OCCUPATIONAL DISEASES IN WORKING LIFE

Occupational disease and occupational accident are concepts that are confused with each other. In previous studies, occupational accidents have been mentioned in detail under the title 'WORK ACCIDENTS IN WORKING LIFE'. In this study, occupational diseases will be included.

What is Occupational Disease?

Occupational diseases are defined separately in the Social Security and General Health Insurance Law No. 5510 and the Occupational Health and Safety Law No. 6331;

Under Law No. 5510, an occupational disease is a temporary or permanent illness, physical or mental disability suffered by the insured due to a repeated reason due to the nature of the work or the conditions of the work.

Under Law No. 6331, an occupational disease is a disease that occurs as a result of exposure to occupational risks. As can be understood from this explanation, in order to talk about an occupational disease, it must be a disease that occurs due to work-related factors.

What are the Concepts Related to Occupational Disease?

Obligation Period: The longest period of time between the cessation of the harmful occupational effect that will cause the occupational disease and the occurrence of the disease.

Exposure Duration: The period between the onset of the harmful occupational effect that will cause the occupational disease and the appearance of the symptoms of the disease. This concept is used to explain how long the patient has been exposed to the disease element.

What are the Types of Occupational Diseases?

Occupational diseases that appear in people directly exposed to the agent at work are divided into different groups. Occupational diseases are diseases specific to certain occupations. The types of occupational diseases that occur as a result of the existence of a certain causal link are specified in the Social Insurance Institution Social Insurance Health Procedures Regulation published in the Official Gazette dated 1972 and numbered 14223.

Pursuant to Article 5 of the relevant Regulation; 'The extent to which the impairments caused by work accident or occupational disease will reduce the earning capacity of the insured in his/her occupation is determined according to Schedules A, B, C, D, and E attached to the Regulation. The statement is included. As can be understood from this article, occupational diseases are divided into 5 different groups (A, B, C, D, E,).

Group A: Occupational Diseases with Chemical Substances; This group includes diseases caused by chemicals such as lead, mercury, cadmium, benzene, hexane, some of which cause poisoning and some of which cause cancer types. The damage caused by each substance in the body may be different. These chemicals enter the body in solid, liquid or gaseous form through digestion, inhalation or through the skin. These diseases are found in 67 disease types in 25 subgroups within Group A.

Group B: Mesleki Deri Hastalıkları: Bir kısmı kansere, bir kısmı da kanserleşmeyen deri hastalıklarına neden olan maddelerin cilde teması sonucunda ortaya çıkan hastalıkları içinde barındıran gruptur. Meslek hastalıklarının yaklaşık %30 deri hastalıklarıdır. Bu hastalıkların da %90’ı Kontrakt Dermotitlerdir (deri iltihabı). Deri hastalıkları en çok el bölgesinde gözükmektedir. Bu hastalık grubunda işveren tarafından yükümlülük süresi; kanserler için 5, kanserleşmeyen deri hastalıkları için ise 2 yıldır.

Group C: Pneumoconiosis and Other Occupational Respiratory Diseases: Pneumoconiosis is an occupational disease that causes tissue damage as a result of dust accumulation in the lungs. This group of diseases caused by respiratory exposure occurs as a result of airborne pollutants entering the body through the respiratory tract. Dust is the most important of these pollutants. Dusts with sizes between 0.5-100 microns, which are important for human health, are the most important factor in the formation of occupational lung diseases. There are 9 diseases in 6 subgroups under this group.

Group D: Occupational Infectious Diseases: A group of diseases transmitted through respiratory, skin and digestive tracts, usually by viruses, bacteria and parasites, as a result of exposure to certain products. For example; anthrax disease occurs as a result of the transmission of bacteria and this disease is usually seen in occupational groups that have contact with animals such as farmers, butchers and veterinarians. This disease group includes 4 subgroups and 30 disease types.

