Summary of Webinar de salut laboral. Malalties professionals: “La punta de l’iceberg”

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00:00:00 - 01:00:00

In this section of "Webinar de salut laboral. Malalties profesionales: "La punta de l'iceberg", Dr. Carmen Benat discusses the concept of work-related illnesses and accidents in the context of professional nursing. She defines work accidents as incidents that occur in a specific time and place and are caused directly by work-related activities, while occupational diseases are contracted as a result of exposure to substances or elements listed in the professional diseases catalog. Dr. Benat emphasizes the importance of diagnosing and preventing work-related diseases, highlighting the benefits of early detection and prevention in order to implement effective policies and protect vulnerable worker groups. She also discusses the limitations of the concept of enfermera profesional, such as the difficulty in determining a specific connection between a patient's symptoms and their job, and the importance of addressing any external factors that may contribute to a patient's condition.

00:00:00 In this section, Dr. Carmen Benat discusses the concept of professional contingencies in the context of work-related issues. Specifically, she defines what is considered an accident of work, focusing on the concept of an "accident that occurs" or "as a result of working." She states that this term applies to all workers and not just specific professions, and that accidents that occur while commuting to work or during tasks that do not involve working in a typical workplace can still be considered work-related accidents. It is important to note that accidents that result from force majeure or imprudence will not be considered accidents of work. Associated injuries and ethics-related injuries may be considered accidents of work if they result from the accident.
00:05:00 In this section, the speaker discusses the difference between work accidents and occupational diseases. They explain that work accidents are incidents that occur in a specific time and place and are caused directly by work-related activities. On the other hand, occupational diseases are contracted as a result of work, specifically from exposure to substances or elements listed in the professional diseases catalog. The speaker also mentions that establishing a causal relationship can be challenging in some cases, especially when the disease is not included in the catalog. In those situations, the disease may be recognized as a work accident instead. They highlight that work accidents have a sudden onset, are usually caused by external factors, and have a clear causal relationship, while occupational diseases may have a slower and more gradual onset.
00:10:00 In this section, the speaker discusses the concept of the enfermera profesional, or the professional nurse, which is a legal recognition of a health problem caused by work. This recognition establishes a causal relationship between the patient's symptoms and their job, and it is important to understand the specific conditions of work and the exposures in order to determine the cause of a suspected work-related illness. The speaker also highlights the limitations of the concept of enfermera profesional, such as the difficulty in determining a specific connection between a patient's symptoms and their job, and the importance of addressing any external factors that may contribute to a patient's condition.
00:15:00 In this section, the speaker discusses the importance of individual protection equipment and the role of professionals in detecting and diagnosing workplace-related diseases. The speaker also highlights the benefits of changing jobs for patients who have been diagnosed with work-related illnesses, which can reduce social security contributions. The speaker emphasizes the need for proper risk assessment, effective communication among all parties involved, and a good understanding of medical and legal implications.
00:20:00 In this section, the speaker discusses the importance of including a complete and detailed work history in medical records for the early detection and suspicion of occupational diseases. They emphasize the need for training not only the healthcare professionals but also informing the companies about the importance of diagnosing and preventing diseases in the workplace. They also highlight the inhibitions of affected individuals due to lack of knowledge or fear of job loss. The speaker explains the effects of failing to recognize occupational diseases, including the costs and benefits that individuals are entitled to when their illness is recognized as work-related. They stress the importance of early detection and prevention in order to implement effective policies and protect vulnerable worker groups. The speaker presents data from Asepeyo, a mutual insurance company, showing a significant number of reported cases of work-related diseases, particularly in the field of musculoskeletal disorders.
