DDDVI 2.indd 1DVI 2.indd 1 111/29/12 4:29 PM1/29/12 4:29 PM · Occupational Diseases in 1974. By joining these two institutions the Centre of Occupational and By joining these two

DDVI 2.indd 1DDVI 2.indd 1 11/29/12 4:29 PM11/29/12 4:29 PM

2 FOREWORD

ForewordSince 2002 the new Law on Occupational Health and Safety is in force in Latvia together with

a whole set of new legal requirements in the area of occupational health and safety thus setting a

new background for workers’ health and safety. During that period a new development strategy for

Occupational Health and Safety has been adopted in Latvia and some institutional changes have

taken place as well. Also neighbouring Lithuania and Estonia have had similar changes with new

legal frameworks established around 10 years ago. Other global changes have taken place in the

countries around the Baltic Sea and in other EU countries in terms of OH&S policies and economy.

The economic crisis of 2008 brought yet another aspect to work environment, potentially infl uencing

workers’ health and safety.

During this time the new EU policies on OH&S as well as several other policies for health and

safety of workers have already become “old”. In the light of recent eff orts to provide new policy tools

to improve health and safety of the working population and to mainstream it into the approach of

”healthy lifestyles in healthy working conditions” it is worth taking a look at what has been achieved.

The aim of this conference is to look back whether the changing policies have brought changes

in workers’ health and safety or in other words - have they been put into practice – and not only in

Latvia and other countries around the Baltic Sea but all around the world.

This conference proceedings contain abstracts that were presented during the “International

Conference on Occupational Health and Safety: From Policies to Practice” held in Riga, on Decem-

ber 6-7, 2012, organised by the Institute of Occupational Safety and Environmental Health of Riga

Stradiņš University.

On behalf of the organisers of the conference I express the hope that you will learn more about

the Occupational Health and Safety policies and their implementation as well as on other aspects of

workers’ health and safety.

Ivars Vanadziņš, Ph.D

Director

Institute of Occupational Safety and Environmental Health

Riga Stradiņš University


3

Institute of Occupational Safety and Environmental Health

The Institute for Occupational Safety and Environmental Health is an academic, scientifi c and

training institution, a structural part of Riga Stradinš University.

The Institute for Occupational Safety and Environmental Health was established more than

60 years ago, originally as the Department of Hygiene at Riga Medical Institute in 1949. Later, in

1966 the Laboratory of Hygiene and O ccupational Diseases was set up with a view to conducting

research on the impact area of various chemical substances. In the course of time these institutions

have changed their names and structure, but not the focus on worker health and safety. In 1992

both these structures merged into one – the Institute of Labour Medicine of Medical Academy of

Latvia. In 1964 the Department of Occupational Diseases for diagnostics of these diseases was

opened in PaulsStradiņš Clinical University Hospital, followed by establishing the State Registry of

Occupational Diseases in 1974. By joining these two institutions the Centre of Occupational and

Radiological Medicine was established in 1976. Part of the functions of the Centre was transferred

to the Institute of Labour Medicine during its reorganization in 1995-1997, it becoming the Institute

of Occupational and Environmental Health.

Further development of the occupational health and safety system in Latvia required reorgani-

sation of the Institute and supported by the EU Twinning Facility project it was carried out during

2007 setting up the Institute of Occupational Safety and Environmental Health.

Today, irrespective of it being relatively small, the Institute performs the following functions:

• Training of undergraduate students (in several faculties on topics concerning occupational

health and safety, occupational medicine and environmental health) and postgraduate

students (medical doctors, master and doctoral students etc.);

• Scientifi c research (fundamental and applied) in various fi elds of occupational health and

safety;

• Information services on occupational health and safety issues for employers, experts and

employees (including publications, information campaigns etc.);

• Expert consulting services (providing laboratory measurements in the fi eld of occupational

health and safety at work and expert advice on various specifi c issues).

As there are rapid changes and developments in work environment the Institute of Occupa-

tional Safety and Environmental Health is ready to meet new challenges caused both by traditional

and new and emerging risks.


4 PROGRAM OVERVIEW

INTERNATIONAL CONFERENCE ON OCCUPATIONAL HEALTH AND SAFETY: FROM POLICIES TO PRACTICE RIGA, DECEMBER 6–7, 2012

Thursday, december 6, 2012

09:00–10:00 Registration and coff ee

10:00–12:00 Plenary Session

Occupational health and safety: 10 years of Policy and Practice

12:00–13:00 Lunch

13:00–15:00 Plenary Session

The role of Labour Inspection in improving health and safety – examples of modern inspection strategies

15:00–15:30 Coff ee and Poster Session

15:30–17:00 Working session

Ergonomics, work organization and productivity

19:00– Conference dinner

Friday, december 7, 2012


New and emerging risks

10:30–11:00 Coff ee and Poster Session


Occupational diseases in changing times. Occupational health in practice

12:30–13:30 Lunch


Workplace stress and workers wellbeing

15:00–15:30 Coff ee

15:30–16:30 Closing session

From Policies to Practice: The way forward


5CONTENTS

APPLICATION OF INTERNATIONAL STANDARDS ON PROFESSIONAL RISKS ASSESSMENT IN THE FIELD OF HYGIENIC SAFETY OF POPULATION OF KAZAKHSTAN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9Iztileu Amanzhol, Aigul Ismailova, Dinara Omarova, Aizhan Izmailova

OCCUPATIONAL SAFETY POST-GRADUATION PROGRAMS IN EUROPE: A GENERAL OVERVIEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10Pedro Arezes, Paul Swuste

PODOMETRY — BASIS OF EARLY DIAGNOSTICS AND PREVENTION OF MUSCULOSKELETAL SYSTEM DISORDERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11Marija Avota, Andrejs Avots

APPLICATION OF TELEMEDICAL INFORMATIVELY-DIAGNOSTIC COMPLEX IN THE ESTIMATION OF THE STATE OF DISK OF VISUAL NERVE . . . . . . . . . . . . . . . . . . . 13Ilya Bakutkin, Vladimir Spirin, Valery Bakutkin

CONTINUING MEDICAL EDUCATION OF OCCUPATIONAL PHYSICIANS AS THE NEW MODEL OF POSTGRADUATE COURSES IN THE RUSSIAN FEDERATION . . . . . 14Zukhra Berkheeva, Nailya Mazitova

OPTIMISATION OF TEMPERATURE CONTROL SYSTEM OF HABITATS AND BIOLOGICAL HUMAN ENVIRONMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15Tatyana Bogdanova, Vladimir Lobanov, Vladimir Spirin, Alexander Bolshakov, Valery Bakutkin

NEGATIVE ASPECTS OF THE PROFESSIONAL QUALITY OF LIFE AMONG NURSES . . . . . 17Kristaps Circenis, Inga Millere, Liāna Deklava

OCCUPATIONAL NOISE AND URBAN HABITAT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18Jānis Dundurs, Miervaldis Lācis

DEVELOPMENT OF LATVIAN SOCIETY OF OCCUPATIONAL PHYSICIANS AND ITS INFLUENCE ON OCCPATIONAL SAFETY AND HEALTH SYSTEM IN LATVIA . . . . 19Maija Eglite, Ivars Vanadzins, Ilze Feldberga, Inese Usacka

OHS — TRAINING AND EDUCATION OF PROFESSIONALS . . . . . . . . . . . . . . . . . . . . . . . . . 20Melánia Feszterová, Tomá Kozík, Ivana Tureková

PSYCHOSOCIAL RISK FACTORS IN HOSPITAL NURSES WORKING LIFE. . . . . . . . . . . . . . 21Tiina Freimann, Eda Merisalu

DEFINITION OF ZONE OF THERMAL COMFORT IN MINES . . . . . . . . . . . . . . . . . . . . . . . . . 22Alexandr F. Galkin

RISK ASSESSMENT OF PERSISTENT ORGANIC POLLUTANTS ON HUMAN HEALTH IN INDOOR ENVIRONMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23Alexandr Gankine, Tatiana Gritsenko, Tatiana Naumenko

ERGONOMIC CULTURE AS A COMPONENT OF WORKING SAFETY IN THE CONTEXT OF GENERAL ORGANIZATIONAL CULTURE . . . . . . . . . . . . . . . . . . . . . . 24Janis Gedrovics


6

AMBIENT DESCRIPTION OF SOFTWARE USABILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Sabine Grinberga

IMPROVING WELL-BEING AT WORK WITH THE PARTICIPATORY METAL AGE METHOD . . . . . 26Essi Gustafsson

OCCUPATIONAL HEALTH AND SAFETY IN RUSSIA: TODAY AND THE FUTURE . . . . . . . . 27Nikolay Izmerov, Igor Bukhtiyarov, Ludmila Prokopenko, Nina Rubtsova

SITUATION ANALYSIS OF EXISTING OCCUPATIONAL HEALTH AND SAFETY SERVICE SYSTEMS IN NDPHS COUNTRIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28Remigijus Jankauskas, Raimonda Eičinaitė-Lingienė, Jolita Kartunavičiūtė

OCCUPATIONAL HEALTH SERVICES IN ESTONIA — QUO VADIS? . . . . . . . . . . . . . . . . . . . 29Mari Järvelaid

FORMAL SAFETY VERSUS REAL SAFETY: QUANTITATIVE AND QUALITATIVE APPROACHES TO SAFETY CULTURE – EVIDENCE FROM ESTONIA . . . . . . . . . . . . . . . . . . 30Marina Järvis, Charles Woolfson, Piia Tint

PROCESS MANAGEMENT IMPROVEMENT WITH ERGONOMICS SOLUTIONS. . . . . . . . . . 31Henrijs Kalkis, Valdis Kalkis, Zenija Roja

PRACTICAL EVALUATION OF MUSCLE FATIGUE USING MYOTONOMETRIC METHOD. . . 32Valdis Kalkis, Zenija Roja, Henrijs Kalkis, Inesa Remeza, Artis Ruiss

LABOUR PROTECTION REGULATIONS IN LATVIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Uldis Karlsons

PSYCHOLOGICAL RISKS IN PROFESSIONAL ACTIVITY OF SHIFT WORK IN THE FAR NORTH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34Yana Korneeva, Natalia Simonova, Galina Degteva

FROM EARLY SIGNS OF HARM TO PREVENTION OF OCCUPATIONAL HEALTH PROBLEMS BY USING LEADING INDICATORS. . . . . . . . . . . . . . . . . . . . . . . . . . . . 35Kari Kurppa

IMPACT OF WORK ORGANIZATION FACTORS ON SICKNESS ABSENCE AND PRESENTEEISM OF EMPLOYEES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36Svetlana Lakisa, Inese Martinsone

A SURVEY ON BYPASSING PROTECTIVE DEVICES AND GUARDS IN POLAND. . . . . . . . . 37Agata Latała

INFLUENCE OF PSYCHOSOCIAL PRODUCTION FACTORS ON EMERGENCE OF SOME FUNCTION VIOLATIONS AT WOMEN – TEACHERS . . . . . . . . . . . . . . . . . . . . . . 38Evgenia Leonteva

ASSESSMENT OF INDOOR AIR POLLUTION AND HEALTH COMPLAINTS AMONG OFFICE EMPLOYEES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39Žanna Martinsone, Mārīte Ārija Baķe, Maija Eglīte

CONTENTS


7

RETROSPECTIVE COHORT STUDY OF INDUSTRIAL WORKERS: CONTRIBUTION OF SMOKING AND OCCUPATIONAL FACTORS TO COPD DEVELOPMENT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40Nailya Mazitova, Nail Amirov

JOB SPECIFIC FACTORS AND PREVALENCE OF MULTI-SITE AND DISABLING MUSCULOSKELETAL PAIN AMONG OFFICE WORKERS, NURSES AND CAREGIVERS IN ESTONIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41E. Merisalu, L. Animägi, K. Oha, T. Freimann, T. Sirk

STUDENT STRESS, BURNOUT AND HEALTH IN THE MEDICAL FACULTY OF THE UNIVERSITY OF TARTU. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42Eda Merisalu, Ulrich Wiesmann, Merli Ilves, Karina Haefke, Hans-Joachim Hannich

APPLICATION OF ERGONOMIC STANDARDS IN THE DESIGN OF A PROCESSING MACHINE: DIFFICULTIES AND CHALLENGES . . . . . . . . . . . . . . . . . . . 43Anna Sophia Piacenza Moraes, Pedro Arezes, Ricardo Vasconcelos

PERFORMANCE EVALUATION STRATEGY AND SAFETY CULTURE MATURITY LEVEL . . . . . 44Hernâni Veloso Neto, Pedro Arezes

TECHNICAL SOLUTIONS TO PREVENT CONTACT DERMATITIS CAUSED BY CONTACT WITH BIOLOGICAL AGENTS FOR ARCHIVES STAFF, FUNDED BY NATIONAL PROJECT PNII-92-083/2008–2011 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45Steluta Nisipeanu, Maria Haiducu, Iuliana Scarlat, Valentin Moise

TRUST AND MISTRUST AS STRESS REDUCING AND INCREASING FACTORS IN WORKING LIFE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46Jukka Piippo

OCCUPATIONAL HEALTH AND SAFETY IN LITHUANIA: 20 YEARS EXPERIENCE AND FUTURE TRENDS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47Rita Raškevičienė, Vidmantas Januškevičius, Paulius Vasilavičius

THE INFLUENCE OF CHEMICAL FACTORS ON THE HEALTH OF WORKERS OF MANUFACTURE OF LEATHER GOODS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48Inesa Remeza, Dagmara Sprudza, Zanna Martinsone

MUSCULOSKELETAL OCCUPATIONAL DISEASES AND AGING WORKFORCE IN LATVIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49Jelena Reste, Maija Eglite, Tija Zvagule, Natalja Kurjane

SMOKING PREVALENCE IN WORKERS AT RISK FOR OCCUPATIONAL DISEASES OF THE ВRONCHO-PULMONARY SYSTEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50Natalia Roslaya, Oleg Rosly, Natalia Efremova

THE IMPLEMENTATION OF THE MANAGEMENT SYSTEMS CONCERNING HEALTH AND SAFETY AT WORK IN ROMANIA IN VIEW OF THE EUROPEAN STRATEGY. . . . . 51Gilda Rusu-Zagar, Ionel Iorga, Steluta Nisipeanu, Andrei Iorga, Octavian Iorga, Catalin Rusu-Zagar, Mihaela Mocanu

CONTENTS


88

OCCUPATIONAL HEALTH SERVICES IN VOLUNTARY HEALTH INSURANCE IN POLAND – ECONOMIC INCENTIVES SCHEME OPPORTUNITY AND DILEMMAS . . . . . 52Izabela Rydlewska-Liszkowska, Alicja Sobczak

INDEX-BASED VERSUS COST-RELATED MODEL OF DIFFERENTIATING PREMIUMS FOR ACCIDENT INSURANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Jan Rzepecki

QUALITATIVE AND QUANTITATIVE CHARACTERISTICS OF PAIN SYNDROME . . . . . . . . . 55Vasiliy Shirokov, Helen Bahtereva, Inna Krivcova, Yakov Zakharov

PREVALENCE AND INCIDENCE OF SHOULDER PAIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56Vasiliy Shirokov, Tatyana Makar, Tatyana Derstuganjva

OCCUPATIONAL HEALTH AND HEALTH PROTECTION OF THE WORKING POPULATION OF THE REPUBLIC OF KAZAKHSTAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57E.Sraubaev, N.Shintaeva, B.Serik, A.Dauletova, N.Erdessov

PERSISTENT ORGANIC POLLUTANTS IN BLOOD SERUM OF ELECTRICIANS AND WELDERS IN LATVIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58Pavels Sudmalis, Marite A. Bake, Juris Rotbergs

THE HEALTH RISKS CONNECTED WITH MONOTONOUS WORK BY COMPUTERS . . . . . . 59Piia Tint, Marina Järvis, Viiu Tuulik

ERGONOMIC ASSESSMENT OF WORKPLACES IN ATRIUM-TYPE BUILDINGS . . . . . . . . . 60Piia Tint, Laura Tkatsova

OCCUPATIONAL HEALTH AND SAFETY CULTURE PROMOTION: EVALUATION OF SAFETY SIGNS INFLUENCE ON OCCUPATIONAL ACCIDENTS AND DISEASES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61Laura Tkatsova

DEPRESSION AS OCCUPATIONAL DISEASE FROM THE INFLUENCE OF PHYSICAL AND CHEMICAL FACTORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62Sergei Tretyakov

ANALYSIS OF OCCUPATIONAL ACCIDENT REGISTRATION SYSTEM IN LATVIA AND COMPARISON OF ACCIDENT RATES IN VARIOUS EU COUNTRIES . . . . . . . 64Ivars Vanadzins, Inese Martinsone

OCCUPATIONAL SAFETY AND HEALTH IN LITHUANIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65Gediminas Vilkevičius, Audrius Spirgys

WORKERS’ HEALTH PRESERVATION, PROBLEMS AND APPROACHES TO THEIR SOLUTION (ON THE EXAMPLE OF THE PERM REGION). . . . . . . . . . . . . . . . . . . 66Elena Vlasova, Dmitry Shlyapnikov, Irina Danilina

ATTITUDES OF LATVIAN ADULT POPULATION TOWARDS EMPLOYMENT OF PEOPLE WITH MENTAL DISORDERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67Inga Zarde, Kate Pulmane, Anita Villerusa, Elmars Rancans

CONTENTS


PRESENTATION SUMMARIES 9PRESENTATION SUMMARIES 9

APPLICATION OF INTERNATIONAL STANDARDS ON PROFESSIONAL RISKS ASSESSMENT IN THE FIELD OF HYGIENIC SAFETY OF POPULATION OF KAZAKHSTAN

Iztileu Amanzhol, Aigul Ismailova, Dinara Omarova, Aizhan IzmailovaNational Center of Labor Hygiene and Occupational

Diseases, Karaganda, Republic of Kazakhstan

Key words: health, labor hygiene, occupational risks, safety standards

INTRODUCTIONIn recent years due to the rapid growth of industrialization of Kazakhstan there were introduced

new technologies and high-performance equipment, energy production increased by using hazard-

ous and noxious substances, the infl uence of which on human remains to be assessed. One of

the major challenges of sustainable development of Kazakhstan in the fi eld of occupational health

and safety is to reduce the occupational risk and rehabilitation of workers. In the framework of the

National program of industrial-innovative development of Kazakhstan till 2020 there was a need for

further modernization of production, and the use of modern and safety technologies and technical

devices, a gradual transition to international standards for the protection of workers’ health. The

assessment and management of health of the working population formed the theoretical aspects

of occupational risk assessment, its legal basis, the principles, criteria, which are refl ected in the

manual “Occupational Hazard for Health Workers”, developed by scientists of the Research Institute

of Labor Medicine of the Russian Academy of Medical Sciences.

