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Abstract

Background Graves’ disease has adverse effects on quality of life, because of somatic psychiatric symptoms and an inability to work. Chefs face many occupational hazards that can aggravate certain medical conditions, worsen the disease, and pose safety risks at work. This case report aims to assess the returning-to-work evaluation and program for a chef with Graves’ disease.

Case Description A forty-seven-year-old Indonesian male who was diagnosed with Graves’ disease from characteristic clinical features and biochemical abnormalities was admitted to the hospital with shortness of breath. TSH concentration was 0.001mU/L, FT4 concentration was 2.85 ng/dL, hemoglobin level was 10.6 g/dL, and thrombocyte level was 85,000mcL. The patient was a chef in a western food restaurant for eight years and exposed to several hazards related to health conditions, such as physical (hot and high humidity environment), chemical (kitchen smoke, carbon dust, allergens, and irritants from spices and foods), ergonomic (long time standing), and psychosocial (complaints from discontented customers). The return-to-work assessment on this worker was performed using the Seven Steps of Return-to-Work Evaluation Method issued by the Indonesian Occupational Medicine Association (IOMA), taking into account capacity, risk, and tolerance.

Summary This worker suffers from Graves' disease, which can be exacerbated by work. The fit-to-work status was temporarily unfit to work as a chef and required a job adjustment upon returning to work.

References

  1. Kusrini I, Kumorowulan S. Nilai diagnostic indeks wayne dan indeks newcastle untuk penapisan kasus hipertiroid. Jakarta: Balai Penelitian dan Pengembangan GAKI, Kementerian Kesehatan RI; 2010. https://doi.org/10.22435/mpk.v28i2.180
  2. Zimmermann MB, Boelaert K. Iodine deficiency and thyroid disorders. Lancet Diabetes Endocrinol. 2015; 3: p. 286-95. https://doi.org/10.1016/s2213-8587(14)70225-6
  3. Kahaly GJ, Petrak F, Hardt J, Pitz S, Egle UT. Psychosocial morbidity of Graves’orbitopathy. Clin Endocrinol (Oxf). 2005; 63: p. 395-402. https://doi.org/10.1111/j.1365-2265.2005.02352.x
  4. Brandt F, Thvilum M, Almind D, et al. Morbidity before and after the diagnosis of hyperthyroidism: a nationwide register-based study. PLoS One. 2013; 8(6):e66711. https://doi.org/10.1371/journal.pone.0066711
  5. Brandt F, Thvilum M, Almind D, et al. Hyperthyroidism and psychiatric morbidity: evidence from a Danish nationwide register study. Eur J Endocrinol. 2014; 170: 341-8. https://doi.org/10.1530/eje-13-0708
  6. Brandt F, Thvilum M, Hegedüs L, Brix TH. Hyperthyroidism is associated with work disability and loss of labour market income: a Danish register-based study in singletons and disease-discordant twin pairs. Eur J Endocrinol. 2015; 173:595-602. https://doi.org/10.1530/eje-15-0306
  7. Brandt F, Almind D, Christensen K, Green A, Brix TH, Hegedüs L. Excess mortality in hyperthyroidism: the influence of preexisting comorbidity and genetic confounding: a Danish nationwide register-based cohort study of twins and singletons. J Clin Endocrinol Metab. 2012; 97:4123-9. https://doi.org/10.1210/jc.2012-2268
  8. Nordyke RA, Gilbert FI Jr, Harada ASM. Graves’ disease: influence of age on clinical findings. Arch Intern Med. 1988;148:626-31. https://doi.org/10.1001/archinte.1988.00380030132023
  9. Terry J. Smith, M.D., and Laszlo Hegedus, M.D., D.M.Sc. Graves’ Disease. N Engl J Med. 2016;375:1552-65. https://doi.org/10.1056/NEJMra1510030
  10. Wiersinga WM. Smoking and thyroid. Clin Endocrinol (Oxf). 2013; 79:145-51. https://doi.org/10.1111/cen.12222
  11. Bartalena L, Burch HB, Burman KD, Kahaly GJ. A 2013 European survey of clinical practice patterns in the management of Graves’ disease. Clin Endocrinol (Oxf). 2016; 84:115-20. https://doi.org/10.1111/cen.12688
  12. Ljunggren J-G, Törring O, Wallin G, et al. Quality of life aspects and costs in treatment of Graves’ hyperthyroidism with antithyroid drugs, surgery, or radioiodine: results from a prospective, randomized study. Thyroid. 1998; 8:653-9. https://doi.org/10.1089/thy.1998.8.653
  13. Borkenhagen C, Martin JL. Status and Career Mobility in Organizational Fields: Chefs and Restaurants in the United States, 1990–2013. Social Forces. 2018;97(1): 1–26. https://doi.org/10.1093/sf/soy024
  14. Fullana A, Carbonell-Barrachina ÁA, Sidhu S. Comparison of volatile aldehydes present in the cooking fumes of extra virgin olive, olive, and canola oils. J Agric Food Chem. 2004;52:5207–14. https://doi.org/10.1021/jf035241f
  15. Danielle H, Martina S, Romano G, Sylvia K, Gerhard J, Hartung et al. Work and diet-related risk factors of cardiovascular diseases: comparison of two occupational groups. Journal of Occupational Medicine and Toxicology. 2010; 5:4. https://doi.org/10.1186/1745-6673-5-4
  16. Gianoukakis AG, Leigh MJ, Richards P, Christenson PD, Hakimian A, Fu P, et.al. Characterization of the anaemia associated with Graves’ disease. Clinical Endocrinology. 2009;781-7. https://doi.org/10.1111/j.1365-2265.2008.03382.x
  17. Torring O, Tallstedt L, Wallin G, et al. Graves' hyperthyroidism: treatment with antithyroid drugs, surgery, or radioiodine—a prospective, randomized study. Thyroid Study Group. J Clin Endocrinol Metab. 1996;81(8):2986– 93. https://doi.org/10.1210/jc.81.8.2986
  18. Szeto CC, Chow CC, Ko GT, Li KY, Yeung VT, et al. A patient with Graves' disease, thrombocytopenia and chronic hepatitis B. Postgraduate Medical Journal. 1997;73(855):39. https://doi.org/10.1136/pgmj.73.855.39
  19. Fahrenfort JJ, Wilterdink AM, van der Veen V. Long-term residual complaints and psychosocial sequelae after remission of hyperthyroidism. Psychoneuroendocrinology. 2000;25(2):201–11.
  20. Nexo MA, Watt T, Pedersen J, Bonnema SJ, Hegedüs L, Rasmussen AK, et al. Increased Risk of Long-Term Sickness Absence, Lower Rate of Return to Work, and Higher Risk of Unemployment and Disability Pensioning for Thyroid Patients: A Danish Register-Based Cohort Study. The Journal of Clinical Endocrinology & Metabolism. 2014;99 (9):3184–92. https://doi.org/10.1210/jc.2013-4468

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