1. STOP THAT NOISE!1 Case study: particularities in occupational hearing impairment diagnosis Claudia Handra- MD Prof. Eugenia Naghi- MD, Ph D Chair of Occupational Medicine, UMF Occupational Medicine Clinic, Hospital Colentina, Bucharest

2. STOP THAT NOISE!2 Noise Dictionary= sound or a mixture of discordant, strong sounds, disagreeable for the hearing

3. STOP THAT NOISE!3 Occupational noise One of the most frequent hazard in very different work places Mechanization of the production processes increased the intensity of noise

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10. 10 Case presentation M.D. male, age 39 engine technician power plant I. G. male, age 49 locksmith steel foundry

11. STOP THAT NOISE!11 Diagnosis COPD Cor pulmonale- work related disease Ischemic heart disease Occupational loss of hearing Spondilarthrosys Chronic bronchitis- work related disease High blood pressure Occupational loss of hearing Dorsal scoliosis Neurasthenic syndrome

12. STOP THAT NOISE!12 Professional route Exposure= 23 years 1982- 1986 - excavator operator- power plant 1986- 1987-military service 1987- 2005- engine technician- power plant Exposure= 25 years 1974- 1976- locksmith- steel foundry 1976- 1977- military service 1977- 1980- locksmith- steel foundry 1980- 2005- locksmith- steel foundry

13. STOP THAT NOISE!13 Medical history Two medical evaluations- local hospital 2005- complete medical evaluation, diagnosis, recommendations- occupational medicine clinic 2001- complete medical evaluation, diagnosis, recommendations- occupational medicine clinic

14. STOP THAT NOISE!14 Consequences Job restrictions/ preventive measures Irreversible loss of hearing Severe aggravation of work related diseases Medical retirement Freequent hospitalizations Job restrictions/ preventive measures Irreversible loss of hearing Aggravation diseases Frequent hospitalizations

15. STOP THAT NOISE!15 Hazard coal dust noise >87 dB vibrations outdoor work conditions silica dust noise > 87 dB indoor work conditions

16. STOP THAT NOISE!16 Expected occupational disease Coal miner’s pneumoconiosis Occupational loss of hearing Occupational musculoskeletal disease Silicosis Occupational cancer Occupational loss of hearing Occupational musculoskeletal disease

17. STOP THAT NOISE!17 Diagnosed occupational disease Occupational loss of hearing

18. STOP THAT NOISE!18 Possible causes Lack of personal protective equipment Unsuitable pace and duration of work activities Lifestyle Lack of personal protective equipment Unsuitable pace and duration of work activities Lifestyle

19. STOP THAT NOISE!19 Preventive measures Occupational risk acknowledgment Pre-employment medical evaluation Periodical medical examination Education

20. STOP THAT NOISE!20 Occupational risk acknowledgment Assessment of occupational hazards endangering hearing other than occupational noise Epidemiological studies

21. STOP THAT NOISE!21 Medical examination Early stage diagnosis; professional reorientation; prevention of disease aggravations Occupational physician in charge of medical evaluation and follow-ups

22. STOP THAT NOISE!22 Education Employer Adequate technical and administrative measures of prevention Employee Personal hygiene Personal protection equipment First- aid measures First symptom acknowledgement Awareness of the importance of medical follow-ups

23. STOP THAT NOISE!23 STOP THAT NOISE!