OBJECTIVEDevelopment of health management systems of the working population from the position of

occupational risks.

METHODSComplex of modern hygienic, clinical and functional, statistical and other methods. Objects of

research: enterprises of oil-processing, metallurgical and mining industries in Kazakhstan.

RESULTSFor the fi rst time calculation of the dose-dependent loads of harmful factors of production when

developing criteria for predicting the risk of occupational diseases and the reasons for and eff ect of

adverse occupational factors; development of programs of rehabilitation and a number of guidance

documents aimed at optimizing labor and improving the health of the working population.

CONCLUSIONProfessional risk management system is aimed at the identifi cation, assessment of risks and

development of mechanisms to minimize them. Implementation of eff ective risk management sys-

tems in industrial plants allows local companies to meet international standards for the protection

of workers’ health.

Correspondence e-mail: [email protected]


PRESENTATION SUMMARIES10

OCCUPATIONAL SAFETY POST-GRADUATION PROGRAMS IN EUROPE: A GENERAL OVERVIEW

Pedro Arezes1, Paul Swuste2

1 DPS, Engineering School, University of Minho, Guimaraes, Portugal2 Safety Science group, TPM Faculty, TU Delft, Netherlands

Key words: occupational safety, education programs, Europe

INTRODUCTIONAlthough the scientifi c literature on safety science is profuse, the specifi c literature on safety

practitioners’ education is surprisingly scarce. The safety education presents a high diversity in dif-

ferent European countries, which manifests not only on the education contents but also on the levels

of education considered between countries and also within a specifi c country. These levels may

range from basic safety training to high-level education programs at universities.

AIMThis study was focused on the analysis of the post-graduation education off er in the domain of

safety in 18 European countries and aimed at characterizing the scenario of the safety education in

high education organizations, as well as analyzing specifi cs of some countries.

METHODSThe current study comprises two diff erent stages. The fi rst one consisted in the application of

an online survey, which was sent to the course coordinators and carried out within the framework of

a broader European research project related to safety education and qualifi cations across Europe.

The second stage included an interview with some course coordinators on a selected sample of

courses and countries. So far, two countries had already been visited in this second stage, Portugal

and Finland.

RESULTSThe results of the survey are presented to almost 100 courses, from 18 countries, mainly uni-

versities. As expected, the majority of the courses are MSc courses (or equivalent), and are organ-

ized primarily by faculties of engineering, applied sciences and management. The data collected at

the 2nd stage included detailed information about the courses, namely, the selection and organiza-

tion of the content, the composition of the teaching staff , the teaching methods, the implemented

quality systems and the eff ect or its absence on the courses by the research carried out by the

organizing group.

CONCLUSIONSThe main conclusion of the survey – there is a high variability amongst courses, not only con-

cerning the title of the course, but also on the content, length, and selected topics. However, it

should be emphasized that these results are not representative of the European situation, as it was

focused on a restricted sample of courses. The results of the ongoing second stage also show that

the course characteristics is much more infl uenced by the characteristics of the group organizing

the course than by the infl uence of legislation or market requirements.



PRESENTATION SUMMARIES 11

PODOMETRY — BASIS OF EARLY DIAGNOSTICS AND PREVENTION OF MUSCULOSKELETAL SYSTEM DISORDERS

Marija Avota1, Andrejs Avots2

1 Department of Occupational and Enviromental

Medicine, Riga Stradiņš University2 Riga Latvia Pirmaden Medical Centre, Ltd., Latvia

Key words: podometry, foot biomechanics, early

diagnostics, musculoskeletal disorders

INTRODUCTIONMusculoskeletal disorders amount to 46.1% of all occupational diseases in Latvia, leading to

serious socio-economic consequences. In this situation it is effi cient to focus on early diagnostics

and early intervention in order to prevent the development of disability. It is known that pathogen-

esis of non-specifi c musculoskeletal diseases roots in foot biomechanics disorders. Podometry

allows us to understand and correct foot biomechanics disorders long before pain, foot deforma-

tion, or any signs of osteoarthritis of feet or spine joints occur. Our experience of podometry

examination of 11 thousand people since 2002-2012 shows that it is just podometry that might

become a good example of MSD early diagnostics, and it is necessary to start solving this problem

from early childhood.

MATERIALS AND METHODSThe research involved 765 schoolchildren of Riga secondary schools, 354 schoolchildren of

eight Riga sports schools, 102 medical personnel of a multi-profi le clinic nurses, doctors, nurse

assistants. A standardized questionnare was used as an instrument of the research that included

analysis of questions providing information about gender, age group, post, BMI, physical activities,

performed objective foot examination methods, awareness about the ways of foot deformation cor-

rections. A computerized foot diagnostic system Pad Professional was used to assess objectively the

condition of the feet. The data of the research work were processed with computer programs SPSS

for Windows and Excel. Descriptive statistics is used.

RESULTSThe results of podometry of 765 schoolchildren aged 12-19 years in Riga secondary schools

(429 girls and 366 boys) show signs of transeverse arches increased from 5th up to 12th form: from

11.24% up to 18.50% of boys and from 14.81% up to 43.3% of girls. Longitudinal arches of 3.2% of

boys and 2.4% of girls. One of three examined schoolchildren has disorders of posture and signs

of scoliosis. In the course of examination of 354 schoolchildren in eight Riga sports schools aged

10-16 years (236 boys and 118 girls) there were detected signs of transverse arches of 16.10 % of

boys and 20.33% of girls, as well as signs of longitudinal arches of 6.35% of boys and 5.08% of girls.

102 medical personnel of a multi-profi le clinic was diagnosed to have a totally healthy foot, 83.3%

have transverse arch fl attening, 10.3% explicit transverse arch fl attening and 6.4% longitudinal arch

fl attening. The awareness of medical personnel about their feet problems is insuffi cient, 9.3% re-

spondents have never used any of the objective feet examination methods. There is also not enough



attention paid to prevention of feet problems - footwear with wrong height of heel is being worn at

home and at work, orthopaedic footwear, instep-raisers are practically not used at work. Most medi-

cal workers, 66.1%, have some of the spinal or articular illnesses.

CONCLUSIONIt is appropriate to apply podometry widely from the age of 9-10 for detection of peculiar

features of musculoskeletal system of a child, ensuring an early prevention of posture disorders,

choice of an effi cient kind of sport, suitable footwear and further occupational orientation. Podom-

etry should become an obligatory diagnostic examination for those employees whose work is related

to sustained burden on feet.




APPLICATION OF TELEMEDICAL INFORMATIVELY-DIAGNOSTIC COMPLEX IN THE ESTIMATION OF THE STATE OF DISK OF VISUAL NERVE

Ilya Bakutkin, Vladimir Spirin, Valery BakutkinSaratov Research Institute of Rural Hygiene, Russia

Key words: diagnostic, visual nerve, monitoring, visual acuity

Was developed by the diagnostic complex to assess the condition of the optic nerve. The optic

disc images form a separate fi le that can be transmitted over the Internet and stored on any media.

Then the resulting image is loaded in a specialized program (you can automatically download im-

ages) that produces the kolorometry analysis and classifi es either a norm or pathological changes.

The main feature of the program is the ability to obtain not only objective data (digital image), but

subsequent analysis, which is the basis for attributing to either normal or pathological changes.

The fi nal conclusion is provided by a qualifi ed specialist. The main options for getting digital images

papilledema (vertical and horizontal image size, depth, color encoding, archiving, transfer, storage,

and analysis of images), has developed computer programs for analysis of images with a kolorometry

of topographic schema (spatial arrangement of color fi elds).

The study was conducted with healthy people of all ages: 10 persons of the age group 20-30

years; 10 persons of 30-40 years; 10 persons of 40-50 years; 10 persons 60-70 years; 10 persons

70-80 years old. The task at this phase of the research was to determine the age-related changes

in the disk of the optic nerve. The second group of 30 patients had primary open-angle stage 3

glaucoma. All patients had complete clinical examination (scanning of visual acuity, tonometry, per-

imetry, biomicroscopy, photographic recording of papilledema. Optic disc images in digital format

were developed by the program. The analysis was conducted for square images, and on the analysis

of the main color components (red, green, and blue). Set the rules for a group of healthy obsledumyh

persons. A drastic change in color characteristics of the optic nerve was observed in the group of

patients with stage 3 glaucoma. The main diff erence was the decline of the red component (up to

40% against the norm), the decline of the blue component (up to 20% of the norm). The green com-

ponent of the indicator had changed slightly. As a result, was proposed by diagnostic ratio of basic

color components, enables review of screening images of the optic nerve.

CONCLUSIONCreated by complex allows the optic disc image analysis in relation to the diagnosis of diseases

of the eye. This system can be used for both screening and image analysis in clinical practice to as-

sess the dynamics of the pathological process. Created by colorimetric model of optic disc in normal

and when major diseases involving changes in the optic nerve can be used for diagnostic purposes.

The program provides the ability to remotely survey large groups of patients and to determine the

need for an in-depth examination, hospitalization, monitoring the dynamics of papilledema. This

provides a new level of possibilities in remote diagnostics of early stages of glaucoma.




CONTINUING MEDICAL EDUCATION OF OCCUPATIONAL PHYSICIANS AS THE NEW MODEL OF POSTGRADUATE COURSES IN THE RUSSIAN FEDERATION

Zukhra Berkheeva, Nailya MazitovaDepartment of Hygiene and Occupational Medicine,

Kazan State Medical University, Russian Federation

Key words: continuing medical education, occupational physicians

The process of globalization aff ects diff erent aspects of life, including the activities of countries

on occupational medicine. Work on harmonization of approaches to occupational medicine with

international concepts and standards is actively carried out in the Russian Federation, especially

in the fi eld of postgraduate education. Providing of quality health care is impossible without profes-

sional training of health professionals at the postgraduate stage, occupational medicine including.

Continuing medical education (CME) is one of the most eff ective tools of high quality training at the

postgraduate level today. However, now in the Russian Federation the CME system is just beginning

to be established.

In the Russian Federation nowadays there are two ways to become an occupational physician.

The fi rst is the two-year traineeship in occupational medicine for those who would like to become

a high-qualifi ed specialist in occupational medicine. The second are postgraduate training cours-

es for qualifi ed physicians and general practitioners, who would like to certify as an occupational

physician.

After the course and successful passing of the exam, they are certifi ed as occupational physi-

cians and are allowed to work for the next fi ve years. This year the Department of Hygiene and Oc-

cupational Medicine of the Kazan State Medical University tested a new model – a distance learning

based on modular technology by integrating it into the traditional scheme of postgraduate. The new

Program is developed within the framework of continuing postgraduate education of occupational

physicians.

The fi st course was held in April 2012. The further stages of the development of the Program

includes: (1) the development of the system of CME credits in the fi eld of the occupational medicine,

(2) the application of CME credits system for confi rmation of qualifi cation level for occupational

physicians with work experience longer than 3 years, and, fi nally, (3) the realisation of the whole

Program, consisting of three units: (a) full-time education, (b) distance learning, (c) participation

in approved activities. Using of these technologies will help to improve the quality of postgraduate

education of occupational physicians in the Russian Federation.




OPTIMISATION OF TEMPERATURE CONTROL SYSTEM OF HABITATS AND BIOLOGICAL HUMAN ENVIRONMENTS

Tatyana Bogdanova, Vladimir Lobanov, Vladimir Spirin,

Alexander Bolshakov, Valery Bakutkin1

1 Saratov State Technical University, Gagarin Saratov State Medical

University, Saratov Research Institute of Rural Hygiene, Russia

Key words: temperature control, human environments, hygiene, profi lactic

Measuring the temperature of the environment and the human body is important. The often

used mercury thermometers for measuring the temperature have limitations as to the accuracy

and speed of measurements and they pose environmental risks. In the European Union the use of

mercury thermometers is prohibited by legislation. Digital thermometers have a wide range of data,

inertial.

The authors have developed a system of remote monitoring of human body temperature that

allows longer continuous automated monitoring of thermal parameters both in habitats and biologi-

cal objects. The device can also be used in medical institutions and at home to generate diagnostic

charts, as well as automated analysis and evaluation of changes in the body temperature and the

use of a single centralized server consolidation data for a group of patients. The system of remote

monitoring of human body temperature is a temperature control device, a data processing and dis-

play unit with wireless data transmission of standard Wi-Fi. What is new is the additional introduction

of Wi-Fi Router and server consolidation that provide wireless data exchange with data processing

and display.

The temperature control device of the body is a uniform measuring and transmitting module

containing a temperature sensor, a data processing and display unit which is connected to the

temperature measuring sensor fl exible conductor. In its turn, the data processing and display unit

contains a microprocessor module, a management module, a module for wireless data transmission

of standard Wi-Fi module, a display control panel. In addition, the data processing and display unit

includes the playback sound module which is connected with the microprocessor control module.

The measuring and transmitting module is a stand-alone, portable hardware device consisting of a

temperature measurement sensor unit of processing and information display. Temperature Sensor is

connected to the data processing and display fl exible conductor and allows you to measure the body

temperature in the armpit or the inner side of the forearm, and the data processing and display unit

is positioned on the outside of the forearm and attached to a special cuff .

The control panel contains the buttons “Start/Stop” and “Reset”, designed to accept from the

user manual control commands, respectively, enable or disable the device and reboot. The display

module, a color LCD display with anti-refl ection coating or plating, visually displays the measured

temperature. The remote monitoring system of temperature of the human body works as follows:

the portable measuring and transmitting module performs periodic measurement of the tempera-

ture of the human body based on the sensor measuring the temperature of not less than once in 10

minutes. The temperature measuring sensor is measuring the temperature of the human body, and



transmits the result in this module. Specialized software allows you to store the monitoring data in

the information database, perform retrospective analysis, to carry out operational analysis of tem-

perature curves, supports functions for registering and authenticating users in the system in accord-

ance with personal profi les. The system allows you to automatically carry out continuous monitoring

of the temperature without human intervention as the controlling entity conducts monitoring of the

body temperature in a Wi-Fi zone without restricting movement and location. Automatic control and

signals exceeding the permissible temperature thresholds.The proposed performance measuring

transmitter module allows simultaneous visual monitoring of the current status of the temperature

of the patient and the medical personnel. Seamless long fi nding the measuring transmitter module

on human body without limitation of motor functions and the need to hold the device.




NEGATIVE ASPECTS OF THE PROFESSIONAL QUALITY OF LIFE AMONG NURSES

Kristaps Circenis, Inga Millere, Liāna DeklavaFaculty of Nursing, Riga Stradiņš University, Latvia

Key words: nurse, professional quality of life, depression, anxiety

INTRODUCTIONProfessional quality of life for those providing care has been a topic of growing interest over the

past twenty fi ve years. The nursing profession is one of the most stressful occupations today, due to

the quantity and diversity of risk factors associated with the work environment. Professional quality

of life incorporates two aspects: the positive (Compassion Satisfaction) and the negative (Compas-

sion Fatigue). Nurses are at risk for developing negative symptoms associated with burnout, com-

passion fatigue, anxiety, depression and posttraumatic stress disorder. Due to compassion fatigue

and burnout, nurses` work may become less productive; employees are absent due to illness, as

well as the fl uctuation of staff increases.

OBJECTIVEThe aim of the present study was to explore negative aspects of the professional quality of life

among nurses.

METHODSDemographic questionnaire, Beck`s Depression Inventory, The State-Trait Anxiety Inventory,

The Professional Quality of Life Scale.

RESULTSThe participants of the study were 500 nurses from several hospitals and outpatient care insti-

tutions in Latvia. All participants were women, age range - from 22 to 68 years (M=42.72; SD=8.50).

All respondents fullfi lled Professional Quality of Life Scale, but 281 nurses were surveyed using three

research tools: Beck’s Depression Inventory, State-Trait Anxiety Inventory and Professional Quality

of Life Scale. The average mean for Professional Quality of Life Scale’s Compassion Satisfaction

subscale was 37.41 (SD=7.94), for Burnout subscale mean was 22.74 (SD=6.43), for Secondary

Traumatic Stress subscale mean was 19.37 (SD=6.58). The correlation analysis using Spearman’s

correlation coeffi cient was done to fi nd out relationship between negative aspects of professional

quality of life.

CONCLUSIONSThere are statistically signifi cant correlations among the selected nurses between the negative

psychosocial aspects of the professional quality of life, and statistically signifi cant diff erences be-

tween the psychosocial aspects of the professional quality of life for the selected nurses, depending

on age, work experience, professional work fi eld. The research will continue with collecting data

among nurses practicing in diff erent fi elds of health care that will help to develop a prevention

program and early recognition of compassion fatigue, burnout and related psychological disorders.




OCCUPATIONAL NOISE AND URBAN HABITATJānis Dundurs1, Miervaldis Lācis2

1 Riga Stradiņš University, Latvia2 Riga City Municipality, Latvia

Key words: noise mapping, noise reduction action plan

There are many manufacturing enterprises and service industry companies which emit noise in

urban areas. In some EU cities since the1980s some stationary noise monitoring stations have been

installed within few mobile noise monitoring units were moving across the city and measuring sound.

