Tropical infections as occupational diseases – labor inspectorate physicians’ aspects of a complex problem
DOI:
https://doi.org/10.5604/01.3001.0015.0505Keywords:
tropical diseases, occupational diseases, travel medicine, malaria, diagnosis, prevention, surveillance, compensationAbstract
Background: Occupational physicians work directly with individual employees regarding diseases that has been caused or exacerbated by workplace factors. However, employees are increasingly required to travel for their work, including to tropical countries where they risk exposure to diseases they would not normally encounter at home (i.e., malaria). Such disease/s may also take days to months to incubate before becoming symptomatic, even after their return home, thus delaying and complicating the diagnosis. Proving this was an occupational disease with respective sick leave entitlement or compensation can be challenging. There is a lack of data concerning occupational diseases caused by tropical infections.
Material and methods: Employee case records for the period 2003-2008 from the State Institute for Occupational Health and Safety of North-Rhine Westphalia in Germany were analysed and assessed within Germany’s regulatory framework. These records included Germany’s largest industrial zone.
Results: From 2003-2008the suspected cases of “tropical diseases and typhus”, categorized as occupational disease “Bk 3104” in Germany, have decreased significantly. A high percentage of the suspected cases was accepted as occupational disease, but persistent or permanent sequelae which conferred an entitlement to compensation were rare.
Conclusion: There is scope to improve diagnosis and acceptance of tropical diseases as occupational diseases. The most important diseases reported were malaria, amoebiasis, and dengue fever. Comprehensive pre-travel advice and post-travel follow-ups by physicians trained in travel and occupational health medicine should be mandatory. Data indicate that there is a lack of knowledge on how to prevent infectious disease abroad.
Downloads
References
Saretzki C, Dobler G, Iroc E, Mayc Y. Chikungunya seroprevalence in two South Pacific Island States – the Cook Islands and Vanuatu. Annual Meeting of the German Society of Travel Medicine, Coburg, September 18-19, 2020 [in print]. Google Scholar
DuPont HL, Ericsson CD, Farthing MJ, et al., Expert review of the evidence base for prevention of travelers’ diarrhea. J Travel Med. 2009;16(3):1491-60. doi: 10.1111/j.1708-8305.2008.00299.x. Google Scholar
Toovey S, Moerman F, van Gompel A. Special infectious disease risks of expatriates and long-term travelers in tropical countries. Part II: Infections other than malaria. J Travel Med. 2007;14(1):50-60. doi: 10.1111/j.1708-8305.2006.00092.x. Google Scholar
Neppach K. Nicht-infektiöse Risiken junger Freiwilliger bei internationalen Sozialprojekten von Non-Governmental Organizations [Non-infectious risks of young volunteers of international social projects of NGOs]. [master’s thesis] Aachen: RWTH Aachen University. Institute of Occupational and Social Medicine; 2013. Google Scholar
Küpper T, Neppach K, Martin J, Heggie T, Rieke B. Non-infectious health risks of young adults serving in international volunteer services. Health Promot Phys Act. 2020; 13(4): 29-39. Google Scholar
Martin J, Rieke B, Neppach K, Hillebrandt D, Küpper T. Risks to young volunteers in international social projects. Ann Occup Hyg. 2012;56(2):242-252. doi: 10.1093/annhyg/mer104. Google Scholar
Schoneberg I, Frank C, Stark K. Reiseassoziierte Infektionserkrankungen 2010 [Travel-related infectious diseases 2010]. Epidem Bull. 2011;41:371-378. Google Scholar
Chen LH, Leder K, Barbre KA, et al. Business travel-associated illness: A GeoSentinel analysis. J Travel Med. 2018;25(1). doi: 10.1093/jtm/tax097. Google Scholar
