{"id":20784,"date":"2016-05-04T12:54:33","date_gmt":"2016-05-04T09:54:33","guid":{"rendered":"http:\/\/politeknik.org.tr\/\/?p=20784"},"modified":"2019-01-28T20:40:27","modified_gmt":"2019-01-28T17:40:27","slug":"turk-mucizesi-meslek-hastaliklari-sifirlaniyor-dr-arif-muezzinoglu-dr-ahmet-tellioglu","status":"publish","type":"post","link":"https:\/\/eonmeet.com\/pol\/turk-mucizesi-meslek-hastaliklari-sifirlaniyor-dr-arif-muezzinoglu-dr-ahmet-tellioglu\/","title":{"rendered":"‘T\u00fcrk mucizesi’: Meslek hastal\u0131klar\u0131 s\u0131f\u0131rlan\u0131yor- Dr. Arif M\u00fcezzino\u011flu & Dr. Ahmet Tellio\u011flu* (Sendika.Org)"},"content":{"rendered":"

T\u00fcrkiye, i\u015fe ba\u011fl\u0131 hastal\u0131klar ve meslek hastal\u0131klar\u0131yla m\u00fccadelede s\u0131rad\u0131\u015f\u0131 bir profil sunmaktad\u0131r; T\u00fcrkiye\u2019de te\u015fhis edilen meslek hastal\u0131\u011f\u0131 say\u0131lar\u0131 ve y\u0131ll\u0131k insidanslar\u0131 25 y\u0131ld\u0131r d\u00fczenli olarak azalmaktad\u0131r!<\/em><\/p>\n

\u0130nceledi\u011fimiz y\u0131llar boyunca T\u00fcrkiye\u2019de \u00e7al\u0131\u015fanlar tamamen sendikas\u0131zla\u015ft\u0131r\u0131lm\u0131\u015f, kamu \u00e7al\u0131\u015fanlar\u0131n\u0131n say\u0131s\u0131 b\u00fcy\u00fck \u00f6l\u00e7\u00fcde azalt\u0131lm\u0131\u015f, ta\u015feron \u00e7al\u0131\u015fma yayg\u0131nla\u015ft\u0131r\u0131lm\u0131\u015f, i\u015fyeri hekimleri g\u00fcvencesizle\u015ftirilmi\u015f ve b\u00fct\u00fcn bunlar olurken meslek hastal\u0131\u011f\u0131 insidanslar\u0131 da 1990\u2019da 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 36,6\u2019dan, 2013\u2019te 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 3\u2019e gerilemi\u015ftir. G\u00f6r\u00fcnen odur ki mucize MH te\u015fhis rakamlar\u0131ndaki mucizevi d\u00fc\u015f\u00fc\u015f de\u011fildir. Mucize T\u00fcrkiye\u2019de \u00e7al\u0131\u015fanlar\u0131n neredeyse bir nesile s\u0131\u011facak k\u0131sa bir zaman diliminde t\u00fcmden sendikas\u0131zla\u015ft\u0131r\u0131lm\u0131\u015f ve b\u00fcy\u00fck \u00f6l\u00e7\u00fcde g\u00fcvencesizle\u015ftirilmi\u015f olmalar\u0131d\u0131r<\/em><\/p>\n

\"meslek-hastaligi\"<\/a><\/p>\n

\u0130\u015fe Ba\u011fl\u0131 Hastal\u0131klar<\/strong><\/p>\n

\u0130\u015fle ilgili\/i\u015fe ba\u011fl\u0131 sa\u011fl\u0131k sorunlar\u0131 ve hastal\u0131klar\u0131n\u0131 en geni\u015f anlam\u0131yla \u00e7al\u0131\u015fma \u015fartlar\u0131n\u0131n k\u0131smen ya da tamamen neden oldu\u011fu veya k\u00f6t\u00fcle\u015ftirdi\u011fi fiziksel ya da ruhsal sa\u011fl\u0131k sorunlar\u0131 ve hastal\u0131klar olarak tan\u0131mlayabiliriz.[1]\n

2012 tarihli \u00f6nemli bir \u00e7al\u0131\u015fmada[2] d\u00fcnyada her y\u0131l 100,000 \u00e7al\u0131\u015fandan 54,8\u2019inin (54,8\/100.000) i\u015fe ba\u011fl\u0131 hastal\u0131k, 10,3\u2019\u00fcn\u00fcn de (10,3\/100,000) i\u015f kazalar\u0131 nedeniyle hayat\u0131n\u0131 kaybetti\u011fi tahmin edilmektedir. Bu rakamlar T\u00fcrkiye\u2019nin i\u00e7inde yer ald\u0131\u011f\u0131 Avrupa b\u00f6lgesi i\u00e7in y\u0131ll\u0131k 92,8\/100.000 \u00e7al\u0131\u015fan ve 7,6\/100.000 \u00e7al\u0131\u015fand\u0131r. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc\u2019n\u00fcn (WHO) tahminlerine g\u00f6re ise d\u00fcnyada ger\u00e7ekle\u015fen \u00f6l\u00fcmler[3] ile hastal\u0131k\/\u00f6l\u00fcm nedeniyle kaybedilen sa\u011fl\u0131kl\u0131 g\u00fcnlerin[4] yakla\u015f\u0131k %1,7\u2019si i\u015fe ba\u011fl\u0131 risk fakt\u00f6rlerine atfedilmektedir. WHO\u2019nun 2009 tarihli bu raporunda i\u015fyeri havas\u0131ndaki zararl\u0131 maddelere maruz kalman\u0131n \u2018Kronik Obstr\u00fcktif Akci\u011fer Hastal\u0131\u011f\u0131\u2019na (KOAH) ba\u011fl\u0131 \u00f6l\u00fcmlerin %12\u2019sinden ve en yayg\u0131n mesleki kanser olan AC kanserlerinin %8\u2019inden sorumlu oldu\u011fu tahmin edilmekte; keza end\u00fcstrile\u015fmi\u015f \u00fclkelerden i\u015fe ba\u011fl\u0131 stresten kaynaklanan depresyon ile koroner kalp hastal\u0131\u011f\u0131 aras\u0131ndaki ba\u011flant\u0131ya dair g\u00fc\u00e7l\u00fc kan\u0131tlar derlendi\u011fi ifade edilmektedir. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc\u2019yle ba\u011flant\u0131l\u0131 yine bir ba\u015fka \u00f6nemli \u00e7al\u0131\u015fmada[5] ise se\u00e7ilmi\u015f i\u015fe ba\u011fl\u0131 risklerin (kazalar, kanser yap\u0131c\u0131 maddeler ve i\u015fyeri havas\u0131ndaki zararl\u0131 maddeler) global olarak her y\u0131l 100.000 \u00e7al\u0131\u015fandan 19,9\u2019unun i\u015f kazalar\u0131n\u0131n ise her 100.000 \u00e7al\u0131\u015fandan 11,5\u2019inin \u00f6l\u00fcm\u00fcnden sorumlu oldu\u011fu tahmin edilmektedir.<\/p>\n

\u0130\u015fe ba\u011fl\u0131 hastal\u0131klar\u0131n etkiledi\u011fi n\u00fcfusun geni\u015fli\u011fi ve neden oldu\u011fu sa\u011fl\u0131k sorunlar\u0131n\u0131n \u00e7e\u015fitlili\u011fine ra\u011fmen d\u00fcnyada esasen i\u015fe ba\u011fl\u0131 hastal\u0131klar\u0131n tamam\u0131n\u0131 de\u011fil hastal\u0131\u011fa neden olan maruziyetin tamamen i\u015ften kaynakland\u0131\u011f\u0131 \u2018Meslek Hastal\u0131klar\u0131\u2019n\u0131 (MH) te\u015fhis etmeye ve tan\u0131maya d\u00f6n\u00fck sistemler bulunmaktad\u0131r. Meslek hastal\u0131\u011f\u0131 ise Uluslararas\u0131 \u00c7al\u0131\u015fma \u00d6rg\u00fct\u00fc (ILO) taraf\u0131ndan i\u015fe ba\u011fl\u0131 risk fakt\u00f6rlerinden kaynaklanan maruziyetler sonucu ortaya \u00e7\u0131kan hastal\u0131k olarak tan\u0131mlanmaktad\u0131r.[6] Bu tan\u0131m\u0131n iki temel unsuru vard\u0131r: 1.\u00a0<\/strong>Hastal\u0131k ile i\u015f kaynakl\u0131 maruziyet aras\u0131ndaki nedensel ili\u015fki 2.\u00a0<\/strong>Hastal\u0131\u011f\u0131n maruziyete u\u011frayan ki\u015filerde normal n\u00fcfusun \u00fczerinde bir s\u0131kl\u0131kta g\u00f6r\u00fclmesi. [7]\n

