Метод определения экспозиции латентного чрезмерного потребления алкоголя в коллективах операторских профессий, влияние этого фактора на сердечно-сосудистую заболеваемость и смертность

Abstract

Introduction. The problem of latent alcohol consumption in groups of certain professions, in particular among railway engine crews, still exists, despite the fact that admission to train operation is carried out by a medical expert commission and railway engine crews undergo mandatory breath alcohol testing. An association between an excessive alcohol consumption, in the doses exceeding safe limit, and cardiovascular diseases and mortality of this professional group has been established, that is directly related to the safety of train operation. However, the dose of latent excessive alcohol consumption that can cause specific cardiovascular diseases and a fatal outcome remains unknown. Aim. To find out the effect of latent excessive alcohol consumption on cardiovascular morbidity and mortality among railway engine crews, determine the exposure to this factor in the observation group. Materials and methods. Based on the material of the 2008-2013 study of a natural group of initially healthy 7,959 male railway engine crew members of the Trans-Baikal Railway aged 18-66 years, predictors of acute coronary syndrome, cerebral stroke, of coronary heart disease and sudden cardiac death were established using multivariate statistical analysis. Cardiovascular diseases had a common predictor – latent excessive alcohol consumption, the characteristics of which as a screening tool were assessed using the quality control method of a verifiable diagnostic test with binary outcomes. By determining the sensitivity value of latent excessive alcohol consumption, the exposure of the predictor in the observed group was determined with this method. Results. The latent excessive alcohol consumption determined the occurrence of acute coronary syndrome, of coronary heart disease, cerebral stroke and sudden cardiac death in the 7,959 railway engine crew members, in the exposure of 0.13; 0.03; 0.10 and more than 0.24 respectively of the total population studied. Cardiocerebral morbidity in the railway engine crew members involved in latent excessive alcohol consumption and mortality from all causes constituted 1.6% and 1.2%. Acute cardiovascular diseases – 0.7% Conclusion. It is necessary to monitor latent excessive alcohol consumption determined in railway engine crews. The data obtained can be used in planning the range of preventive measures and medical care among the railway engine crews or in other socially significant groups of the population, as well as in scientific studies aimed to determine the effect of the exposure of excessive alcohol consumption on the formation and development of cardiovascular events.