All these stations were linked to a central data logging center where the noise maps on empirical

algorithms were built comprising the long-term average noise levels with positioning information and

average weather data. By means of those strategic noise maps municipalities identifi ed the places

where immediate actions should be taken to protect the city inhabitants. Since the implementation

of Directive 2002/49/EC noise monitoring stations have remained in use for validation of noise

map measurements.

Solving noise complaints coming from dense urbanized territories, the authorities came to the

conclusion that some complaints can be solved by using short-term noise measurements. The Lat-

vian laws were harmonized with the respective EU Directive to provide the legislative background for

the local authorities to draw noise maps to be used as a basis for noise reduction action plans with

a view to be integrated into the land use plans indicating the places where the noise levels exceed

the allowed limit. Riga agglomeration strategic noise map was calculated using software “IMMI 6.3”

and has been completed, covering all noise indicators (Lden, Lday, Levening and Lnight), all kinds of

noise sources (industrial sites, railways, airports) and dwelling sites, where noise levels exceed the

allowed limits as well. The map shows Riga as a rather noisy city because industry, service compa-

nies and major roads, railway lines cross the city center. The Freeport of Riga with its access roads

also contribute to the total noise level. In Riga City one can fi nd few territories where the night noise

indicator Lnight meets the limit value fi xed in Latvia (Lnight=40 dB(A)).

The explanation lies not only in the reasons mentioned above, but in the implementation of the

strict limit values. Latvia and the Netherlands have the most strict night noise limit values in Europe.

The Directive also obliges the EU Member states to draw noise reduction action plans. In Latvia it

refers to Riga and Daugavpils. Regretfully, the Riga City Noise Reduction Action Plan is still under

consideration and in the process of development because there are involved the interests of too

many third parties.




DEVELOPMENT OF LATVIAN SOCIETY OF OCCUPATIONAL PHYSICIANS AND ITS INFLUENCE ON OCCPATIONAL SAFETY AND HEALTH SYSTEM IN LATVIA

Maija Eglite1, Ivars Vanadzins 2, Ilze Feldberga2, Inese Usacka3

1 Department of Occupational and Environmental Medicine,

Riga Stradiņš University2 Institute of Occupational Safety and Environmental Health,

Riga Stradiņš,University3 State Labour Inspectorate

Key words: occupational health physicians, occupational morbidity

INTRODUCTIONThe Latvian Society of Occupational Physicians was founded in 1994. The study aims at assess-

ing the development of the Society and its impact on diff erent areas of occupational health.

MATERIALS AND METHODSData from the Registry of Occupational Physicians and the State Registry of Occupational Diseases

run by the Centre of Occupational and Radiation Medicine of Pauls Stradiņš Clinical University Hospital.

Statistical data on the mandatory health checks from the State Labour Inspectorate were analysed.

RESULTSData from the Registry of Latvian Occupational Physicians reveal that the number of occupational

physicians has grown from 35 physicians in 1994 to 430 in 2012. The membersship in 18 years has

increased 12.7 times. At present there are two ways to be certifi ed as occupational physician: through

residency – 4 years or through updating course for physicians already working – 500 hours (1 year). Re-

certifi cation is required after 5 years. Occupational medicine in Latvia is a speciality in its own right. This

is a reason why the speciality is popular as “the other” training for many physicians. Analysis of the infl u-

ence on the development of occupational health and safety system shows that physicians have taken part

in the legislative development and improvement of the occupational health and safety system, improved

quality of mandatory health and diagnostics of occupational diseases. This has resulted in the decreased

number of companies not providing health examinations – in the years 2005 and 2006 health checks

were not provided by about 50% of the companies as compared to about 15% of the companies during

the last three years. The number of fi rstly diagnosed occupational diseases and patients has gradually in-

creased from 1995 until 2009, exhibiting a small decline from 2011. The total number of fi rstly diagnosed

and registered occupational patients per 100 000 employees has risen from 11.2 in 1995 to 138.6 – in

2009. The increase in occupational morbidity is also related to the increasing number of occupational

physicians. The decrease of occupational morbidity in 2006 and 2007 could be explained by the political

decision to give examination rights to general practitioners, abolished after two years.

CONCLUSIONSOccupational physicians have made an important contribution to the development of the occu-

pational safety and health system in the country. The results of the study could provide background

information for policy makers in the area of occupational health and safety.




OHS — TRAINING AND EDUCATION OF PROFESSIONALSMelánia Feszterová1, Tomá Kozík2, Ivana Tureková2

1 Department of Chemistry, Faculty of Natural Sciences,

Constantine the Philosopher University in Nitra, Slovakia2 Department of Technology and Information Technologies, Faculty of

Education, Constantine the Philosopher University in Nitra, Slovakia

Key words: Occupational Health and Safety (OHS),

Exposure Scenario (ES), education, training

Education at universities is the most important and best way for young people to promote their

personal and professional growth. The main aim of state policy of Occupational Health and Safety

(OHS) is to develop an eff ective system of education in work safety. OHS is a very actual topic from

the point of view of dangers and risks in the workplace, in the working environment when employ-

ing graduates after their practice. Therefore, the OHS programme for BA students at Constantine

the Philosopher University in Nitra provides systematic education on the possible risks of accidents

and principles of safety at work. Training and education about OHS present a very important area

in training of professionals and employees. The basic skills, the principles of safety at work that

students are familiarized with during their studies are necessary for their future orientation and

practice.

Our article focuses on the risks to be faced by the graduates of OHS in their practice. An ex-

ample of creating an exposure scenario and its role in education process is given. Education with

orientation on practice must also include risk management measures and operational conditions in

which the risk due to the use of substances will be controlled. Creating an exposure scenario (ES)

involves some problems, described in this article. Creating of ES is an interactive process, which is

part of the chemical safety assessment (CSA). ES is a set of conditions describing the substance as

manufactured or used during its life cycle and the way the manufacturer, importer or downstream

user control or recommend controlling the exposure to humans or the environment. Man is and will

always be the main factor when introducing new technologies. The recent knowledge and experi-

ence reveal the obvious interest of the young generation in education about safety at work. The study

programe Occupational Health and Safety (OHS) allows to use nonstandard approaches, promotes

independence, activity and creativity.

ACKNOWLEDGEMENT: This work has been supported by project KEGA No. 041UKF-4/2011

entitled “Implementation of modern trends of OHS education in lifelong learning.”




PSYCHOSOCIAL RISK FACTORS IN HOSPITAL NURSES WORKING LIFE

Tiina Freimann1,2, Eda Merisalu2

1 Tartu University Hospital, Estonia2 Department of Public Health, Medical Faculty, University of Tartu, Estonia

Key words: psychosocial risk factors, nurses working life

INTRODUCTIONEstonian nurses face a diffi cult situation. The rapid changes in health care over the past 20

years have signifi cantly changed the working life in hospitals.

Aim. The purpose of this study was to describe psychosocial risk factors of hospital working life

in the nursing profession.

MATERIALS AND METHODSA cross-sectional survey was carried out among the registered nurses in the Tartu University

Hospital. The electronic questionnaire was sent to all 906 full staff nurses working in this hospital.

In total, 409 (45%) questionnaires were completed and returned to the researchers. We used the

long version of the Copenhagen Psychosocial Questionnaire II (COPSOQ II) (Kristensen et al 2005),

which is composed of 128 items, grouped into 41 dimensions (scales). All items of the psychosocial

environment dimensions were scored 0-100 points (fi ve response options 0,25,50,75,100 and four

response options 0, 33.3, 66.7, 100). The total score on a scale was the average of the scores of

the individual items. Descriptive statistics was used to describe the psychosocial aspects of nurses

working life and the results were presented as statistical averages and standard deviations.

RESULTSA total 404 questionnaires were used in the analysis. The average age of the study group was

40.2 years (SD 10.8) and most of the respondents were women (98.3%). The largest group of sub-

jects (56.4%) had service length >10 years and one-fi fth of the nurses studied worked as nursing

managers. High average scores in a 100 point scale were detected on the positive work characteris-

tics as meaning of work, role clarity, social relationships at work and mutual trust between employ-

ees. High average scores were measured also on the negative work characteristics as work-family

confl ict, work pace, emotional and cognitive demands. Among health outcome indicators relatively

high average values of burnout and stress have been revealed.

CONCLUSIONSMore attention should be paid to the psychosocial risk factors at work, as work-family confl ict,

work pace, emotional and cognitive job demands, because these factors might threaten health and

wellbeing of nurses.




DEFINITION OF ZONE OF THERMAL COMFORT IN MINESAlexandr F. GalkinDepartment of Safety at Work, Mining University, St.Petersburg, Russia

Key words: health, thermal comfort, mine, mathematical model

Experience with exploitation of mines in the North has revealed that most cases of professional

diseases are caused by unfavorable climatic conditions in mine workings.

The aim of the research was to determine the parameters of microclimate in mine workings

which comply with the zone of thermal comfort and do not cause catarrhal diseases in workers.

A system analysis of domestic and foreign experience of rationing of microclimate conditions has

been done. The mathematical model of interaction of worker with the environment was developed.

The results of mathematical modeling allowed determination of optimal combination of microclimate

parameters for various types of conditions and works in mines. Creation of comfortable conditions

in mines not only allows decrease of demands on the system of thermal regulation of workers but

also increase of effi ciency of production both because of reduction of catarrhal diseases occurrence

and decrease of total energy expenditure of a worker. For quantitative assessment of this assertion,

a method for assessing the applied measures on normalization of microclimate in mines has been

developed. The method is based on comparison of energy expenditure on doing work of the same

type at diff erent air temperatures.

The data of calculations show that amount of time of rest needed for complete recovery of

strength of a worker when temperature decreases is rapidly increasing, and, consequently, the work-

ing effi ciency decreases. Comparison of results of theoretical calculations with results of practical

experiments of other scientists proves that the method is reliable. In total, the developed method al-

lows: a) to determine compliance of existing microclimate parameters with those of thermal comfort

zone; b) determine optimal combination of speed and temperature of air for various types of works

in mines; c) to choose overall sets, which will provide minimal tension of worker’s thermoregulation

system during working activities and time of rest; d) to choose optimal temperature for the time

of rest, which will prevent undercooling of organism; e) determine extent of working effi ciency de-

crease of workers during the work in adverse climatic conditions; f) determine the limit permissible

air temperature by a hygienic factor.




RISK ASSESSMENT OF PERSISTENT ORGANIC POLLUTANTS ON HUMAN HEALTH IN INDOOR ENVIRONMENTS

Alexandr Gankine, Tatiana Gritsenko, Tatiana NaumenkoRepublican Scientifi c and Practical Centre of Hygiene, Minsk, Belarus

Key words: persistent organic pollutants, fl ame retardants, risk assessment

At the international level the turnover of POPs is regulated by a number of international instru-

ments, including the Stockholm Convention on Persistent Organic Pollutants (Stockholm, 2001). Be-

larus acceded to the Stockholm Convention in 2003. In 2011, when adopting the National Plan,the

Republic of Belarus undertook commitments to the Stockholm Convention, 2011-2015. In 2009,

the Stockholm Convention included nine additional chemicals. The following are of special inter-

est: polybrominated fl ame retardants and polybrominated diphenyl ethers - a group of cemicals for

preventing the spread of fi re. The main sources of fl ame retardants are fl exible polyurethane foams,

textiles, plastic surfaces (PC devices), televisions, electronic circuit boards, high-impact polystyrene,

insulated winding cables, wires, textile coatings, so the person is exposed to polybrominated fl ame

retardants in indoor air.

In 2005, in the Republic of Belarus the International POPs Elimination Project conducted a

pilot study, the results of which was the discovery of polybrominated fl ame retardants in dust sam-

ples from residential apartments, offi ce space and a computer club (IPEN, April 2006). However,

at present, there are no hygienic standards (maximum permissible concentrations or occupational

exposure) and methods of identifying new POPs - polybrominated fl ame retardants in the environ-

ment in Belarus.

In light of this, we have developed the project “Developing a scientifi c basis for the control of

persistent organic pollutants (polybrominated compounds) in the air to assess and minimize the risk

of their impact on human health” within the scientifi c and technical program “Modern living condi-

tions and health preservation”, setting the following tasks: a) to develop a method for determination

of polybrominated compounds in ambient air; b) to develop an algorithm for estimating indoor air

pollution with polybrominated compounds in residential and public buildings; c) to conduct research

and provide hygienic assessment of indoor air pollution with polybrominated compounds in homes

and public buildings.




ERGONOMIC CULTURE AS A COMPONENT OF WORKING SAFETY IN THE CONTEXT OF GENERAL ORGANIZATIONAL CULTURE

Janis GedrovicsDepartment of Informatics and Science, Riga Teacher Training

and Educational Management Academy, Latvia

Key words: ergonomic culture, safety, general organizational culture

INTRODUCTIONDuring the last two decades much attention has been paid to the working safety and educating

workers regarding safety demands in order to improve their quality of living. Those regulations and

demands are frequently regarded as an integral part of working culture, which in turn is considered

inseparable from general organizational culture and ergonomic culture as a component in it.

AIMTo defi ne the role of ergonomic culture in the context of safety culture within the concept

of general organisational culture, and to describe the ergonomic culture among various groups of

computer users in Latvia.

MATERIALS AND METHODSAnalysis of literature and a poll among computer users (students, teachers and offi ce workers) has

been used. The questionnaires were later processed by means of statistics software package SPSS 20.

RESULTSThe notion of working culture is defi ned as a set of methods, guidelines, patterns and behaviour

standards for certain groups of workers observed by them while at work. Any individual’s demand

and need is safety, and the related safety culture should be regarded as the product of individual and

group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the

commitment to, and the style and profi ciency of, an organisation’s health and safety management.

The arrangement of any working area, including the one with a computer, is determined by general

ergonomic demands, therefore we have to view the ergonomic culture of workers as their culture

of computer use, and their attitude to those demands. A considerable group of computer users

have not attended the mandatory working safety trainings. The compulsory breaks are taken only

by slightly more than a quarter of all respondents. Numerous respondents regularly work on their

computers for over 4 hours per day thus posing considerably greater risks to their health. Very rarely

computer users take the exercises recommended to ensure healthy computer use.

CONCLUSIONSErgonomic culture exists as a component of general safety culture related to ergonomic work-

ing environment and workers’ attitudes towards ergonomically safe computer use, defi ned by work

safety regulations. Both those aspects are signifi cant factors within working safety culture as an

important component of general organizational culture. However, computer users in Latvia demon-

strate overall poor ergonomic culture which means that their working safety culture is also poor.




AMBIENT DESCRIPTION OF SOFTWARE USABILITYSabine GrinbergaDepartment of Occupational and Environmental

Medicine, Riga Stradiņš University, Latvia

Key words: software, ergonomics, usability, ISO, usability attributes

INTRODUCTIONUsability is a key concept of human-computer interface and is concerned with making com-

puter systems easy to learn and easy to use through a user-centered design process (Preece et al.,

1994). Poorly designed software can be extremely annoying to users. Smith and Mayes state that

„usability is now recognised as a vital determining factor in the success of any new computer system

or computer-based service” (Smith & Mayes, 1996).

AIMTo determine the usability concepts and the main attributes of usability.

MATERIALS AND METHODA literature review.

RESULTSUsability is central to ergonomics that tries to fi t offi ce technology to the needs of workers (and

not the other way round). Ergonomics has become of great concern to many international organiza-

tions, including the International Organization for Standards (ISO) (Nielsen, 1993). As early as 1991,

ISO recognized the need for ergonomic regulation of computers that were increasingly becoming a

part of offi ce equipment. In the directive of the same year entitled “Ergonomic requirements for of-

fi ce work with visual display terminals” ISO issued guidelines for human computer interactions (ISO,

1991). ISO identifi ed usability as the central concern of ergonomics and defi ned it as follows: “the

extent to which a product can be used by specifi ed users to achieve specifi ed goals with eff ective-

ness, effi ciency and satisfaction in a specifi ed context of use,” and the organization has expanded

upon this defi nition in subsequent directives (ISO 9241-11, 1998) (Jirgensons, 2012). Usability can

be specifi ed and tested by means of a set of the operational dimensions or attributes. Usability at-

tributes reviewed in the literature for software include: a) ease of learning (Guillemette, 1995; Lind-

garrd, 1994; Nielsen, 1990; Reed, 1992; Shackel, 1991); b) ease of use (Guillemette, 1995; Nielsen,

1990); c) easy to remember (Nielsen, 1990); c) performance eff ectiveness (Lindgaard, 1994; Reed,

1992; Shackel, 1991); d) few errors and system integrity (Guillemette, 1995; Nielsen, 1990; Reed,

1992); e) fl exibility (Guillemette, 1995; Lindgaard, 1994; Shackel, 1991), and f) user satisfaction

(Nielsen, 1993, Reed, 1992; Shackel, 1991).

CONCLUSIONSUsability concepts have been in the focus of attention for years and in the course of develop-

ment researchers have defi ned it diff erently. Diff erent attributes have been built for a clear view of

usability and its aspects.




IMPROVING WELL-BEING AT WORK WITH THE PARTICIPATORY METAL AGE METHOD

Essi GustafssonArcada University of Applied Sciences, Helsinki, Finland

Key words: participatory intervention, the Metal Age method, well-

being at work, implementation process, organizational development

When improving well-being at work with the participatory Metal Age method, health promot-

ing interventions, like the Metal Age method, aff ect employees’ health, competences and attitudes

towards work and organizational learning through enhancing the fl ow of information inside the or-

ganization. In addition to prioritizing of development areas employee participation is one of the main

factors in the solution based Metal Age method that focuses on issues currently on the table and

tries to fi nd practical custom tailed solutions to these development areas.

To understand the results of a participatory intervention like the Metal Age method that aims

at enhancing productivity and profi tability in the organization, attention should be paid to the imple-

mentation process.

