Personified approaches to organization of risk-oriented medical observation in conditions of opportunistic-pathogenic microbial air contamination of working zone

Abstract

Aim. To ground the personified approaches when organizing risk-oriented medical observation of animal breeding workers.
 Materials and methods. The total capillary blood analysis with calculation of percentage of peripheral blood cellular composition was carried out, allergization index (AI) and immunoreactivity index (IRI) was assessed, the total number of microorganisms per 1 m3 of the air in the working zone was determined, the total microbial count (TMC) was calculated.
 Results. The standard periodic medical examination of workers is sufficient with TMC value less than 500 CFU/m3, absence of chronic infectious inflammatory diseases (CIID), AI value less than 1.08 standard units, IRI value less than 13 standard units. When having a mean level of microbiological risk, CIID detection ranging from 1 to 3, AI value less than 1.08 and IRI value less than13 standard units, it is recommended to add a survey to the previous stage, using special questionnaire (attitude to work, working conditions, fatigability degree, susceptibility to allergy etc.). When having TMC value more than 2500 CFU/m3, CIID detection from 4 to 5, AI value 1.08–1.3 standard units, IRI value 13.1–15.7 standard units, an additional study of the upper airways microflora as well as immune status using tests of the first level should be realized; further recommendations on treatment-and-preventive measures in outpatient conditions should be given; with TMC value more than 5000 CFU/m3, presence of CIID – 6 and more, AI value 1.4–1.5 standard units, IRI value 15.8–18.3 standard units, it is recommended to perform immunological studies using tests of the second level with determination of susceptibility to antimicrobial preparations in hospital conditions of Occupational Pathology Center.
 Conclusions. The method of personified risk-oriented medical observation of persons, working in animal breeding is offered.