On the issue of taking into account new factors in the pathogenesis of occupational hearing loss (on the example of transport workers)

Abstract

Introduction. In the period from 2013 to 2021, industrial enterprises saw a reduction in jobs that did not meet sanitary and hygienic requirements for the level of exposure to noise, vibration, illumination, microclimate parameters and electromagnetic fields on the workers' bodies. However, the proportion of unfavorable workplaces that do not meet the standards for noise levels remains the largest, which determines the peculiarities of the structure of the occupational pathology of workers in the Russian Federation: professional pathology of the hearing organ - professional sensorineural hearing loss - remains in the first place. The transport industry is among the sectors of the economy with the most significant indicators of occupational diseases exceeding the average Russian indicator. The study aims to analyze additional causes of pathogenetic significance in the development of professional hearing loss using the example of employees of the driving professions of railway transport and flight professions of civil aviation aircraft. Materials and methods. We have analyzed the state of the auditory function in members of locomotive crews of JSC Russian Railways for 2017-2021 according to the Territorial Administration of Rospotrebnadzor for Railway Transport and persons of flight professions of civil aviation aircraft of the Russian Federation for 2010-2020 according to the data of the Federal Center for Hygiene and Epidemiology. Results. Professional sensorineural hearing loss prevails in the structure of occupational morbidity of railway and aviation transport workers. Despite the absence of excess in-cabin noise levels, the leading professional group for hearing loss in railway transport are locomotive drivers and assistants, in civil aviation - aircraft commanders and co-pilots. The complexity of the professional activities of persons of these professions, a high degree of responsibility for the safety of transportation of passengers and cargo, readiness to act in non-standard conditions, loads on visual and auditory analyzers, create a high degree of labor intensity that causes chronic stress. The factor of chronic stress causes a violation of adaptive mechanisms and causes a number of complex neuro-reflex and neurohumoral shifts in the body, as a result of which labor intensity need to consider as a pathogenetically significant factor in the development of professional sensorineural hearing loss. Conclusions. Chronic sensorineural hearing loss is a priority occupational disease in persons of driving and flying professions, it is registered even in persons working in conditions of regulatory levels of industrial noise and a high degree of labor intensity. It is necessary to discuss the possibility of including labor intensity indicators as an additional etiological, pathogenetically significant factor in the expert criteria for establishing the connection of hearing loss with professional activity.