Oysa i\u015f ola\u011fan\u00fcst\u00fc \u00e7ok say\u0131da insani, maddi ve sosyal ko\u015fulun ola\u011fan\u00fcst\u00fc \u00e7ok say\u0131da farkl\u0131 kombinasyonu i\u00e7inde ifa edilen bir etkinliktir. \u00dcstelik i\u015fe ba\u011fl\u0131 hastal\u0131klar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu i\u015fyerindeki ya da \u00e7al\u0131\u015fma s\u0131ras\u0131ndaki etkene maruz kal\u0131nmas\u0131ndan y\u0131llar sonra ortaya \u00e7\u0131kmaktad\u0131r. Bu durumda ortaya \u00e7\u0131kan hangi hastal\u0131k belirtisi ya da bulgusunun hangi i\u015fyerinden, i\u015fin hangi k\u0131sm\u0131ndan ya da i\u015fi \u00e7evreleyen \u015fartlar\u0131n hangisinden kaynakland\u0131\u011f\u0131n\u0131 kan\u0131ta dayal\u0131 \u015fekilde ortaya koyabilmek olduk\u00e7a zorla\u015fmaktad\u0131r. Bu zorluk \u00f6nceden tespit edilmi\u015f spesifik bir fakt\u00f6r ve bu fakt\u00f6r\u00fcn varl\u0131\u011f\u0131n\u0131 g\u00f6steren \u00fczerinde uzla\u015f\u0131lm\u0131\u015f kan\u0131tlar olmad\u0131\u011f\u0131 durumlarda, hastal\u0131\u011f\u0131n meslek hastal\u0131\u011f\u0131 olarak tan\u0131mlanamamas\u0131na yol a\u00e7maktad\u0131r. Kald\u0131 ki; i\u015ften kaynaklanan kimi hastal\u0131k etkenlerinin spesifik olarak tespit edilmesi durumunda dahi bunun i\u015fverenler ve kamu otoritelerince kabul edilmesi uzun y\u0131llar alabilmektedir.[8]\n

\u0130\u015fe ba\u011fl\u0131 hastal\u0131klardan sadece meslek hastal\u0131klar\u0131 te\u015fhis edilmeye \u00e7al\u0131\u015f\u0131lmakta ama bunda da ba\u015fta yukar\u0131da ifade etti\u011fimiz neden ve buna e\u015flik eden pek \u00e7ok nedenden yeterince ba\u015far\u0131l\u0131 olunamamaktad\u0131r. T\u00fcm \u00fclkelerde de\u011fi\u015fik \u00f6l\u00e7\u00fclerde meslek hastal\u0131klar\u0131n\u0131n gereken \u00f6l\u00e7\u00fcde te\u015fhis ve tazmin edilmemesi (under-reporting) sorunu de\u011fi\u015fen \u00f6l\u00e7\u00fclerde ya\u015fanmaktad\u0131r. Bu nedenle t\u00fcm \u00fclkelerden ba\u015fta meslek hastal\u0131klar\u0131 olmak \u00fczere i\u015fe ba\u011fl\u0131 hastal\u0131klar\u0131n te\u015fhisini artt\u0131r\u0131c\u0131 \u00f6nlemler almalar\u0131, i\u015ften kaynaklanan hastal\u0131k ve \u00f6l\u00fcmleri te\u015fhis ve kay\u0131t edecek sistemleri geli\u015ftirmeleri beklenmektedir.[9]\n

Rapor edilen hastal\u0131k ve yaralanmalar\u0131n tipleri ve raporlama e\u011filimleri \u2013o \u00fclkedeki yn.- ilgili mevzuat ve sosyal g\u00fcvenlik kapsam\u0131na g\u00f6re geni\u015f \u00f6l\u00e7\u00fcde de\u011fi\u015fmektedir.[10] Bir meslek hastal\u0131\u011f\u0131n\u0131n bir \u00fclkede az te\u015fhis edilmesi bu hastal\u0131\u011f\u0131n o \u00fclkede olmad\u0131\u011f\u0131n\u0131n ya da bu hastal\u0131\u011fa kar\u015f\u0131 ba\u015far\u0131l\u0131 bir koruma yap\u0131ld\u0131\u011f\u0131n\u0131n kan\u0131t\u0131 olamamaktad\u0131r. Tam aksine bir \u00fclkede \u00e7ok say\u0131da meslek hastal\u0131\u011f\u0131n\u0131n te\u015fhis edilmesi (sigorta sistemi taraf\u0131ndan tan\u0131nmas\u0131 yn.) o \u00fclkede saptama ve bilgilendirme sistemlerinin iyi kurulmu\u015f oldu\u011funu g\u00f6stermektedir.[11]\n

T\u00fcrkiye\u2019de Durum<\/strong><\/p>\n

Gerek yukar\u0131ya ald\u0131\u011f\u0131m\u0131z ve WHO, ILO gibi uluslararas\u0131 \u00f6rg\u00fctlerin referans ald\u0131\u011f\u0131 bilimsel \u00e7al\u0131\u015fmalardan gerekse de T\u00fcrkiye\u2019nin de dahil oldu\u011fu Avrupa b\u00f6lgesindeki kimi \u00fclkelerde te\u015fhis edilen meslek hastal\u0131\u011f\u0131 say\u0131lar\u0131ndan[12] T\u00fcrkiye\u2019de her y\u0131l<\/p>\n

-\u0130\u015f kazalar\u0131na ba\u011fl\u0131 olarak ger\u00e7ekle\u015fen \u00f6l\u00fcmlerin yakla\u015f\u0131k 213\u2013 1014 kat\u0131 say\u0131da meslek hastal\u0131\u011f\u0131na ba\u011fl\u0131 \u00f6l\u00fcm,<\/p>\n

-\u00c7al\u0131\u015fan n\u00fcfusun 100.000\u2019de 5015 veya 68-10016 say\u0131da meslek hastal\u0131\u011f\u0131 te\u015fhis ediliyor olmas\u0131 gerekti\u011fini s\u00f6yleyebiliriz.[17]\n

Kald\u0131 ki; T\u00fcrkiye\u2019de ger\u00e7ekle\u015fen \u00f6l\u00fcml\u00fc i\u015f kazalar\u0131na ait rakamlar yukar\u0131ya ald\u0131\u011f\u0131m\u0131z tahminleri do\u011frular niteliktedir. 1990-2014 y\u0131llar\u0131 aras\u0131nda ger\u00e7ekle\u015fen \u00f6l\u00fcml\u00fc i\u015f kazas\u0131 insidans ortalamas\u0131 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 22,5 ve son 10 ve 5 y\u0131l\u0131n ortalamalar\u0131 da s\u0131ras\u0131yla 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 13 ve 12\u2019dir.[18]\n

T\u00fcrk Mucizesi<\/p>\n

Fakat T\u00fcrkiye, i\u015fe ba\u011fl\u0131 hastal\u0131klar ve meslek hastal\u0131klar\u0131yla m\u00fccadelede s\u0131rad\u0131\u015f\u0131 bir profil sunmaktad\u0131r; T\u00fcrkiye\u2019de te\u015fhis edilen meslek hastal\u0131\u011f\u0131 say\u0131lar\u0131 ve y\u0131ll\u0131k insidanslar\u0131 25 y\u0131ld\u0131r d\u00fczenli olarak azalmaktad\u0131r!<\/p>\n

1990-2014 y\u0131llar\u0131 aras\u0131nda te\u015fhis edilen ve sigorta sistemi taraf\u0131ndan tan\u0131nan meslek hastal\u0131klar\u0131n\u0131n insidans\u0131n\u0131 g\u00f6sterir grafik a\u015fa\u011f\u0131dad\u0131r.<\/p>\n

T\u00fcrkiye\u2019de Y\u0131llara G\u00f6re Te\u015fhis Edilen MH \u0130nsidanslar\u0131-100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na[19]\n

\"1-1\"<\/a><\/p>\n

T\u00fcrkiye\u2019de 1990 y\u0131l\u0131nda 36,6\/100.000 olan MH insidans\u0131 2014 y\u0131l\u0131na gelindi\u011finde 10 kat gerileyerek 3,7\/100.000 olmu\u015ftur.<\/p>\n

T\u00fcrkiye\u2019nin y\u0131ll\u0131k insidans rakamlar\u0131yla kimi Avrupa \u00fclkeleri\u2019nin[20] verilerine ula\u015fabildi\u011fimiz y\u0131llar\u0131ndan elde etti\u011fimiz ortalama insidans rakamlar\u0131yla birlikte g\u00f6steren grafik ise a\u015fa\u011f\u0131dad\u0131r.<\/p>\n

