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2011 (pdf, 4 MB) - Universitätsklinikum Hamburg-Eppendorf

2011 (pdf, 4 MB) - Universitätsklinikum Hamburg-Eppendorf

Arbeits- und

Arbeits- und Forschungsbericht 2011 und Planung 2012 • Fachliches Profil stärker akzentuieren • Ausbau der internen Kooperation und Integration • Aufgabenbeschreibung für Ärzte und Wissenschaftler • Optimierung der Führungskompetenz • Sicherung der Methodenkompetenz • Internetpräsenz • Implementierung der EDV-gestützten Patientenverwaltung Central Executive The managers and governors of ZfAM define the main responsibilities and themes for the various departments to undertake – in the publication of findings, in the development of guidelines at national and international levels, and in networking in the occupational medicine scientific community – and empowers them by providing the organisational and structural environment for productive work. During 2011, the successful attainment of Quality Management certification, according to DIN ISO 9001: 2008, was complemented by its continued improvement and consolidation. Of particular note was the conception and holding of a third international workshop: “How to handle Import Containers safely“ (cf. p. 184). The already in 2007 initiated ERS Task Force „New Lung Function Reference values – a united Approach“has finished the main part of ist work with new worldwide recommandations of reference values ( 135) (Quanjer PH, Stanojevic S, Cole TJ, Baur X ERJ, in press). For the Medical Expert Group Occupational Diseaes at the BMAS a literature search and evaluation for the BK 4212 “The Effect of Crystalline Silicon Dioxide (SiO2) on Tumorigenesis in Lung Disorders Caused by Quartz Dust“is going on. Specially the exclusion of hard cole miners and the question of dose-response relationship instead of the orientation on the radiological defined silicose. A significant milestone in the diagnostics and expert assessment of asbestos-induced occupational diseases was attained when the 2008 initiative to develop appropriate medical and scientific guidelines was ultimately successful in 2011 (Baur, Clasen et al. 2011). These AWMF-like guidelines (AWMF, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; Federal Organisation of Scientific Medical Societies) provide a standardisation and quality assurance in asbestos-induced occupational diseases that has produced a fairer recognition and compensation process for those affected. In a similar manner – a notable first in the area of occupational disease diagnostics and compensation – was the successful inclusion of COPD in coal miners on the Occupational Disease List (as BK Nr. 4111), which was achieved in 1997 (Baur, Hillenbach et al. 1994; Bundesministerium für Arbeit 1995). Another protracted battle was also won in 2008 when the compensation rights of many patients with silicosis were reinstated upon the removal of the restricitive exemptions imposed in the 1970s by the Moerser Konvention, which arbitrarily raised the severity threshold for compensation (Baur, Heger et al. 2008; Baur, Köhler et al. 2005, Deutsche Gesetzliche Unfallversicherung (DGUV) Berlin 2011). Baur, X., M. Clasen, et al. (2011). "Diagnostics and expert opinion of asbestos-induced occupational diseases." Pneumologie 65(3): e1-47; Baur, X., M. Heger, et al. (2008); " Diagnostics and expert opinion in the occupational disease No. 4101 silicosis (including coal worker's pneumoconiosis). Guideline (S2; AWMF) of the Deutsche Gesellschaft fur Pneumologie und Beatmungsmedizin and the Deutsche Gesellschaft fur Arbeitsmedizin und Umweltmedizin." Pneumologie 62(11): 659- 684; Baur, X., C. Hillenbach, et al. (1994). Literaturstudie "Chronische Bronchitis und Emphysem - eine Berufskrankheit der Bergleute?". Bochum, BGFA; Baur, X., D. Köhler, et al. (2005). "[Position paper of the German Society of Pneumology on medical expert opinion for silicosis]." Pneumologie 59(8): 549-553; Bundesministerium für Arbeit (1995). "Wissenschaftliche Begründung zur BK Nr. 4111: Chronische obstruktive Bronchitis oder Emphysem von Bergleuten unter Tage im Steinkohlenbergbau bei Nachweis der Einwirkung einer kumulativen Dosis von in der Regel 100 Feinstaubjahren [(mg/m^3) x Jahre]." BArbBl 10: 39-45; Deutsche Gesetzliche Unfallversicherung (DGUV) (Berlin 2011). "Empfehlung für die Begutachtung von Quarzstaublungenerkrankungen (Silikosen) - Bochumer Empfehlung. ". Projects 2011-2012 Important work and results Ethics in Occupational Medicine Consolidation and improvement of scientific practice Status 2011 Collection of material for review articles Plan 2012 37

Working and Research Activities 2011 and Plans 2012 Prevention and Management of Occupational Asthma with AG Clinical Occupational Medicine Isocyanate Asthma directed by AG Occupational Toxicology and Immunology, with AG Clinical Occupational Medicine Lung and Pleural Disorders Caused by Asbestos directed by AG Clinical Occupational Medicine Extra Activities Publishing Activities Quality Targets according to ISO DIN EN 9001:2008 • Review on the subject of “Medical Ethics“. Establishment of the International Review Board (IRB) in ZfAM (an international system to promote the recognition of ethics boards) Status 2011 The international guidelines “Management of work-related asthma“ were successfully submitted for publication in a series of 6 articles (ERJ/ European Respiratory Journal, ERR/ European Respiratory Review), the same is true for the national S1 guidelines “Prevention of occupational obstructive lung diseases“ were also published ( Baur et al., Asu, in press) The first project belongs to a WHO Collaboration Project under the auspices of the “European Respiratory Society“ (ERS) and completed by an international group of experts. The results were communicated in a dedicated symposium at the ERS Congress Meeting in September 2011. The guidelines cover all exposed and affected workers with asthma regardless of occupation and are for use by health experts, from general practitioners to pulmonologists, as well as those in government and authorities responsible for occupational safety. Plan 2012 Now that the ERS Guidelines and the aforementioned 6 articles are published, their broader implementation and communication at international meetings will continue. The ERS Guidelines are available online using the following link: X. Baur, T. Sigsgaard Eur Respir J 2012;39 518-519 Side project: Conceptual design, analysis and evaluation of immunological and clinical aspects Plan 2012 • Application for external funding Side project: S2k Guidelines “Assessment and diagnosis of asbestos-related occupational diseases“ Status 2011 • Publication of the aforementioned guidelines prepared under the auspices of five professional societies with numerous expert and interest groups (see p. 131) Plan 2012 • Because of non-scientific restrictions in compensation issues: a review of the pathogenesis of chrysotile (white) asbestos • Analysis of the cases and publications pertaining to laryngeal carcinoma in situ caused by asbestos The research findings of the ZfAM and the attainment of the Quality Management certification, according to DIN ISO 9001: 2008, were communicated to the public. A public awareness strategy is under development. The ZfAM attended numerous congresses in 2011, often as a presenter (Tag der Arbeitsmedizin, Gesundheitstag der Hamburger Wirtschaft, Jahrestagung der Gesellschaft für Maritime Medizin). This will continue in 2012. A corporate design (for posters, visiting cards, annual reports) is being developed. Publications under internal editorial control are planned (web and press statements, internal news, seminars and meetings). A report covering the social and political controversies in occupational medicine is planned during 2012. Quality Targets for 2011 – Status • Training for the optimization of the ZfAM management capabilities was begun in 2011 and will continue in 2012 with a two-day seminar. • An improvement in technological and scientific capabilities through training was also achieved. All working group have PubMed listed published, scientific know-how would 38

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