Occupational incidence in the modern socio-economic conditions of Donbass

Abstract

An analysis of the current state of occupational pathological assistance to the working contingent of industrial enterprises of the Donetsk People's Republic is presented. When analyzing the dynamics of occupational morbidity for the period 2017-2021, it shows a significant increase from 12.3 cases in 2017 to 30.5 cases in 2021 (per 10,000 workers), mainly due to workers in coal mines. Most of all occupational diseases were registered among workers of the main underground professions - miners of a stope (37.5%) and sinkers (23.3%). The observed increase in occupational morbidity is considered from the standpoint of today's specifics of the working conditions of coal mining enterprises in Donbass. First of all, the absence of a leading occupational hazard with simultaneous multifactorial industrial exposure, often exceeding the threshold values of limit values, as well as a change in operating factors and the intensity of their impact during the length of service. Most cases of occupational diseases identified when workers applied for medical help to the Republican Center for Occupational Pathology had pronounced chronic forms of diseases in workers with work experience in harmful production factors of 20-39 years (up to 75%) and over 50 years of age - more than half of all cases (2020 - 52.7%, 2019 - 51.2%, 2018 - 53%, 2017 - 51.8%). At the same time, when analyzing primary medical documentation (originals of outpatient cards, professional examination cards) working in hazardous conditions, it is noted that more than 80% are «healthy». One of the main reasons for the growth of occupational morbidity is the poor quality of medical examinations carried out by general medical institutions, which causes late detection of occupational and work-related pathologies, the development of advanced forms of general somatic diseases that prevent employees from fulfilling their job duties. In the structure of occupational pathology in the DPR, the largest share falls on diseases caused by physical overload - 44.3%; industrial aerosols - 37.1%; physical factors: vibration - 17.2%, noise - 0.7%. It is concluded that all of the above processes are due to a number of interrelated reasons - a change in the socio-economic situation caused the economic instability of coal enterprises, which led to worsening working conditions, a reduction in the number of employees, an increase in intensive appeals to the Republican Center for Occupational Pathology in order to resolve the issue of the relationship of morbidity with the profession, and , consequently, the solution of social problems through compensation for damage to health.