Publication: Podoloji̇ üni̇tesi̇ çalışanlarının mesleki̇ ri̇skleri̇ ve alınabi̇lecek önlemleri̇n araştırılması
Abstract
Bu çalışmada, dünyada çok eski bir tarihe sahip olmasına rağmen ülkemizde yakın dönemde hizmet vermeye başlayan podologların majör mesleki riskleri bütüncül olarak incelenmiştir. Podoloji ünitelerinde görev yapan podologların mesleki risklerini değerlendirebilmek için çalışma, Kocaeli’de hizmet veren 5 podoloji ünitesinde ve evrak hizmeti gerçekleştiren 3 ofiste gerçekleştirilmiştir. Podologlar deney grubu; ofis çalışanları kontrol grubu olarak sınıflandırılmıştır. Her iki çalışma alanında biyoaerosol, PM4, PM2.5, UOB, gürültü, titreşim, CO, CO2, hava akım hızı, sıcaklık, nem ölçümleri gerçekleştirilmiştir. Çalışmada yaz ve kış dönemlerini kapsayacak şekilde 2 kez örnekleme yapılmıştır. Podologlara ve ofis çalışanlarına Solunum Fonksiyon Testi ve sağlık şikayetlerini irdeleyen anket uygulanmıştır. Yapılan çalışma sonucunda podoloji ünitelerinde PM2.5 konsantrasyonu yaz döneminde ofislere oranla 10 kat, kış döneminde 3,5 kat yüksek bulunmuştur. Podoloji ünitelerinde PM2.5 için WHO sınır değeri olan 35 µg/ m3’ün aşıldığı görülmüştür. PM4 konsantrasyonu ise podoloji ünitelerinde yaz döneminde ofislere oranla 4 kat, kış döneminde 2 kat daha yüksek hesaplanmıştır. Biyoaerosol konsantrasyonları incelendiğinde podoloji ünitelerinde mantar konsantrasyonu ofislere oranla yaz döneminde 1,5 kat; kış döneminde 2 kat kadar daha yoğun bulunmuştur. Bakteri konsantrasyonu podoloji ünitelerinde yaz döneminde ofislere oranla 5 kat, kış döneminde 2-3 kat daha yoğun bulunmuştur. Biyoaerosol çeşitliliğine bakıldığında ofislerde genellikle atmosfer havasında, dış atmosfer havasında bulunması beklenen bakteriler ve küf mantarları ürerken, podoloji ünitelerinde bunlara ilave olarak S. aures, Klebsiella Pneumonia, Pseudomonas spp. gibi bakteriler ve Trichophyton rubrum, Trichophyton mentagrophytes, Mucor spp. gibi solunum sistemi hastalıklarına neden olabilen mikroorganizmaların ürediği saptanmıştır. Podoloji ünitelerinde TUOB (Toplam Uçucu Organik Bileşik) konsantrasyonu yaz ve kış dönemlerinde ofislere oranla yaklaşık 1,5-2 kat daha yüksek bulunmuştur. Podoloji ünitelerinde Toluen, benzen, M, p- Ksilen, o-Ksilen, n-butil benzen en yaygın görülen UOB’ler olarak saptanmıştır. Podoloji ünitelerinde yaz ve kış dönemlerinde CO, CO2 değerleri ofislere oranla daha yüksek bulunmuştur. CO’nun düzeyi iş sağlığı ve güvenliği örgütlerince önerilen 50 ppm sınırının altında bulunmuştur. Podoloji ünitelerinde CO2 düzeyleri WHO’nun önerdiği 350 ppm ve ASHRAE’nin önerdiği 1000 ppm sınırının üzerinde saptanmıştır. Gürültü düzeyi podoloji ünitelerinde ofislere oranla 10 dB(A) daha yüksek; el kol titreşimi de daha yüksek saptanmıştır. Çalışmaya katılan Podologların solunum fonksiyon test sonuçları ofis çalışanlarına göre istatistiksel olarak anlamlı derecede düşük; solunum, cilt, göz şikayetleri ise daha yüksek sıklıkta saptanmıştır. Bu sonuçlar birlikte değerlendirildiğinde podologların Türkiye’deki mesleki geçmişleri çok eski olmamasına rağmen, ofis çalışanlarına göre yaptıkları işler sırasında ortaya çıkabilecek kimyasal, fiziksel ve biyolojik tehlikelerden sağlıklarının etkileniyor/ etkilenebileceği sonucuna varılmıştır. Bu nedenlerle podologların meslek hastalıkları risklerini azaltmak, iş sağlığını geliştirmek adına acil önelemlere ihtiyaç duyulduğu belirlenmiştir.
