Sağlıklı ve Kaliteli Yaşam Hedefinde Kronik Hastalık Taramaları
Özet
Kronik hastalıklar, dünya genelinde önde gelen ölüm nedenidir ve tüm ölümlerin %74’ünden sorumludur. Kardiyovasküler hastalıklar, kanserler, KOAH ve diyabet başlıca kronik hastalıklardandır ve tüm erken BOH ölümlerinin %80'inden fazlasını oluşturur. Bu hastalıklar, hızlı plansız kentleşme, sağlıksız yaşam tarzlarının küreselleşmesi ve nüfusun yaşlanması gibi faktörler tarafından yönlendirilir. Hipertansiyon ve diyabet, çalışanlarda yıllarca tespit edilemeyen ancak iskemik kalp hastalığı, felç ve erken ölüm açısından ani sonuçlara yol açabilen ciddi bulaşıcı olmayan hastalıklara örnektir. Kronik hastalık taramaları bulaşıcı olmayan hastalıklar açısından risk altında olan çalışanları belirlemek için yararlı bir başlangıç noktası olabilir. Sağlık taraması, kendilerini genel olarak sağlıklı olarak algılayan ancak belirli bir sağlık bozukluğu riski altında olan bireylerde hastalıkları veya klinik öncesi durumları tespit etmeyi amaçlayan hedefli ve sistematik bir yaklaşımdır. Çalışanlar uyanık oldukları saatlerin önemli bir kısmını işyerinde geçirdikleri için, işyeri aracılığıyla dünya nüfusunun büyük bir kısmının sağlığını etkileme potansiyeli muazzamdır. Bu nedenle işyerleri, sağlığı teşvik edici stratejileri uygulayarak halk sağlığı girişimlerini desteklemek ve küresel sağlık sorunlarıyla mücadele etmek için benzersiz bir potansiyele sahiptir. Risk faktörleri ve çalışma koşulları, bireysel sağlık davranışlarını iyileştirmeyi amaçlayan sağlığın teşviki ile mesleki güvenlik ve sağlık müdahaleleri de dahil olmak üzere sağlığın koruması çalışan sağlığını destekleme çabaları yoluyla ele alınabilir. Bu doğrultuda sürdürülebilir kalkınma hedeflerinden “Hedef 3: Sağlık ve Kaliteli Yaşam” yol göstericidir.
Chronic diseases are the leading cause of death worldwide, accounting for 74% of all deaths. Cardiovascular diseases, cancers, COPD, and diabetes are the leading chronic diseases, accounting for more than 80% of all premature NCD deaths. These diseases are driven by factors such as rapid unplanned urbanization, globalization of unhealthy lifestyles, and population aging. Hypertension and diabetes are examples of serious noncommunicable diseases that can go undetected in employees for years but can lead to immediate consequences in terms of ischemic heart disease, stroke, and premature death. Chronic disease screening can be a useful starting point to identify employees at risk for noncommunicable diseases. Health screening is a targeted and systematic approach that aims to detect diseases or preclinical conditions in individuals who perceive themselves as generally healthy but who are at risk for a particular health disorder. Since employees spend a significant portion of their waking hours at work, the potential to affect the health of a large portion of the world’s population through the workplace is enormous. Workplaces therefore have a unique potential to support public health initiatives and combat global health issues through the implementation of health-promoting strategies. Risk factors and working conditions can be addressed through efforts to support worker health, including health promotion and occupational safety and health interventions aimed at improving individual health behaviors. In this regard, “Goal 3: Healthy and Quality Life” from the sustainable development goals can be a guide.
Referanslar
Altun, B., Arici, M., Nergizoğlu, G., Derici, U., Karatan, O., Turgan, C., et al. (2005). Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens, 23, 1817–23.
American Diabetes Association (ADA). (2024). Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024. Diabetes Care, 47(Suppl. 1), S20–S42. https://doi.org/10.2337/dc24-S002.
American Tyroid Association (ATA) (2019).. https://www.thyroid.org/thyroid-function-tests/.
Andersen L. L. (2024). Health Promotion and Chronic Disease Prevention at the Workplace. Annual Review Of Public Health, 45(1), 337–357. https://doi.org/10.1146/annurev-publhealth-060222-035619.
Arici, M., Turgan, C., Altun, B., Sindel, S., Erbay, B., Derici, U., et al. (2010). Hypertension incidence in Turkey (HinT): a population-based study. J Hypertens, 28, 240–4.
