Health status of coal industry workers

Abstract

Introduction. The coal industry, being one of the leading sectors of the Russian economy, occupies a leading position in terms of the share of workers employed in harmful and dangerous working conditions (79.1% in 2021). The social significance of occupational pathology is due to large contingents exposed to harmful and(or) hazardous production factors and the complexity of solving issues of compensation for damage to workers' health. Unfavorable working conditions and overwork make a significant contribution to the formation of mortality rates in the workplace of workers engaged in coal mining, both due to occupational injuries and from general diseases. In this regard, of particular importance is the improvement of measures related to strengthening the health of coal industry workers, including measures to improve the effectiveness of prevention, treatment and rehabilitation, as well as measures to improve working conditions, social protection of employees of coal industry organizations, optimization of the management system and the creation of regulatory mechanisms in the field of coal mining and use.
 The study аims to examine the health status of employees in the coal industry organizations located in the Kemerovo and Rostov regions.
 Materials and methods. The authors studied and analyzed the results of mandatory preliminary and periodic medical examinations, mandatory periodic (during work) medical examinations of workers engaged in work with dangerous and(or) harmful working conditions for the extraction (processing) of coal (oil shale), the results of psychiatric examination, information about the organization of post-shift rehabilitation, medical rehabilitation after provision of medical care according to the profile "Occupational pathology" of coal industry workers in 2022 in accordance with the regulatory legal acts of the Ministry of Health of the Russian Federation.
 Results. According to the Center for Occupational Pathology of Treatment and Rehabilitation Center No. 2 (Shakhty, Rostov region), the number of employees of coal industry organizations subject to mandatory periodic medical examinations (PME) in 2022 amounted to 4,166 people, including women — 1,066. At the same time, the number of employees who have passed PME is 4,001 people (96.0%), including 867 women (81.3% of the total number of women and 21.7% of the number of people who have passed PME). According to the results of the PME, the number of persons who do not have medical contraindications to work amounted to 3,927 (98.1%), including 859 women (21.9% of the number of persons who do not have medical contraindications to work). The number of persons with temporary medical contraindications to work is 42 (1.05%), including women — four. The number of persons with permanent medical contraindications to work is 32 (0.79%), including women — four. According to the Kemerovo Regional Center for Occupational Pathology, the number of employees of coal industry organizations subject to PME in 2022 amounted to 43,145 people, including women — 7,288 (16.9%). At the same time, the number of employees who have passed PME is 39,830 people (92.3%), including women — 7,142 (98% of the total number of women and 17.9% of the number of people who have passed PME). According to the results of the PME, the number of persons who do not have medical contraindications to work amounted to 39,221 (98.5%), including 7,124 women (18.2% of the number of persons who do not have medical contraindications to work). The researchers have identified in 609 employees (1.5%), including 18 women (2.95% of the number of persons with temporary or permanent medical contraindications to work), temporary or permanent medical contraindications to work, namely: 89 employees (14.6%) — diseases of the cardiovascular system (I10–I149), in 219 workers (35.9%) — myopia (H52.1), in 142 workers (23.3%) — sensorineural hearing loss is bilateral (H90.3), in 94 workers (15.4%) — varicose veins of the lower extremities without ulcers or inflammation (I 83.9), in 65 employees (10.7%) — neoplasms (C00–D48). During mandatory periodic medical examinations in medical organizations of the Kemerovo region, we have diagnosed 7,325 cases of chronic somatic diseases that are not contraindications to the performance of work for the first time. In 57.5% of cases, experts have diagnosed symptoms, signs and deviations from the norm identified in clinical and laboratory studies (R00–R99), which may indicate the presence of early signs of occupational disease in workers and requires further attention. 
 In 13.3% of cases, scientists have detected diseases of the endocrine system, eating disorders and metabolic disorders (E00–E90); in 11.7% — diseases of the circulatory system (I00–I99); in 5.5% — diseases of the genitourinary system (N00–N99); in 4.7% — diseases of the blood, hematopoietic organs and individual disorders, involving the immune mechanism (D50–D89), and others.
 Limitations. A relatively short observation period.
 Conclusion. On the example of the analysis of the work of the centers of occupational pathology of the Rostov and Kemerovo regions in terms of mandatory preliminary and periodic medical examinations, pre-shift and post-shift examinations, post-shift rehabilitation, medical rehabilitation after medical care in the profile of "Occupational Pathology", we can see a tendency to increase attention from the state, the management of coal mining companies about the health of employees of coal mining companies. A risk-oriented approach to employee health management, the development and implementation of corporate programs will reduce occupational risks and timely identify signs of the initial development of a possible occupational disease.
 Ethics. In preparing the article, the authors were guided by the Ethical principles of medical research set out in the Helsinki Declaration of the World Medical Association of the last revision.