\"2\"<\/a><\/p>\n

Bu \u00fclkelerde 1990 y\u0131l\u0131nda her 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na y\u0131lda ortalama 67 MH te\u015fhis edilir iken bu ortalama insidans 2006 y\u0131l\u0131nda 102\/100.000\u2019e \u00e7\u0131km\u0131\u015ft\u0131r, MH te\u015fhis\/tan\u0131ma insidanslar\u0131 17 y\u0131lda ortalama 1.5 kat artm\u0131\u015ft\u0131r. T\u00fcrkiye\u2019de ise ayn\u0131 y\u0131llarda geli\u015fme tam tersi y\u00f6nde olmu\u015f MH te\u015fhis insidans\u0131 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 36.6\u2019dan 7,3\u2019e 5 kat gerilemi\u015ftir. Keza bu verileri a\u015fa\u011f\u0131daki tablolarda oldu\u011fu gibi ba\u015fka kaynaklardan kontrol etti\u011fimizde de durum de\u011fi\u015fmemektedir.<\/p>\n

\"3\"<\/a><\/p>\n

*Eurogip 2002\u2019den aktaran Occupational Health Eight Priority Action Areas for Community Policy, European trade Union Technical Bureau for Health and Safety<\/p>\n

**Report on the current situation in relation to occupational diseases\u2019 systems in EU Member States and particular relative to Commission Recommendation 2003\/670\/EC EFTA\/EEA countries, in Diseases and gathering of data on concerning the European Schedule of Occupational relevant related aspects, EUROPEAN COMMISSION<\/p>\n

Meslek Hastal\u0131klar\u0131ndan Kaynaklanan \u00d6l\u00fcmler<\/p>\n

Yukar\u0131ya ald\u0131\u011f\u0131m\u0131z verilerden g\u00f6r\u00fcld\u00fc\u011f\u00fc gibi T\u00fcrkiye MH\u2019n\u0131n te\u015fhis ve tan\u0131nmas\u0131nda s\u0131f\u0131rlamaya \u00e7ok yakla\u015fm\u0131\u015ft\u0131r. Fakat meslek hastal\u0131klar\u0131yla alakal\u0131 ba\u015fka bir alanda s\u0131f\u0131rlama s\u00fcrecini tamamlam\u0131\u015ft\u0131r: T\u00fcrkiye\u2019de son 10 y\u0131lda MH\u2019a ba\u011fl\u0131 olarak geli\u015fti\u011fi kabul edilen \u00f6l\u00fcm say\u0131s\u0131 toplam 56\u2019d\u0131r. MH\u2019a ba\u011fl\u0131 \u00f6l\u00fcmleri s\u0131f\u0131rlama s\u00fcreci 2000 y\u0131l\u0131nda ba\u015flam\u0131\u015f ve bu g\u00fcnlerde tamamlanm\u0131\u015f g\u00f6z\u00fckmektedir. T\u00fcrkiye\u2019de 2013 ve 2014 y\u0131llar\u0131nda MH\u2019na ba\u011fl\u0131 \u00f6l\u00fcm kaydetmemi\u015ftir. A\u015fa\u011f\u0131daki grafik Almanya ve T\u00fcrkiye\u2019nin meslek hastal\u0131\u011f\u0131 ve i\u015f kazalar\u0131na ba\u011fl\u0131 \u00f6l\u00fcm insidanslar\u0131n\u0131 kar\u015f\u0131la\u015ft\u0131rmaktad\u0131r. \u0130\u015f kazalar\u0131na ba\u011fl\u0131 \u00f6l\u00fcm insidanslar\u0131 Almanya\u2019n\u0131n \u00e7ok \u00fczerinde (4-5 kat\u0131) seyreden T\u00fcrkiye\u2019nin MH\u2019na ba\u011fl\u0131 \u00f6l\u00fcm insidanslar\u0131 1997\u2019den itibaren dramatik olarak gerilemeye ba\u015flam\u0131\u015f 2007\u2019den itibaren de s\u0131f\u0131rlanm\u0131\u015ft\u0131r!<\/p>\n

\"4-1\"<\/a><\/p>\n

Sources: \u2013Dokumentation des Berufskrankheiten-Geschehens in Deutschland BK-DOK 2005, Barbel Haupt and others, Deutsche Gesetzliche Unfallversicherung e.V. (DGUV) -DGUV Statistics 2010, 2011, 2012, 2013, 2014 Figures and long-term trends Deutsche Gesetzliche Unfallversicherung e.V. (DGUV) -Annual Statistical Reports of Public Insurance Institution of Turkey<\/p>\n

Meslek Hastal\u0131klar\u0131ndaki Azalman\u0131n Olas\u0131 Nedenleri<\/p>\n

Bir hastal\u0131\u011f\u0131n bir toplumdaki insidans\u0131 dramatik olarak d\u00fc\u015f\u00fcyorsa a\u015fa\u011f\u0131daki olas\u0131l\u0131klar\u0131 d\u00fc\u015f\u00fcnmek gerekir:<\/p>\n

1-<\/strong>Hastal\u0131k etkeni dramatik \u00f6l\u00e7\u00fcde azalm\u0131\u015ft\u0131r. Bu durumda risk alt\u0131ndaki n\u00fcfus etkenle daha az kar\u015f\u0131la\u015faca\u011f\u0131ndan hastal\u0131k da daha az g\u00f6r\u00fclecektir. \u00d6rne\u011fin s\u0131tmayla m\u00fccadelede batakl\u0131klar\u0131n kurutulmas\u0131n\u0131n mant\u0131\u011f\u0131 budur.<\/p>\n

Acaba inceledi\u011fimiz d\u00f6nemde T\u00fcrkiye\u2019de MH etkenleri azalm\u0131\u015f ya da risk alt\u0131ndaki n\u00fcfus bu etkenlere daha m\u0131 az maruz kalm\u0131\u015ft\u0131r?<\/p>\n

B\u00f6yle bir veriye sahip degiliz. Tam aksine inceledigimiz y\u0131llarda \u00fcretim tekniklerinde ola\u011fan d\u0131\u015f\u0131 bir de\u011fi\u015fiklik oldu\u011funa dair belirti olmad\u0131\u011f\u0131 gibi bu d\u00f6nemde (1990-2014) T\u00fcrkiye \u00e7al\u0131\u015f\u0131lan saat ba\u015f\u0131na \u00fcretimini yukar\u0131ya ald\u0131\u011f\u0131m\u0131z di\u011fer b\u00fct\u00fcn \u00fclkelerden -\u0130talya istisna olmak \u00fczere 64%- daha fazla olmak \u00fczere 60% art\u0131rm\u0131\u015ft\u0131r. [21] Keza ayn\u0131 d\u00f6nemin verilerini derleyebildi\u011fimiz bir ba\u015fka uzunca kesitinde (1996-2013) T\u00fcrkiye\u2019li bir i\u015f\u00e7inin y\u0131ll\u0131k ortalama \u00e7al\u0131\u015fma s\u00fcresi buradaki kar\u015f\u0131la\u015ft\u0131rmada i\u00e7erilen b\u00fct\u00fcn di\u011fer \u00fclkelerden fazla olmak \u00fczere[22] y\u0131ll\u0131k 1903 saat olmu\u015ftur. Bu d\u00f6nem i\u00e7in OECD ortalamas\u0131 1808 saat\/y\u0131l\u2019d\u0131r. OECD \u00fcyesi \u00fclkeler aras\u0131nda, T\u00fcrkiye haftada 50 saatten fazla \u00e7al\u0131\u015fan i\u015f\u00e7i say\u0131s\u0131 bak\u0131m\u0131ndan en y\u00fcksek orana (%43) sahiptir. Halbuki t\u00fcm OECD \u00fclkeleri i\u00e7in, haftada 50 satten fazla \u00e7al\u0131\u015fma oran\u0131 ortalama olarak erkek \u00e7al\u0131\u015fanlarda %12, kad\u0131n \u00e7al\u0131\u015fanlarda %5\u2019dir.<\/p>\n

Yani inceledi\u011fimiz bu d\u00f6nemde T\u00fcrkiye\u2019li \u00e7al\u0131\u015fanlar Avrupal\u0131 \u00e7al\u0131\u015fanlar g\u00f6re daha fazla \u00e7al\u0131\u015fm\u0131\u015f, daha \u00e7ok \u00fcretmi\u015f, dolay\u0131s\u0131 ile i\u015fe ba\u011fl\u0131 hastal\u0131k etkenleriyle daha \u00e7ok kar\u015f\u0131la\u015fm\u0131\u015f ama Sosyal G\u00fcvenlik Kurumu\u2019nun (SGK) MH rakamlar\u0131ndan anla\u015f\u0131lmaktad\u0131r ki bu etkenlerden daha az hastalanm\u0131\u015flard\u0131r!<\/p>\n