Birtwhistle, R., Morissette, K., Dickinson, J. A., Reynolds, D. L., Avey, M. T., Domingo, F. R., Rodin, R., Thombs, B. D., & Canadian Task Force on Preventive Health Care (2019). Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care. CMAJ: Canadian Medical Association journal = journal de l'Association medicale canadienne, 191(46), E1274–E1280. https://doi.org/10.1503/cmaj.190395.
Centre for Disease Control and Prevention (CDC) (2024). About Coronary Artery Disease (CAD). https://www.cdc.gov/heart-disease/about/coronary-artery-disease.html.
Chaker, L., Bianco, A., Jonklaas, J., et al. (2017). Hypothyroidism. Lancet, 390, 1550–62.
Compston, J., Bowring, C., Cooper, A., Cooper, C., Davies, C., Francis, R, et al. (2013). Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas, 75, 392-6.
Cosman, F., de Beur, S. J., LeBoff, M. S., Lewiecki, E.M., Tanner, B., Randall, S., Lindsay, R. (2014). Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int, 25, 2359–2381.
European Society of Cardiology (2024). 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. European Heart Journal, 45, 3912–4018 https://doi.org/10.1093/eurheartj/ehae178.
Gaitonde, D. Y., Rowley, K., Sweeney, L. (2012). Hypothyroidism: an update. Am Fam Physician, 86, 244–51.
GBD 2019 Risk Factors Collaborators (2020). Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England), 396(10258), 1223–1249. https://doi.org/10.1016/S0140-6736(20)30752-2.
Gillett, M. (2004). Subclinical hypothyroidism: subclinical thyroid disease: scientific review and guidelines for diagnosis and management: JAMA, 291, 228–38. Clin Biochem Rev, 25, 191–4.
Hernlund, E., Svedbom, A., Ivergard, M., Compston, J., Cooper, C., Stenmark, J., McCloskey, E.V., Jonsson, B., Kanis J.A. (2013). Osteoporosis in the European Union: Medical management, epidemiology and economic burden. Arch. Osteoporos, 8, 136. doi: 10.1007/s11657-013-0136-1.
https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357
Institute for Health Metrics and Evaluation (IHME) (2019). Global Burden of Disease. https://ghdx.healthdata.org/gbd-2019.
International Diabetes Federation. (2021). The IDF Diabetes Atlas. https://diabetesatlas.org/atlas/tenth-edition/.
International Labour Office (ILO). (2023).World Employment and Social Outlook: Trends 2023. Geneva. doi: https://doi.org/10.54394/SNCP1637.
International Osteoporosis Foundation (IOF). (2019). Compendium of Osteoporosis 2019. 2nd Edition. https://www.iofbonehealth.org/compendium-of-osteoporosis.
Jameson, J., Mandel, S., Weetman, A. (2014). Disorders of the thyroid gland. In: Kasper D, Fauci A, Hauser S, editors. Harrison’s principles of internal medicine. 19th ed. New York: McGraw-Hill.
Kanis, J. A. on behalf of the World Health Organization Scientific Group. (2007). Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK.
Kanis, J. A., Burlet, N., Cooper, C, et al. (2008). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int, 19, 399.
Kravets, I. (2016). Hyperthyroidism: diagnosis and treatment. Am Fam Physician, 93, 363–70.
LeFevre, M. L., Siu, A. L., Bibbins-Domingo, K., et al. (2015). Screening for thyroid dysfunction: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 162, 641–50.
Leso, V., Vetrani, I., De Cicco, L., Cardelia, A., Fontana, L., Buonocore, G., & Iavicoli, I. (2020). The Impact of Thyroid Diseases on the Working Life of Patients: A Systematic Review. Int J Environ Res and Public Health, 17(12), 4295. https://doi.org/10.3390/ijerph17124295.
Murray, C.J.L. (2022). The Global Burden of Disease Study at 30 years. Nat Med 28, 2019–2026. https://doi.org/10.1038/s41591-022-01990-1.
Onat, A., Can, G. (2017). Erişkinlerimizde kalp hastalıkları prevelansı, yeni koroner olaylar ve kalpten ölüm sıklığı. (ed) Onat A. “TEKHARF 2017 Tıp Dünyasının Kronik Hastalıklara Yaklaşımına Öncülük” içinde. İstanbul, Logos yayıncılık Tic. A.Ş.
