title: [Diagnostics of occupational voice diseases following the amendment of the Polish Occupational Diseases Certification Act].
abstract: BACKGROUND
  The aim of the study was to assess whether the amended Polish Occupational Diseases Certification Act of 2002 has made an impact on the medico-legal process of the occupational voice diseases certification.
  
  
  METHODS
  Nationwide reports on the number and types of occupational diseases diagnosed in Poland in 1999-2004, and the medical records of 267 teachers diagnosed for the occupational voice organ disease were analyzed.
  
  
  CONCLUSIONS
  A 4-fold gradual and continuous reduction (from 3521 to 881 cases) in the number of registered occupational voice diseases was noted in 1999-2004, which was not really associated with the date the amended Act came into force. The patients challenging the first instance refusals issued after 2002 were characterized by significantly worse phoniatric and videostroboscopic indices than those consulted before that date. Before 2002, the percentage of the second instance positive decisions, changing the first instance refusals was over 16%, while after 2002 the corresponding number was only 5%. This indicates that a consensus of decisions issued by the first and second instances has significantly increased since the amended Act came in effect.
authors.affiliation: Klinika Audiologii i Foniatrii, Instytut Medycyny Pracy, Lodzi. marsliw@imp.lodz.pl
authors.forename: Mariola
authors.initials: M
authors.lastname: Sliwińska-Kowalska
authors.forename: Marta
authors.initials: M
authors.lastname: Fiszer
authors.forename: Izabela
authors.initials: I
authors.lastname: Kwaśniewska
authors.forename: Maja
authors.initials: M
authors.lastname: Domańska
authors.forename: Ewa
authors.initials: E
authors.lastname: Niebudek-Bogusz
mesh_terms: D004185:Disability Evaluation; D005178:Faculty; D006801:Humans; D009313:National Health Programs / Q000331:legislation & jurisprudence; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D016272:Occupational Health / Q000331:legislation & jurisprudence*; D009787:Occupational Medicine / Q000331:legislation & jurisprudence; D011044:Poland / Q000453:epidemiology; D011322:Primary Prevention / Q000331:legislation & jurisprudence; D012189:Retrospective Studies; D014832:Voice Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control