Book of Abstracts (pdf) / (zip)

  • Obavijest o Kongresu


    6th Croatian Congress on Occupational Health with International Participation - ESSENTIALS FOR WORKERS' HEALTH, organised by Croatian Occupational Health Society, part of the Croatian Medical Association, in cooperation with the World Health Organization-WHO, International Commission on Occupational Health-ICOH, European Union of Medical Specialists/UEMS - Occupational Health Section, was held in Šibenik, Solaris Hotels in the period September 30th – October 4th, 2015

    The Congress was organized under the auspices of her excellency Kolinda Grabar Kitarović, president of the Republic of Croatia, and Ministry of Health and Ministry of Labour & Pension System of the Republic of Croatia. Prof. Jadranka Mustajbegović, PhD was the personal envoy of the President of the Republic of Croatia.

    The importance and the achievements of the Croatian occupational health in workers' health protection have already been recognised, and the colleagues from the Croatian Medical Society and the President of the Croatian Medical Chamber have addressed the Congress with the best wishes for the successful work.

    The Croatian Occupational Health Society has been successfully operating for more than 50 years, and the Congress is proud to host distinguished guests, outstanding personalities and doyens of occupational health, member of the Academy Prof. Marko Šarić, and Prof. Dunja Beritić Stahuljak. The Congress opening ceremony was attended by the Mayor of Šibenik, Željko Burić, MD, who addressed all the participants. The Opening ceremony was enhanced by music a cappella group „Maslina“.

    The level of the event, participated by the top world organisations, whose existence and activities are focused on health protection in its interdependence with work modes and conditions, makes this event one of the most important congress events in 2015 in our country. The list of distinctive participants was long: starting from former ICOH President Prof. Jorme Rantanan, WHO ECEH/ European Centre for Environment and Health representatives from Bonn, Dorota Jarosinska and Aliya Kosbayeva, SEENWH /South-East European Network on Workers’ Health coordinator, Prof. Jovanka Bislimovska and lot of our colleagues, occupational health specialists from European countries – UEMS members. We were proud and honoured by participation of eminent experts from the most developed countries, and the experts from other specialist fields who have also taken part in our work.

    The Congress was attended by 220 participants, of which 85 had the active role. The rich programme included and invited 11 plenary lectures, 52 lectures, 12 posters and 6 workshops. The Congress had two video conference events: WHO SEE Network WH and UEMS OH Meeting.

    Special attention was dedicated to multidisciplinary approach in protection of workers’ health. The Congress work involved the distinguished international and national experts from different medical professions, and other experts with whom the occupational health specialists firmly and regularly cooperate in resolving the problems related to health protection and safety at work.

    The introductory plenary lectures have shown the whole range of different focuses of occupational health, ranging from the top issue of ethics in globalizing work life, huge European project aimed at preventing the professional skin diseases, issues of education and establishment of EASOM / European Association of Schools of Occupational Medicine, creation of SEE network for workers’ health, to human resources management and psycho-social risks in preventing the stress in work environment.

    The great interest for participation in Congress work was raised, representing the true acknowledgement of activities and results of Croatian occupational health medicine, both in the past and also in its overall current contribution in workers' health protection. We have particularly referred to coming tasks resulting from the Global Action Plan for Workers' Health, adopted by the WHO. The Croatian Occupational Health Society, the Croatian Medical Association, and generally, our profession have accepted the commitment and the liability to adjust our standards with the existing standards in EU, by pursuing continuously, from the health aspect, the improvement of all the elements of work process, substantial for workers’ health protection.

    Workers’ health, which we mention often and permanently insist on, should be the inevitable part of the frame of each health policy of entire community, particularly the community based on the results of the work of its workers. All together it depends on the status of workers' health and safety at work, in compliance with the objectives of National programme of health protection and safety at work and National programme of health protection and safety at work of the persons employed in the health protection activities.

    Prevention is one of crucial elements of occupational health experts' activities, primarily the sports & occupational health specialists, psychologists, toxicologists, safety at work experts and all the others involved in different forms and programmes of promotion of health in work environment. Due to these reasons, 6th Congress of Occupational Health has involved in its work high number of specialists active in different fields and issues essential for workers’ health. Active participants of the Congress, besides occupational health specialists, have also been psychologists, toxicologists, specialists of various fields who participate in workers’ health protection and/or work ability assessment, safety at work engineers, nurses working in occupational health, etc.

    Informatisation, changes of job structure and performance techniques have resulted in emergence of stress, as substantial element of workers' health, and projections of further industrial growth warn and suggest cautious actions in stress prevention, the topic which was particularly strongly addressed at this Congress.

