МЕТОД ДЕРЕВЬЕВ КЛАССИФИКАЦИИ В ОЦЕНКЕ ВКЛАДА ФАКТОРОВ РИСКА В РАЗВИТИЕ ХРОНИЧЕСКОЙ ПАТОЛОГИИ У РАБОТНИКОВ МЕТАЛЛУРГИЧЕСКОГО ПРЕДПРИЯТИЯ

Abstract

The working conditions of blacksmiths working in the production of titanium alloys are characterized by a high risk of developing an occupationally conditioned pathology of the musculoskeletal system (MSS). The identification of factors that increase and modify the prevalence of chronic pathology, as well as the estimate of their contribution to the prevalence, are relevant and socially significant. The purpose of the study was to assess the contribution of risk factors for the development of chronic pathology of MSS in workers in the production of titanium alloys using the Classification Tree method (CT). Objects and Methods. We used retrospective data from 330 male titanium workers who underwent a routine medical examination in 2020. Data were collected on age, length of service, BMI, and behavioral and occupational hazards (OH). Occupational risk factors at workplaces were: titanium aerosol in the air of the working area, heating microclimate, general and local vibration and the severity of the labor process. The CT method was used to assess the contribution of behavioral and HMF to the development of chronic CMS pathology in blacksmiths. Results. In the structure of chronic pathology among blacksmiths of the studied enterprise, MMS diseases occupied the second place (31,2%). As the experience of blacksmiths increased by 10 years, the number of patients with MSS increased by 8,3% — 18,3%. When the concentration of titanium in the air of the working area is above the MPC (10 mg/m3), a statistically significantly higher prevalence of chronic pathology of the MSS was established in comparison with the group of workers in acceptable working conditions. For workers with overweight and obesity (further — overweight), a tendency to an increase in the prevalence of chronic MSS pathology was found under the influence of general vibration, the severity of the labor process, and smoking. Examples of constructing visual, intuitive decision rules when using CT in a multivariate analysis of the formation of chronic pathology are demonstrated. Conclusions. Significant risk factors for the development of MSS pathology for blacksmiths working in the production of titanium alloys were: experience of more than 11 years, the presence of professional contact with titanium, exposure to general vibration, heavy physical load, overweight, smoking (RR=3,02; 95% CI=2,15‑4,24).