[Problems in determining the occupational etiology of liver damage]

Workplaces involving the use of hepatotoxic substances are classified as workplaces with hazardous and/or special working conditions. Rules and Regulations for Workplaces with Special Working Conditions refer to safety measures to be observed both by the workers at such workplaces and by their employers. This paper presents the cases of plaster moulds casters occupationally exposed to chlorine carbohydrates. The employer did not classify those workplaces as workplaces with special working conditions. Liver damage was found in five (of 12) workers. After further examination, two of the five workers were diagnosed to suffer from occupational liver damage. Unable to confirm the etiology of the liver damage, however, a committee appointed for determining occupational disability did not recognize the disease of the two workers as occupational. This example shows the necessity to introduce and perform strict control of technological processes and working conditions. At the same time, accurate assessment of the danger present at the workplace requires preliminary and periodical examination of the workers. This is extremely important today when the necessity of performing such examinations is frequently disputed. It is expected that the compulsory health insurance for occupational diseases imposed on employers will eventually bring medical examination to the deserved place.