Therefore the aim is to present the Metal Age method and some factors aff ecting implementa-

tion success based on earlier research and the WASI projects’ preliminary results gathered with a

feedback questionnaire with both fi xed and open answers (N=59) and 15 interviews with partici-

pants from one organization. Some of these factors imply participation of the whole work unit (both

leaders and employees) and the leaders’ visible support of the intervention. Without the leader

support the participants seem to be worried that they do not have the power to accomplish the

planned practical solutions. Furthermore, it would be important to consider earlier (failed) interven-

tions, power relations in the participating group and adjusting the program to the requirements of

the participating group.

In conclusion every participatory intervention is unique therefore attention should be paid to

the unique social context where the Metal Age method is implemented.




OCCUPATIONAL HEALTH AND SAFETY IN RUSSIA: TODAY AND THE FUTURE

Nikolay Izmerov, Igor Bukhtiyarov, Ludmila Prokopenko,

Nina RubtsovaResearch Institute of Occupational Health, Russian Academy

of Medical Sciences, Moscow, Russian Federation

Key words: occupational health, workers health and safety, workplace

National health depends on the quality of workforce that is the basis of any economic model

of any state. Development of innovative economy in Russia has led to serious challenges related

to progressing insuffi ciency of labour resource, the latter being one of the main strategic risks and

threats to national safety for a long-term perspective in the fi eld of economic growth (“Strategy of

National Safety in the RF till 2020” approved by the President of the Russian Federation, Decree

No 537, 2009). Among other tasks posed to be fulfi lled concerning public health the national de-

mographic policy concept for the period till 2020 specifi es “reduction of mortality rates primarily of

the working-age population”. Along with the other tasks it includes reduction of mortality rates, oc-

cupational injuries and pathologies due to the following: a) in the sphere of safety at work to develop

the system of occupational risk control and management (including workers’ awareness of relevant

occupational risks, development of a system of identifi cation, risk assessment, management and

control); b) economic motivation of the employer to improve the working conditions.

In October 2010 the Federal law ratifi ed the ILO Convention Promotional Framework for Oc-

cupational Safety at Work and Occupational Hygiene (No 187), this year the ratifi cation of ILO Con-

vention 161 is in process. This fully conforms to the WHO Global Plan of Action on Workers’ Health

adopted in May 2007 with recommendations to develop in member-states national health programs

and national occupational health systems. The National Program of Action to improve working con-

ditions and safety at work in the period 2011-2015 off ers incremental reduction of hazardous and

harmful to health workplaces and introduction of healthy lifestyle programs for workers. Russia

regards the development of a new national system of occupational risk management as a tool to

prevent injuries and promote workers’ health at Russian enterprises. To solve the problems suc-

cessfully the Federal Program “Workers’ Health of Russia” as well as the National Model of Occu-

pational Health System are developed and improved. The Federal Research Center “Workers Health

and Safety” will provide successful coordination and integration of scientifi c, legislative, practical,

economic, educational, informational activities in Russia in the area of workers’ health ensuring

decrease of occupational risks, lowering the rate of occupational and work related diseases as well

as improving the occupational health system.




SITUATION ANALYSIS OF EXISTING OCCUPATIONAL HEALTH AND SAFETY SERVICE SYSTEMS IN NDPHS COUNTRIES

Remigijus Jankauskas, Raimonda Eičinaitė-Lingienė,

Jolita KartunavičiūtėInstitute of Hygiene, Lithuania

Key words: occupational health services, risk assessment

INTRODUCTIONWhen drafting national occupational health strategies, the countries of the so-called Northern

Dimension Partnership in Public Health and Social Well-being (NDPHS) must accept challenges im-

posed on them by the WHO Global Plan of Action on Workers’ Health 2008–2017 including the re-

quirement to set up a network of occupational health services (OHS). To assess the current situation

there was a need to make a comparative analysis of the existing policy documents, infrastructures

and human resources in OHS in the NDPHS countries.

AIMThe aim of the survey was to analyse the practical set-up of OHS, describing their structure,

content and professionals engaged in the selected NDPHS countries by using descriptive – com-

parative analysis.

METHODOLOGYThe survey was based on a questionnaire elaborated at the Institute of Hygiene in Lithuania,

and all the NDPHS countries were requested to reply to it. The questionnaire (Model-I) was prepared

after the analysis of the international and national OS&H legislation, the OHS services establishment

policy and the main functions of OHS specialists. The survey started in June 2011 and the feedback

reports from the countries (Model-II) were collected at the end of 2011 from the following respond-

ents: Estonia, Finland, Germany, Latvia, Lithuania, Norway, Poland and the Russian Federation.

RESULTSIt was of utmost importance to gather information from the countries, although it was clear that

not much comparative analysis can be done because the OHS structures in the countries are so

diff erent and based on the historical and cultural diff erences. In the NDPHS countries OHS provided

the main activities, listed in the ILO Convention 161 on Occupational Health Services, such as iden-

tifi cation and assessment of the risks from health hazards in the workplace, surveillance of workers’

health in relation to work, organisation of the fi rst aid, participation in analysis of occupational acci-

dents and occupational diseases, etc.. Taking into account the international standards (BOHS, Occu-

pational Medicine in Europe: Scope and Competencies; The Role of the Occupational Health Nurse

in Workplace Health Management), the team of OHS should be multidisciplinary. The results showed

that monodisciplinary team is still dominant in such NDPHS countries as Lithuania, Latvia, Estonia,

Russia and Germany where the occupational health physician is seen as the main OHS specialist.

The study was carried out at the Institute of Hygiene, with the fi nancial support of NDPHS.




OCCUPATIONAL HEALTH SERVICES IN ESTONIA — QUO VADIS?

Mari Järvelaid Health Board, Estonia

Key words: occupational health, public health, life

expectancy, healthy life years, working population

INTRODUCTIONThe target of health system is to help their clients to live longer lives and more healthy life years.

It can be achieved in partnership between diff erent levels of health care. In Estonia, there are seen

positive developments: the life expectancy has risen more rapidly than the average in the EU, the

national health care system has been estimated as the most cost-eff ective by the Health Consumer

Powerhouse´s survey Euro Health Consumer Index 2012. The number of cases of occupational

diseases is in decline, as only 87 cases were diagnosed in 2011.

AIMTo describe the occupational health characteristics among the working population.

MATERIALS AND METHODThe internet was the data source: the webpages of the Ministry of Social Aff airs (www.sm.ee),

the Statistics Estonia (www.stat.ee), the Health Board (www.terviseamet.ee), the Social Insurence

Board (www.ensib.ee) and the National Institute for Health Development (www.tai.ee).

RESULTSThe poll conducted within the framework of Estonian Labour Force Study 2011 showed that

less than two per cent of 50 to 54 year old workers had very good health and 49.5% considered their

health as good; only one per cent of 60 to 64 year olds considered their health very good and 29%

good, so that it can be said that most working population at the age of 50 and older has health prob-

lems. It manifests in the drastically increased number of people with primary permanent incapacity

for work that has almost doubled since 2001 and makes nearly 9.5% of the population in 2011. The

number of healthy life years has shown decline since 2010. In Estonia, the average life expectancy

is 68.3 years for men and 79.2 years for women, and the expected healthy lived life is 54.1 years

for men and 58.1 years for women; ibidem the average life expectancy in the European Union has

risen to more than 81 years.

CONCLUSIONSIf there is a wish to improve the health and quality of health of the working population, a na-

tional occupational health and safety policy should be a part of an overall national socio-economic

development policy as it was proposed by the fi nal report of the legal analysis for amendment of the

Occupational Health and Safety Act in Estonia, available for public on the webpage of the Ministry

of Social Aff airs.




FORMAL SAFETY VERSUS REAL SAFETY: QUANTITATIVE AND QUALITATIVE APPROACHES TO SAFETY CULTURE – EVIDENCE FROM ESTONIA

Marina Järvis1, Charles Woolfson2, Piia Tint3

1 Department of Business Administration, Tallinn University of Technology, Estonia2 Institute for Research on Migration, Ethnicity and

Society, Linköping University, Sweden3 Department of Business Administration, Chair of Labour Environment

and Safety, Tallinn University of Technology, Estonia

Key words: safety culture, occupational health and safety, organizational values

INTRODUCTIONIn today’s competitive business environment organizations face a challenge to create and pre-

serve a self-sustained safety culture. From an academic perspective, safety culture is seen to be a

construct that describes the values, norms, attitudes and beliefs that are held collectively concern-

ing safety within an organization.

AIMThe article is to provide an analytical overview of the existing Estonian organisational safety cul-

ture, to analyse how safety exists as an organizational value and to explore the diff erences between

formal safety and real safety.

METHODSThe national questionnaire survey was carried out by Statistics Estonia in 2009. Two questionnaires

measuring safety attitudes, perceptions, values, confl icts and relationships, information dissemination,

team work and communication, job satisfaction, responsibility and commitment, risk awareness and

working conditions were administrated anonymously to employees and employers from small and medi-

um-size enterprises from diff erent branches of industry. In total 463 Estonian SMEs and 1757 employees

fi lled in the questionnaires and participated in the study. In addition, the results of qualitative studies

by Järvis & Tint (2008-2009) were also used in order to complement and verify the results. Qualitative

methods included a case study at 8 Estonian medium-sized manufacturing enterprises; personal semi-

structured safety culture interviews with 8 senior managers and focus group interviews with 22 workers.

RESULTS AND CONCLUSIONThe results reveal key issues in safety culture assessment. The statistical analysis of the safety

culture questionnaires shows many organizations with an outstanding safety culture and positive

safety attitudes. However, the qualitative data indicate some important safety weaknesses and as-

pects that should be included in the process of evaluation of safety culture in an organization. The

contrast between the quantitative data and the qualitative data shows how quantitative data by itself,

even in the best conditions of sincerity and commitment, can conceal important risks and depict

a superfi cial view of organizational safety culture. The main problems related to the fi eld of OH&S

described from diff ering perspectives and some recommendations for eff ective operational practice

for safety management system is off ered based on the empirical outcomes of the research.




PROCESS MANAGEMENT IMPROVEMENT WITH ERGONOMICS SOLUTIONS

Henrijs Kalkis1, Valdis Kalkis2, Zenija Roja2

1 Faculty of Economics and Management, University of Latvia2 Latvian Ergonomics Society, Ergonomics Research Centre,

University of Latvia

Key words: process, management, ergonomics, improvement

INTRODUCTIONThe world experience shows that human factor or ergonomics is of great importance in process

management and productivity growth. It is a new approach to entrepreneurship, where ergonomic

aspects and values are taken into account in business strategy, including ensuring of process man-

agement and profi tability of enterprises. Organizations need a paradigm shift to achieve eff ective-

ness, and micro- and macroergonomics integration in process management is an essential activity.

The small and medium sized woodworking organizations were chosen for the research.

OBJECTIVESThe aim of the research was to study how ergonomics can improve process management,

based on examples from woodworking organizations.

METHODSThe following methods were applied: interviews and checklists, process management methods,

including logical analysis of process and technological faults; methods of ergonomic analysis, includ-

ing calculations of economic eff ectiveness of implementation of ergonomic solutions; and fi nancial

aspects of process quality improvements with ergonomics interventions were calculated.

RESULTS AND DISCUSSIONIn the studied enterprises of the woodworking branch the human factor in process management

does not receive proper attention: the employees are not involved in strategic planning and in pro-

cess improvement programmes, the employees do not know work quality criteria, fi nancial indices

of the organisation. The analysed ergonomics interventions in process quality improvement were as

follows: purchase of automatic lifting machines in packaging process, new machinery tools for sort-

ing and assembling the furniture parts. Participatory ergonomics interventions involved job rotation,

staff training, involvement in decision making about necessary improvements in the work process.

CONCLUSIONSThe objective process management and ergonomics analysis proved that ergonomics risks

have a negative impact on process management systems, but ergonomics integration in process

management enhance the competitiveness of businesses and resources, including human wellbe-

ing. This research has been supported by the European Social Fund within the project “Support for

Doctoral Studies at the University of Latvia”.




PRACTICAL EVALUATION OF MUSCLE FATIGUE USING MYOTONOMETRIC METHOD

Valdis Kalkis1, Zenija Roja1, Henrijs Kalkis1, Inesa Remeza2, Artis Ruiss1

1 Latvian Ergonomics Society, Ergonomics Research Centre, University of Latvia2 Dziedniecība SIA

Key words: muscle, fatigue, myotonometric, workload

INTRODUCTIONAccording to statistical data, in Latvia health problems caused by ergonomic risks at work are grow-

ing, including work related muscular skeletal disorders (WRMSD) (www.vdi.gov.lv, 2012). Almost 30% of

employees in Latvia report about physical work load increase (Fit for work, 2012). Excessive work load

can result in health problems and worsen the health in general. In Latvia there is lack of researches of

objective evaluations of the workload, especially investigations in the fi eld of muscle fatigue analysis.

OBJECTIVESThe aim of the research was to prove myotonometric method application as eff ective objective

assessment method for muscle fatigue in relation to workload. The research is focused on the data

analysis and practical experience of muscle fatigue evaluation.

METHODSThe questionnaire should be used to assess musculoskeletal problems and determine the mus-

cles groups with intensifi ed discomfort after work. Assessment of the functional state of skeletal

muscles and muscle fatigue can be carried out by using myotonometric measurements with the

MYOTON-3 device created in Estonia, the University of Tartu (Vain, 1995).

RESULTS AND DISCUSSIONThe questionnaire data were gathered in various sectors of Latvian economy. According to the

survey data, employees complain frequently about feeling discomfort after work in the neck, shoulders,

arms and legs. Employees subjectively pointed out hard work conditions, and most of them (63%) noted

that they felt very tired after the work shift. The analyzed work conditions involved load lifting, moving,

handling, repetitive movements. Hence the device MYOTON-3 was chosen for the measurements to

determine muscles tone. The measurements were carried out with relaxed muscles before and after

the work cycle (mainly one workweek). Myotonometry testing of the following muscles was performed

in a relaxed state: m. gastrocnemius; m. tibilais anterior; m. trapezius; m. extensor digitorum; m. fl exor

carpi radialis. The procedure of muscles testing was performed in a sitting position; the muscles length

was middle; for all measurements the subject took the same position.

CONCLUSIONSBy using the myotonometric method results it is possible to determine a change in muscle tonus

during a work cycle, the ability to adapt to the work rhythm and work load, as well as the onset of

muscle fatigue. Myotonometric measurements are suitable for objective determination of the fatigue

of various muscle groups.




LABOUR PROTECTION REGULATIONS IN LATVIAUldis KarlsonsFaculty of Forest, Latvia University of Agriculture, Jelgava, Latvia

Key words: Labour Protection Law, Council Directive

89/391/EEC, State Labour Inspectorate

INTRODUCTIONFollowing Latvia’s accession to the European Union all national regulations in Latvia have been

worked out, having regard to the existing EU directives. In respect of labour protection area the

country has adopted Labour Protection Law (LPL) that is based on the Council Directive 89/391/

EEC of 12 June 1989.

AIMTo identify the system problems and solutions.

METHODSTheoretical analysis of literature.

RESULTSA variety of measures have been taken in Latvia, establishing such labour protection rules

when the employer is responsible for training in labour protection, for determining and controlling

occupational health, and for ensuring safe working environment to workers, while the government is

responsible for establishing the relevant regulations, and for the supervision of the employers. Eff ec-

tive or faulty operation of the system is proven by the statistics concerning accidents at work and

the seriousness of consequences, arising out of such accidents. Latvia shows the highest number

of accidents at work of all EU Member States. Is there any rationale for such numbers? Perhaps,

it relates to the existing culture and compliance with the relevant labour protection regulations as

demonstrated by the party that is most frequently involved in such accidents, namely, by workers. In

Latvia the employer and the activities carried out by the employer in the fi eld of labour protection is

governed and supervised by the VDI that, subject to need, is eligible to apply the sanctions specifi ed

in the Latvian Administrative Violations Code. The situation with workers is diff erent, as it is only the

employer that controls the workers compliance with the stated labour protection requirements and

that, if need be, is entitled to punish them as prescribed in the LPL - in accordance with the law, to

apply disciplinary sanctions to employees. However, there is no detailed mention in the LPL as to

what is considered a disciplinary sanction. Council Directive imposes another obligation – Article 4.

1. Member States shall take the necessary steps to ensure that employers, workers and workers’

representatives are subject to the legal provisions necessary for the implementation of this Direc-

tive. This means that there has to be an institution that would supervise workers for and on behalf

of the government.

Conclusion. An effi cient means of achieving this goal would be through deploying health insur-

ance system and State Social Insurance Agency (VSAA) that would determine the compensation

amounts payable to the injured worker appropriate to the level of co-participation by the said injured

worker in the accident and in advancing the seriousness of consequences.




PSYCHOLOGICAL RISKS IN PROFESSIONAL ACTIVITY OF SHIFT WORK IN THE FAR NORTH

Yana Korneeva1, Natalia Simonova2, Galina Degteva1

1 Arctic Institute of Medicine, Northern State Medical University,

Arkhangelsk, Russia 2 Department of Psychology, Northern (Arctic) Federal University,

Arkhangelsk, Russia

Key words: psychological risks, shift work

In the Far North and the Arctic mineral production is carried out mainly in shifts. The work

demands involvement of functional reserves and adaptation of the body systems. According to the

research of O.Garanina, N.Davydova, N.Simonova, A.Kharitonov, and others, in shift work there

increases the psycho-emotional stress, emotional burnout, the level of confl ict, aggression, and

develop a sense of social isolation, withdrawal, and social desynchronosis. The emergence of these

adverse functional states and personality traits leads to a decrease in productivity, effi ciency and

reduces the level of mental health of shift workers. Currently, there has developed a whole direction

that studies physiological, psychosocial, psychological, social and psychological aspects of working

in shifts: identifi cation of professionally important qualities for shift workers, analysis of occupation-

al groups, etc. It is aimed at foreseeing the performance of shift workers, the likelihood of negative

psychological states and qualities. This goal can be achieved by applying a risk-based approach that

is widely used in medicine, and economics. Psychological risk in the profession implies the probabil-

ity of professional destruction and the formation of functional states of adverse personnel actions

while performing job functions due to prolonged exposure to domestic and social factors. Among

the adverse functional states occurring in a workers shift are fatigue, monotony, tension, and various

forms of psychological stress and conditions from exposure to extreme factors of physical nature. To

avoid negative psychological formations in shift workers and professional destruction there is sug-

gested changing of the pattern of activity and cooperation with other actors (E. Zeer, 2005).