2-<\/strong>Koruyucu \u00f6nlemler yayg\u0131nla\u015fm\u0131\u015ft\u0131r. \u00d6rne\u011fin bula\u015f\u0131c\u0131 bir hastal\u0131\u011fa kar\u015f\u0131 a\u015f\u0131lamada oldu\u011fu gibi etken do\u011frudan azalt\u0131lamasa da etkene kar\u015f\u0131 al\u0131nan \u00f6nlemler artt\u0131r\u0131lm\u0131\u015f, bu yolla hastal\u0131k \u00f6nlenmi\u015f olabilir. Bu durumda da hastal\u0131\u011f\u0131n daha az g\u00f6r\u00fclmesi beklenir.<\/p>\n

Acaba inceledi\u011fimiz d\u00f6nemde T\u00fcrkiye\u2019de MH\u2019na yol a\u00e7an etkenlere\/risklere kar\u015f\u0131 \u00e7al\u0131\u015fanlar\u0131 koruyucu \u00f6nlemlerin artt\u0131\u011f\u0131na dair bir iddiada bulunulabilir mi? Evet b\u00f6yle bir iddiada bulunulabilir, \u00e7al\u0131\u015fanlar\u0131n bu d\u00f6nemde i\u015f kazas\u0131na u\u011frama oranlar\u0131ndaki nisbi iyile\u015fme de bu iddiaya kan\u0131t olarak ileri s\u00fcr\u00fclebilir. \u00c7\u00fcnk\u00fc; \u00f6rne\u011fin T\u00fcrkiye\u2019de 1994 y\u0131l\u0131nda yakla\u015f\u0131k 30\/100.000 olan \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 insidans\u0131 2006 y\u0131l\u0131na gelindi\u011finde yakla\u015f\u0131k 20\/100.000 olmu\u015ftur. Bu oransal azalma e\u011filimi yukar\u0131ya ald\u0131\u011f\u0131m\u0131z Avrupa \u00fclkelerinde de g\u00f6zlenmektedir. Yukar\u0131da se\u00e7ili Avrupa \u00fclkelerinde de 1994 y\u0131l\u0131nda yakla\u015f\u0131k 4,8\/100.000 olan \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 insidans\u0131[23] 2006\u2019da 3\/100.000\u2019e gerilemi\u015ftir. T\u00fcrkiye\u2019deki \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 rakamlar\u0131n\u0131n Avrupa \u00fclkelerindeki ortalamadan \u00e7ok fazla olmas\u0131n\u0131 bir kenara b\u0131rakal\u0131m, T\u00fcrkiye i\u015fe ba\u011fl\u0131 sa\u011fl\u0131k sorunlar\u0131n\u0131n hastal\u0131k ve yaralanmalar alt ba\u015fl\u0131klar\u0131nda kar\u015f\u0131la\u015ft\u0131rd\u0131\u011f\u0131m\u0131z Avrupa \u00fclkelerinden ciddi bir bi\u00e7imde ayr\u0131\u015fmaktad\u0131r. A\u015fa\u011f\u0131daki grafik bu paradoksal ayr\u0131\u015fmay\u0131 a\u00e7\u0131k bir \u015fekilde g\u00f6stermektedir. Grafik T\u00fcrkiye ve se\u00e7ili Avrupa \u00fclkelerini \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 ba\u015f\u0131na te\u015fhis edilen\/tan\u0131nan MH say\u0131s\u0131 baz\u0131nda kar\u015f\u0131la\u015ft\u0131rmaktad\u0131r.<\/p>\n

\"5\"<\/a><\/p>\n

Grafikten g\u00f6r\u00fclece\u011fi \u00fczere \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 ba\u015f\u0131na te\u015fhis edilen MH say\u0131s\u0131 se\u00e7ili Avrupa \u00fclkelerinde 1994 y\u0131l\u0131nda ortalama13,7 iken 2006\u2019da 34,5\u2019e y\u00fckselmi\u015f, T\u00fcrkiye\u2019de ise bu oran 1,07\u2019den 0,36\u2019ya gerilemi\u015ftir. \u00d6l\u00fcmc\u00fcl i\u015f kazalar\u0131ndaki g\u00f6reli iyile\u015fme se\u00e7ili Avrupa \u00fclkelerinde te\u015fhis edilen MH say\u0131lar\u0131nda art\u0131\u015fla paralel giderken T\u00fcrkiye\u2019de tam aksi olmu\u015ftur.<\/p>\n

3-<\/strong>Hastal\u0131\u011f\u0131 te\u015fhis etmenin t\u0131bbi olanaklar\u0131 azalm\u0131\u015f olabilir. Bu durumda etken de hastal\u0131k da yerli yerinde duruyordur ama sava\u015f, do\u011fal afet, ekonomik kriz ya da siyasi kaos vb. bir nedenle \u00fclkenin t\u0131bbi kapasitesi gerilemi\u015f ve hastal\u0131k daha az te\u015fhis edilir hale gelmi\u015f olabilir.<\/p>\n

Acaba T\u00fcrkiye\u2019de MH\u2019lar\u0131n\u0131n ba\u015f\u0131na gelen de bu mudur?<\/p>\n

MH y\u00f6n\u00fcnden \u0130nceledi\u011fimiz bu d\u00f6nemde T\u00fcrkiye\u2019de ki\u015fi ba\u015f\u0131na ortalama sa\u011fl\u0131k harcamas\u0131 tutar\u0131n\u0131n 8,7 kat, GSYIH\u2019dan sa\u011fl\u0131k i\u00e7in ayr\u0131lan pay\u0131n 2,4 kat artt\u0131\u011f\u0131n\u0131 biliyoruz.[24]\n

Keza bu d\u00f6nemde T\u00fcrkiye\u2019deki sa\u011fl\u0131k harcamalar\u0131ndaki art\u0131\u015fa paralel olarak, sa\u011fl\u0131k hizmetlerinin arz\u0131nda ve sa\u011fl\u0131k teknolojisi kullan\u0131m\u0131ndaki art\u0131\u015flar da kesindir:<\/p>\n

OECD verilerine g\u00f6re \u00f6rne\u011fin 2002 y\u0131l\u0131nda ki\u015fi ba\u015f\u0131na y\u0131ll\u0131k doktor muayene say\u0131s\u0131 1,2 iken 2013\u2019te bu rakam 8,2\u2019e keza 2008\u2019de 78 olan 1000 ki\u015fi ba\u015f\u0131na Bilgisayarl\u0131 Tomografi (BT) inceleme say\u0131s\u0131 2013\u2019te 145\u2019e \u00e7\u0131km\u0131\u015ft\u0131r. Ya da 2000 y\u0131l\u0131nda 2 olan 1000 ki\u015fi ba\u015f\u0131na d\u00fc\u015fen hastane yata\u011f\u0131 say\u0131s\u0131 2013\u2019te 2,65\u2019e, 2002\u2019de 4,66\u2019 olan 1.000.000 ki\u015fi ba\u015f\u0131na BTsay\u0131s\u0131 2013\u2019te 14,18\u2019e \u00e7\u0131km\u0131\u015ft\u0131r. Dolay\u0131s\u0131yla bu d\u00f6nemde t\u0131bbi te\u015fhis olanaklar\u0131n\u0131n ve bunlar\u0131n kullan\u0131m\u0131n\u0131n artt\u0131\u011f\u0131n\u0131 kesinlikle s\u00f6yleyebiliriz.<\/p>\n

Ek olarak, d\u00f6nem boyunca T\u00fcrkiye\u2019deki MH kliniklerinin say\u0131s\u0131nda azalma olmam\u0131\u015f aksine yap\u0131lan yeni d\u00fczenlemelerle MH te\u015fhis yetki ve y\u00fck\u00fcml\u00fcl\u00fc\u011f\u00fc olan klinik say\u0131s\u0131 3\u2019ten yakla\u015f\u0131k 140\u2019a \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r.<\/p>\n

4<\/strong>-Sa\u011fl\u0131k hizmetlerine ula\u015f\u0131m olanaklar\u0131 azalm\u0131\u015ft\u0131r.<\/p>\n

\u00dclkenin sa\u011fl\u0131k hizmeti kapasitesi ve arz\u0131nda gerileme olmaks\u0131z\u0131n bir hastal\u0131k grubunun kurbanlar\u0131n\u0131n \u015fu ya da bu nedenle kendileriyle ilgili sa\u011fl\u0131k hizmeti sunucular\u0131na ula\u015f\u0131m olanaklar\u0131 azalm\u0131\u015f olabilir.<\/p>\n