00:25:00 In this section, the presenter is discussing the distribution of work-related professional diseases in Spain in 2019, and how it varies across different communities and regions. The presenter notes that the Spanish system is designed to identify potential cases of professional diseases through units of centinels that are set up in specific regions such as Cataluña and Navarra. These centinels collect data and create a system of alert that is used to study the identified cases of professional diseases. The presenter finds that the center of attention seems to be in Barcelona, or in Cataluña, with three thousand, three hundred and sixty-three cases, compared to twenty-seven thousand, two hundred and ninety-two cases nationwide. The presenter also mentioned that the differences are due to the different detecting mechanism set up by the autonomous communities, in which the centinels have an effective system of alert that is well connected with the prevention services, and with the entities gestor. The presenter also mentions the importance of detecting professional diseases, highlighting that, in the mentioned Spanish system it is the most important, with an estimated average of four thousand cases in the Spanish region. He also expresses that, if a more effective centralized system were to be implemented, the number of cases of professional diseases that go unnoticed would be reduced. The presenter also mentions other systems, such as the model of Navarra, which has been more successful in detecting hidden cases of professional diseases.
00:30:00 In this section, the speaker discusses the under-detection and variability in the detection of occupational diseases, particularly in industries such as construction, chemical, and agriculture. They highlight how certain industries, like cleaning or hotel assistance, may go unnoticed in terms of occupational diseases. The speaker also mentions the different regions in Spain where diseases caused by chemical agents, biological agents, inhalation of substances, and physical risks are more prevalent. They explain the importance of improving detection, assistance, diagnosis, and declaration of occupational diseases, as well as the need for interdisciplinary teamwork and consultation with specialists. Additionally, they mention the existence of a network of occupational health units in Catalonia, which also considers diseases related to psychosocial risks.
00:35:00 In this section, the speaker discusses how cases of work-related illnesses are identified and managed. When a potential work-related illness is suspected, it can be referred to the appropriate medical professionals for assessment. The speaker mentions that their organization has several units specialized in occupational diseases, where they handle interconsultations and visit cases that require their expertise. They emphasize the importance of collaboration and communication within their units and with other healthcare entities. Additionally, they mention their involvement in training, research, and epidemiological studies related to occupational diseases. The speaker explains that they can receive cases from various sources, including referrals from healthcare centers or direct appointments by patients with a letter from their employer. They also mention that cases can come through the National Institute of Social Security or be evaluated by medical tribunals.
00:40:00 In this section of the YouTube video titled "Webinar de salut laboral. Malalties profesionales: “La punta de l’iceberg”", the speaker discusses the topic of work-related illnesses and accidents. The speaker mentions that although the capital dictamina considers these cases to be accidents of work, they can also be considered as work-related illnesses. The speaker also mentions the importance of having a good history of work as it is necessary to develop a thorough understanding of the illness. The speaker emphasizes that this is not a one-person job but rather an effort of the entire team, including técnicos de salud laborales, compañeros médicos de enfermería, and compañeros de prestaciones. If an occupation is not included in the list of work-related illnesses and accidents, the speaker advocates for a thorough "workup" and suggests seeking advice from "valuable people" in the field of social security.
00:45:00 In this section, the presenter discusses the declaration of professional diseases and the importance of interconsultations. Arthritis Reumatoidea and Túnnel Carpio are cited as examples, with no predisposing factors, but if a relationship between an individual with these conditions and their job is clearly established, it can lead to a claim for a professional disease. Despite declarations, individuals with these conditions can still carry out their duties with some difficulty. Interconsultations are highlighted as important in identifying respiratory and skin conditions among professionals, and their impact is discussed on the role of a medic in treatments.
00:50:00 In this section, the speaker discusses various occupational diseases that can occur, such as silicosis and lung cancer related to asbestos. They emphasize the importance of improving knowledge and awareness of these diseases and the need for a good understanding of a patient's work history in order to suspect and diagnose them. They present a case of a worker who was referred by their primary care doctor, describing their medical history and various symptoms they experienced. The speaker highlights the importance of thorough investigation and consideration of all factors to ensure accurate diagnosis and seek justice for the patient.
00:55:00 In this section, the speaker describes the workplace safety measures that were in place in a small company with three employees. The company used FP3 masks for particulate matter, gloves, goggles, safety shoes, and ear protection. The speaker explains that the employees would wear these protective measures while working in the workshop but would not use them when performing small tasks or repairs outside of the workshop. The speaker also discusses the importance of family and personal health, stating that the employees had no significant health issues except for tuberculosis and that they were not exposed to any hazardous substances in their work.