FROM EARLY SIGNS OF HARM TO PREVENTION OF OCCUPATIONAL HEALTH PROBLEMS BY USING LEADING INDICATORS

Kari KurppaFinnish Institute of Occupational Health, Helsinki, Finland

Key words: prevention, leading indicator

The indicators of occupational health are either outcome indicators that measure health end-

points of complex causative chains (occupational diseases) or proactive indicators that refl ect

potential risks at work sites and the performance of preventive systems. Considering health, the

outcome indicators are lagging indicators (outcome has already materialized), and the proactive

indicators are leading indicators (potential loss of health in future). Until now, occupational health

performance evaluation has traditionally made use mainly of the statistics of occupational diseases

and injuries (i.e. lagging indicators), particularly in formal reporting. Yet, all work-related health out-

comes (lagging indicators) have their roots in the working conditions and arrangements and in the

performance of the established preventive systems, i.e. in the setting that is monitored by leading

indicators. The proactive leading indicators are the following: indicators of working conditions (expo-

sure, loading, working hours) and process indicators of preventive systems (objectives, responsibili-

ties, evaluation). The quality aspects of management systems of occupational health, i.e. leading

indicators, are important drivers for outcomes (lagging indicators). Good preventive systems are well

managed because of having clear objectives, defi ned accountabilities, and evaluation procedures.

Such characteristics can be easily monitored by using check-lists and simple qualitative indicators.

The outcome indicators of occupational health will show the desired results if the risks are prevented

or minimized by technical means, employment of safe practices, and early corrections of detected

problems. The quality of preventive measures is often best monitored by a selection of straightfor-

ward qualitative process indicators.




IMPACT OF WORK ORGANIZATION FACTORS ON SICKNESS ABSENCE AND PRESENTEEISM OF EMPLOYEES

Svetlana Lakisa, Inese MartinsoneLaboratory of Hygiene and Occupational Diseases,

Riga Stradiņš University, Latvia

Key words: sickness absence, job satissfaction, salary, presenteeism

Recent scientifi c discoveries prove that organization of work has an impact on the health and

social well-being of employees and also could cause mental disorders. The result of those factors is

not just at employee level but also on a social level. Regularity of absenteeism is one of the indicators

that show the health of the population. In this publication attention is paid to the relevance between

the work organizational factors and absence from work.

The publication contains an analysis of employee surveys (n=2272) in the study “Work condi-

tions and risks in Latvia”. There were included a lot of questions on work related issues. The publica-

tion examines the following factors: job satisfaction, the size of company, the employee position in

the company, salary, overwork and the number of work places.

Investigation was based on the hypothesis that more often sickness absence aff ects those em-

ployees who do not have job satisfaction and those who work in big companies, in higher positions

and work over-time, also are not well paid and work in more than one place. This hypothesis had

been partly proved by the results of the study.

The results show statistically proven diff erences between genders in job positions, salaries

and overwork. It also shows relevant diff erences between the age groups of employees and work

organization, positions, salaries and the size of the company. Statistically proven diff erences are in

the health condition between employees in high risk groups and those who are not included in this

group. Multivariate analysis shows that higher risk of absence is typical of employees who are not

satisfi ed in the workplace, often work over-time and work in big companies. The analysis also shows

that those employees who are not satisfi ed with work and work over-time often go to work despite

sickness.




A SURVEY ON BYPASSING PROTECTIVE DEVICES AND GUARDS IN POLAND

Agata LatałaCentral Institute of Labour Protection – National Research Institute

(CIOP-PIB), Poland

Key words: tampering, bypassing, cheating, safeguard, protective device

INTRODUCTIONBypassing protective devices and guards means improper or illegal act which leads to the limi-

tation of the protective device effi ciency. Results presented in this article are obtained from the

research task “Accident prevention: developing principles to stop workers bypassing protective de-

vices and guards” carried out within the National Programme “Improvement of safety and working

conditions” partly supported in 2011-2013 – within the scope of state services – by the Ministry of

Labour and Social Policy. The Central Institute for Labour Protection – National Research Institute

acts as the main co-ordinator of the Programme.

AIMSThe fi rst aim was to estimate how many devices and guards are bypassed and how they are

bypassed. The second aim was to assess the attitude to bypassing protective devices and guards.

MATERIALS AND METHODSTwo questionnaires were carried out. One for OSH experts and industrial engineers and the

other for operators of machineries equipped with protective devices and guards. The fi rst question-

naire consisted of 6 questions: estimation, how often bypassing occurs, occurrence of manipula-

tions depending on the kind of protective device, operational mode in which bypassing occurs, as-

sessment of the risk connected with bypassing and some personal data. The second questionnaire

consisted of 5 questions: attitude to bypassing protective devices and guards and risk assessment,

the reasons of bypassing protective devices and some personal data. The companies for survey

were randomly chosen. They represent the structure of companies in Poland as far as the number of

employees and the branch are considered.

RESULTSThe OSH experts estimate that about 15% of protective devices and guards are bypassed, about

45% of machineries with bypassed devices are accident potential, bypassing is the reason of about 25%

of accidents. Most OSH experts and machinery operators assess the risk of protective devices bypass-

ing as high or very high. However, there is a group of operators who assess that risk as very low.

CONCLUSIONSA similar survey was conducted in Germany [1,2]. The German OSH experts assess that 37%

of protective devices are bypassed, 51% machineries equipped with bypassed devices are accident

potential and 25% are caused by bypassing. The German experts assess risk as very high, and work-

ers – very low. That can be a reason of diff erence in the number of bypassed devices and guards.

Bibliography [1] Lüken K, Pardon H, Windemuth D. (2006) Bypassin.




INFLUENCE OF PSYCHOSOCIAL PRODUCTION FACTORS ON EMERGENCE OF SOME FUNCTION VIOLATIONS AT WOMEN – TEACHERS

Evgenia LeontevaDepartment of Hygiene and Occupational Health,

Kazan Medical University, Russian Federation

Key words: psychosocial production factor,

biological markers of stress, biological age

INTRODUCTIONUnder the modern conditions in the social and economic sphere and production a typical ten-

dency is the increase of psychosocial load upon workers. This circumstance determines the analysis

of psychosocial factors infl uencing health to become an important aspect of medicine at work. To-

day the analysis of psychosocial factors is focusing on determining the work burden, organizational

patterns of work and personal features of workers. Potential stress factors at a workplace, infl uenc-

ing the labor productivity and health of the workers, include the work organization, the content of

work, the interpersonal relations. The scientists R. Karasek, T. Treorell reduced the above-stated

production stress factors to two - and three-dimensional models of working stress: combination

of high requirements, low monitoring over a working situation and absence of social support in the

collective. Another model (by J. Siegrist) of working stress treats working stress as an imbalance

between high operating load and low control of long-term “compensation” at work.

URGENCY AND AIMSThe urgency of the carried-out research was provoked by the following circumstances: 1) ab-

sence of research on the role of psychosocial production factors in the development of health dis-

orders in representatives of professions; 2) absence of suffi cient information on the consequences

of infl uence of psychosocial working stress upon menstrual cycles AND the development of high

prolactin level in blood; 3) need to develop approaches for decreasing psychosocial stressful load

and prevention of negative consequences of working stress.

METHODS AND RESULTSWithin the realized research questioning of 60 female teachers of various age groups and level

of social wellbeing was carried out. The questioning was carried out by means of the standardized

Russian-speaking questionnaire created on the basis of two English questionnaires “Job Content

Questionnaire” (JCQ), and the questionnaire “Eff ort-Reward Imbalance Questionnaire” (ERI) com-

plemented with the questionnaire “Autonomy Dependence” of G.S.Prygin and “Scale of Personal

Uneasiness” of Ch.D.Spilberg. Identifi cation of biological markers of stress (the level of a morning

hydrocortisone in saliva) and indexes of biological age (the Australian system of defi nition of biologi-

cal age includes det mination of concentration of nitrogen of urea in serum, volume of the forced

exhalation, systolic arterial pressure, activity of alkaline phosphatase, ESR in serum) is planned to be

fi nished in the second quarter of the year 2013.




ASSESSMENT OF INDOOR AIR POLLUTION AND HEALTH COMPLAINTS AMONG OFFICE EMPLOYEES

Žanna Martinsone, Mārīte Ārija Baķe, Maija EglīteInstitute of Occupational Safety and Environmental

Health, Riga Stradiņš University, Latvia

Key words: indoor air quality, health complaints

INTRODUCTIONIndoor air quality is an important public health factor that infl uences persons’ health and well-

being. Indoor air quality is characterized by physical, chemical and biological pollutants. In the world

much attention is given to very fi ne dust particles in ambient and occupational environment. The

urgent problem of industrial hygiene is the risks of the exposure of diff erent pollutants at diff erent

levels of exposure to the employees’ health.

AIMTo assess the non-industrial workplace indoor air quality indicators and the health complaints

of employees.

METHODSThere have been used internationally recognized indoor air quality assessment methods and

equipment in the study, as well as for the fi rst time in the occupational environment of Latvia dust

particle count and surface area concentrations were estimated. The employee’s survey was done to

evaluate the impact of indoor air quality and health complaints in offi ces.

MAIN RESULTSThe measurement results of indoor air quality indicated that the most important indoor air

pollutants in offi ces are: CO2, formaldehyde, hydrocarbons (by C), ethyl acetate, the count of dust

particles (nanoparticles), and surface area of dust alveolar fraction. NO2 and O

3, as well as humid-

ity, temperature and air velocity should be taken in account in the evaluation of the non-industrial

occupational environment of workplaces. The measurement data and survey indicated a strong

correlation between CO2 concentrations and specifi c health complaints (diffi culties to concentrate,

fatigue, headaches, etc.). The survey results also indicated that poor indoor air quality in offi ces gave

the higher odds ratio for such health complaints as: dry skin (OR = 3.4) and dry and itchy eyes (OR =

2.5) in case of low air humidity; nausea or feeling sick (OR = 2.6) and sore, dry throat (OR = 2.6) in

case of chemical exposure; sneezing (OR = 2.2) in case of low air velocity etc. However, age and sex

play a role in the development of health symptoms (neck fatigue, back pain, etc.).

CONCLUSIONIn general, long-term and systematic impact of poor non-industrial indoor air can cause health

complaints of offi ce workers.




RETROSPECTIVE COHORT STUDY OF INDUSTRIAL WORKERS: CONTRIBUTION OF SMOKING AND OCCUPATIONAL FACTORS TO COPD DEVELOPMENT

Nailya Mazitova, Nail AmirovDepartment of Hygiene and Occupational Medicine, Kazan

State Medical University, Russian Federation

Key words: chronic obstructive pulmonary disease, occupational

exposure, risk assessment, silica dust, smoking

INTRODUCTIONA signifi cant part of the literature accumulated over the past two decades demonstrated the

relationship between occupational exposure to vapours, gases, dusts, and fumes (VGDF) and the

development of chronic obstructive pulmonary disease (COPD). However, its importance remains

still underappreciated in many countries. It is well known also that tobacco smoke and occupational

exposures exert a synergistic eff ect and increase each other′s infl uence to the development of

COPD. However, relative impacts of each of these factors are poorly understood.

AIMSTo ascertain COPD prevalence among industrial workers and to determine relative contribution

of smoking and occupational factors to COPD.

METERIALS AND METHODSWe randomly recruited 1,375 workers aged 30 or over. 624 of them were occupationally ex-

posed to VGDF in a foundry plant. Physical examination and baseline spirometry were performed for

all the participants of the study. Data on occupational history and VGDF levels in the working area

were collected from all participants.

RESULTSIn total, 105 cases of COPD and 170 cases of CB were diagnosed in the cohort of examined work-

ers. Analysis of the values of linear predictors in the model showed that the eff ect of smoking on COPD

development in the cohort of workers studied ranged from 5% to 40% depending on other risk factors.

The contribution of VGDF to COPD likelihood increased monotonously with the worsening of working

conditions and was found statistically absolutely signifi cant (p <0.0001). The VGDF impact was within

3 to 5.2% at low VGDF levels (less than 3.0 OEL), 33% at middle levels (from 3.0 to 6.0 OEL), and

reached 44 % at high levels (more than 6.0 OEL). Whereas contribution of occupational factors in the

development of COPD monotonously and signifi cantly (p<0.0001) increased with the growth of WGDF

levels: OR from 1.7 (95%CI 0.9-3.4) to 24.9 (95%CI 12.1-51.5), PAR% from 20.1 to 47.7. Therefore, the

degrees of smoking and VGDF infl uence on COPD development are probably rather similar.

CONCLUSIONSBoth smoking and VGDF seem to be important for the development of COPD. Therefore, a

comprehensive assessment of the two leading risk factors contribution is of special interest for oc-

cupational medicine specialists. Future investigations of occupational COPD seem to be important

for developing prevention strategies.




JOB SPECIFIC FACTORS AND PREVALENCE OF MULTI-SITE AND DISABLING MUSCULOSKELETAL PAIN AMONG OFFICE WORKERS, NURSES AND CAREGIVERS IN ESTONIA

E. Merisalu1, L. Animägi1, K. Oha2, T. Freimann3, T. Sirk4

1 Department of Public Health, University of Tartu, Estonia2 North-Estonian Medical Centre3 Tartu University Hospital, Estonia4 Põlva Hospital, Estonia

Key words: job factors, multi-site pain, disabling pain

AIMTo describe prevalence of multi-site pain in the past 12 months and disabling pain in the past

month by the occupation and to analyse relationships between work related factors and MSP.

METHODThe international study “Cultural and Psychosocial Infl uences on Disability” (CUPID) was car-

ried out using a postal survey in autumn 2008. The study group consisted in random samples of

offi ce workers of Tartu University and Estonian University of Life Sciences and nurses of Tartu Uni-

versity Hospital and of total sample of caregivers from Estonian hospitals and Nursing Centres. The

questionnaire consisted of the demographic parameters, work specifi c factors, multisite MSP in the

past 12 months and disabling pain in the past month. The descriptive data, Chi-square Statistics,

Spearmann Correlation and Binary Logistic Regression Analysis were used (OR, 95% CI).

RESULTSThe questionnaires were sent in total to 1291 participants, 698 received and 588 analysed. The av-

erage response rate was 55.5% (offi ce workers 59%, nurses 57%, caregivers 47%). Most of the participants

were female (94%), had service length more than fi ve years and 73-90% worked more than 40 hrs per

week. The average age of the study group was 41.2 years (±10.2). The caregivers reported more weight

lifting >25 kg, repeated movements of wrist/fi ngers, bending of elbow and working while kneeling above

one hour a day (p<0.0001). Offi ce workers reported more autonomy in time, work content and working

style than nurses and caregivers (p<0.0001). The prevalence of low back pain among caregivers was

higher (67%) than offi ce workers (42%) (p<0.0001). The prevalence of wrist/hand pain among nurses was

lower than the other groups (p<0.002). Low back pain correlated positively with lifting weights >25 kg

and kneeling in total above one hour (r=0.20 and r=0.18, p<0.01). The prevalence of multisite pain was

3.5-16x higher among nurses and offi ce workers when job control was high, but among caregivers when

physical demands were high. Disabling pain among nurses depended on age, among offi ce workers – on

work satisfaction and among caregivers – on physical and time demands and job support. The prevalence

of disabling pain of all occupations was related to the other health complaints and emotional status.

CONCLUSIONSIt is essential to pay attention to work specifi c factors, especially in caregivers work. It is very

important to improve awareness about MSP prevention, thus to improve working eff ectiveness and

reduce lost working days.




STUDENT STRESS, BURNOUT AND HEALTH IN THE MEDICAL FACULTY OF THE UNIVERSITY OF TARTU

Eda Merisalu1, Ulrich Wiesmann2, Merli Ilves1,

Karina Haefke2, Hans-Joachim Hannich2

1Department of Public Health, University of Tartu, Estonia2Institute for Medical Psychology, University of Greifswald, Germany

Key words: medical student, stress, burnout, health

AIMThe aim of the study was to assess stress, burnout and subjective health among students by

gender and semester and analyse relationships between these indicators.

METHODThe cross-sectional study was carried out in autumn 2010. The questionnaire was adapted by

eight validated questionnaires used in earlier international studies. The anonymous questionnaire

was sent to the medical students of the 1st, 3rd and 5th semesters. Non-parametric T-Test was used

to fi nd time diff erences in stress and health indicators.

RESULTSThe average response rate was 58.4% (from 48% to 71%). The study group consisted of 344

medical students, where 70% of them were women. General stress level was moderate and health

was assessed as good. But during the fi rst three study years the stress level increased and general

health worsened (p=0.000). If to compare the fi rst and the fi fth semesters GHQ12-health score,

symptom reporting, the sum-scores of negative aff ectivity, emotional exhaustion and depersonalisa-

tion increased (p=0.01…0.000). At the same time positive aff ectivity (p=0.000), motivation of study

(p=0.011) and self-confi dence to pass the exams (p=0.026) diminished. But no signifi cant changes

of these characteristics between the fi rst and the third year were detected. The gender diff erences

were observed: the higher negative aff ectivity (p=0.04), GHQ and symptom sum-scores by the wom-

en (p=0.06 and p<0.000) and the higher cynicism (p=0.023) by the men were measured. The stress,

burnout and symptom sum-scores strongly correlated between each other (p<0.000).

CONCLUSIONSThe increased stress and burnout levels and worsened subjective health among medical stu-

dents have been observed in the fi fth semester. Therewith women have higher negative attitudes and

more health complaints than men. More attention needs to be paid to the health status of medical

students during the academic years. Stress prevention programs need to be introduced and psycho-

logical advisoring must be more accessible to students.