Esasen bu d\u00f6nemde T\u00fcrkiye\u2019nin sa\u011fl\u0131k sisteminde \u00e7al\u0131\u015fanlar\u0131n mesleki sa\u011fl\u0131k hizmetlerine ula\u015f\u0131mlar\u0131n\u0131 zorla\u015ft\u0131racak g\u00f6r\u00fcn\u00fcr bir olumsuzluk olmam\u0131\u015ft\u0131r. T\u00fcrkiye\u2019deki d\u00fczenlemeler ve sa\u011fl\u0131k sisteminin i\u015fleyi\u015fi bak\u0131m\u0131ndan meslek hastal\u0131\u011f\u0131 kliniklerine ula\u015fmak 1990\u2019da ne kadar zor ya da kolaysa 2000\u2019li y\u0131llar boyunca bu durum de\u011fi\u015fmemi\u015ftir. Hatta inceledi\u011fimiz d\u00f6nemin sonlar\u0131nda 2012 y\u0131l\u0131nda yap\u0131lan yeni bir yasal d\u00fczenleme ile k\u00fc\u00e7\u00fck i\u015fletmelere de \u00e7al\u0131\u015fanlar\u0131na mesleki sa\u011fl\u0131k hizmeti verme y\u00fck\u00fcml\u00fcl\u00fc\u011f\u00fc getirilmi\u015ftir.<\/p>\n

Tart\u0131\u015fma<\/strong><\/p>\n

Yukar\u0131daki k\u0131sa epidemiyolojik tart\u0131\u015fma T\u00fcrkiye\u2019deki meslek hastal\u0131\u011f\u0131 te\u015fhis say\u0131 ve oranlar\u0131nda y\u0131llar i\u00e7inde g\u00f6r\u00fclen bu mucizevi azalman\u0131n sa\u011fl\u0131k ortam\u0131ndaki de\u011fi\u015fmelerle a\u00e7\u0131klanamayaca\u011f\u0131n\u0131 g\u00f6stermektedir.<\/p>\n

\u00d6te yandan ortalama bir i\u015fverenin i\u015f\u00e7ilerinden birinde g\u00f6r\u00fclen bir hastal\u0131\u011f\u0131n meslek hastal\u0131\u011f\u0131 olarak te\u015fhis edilmesine kar\u015f\u0131 do\u011fal bir m\u00fccadele i\u00e7inde olaca\u011f\u0131 da vak\u0131ad\u0131r. \u00c7\u00fcnk\u00fc; bir hastal\u0131\u011f\u0131n i\u015fle ili\u015fkisi somut olarak ortaya kondu\u011funda 1. \u0130\u015fveren tazminat \u00f6deyecek 2. Meslek hastal\u0131klar\u0131n say\u0131s\u0131ndaki art\u0131\u015f \u00e7al\u0131\u015fanlar\u0131n daha y\u00fcksek \u00fccretler ve daha iyi \u00e7al\u0131\u015fma ko\u015fullar\u0131 talep etmelerine neden olacak 3. \u0130\u015fyeri daha s\u0131k ve daha dikkatle tefti\u015f edilecektir.[25]\n

Keza hastal\u0131\u011f\u0131n te\u015fhis edilmesi ile \u00e7al\u0131\u015fan da \u00e7e\u015fitli olumsuz sonu\u00e7larla kar\u015f\u0131 kar\u015f\u0131ya kalabilmekte bu nedenle bizzat \u00e7al\u0131\u015fan, hastal\u0131\u011f\u0131n\u0131n meslek hastal\u0131\u011f\u0131 olarak te\u015fhis edilmesinden ka\u00e7\u0131nabilmektedir. 1-\u0130\u015ften ayr\u0131lmak zorunda kalmak ya da i\u015ften \u00e7\u0131kar\u0131lmak 2-\u0130\u015fveren taraf\u0131ndan su\u00e7lanmak hatta taciz edilmek 3-Maluliyet tespit edilmesi durumunda yeni i\u015f bulmakta zorlanmak.<\/p>\n

Sosyal Sigorta otoriteleri ise meslek hastal\u0131\u011f\u0131 te\u015fhis edildi\u011finde i\u015f\u00e7iye sigorta fonundan \u00f6deyece\u011fi tazminat\u0131 \u00f6demekten ka\u00e7\u0131nmakta, te\u015fhis ve tazminat s\u00fcrecini i\u015f\u00e7inin katlanamayaca\u011f\u0131 denli uzun, me\u015fakkatli ve \u00e7o\u011fu noktada i\u015f\u00e7iyi a\u015fa\u011f\u0131lay\u0131c\u0131 bir s\u00fcre\u00e7 olarak d\u00fczenlemektedir.<\/p>\n

B\u00fct\u00fcn bu nedenlerle i\u015fe ba\u011fl\u0131 hastal\u0131klar\/meslek hastal\u0131klar\u0131 insidanslar\u0131ndaki de\u011fi\u015fime ili\u015fkin bir incelemenin bizce i\u015f s\u00fcre\u00e7lerindeki ve emek piyasas\u0131ndaki de\u011fi\u015fimlere dair verilerle tamamlanmas\u0131 ve hatta meslek hastal\u0131\u011f\u0131 te\u015fhis s\u00fcrecini bi\u00e7imlendiren t\u0131bbi ve yasal s\u00fcre\u00e7lerin de mercek alt\u0131na almas\u0131 gerekir.<\/p>\n

T\u00fcrkiye\u2019de \u0130\u015f S\u00fcre\u00e7leri<\/strong><\/p>\n

T\u00fcrkiye\u2019nin an\u0131lan y\u0131llarda \u00e7al\u0131\u015fma ya\u015fam\u0131n\u0131n iki temel unsuru olan \u00e7al\u0131\u015fanlar ile i\u015fverenler aras\u0131ndaki ili\u015fkiye yak\u0131ndan bakal\u0131m.<\/p>\n

\"gratik-is\"<\/a><\/span><\/p>\n

Yukar\u0131daki grafiklerden g\u00f6r\u00fcld\u00fc\u011f\u00fc gibi inceledi\u011fimiz bu d\u00f6nem boyunca \u00e7al\u0131\u015fanlar\u0131n sendikal \u00f6rg\u00fctl\u00fcl\u00fckleri s\u0131f\u0131rlanm\u0131\u015f, toplu s\u00f6zle\u015fme yapabilen \u00e7al\u0131\u015fanlar\u0131n t\u00fcm \u00e7al\u0131\u015fanlara oran\u0131 %24\u2019lerden %2\u2019lere kadar gerilemi\u015ftir.<\/span><\/p>\n

Ayn\u0131 d\u00f6nemde K\u0130T\u2019lerdeki istihdam\u0131n Toplam \u00fccretlilere oran\u0131; 1985\u2019te %10,5 iken 2013\u2019e gelindi\u011finde %0,8\u2019e gerilemi\u015ftir.[26] Benzer bir bi\u00e7imde ta\u015feron \u00e7al\u0131\u015fanlar\u0131n\u0131n t\u00fcm \u00fccretlilere oran\u0131 da 2002\u2019de 4% iken 2011\u2019de 12%\u2019ye y\u00fckselmi\u015ftir.[27]\n

Bu geli\u015fmelerin \u00e7al\u0131\u015fanlar\u0131n i\u015f g\u00fcvencesini erozyona u\u011fratt\u0131\u011f\u0131 a\u015fikard\u0131r. Kald\u0131 ki d\u00f6nemin i\u015fte kal\u0131m s\u00fcrelerine ait veriler de bu erozyonu do\u011frular niteliktedir.<\/p>\n

\"9-1\"<\/a><\/p>\n

Yukar\u0131daki grafikten izlenebilen 2004-2013 y\u0131llar\u0131na ait veriler[28] bu y\u0131llar boyunca T\u00fcrkiye\u2019li \u00e7al\u0131\u015fanlar\u0131n i\u015fte kal\u0131m s\u00fcrelerinde ciddi azalma oldu\u011funu g\u00f6stermektedir. 2004 y\u0131l\u0131nda mevcut i\u015finde 3 y\u0131ldan fazla \u00e7al\u0131\u015fanlar\u0131n oran\u0131 ise 58% iken bu oran 2013\u2019te 41%\u2019e gerilemi\u015ftir. Benzer bi\u00e7imde mevcut i\u015finde 1 y\u0131ldan az s\u00fcredir \u00e7al\u0131\u015fanlar\u0131n t\u00fcm \u00e7al\u0131\u015fanlara oran\u0131 2004\u2019te 19% iken bu oran da 2014\u2019te 35%\u2019e y\u00fckselmi\u015ftir. Elimizde inceledi\u011fimiz t\u00fcm d\u00f6neme ili\u015fkin rakamlar olmamakla birlikte e\u011filimin ele ald\u0131\u011f\u0131m\u0131z t\u00fcm d\u00f6nem boyunca bu y\u00f6nde geli\u015fmi\u015f oldu\u011funu kestirebiliriz. T\u00fcrkiye\u2019ye ait bu veriler T\u00fcrkiye\u2019deki ta\u015feron \u00e7al\u0131\u015fmadaki art\u0131\u015fla ilgili parametreyi de teyit etmektedir.<\/p>\n

