Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul...
-
Upload
marion-ray -
Category
Documents
-
view
217 -
download
0
Transcript of Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul...
![Page 1: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/1.jpg)
Occupational Lung Disease in ThailandPerspective from a
Chest PhysicianNitipatana Chierakul
Faculty of Medicine Siriraj Hospital
Secretary General of The Thoracic Society of Thailand
Consultant of Workmen’s Compensation Fund
![Page 2: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/2.jpg)
SCOPE Magnitude Strength Weakness Opportunity Threat
![Page 3: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/3.jpg)
1997-2000
2002-2004 No. submitted
No. considered
Percentage of decision (%)
Silicosis (%)
Byssinosis (%)
Occupational asthma (%)
Bronchitis (%)
145 32
91 12
63
4535
10
8
32
428
17
25
![Page 4: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/4.jpg)
Chronic Simple Silicosis FEV1 52 %, FVC 66 %, FEV1/FVC 55 %
![Page 5: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/5.jpg)
Progressive Massive Fibrosis FEV1 35 %, FVC 48 %, FEV1/FVC 75 %
![Page 6: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/6.jpg)
Accelerated Silicosis FEV1 41 %,
FVC 54 %, FEV1/FVC 82 %, DLCO 38 %
![Page 7: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/7.jpg)
Small Nodular Opacity FEV1 83 %, FVC 82 %, FEV1/FVC 87 %
![Page 8: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/8.jpg)
Small Nodular Opacity
![Page 9: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/9.jpg)
Mediastinal Node Calcification
![Page 10: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/10.jpg)
Mediastinal Node Calcification
![Page 11: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/11.jpg)
Air Trapping
Inspiration Expiration
![Page 12: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/12.jpg)
Siriraj Siriraj Occupational Lung Occupational Lung
ClinicClinic Patient profiles :•Silicosis 46•Byssinosis 5•Occupational asthma 3
![Page 13: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/13.jpg)
Silicosis Silicosis •Male : female 19 : 27
•Smoking : non-smoking 19 : 27•Continue : discontinue 11 : 35•TB : No TB 11 : 35•Dead : alive 4 : 42
![Page 14: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/14.jpg)
Factors Factors determining determining
severity of FEVseverity of FEV11 Sex TB Smoking
Profusion
Opacity
Large
opacity
M F + - + - 1 2 3 round
irreg
+ -
Severe
3 4 2 5 3 4 0 7 0 2 5 7 0
Non-severe
7 20
3 24
10
17
3 16
8 20 7 9 18
P-value
0.4 0.268
0.55 0.434 0.07 0.02
![Page 15: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/15.jpg)
Byssinosis•All 32 cases were female •Mostly were textile workers•Irreversible airflow obstruction in 11 cases
•Post-shift drop of FEV1 in 2 cases
•Clinical compatible in 19 cases
![Page 16: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/16.jpg)
Occupational Asthma•Glue 2 cases
•Dye for clothing 2 cases •Cooking 2 cases•Wood dust 2 cases•Seafood packaging 2 cases•RADS from inadvertent burning of bitumen 1 case
![Page 17: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/17.jpg)
Occupational COPD
•Metal fume 3 cases•Noxious gases 3 cases •Mixed inorganic dust 2 cases
•Volatile agents 2 cases•Painter 1 case
![Page 18: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/18.jpg)
STRENGTH•Established guidelines for
diagnosis and compensate evaluation since 1998
•Good support from the Workmen’s Compensation Fund, Social Security Office
•Strong international support•Effective anti-smoking campaign
![Page 19: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/19.jpg)
WEAKNESS•No clearly context in the medical
curriculum •Low awareness from physicians•Penumbra in the guidelines•Unease assess to the supporting system•Unfair amount of compensation
–Upper limit of 60 months (80 % of salary)– Initial 35,000 Baht for treatment, and additional 50,000 Baht
![Page 20: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/20.jpg)
OPPORTUNITY•Collaboration between academic
centers and professional organizations
•Concerning of the new generation•Direction of the country towards
sufficiency economy•Acceptance for civil politic and
peaceful coexistence
![Page 21: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/21.jpg)
THREAT•Political driven of some profit-
baring groups•Public over expectation for
medical services•Complicated legal procedures•System for determining work-
related illness by only one specialist
![Page 22: Occupational Lung Disease in Thailand Perspective from a Chest Physician Nitipatana Chierakul Faculty of Medicine Siriraj Hospital Secretary General of.](https://reader035.fdocuments.in/reader035/viewer/2022062423/56649ea35503460f94ba6fad/html5/thumbnails/22.jpg)