Avtor/Urednik		Črnivec, Rajko
Naslov		Poklicna kronična radiacijska bolezen - prikaz primera
Prevedeni naslov		Occupational chronic radiation disease - a case report
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 70, št. 2
Leto izdaje		2001
Obseg		str. 73-6
Jezik		slo
Abstrakt		Background. Chronic occupational radiodermatitis is caused by long term repeated skin ionizing radiation with dose over 5 mSv per day, or by cummulative skin dose over 10 Sv. Depending on intensity and duration of ionizing radiation chronic radiodermatitis appears as skin inflamation, sclerodermic, hyperplastic or ulcus features. After 10 years or longer period of latency according to genetic mutations radiation epithelioma (the most frequent planocellular typ), usually multicentric location with tardy metastasis could be detected. The consequences could be invalidity or even specific mortality of worker. Patient and materials. The experts procedure comprised 68 old male medical tehnician whose hands were during 30 years of working activity especially by bones reposition in Traumatologic clinic of Medical centre Ljubljana directly under x-ray overexposed. He was not in dosimetric control and did not use any radiation protective appliences. Estimated cumulative radiation dose on hands was in the range of several hundred Sieverts and cumulative whole body dose to 10 Sieverts. The interdisciplinary experts medical procedure proved by worker chronic occupational radiodermatitis of both hands with epithelioma planocellulare of right hand status after amputation of the third finger of the same hand. The total amputation of the right hand and plastic operation of two fingers of the left hand were proposed. Also was proposed the renewal of the cause of the 1st stage of patients invalidity according to occupational disease (retirement caused by invalidity). Conclusions. In Republic of Slovenia the validity and reliability of occupational health impairments caused by ionizing radiation are known because computerised republic register of occupational pathology has not been founded yet. (Abstract truncated at 2000 characters.)
Izvleček		Izhodišča. Kronični poklicni radiodermatitis je posledica ponavljajoče se zunanje obsevanosti kože z dozo preko 5 mSv dnevno oziroma pri celotni kumulativni dozi na kožo preko 10 Sv. Odvisno od doze in trajanja obsevanosti se klinično pojavi z znaki vnetja kože, sklerodermičnimi, hiperplastičnimi in ulceroznimi spremembami. Po latentni dobi 10 let in več se zaradi genetskoh mutacij lahko pojavljajo radiacijski epiteliomi (najpogosteje planocelularni), ki so po navadi multicentrični in kasno metastazirajo. Posledično lahko pride do invalidnosti in specifične umrljivosti delavca. Bolnik in metode. V prispevku je opisan izvedensko obravnavan primer 68-letnega mavčarja in operacijskega strežnika, ki je bil pri delu 30 let čezmerno izpostavljen rentgenskemu sevanju, zlasti pri repozicijah kosti neposredno pod kontrolo z RTG na Travmatološki kliniki KC. Pri delu ni imel ustrezne zaščite pred sevanji in ni bil v dozimetrični kontroli. Obstaja ocena, da je prejel v tridesetih letih dela na roke ekvivalentno dozo reda velikosti nekaj stotin Sievertov oziroma na vse telo do 10 Sievertov. Izvedenska obdelava je pri delavcu potrdila kronični poklicni radiodermatitis obeh rok s planocelularnim epiteliomom desne roke in stanje po amputaciji sredinca desne roke. Predlagana je amputacija desne roke in plastična operacija na dveh prstih leve roke. Predlagana je tudi ponovna ocena na invalidski komisiji v Ljubljani zaradi opredelitve poklicnega vzroka invalidnosti I. kategorije (invalidska upokojitev). Zaključki. Ker v RS še ni računalniško podprtega republiškega registra sumov na poklicno bolezen, poklicnih bolezni in bolezni v zvezi z delom, veljavnih in zanesljivih podatkov o resnosti problematike poklicnih zdravstvenih okvar od ioniziranega sevanja ne poznamo. Po nepopolnih podatkih med kroničnimi poklicnimi radiacijskimi boleznimi izstopajo kožne v smislu radiodermatitisa, poklicne katarakte in rak različnih lokalizacij. (Izvleček prekinjen pri 2000 znakih.)
Deskriptorji		RADIATION INJURIES OCCUPATIONAL DISEASES AGED RADIODERMATITIS CARCINOMA, SQUAMOUS CELL CHRONIC DISEASE