Ayn\u0131 grafikte bu incelemede T\u00fcrkiye\u2019yi kar\u015f\u0131la\u015ft\u0131rd\u0131\u011f\u0131m\u0131z Avrupa \u00fclkelerindeki i\u015fte kal\u0131m s\u00fcrelerinin ortalamas\u0131na ait veriler de bulunmaktad\u0131r. Ki bu kar\u015f\u0131la\u015ft\u0131rma T\u00fcrkiye\u2019nin ortalama i\u015fte kal\u0131m s\u00fcreleri bak\u0131m\u0131ndan bu \u00fclkelerden ciddi \u015fekilde farkl\u0131la\u015fm\u0131\u015f oldu\u011funu g\u00f6stermektedir.<\/p>\n

Ele ald\u0131\u011f\u0131m\u0131z d\u00f6nemde t\u00fcm rakamsal izlerini s\u00fcrmek m\u00fcmk\u00fcn olmamakla birlikte T\u00fcrkiye halen kay\u0131t d\u0131\u015f\u0131 \u00e7al\u0131\u015fman\u0131n yayg\u0131n oldu\u011fu, \u00e7ocuk i\u015f\u00e7ili\u011finin tam olarak engellenemedi\u011fi bir \u00fclkedir. 2014 y\u0131l\u0131 i\u00e7in sosyal g\u00fcvenlik kurumunun verdi\u011fi kay\u0131t d\u0131\u015f\u0131 \u00e7al\u0131\u015fma oran\u0131 35%\u2019tir. [29] T\u00fcrkiye \u0130statistik Kurumu\u2019nun 2013 y\u0131l\u0131nda yay\u0131mlad\u0131\u011f\u0131 verilere g\u00f6re ise 6-14 ya\u015f grubu \u00e7ocuklar\u0131n \u00e7al\u0131\u015fma oran\u0131 2,6%, 15-17 ya\u015f grubu \u00e7ocuklar\u0131n \u00e7al\u0131\u015fma oran\u0131 ise 15,6%\u2019d\u0131r. Daha da k\u00f6t\u00fcs\u00fc 2012 y\u0131l\u0131 i\u00e7in verilen bu rakamlar 6-14 ya\u015f \u00e7ocuk i\u015f\u00e7ili\u011finin 2006 y\u0131l\u0131ndan bu yana artmakta oldu\u011funu g\u00f6stermektedir.[30]\n

Ek olarak, inceledi\u011fimiz bu y\u0131llar boyunca bir di\u011fer \u00f6nemli politika da i\u015fyeri hekimlerinin i\u015f g\u00fcvencelerinin erozyona u\u011frat\u0131lmas\u0131 olmu\u015ftur. 1990\u2019l\u0131 y\u0131llar\u0131n ba\u015f\u0131 hari\u00e7 d\u00f6nem boyunca i\u015fyeri hekimlerinin i\u015f s\u00f6zle\u015fmeleri \u00fczerindeki Tabip Odas\u0131 g\u00fcvencesi \u00e7e\u015fitli yasal de\u011fi\u015fikliklerle erozyona u\u011frat\u0131lm\u0131\u015ft\u0131r. 2000\u2019lerde bu erozyon h\u0131zland\u0131r\u0131lm\u0131\u015f, 2010 y\u0131l\u0131nda ise Tabip Odas\u0131 g\u00fcvencesi t\u00fcmden kald\u0131r\u0131lm\u0131\u015ft\u0131r. En son 2012\u2019de \u00e7\u0131kar\u0131lan \u0130SG yasas\u0131yla da i\u015fyeri hekimli\u011fi hizmetlerinin ta\u015feronla\u015ft\u0131r\u0131lmas\u0131n\u0131n yolu a\u00e7\u0131lm\u0131\u015ft\u0131r.<\/p>\n

SONU\u00c7<\/strong><\/p>\n

\u0130nceledi\u011fimiz bu y\u0131llar boyunca T\u00fcrkiye\u2019de \u00e7al\u0131\u015fanlar tamamen sendikas\u0131zla\u015ft\u0131r\u0131lm\u0131\u015f, kamu \u00e7al\u0131\u015fanlar\u0131n\u0131n say\u0131s\u0131 b\u00fcy\u00fck \u00f6l\u00e7\u00fcde azalt\u0131lm\u0131\u015f, ta\u015feron \u00e7al\u0131\u015fma yayg\u0131nla\u015ft\u0131r\u0131lm\u0131\u015f, i\u015fyeri hekimleri g\u00fcvencesizle\u015ftirilmi\u015f ve b\u00fct\u00fcn bunlar olurken meslek hastal\u0131\u011f\u0131 insidanslar\u0131 da 1990\u2019da 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 36,6\u2019dan, 2013\u2019te 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 3\u2019e gerilemi\u015ftir.<\/p>\n

G\u00f6r\u00fcnen odur ki mucize MH te\u015fhis rakamlar\u0131ndaki mucizevi d\u00fc\u015f\u00fc\u015f de\u011fildir. Mucize T\u00fcrkiye\u2019de \u00e7al\u0131\u015fanlar\u0131n neredeyse bir nesile s\u0131\u011facak k\u0131sa bir zaman diliminde t\u00fcmden sendikas\u0131zla\u015ft\u0131r\u0131lm\u0131\u015f ve b\u00fcy\u00fck \u00f6l\u00e7\u00fcde g\u00fcvencesizle\u015ftirilmi\u015f olmalar\u0131d\u0131r. Meslek hastal\u0131klar\u0131n\u0131n s\u0131f\u0131rlanmas\u0131 \u00f6zelde sendikalar\u0131n s\u0131f\u0131rlanmas\u0131 genelde de t\u00fcm \u00e7al\u0131\u015fanlar\u0131n g\u00fcvencesizle\u015ftirilmesini takip etmi\u015f g\u00f6z\u00fckmektedir. Ku\u015fkusuz burada ortaya koydu\u011fumuz ili\u015fkiyi somutlayacak daha fazla ara\u015ft\u0131rmaya ihtiya\u00e7 vard\u0131r. Ama bu ihtiya\u00e7 b\u00fcy\u00fck rakamlar\u0131n yalan s\u00f6ylemeyece\u011fi ger\u00e7e\u011fini de unutturmamal\u0131d\u0131r.<\/p>\n

Bu noktada i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 ve i\u015fg\u00fcvenli\u011fi alan\u0131nda T\u00fcrkiye\u2019deki en \u00f6nemli kurum olan \u00c7al\u0131\u015fma Bakanl\u0131\u011f\u0131\u2019n\u0131n konumu ne yaz\u0131k ki hen\u00fcz geli\u015fmi\u015f d\u00fcnyan\u0131n i\u015faret etti\u011fi noktadan uzakta ve hatta yanl\u0131\u015f y\u00f6ndedir. Bakanl\u0131k bir yandan kendi yay\u0131nlar\u0131nda (bilimsel kayna\u011f\u0131 belirsiz abart\u0131l\u0131 rakamlar zikrederek \u2018zaten bu beklenen insidans rakamlar\u0131 tamamen varsay\u0131msal hayatta kar\u015f\u0131l\u0131\u011f\u0131 olamayacak teorik rakamlard\u0131r\u2019 dercesine. yn) her y\u0131l 100.000 \u00e7al\u0131\u015fan ba\u015f\u0131na 400-1200 aras\u0131 meslek hastal\u0131\u011f\u0131 te\u015fhis edilmesi gerekti\u011fini s\u00f6ylemekte[31] \u00f6te yandan haz\u0131rlad\u0131\u011f\u0131 i\u015f sa\u011fl\u0131\u011f\u0131 g\u00fcvenli\u011fi politika belgesinde te\u015fhis edilen MH say\u0131lar\u0131ndaki d\u00fc\u015f\u00fc\u015f\u00fc \u00f6l\u00fcml\u00fc i\u015f kazalar\u0131 ve s\u00fcrekli i\u015f g\u00f6remezlik say\u0131lar\u0131ndaki d\u00fc\u015f\u00fc\u015fle ayn\u0131 paragrafta ele alarak bu hazin durumu bir ba\u015far\u0131 olarak takdim edebilmektedir.[32]\n

\u0130\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 ve i\u015f g\u00fcvenli\u011finde temel ama\u00e7<\/p>\n

1-\u0130\u015ften kaynaklanan hastal\u0131k ve kaza etkenlerinin ay\u0131rt edilmesi ve \u00f6nlenmesi\/ortadan kald\u0131r\u0131lmas\u0131<\/p>\n

2-\u0130\u015f kaynakl\u0131 etkenlerin ortaya \u00e7\u0131kard\u0131klar\u0131 bireysel ve toplumsal d\u00fczeydeki sa\u011fl\u0131k zararlar\u0131n\u0131n bilimsel bir \u015fekilde giderilmesi, adil bir \u015fekilde tazmin edilmesidir.<\/p>\n