APPLICATION OF ERGONOMIC STANDARDS IN THE DESIGN OF A PROCESSING MACHINE: DIFFICULTIES AND CHALLENGES

Anna Sophia Piacenza Moraes1, Pedro Arezes1, Ricardo Vasconcelos2

1 Department of Production and Systems Engineering,

University of Minho, Guimarães, Portugal2 Faculty of Psychology and Educational Sciences,

University of Porto, Porto, Portugal

Key words: ergonomics, standards and guidelines,

engineering design process, manufacturing company

One of the reasons for not implementing ergonomics is the claim that it is diffi cult for engineers

to meet the standards when designing workplaces. Some authors have already discussed how the er-

gonomic recommendations are evaluated by engineers: too general, wordy and vague. But the analysis

of this issue reveals discordancy at other levels. In some cases the ergonomic standards look insuffi -

ciently elaborate, in other cases seem to be over prescriptive. The problem can also be related with the

unavailability or lack of knowledge of ergonomic guidelines. Added to this, it is impossible to ignore the

extensive amount of standards that compete with ergonomic ones during the design process. These

issues lead to diffi culties in implementation of ergonomics in the design of workplaces.

AIMTo identify some of the reasons that hamper the incorporation of ergonomic standards and

guidelines during the earlier phases of the design process. The methodology involves a case study,

conducted in a manufacturing company, where a processing machine was being refurbished. Al-

though this cannot be considered a pure design process, many modifi cations were going to be made

to the machine. Interviews and work observations were made with the design members.

The main objective was to understand their activities and how decisions were made. The certi-

fi cation of the machine was the main worry of the project manager, as it would also require meeting

the standards of Ergonomics and Health and Safety at Work.

RESULTSThe case study revealed that the knowledge of the design team regarding the ergonomic recom-

mendations were very scarce. Standards related to ergonomics were in the domain of the Safety

Department, with no participation in the machine design team. Despite the concern about clarity and

precision of ergonomic specifi cations, it is possible to conclude that there should be made eff orts at

other levels in order to improve the incorporation of ergonomics in the design of workplaces. It is nec-

essary to promote paying attention to ergonomics and occupational health and safety aspects in the

design process. It is of major concern to raise the awareness of engineers about these subjects, and

encourage the participation of health and safety specialists in the design teams. The implementation of

ergonomics does not only depend on the standards and guidelines: it is also a matter of changing the

way engineering design is made and the values and criteria that clash during the design decisions.




PERFORMANCE EVALUATION STRATEGY AND SAFETY CULTURE MATURITY LEVEL

Hernâni Veloso Neto1, Pedro Arezes2

1 Institute of Sociology, University of Porto, Porto, Portugal2 School of Engineering, University of Minho, Guimarães, Portugal

Key words: safety culture, maturity levels,

performance evaluation, SafetyCard

In the presentation we intend to show how the safety culture maturity level of an organization

can be specifi ed by the performance monitoring strategy. Some authors, e.g. Fleming (2001) have

argued that the safety performance demand level (in terms of results and how it is measured) in-

creases the culture maturity. Organizations seeking for continuous improvement of their workplaces

are those that usually show a more sustained organizational safety culture. The use of structured

performance evaluation matrices provides an active and integrated framework of monitoring, cover-

ing a wide range of data and indicators that are then used for the benefi t of improving processes,

attitudes and values.

The performance evaluation of occupational health and safety within a management system

has assumed, currently, a growing corporate and scientifi c relevance. This very circumstance is due

to the fact that continuous improvement became a key-element of health and safety management.

To meet this requirement, organizations have to invest in the development of capable performance

evaluation systems. The development of scorecards for the occupational health and safety area

arises in this context. Several similar instruments can be identifi ed in the specialized literature.

This paper focuses on the SafetyCard - Performance Scorecard for Occupational Safety and Health

Management Systems (Neto, 2012), seeking to show how it can help organizations locate and im-

prove their performance and maturity levels. The SafetyCard considers the main technical-scientifi c

and normative-legal requirements of occupational health and safety. It assumes an evolving and

transformative nature, because it has key-elements of success that can naturally evolve to a more

minimalist or wider matrix (global or partial use). This situation means a great operational fl exibility,

adapting itself to diff erent organizational realities. Furthermore, this tool is an innovation compared

to traditional scorecarding, representing the modern approach to the preparation of organization-

al performance evaluation systems and it is also able to generate solid learning processes within

and between organizations (benchmarking). References: Fleming, M (2001). Safety culture matu-

rity model. Off shore Technology Report 2000/049, London: HSE. Neto, H. V. (2012). Performance

scorecard for occupational safety and health management systems. International Journal on Working

Conditions, No. 3, pp. 42-53.




TECHNICAL SOLUTIONS TO PREVENT CONTACT DERMATITIS CAUSED BY CONTACT WITH BIOLOGICAL AGENTS FOR ARCHIVES STAFF, FUNDED BY NATIONAL PROJECT PNII-92-083/2008-2011

Steluta Nisipeanu1, Maria Haiducu1, Iuliana Scarlat1, Valentin Moise2

1 National Research and Development Institute on Occupational

Safety “Alexandru Darabont”, Bucharest, Romania 2 Horia Hulubei National Institute of Physics and

Nuclear Engineering (IFIN HH), Romania

Key words: ionizing radiation, human health, biocide eff ect

International attention paid to health, environment protection and human rights has consider-

ably increased during the past fi ve decades. Diff erent environmental factors above the tolerance

limits could impair the normal development, human health and labour capacity. The biocide eff ect

of the ionizing radiation is indubitable. The method’s effi ciency recommends it for the disinfection of

cultural heritage items. The results presented in this paper were obtained in a larger study initiated

in Romania and coordinated by IFIN-HH Magurele in Program 4 - Partnerships in priority areas, in

cooperation with INCDPM “Alexandru Darabont” Bucharest, CEPROHART SA Museum of Braila.




TRUST AND MISTRUST AS STRESS REDUCING AND INCREASING FACTORS IN WORKING LIFE

Jukka PiippoDepartment of Healthcare, Arcada University of

Applied Sciences, Helsinki, Finland

Key words: trust, eustress, social interaction

Trust is considered a basic human need and its development is to a high degree depending on

interaction within the human environment and it is also an important factor within working com-

munities and other situations of human interaction (Erikson, 1968; Piippo, 2008). Concerning trust

within working communities there are identifi ed three signifi cant factors: participating and justifi ed

leadership, functional working-group and increasing of workers independency (Gilson, 2003). The

phenomenon of trust has also been studied from the social capital point of view (Jokivuori, 2005;

Sinervo et.al. 2005). Development of trust has also been studied outside working life (Helkama &

Seppälä, 2004; Piippo 2008). Based on these researches we can assume that trust as an independ-

ent phenomenon is hard to study since its development is connected and infl uenced by several

other factors.

Stress can be considered as having both negative (distress) and positive (eustress) sides and

eff ects. Distress is the most commonly referred to type of stress, having negative implications. Eus-

tress is the positive cognitive to stress that is healthy, or gives one a feeling of fulfi llment or other

positive feelings. Occupational eustress may be measured on subjective levels, such as quality of

life or work life, job pressure, psychological coping resources, complaints, overall stress level and

mental health. Research on eustress has focused on its presence in the workplace where stress can

often be interpreted as a challenge, which generally denotes positive eustress, or as a hindrance,

which refers to distress that interferes with one’s ability to accomplish a job or task. Negative stress

should be reduced and it might be that sometimes the positive stress could be increased for wellbe-

ing in working life. During this session aspects eff ecting development of trust and mistrust shall be

discussed in relation to eustress and distress.




OCCUPATIONAL HEALTH AND SAFETY IN LITHUANIA: 20 YEARS EXPERIENCE AND FUTURE TRENDS

Rita Raškevičienė1, Vidmantas Januškevičius1,2, Paulius Vasilavičius1,2,3

1 Department of Environmental & Occupational Medicine, Medical

Academy, Lithuanian University of Health Sciences, Lithuania2 Hospital of Lithuanian University of Health Sciences Kaunas Clinics3 Institute of Hygiene, Lithuania

Key words: occupational health and safety, occupational health

care, statistics of occupational diseases, accidents at work

THE MAIN OHS PROBLEMSWorkplace risk assessment and medical examination of workers health is formal or not con-

ducted at all. Little attention is paid to education of workers.

AIMTo review changes in the OHS system, legislation and trends of occupational diseases and ac-

cidents at work in Lithuania over the last 20 years.

ANALYSIS OF STATISTICAL DATA AND LEGAL REGULATIONSThe main law containing the basic provisions for OHS in Lithuania is the Law on Safety and Health

at Work, No IX-1672 (latest amendment on 11 May, 2010). The Law on Occupational Health Care,

adopted in 1999, was annulled in 2007. After 2007 the main EU OHS directives were incorporated in

the national legislation. The number of measures taken increased during 2001-2011 from 68426 to 83

624. The number of workers decreased from over 1.6 mln. in 1994 to 1094 869 in 2011. The number

of inspectors in the State Labor Inspection increased from 42 in 1993 up to 197 in 2011. There were

17 occ.physicians in 2011, though there should be at least 150, medical health examination of work-

ers is performed by family doctors, who have completed a 36 h. course on Occupational Medicine at

a university. The number of occ. health care specialists is not known. 321 cases of occ. diseases were

registered in 1991, vibration disease mainly (44.9% of all occ. diseases). The number of occ. diseases

was increasing until 2006, when 1447 cases were registered (9.7/100 000), mainly diseases of mus-

culoskeletal system and connective tissue, followed by ear diseases (25.5% of all occ. diseases). The

perception of occ. diseases changed notably in 2006, because a new list of Occ. diseases was adopted

and vibration diseases were not included as such (diseases caused by mechanical vibration were di-

vided into two groups). Since 2006 the number of occ. diseases has decreased to 402 in 2011. The

vast majority of the diseases were caused by physical factors (noise and vibration) and ergonomics,

only one case of occ. cancer was recognized during the 20 year period. Nearly 60 000 workers were

injured and approx. 1500 were killed at work during the period 1991-2011. The number of accidents

at work was the highest in 1994 - 3790 cases and in 2006 - 2675 cases or 279.2/100 000 and then

steadily decreased: in 2011 there were 2675 accidents or 244.3/100 000. Fatal accidents at work

decreased from 83 deaths (7.3/100 000) in 1997 to 53 deaths (4.8/100 0000) in 2011. The highest

number of deaths at work was registered in 2006 - 108 cases (8.4/100 000).




THE INFLUENCE OF CHEMICAL FACTORS ON THE HEALTH OF WORKERS OF MANUFACTURE OF LEATHER GOODS

Inesa Remeza, Dagmara Sprudza, Zanna MartinsoneDepartment of Occupational and Environmental Medicine,

Riga Stradiņš University Latvia

INTRODUCTIONOne of the main professions in leather goods manufacturing plants is fi tters. They put together pieces

of leather, glue them together to the frame and sent for sewing. The surface of pieces of leather and basic

material are lubricated with glue (30 minutes). During this process the adhesive glue solvent vaporise in

the indoor air of working area, adversely aff ecting the respiratory system, skin and eyes. Reducing the risk

of exposure to chemical factors on health depend on the state of the ventilation system.

AIMTo evaluate the eff ect of the state of the ventilation system on the health of fi tters.

MATERIALS AND METHODSDetermination of a worker’s exposure to airborne leather dust was made using GilAir individual

sampler and NIOSH methods for analysis of nuisance dusts (NIOSH MAM Method 0500, 2003). Eval-

uation of chemical compounds in the work area was carried out by using the ISO methods and gas

chromatograph Varian 3800 with FID and ECD detectors. The evaluation was conducted in working

places assemblers. Morbidity (registration of sick leave) was assessed during one year before and

after the repair of ventilation system. Analysis of morbidity was conducted in 30 fi tters. Glue “Mark

B” had been used, which contained a derivative of oil: light fractions of gasoline and natural rubber.

RESULTS AND DISCUSSIONThere was determined in the air of the working area of fi tters: acetone 35.0±7.0 mg/m3; vinylac-

etate 279.0±39.0 mg/m3; isobutane 356.0±71.0 mg/m3; butane 181.0± 36.0 mg/m3; ethylacetate

586.0±117.0 mg/m3. The total hydrocarbon content was 357.0±71.0 mg/m3. For the assessment

of probability of health risk caused by the occupational exposure to chemical factor in working en-

vironment the exposure index (EI) is being used, which shows the degree of occupational exposure

of chemical substance and at the same time provides information on the probability of the eff ect of

chemical substance workers health [EN 689]. The exposure index is determined relating the actual

concentration of chemical substance in the working environment to the occupational exposure limit

value set out in legislation for each substance (OEL). In this case have found high exposure index of all

chemicals (vinylacetate 167; isobutane 132; butane 14; ethylacetate 58; total hydrocarbon content 10)

in the air of the working area of fi tters. The analysis revealed a high incidence in the frequency of acute

respiratory diseases (18%), allergic diseases (8%), and diseases of circulatory system (9%). After repair

of the ventilation system has been re-analysis of the incidence among fi tters to 7 % for acute respiratory

diseases, 4% for allergic diseases and 5% for diseases of the circulatory system.

CONCLUSIONHygienic control and measures to improve the air quality of the working area is an integral part

of the struggle for workers’ health.




MUSCULOSKELETAL OCCUPATIONAL DISEASES AND AGING WORKFORCE IN LATVIA

Jelena Reste1,2, Maija Eglite1,2, Tija Zvagule1,2, Natalja Kurjane1,2

1 Institute of Occupational Safety and Environmental Health,

Riga Stradiņš University, Latvia2 Centre of Occupational and Radiological Medicine,

Pauls Stradiņš Clinical University Hospital, Riga, Latvia

Key words: musculoskeletal, occupational, disease,

aging, morbidity, age, length of service

INTRODUCTIONThe aging of population is becoming one of the most urgent problems in many developed coun-

tries. Morbidity with musculoskeletal disorders (MSD) increases alongside with aging. The graying

of workforce increases their stay in the labour market. The aging musculoskeletal system enhances

the probability to get work-related MSD due to extended exposure to harmful working conditions.

AIMThe aim of the study was evaluation of population aging eff ect on morbidity with occupational

MSD in Latvia during the last 15 years.

MATERIALS AND METHODSThe analysis of offi cially registered occupational diseases (ODs) was performed using the data

of the Latvian State Registry of Occupational Diseases from 1997 till 2011. The data of the Latvian

Central Statistical Bureau were used for the ratio evaluation of the Latvian working age population.

For statistical analysis Microsoft Excel and IBM SPSS software was used.

RESULTSThe total of persons with primary revealed ODs was 812 persons in 2011 (494 females and 318

males) or 84.1 per 100 000 employees. The median age of patients with primary revealed ODs in 2011

was 55 years (25th and 75th percentiles were 50 and 58 years accordingly). The median age was ap-

proximately similar in women and men. The median length of service in harmful working conditions was

29 years (23; 34). 63% of all primary occupational patients had at least one MSD. Occupational MSD

patients’ median age was 54 years (50 and 58 years accordingly). Their median length of service in

harmful conditions was approximately the same as in other patients. For comparison, 15 years earlier (in

1997) the number of persons with primary revealed ODs was 118 (41 female and 77 males) or 11.9 per

100 000 employees. Their median age was 51 year (45; 56); moreover, males were slightly older than

females. Only 20% of them had at least one MSD. MSD patients’ median age was very similar to other oc-

cupational patients. In 1997 the ratio of people in the working age group was 57.3% of the total number of

Latvian inhabitants and the ratio of children was 20%. In 2011 it was already 64.2% and 14.2% accordingly.

CONCLUSIONSThe population aging processes are progressing in Latvia. Median age of patients with ODs

has increased by at least 3 years during the last 15 years and the ratio of occupational MSD has

increased by 43%. When evaluating working conditions and improving working environment, special

attention should be paid to ergonomical risk factors for MSD morbidity reduction.




SMOKING PREVALENCE IN WORKERS AT RISK FOR OCCUPATIONAL DISEASES OF THE ВRONCHO-PULMONARY SYSTEM

Natalia Roslaya, Oleg Rosly, Natalia EfremovaYekaterinburg Medical-Research Centre for Disease

Prevention and Health of Industrial Workers, Russia

Key words: smoking, prevalence, risk for occupational diseases

AIMTo study the prevalence and intensity of smoking among workers at risk for occupational dis-

eases of the bronchopulmonary system.

METHODSStudying the prevalence and intensity of smoking in selected 150 employees at risk for occupa-

tional diseases of the bronchopulmonary system (men 77, 3%, women -22,7%, mean age 51.0 ±0.9

years. Length of service in conditions of aerosol high fi brogennyh multiplicity mean-excess greater

than 10 and the maximum permissible concentration of 4 or more times was 18.9 ±0.8 year). The

selection criteria included modifi ed pulmonary pattern (diff use enhancement, outlines the mesh

deformation) and the reduction of individual lung function.

RESULTSMost of the patients (67.1%) were daily smokers of tobacco; the smoking experience from 3 to

30 years. The prevalence of smoking was 81.9% among men and 47.1% among women, surpassing

tobacco use in the adult population of Russia (60.2% and 21.7% respectively). The number of ciga-

rettes ranged from 5 to 30 per day, the index of smoking - from 3 to 35, with an average 22,3±2,7

pack/years. 13 people (8.7%), including 11 men and 2 women were ex-smokers, and the average

index of smoking was 15.2± 4.3 pack/years. Never smokers only 8.6% of men and 47.1% women.

CONCLUSIONThe prevalence and intensity of tobacco use among workers at risk for occupational diseases

of the bronchopulmonary system is signifi cantly higher than the average of the adult population of

Russia.




