Çevre Sorunları ve Akciğer Sağlığı Çalışma Grubu

Zonguldak Pnömokonyoz Maluliyet Çalıştayı/2009

PNÖMOKONYOZLARDA MALULİYET DEĞERLENDİRMESİNDE SORUNLAR ÇALIŞTAYI (ZONGULDAK-20 HAZİRAN 2009) SONUÇ BİLDİRGESİ 

Akciğerin toz hastalığı olan pnömokonyozlar, günümüzde önemini sürdürmektedir.  Birincil korunma önlemleri ile büyük işletmelerde görülme sıklığında son yıllarda ciddi düşüşler olmasına rağmen özellikle 50 kişinin altında işçi çalıştıran işletmelerde görülme sıklığı halen oldukça yüksektir.  Bu nedenle çalıştayımız aşağıdaki tespitlerin kamuoyuna duyurulmasını gerekli görmüştür:

1.      “Korunmanın tedavi ve tazminden daha ucuz ve insani” olduğu gerçeğinin çalışma yaşamının saç ayağı olan Devlet-İşçi-İşveren kesiminin bilgisine bir kez daha sunulması.   Bu nedenle özellikle Çalışma Bakanlığının iş yerleri açılırken birincil korunma önlemlerini daha yoğun bir şekilde denetlenmesi işlevini yerine getirmesinin hatırlatılması. 

2.      Birincil korunma önlemlerine rağmen önümüzdeki yıllarda da pnömokonyoz gerçeğinin ülkemiz için sorun olmaya devam edeceği görülmektedir.  Bu nedenle ikincil korunma önlemlerinden işe giriş muayenelerinin ve daha sonraki radyolojik izlemlerin uluslar arası standartlarda sağlanması, kayıt altına alınması gerekmektedir.

3.      Maluliyet değerlendirme işlemleri pnömokonyozlarda ciddiyetini arttırarak devam etmektedir.  Maluliyetin patoloji ne olursa olsun kişinin günlük yaşamındaki kısıtlılıkla ilgili olduğu gerçeğinin altı çizilmiştir.  Maluliyet değerlendirmesinde tek bir faktörün göz önüne alınması günümüzün gelişen tıbbi koşullarında ciddi hatalara yol açmaktadır.  Kişinin günlük yaşamındaki kısıtlılığı gösterebilecek her türlü klinik-radyolojik ve fonksiyonel değerlendirmenin yapılması zorunludur.  Ayrıca maluliyetin yaşa göre düzenlenmesi genç yaştaki işçilerin hak ettiği maluliyet derecesinin daha düşük hesaplanmasına yol açmaktadır. Bunlar için ilgili ulusal ve uluslar arası bilimsel tıbbi organizasyonların maluliyet değerlendirme şemalarının göz önüne alınacağı bir sistemin uygulamaya geçirilmesi zorunluluktur.  Bu nedenle zaman geçirilmeden Sosyal Güvenlik Kurumlarımızın ülkemizdeki bilim camiası ile temasa geçip bu konuda gerekli düzenlemelere geçilmesi bir zorunluluktur.

4.      Pnömokonyozlarda maluliyet değerlendirmelerinde ciddi sıkıntılar mevcuttur.  Maluliyet genel kavramı çerçevesi içinde zaman kaybedilmeden bu konuda gerekli düzenlemelerin yapılması gerekmektedir.    

5.      Pnömokonyozlardaki maluliyet değerlendirmesi diğer patolojilere bağlı maluliyet değerlendirmelerinden daha da komplike bir durumdur.  Bu nedenle konuyla ilgili birimlerin bir araya gelip gerekli düzenlemeleri yapması bir zorunluluktur.  Bunun için zaman kaybedilmeden SGK’nun ilgili uzmanlık dernekleri ile bir araya gelip bilimsel değerlendirme kriterlerinin oluşturulması gerekmektedir.

6.      Yapılan düzenlemeler ile ilgili konunun tüm tarafları ve uygulayıcıların ortak dili kullanacağı eğitim çalışmalarının yapılması bir zorunluluktur. Bu konuda ülkede tecrübeli uzmanların belirlenmesi ve gerektiği takdirde yetkilendirilmesi sağlanmalıdır.

 

Prof. Dr. İbrahim Akkurt (Cumhuriyet Uni. Tıp Fak. Göğüs Hastalıkları)

Doç. Dr. Metin Akgün (Atatürk Üni. Tıp Fak. Göğüs Hastalıkları)

Doç Dr Remzi Altın (Zonguldak Karaelmas Üni. Tıp Fakültesi Göğüs Hastalıkları)

Doç. Dr. Peri Arbak (Düzce Üni. Tıp Fakültesi Göğüs Hastalıkları)

Doç. Dr. Figen Atalay (Zonguldak Karaelmas Üni. Tıp Fakültesi Göğüs Hastalıkları)

Uzm Dr Metin Çelikiz (Zonguldak Meslek Hastalıkları Hastanesi)

Prof Dr Arif Çımrın (Dokuz Eylül Üni Tıp Fak. Göğüs Hastalıkları)

Rıfat Dağdelen (TTK Genel Md.)

Doç. Dr. Levent Kart (Zonguldak Karaelmas Üni. Tıp Fakültesi Göğüs Hastalıkları, TTD Batıkaradeniz Şb. Başkanı)

Ramis Muslu (Maden-iş Sendikası bşk.)

Uzm. Dr. Cebrail Şimşek (Atatürk Göğüs Hast. ve Göğüs Cerrahisi Eğ. Ar. Hastanesi)

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