T\u00fcrkiye\u2019deki \u00e7eyrek as\u0131rl\u0131k tablo \u00e7al\u0131\u015fanlar\u0131 g\u00fcvencesizle\u015ftirmek ve \u00f6rg\u00fcts\u00fczle\u015ftirmeye dayal\u0131 bir iktisadi sistemin do\u011fal e\u011filiminin bu iki amaca hizmet etmek de\u011fil i\u015f kaynakl\u0131 hastal\u0131klar\u0131 gizlemek oldu\u011funu g\u00f6stermektedir. H\u00fck\u00fcmet bu gizleme s\u00fcrecindeki kritik rol\u00fcn\u00fc de gizleyebilmekte, kendisini kamuoyuna \u2018bu s\u00fcrece d\u0131\u015fsal iyi niyetli ve \u00e7al\u0131\u015fanlardan yana bir akt\u00f6rm\u00fc\u015fcesine\u2019 sunabilmekte ve ne ac\u0131d\u0131r ki; bundan ald\u0131\u011f\u0131 cesaretle de uluslararas\u0131 d\u00fczeyde i\u015f sa\u011fl\u0131\u011f\u0131 g\u00fcvenli\u011fi konferanslar\u0131 d\u00fczenleyebilmektedir.[33]\n

D\u0130PNOTLAR:<\/p>\n[1]Contract to elaborate a \u2018Report on the current situation in relation to occupational diseases\u2019 systems in EU Member States and EFTA\/EEA countries, in particular relative to Commission Recommendation 2003\/670\/EC concerning the European Schedule of Occupational Diseases and gathering of data on relevant related aspects<\/em><\/p>\n[2] Global Estimates of the Burden of Injury and Illness at Work in 2012, Jukka Takalaa, P\u00e4ivi H\u00e4m\u00e4l\u00e4inenb, Kaija Leena Saarelac, Loke Yoke Yuna, Kathiresan Manickama, Tan Wee Jina, Peggy Henga, Caleb Tjonga, Lim Guan Khenga, Samuel Lima & Gan Siok Lina<\/em><\/p>\n[3] GLOBAL HEALTH RISKS Mortality and burden of disease attributable to selected major risks, World Health Organization 2009, Table A3, Sf 50<\/em><\/p>\n[4] GLOBAL HEALTH RISKS Mortality and burden of disease attributable to selected major risks, World Health Organization 2009, Table A3, Sf 52<\/em><\/p>\n[5] Contribution of occupational risk factors to the global burden of disease-a summary of findings, Marilyn Fingerhut, PhD, Tim Driscoll, PhD, Deborah Imel Nelson, PhD, Marisol Concha-Barrientos, MD, Laura Punnett, ScD, Annette Pruss-Ustin, PhD, Kyle Steenland, PhD, Jim Leigh,\u00a0<\/em>MD, Carlos Corvalan, PhD<\/em><\/p>\n[6] Recording and notification of occupational accidents and diseases, International Labour Office Geneva, 1996, Sf 3<\/em><\/p>\n[7] LIST OF OCCUPATIONAL DISEASES (revised 2010) International Labour Office Geneva, 2010, Sf 7<\/em><\/p>\n[9] THE PREVENTION OCCUPATIONAL DISEASES, ILO 2013, Page 13-14<\/em><\/p>\n[10] THE PREVENTION OCCUPATIONAL DISEASES, World Day for safety and health at work 28 April 2013 by ILO<\/em><\/p>\n[11] Contract to elaborate a \u2018Report on the current situation in relation to occupational diseases\u2019 systems in EU Member States and EFTA\/EEA countries, in particular relative to Commission Recommendation 2003\/670\/EC concerning the European Schedule of Occupational Diseases and gathering of data on relevant related aspects, Page 42<\/em><\/p>\n[12] Rapport \u201cLes maladies professionnelles en Europe \u2013 Statistiques 1990-2006 et actualit\u00e9 juridique\u201d(R\u00e9f. Eurogip-34\/F)\u2019den derledi\u011fimiz ortalama ve std. sapma de\u011ferlerine g\u00f6re.<\/em><\/p>\n[13] Contribution of occupational risk factors to the global burden of disease-a summary of findings, Marilyn Fingerhut, PhD, Tim Driscoll, PhD, Deborah Imel Nelson, PhD, Marisol Concha-Barrientos, MD, Laura Punnett, ScD, Annette Pruss-Ustin, PhD, Kyle Steenland, PhD, Jim Leigh,\u00a0MD, Carlos Corvalan, PhD<\/em><\/p>\n[14] Global Estimates of the Burden of Injury and Illness at Work in 2012, Jukka Takalaa, P\u00e4ivi H\u00e4m\u00e4l\u00e4inenb, Kaija Leena Saarelac, Loke Yoke Yuna, Kathiresan Manickama, Tan Wee Jina, Peggy Henga, Caleb Tjonga, Lim Guan Khenga, Samuel Lima & Gan Siok Lina<\/em><\/p>\n[15] Report on the current situation in relation to occupational diseases\u2019 systems in EU Member States and particular relative to Commission Recommendation 2003\/670\/EC EFTA\/EEA countries, in Diseases and gathering of data on concerning the European Schedule of Occupational relevant related aspects, EUROPEAN COMMISSION\u2019da verilen 2009-2010 y\u0131l\u0131na ait rakamlardan derlenen ortalama<\/em><\/p>\n[16] Rapport \u201cLes maladies professionnelles en Europe \u2013 Statistiques 1990-2006 et actualit\u00e9 juridique\u201d (R\u00e9f. Eurogip-34\/F)\u2019den derledi\u011fimiz ortalama ce std. sapma de\u011ferlerine g\u00f6re<\/em><\/p>\n[17] Kald\u0131 ki \u00c7SGB\u2019n\u0131n ilgili Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc\u2019ne gore bu oran bizim burada verdi\u011fimizin \u00e7ok \u00fczerinde 100.000\u2019de 400-1200\u2019d\u00fcr. Bkz. Meslek Hastal\u0131klar\u0131 Rehberi, Sf 7, \u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakanl\u0131\u011f\u0131 \u0130\u015f Sa\u011fl\u0131\u011f\u0131 ve G\u00fcvenli\u011fi Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc<\/em><\/p>\n[18]\u00a0Source: \u0130nceledi\u011fimiz d\u00f6nemin 2000 y\u0131l\u0131 \u00f6ncesine ait rakamlar i\u00e7in<\/em><\/p>\n

–T\u00fcrkiye\u2019de Meslek Hastal\u0131klar\u0131, Dr. Rana G\u00fcven, Meslek Hastal\u0131klar\u0131 Kongresi, 20-22 KAs\u0131m 2008 Bursa, http:\/\/iyh.istabip.org.tr\/sirer\/kk\/21.pdf, (Sf 253-264)<\/em><\/p>\n

-Meslek Hastal\u0131klar\u0131 Rehberi, Sf 17-19, \u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakanl\u0131\u011f\u0131 \u0130\u015f Sa\u011fl\u0131\u011f\u0131 ve G\u00fcvenli\u011fi Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc (\u0130SGGM)<\/em><\/p>\n

-TTB \u0130\u015fyeri Hekimli\u011fi Ders Notlar\u0131<\/em><\/p>\n

-Sosyal Sigorta Finansman Y\u00f6ntemleri Ve T\u00fcrkiye\u2019de Sosyal Sigorta Kurumlar\u0131n\u0131n Finansman Y\u00f6ntemlerinin De\u011ferlendirilmesi ,Yrd. Do\u00e7. Dr. \u0130smail G\u00dcNE\u015e, Ar\u015f. G\u00f6r. Soner YAKAR<\/em><\/p>\n

Source: \u0130nceledi\u011fimiz d\u00f6nemin 2000 y\u0131l\u0131 ve sonras\u0131na ait rakamlar i\u00e7in<\/em><\/p>\n

-SGK Y\u0131ll\u0131klar\u0131,<\/em><\/p>\n

ILO\u2019nun da referans ald\u0131\u011f\u0131 yukar\u0131ya ald\u0131\u011f\u0131m\u0131z \u00e7al\u0131\u015fmada T\u00fcrkiye\u2019nin de dahil oldu\u011fu Avrupa B\u00f6lgesi i\u00e7in \u00f6l\u00fcml\u00fc i\u015f kazas\u0131 insidans\u0131 tahmini 7.6\/100,000, WHO\u2019nun yukar\u0131ya ald\u0131\u011f\u0131m\u0131z \u00e7al\u0131\u015fmas\u0131nda t\u00fcm d\u00fcnya i\u00e7in \u00f6l\u00fcml\u00fc i\u015f kazas\u0131 tahmini 11.6\/100,000)<\/em><\/p>\n[19] \u0130nceledi\u011fimiz d\u00f6nemde T\u00fcrkiye\u2019de te\u015fhis edilen ve tan\u0131nan Meslek Hastal\u0131\u011f\u0131 ve Sigortal\u0131 \u0130\u015f\u00e7i say\u0131lar\u0131n\u0131n t\u00fcm\u00fcn\u00fc kapsayan bir kaynak bulunmamaktad\u0131r. Bu makaledeki T\u00fcrkiye\u2019ye ili\u015fkin say\u0131lar ve oranlar i\u00e7in a\u015fa\u011f\u0131daki belge ve makalelerden yararlan\u0131lm\u0131\u015ft\u0131r.<\/em><\/p>\n