    Due to strong interest of Congress participants for some lectures and presentations, upon authors’ approval, these are going to be published on Congress and Croatian Occupational Health Society websites. The conclusions of 6th Congress with International Participation ESSENTILAS FOR WORKERS’ HEALTH shall also be published on websites.

    At the end allow me to say that I consider this Congress extremely successful, and also would like to express my personal feeling of pride for all that has been done. I further think that this Congress has shown full power of togetherness of all of us – occupational health specialists, friendship, collegiality, respect and discipline.

    As already stated in the acknowledgment, we have shown at the Congress our achievements and experiences in the past, our current activities and projections for further work and actions. I do hope that our younger colleagues in future shall manage to obtain the same level of unity in cooperation and performance of professional commitments

    President of Croatian Occupational Health Society, part of the Croatian Medical Association and Organising Committee of 6th Congress
    Prim. Azra Huršidić Radulović, PhD

  • Report of programme

    Report of programme outcomes 6th Croatian Congress on Occupational Health with International Participation

    In twenty years period, since September 1995, when the First Croatian Congress on Occupational Health with International Participation was held in Opatija, until the Sixth Congress held in September 2015, the Congress topics and its participants reflect the true core of the occupational medicine: the most dynamic branch of medicine which besides its clinical dimension, must follow, and pursue by itself the scientific research, and adjust its activities in public health features of the surrounding community.

    85 papers, selected in the programme of the 6th Congress were applied by the authors from 14 countries, besides Croatia: Albania, Austria, Bosnia & Herzegovina, Bulgaria, Finland, Germany, Greece, Macedonia, Montenegro, Netherlands, Poland, Romania, Serbia and Switzerland.
    Eleven plenary lectures, round table on psycho-social risks at work, six workshops, and two satellite events: Meeting of South East European Network on Workers Health- SEENWH and European Union of Medical Specialists -Section for Occupational Medicine. Concurrently with the official programme, the Section of Occupational Health Nurses of Croatian Nurses Society also held its symposium. Consequently these events have shown that, along with significant and ongoing changes in the legislation, system or daily practice of health protection and safety at work, remains one constant and unchanging value: health protection and maintenance of life quality of worker, human being – in his work and creation environment. Therefore the Congress started with the opening topic Ethics in globalizing work life, lecture by prof. Jorme Rantanan, PhD, long years president of International Commission on Occupational Health-ICOH.

    Congress offered high quality plenary lectures, workshops, presentations and poster sections on researches and practical experiences of physicians – specialists of occupational medicine, occupational psychology and occupational health nurses, to safety at work experts, persons involved in different forms and programmes of health promotion at work places at local, national and international level, and as well to university members, persons in charge of government health policy, all integrated in thematic groups: Psycho-social risks in occupational health and Identification and prevention of psycho-social risks; Work ability assessment – principles and doubts; Overall preservation of workers' health; Health of healthcare professionals; Recommendations based on scientific evidence; Work and work conditions, Interdisciplinary approach in workers' health protection, and finally Occupational health in Croatia pursuing World Health Organisation Global action plan for workers' health. Presented structure, visions, missions in promoting and protecting workers' health in the Republic of Croatia have also confirmed and emphasised the cooperation among all relevant stakeholders in protection and contributions in promotion of occupational health as substantial profession already since the establishment of Croatia until present: Croatian Institute for Health protection and Safety at Work, Croatian Occupational Health Society as part of the Croatian Medical Association, Institute for Medical researches and Occupational Health, Croatian Public Health Institute, School of Public Health A.Štampar – School of Medicine, University of Zagreb and Croatian Health Insurance Fund.


