ПРЕДИКТОРЫ РАЗВИТИЯ ОСТРОГО ИНФАРКТА МИОКАРДА ДЛЯ ПЕРСОНАЛА ТРУДОСПОСОБНОГО ВОЗРАСТА НА РАДИАЦИОННО-ОПАСНЫХ ПРОИЗВОДСТВАХ

Abstract

Purpose: To examine the predictors of acute myocardial infarction development and to evaluate the relationship of the radiation component (external γ-radiation) with the probability of developing acute myocardial infarction in workers of radiation-dangerous plants working age (under 60 for men, 55 for women), by the example of the Siberian Group of Chemical Enterprises personnel. 
 Material and methods: The work is based on the results of a prospective population study (1998–2013). The diagnosis of acute myocardial infarction was verified in 540 people of working age (34 women and 506 men). For each case selected control (n = 1,080) among the employees of the Siberian Group of Chemical Enterprises, passed periodic medical examination in the study period. Every person was described by means of 46 variables including characteristics of social status, a number of risk factors, associated diseases, biochemical indices including the level of general cholesterol, the main clinical data, cumulative dose of external radiation and the amount of 239Pu content in an organism. 
 Results: It was determined that in the group of the personnel of working age the most important traditional predictors of acute myocardial infarction, less important factor in the pathogenesis of the disease are conditions of the individual accumulation of a dose, but not the magnitude of the total external doses in the evaluation range. 
 Conclusion: To improve the system of preventive measures aimed at reducing the level of morbidity and mortality from acute myocardial infarction, it is recommended to form risk groups taking into account the most significant predictors of this disease (age, systolic blood pressure, smoking). For the personnel of radiation dangerous plants working age insignificant conditions for the formation of radiation dose (age of first exposure, the rate of accumulation of radiation dose, duration of exposure) under conditions of trouble-free operation of the equipment. 
 Active measures for the diagnosis of coronary heart disease and targeted correction of detected somatic disorders for the prevention of acute vascular catastrophes are expedient for workers of radiation hazardous industries from 40 to 60 years with an individual risk of acute myocardial infarction less than 50 % using the model described below.