Abstract

Introduction. The creation of safe working conditions allows not only to reduce the rates of occupational morbidity and occupational injuries among employees, but also to increase the efficiency and efficiency of work, which together reduce the financial losses of employers. Therefore, the improvement of methodological approaches to the assessment of occupational risks is an urgent task of modern preventive medicine. The study aims to substantiate the need to apply new approaches and criteria for determining the level of occupational risk based on the analysis of occupational morbidity in a group of people exposed to harmful industrial factors. Materials and methods. Researchers have carried out a retrospective analysis of occupational morbidity and an analysis of the working conditions of railway transport workers (798,126 people) operating in conditions of constant exposure to harmful production factors. Indicators of occupational morbidity have been recalculated for 10 thousand workers employed in workplaces with harmful and dangerous working conditions. The authors used the software and application package "SPSS 23" during the calculations. Results. The main occupational diseases of railway transport workers are: professional sensorineural hearing loss (PSHL) (60-75%), pneumoconiosis and dust bronchitis (4-20%), diseases of the peripheral nervous system and musculoskeletal system (6-9%), vibration disease (WD) (3-10%). The indicator of occupational morbidity per 10.000 of all employees of JSC "Russian Railways" for PNST, radiculopathy and vibration disease were 0.25, 0.014, 0.056, respectively. The new indicator of occupational morbidity, calculated for 10,000 workers working in harmful and dangerous working conditions with factors such as noise, vibration, and severity of labor, was: PSHL - 1.08, radiculopathy - 0.06, WD - 0.78. We have carried out the forecasting of the development of PSHL, which is based on data on the profession, the presence of harmful production factors, age-experience indicators and the degree of PSHL. Conclusion. The existing approach to the assessment of occupational morbidity, calculated for 10 thousand of all employees, is not objective, does not reflect real risk levels, understates official data on occupational morbidity, and creates difficulties for the development of effective management decisions. It is necessary to approve a new approach to the assessment of occupational morbidity, calculating it for 10 thousand workers directly exposed to harmful and dangerous factors. The developed prognostic model of the risk of developing PSHL, based only on information about the profession, work experience, and age of the employee, is not objective and does not give accurate predictions about the timing of the onset of occupational disease. To improve the prognostic model, it is necessary to include additional indicators based on clinical and laboratory studies, as provided by the methodology for the formation of risk groups (groups 1-5) for the development of occupational diseases.

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