Влияние вредных производственных факторов на развитие хронических неинфекционных заболеваний у рабочих в разных профессиональных категориях

Abstract

The article presents data on harmful production factors for the development of the most common non-infectious diseases depending on the occupational category with a different number of them, with different leading factors and work experience in these working conditions among workers at an industrial enterprise. Materials and methods. A comprehensive study of 656 workers was carried out in 2016-2020. Their average age was 48.3 ± 14.2 years. In the study, the number of men (n = 453, 69.1%) prevailed over the number of women (n = 203, 30.9%), p < 0.001. Professional categories were determined according to the International Standard Classification of Occupations ISCO-08. Each profession is assigned to a 3 professional category, taking into account the number of harmful production factors, leading factors and work experience. The comparison group consisted of management professions (engineers, section chiefs, department heads, technologists) without harmful production factors – 66 people, in which there were 30 women and 36 men, average length of service was 27.1 ± 15.4 years. Group 1 consisted of foremen, inspectors, plasterers (painters), and drivers. In this group, there are 2-3 harmful production factors (M (SD) 2.3 ± 1.3), of which the leading harmful production factors are physical overstrain, work at height, in which 185 people work, of which 71 are women and 114 men, the average length of service in these conditions is 15.9 ± 14.3 years. Group 2 consisted of crane and bulldozer operators, repairmen, operators, metering operators, fitters, molders, assemblers, electric gas welders, and finishers. In this group, 4-6 harmful production factors (M (SD) 3.2 ± 1.6) are noted, of which the leading production factors are general vibration and industrial noise, industrial dust / welding aerosol, in which 405 people work, of which 102 women and 303 men, the average length of service in these conditions is 27.7 ± 13.8 years. The average age of workers in the groups is comparable; no statistically significant difference was found (p = 0.526). There were no statistically significant differences by gender (p = 0.527). To compare more than two groups, we used one-way ANOVA with Fisher’s test (F) and Post-Hoc with Tukey’s test (aqual variances) to avoid type I errors and “multiple comparisons effect”. Since in our study there are confounder factors that can affect the study result, contingency tables and Pearson’s χ2 criterion were used to analyze the relationship between qualitative characteristics; at p < 0.05, the probability of differences was 95% or more. Results and discussion. Thus, in our study, we found that general vibration, industrial noise, industrial dust and welding aerosol affect the development of arterial hypertension and chronic obstructive disease and their comorbid diseases in the professional category of workers with 11 years of experience, who are affected by several harmful industrial factors. at the same time, compared with a group without harmful production factors. These harmful production factors had a stronger effect on the development of arterial hypertension by 15% and on the development of chronic obstructive pulmonary disease by 2 times, increased systolic blood pressure and diastolic pressure than work at height and physical overstrain. Arterial hypertension is the most common factor in the development of comorbid coronary artery disease. The most frequent concomitant factors of hypertension in workers with general vibration, occupational noise, industrial dust and welding fumes were excess body weight, grade 1 obesity and smoking. The definition of occupational categories is an important socio-economic and medical determinant for patient-centered prevention of non-communicable diseases, comorbid pathology of non-communicable diseases and their risk factors in workers exposed to harmful production factors. Conclusions. The study carried out using Pearson’s criterion and regression analysis showed that the relationship with multiple occupational factors is significantly higher among workers, which allows us to conclude that general vibration, industrial noise, industrial dust / welding aerosol are additional factors for the development of arterial hypertension and chronic obstructive pulmonary disease. from workers. The obtained correlations also allow us to draw a conclusion about the influence of the combined effect of these factors, taking into account the length of service, on the likelihood of developing arterial hypertension and chronic obstructive pulmonary disease.