01:00:00 - 01:15:00

In the first section of the webinar, a radiologist discusses radiographic and tomographic examinations of lung abnormalities, observing a small profusion in the upper lobes. The lack of scar tissue on the pleura rules out conditions like asbestosis and suggests that the profusion is related to tuberculosis. They explain that there are two types of chronic silicosis and that complicated silicosis leads to permanent total disability while simple silicosis requires a change of occupation. The speaker also discusses the appropriate use of personal protective equipment and hierarchy measurements that indicate that exposure levels are within normal limits. In the second section, the speaker discusses a marble worker who has developed bronquietasias secondary to tuberculosis. Despite the company's claims that exposure limits were within safe levels, further testing revealed that the worker had been exposed to silica dust. The speaker stresses the importance of conducting regular testing and diagnosis to detect and prevent the progression of silicosis in workers. The third section discusses the process of diagnosing a silicosis patient. A doctor who had no prior experience working with silicion was contacted by the Spanish National Institute of Occupational Diseases to diagnose a case. The patient's medical history was taken, examinations, and radiographs were ordered, and the patient was informed about the occupational nature of the disease. The doctor highlighted the importance of early diagnosis for the patient's treatment and eventual need for a lung transplant and provided an update on the patient's condition. Finally, the speaker discusses the importance of knowledge and expertise in the field of professionals, specifically in the case of radiologists. They end by expressing gratitude to all those involved in organizing the webinar and the value of discussions about these topics.

01:00:00 In this section, the speaker discusses the results of radiographic and tomographic examinations of lung abnormalities. They observe a small profusion in the upper lobes, particularly in the middle lobe, with a slightly grainy appearance. Comparing the images to previous records, they suspect it to be a profusion between 0 and 10, possibly related to tuberculosis. Further imaging reveals scar tissue and a micro-nodular interstitial pulmonary disease in an asymmetric distribution in the upper lobes, suggestive of chronic silicosis. The absence of lesions on the pleura rules out other conditions like asbestosis. The speaker explains the difference between simple and complicated chronic silicosis, emphasizing the different implications and benefits for the affected person. They mention that complicated silicosis would lead to permanent total disability, while simple silicosis would require a change of occupation. The speaker then discusses the occupational history and working conditions of a marble worker, including the appropriate use of personal protective equipment. Hierarchy measurements indicate that silica levels are within normal limits, according to the permissible exposure limit for crystalline silica.
01:05:00 In this section, the speaker talks about the discovery of a worker who has been working with silestone and resins for many years and has been exposed to silica dust in the process. Despite the company's claims that the exposure level was within safe limits and that no information was available to confirm the worker's exposure, the speaker reveals that further testing revealed that the worker has bronquietasias secondary to tuberculosis. The speaker describes the process of diagnosing a silicosis as difficult and sensitive to the operator, requiring specialized expertise and experience to accurately interpret the radiographs. The speaker emphasizes the importance of conducting regular testing and diagnosis to detect and prevent the progression of silicosis in workers.
01:10:00 This section discusses the process of diagnosing a patient with silicosis. The speaker is a doctor, and she had no prior experience working with the siliciation before she was contacted by the Spanish National Institute of Occupational Diseases for assistance in diagnosing a case. The doctor explained the patient's medical history, including his history of pulsatile moderately severe bilateral pleural fibrosis and lung nodules. The doctor ordered examination, radiographs, and cardiographs, and informed the patient about the occupational nature of the disease. The doctor also mentioned the importance of early diagnosis for the patient's treatment and recovery, as silicosis can lead to irreversible damage to the lungs. The doctor also provided an update on the patient's condition, including the possibility of an exacerbation and the patient's eventual need for lung transplant.
01:15:00 In this section, the speaker discusses the importance of knowledge and expertise in the field of professionals, specifically in the case of radiologists. They mention that radiographers possess a unique and valuable skill set that is not easily taught to outsiders in the industry. Additionally, the speaker emphasizes the importance of maintaining a professional mindset and maintaining confidentiality in the workplace. They end by expressing gratitude to all those involved in organizing the webinar and the value of discussions about these topics.