    • Nowadays, while "the third industrial revolution" is expanding at high speed and tackling each corner of the globe, the challenges of occupational medicine are numerous and intensive. Therefore, the recommendations based on ethical principles and intended for health professionals, particularly those who often work alone or in relatively small organisational units, have become indispensable: promotion of human dignity, promotion of the highest ethical principles in policies and programmes, in compliance with the principles of honesty in professional work, impartiality and confidentiality in workers' health protection, and full respect of their privacy and confidential medical data. For healthcare professionals in occupational health, it implies pursuance of professional independence, competence and insistence on conditions of work which enable good professional health practice. Considering growing heterogeneity, it is recommended public-health oriented approach, namely the activities undertaken according to professionals' own judgement, not waiting for the previous request by the others (Ramazzini's pro-active approach).
    • Preventive programmes of workers' health protection tend to replace harmful exposures to technical and organisational measures, include identification of individuals who might be more inclined to development of disease or health deterioration in conditions of exposure at work; however the undertaken intervention studies show that education and implementation of protection measures are the most important in their prevention. Therefore education and awareness raising of workers in Europe are identified as main objectives in current actions and projects, aimed at decreasing the burden of work related and professional diseases.
    • In the last two decades, South-East European countries have been facing increased need to adjust the workers' health protection policies, systems and services with new political and social-economic conditions. South-East European Network on Workers’ Health is the network of cooperation centres of World Health Organisation (WHO), Occupational Health Institutes and WHO national hot spots from nine countries, all in cooperation with WHO Regional Office Europe aiming at improving the workers' health in South-East European countries by implementing the guidelines proposed by WHO, ILO and EU, and Global action plan for workers' health.
    • The presented lectures have shown that new challenges and new spheres for possible actions always emerge in diversified and complex environment of work and work conditions. Interdisciplinary approach, cooperation of different profiles' experts, and personal engagement are the cornerstones of workers' health protection system. Participation of colleagues from Macedonia, Bosnia & Herzegovina and Croatia has contributed to the feeling of togetherness whenever the issue of essentials for workers' health is the topic. We recognise common spheres of operation, common challenges, all pursuing the common goal – workers' health.
    • The world of labour is extremely changing, it faces the transition from economy of physical work to economy of services and knowledge based economy. Work motivation, creativity, knowledge and competence in acquiring new knowledge, communication skills and flexibility obviously become crucially important qualities of employees in economic sector. Due to such prevailing circumstances in economy and community, the role of OM specialists in companies exceeds the prevention of professional diseases and accidents at work, and instead takes up active role in health management. The corporate health management lies on three pillars: prevention, promotion of health and return to work.
    • In order to enable the occupational health specialists to take over this extended role in the company with due responsibility, they indispensably need the education, not only within the university programme of medicine, followed by occupational health specialisation, rather insisting on permanent medical education. All three forms of education must be in line with the required new role of OM specialists in corporate sector and new role of economy in general. Promotion of occupational medicine as profession and knowledge enhancement with state of-the-art topics compliant with needs of fast changing economies should be the task of universities, national OM professional societies, and international organisations.
    • Safety at work as systematically organised operation is the integral part of each work organisation which is aimed at improving the safety and health protection of workers and persons at work, therefore the role of experts in the realisation of such objective is highly significant. Safety at work experts are often overburdened with their work load, since their scope of work, besides safety at work, also comprises fire prevention and environmental protection issues. This is exactly the reason why the safety at work expert must have appropriate education, and constantly improve his competences in the fields which comprise his specific work scope, cooperate with all the participants involved in the implementation of safety at work, starting from employer, his proxies, to occupational health specialists, and respective inspection authorities.
    • The priority in occupational health experts' practice should be given to assessment of health risk imposed by workplace. The implementation of prevention measures must strictly observe doctrine and apply it on primary, secondary and tertiary level, just the same as at the level of individual, work organisation and employer.
    • Active and constant education and promotion of health at workplace. Providing workers with a lot of information on key risk factors, determine control measures over these factors, by implementing safety at work measures, appropriate use of personal safety & protective equipment, and other preventive actions like stress mitigation programmes, education of physicians at all levels on identification of professional cause of disease, is going to contribute to healthy workplace, decrease incidence of professional diseases, work – related diseases, injuries at work, reduce absenteeism and workers' permanent inability, increase work motivation and productivity – which was the true message of the 6th Congress of Occupational Health “Essentials for workers' health”.
    • The „return to work“process requires multidisciplinary approach and cooperation of all involved parties. It imposes indispensable cooperation among employer, diseased and health experts involved in the process of medical treatment and rehabilitation (clinical specialists, family physicians, occupational health specialists).
    • Constant psychological help, work anamnesis survey, cooperation with occupational medicine and employers would facilitate return to work to cancer diseased.
    • Stress as recognised injury at work records more frequent incidence in healthcare professions and professions related to trade and financial operations, while the costs of health system and duration of temporary work inability differ at different employers.
    • The current legislation provides new space for interventions in the issue of stress at work, which must be implemented as multidisciplinary scheme. The most efficient and most profitable are the interventions at primary level which are proactive-removal of stress cause, which must be systematically referred to the employers. In the situations of exposure to stressors and appearance of workers' reactive status, the interventions at secondary and tertiary level implemented by physicians and psychologists, must be widely available.
    • Researches of psycho-physiological hazards and work stress solving methods are important in professions providing help to people (healthcare professionals, school teachers, educators of persons with disabilities………), and should be undertaken further on.
    • The silent epidemics of work related psycho-social risks impacting health professionals providing medical care to security guards, night shift workers in different services, and to production workers. They all have high rates of exposure to psycho-social stressors with emphasis on short term and intensive exposure to psycho-social risks like violence, aggression and assault to worker, i.e. long lasting and cumulative impact of shift work, irregular supervision and control at workplace. Presenteeism is related to exposure to psycho-social stressors and burnout syndrome. Shift work is important psycho-social stressor and health disorder hazard.