Poscia A., Moscato U., La Milia D.I., Milovanovic S., Stojanovic J., Borghini A., Collamati A., Ricciardi G., Magnavita N. (2016). Workplace health promotion for older workers: A systematic literature review. BMC Heal Serv Res, 16, 415–428. doi: 10.1186/s12913-016-1518-z.
Sacks, D.B., Arnold, M., Bakris, G.L., et al. (2023). Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care, 46, e151–e199.
Sarafrazi, N., Wambogo, E.A., Shepherd, J.A. (2021). Osteoporosis or low bone mass in older adults: United States, 2017–2018. NCHS Data Brief, no 405. Hyattsville, MD: National Center for Health Statistics. doi: https://dx.doi.org/10.15620/cdc:103477external icon.
Sorensen, G., Landsbergis, P., Hammer, L., Amick, B. C., 3rd, Linnan, L., Yancey, A., Welch, L. S., Goetzel, R. Z., Flannery, K. M., Pratt, C., & Workshop Working Group on Worksite Chronic Disease Prevention (2011). Preventing chronic disease in the workplace: a workshop report and recommendations. American Journal Of Public Health, 101 Suppl 1(Suppl 1), S196–S207. https://doi.org/10.2105/AJPH.2010.300075.
T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu (2015). Aile Hekimliği Uygulamasında Önerilen Periyodik Sağlık Muayeneleri ve Tarama Testleri, Yayın No: 991, Ankara.
Tuzun, S., Eskiyurt, N., Akarırmak, U., Sarıdoğan, M., Şenocak Turkish Osteoporosis Society (2012). Incidence of hip fractue and prevalance of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int, 23(3), 949-55.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). (2022). Hipertansiyon Tanı Ve Tedavi Kılavuzu. https://temd.org.tr/yayinlar/kilavuzlar.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). (2023). Tiroid Hastalıkları Tanı Ve Tedavi Kılavuzu, Ankara. https://temd.org.tr/yayinlar/kilavuzlar.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD).(2021). Dislipidemi Tanı Ve Tedavi Kılavuzu. https://temd.org.tr/yayinlar/kilavuzlar.
Türkiye İstatistik Kurumu (TÜİK). (2023). Ölüm ve Ölüm Nedeni İstatistikleri, 2023. https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2023-53709.
U.S. National Library of Medicine (2016). Benefits and risks of screening tests. www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072602/
U.S. Preventive Service Task Force. (2015). Thyroid Dysfunction: Screening. https://www.uspreventiveservicestaskforce.org/ uspstf/recommendation/thyroid-dysfunction-screening.
Watts, N. B., Bilezikian, J. P., Camacho, P. M., Greenspan, S. L., Harris, S. T., Hodgson, S. F., et al. (2010). American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract, 16(Suppl 3), 1–37. https://doi.org/10.4158/10024.GL).
Watts, N.B., Adler, R. A., Bilezikian, J. P., et al. (2012). Osteoporosis in men: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 97, 1802.
World Health Organization (WHO). Diabetes. https://www.who.int/health-topics/diabetes#tab=tab_1.
World Health Organization (WHO, 2023). https://www.who.int/health-topics/hypertension#tab=tab_1.
World Health Organization (2023). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
World Heart Federation. (2023). World Heart Report 2023: Confronting the World’s Number One Killer. Geneva, Switzerland.
Xiao, PL., Cui, AY., Hsu, CJ. et al. (2022). Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporos Int, 33, 2137–2153 https://doi.org/10.1007/s00198-022-06454-3).
Referanslar
Altun, B., Arici, M., Nergizoğlu, G., Derici, U., Karatan, O., Turgan, C., et al. (2005). Prevalence, awareness, treatment and control of hypertension in Turkey (the PatenT study) in 2003. J Hypertens, 23, 1817–23.
American Diabetes Association (ADA). (2024). Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2024. Diabetes Care, 47(Suppl. 1), S20–S42. https://doi.org/10.2337/dc24-S002.
American Tyroid Association (ATA) (2019).. https://www.thyroid.org/thyroid-function-tests/.
Andersen L. L. (2024). Health Promotion and Chronic Disease Prevention at the Workplace. Annual Review Of Public Health, 45(1), 337–357. https://doi.org/10.1146/annurev-publhealth-060222-035619.
Arici, M., Turgan, C., Altun, B., Sindel, S., Erbay, B., Derici, U., et al. (2010). Hypertension incidence in Turkey (HinT): a population-based study. J Hypertens, 28, 240–4.