THE IMPLEMENTATION OF THE MANAGEMENT SYSTEMS CONCERNING HEALTH AND SAFETY AT WORK IN ROMANIA IN VIEW OF THE EUROPEAN STRATEGY

Gilda Rusu-Zagar1, Ionel Iorga1, Steluta Nisipeanu1,

Andrei Iorga1, Octavian Iorga1, Catalin Rusu-Zagar2,

Mihaela Mocanu3

1 National Research & Development Institute on Occupational

Safety “Alexandru Darabont”, Bucharest, Romania2 Polytechnical University, Bucharest, Romania3 Christian University “Dimitrie Cantemir”, Bucharest, Romania

Key words: management, safety, health, good practices,

prevention, awareness

Health and safety at work has become lately one of the most important and substantial sectors

in the EU social policy. The European Community strategy is based on building up and strengthen-

ing a culture of risk prevention, on combining a variety of tools for applying the community policies:

legislation, social dialogue, technical progress and good practices, the companies social responsibil-

ity, as well as on establishing partnerships among all the actors on the stage of health and safety

at work.

In Romania, the workplace health and safety management systems are supporting the imple-

mentation of the European strategy by means of: the systematic approach to the problems in the

fi eld; the emphasis laid on training and awareness as key elements of the culture concerning health

and safety at work; the establishment of some effi cient tools for managing the organization’s specifi c

elements, as well as the involvement of all the levels of an organization.

The article deals with the implementation of the workplace health and safety management sys-

tems within Romanian companies that complement the organizational system existing at the com-

pany level and fostering the application of the workplace health and safety legislation. We present

a case study carried out on a building site regarding the implementation of the good practices in

construction activity. The case study has reached its goal as to raising the workers and employers

awareness and the necessity of establishing a healthy and safe working environment. The estab-

lishment of a healthier and safer working environment in Europe represents an objective which is

beyond the resources and expertise of a single country or institution.

Correspondence e-mails: [email protected]; [email protected];

[email protected]; [email protected]; [email protected];

[email protected]



OCCUPATIONAL HEALTH SERVICES IN VOLUNTARY HEALTH INSURANCE IN POLAND – ECONOMIC INCENTIVES SCHEME OPPORTUNITY AND DILEMMAS

Izabela Rydlewska-Liszkowska1, Alicja Sobczak2

1 Health Economics Unit, Medical University, Lodz, Poland2 Management Department, University of Warsaw, Poland

Key words: occupational medicine, insurance, economic incentives at

workplace

INTRODUCTIONOccupational Health Services (OHS) has become one of the controversial issues in the Polish

health system due to the governmental draft stating that occupational medicine will become an

additional insurance product of health insurance. Many opinions have been voiced by ministries

offi cials, lawyers, employers associations, occupational medicine specialists, representatives of the

Polish Chamber of Insurance but very few participants of public forum have noticed that this issue

is the top of the iceberg. The occupational medicine services/activities are provided at the follow-

ing organizational levels: ministerial, research institutes and universities, regional level (Regional

Occupational Health Services Centers) and primary level (OHS basic units). Occupational medicine

activities include not only preventive examinations but also other activities, like analysis of health

status, occupational risks assessment. OHS fi nancing sources are correlated with the types of activi-

ties and the organizational level.

OCCUPATIONAL MEDICINE IN HEALTH INSURANCEAdditional Health Insurance draft defi nes occupational medicine as a product of additional

health insurance. Insurance premium for occupational medicine services would be set separately

(diff erent premium for other services than occupational medicine) and alternative preventive exami-

nation contracts (with health services providers or private health insurer) would be allowed. Moreo-

ver, employers would be entitled to choose not only providers but insurers as well.

DILEMMAS AND OPPORTUNITIESThe economic aspect of occupational medicine as insurance product needs to be considered

from diff erent perspectives: occupational medicine as insurance product, OHS funding in relation to

the organization and activities, statistical determinants of OHS economic analysis. The main dilem-

mas of the proposed occupational medicine status are connected with relations between additional

health insurance and the existing OHS system, clarifi cation of the insurance product, the OHS fund-

ing, the role of third actor in occupational medicine contracting, relationships between the National

Health Fund and OHS providers in additional insurance environment and institutional coordination of

occupational medicine activities. Additional health insurance implementation provides an opportu-

nity to make the economic incentives scheme encourage employers to invest in occupational health.

Insurers can infl uence the employers’ behavior by diff erentiating multi-factorial premiums,grants,

return costs covered by insurance in case of not protecting workers’ health etc.



COCLUSIONSThe economic perspective is one of several perspectives in treating the problem of transform-

ing OHS into insurance product. From this standpoint the prerequisites for introducing the OHS

insurance product should be met. The economic aspect of OHS should not be separated from other

key problems of the system such as organization, fi nancing and coordination of the activities of oc-

cupational medicine.




INDEX-BASED VERSUS COST-RELATED MODEL OF DIFFERENTIATING PREMIUMS FOR ACCIDENT INSURANCE

Jan Rzepecki Department of Safety and Health Management, Central Institute for

Labour Protection - National Research Institute Warsaw, Poland

Key words: accident insurance, model, premium, stimulator

Accident insurance is applied in most of economically developed countries. Diff erentiated pre-

miums represent the basic economic factor with an impact conducive to limiting the number of

accidents and occupational diseases. The years-long application of this stimulus has led to many

benefi ts at the level of an individual company as well as on a macroeconomic scale because it has

helped to reduce the number of accidents at work and occupational diseases along with their social

costs.

In majority of the economically developed countries, diff erentiation of premiums is based on

the cost-related system, where the costs of compensations and benefi ts paid by insurance institu-

tions as a consequence of workers accidents and occupational diseases are used as the basis for

determining the insurance premiums at both, the level of a group of business branches as well as

companies. The system of diff erentiated premiums in workers accidents insurance has been applied

in Poland at the level of business branches since 1 January, 2003, and at the level of companies

since 1 April, 2006. However, it is not the costs of the benefi ts and compensations paid by the Social

Insurance Institution that provides the basis for diff erentiating premiums, but the quantitative data

on the number of workers exposed to professional hazards and the number of accidents at work,

including serious and fatal accidents per 1000 employees.

The paper presents both the indicators-based system of diff erentiated premiums for workers

accidents insurance now eff ective in Poland as well as a proposal of a new, cost-related system de-

veloped by the author of this paper. It also presents the fi ndings of a research project that the author

carried out in some selected companies in order to compare the eff ectiveness of the cost-related

system with that of the indicators-based system now used in Poland.




QUALITATIVE AND QUANTITATIVE CHARACTERISTICS OF PAIN SYNDROME

Vasiliy Shirokov, Helen Bahtereva, Inna Krivcova,

Yakov ZakharovFederal State Scientifi c Institution “Ekaterinburg Medical Research Center

for Prophylaxis and Health Protection of Industrial Workers”, Russia

Key words: hand-arm vibration syndrome, pain

The most common complaints of patients with Hand-Arm Vibration Syndrome (HAVS) include

pain, tingling or numbness in fi ngers and chillness of hands (heightened sensibility to cold) and fi n-

gers albication (white fi ngers).

The study of the relationship between qualitative and quantitative indicators of pain may con-

tribute to the study of mechanisms of pain reception. In clinical medicine nociceptive and neuro-

pathic pain mechanisms help to fi nd adequate analgesia methods.

The aim of the present study was to investigate the characteristics of pain syndrome in HAVS.

A group of 26 miners with upper extremities disorders was examined in a clinic in order to study the

character of the pain syndrome. Their participation was voluntary, and the participants gave their

informed consent. Age: 35-57 years old, length of service: 10-33 years (24±1.1). These patients

fi lled in the DN4 and pain Detect (PD) questionnaires and were examined with EMG (the amplitude

of the M-wave, nerve conduction velocity, latency) and QST. All patients got more than 4 points in

the DN4 questionnaire, but on the PD questionnaire the number of PD points (over 13) was observed

in 19/26 – 73.1%. It should be noted that the largest number of experienced workers gave positive

answers to the questions on VAS and DN4 as they have a motivation to get social benefi ts. The

examination revealed a decrease of the CS, an increase of the WS (р<0.05) and VS, decrease of

the CP, an increase of the HP (р<0.05). Statistically signifi cant Spearman correlation was revealed

between the level of pain on the VAS and the questionnaires on neuropathic pain, PD and CS, PD and

WS, NCV- and DN4 (r = 0.406; p = 0.040), SNAP and CP, NCV and WS, NCV and QST. The received

QST and ENMG data prove mainly the sensory character of vibration neuropathy.




PREVALENCE AND INCIDENCE OF SHOULDER PAINVasiliy Shirokov, Tatyana Makar, Tatyana Derstuganjva Federal State Scientifi c Institution “Ekaterinburg Medical Research Center

for Prophylaxis and Health Protection of Industrial Workers”, Russia

Key words: shoulder pain syndrome, prevalence

AIMTo determine the prevalence and incidence of shoulder pain syndrome (SPS), relative contribu-

tion of hard manual labor, fl uorides infl uence.

METHODSOne-stage cross-sectional observation of SPS prevalence was investigated. The observed 6094

workers were divided into four groups. The fi rst group was formed by 407 workers of an aluminium

plant (aluminium electrolysis), whose professional activity includes hard manual labor connected

with loadings on the shoulder region and fl uorides infl uence. The 2nd group consisted of 369 work-

ers with fl uorides infl uence without manual labor. The 3rd group included 2078 workers, hard manu-

al labor without infl uence of bone-seeking toxic factors (metalworkers, painters, moulders etc.). The

4th group - 3240 workers and employees of auxiliary departments not subjected to the infl uence

of unfavorable industrial factors (engineers, administrators, economists etc.). The observed were

divided into four age groups and three working experience groups.

RESULTSIn the observed population the prevalence of SPS was 9.6 (95% CI 8.9 – 10.7), among males –

8.6 (7.8 – 9.4), among females – 1.98 (10.5 – 13.5). The highest SPS rates were in the age group

40 to 49 years – 11,0 (9,6 – 12,4) and older than 50 years – 11,9 (10,5 – 13,3). The highest SPS

prevalence index was registered in the fi rst group – 32.9% (workers exposed to toxic eff ects of fl uo-

ride and physical strain), the lowest - in the 3rd group – 6.9% (without the impact of toxic action).

The prevalence of shoulder pain rate is authentically higher among the workers of hard manual labor

and under the toxic infl uence of fl uoride. The SP prevalence in the 3rd group was similar to the index

of the 4th group.

СОNCLUSIONThe highest RR of SPS progress was observed in the 1st group in relation to the 4th (5.67) and

the 3rd groups (5.24), at the same time etiological fraction (EF) was 77.5% and 78.7%, it indicates

very high infl uence of labour conditions on the SPS prevalence. Infl uence without the manual labor

index of RR and EF is much higher in the 2nd group, than in the 3rd and the 4th groups. It is note-

worthy that the highest SPS prevalence was found among patients with broncho-pulmonary system

diseases – 24.86 (20.1 – 29.41), it is higher than among patients with cervical osteochondrosis –

23.40 (21.50 – 25.29). Among the analysed “nonmanufacturing” data co-morbid pathology of the

respiratory system and neck osteochondrosis increase thе risk of the shoulder pain syndrome de-

velopment. The relative risk of SPS was higher among patients with cervical osteochondrosis – 7.0

than with co-morbidity of broncho-pulmonary system (2.6). This message is preliminary. The analysis

of the results is continuing.




OCCUPATIONAL HEALTH AND HEALTH PROTECTION OF THE WORKING POPULATION OF THE REPUBLIC OF KAZAKHSTAN

E.Sraubaev, N.Shintaeva, B.Serik, A.Dauletova, N.ErdessovDepartment of Labor Hygiene, Professional Diseases, Hygiene of Children and

Teenagers, Karaganda State Medical University, Kazakhstan

Key words: professional incidence, labor hygiene

The system approach to a solution of the problem of preservation of health of manpower con-

sists in recognition of the key role of health of the working population as strategic potential, a factor

of national security, stability and wellbeing of society. Production is a basis of wellbeing of Kaza-

khstan, leaning on labor health.

Working conditions hazardous to health have remained in many branches. The total number of

the population is 16.8 million people. 53% of it is manpower is employed in industrial enterprises and

agriculture. In the last decade professional incidence has increased 3.5 times. If in 2001 it was 2.3

per 10 thousand workers in industrial enterprises and agriculture, in 2010 it reached 8.1. Profes-

sional Incidence (PI) is characterized by its high share up to 20.6 % - out of 1136 cases it is revealed

in 747 patients. Among primary professional pathology there prevail diseases of respiratory organs

(30%), bone and muscular system and connective tissues (28.3%), ear diseases (19.2%). Traumas,

poisonings and some other consequences of external reasons make 11.6%. The highest professional

incidence is traced in the mining industry (64%), coal (19%,) and metallurgical industry (10.7%). The

PI ratio in the chemical industry makes 2.6 %, oil and gas industry – 2.1%. The traceable level of

professional incidence is not adequate to the working conditions in Kazakhstan as it is much lower

than in the European countries and Russia (in Germany - 13365 cases, in France - 51142, Finland

– 5311, Russia - 7691).

It is obvious that most of PI is concealed in the structure of general incidence therefore workers

with health damage caused by work do not receive appropriate medical care and social compensa-

tions for health loss. The Decent Work Country Programme of the Republic of Kazakhstan for 2010-

2012 was signed between the International Labour Organization and Kazakhstan in June, 2010. This

national program on decent work is developed together with tripartite partners of the Republic of

Kazakhstan and is carried out to advance the principles of decent work in Kazakhstan with a view

of ensuring sustainable social and economic development and increase of standards and quality of

life of men and women.




PERSISTENT ORGANIC POLLUTANTS IN BLOOD SERUM OF ELECTRICIANS AND WELDERS IN LATVIA

Pavels Sudmalis1,2, Marite A. Bake1, Juris Rotbergs2

1 Institute of Occupational Safety and Environmental Health,

Riga Stradiņš University2 Faculty of Farmacy, Riga Stradiņš University

Key words: polichlorinated biphehyls (PCB), polibrominated diphenylethers

(PBDE), chlorinated pesticides, blood serum, toxic equivalents (TEQ)

Persistent Organic Pollutants (POPs) are chemical substances that persist in the environment,

bioaccumulate through the food web, and pose a risk of causing adverse eff ects to human health

and the environment.

The aim of the study was to assess the contaminations of blood serum with polychlorinated

biphenyls (PCBs), polybrominated diphenylethers (PBDEs), DDT and their derivatives of possible risk

group workers. Blood serum samples (total 116) were collected from two groups of workers – elec-

tricians who can contact PCBs containing transformer and capacitor oils and welders who were used

as a control group. The sample purifi cation was done by double solid phase extraction.

The concentration of POPs in blood serum was determined by gas chromatography with elec-

tron capture detector GC/ECD and recovery was controlled by internal standard CB-174. None of

the 116 samples contained a full range of the analyzed POPs. But all samples contained at least

one of pesticides, marker and mono-ortho PCB. The blood serum samples of 52% of electricians and

97.8% of welders contained non-ortho PCB, but PBDEs 84% and 74.7% respectively. The concentra-

tion of the 18 detected PCBs, 4 detected PBDEs and 6 chlorinated pesticides and their metabolites

varied in a wide range. The concentration of POPs corresponds to the lowest levels detected in other

countries. Average concentrations of low chlorinated marker PCBs are higher in the electricians

group and it can indicate that the work sites are contaminated with PCBs, or workers have a contact

with PCB-containing items.




THE HEALTH RISKS CONNECTED WITH MONOTONOUS WORK BY COMPUTERS

Piia Tint1, Marina Järvis1, Viiu Tuulik2

1 Department of Work Environment and Safety,

Tallinn University of Technology, Estonia2 Department of Biotechnology, Tallinn University of Technology, Estonia

Key words: computer workers, monotonous work,

health complaints, Kiva questionnaire, ART tool

This paper is aimed at improving the workplace ergonomics of computer workers (working in

offi ces and at the till of trade companies). The paper includes the assessment of the risk of mo-

notonous work, but also the infl uence of indoor climate conditions on the development of health

damages at workplace (developing carpal channel syndrome).

A questioning of workers was carried out (Kiva questionnaire) to clarify the opinion of workers

about the work atmosphere at the workplace. A total of 192 people answered the Kiva question-

naire. The data were analyzed from 181 questionnaires (69 of them were male workers). The aver-

age age of men was 40.8 years and 45.6 years of female workers. The workers were divided into

two groups: Group 1 – worked with computers up to 10 years (125 persons) and Group 2 – over 10

years (56 persons).

The Kiva questionnaire (scale 1-10) revealed that the average of the fi rst group enjoyed coming

to work (6.7 points), and the work was considered important (8.2 points); the work process was

evaluated with 8 points, relationships with co-workers and the boss were assessed with 8.5 and 7.4

points respectively. The possibility to infl uence their own working process was assessed with 6.8

points. The second group (worked up to 10 years) enjoyed coming to work (7.3 points), the impor-

tance of their work was assessed with 8.5 points, relationships with co-workers (8.5 points) and with

the boss – 7.1 points.,The workers were confi dent (average 6.8 points) that they will continue with

the same employer after 2 years and 6.8 points were given to the possibility to infl uence their own

working process. The novelty of the study is that the working conditions (indoor climate, lighting,

noise) are closely connected with the monotonousness of the work. Cold temperatures (<200C in

the offi ce), bad lighting (<300 lx at the till or <400 lx in the offi ce) are supplementary factors for

developing the musculoskeletal disorders.

The results of the analysis of repetitive work (ART tool) show that the intensity of work for

workers totally engaged in info-technology is high, but in some way monotonous, therefore health

problems like musculoskeletal disorders are very common. The rehabilitation possibilities were

proposed.




ERGONOMIC ASSESSMENT OF WORKPLACES IN ATRIUM-TYPE BUILDINGS

Piia Tint, Laura TkatsovaDepartment of Work Environment and Safety,

Tallinn University of Technology, Estonia

Key words: ergonomic design, atrium-type buildings, indoor climate

INTRODUCTIONAtrium-type buildings are very common in the modern construction of big educational facilities.