Siebtes Buch Sozialgesetzbuch – Gesetzliche Unfallversicherung (Artikel 1 des Gesetzes vom 7.8.1996, BGBl I: 1254), zuletzt geändert durch § 62 Abs. 19 des Gesetzes vom 17. Juni 2008. BGBl I, 2010: 1010. Google Scholar
DGUV, Grundsätze für arbeitsmedizinische Vorsorgeuntersuchungen, Grundsatz G35 “Arbeitsaufenthalt unter besonderen klimatischen und gesundheitlichen Belastungen”. 6th ed. Stuttgart: Gentner Verlag; 2014. Google Scholar
Berufskrankheitenverordnung vom 31. Oktober 1997, BGBl I: 2623, zuletzt geändert durch Artikel 1 der Verordnung vom 10.7.2017. BGBl I, 2017:2299. Google Scholar
Merkblatt zur Bk Nr. 3104: Tropenkrankheiten, Fleckfieber. BArbBl, 2005;7:48-62. Google Scholar
Becker P. Neues Prüfschema für Arbeitsunfälle und Berufskrankheiten [New checking procedure for occupational accidents and diseases]. Med Sach. 2010;106:145-152. Google Scholar
Maruna H, Westphal G. Tropenkrankheiten als Berufskrankheiten [Tropical diseases as occupational diseases]. Mitt Österr Ges Tropenmed Parasitol, 1985;7:197-205. Google Scholar
(anonymous) (2018) Anhang 1 UVV. Google Scholar
EC, Information notices on occupational diseases: A guide to diagnosis. Luxembourg: Office for Official Publications of the European Communities; 2009. doi: 10.2767/38249. Google Scholar
Boulware DR. Influence of hygiene on gastrointestinal illness among wilderness backpackers. J Travel Med. 2004;11(1):27-33. doi: 10.2310/7060.2004.13621. Google Scholar
Schlaich CC, Oldenburg M, Lamshöft MM. Estimating the risk of communicable diseases aboard cargo ships. J Travel Med. 2009;16(6):402-406. doi: 10.1111/j.1708-8305.2009.00343.x. Google Scholar
Khan NM, Jentes ES, Brown C, et al. Pre-travel medical preparation of business and occupational travelers: An analysis of the Global TravEpiNet Consortium, 2009 to 2012. J Occup Environ Med. 2016;58(1):76-82. doi: 10.1097/JOM.0000000000000602. Google Scholar
Pierre CM, Lim PL, Hame DH. Expatriates: Special considerations in pretravel preparation. Curr Infect Dis Rep. 2013;15(4):299-306. doi: 10.1007/s11908-013-0342-4. Google Scholar
Liese B, Mundt K, Dell L, Nagry L, Demure B. Medical insurance claims associated with international business travel. Occup Environm Med. 1997;54:499-503. doi: 10.1136/oem.54.7.499. Google Scholar
Patel D, Easmon C, Seed P, Dow C, Snashall D. Morbidity in expatriates – a prospective cohort study. Occup Med (Lond). 2006;56(5):345-352. doi: 10.1093/occmed/kql026. Google Scholar
Gomes MF, Pastore YPA, Rossi L, et al. Assessing the international spreading risk associated with the 2014 West African ebola outbreak. PLoS Curr. 2014;6. doi: 10.1371/currents.outbreaks.cd818f63d40e24aef769dda7df9e0da5. Google Scholar
Kupper T. Occupational medicine. In: Rieke B, Küpper T, Muth CM, eds. Moderne Reisemedizin [Modern Travel Medicine] Stuttgart: Gentner Verlag; 2013. Google Scholar
Lopez-Velez R, Bayas, JM. Spanish travelers to high-risk areas in the tropics: Airport survey of travel health knowledge, attitudes, and practices in vaccination and malaria prevention. J Travel Med. 2007;14(5):297-305. doi: 10.1111/j.1708-8305.2007.00142.x. Google Scholar
Florchinger B. Beruflicher Auslandsaufenthalt mit Familien. Ergomed. 2011;35:23. Google Scholar
Ricken U. Arbeitsaufenthalt im Ausland unter besonderen klimatischen und gesundheitlichen Belastungen. Prakt Arbmed. 2010;18:245. Google Scholar
Steffen R, Amitirigala I, Mutsch M. Health risks among travelers – need for regular updates. J Travel Med. 2008;15(3):145-146. doi: 10.1111/j.1708-8305.2008.00198.x. Google Scholar
Cramer JP, Burchard GD, von Sonnenburg F. Reiseassoziierte Erkrankungen frühzeitig erkennen [Early diagnosis of travel-related diseases]. Dtsch Ärztebl. 2011;108:2594-2597. Google Scholar
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 University of Applied Sciences in Tarnow, Poland
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