Birtwhistle, R., Morissette, K., Dickinson, J. A., Reynolds, D. L., Avey, M. T., Domingo, F. R., Rodin, R., Thombs, B. D., & Canadian Task Force on Preventive Health Care (2019). Recommendation on screening adults for asymptomatic thyroid dysfunction in primary care. CMAJ: Canadian Medical Association journal = journal de l'Association medicale canadienne, 191(46), E1274–E1280. https://doi.org/10.1503/cmaj.190395.
Centre for Disease Control and Prevention (CDC) (2024). About Coronary Artery Disease (CAD). https://www.cdc.gov/heart-disease/about/coronary-artery-disease.html.
Chaker, L., Bianco, A., Jonklaas, J., et al. (2017). Hypothyroidism. Lancet, 390, 1550–62.
Compston, J., Bowring, C., Cooper, A., Cooper, C., Davies, C., Francis, R, et al. (2013). Diagnosis and management of osteoporosis in postmenopausal women and older men in the UK: National Osteoporosis Guideline Group (NOGG) update 2013. Maturitas, 75, 392-6.
Cosman, F., de Beur, S. J., LeBoff, M. S., Lewiecki, E.M., Tanner, B., Randall, S., Lindsay, R. (2014). Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporos Int, 25, 2359–2381.
European Society of Cardiology (2024). 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. European Heart Journal, 45, 3912–4018 https://doi.org/10.1093/eurheartj/ehae178.
Gaitonde, D. Y., Rowley, K., Sweeney, L. (2012). Hypothyroidism: an update. Am Fam Physician, 86, 244–51.
GBD 2019 Risk Factors Collaborators (2020). Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet (London, England), 396(10258), 1223–1249. https://doi.org/10.1016/S0140-6736(20)30752-2.
Gillett, M. (2004). Subclinical hypothyroidism: subclinical thyroid disease: scientific review and guidelines for diagnosis and management: JAMA, 291, 228–38. Clin Biochem Rev, 25, 191–4.
Hernlund, E., Svedbom, A., Ivergard, M., Compston, J., Cooper, C., Stenmark, J., McCloskey, E.V., Jonsson, B., Kanis J.A. (2013). Osteoporosis in the European Union: Medical management, epidemiology and economic burden. Arch. Osteoporos, 8, 136. doi: 10.1007/s11657-013-0136-1.
https://www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20049357
Institute for Health Metrics and Evaluation (IHME) (2019). Global Burden of Disease. https://ghdx.healthdata.org/gbd-2019.
International Diabetes Federation. (2021). The IDF Diabetes Atlas. https://diabetesatlas.org/atlas/tenth-edition/.
International Labour Office (ILO). (2023).World Employment and Social Outlook: Trends 2023. Geneva. doi: https://doi.org/10.54394/SNCP1637.
International Osteoporosis Foundation (IOF). (2019). Compendium of Osteoporosis 2019. 2nd Edition. https://www.iofbonehealth.org/compendium-of-osteoporosis.
Jameson, J., Mandel, S., Weetman, A. (2014). Disorders of the thyroid gland. In: Kasper D, Fauci A, Hauser S, editors. Harrison’s principles of internal medicine. 19th ed. New York: McGraw-Hill.
Kanis, J. A. on behalf of the World Health Organization Scientific Group. (2007). Assessment of osteoporosis at the primary health-care level. Technical Report. World Health Organization Collaborating Centre for Metabolic Bone Diseases, University of Sheffield, UK.
Kanis, J. A., Burlet, N., Cooper, C, et al. (2008). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int, 19, 399.
Kravets, I. (2016). Hyperthyroidism: diagnosis and treatment. Am Fam Physician, 93, 363–70.
LeFevre, M. L., Siu, A. L., Bibbins-Domingo, K., et al. (2015). Screening for thyroid dysfunction: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med, 162, 641–50.
Leso, V., Vetrani, I., De Cicco, L., Cardelia, A., Fontana, L., Buonocore, G., & Iavicoli, I. (2020). The Impact of Thyroid Diseases on the Working Life of Patients: A Systematic Review. Int J Environ Res and Public Health, 17(12), 4295. https://doi.org/10.3390/ijerph17124295.
Murray, C.J.L. (2022). The Global Burden of Disease Study at 30 years. Nat Med 28, 2019–2026. https://doi.org/10.1038/s41591-022-01990-1.
