Remarks on the principles of medical assessment in phoniatric and audiological diseases
Kliniki Fonioatrii i Audiologii AM w Poznaniu.Otolaryngologia polska. The Polish otolaryngology 02/1995; 49 Suppl 23:81-5.
Some principles of medical assessment in phoniatric and audiological diseases are critically discussed. The necessity of preliminary qualifying examination to voice profession is underline. Attention is paid to the importance of adequate medical documents in judgement of professional voice and hearing diseases.
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ABSTRACT: The current regulations allow in special cases for the acknowledgement of the occupational disease among teachers who suffer from voice disorders. The physician who acts as the adjudicator in ZUS (National Insurance System) usually consults a phoniatrician and determines the percent of the permanent or long-term health damage, which can vary between 10-40%. The aim of the paper was to analyze the evidence which is taken into consideration while determining the percent of health damage and granting the occupational disease pension. The authors present proposition in detail the rules which govern the process of health damage calculation due to advancement of voice disorders, which can be very useful to adjudicating physicians in government and commercial insurance companies.Otolaryngologia polska. The Polish otolaryngology 02/2006; 60(1):55-60.
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ABSTRACT: Introduction An amendment of the Polish Occupational Diseases Certification Act of 2002 has essentially influenced on the procedures of diagnosis and certification. Aim The aim of the study was to assess the diagnostics of occupational vocal organ disorders in the first and second instance. The clinical diagnosis of the first and second instance certification units were analyzed. Material and methods The study covered 500 cases selected randomly from 921 teachers which applied to IMP and ZŚ in Sosnowiec in the years 2002–2005 in order to diagnose the occupational disease. In this group 298 patients were examined according to rules forced until the amendment act and 202 patients according to new rules. In the all patients the standard diagnosis and certification were carried out according to recommended procedures. Results Among examined patients the most numerous group constituted teachers from primary school aged from 50 to 60 years, 35-years of seniority, specializes in elementary teaching and the Polish language. More than 80% of studied patients began the certification procedure concerning occupational larynx diseases to 5 years from stopping the exposure. Occupational disease was recognized in 71 patients, which was 14,2% of studied population. The most frequent occupational pathology, was vocal folds paralysis (79,2%), hypertrophy of the vocal folds was found rarely (16,6%) and vocal nodules were found most rarely (4,2%). According to old rules 18,5% of appeals were positively considered, i.e. 55 patients from 298 teachers, whereas according to new rules 7,9% of appeals, i.e. 16 patients from 202 teachers. Conclusion Specifying the diagnostic criteria of teachers’ occupational diseases certification have made the significant impact on a consensus of decisions issued by the first and second instances. There was the statistically significant difference between frequency of the clinical diagnosis authorizing to pronounce the occupational disease according to old rules and according to rules which came into force from 2002.Otolaryngologia polska. The Polish otolaryngology 02/2009; 63(1):19-24. DOI:10.1016/S0030-6657(09)70065-4
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