A qualitative assessment of occupational disease process

Introduction and Aim The term "silent epidemic" of modern times is used for occupational diseases. It is estimated that every day 7500 people in the world die due to work, 6500 of them from work-related diseases and 1000 from work accidents and injuries. It is emphasized in many publications that there is a serious deficit in both the diagnosis and surveillance system in terms of occupational diseases in our country. Due to this lack of diagnosis and surveillance, the financial and moral loss of employees and their families who are not diagnosed and supervised cannot be compensated and they are deprived of social protection. Adequate research and development financing and qualitative / quantitative scientific research are needed in order to increase the information needed and to make positive contribution to these processes by creating evidence for constituting and sustaining of both protection and prevention programs as well as diagnosis, treatment and rehabilitation programs. The aim of this study is to determine and evaluate the emotions, thoughts, observations and experiences of people diagnosed with occupational diseases in the Dokuz Eylül University Occupational Diseases Clinic before, during and after the diagnosis. Method This research is a qualitative type, phenomenological approaching, descriptive and interpretative research. 12 employees who applied to Dokuz Eylül University Occupational Diseases Clinic in the last 6 months, according to the time they started the interviews, selected with the purposive sampling method from among the employees diagnosed with occupational diseases, narrative interviews were made, and the audio recordings of the interviews were transcribed and evaluated with thematic content analysis method. In order to provide triangulation, 1 academician, 1 specialist, 2 specialty students and 1 staff from the same clinic, according to the level of seniority and experience In-depth interviews were made with the personnel. In addition, the OHS system and program in our country were evaluated using the method of Rantanen et al., and those selected from the national and international guide documents published in the field of OHS were evaluated by document analysis method. Findings 2 of 12 interviewees are women and 10 of them are men. Participants are between the ages of 31-58, and the distribution is balanced in terms of age groups. In terms of business lines, those from the mining and manufacturing sectors are predominant. When their current diagnoses are examined, some of them have more than one diagnosis, diseases of the respiratory system and neuromuscular system, as well as hearing losses. The emerging themes are "Migration and Catastrophe", "Proletarianization", "Sub-Sociocultural Organization and Ghettoization", "Traditional Labor Culture and Organizations", "Precarization and Precarious Work", "Maltreatment and Workplace Bullying", "Trauma and Self Crisis", "Disclosure and Confrontation", "Disclosure and Dehumanization", "New self and Reconciliation". The most recurring codes under these themes are job insecurity, poverty, lack of education, stigmatization, citizenship/family solidarity, fear and anxiety. The most repetitive codes of key interviewers related to occupational diseases are the situations they encounter during and after the diagnosis process, the lack of awareness of other physicians, prolongation in the examination and consultation processes, the slow operation of the post-diagnosis of occupational disease, and the conscientious dilemmas of the professionals. Conclusion It is concluded that, the focus of the research, as perceived as an occupational disease, is not merely a medical concept nor a diagnosis, but a self-disclosing phenomenon, which is exposed in the employee's body; the body, which is one of the other multiple environments (individual or social), where the transnational work hegemony spreads, and make breakdowns. This phenomenon, which is perceived as an occupational disease, has already been spread in social and cultural environments before the diagnosis, and undergone multiple breakdowns, such as proletarianization, migration, ghettoization, precarization, mistreatment and workplace bullying (psychological harrasment). After diagnosed, and exposed in the employee's body, it seems to be, it spreads beyond, and makes breaks like stigmatization and dehumanization. As a suggestion, an authorized and autonomous high-level executive mechanism that will ensure and supervise coordination and cooperation in the OHS system, should be established and the capacity and quality of the institutions that are stakeholders of the OHS system should be improved. Prolongation in the diagnosis process should be prevented and the lack of awareness of other physicians should be eliminated. Finally, the necessity of will and organization, as stated by Albert Thomas, the first director general of ILO, a century ago, still seems to be the top of all other suggestions. Keywords: occupational diseases, qualitative research, poverty, job insecurity, stigmatization