In the present study the indoor climate and ergonomic design of workplaces and auditoriums are

investigated in three diff erent atrium-type university buildings.

AIMTo remedy the design drawbacks and give recommendations for better solutions for arranging

work- and study-places for people in atrium-type buildings.

MATERIALS AND METHODSThree confi gurations of the new atrium-type buildings were investigated. There was done meas-

uring of the working conditions (air conditions: temperature, humidity, velocity; the lighting of the

workplaces, content of CO2 in small offi ce-rooms); questioning of 240 workers about their working

conditions was carried out; the workplace design was assessed by an ergonomist.

RESULTSThe ambient air in the rooms facing the atrium is not fresh even if the mechanical ventilation is

working, the air is too dry in the winter season, the system of artifi cial lighting is not designed taking

into account the ergonomic principles, the shortage of natural light in the rooms facing the atrium

is considerable, the workrooms are too small and the requirements of EVS-EN 15251 are not met

in the distribution of the rooms to the workers in the new buildings. Recommendations are given to

prevent similar drawbacks in the future and to improve the present situation in the workrooms in

atrium-type buildings.

CONCLUSIONSInvestigation of working conditions and the design of workplaces in the modern atrium-type

buildings is very important in diff erent countries (in cold and hot regions). Scientifi c approach is

needed to maintaining good health of people who spend 60% of their life working in such buildings.

Today it is a problem under investigation in many countries (Finland, Malaysia, the Czech Republic,

the Baltic States etc.). The current study is an attempt to help solving the health problems of people

working in atrium-type buildings.




OCCUPATIONAL HEALTH AND SAFETY CULTURE PROMOTION: EVALUATION OF SAFETY SIGNS INFLUENCE ON OCCUPATIONAL ACCIDENTS AND DISEASES

Laura TkatsovaChair of Work Environment and Safety, Faculty of Economics and

Business Administration,Tallinn University of Technology, Estonia

Key words: safety signs, working environment, workplace hazards, occupational accidents, occupational diseases

INTRODUCTIONMost of injuries can be prevented or minimized by good workplace design, strong management

system and supervision combined with continual risk assessment and eff ective employee training.

Safety signs play a signifi cant role in occupational health and safety culture promotion and preven-

tion of workplace hazards, occupational accidents and diseases. Accident prevention is an integral

part of running a successful enterprise. There is a correlation between ergonomic workplace design,

employee training, safety signs and injuries.

AIMTo identify connection between safety signs, employee training and injuries and analyse their

infl uence on occupational health and safety culture.

METHODS AND MATERIALSThe research included statistical data analysis of registered accidents at work, occupational

and work-related diseases, working environment conditions, and the results of previous inspection in

the fi eld of instruction and training of employees. Target inspection was carried out in small, medium

and large size enterprises. Enterprises that had causalities of occupational accidents and/or dis-

eases, mainly in production and sales sector, were chosen as the focus group. There were evaluated

80 enterprises. The evaluation of working environment regarding the use of safety signs was carried

out applying a visual method and a questionnaire.

RESULTSAccording to the investigation results 51 of the evaluated enterprises had 299 cases of acci-

dents at work; more than 10 had occupational illnesses. Only 14 enterprises showed good organiza-

tion of working environment and safety signs management. Those enterprises that complied with the

requirements had a smaller number of injuries and illnesses at work. The investigation recognised

345 infringements in requirements for the use of safety signs at work. The statistical data analysis

revealed a connection between employee’s injuries, knowledge and use of safety signs at the work-

place. Recommendations to improve the working environment and avoid occupational accidents,

diseases and work-related diseases are given.

CONCLUSIONThe data revealed a strong connection between injuries, risk assessment and especially training

activities that should be provided according to the requirements for the use of safety signs at work.

Attention paid to employees training and risk assessment regarding safety signs contribute to better

working conditions and provide healthier working environment.




DEPRESSION AS OCCUPATIONAL DISEASE FROM THE INFLUENCE OF PHYSICAL AND CHEMICAL FACTORS

Sergei TretyakovNovosibirsk State Medical University, Russia

INTRODUCTIONDepression is an important medical a problem. In patients with somatic diseases depression

can lead to serious medical-social consequences: infringement of psychosocial functioning, deterio-

ration of the clinical current of somatic diseases, decrease in the quality of life of patients, decrease

in adherence of patients to treatment, deterioration of the forecast (Broadhead W.E., 1990; Hays

R.D., 1995). In connection with above told diagnostics of aff ective infringements in persons with a

somatic pathology, in particular, professionals, is of big urgency.

AIMTo reveal in persons with occupational diseases the frequency of occurrence and structure of

depressive frustration from the infl uence of physical and chemical factors.

MATERIAL OF RESEARCHThere were surveyed 79 people. Depending on the character of the infl uencing professional

factor the patients were divided into two groups. The fi rst group was made of 37 people with a pro-

fessional pathology from the infl uence of a physical factor (vibration, noise), average age 59.8 years,

average working experience 35.9 years, the experience in harmful working conditions 25.8 years.

The second group included 42 people with a professional pathology from the infl uence of a chemical

factor (had worked with organic solvents for aromatic series, uranium salts) average age 63.4 years,

average working experience 33.4 years, the experience in harmful conditions 20,6 years.

METHODS OF RESEARCHThe DSM-4 criteria (Diagnostic and Statistical Manual of Mental Disorders, 4-th ed., 1994)

were used for revealing depression. The given criteria allowed revealing a small and big depressive

episode.

RESULTSIn the fi rst group mental frustration of depressive character was revealed in 37.8% of the peo-

ple, in the second group - in 80.9%. Taking into account that depressions represent itself as an

independent risk factor of development АH and IDH (Larson S.L., 2001), it is important to note that

in the group of people with a professional pathology from the infl uence of a physical factor АH was

diagnosed in 62.1% of the cases, in the group of people with pathology from the infl uence of a chemi-

cal factor - in 76.2%. In the fi rst group was revealed АH 3 risk (3 risk – in 47.8%, 4 risk - in 30.4%),

average duration of the disease 12 years, while in the second group - with 4 risk (3 risk – 34.4%, 4

risk - 56.3%), the average duration of the disease 18 years is more often. In the second group IDH

was diagnosed (2nd group – 42.9%, 1st group - 13.5 %) and also diabetes (SD) (2nd group – 19.1%, 1st

group - 3.2%) of the second type is more frequent. Studying of depressive frustration has shown that

the small depressive episode in the structure of depression is met more frequently in the fi rst group,



than in the second (64.2% and 32.3% accordingly), at the same time in the second group the “big”

depression (2nd group - 71.7%, 1st group – 35.8 %) was revealed much more often.

Thus, in the group of people with occupational diseases from the infl uence of chemical factors

higher frequency of occurrence and a degree of expressiveness of depressive frustration is con-

nected with higher frequency of occurrence of a cardiovascular pathology (АH and IDH), including

their complicated forms, and SD 2 types in comparison with the group of people with occupational

diseases from the infl uence of physical factors. The obtained data reveal the need of introducing the

procedure of screening of depressive resources in this category of patients, as well as the use of

energizers in medicamentous therapy.




ANALYSIS OF OCCUPATIONAL ACCIDENT REGISTRATION SYSTEM IN LATVIA AND COMPARISON OF ACCIDENT RATES IN VARIOUS EU COUNTRIES

Ivars Vanadzins, Inese MartinsoneInstitute of Occupational Safety and Environmental Health

of Riga Stradiņš University

Key words: registration of occupational accidents, risk awareness

INTRODUCTIONWork environment in Latvia has changed rapidly over the last 15-20 years due to global changes

and changes in the occupational health and safety (OH&S) system. Changes in the OH&S system

has also brought about changes in reporting of the most signifi cant indicators used to analyse the

effi ciency of OH&S, including those characterising occupational accidents.

AIMTo analyse the development of registration system of occupational accidents as well as its link-

age with the OH&S service coverage and risk awareness in Latvia and to compare it with data from

other countries.

MATERIALS AND METHODSThe data base of two surveys on working conditions from 2006 and 2010 were analysed and

compared with the major changes in the OH&S policy. The surveys included data from interviews

with around 2500 employees and 1000 employers, data from interviews with OH&S experts, data

from the State Labour Inspectorate (occupational accidents). Data provided by Eurostat and by the

International Labour Organization were also used.

RESULTSThe general development trends of registered occupational accidents show interesting patterns

and correspond with major economic and political processes going on in Latvia. The total number

of registered occupational accidents shows on average 20 time less registered accidents than the

European average (121 accidents per 100 000 employees in Latvia in 2007 versus 2860 in EU15)

and also less registered accidents than neighbouring Estonia and Lithuania. The total number of reg-

istered fatal accidents shows a rather diff erent trend (3.2 cases per 100 000 in Latvia in 2007 versus

2.1 in EU15). Another aspect under analysis was the distribution of registered reported accidents

across industries revealing that health care have more accidents than the construction sector. These

discrepancies could be explained by the fact that the survey data bring out large underreporting by

employees and employers together with inadequate legal regulations. Also the overall level of OH&S

service coverage including risk assessment is very low (46% of the companies in 2010) and could be

another reason for underreporting and low awareness of accident reporting as obligation.

CONCLUSIONSThe study reveals that changes and eff orts in improvements of registration of all occupational

accidents in Latvia have not been eff ective and a huge proportion of occupational accidents is not

registered. A diff erent approach should be taken to increase reporting of occupational accidents by

improving coverage of risk assessment and working conditions.




OCCUPATIONAL SAFETY AND HEALTH IN LITHUANIAGediminas Vilkevičius1, Audrius Spirgys2

1 Department of Occupational Safety and Engineering Management,

Aleksandras Stulginskis University, Kaunas, Lithuania2 Department of Environment and Occupational Medicine,

Lithuanian University of Health Sciences, Kaunas, Lithuania

Key words: occupational safety and health (OSH), state OSH

management, external OSH service, OSH research, OSH training

Creation of safe and healthy working conditions in all work-related aspects is the duty of each

employer in Lithuania. However, success of fulfi lling this employers’ duty primarily depends on the

development and eff ectiveness of the whole national occupational safety and heath (OSH) system.

AIMTo identify institutions related to the OSH management and determine their role in this process.

METHODIt involved search of specifi c offi cial data on OSH management in Lithuania, analysis of these

data and attempts to underline the OSH trends in the process. The main sources of information were

research publications, internet sites and data bases of the relevant institutions. The Labour Code,

the Law on Safety and Health at Work and other OSH legal acts transpose into the Lithuanian law

requirements of the European OSH related law. The OSH strategy for 2009-2012 provides the basic

planning for the accomplishment of objectives of the OSH policy at the national level. The Ministry of

Social Security and Labour and the Ministry of Health Care implement state policy in the OSH area.

The State Labour Inspectorate not only controls compliance of enterprises with the requirements of

labour and OSH legal acts and works for prevention of accidents at work and occupational diseas-

es but also collects and analyses certain OSH related information, renders methodical and advise

services, etc. The other ministries infl uence OSH through their relevant bodies (e.g., Occupational

Health Centre, State Energy Inspectorate, etc.). Research and training in OSH area is performed

at the related departments of Aleksandras Stulginskis University, Kaunas University of Technology,

Vilnius Gediminas Technical University, Lithuanian University of Health Sciences, Vilnius University

and the Institute of Hygiene. Various OSH related services for undertakings (including workplace

risk assessment, training of employers, OSH specialists and coordinators, etc.) are rendered by the

OSH service companies.

CONCLUSIONSLithuania has an appropriate OSH legal base and eff ective system for the state OSH supervi-

sion; regional and local authorities are insuffi ciently involved in the OSH matters; the external OSH

service companies render suffi cient OSH services; OSH research is split among several institutions

and establishing of the national OSH research institute would be advisable; highly-qualifi ed OSH

professionals should be prepared at the Universities.




WORKERS’ HEALTH PRESERVATION, PROBLEMS AND APPROACHES TO THEIR SOLUTION (ON THE EXAMPLE OF THE PERM REGION)

Elena Vlasova, Dmitry Shlyapnikov, Irina DanilinaFederal Research Center of Medical and Preventive Technologies

for Public Health Risk Management, Perm, Russia

Key words: system of occupational medicine

The Perm region is one of economically developed regions of Russia. The number of working

people is 1074494; out of those 47.8%. are employed in harmful working conditions. The number

of employees in the region has fallen by more than 126 thousand people. The problem of workers’

health preservation is one of the priorities. To provide consultative-methodological, expert and prac-

tical assistance on the issues of occupational medicine in the regions of the country the Centres of

Occupational Medicine and Pathology have been established.

The Centre of Occupational Medicine and Pathology (the Centre) on the basis of Federal Re-

search Center of Medical and Preventive Technologies for Public Health Risk Management was

created in 2009. In the Centre more than 3000 employees had been examined, more than 1200

examined during medical examinations. While assessing the occupational risk in the enterprises of

the region occupational diseases had been revealed. The main directions of the Centre are develop-

ment of medical technologies in the fi eld of diagnostics, treatment and prevention of occupational

and industrial diseases in some enterprises, algorithms for the evaluation and workers’ health risk

management, implementation in practice of the normative-methodical documents and scientifi c

justifi cation.

The system for prevention of occupational diseases has a positive result: the ratio of patients

with professional diseases revealed at the initial stage has increased from 57.1% up to 59.6%; the

ratio of patients with pathologies due to working conditions detected during prophylactic examina-

tions has grown from 58.4% in 2007 to 79.6% in 2011. A signifi cant proportion of loss of effi ciency

is determined by the production-conditioned diseases. The Centre has methodological basis for

the risk assessment and prediction of diseases, caused by the working conditions. A program of

examination and treatment has been developed taking into account the existing situation in produc-

tion. These programs are introduced through the system of the health units of the enterprises while

assessing eff ectiveness. An information system is being developed (database on production factors

at a particular workplace with the algorithm of actions of the doctor). The work is being conducted

jointly with the Administration of the Perm region. The integrated approach to occupational medicine

is necessary for workers’ health preservation.




ATTITUDES OF LATVIAN ADULT POPULATION TOWARDS EMPLOYMENT OF PEOPLE WITH MENTAL DISORDERS

Inga Zarde1, Kate Pulmane2, Anita Villerusa2, Elmars Rancans1

1 Department of Mental and Addiction Disorders,

Riga Stradiņš University, Latvia 2 Department of Public Health and Epidemiology,

Riga Stradiņš University, Latvia

Key words: stigma, attitudes, mental illness, employment

INTRODUCTIONEmployment is an important indicator of self-esteem. People build social contacts and can

get all kinds of support at work. People who work have daily routine, higher self-esteem and better

quality of life. Employment of mentally ill persons is a major problem. It is estimated that only about

13.5% of patients with any kind of mental disorder and 3.5% of patients with mental disorder that is

treated in secondary health care institution have work. Only 13.5% of mental patients in Latvia have

had public or private job in the past few years. Exclusion from the job market means not only fi nan-

cial instability but also destruction of self-esteem, isolation and impending disablement.

AIMTo fi nd out the attitudes or the so-called perceived stigma of the Latvian adult population to-

wards employment of people with mental disorders.

MATERIALS AND METHODSThe Link’s devaluation and discrimination scale was used in this study. The scale consists of 12

statements that respondents had to evaluate on a Likert scale (from “completely agree” = 1 point

to “completely disagree” = 6 points). Four statements relating employment of mentally ill were as-

sessed in this study. High total score or the mean score above 3.5 was considered as high perceived

stigma towards mentally ill persons. The scale was included in the Health Monitoring Survey (FIN-

BALT) in 2010. The survey was performed in Finland and the Baltic countries. The Health Economy

Center performed the survey in Latvia. 3000 randomly selected adults were surveyed. The obtained

results on the Link’s devaluation and discrimination scale were assessed in compliance with the

respondents’ sex, age, education level and previous contacts with a mentally ill person.

RESULTSThe mean value on the scale was 4.22 points that indicates high level of perceived stigma regard-

ing employment of mentally ill persons. The mean value above 3.5 points was calculated in 77.3% of

respondents. The most positive attitude of the Latvian adult population was about the employment of

mentally ill persons if he or she fi ts the position (3.29 points). But in the situation where two people

have applied for the same position the Latvian adult population estimated that the employer would

accept the person without a background of mental illness (4.94 points). The respondents with a lower

level of education estimated more positively the possibility of employing a mentally ill person. More

than a third of the respondents have had a previous contact with a mentally ill person.



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DDVI 2.indd 02-03DDVI 2.indd 02-03 11/29/12 3:51 PM11/29/12 3:51 PM

UDK 616.8.084(062)+613.6(062) C 42

Conference on Occupational Health and Safety: From policies to Practise [Riga, December 6-7, 2012]. – Riga: Rīga Stradiņš University, 2012 – 72 p.

Organizer: The Institute of Occupational Safety and Environmental Health, Rīga Stradiņš University

Brochure funded by ERDF project „Rīgas Stradiņa universitātes starptautiskās sadarbības aktivitāšuveicināšana zinātnē un tehnoloģijās”, agreement No 2010/0200/2DP/2.1.1.2.0/10/APIA/VIAA/006

Articles are reviewed by:Ivars Vanadzins, Ph.D. (Latvia)Inese Martinsone, Ph.D., Msc.Chem.(Latvia)Linda Skreitule, Msc.sc.sal. (Latvia)

Scientifi c Secretary: Ingrīda KreileEditor: Maija TreilonaLayout: Pēteris Gricenko, Jānis PavlovskisDesign: Iveta Bambere

In case of re-publishing permission from RSU is required

© Rīga Stradiņš University, 2012Dzirciema 16, Riga, LV-1007, Latvia

ISBN 978-9984-793-20-7

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Documents

DDDVI 2.indd 1DVI 2.indd 1 111/29/12 4:29 PM1/29/12 4:29 PM · Occupational Diseases in 1974. By joining these two institutions the Centre of Occupational and By joining these two