Monitoring Program for Health Protection and Prevention of Noise-Related Diseases in Bucharest Municipality during 2000-

1. Health protection and prevention of the noise exposure relateddiseases - a monitoring program developed during 2000-2005 in Bucharestmunicipality Liliana Rapas M.D., Ph.D. Corha Yvonne M.D. Direction of Public Health M.B.

2. Statistics - 2000 – 2005, Bucharest • Occupational noise surveillance • Risk assessment • Health surveillance – National Occupational Diseases Database • THE IMPACT OF THE NOISE ON THE EMPLOYEES HEALTH STATUS IN A TRADE COMPANY WITH ENGINEERING PROFILE

3. Framework european national • 86/188/EEC full transposition under MLSSF and MH • 2003/10/EEC 87 dB(A) ????

4. Method Technologie Measurement * directly - integration sonometer SR CEI 804+A1+A2 - sonometer CEI 651 * indirectly exposure time acustic preassure field samples and statistic distribution

5. 2000 - 2002 90dB(A) The Main Industries with Occupational Noise Surveillance Policy I. Metallurgy I.food I.wood I.printing. I.plastics I.met.mft. I.car mf. I.tex.mf. Ifarm.com I.elec. I. Ch. I.Transp. I.gls.cerm. I.shoes. Construc. 21 000 workers

6. 2003 – 2005 87 dB(A)

7. 2000 – 2005 50 – 75 dB(A)

8. Health Risk • Work related stress • An increasing injuries risks • Phisiology effects (cardiovascular diseases) • Communication disturbances • Pregnancy risks • Hearing loss

9. Occupational health surveillance • Screening: tonal liminar audiometry • Occupational disease diagnostic • Diagnostic of hearing loss type • Diagnostic for difference; • Diagnostic of occupational etiology • signalling • pronuacement • expertise of working capacity

10. Occupational diseases frequency versus occupational hearing loss

12. Presbiacusie ? • Hearing status when exposure started • Enough exposure • Present exposure versus exposure history • Age • Hearing loss < hearing loss estimated for the ageing • Time

13. THE IMPACT OF THE NOISE ON THE EMPLOYEES HEALTH STATUS IN A TRADE COMPANY WITH ENGINEERING PROFILE - Study- Dr. Yvonne Corha Occupational Health

14. The main activity object of the trade company where we are performed this study is: railway frame production, equipments repair, carriages, engines, etc. • The technology process has the following stages: 1. Dismantle – disassemble of the tread and addle equipments; 2. The repairs of this components or producers to new bench-mark; 3. Assembling; 4. The complying of the equipments to trial. • The most frequent occupations of this trade company are: fitters, cutting worker (lathe mans, milling-machine operators, rectification man), fitters, electricians.

15. Within the security and health audit, has been assessed the working conditions by sides and plants of the company. The physical agents and chemical substances were identified in this workplaces. • The noise was identified like the most aggressive noxious and for this reason was measured every year (continuous survey). • The noise investigation and the quantification during the 25 years, since the company existence, has been made in the Ergonomic Laboratory of D.S.P.-M.B. and Noise Laboratory of I.N.C.D.P.M. • The both laboratories has distinguished over fulfilled of M.A.L. with 10-20 dBA in majority side and plants. It is point out that the noise is not continuous and in such plants has impulse character. • In this trade company labour 1100 employees and approximately 1 000 are exhibited to noise.

16. This study was accomplished after the DSP- MB Occupational Medicine Office was received a number of 12 signalling cards (B.P1) with the industrial disease presumption, in this case the occupational hearing loss, made by physician which is performed the employees periodically check up in the foregoing company.

18. The investigation of the industrial disease has the following stages: • I. Particularly assignment of the noise exhibition: • 1. The examination of the result of analyses through the identification and quantification of the noise in the company plants; • 2. The examination of the authorized documents (work card) with the effective time of work in noise (ancientness in noise). • II. The examination of the case history at the following point of view: Occupational case history with the distinguishing of the work places with more A.M.L. noise; The general pathology with distinguishing : • Hearing affections; • The ingestion of the toxic medicines; Another sonorous trauma or exhibition to toxic chemical substances; • III. The liminar tonal audiometry performed in standard condition – the audiogram carry out in CPM ( periodical check up).

19. The pronouncement criteria of the earlier occupational hearing loss: The permanent increases of the auditory threshold ( auditory definitely deficit) to 4000 Hz frequency with over 30 dB(A) inclusively. After the application of the hearing correction. For perception type, bilateral and symmetrical in generally, without frequency conversational involvement. Occupational etiology.

20. Conclusion: • From the documents study of the employees which has had card signalling hearing occupational disease. It was declared a hearing occupational case, if was made the proof of the noise exhibition over 86 dB(A) , the during of the noise exhibition was over 15 years ( and in audiogram was presented un deficit to 4000 Hz at over 50 dB (A)). • The reasons that was carried to the confutation of the industrial diseases was been: • Two cases was been confutation owing to the existence of un otitises affection since a child. • Nine cases was been confutation because the application of the presbiacusie correction, that, after 50 years the auditory deficit is lesser to 30 dB(A). • One case was confutation because the employee has 46 years old, and the presbiacusie correction mean the decreases to 21 dB(A), and the staying deficit is lower to 30 dB(A).

21. Proposal • The exclusion of the obligatory application criteria of the ageing correction in pronouncement of earlier occupational hearing loss.

23. Occupational Health Team Thank you!