational disease was 47.1 years(between 16 and 60 years). The disease occured most frequently between 46 and 55 years. The professional disease was approvedwithin the one year from the first occurence of difficulties in 40 patients (45.5 %). Within the one year of duration of difficulties, allelbow bursitis and mononeuropathies of lower extremities, 44 % of epicondylitis humeri and 33 % of carpal tunnel syndrome werereported according to diagnosis. The most common diagnosis of the carpal tunnel syndrome was found in 27 individuals (22 womenand 5 men), i. e. 30.7 % of the sample. The second most common diagnoses were epicondylitis humeri in 25 individuals (15 womenand 10 men), i. e. 28.4 % of the sample. The folowing most common diagnoses were 7 mononeuropathies of upper extremities, 6bursitis of knee, 6 injuries of shoulder, 4 bursitis of olecranon, 4 arthrosis of the first carpomethacarpal joint, 3 tendosynovitis, 3other arthrosis, 2 mononeuropathies of lower extremities and 1 entesopathy of patella. 87 % injuries were related only to upperextremities. 59 % of injuries were of orthopedic origin and 41 % of neurologic origin. Neurological diagnoses prevailed in women(75 %). Orthopedic diagnoses were prevalent in men in 57.7 %. Professional exposure ranged between 1 day and 41 years. Themost frequent professional exposure to strain was between 26 and 30 years. Coexposure to vibrations, predominantly in men, wasobserved in 31 persons (20 men and 11 women), i.e. 35.2 % of the sample. This combination occured most commonly in professionslike hollow-glass cutters, glass polishers, grinders, cast polishers and dental assistants. On the contrary, current difficulties relatedto the neck vertebral column which deteriorated the course of the disease upon upper extremities in 61 %, were observed predominantlyin women. The most prevalent professions were floor-covering layers, female workers producing rails under car seats,grinders and glass polishers. 37.5 % of patients underwent surgical treatment, 25 % of patients spa treatment. 17 % of patientsreceived full and 13.6 % of patients partial payments for industrial injury. The most common diagnosis causing disability was thesyndrome of a carpal tunnel. 96 % of patients from our sample were indemnified, 33 % of patients for surgery in addition.

Key words:
professional one-sided excessive and long-term strain on extremities, carpal tunnel syndrome, epicondylitis humeri, socialimpact of the disease