-SGK Y\u0131ll\u0131klar\u0131,<\/p>\n

-T\u00fcrkiye\u2019de Meslek Hastal\u0131klar\u0131, Dr. Rana G\u00fcven, Meslek Hastal\u0131klar\u0131 Kongresi, 20-22 KAs\u0131m 2008 Bursa, http:\/\/iyh.istabip.org.tr\/sirer\/kk\/21.pdf, (Sf 253-264)<\/em><\/p>\n

-Meslek Hastal\u0131klar\u0131 Rehberi, Sf 17-19, \u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakanl\u0131\u011f\u0131 \u0130\u015f Sa\u011fl\u0131\u011f\u0131 ve G\u00fcvenli\u011fi Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc (\u0130SGGM)<\/em><\/p>\n

-TTB \u0130\u015fyeri Hekimli\u011fi Ders Notlar\u0131<\/em><\/p>\n

-Sosyal Sigorta Finansman Y\u00f6ntemleri Ve T\u00fcrkiye\u2019de Sosyal Sigorta Kurumlarinin Finansman Y\u00f6ntemlerinin De\u011ferlendirilmesi,Yrd. Do\u00e7. Dr. \u0130smail G\u00dcNE\u015e, Ar\u015f. G\u00f6r. Soner YAKAR<\/em><\/p>\n[20] Rapport \u201cLes maladies professionnelles en Europe \u2013 Statistiques 1990-2006 et actualit\u00e9 juridique\u201d (R\u00e9f. Eurogip-34\/F)\u2019den derlenen Bel\u00e7ika, Almanya, Avusturya, Danimarka, Fransa, Ispanya, Italya, Isvi\u00e7re ve Portekiz\u2019in y\u0131ll\u0131k ortalama insidanslar\u0131<\/em><\/p>\n[21] Source: OECD, Dataset: Level of GDP per capita and productivity, GDP per hour worked, Unit: USD, by constant prices (2010 PPPs)<\/em><\/p>\n[22] Source: OECD, Dataset: Average annual hours actually worked per worker (total employment)<\/em><\/p>\n[23] Sources:<\/em><\/p>\n

-Standardised incidence rate of fatal accidents at work by Member State and age, excluding road traffic accidents and accidents on board of any mean of transport in the course of work [hsw_aw_fims]<\/em><\/p>\n

-Annual Statistical Reports of Public Insurance Institution of Turkey<\/em><\/p>\n

Bu insidans\u0131n hesaplamas\u0131nda se\u00e7ili \u00fclkelerdeki toplam \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 say\u0131s\u0131, bu \u00fclkelerdeki toplam sigortal\u0131 \u00e7al\u0131\u015fan say\u0131s\u0131na b\u00f6l\u00fcnerek bulunmu\u015ftur. Sigortal\u0131 say\u0131lar\u0131 i\u00e7in Maladies Professionales EUROGIP\u2019in rakamlar\u0131 esas al\u0131nm\u0131\u015f, \u00f6l\u00fcmc\u00fcl i\u015f kazas\u0131 say\u0131lar\u0131 da EUROSTAT\u2019dan derlenmi\u015fitir.<\/em><\/p>\n[24] Source: OECD<\/em><\/p>\n[25] http:\/\/www.global-labour-university.org\/fileadmin\/GLU_Column\/papers\/no_178_Tellioglu.pdf<\/em><\/p>\n[26] Toplum ve Bilim 2015-133.T\u00fcrkiye\u2019de ta\u015feron \u00e7al\u0131\u015fma, Alpkan Birelma<\/em><\/p>\n[27] Toplum ve Bilim 2015-133.T\u00fcrkiye\u2019de ta\u015feron \u00e7al\u0131\u015fma, Alpkan Birelma (ger\u00e7ekte bu oran\u0131n resmi rakamlardan daha y\u00fcksek oldu\u011fu kamu otoriteleri dahil t\u00fcm taraflarca bilinmektedir.)<\/em><\/p>\n[28] Source: OECD, Employment by job tenure intervals in Turkey and Selected European Countries<\/em><\/p>\n

https:\/\/azizcelik2013.files.wordpress.com\/2013\/10\/tc3bcrkiye_de-1960-sonrasc4b1-istihdam-ve-c3bccretliler.pdf<\/em><\/p>\n[29] http:\/\/www.sgk.gov.tr\/wps\/portal\/tr\/sigortalilik\/kayitdisi_istihdam\/kayitdisi_istihdam_oranlari\/<\/em><\/p>\n[30] http:\/\/www.tuik.gov.tr\/PreHaberBultenleri.do?id=13659<\/em><\/p>\n[31] -Meslek Hastal\u0131klar\u0131 Rehberi, Sf 17-19, \u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakanl\u0131\u011f\u0131 \u0130\u015f Sa\u011fl\u0131\u011f\u0131 ve G\u00fcvenli\u011fi Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc (\u0130SGGM) Sf 7, 15, 18<\/em><\/p>\n[32] TC \u00c7SGB Ulusal \u0130\u015f Sa\u011fl\u0131\u011f\u0131 ve G\u00fcvenli\u011fi Politika Belgesi \u2013 III ve Eylem Plan\u0131 2014-2018, Sf 14<\/em><\/p>\n[33] Bkz. 8. uluslararas\u0131 i\u015f sa\u011fl\u0131\u011f\u0131 g\u00fcvenli\u011fi konferans\u0131 http:\/\/www.tioshconference.gov.tr\/<\/p>\n

* Dr. Arif M\u00fcezzino\u011flu<\/strong>
\n22 y\u0131ld\u0131r \u00e7e\u015fitli kurulu\u015flarda i\u015fyeri hekimli\u011fi yap\u0131yor. Bu s\u00fcre zarf\u0131nda T\u00fcrk Tabipleri Birli\u011fi(TTB) \u0130\u015f\u00e7i Sa\u011fl\u0131\u011f\u0131 ve \u0130\u015fyeri Hekimli\u011fi Kolunda ve Ankara Tabip Odas\u0131 (ATO) \u0130\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 ve i\u015fyeri hekimli\u011fi komisyonunda \u00e7al\u0131\u015ft\u0131. \u0130\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fmalar\u0131n\u0131 halen TTB, ATO ve \u0130\u015fyeri Hekimleri Derne\u011fi b\u00fcnyesinde s\u00fcrd\u00fcr\u00fcyor.<\/p>\n

**Dr. Ahmet Tellio\u011flu<\/strong><\/p>\n

Meslek hayat\u0131na 1995\u2019te Zonguldak\u2019ta ba\u015flad\u0131. 2000 y\u0131l\u0131ndan bu yana i\u015fyeri hekimi olarak \u00e7al\u0131\u015f\u0131yor.2007-2010 y\u0131llar\u0131 aras\u0131nda T\u00fcrk Tabipleri Birli\u011fi (TTB) ad\u0131na i\u015fkenceye kar\u015f\u0131 fark\u0131ndal\u0131\u011f\u0131 artt\u0131rmay\u0131 ama\u00e7layan bir AB projesinin y\u00f6neticili\u011fini yapt\u0131. 1995 y\u0131l\u0131ndan bu yana TTB b\u00fcnyesinde insan haklar\u0131 ve i\u015f\u00e7i sa\u011fl\u0131\u011f\u0131 alanlar\u0131nda faaliyet g\u00f6steriyor. \u0130\u015fyeri Hekimleri Derne\u011fi \u00fcyesi.<\/p>\n","protected":false},"excerpt":{"rendered":"T\u00fcrkiye, i\u015fe ba\u011fl\u0131 hastal\u0131klar ve meslek hastal\u0131klar\u0131yla m\u00fccadelede s\u0131rad\u0131\u015f\u0131 bir profil sunmaktad\u0131r;…\n","protected":false},"author":2,"featured_media":40571,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[4689],"tags":[623,3069,3068],"class_list":{"0":"post-20784","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-secki","8":"tag-isci-sagligi-is-guvenligi","9":"tag-meslek-hastaligi","10":"tag-meslek-hastaliklari"},"acf":[],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/posts\/20784","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/comments?post=20784"}],"version-history":[{"count":0,"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/posts\/20784\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/media\/40571"}],"wp:attachment":[{"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/media?parent=20784"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/categories?post=20784"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/eonmeet.com\/pol\/wp-json\/wp\/v2\/tags?post=20784"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}