Group E: Occupational Diseases Caused by Physical Factors: It is the group that includes harmful factors that harm the health of employees. Physical factors do not allow employees to work comfortably and cause some occupational diseases. The damages caused by physical environmental factors (vibration, noise, pressure, etc.) and the occupational diseases caused by them are included in this group as 12 disease types in 7 subgroups.

How to Report Occupational Diseases?

In Turkey, in case of occupational diseases, after the preliminary diagnosis process is carried out by the necessary institutions, according to the Law No. 6331; to health service providers authorized by the Social Security Institution, three working days within the deadline.

There are three occupational disease hospitals in Turkey in Istanbul, Zonguldak and Ankara. Hospitals in these three provinces, medical faculties of state universities and state training and research hospitals can diagnose occupational diseases for employees referred by the employer. Until August 2008, only occupational disease hospitals could diagnose occupational diseases, but since then university hospitals have also been authorized to diagnose occupational diseases.

Once a definitive diagnosis has been made, the institutions authorized to diagnose and which have made the diagnosis must notify the Social Security Institution within ten working days at the latest.

The SSI Health Board makes decisions such as whether the diagnosis of occupational disease is occupational or not, and whether there is a ratio of earning capacity to work or occupation. These decisions can be appealed before the Social Insurance Supreme Health Council. In addition, the employee can apply to the Provincial Directorate of SSI or Social Security Centers for the determination of earning capacity.

After the registration of the occupational disease by the SSI Health Board, the SSI units will notify the employer in writing with the Work Accident and Occupational Disease Notification Form. The date of notification of this notification by the employer shall be the date specified in the Law. 'the day it was learned' and notification to the SSI will be required within three working days.

What is Employer-Employee Liability?

Worker Liability

The worker must comply with the instructions set by the employer. In addition, he/she must implement the occupational health and safety trainings given in consideration of himself/herself, his/her coworkers and his/her employer. They should fulfill the necessary instructions by paying attention to the risk group they are in. For example, if there is a skin disease or dust exposure, the employee should take care to use personal protective equipment and should not even neglect it. In addition, they should warn the employer about hazards that the employer fails to recognize and ensure that necessary precautions are taken. In accordance with the legislation, if the necessary precautions have not been taken by the employer although the necessary precautions should be taken by the employer, if the necessary precautions are still not taken although the employee warns the employer to take them; the employee may not do the work or even terminate the employment for just cause.

Employer Responsibility

The employer is obliged to have an Occupational Health and Safety and/or Workplace Physician according to the hazard group of the workplace. These hazard classes and the features that the specialist must have in order to work in these hazard classes are as follows:

• Very Dangerous Workplace Class (OHS specialist must have Class A specialization certificate)
• Dangerous Workplace Class (OHS specialist must have a Class B specialization certificate)
• Less Hazardous Workplace Class (OHS specialist must have a Class C specialization certificate)

Apart from all these, the employer must also take the necessary precautions. It should raise awareness of its personnel by providing trainings through OHS experts. Ensure that protective measures are taken. Take the measures deemed necessary by the OHS expert.

Although the employer has taken all necessary measures and provided all necessary criteria, if the staff acts without complying with Occupational Health and Safety measures, the employer may not let the staff do the work and may even terminate the work for just cause.

Apart from all these, the financial liabilities of Occupational Diseases are as mentioned in detail for work accidents under the heading 'WORK ACCIDENTS IN WORKING LIFE' in previous studies.

Occupational Diseases Statistics in Turkey

Data on occupational diseases in Turkey are published by the SSI. The latest 2018 data was published on the official website of the SSI.

According to 2018 SSI occupational diseases data, three people contracted occupational diseases. One of them was recorded as 'manufacture of other non-metallic products' sector. Another one was recorded in the 'furniture manufacturing' sector. The last one was recorded as 'unknown'. In addition, the person in the 'unknown' section also developed an occupational disease after his/her employment ended. In other words, in this case, two physical workers and one person who quit his/her job had an occupational disease in 2018. There were no deaths from occupational diseases between 2013-2017.