Onat, A., Can, G. (2017). Erişkinlerimizde kalp hastalıkları prevelansı, yeni koroner olaylar ve kalpten ölüm sıklığı. (ed) Onat A. “TEKHARF 2017 Tıp Dünyasının Kronik Hastalıklara Yaklaşımına Öncülük” içinde. İstanbul, Logos yayıncılık Tic. A.Ş.
Poscia A., Moscato U., La Milia D.I., Milovanovic S., Stojanovic J., Borghini A., Collamati A., Ricciardi G., Magnavita N. (2016). Workplace health promotion for older workers: A systematic literature review. BMC Heal Serv Res, 16, 415–428. doi: 10.1186/s12913-016-1518-z.
Sacks, D.B., Arnold, M., Bakris, G.L., et al. (2023). Guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus. Diabetes Care, 46, e151–e199.
Sarafrazi, N., Wambogo, E.A., Shepherd, J.A. (2021). Osteoporosis or low bone mass in older adults: United States, 2017–2018. NCHS Data Brief, no 405. Hyattsville, MD: National Center for Health Statistics. doi: https://dx.doi.org/10.15620/cdc:103477external icon.
Sorensen, G., Landsbergis, P., Hammer, L., Amick, B. C., 3rd, Linnan, L., Yancey, A., Welch, L. S., Goetzel, R. Z., Flannery, K. M., Pratt, C., & Workshop Working Group on Worksite Chronic Disease Prevention (2011). Preventing chronic disease in the workplace: a workshop report and recommendations. American Journal Of Public Health, 101 Suppl 1(Suppl 1), S196–S207. https://doi.org/10.2105/AJPH.2010.300075.
T.C. Sağlık Bakanlığı Türkiye Halk Sağlığı Kurumu (2015). Aile Hekimliği Uygulamasında Önerilen Periyodik Sağlık Muayeneleri ve Tarama Testleri, Yayın No: 991, Ankara.
Tuzun, S., Eskiyurt, N., Akarırmak, U., Sarıdoğan, M., Şenocak Turkish Osteoporosis Society (2012). Incidence of hip fractue and prevalance of osteoporosis in Turkey: the FRACTURK study. Osteoporos Int, 23(3), 949-55.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). (2022). Hipertansiyon Tanı Ve Tedavi Kılavuzu. https://temd.org.tr/yayinlar/kilavuzlar.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD). (2023). Tiroid Hastalıkları Tanı Ve Tedavi Kılavuzu, Ankara. https://temd.org.tr/yayinlar/kilavuzlar.
Türkiye Endokrinoloji ve Metabolizma Derneği (TEMD).(2021). Dislipidemi Tanı Ve Tedavi Kılavuzu. https://temd.org.tr/yayinlar/kilavuzlar.
Türkiye İstatistik Kurumu (TÜİK). (2023). Ölüm ve Ölüm Nedeni İstatistikleri, 2023. https://data.tuik.gov.tr/Bulten/Index?p=Olum-ve-Olum-Nedeni-Istatistikleri-2023-53709.
U.S. National Library of Medicine (2016). Benefits and risks of screening tests. www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072602/
U.S. Preventive Service Task Force. (2015). Thyroid Dysfunction: Screening. https://www.uspreventiveservicestaskforce.org/ uspstf/recommendation/thyroid-dysfunction-screening.
Watts, N. B., Bilezikian, J. P., Camacho, P. M., Greenspan, S. L., Harris, S. T., Hodgson, S. F., et al. (2010). American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of postmenopausal osteoporosis. Endocr Pract, 16(Suppl 3), 1–37. https://doi.org/10.4158/10024.GL).
Watts, N.B., Adler, R. A., Bilezikian, J. P., et al. (2012). Osteoporosis in men: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab, 97, 1802.
World Health Organization (WHO). Diabetes. https://www.who.int/health-topics/diabetes#tab=tab_1.
World Health Organization (WHO, 2023). https://www.who.int/health-topics/hypertension#tab=tab_1.
World Health Organization (2023). Noncommunicable diseases. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases.
World Heart Federation. (2023). World Heart Report 2023: Confronting the World’s Number One Killer. Geneva, Switzerland.
Xiao, PL., Cui, AY., Hsu, CJ. et al. (2022). Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporos Int, 33, 2137–2153 https://doi.org/10.1007/s00198-022-06454-3).
