Mesleksel yaralanma ve ölümlerde bölgesel eşitsizlikler/Regional inequalities in occupational injuries and deaths

Ozet Amac: Turkiye’de mesleksel hastaliklar ile is kazalari nedeniyle olusan yaralanma ve olumlerde bolgesel esitsizlikleri degerlendirmektir. Yontem: Ekolojik tipteki calisma 2000-2011 yillari arasi 12 yillik doneme ait mesleksel guvenlik ve saglik verisinin retrospektif olarak incelenmesiyle yurutulmustur. Veri kaynagi Sosyal Guvenlik Kurumu (SGK) ve Sosyal Sigortalar Kurumu (SSK) istatistik yilliklaridir. Zorunlu sigortalilarin yaralanma ve olum verisi iller bazinda kaydedilmistir. Veri Istatistiki Bolge Birimleri Siniflamasi’na (IBBS) uygun sekilde birlestirilerek bolgesel veri haline donusturulmustur. Yaralanma insidans hizi, mortalite ve fatalite hizlari bu veriden hesaplanmistir. Bolgesel esitsizlikleri gostermek icin risk orani, risk farki, topluma atfedilen risk (PAR) ve yuzdesi (PAR%) hesaplanmistir. Bulgular: Turkiye’de 2000-2011 yillari arasinda is nedeniyle yilda ortalama 74.215 kisi yaralanmis ve 1.092 kisi olmustur. Turkiye’de 2000-2011 yillari arasinda mesleksel yaralanma insidans hizi %58, mortalite hizi %27,3 azalirken fatalite hizi %73,4 artmistir. Mutlak esitsizlik gostergesi olan fatalite hizi risk farki 2000 yilindaki 50,9’dan 2011 yilinda 128,0’a yukselmistir. Bolgesel esitsizlikler olmasaydi 2000-2011 arasindaki 13.099 is nedenli olum sayisi 6.511’e dusecekti. Sonuc: Is kazalari ve meslek hastaliklari nedeniyle yaralanma ve olumlerde bolgelerarasi esitsizlikler belirgindir. Turkiye’de mesleksel hastalik ve is kazasi kayitlari yetersiz olup tum olgular bildirilmemektedir. Bu nedenle mesleksel guvenlik ve saglik durumu degerlendirilirken fatalite hizi da goz onune alinmalidir. Anahtar Kelimeler: Mesleksel yaralanma, meslek hastaligi, mortalite, fatalite Abstract Objective: To evaluate the injuries and the deaths due to occupational diseases and occupational accidents in Turkey with respect to inter-regional inequalities. Methods: This ecological type of study was conducted between the years of 2000-2011 by examining the occupational safety and the health data for the 12 years retrospectively. The data sources were the statistical year books from Social Security Institution (SSI) and Social Insurance Institution (SII). The data for the injuries and deaths of the compulsory insured individuals were recorded on a city basis. The set of data created by cities have been put into regional data categories with respect to the Nomenclature of Territorial Units For Statistics (IBBS). Occupational injury incidence, mortality and fatality rates have been calculated based on the present data. To show the regional inequalities risk ratios, risk differences, absolute population attributable risks (PAR) and the ratios (PAR%) have been calculated. Results: 74,215 people were injured and 1,092 died due to occupational accidents between 2000-2011. During the 12 year period the injury incidence rate decreased by 58%, the mortality rate by 27.3% but the fatality rate increased by 73.4%. The risk difference of the fatality rate which is an indicator of absolute inequality has risen to 128.0 in 2011 from the 50.9 rate in 2000. If there were no regional inequalities the number of death between 2000-2011 would go down to 6,511 from 13,099. Conclusions: Regional inequalities are present for injuries and deaths due to occupational accidents & diseases. There is a dearth of records on occupational diseases and accidents in Turkey and very few of the incidents are being reported. Therefore, the fatality rate should be taken into consideration, when the occupational safety and health status are being examined. Key Words: Occupational injury, occupational diseases, mortality, fatality