    • Availability of E - card to OM specialists, with appropriate anamnesis and clinical status would resolve numerous doubts in the work of the specialist who is responsible for release of certificate on specific health ability.
    • Indispensable development of general algorithms intended for occupational health specialists and psychologists in ongoing education of employers and workers on psycho-social risks management. Their purpose is to reduce the level of psycho-social risks, and in case of health disorders fast implementation of efficient measures.
    • Screening of psycho-social stressors of all the employees (workers) should be done periodically, once a year.
    • The need to initiate the establishment of the psychological crisis intervention group which would provide the workers timely help, thus reducing harmful effects of high level of stress, particularly in violence cases.
    • Work conditions of the members of Defence Forces of the Republic of Croatia in the system of their health protection, notwithstanding daily efforts to improve soldiers' health still allow for additional upgrade.
    • In resolving problems related to assessment of partial or total loss of work ability, and granting the right to disability retirement, it's proposed that one of the meetings of Croatian Occupational Health Society should be dedicated specifically to this topic. Problem issues raised during discussion might be divided in two groups:
    • 1) operation of Institute for Disability Certification, Professional Rehabilitation, and Employment of Persons with Disability (ZOSI) and overall process of work ability assessment in pension insurance, improvement of coordination among occupational medicine and experts in the process of work ability certification in pension insurance; common attitude in issue of Occupational health specialist's certificate on health inability and certification on work ability in pension insurance system;
    • 2) problem of cooperation with family physicians in the issue of temporary work inability, further medical treatment of the patient and negative outcome of the certification in pension insurance system – attitude according to the certification „No decrease of work ability“ questioning whether such certification automatically imposes decision of family physician to cancel temporary work inability status. Proposals also comprise cooperation with Croatian Health Insurance Fund inspectors and common attitude.
    • Some cases of selected (contracted) physicians, occupational health specialists facing difficulties in communication and cooperation with employers. Reported situations when the employer changes selected physician before the expiry of one year period, aiming at avoiding the implementation of prescribed measures, etc. In order to improve the status and respect of the selected physician, OM specialist, it is proposed to report the exact cases of violation of professional position of occupational health specialist, designating the exact employer, along with proposals for the improvement, until October 15, to e-mail: and to colleague Željko Lisac, to his e-mail address. Exactly due to these reasons, the Croatian Health Insurance Fund has been sent the proposal (considered already for a long time) of amendments and integrations of protocol for change of selected physician – OM specialist, which would exclude the possibilities for various manipulations or avoidance of legal liabilities' fulfilment.
    • Contrary to the practice in EU countries, nurses working at occupational health outpatient clinics in Croatia are dealing solely with administrative work and certain diagnostic procedures, while their education and assigned job at their workplace fully neglect the role in workers' health instruction. It requires the integration of nurses' education curriculum, and strengthening of their role in OM team, compliant with EU practice. The situation in the other countries in the region is similar, if not almost identical.
    • There have been identified deficiencies in preparedness of professionals who perform the tasks incurring higher risk of threat to people, material assets and environment (e.g. commanding officers in maritime and air traffic). Certain solutions are proposed, also including constant monitoring of new risky situations, application of new psychological tests, and team approach to preventive and diagnostic methods, particularly from the aspect of psychological assessment of awareness and emotional capacities of an individual, and identification of the level of true knowledge in simulated environment. It's further proposed to incorporate regional centres, gathering teams of experts who are going to address these issues jointly. Arguments are provided stating that it doesn't violate individual human rights, rather protects the interest of majority.
    • Special attention should be dedicated to researching the impact of work on reproductive health, also including professions in service sector which incur the risk of complications in pregnancy and childbirth. Particularly considering that profile of professions and employment of women are subject to change. It is extremely important to identify the etiology of negative impact on fetus growth and development, in order to provide preventive measure, logically if it is possible, without unnecessarily separating mother from her workplace during entire pregnancy.
    • Education programmes for secondary school students, with special emphasis on development of attitudes related to the fields of safety at work and disease prevention which might be consequence of work, should be made and implemented. In spite of good identification of danger and harmfulness which they encounter in their work, high school students do not understand basic principles of safety at work. It's reported that in many cases students are not provided with personal safety equipment, neither at school practical work, nor at craftsmen training. The Project includes practical preventive measures, like educative posters intended for practical work cabinets. Such education should also involve the occupational health specialists and other members of the OM team, since it is recognised as best practice in EU member states.
    • Support the need to develop IT platform with education material related to issues of elderly workers, intended to experts of occupational medicine and safety at work.
    • Increase the awareness on the role of EU REACH Regulation (Registration, Evaluation, Authorisation and Restriction of Chemicals) in workers' health protection, primarily from the aspect of gradual replacement of dangerous substances with less hazardous ones and technological procedures, improvement of the quality of assessment of risk of chemicals on human health due to higher number and quality of data which are the basis for the assessment, and the revision of registration dossiers in European Chemicals Agency (ECHA), and increased quantity and quality of information on chemicals which the employers are obliged to provide to workers.
    • Introduce education from project methodology in planning the measures of health protection and safety at work, in designing relevant project, also including the education and training of staff involved in the planning process.
    • Healthcare professionals, as particularly sensitive group, should be provided cognitive and macro-ergonomic solutions at their respective workplaces. Particular emphasis should be given to the need to create “safe workplaces” in the context of psycho-social risks: implying the respect and tolerance of diversities among employees, not only in professional sense, but also considering the fact that individuals differ in many characteristics (race, gender, age, sexual orientation, ethnical origin, etc.) which present the strength of heterogeneous work team which is always more productive than those having more homogeneous features.
    • Specific programme for healthcare professionals is similar to general measures. Some of the peculiarities highlighted by the attendees involve:
    • - active planning of work breaks in the form of designed workshops or guided programmes (physical exercises, meditation or just talks)
    • - clear allocation of assigned tasks
    • - open and clear communication channels, particularly between management structures and workers
    • - creation of programmes for health improvement and protection through different thematic (e.g. weight reduction, pressure regulation or stop smoking programmes) workshops with active participation of workers in workshops' creation and management
    • - creation of groups dedicated to specific assignment, developing the sense of positive competition among groups
    • - awards for individuals who willingly and regularly attend workshop; not necessarily only material awards
    • - provision of ancillary facilities at workplaces: restaurants with healthy and balanced food for staff, kinder gardens for employed parents
    • - rules of conduct, and clear explanations of unacceptable or undesirable behaviour at workplace should be available; workers must be involved in their identification and implementation
    • Conclusions adopted in the issue of healthcare professionals' health evaluation, are the following:
    • - consequences for those workers who do not adhere to agreed measures must be clearly defined already in advance, and control should be established by appointing the worker-controller, who is going to monitor it; possible even financial fines
    • - positive culture of safety at workplace should be introduced, with all employees jointly pursuing to preserve and improve patients’ safety,
    • - prior to starting the programmes, their evaluation should also be considered: which is the best model, how often and which evaluators are the most convenient,
    • - necessity of cost benefit analyses of undertaken programmes in order to asses appropriately which programmes incur results and which don’t, to facilitate the proper allocation of resources.