In this study, despite having a very ancient history worldwide, the major occupational risks of podiatrists who have recently started to provide services in our country have been comprehensively examined. To assess the occupational risks of podiatrists working in podiatry units, the study was conducted in 5 podiatry units and 3 offices providing document services in Kocaeli. Podiatrists were classified as the experimental group, while office workers were classified as the control group. In both work environments, measurements of bioaerosols, PM4, PM2.5, VOC, noise, vibration, CO, CO2, air flow velocity, temperature, and humidity were performed. Sampling was conducted twice to cover both summer and winter periods. Respiratory Function Testing and a survey assessing health complaints were administered to podiatrists and office workers. According to the results of the study, the PM2.5 concentration in podiatry units was found to be 10 times higher than in offices during the summer period and 3.5 times higher during the winter period. The WHO threshold value of 35 µg/ m³ for PM2.5 was exceeded in podiatry units. The PM4 concentration in podiatry units was calculated to be 4 times higher during the summer period and 2 times higher during the winter period compared to offices. When bioaerosol concentrations were examined, fungal concentration in podiatry units was 1.5 times higher during the summer period and 2 times higher during the winter period compared to offices. Bacterial concentration in podiatry units was found to be 5 times higher during the summer period and 2-3 times higher during the winter period compared to offices. In terms of bioaerosol diversity, while offices mainly harbored bacteria and mold fungi that are expected to be present in atmospheric air and outdoor air, podiatry units were found to additionally host microorganisms such as S. aureus, Klebsiella pneumonia, Pseudomonas spp. among bacteria, and Trichophyton rubrum, Trichophyton mentagrophytes, Mucor spp. among fungi, which can cause respiratory system diseases. In podiatry units, TVOC (Total Volatile Organic Compounds) concentration was approximately 1.5-2 times higher during both the summer and winter periods compared to offices. Toluene, benzene, m-xylene, p-xylene, o-xylene, and n-butylbenzene were identified as the most common TVOCs in podiatry units. CO and CO2 levels in podiatry units were found to be higher during both the summer and winter periods compared to offices. The level of CO remained below the recommended threshold of 50 ppm by occupational health and safety organizations. CO2 levels in podiatry units exceeded the recommended thresholds of 350 ppm by WHO and 1000 ppm by ASHRAE. Noise levels were 10 dB(A) higher in podiatry units compared to offices, and hand-arm vibrations were also detected at higher levels. Respiratory function test results of participating podiatrists were statistically significantly lower compared to office workers. Respiratory, skin, and eye complaints were reported at higher frequencies among podiatrists. Considering these results collectively, despite the relatively recent establishment of the podiatry profession in Turkey, it has been concluded that podiatrists are susceptible to chemical, physical, and biological hazards that may arise during their work, impacting their health compared to office workers. Therefore, urgent measures are needed to reduce the risks of occupational diseases and improve occupational health for podiatrists.
In this study, despite having a very ancient history worldwide, the major occupational risks of podiatrists who have recently started to provide services in our country have been comprehensively examined. To assess the occupational risks of podiatrists working in podiatry units, the study was conducted in 5 podiatry units and 3 offices providing document services in Kocaeli. Podiatrists were classified as the experimental group, while office workers were classified as the control group. In both work environments, measurements of bioaerosols, PM4, PM2.5, VOC, noise, vibration, CO, CO2, air flow velocity, temperature, and humidity were performed. Sampling was conducted twice to cover both summer and winter periods. Respiratory Function Testing and a survey assessing health complaints were administered to podiatrists and office workers. According to the results of the study, the PM2.5 concentration in podiatry units was found to be 10 times higher than in offices during the summer period and 3.5 times higher during the winter period. The WHO threshold value of 35 µg/ m³ for PM2.5 was exceeded in podiatry units. The PM4 concentration in podiatry units was calculated to be 4 times higher during the summer period and 2 times higher during the winter period compared to offices. When bioaerosol concentrations were examined, fungal concentration in podiatry units was 1.5 times higher during the summer period and 2 times higher during the winter period compared to offices. Bacterial concentration in podiatry units was found to be 5 times higher during the summer period and 2-3 times higher during the winter period compared to offices. In terms of bioaerosol diversity, while offices mainly harbored bacteria and mold fungi that are expected to be present in atmospheric air and outdoor air, podiatry units were found to additionally host microorganisms such as S. aureus, Klebsiella pneumonia, Pseudomonas spp. among bacteria, and Trichophyton rubrum, Trichophyton mentagrophytes, Mucor spp. among fungi, which can cause respiratory system diseases. In podiatry units, TVOC (Total Volatile Organic Compounds) concentration was approximately 1.5-2 times higher during both the summer and winter periods compared to offices. Toluene, benzene, m-xylene, p-xylene, o-xylene, and n-butylbenzene were identified as the most common TVOCs in podiatry units. CO and CO2 levels in podiatry units were found to be higher during both the summer and winter periods compared to offices. The level of CO remained below the recommended threshold of 50 ppm by occupational health and safety organizations. CO2 levels in podiatry units exceeded the recommended thresholds of 350 ppm by WHO and 1000 ppm by ASHRAE. Noise levels were 10 dB(A) higher in podiatry units compared to offices, and hand-arm vibrations were also detected at higher levels. Respiratory function test results of participating podiatrists were statistically significantly lower compared to office workers. Respiratory, skin, and eye complaints were reported at higher frequencies among podiatrists. Considering these results collectively, despite the relatively recent establishment of the podiatry profession in Turkey, it has been concluded that podiatrists are susceptible to chemical, physical, and biological hazards that may arise during their work, impacting their health compared to office workers. Therefore, urgent measures are needed to reduce the risks of occupational diseases and improve occupational health for podiatrists.