    Edited by:
    Jadranka Mustajbegović

  • Welcome Note

    Dear colleagues,

    It is our great honour and privilege to invite you to the 6th Croatian Congress on Occupational Health with International Participation, scheduled for the early autumn of 2015 and running under the motto “ESSENTIALS FOR WORKERS' HEALTH”. The Congress shall take place from September 30th to October 4th, 2015, in the beautiful historical city situated in central Dalmatia, where the River Krka meets the Adriatic Sea. In 1066, King Petar Krešimir IV chose this city as his capital and named it Šibenik.

    Due to significant and continuous changes in legislation, the entire system and/or the daily practice concerning the Occupational Health Protection & Safety-at-Work domain, the experts in the field are compelled to keep abreast with novel notions so as to be able to fulfil their newly-emerging professional tasks. However, for over a century, the only everlasting and steady value cherished by the Occupational Health practice has been the protection and preservation of the quality of life of a working man in his occupational and creative environment.

    The Congress shall offer relevant introductory speeches, workshops, oral presentations and posters presenting the research conducted by, and practical experience gathered by, Occupational Health specialists, Occupational Psychology specialists, nurses operating in Occupational Health settings, Safety-at–Work experts and parties involved into various forms of, and programmes dealing with, Occupational Health promotion on a local, national and international scale. On top of that, the Congress shall summon the councillors and university and governmental staff members offering their expertise in the field. We do hope to encourage the participation of individuals operating in various professional and organisational settings (the health sector, volunteer organisations, various associations, etc.).

    Welcome to Šibenik!

    Azra Huršidić-Radulović
    President of the Organizing Committee

    Jadranka Mustajbegović
    President of the Program Committee


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