Diagnosis Of Occupational Diseases Research Articles

Establishment of the quality management system for occupational diseases diagnosis

The quality management system of occupational diseases diagnosis is belonged to one part of the hospital quality management system. It must be adhered to the quality management concept of comprehensive, full staff and whole process. To establish and improve the quality management system should be included: (1) Formulated a quality management manual for occupational disease diagnosis, including organization construction, rules and regulations, responsibilities, work flow, operating procedures and clinical pathways, standard instrument, etc. (2) Managed the document of occupational diseases diagnosis. (3) The continuous improvement of quality management. The quality management of occupational diseases diagnosis focuses on the mastery and implementation of the manual by employees, which is reflected in the continuous improvement of daily work, internal assessment and external assessment.

The application of metaverse in occupational health.

The metaverse, as a new digital interactive platform, is garnering significant attention and exploration across industries due to technological advancements and societal digital transformation. In occupational health, there is immense potential for leveraging the metaverse to enhance work environments and occupational health management. It offers companies more efficient and intelligent solutions for occupational health management while providing employees with safer and more comfortable work environments. A comprehensive literature search was conducted using PubMed, Web of Science, IEEE Xplore, and Google Scholar databases to identify relevant studies published between January 2015 and March 2024. The search terms included "metaverse," "virtual reality," "occupational health," "workplace safety," "job training," and "telemedicine." The selected articles were analyzed, and key findings were summarized narratively. The review summarizes the broad application prospects of metaverse technology in immersive training, occupational risk identification and assessment, and occupational disease monitoring and diagnosis. However, applying the metaverse in occupational health also faces challenges such as inadequate technical standards, data privacy issues, human health hazards, high costs, personnel training, and lagging regulations. Metaverse offers new possibilities for addressing the numerous challenges faced in occupational health and has broad application prospects. In the future, collaborative efforts from multiple stakeholders will be necessary to promote the sustainable development of metaverse technology in occupational health and better protect workers' occupational health.

Development of rehabilitation and preventive programs for employees of "dust-hazardous" professions

Introduction. The main tasks of the occupational pathology service are early diagnosis of occupational diseases, prevention of their formation, and in case of development, slowing down the progression. Due to the timely start of rehabilitation measures, it is possible to preserve employees' ability to work, and the employer — the labor potential of qualified personnel.
 In modern enterprises, it is necessary to create programs to provide workers with medical care at the early stages of the formation of diseases, to prevent their progression, the development of complications and the preservation of professional ability to work.
 The study aims are the scientific substantiation of methodological approaches to optimizing rehabilitation and preventive programs for employees of "dust−hazardous" professions.
 Materials and methods. The scientists have examined 254 employees of KAMAZ PJSC: 164 employees of the Foundry and 90 employees of other divisions of the enterprise. The work uses a complex of hygienic, clinical and laboratory, instrumental, statistical research methods.
 Results. The authors have established the features of the a priori and a posteriori risk of the formation of occupational pathology of the respiratory organs in the departments of a large machine-building enterprise. There is specificity of the development of respiratory pathology depending on the exposure characteristics and characteristics of the physico-chemical properties of industrial aerosols in workers of a machine-building enterprise. The researchers have developed and scientifically substantiated a methodological approach to the application of a set of measures aimed at reducing risk and preventing occupational pathology of the respiratory system in employees of a machine-building enterprise, based on a personalized assessment of harmful factors of the production environment, a differentiated approach to correcting modifiable risk factors.
 Conclusions. The authors justified the use of various rehabilitation and preventive programs for interned employees of the enterprise who have a high risk of developing occupational pathology of the respiratory system, developed a differentiated approach to the use of various rehabilitation and preventive programs based on the analysis of the dynamics of clinical and functional indicators reflecting the course of respiratory pathology under the influence of industrial aerosols of various compositions (formation of obstructive-restrictive disorders, changes in exercise tolerance, the dynamics of morbidity with temporary disability).

İŞYERİ HEKİMLİĞİ UYGULAMALARI VE ÇALIŞANLARIN İKİNCİ VE ÜÇÜNCÜ BASAMAK SAĞLIK KURULUŞLARINA YÖNLENDİRİLMESİ

Employees may need to be referred to health institutions for different indications, such as illness and rehabilitation. In Turkey, the procedure for referring cases from the workplace to health institutions is not fully defined. Learning the approaches of workplace physicians on employee referrals will determine the direction and content of future studies on this matter. This study aims to obtain information about the characteristics of workplace physicians working in Izmir province and their attitudes towards case referral to health institutions. The population of the descriptive study consisted of workplace physicians registered in Izmir Medical Chamber e-mail information network. The subjects were contacted through the information network of the Chamber, and an online questionnaire was sent. 58% of the participants stated that they participated in risk assessment studies and conducted field surveillance. 69.3% of the participants stated that they were able to conduct a pre-employment examination for all employees, and 78.4% stated that they were able to conduct periodic examinations on a regular basis. 52.3% of the participants stated that they referred patients with a preliminary occupational disease diagnosis one or more times. One-fourth of the participants stated that they could not act freely in terms of referring cases from the workplace. The examinations performed at the workplace and referral of the necessary cases to advanced healthcare centers are vital steps in protecting and improving employee health. It is crucial for the workplace physician to feel free to refer suspicious cases and to have job security against all possible consequences.

Synthesis of Models for Predicting and Diagnosing Occupational Diseases Based on Hybrid Fuzzy Technology

The purpose of research is to develop a method for synthesizing models for predicting and diagnosing occupational diseases based on hybrid fuzzy technology, providing an increase in the quality of decision-making in occupational pathology.Methods. It is established that most of the problems related to the topic under study (forecasting, early diagnosis, assessment of the severity and dynamics of the development of professional diseases) belong to the class of poorly formalized problems with fuzzy and incomplete data structure, which are recommended to be solved using the methodology of synthesis of hybrid fuzzy solving rules based on on the interaction of the natural intelligence of doctors and a cognitive engineer with artificial hybrid intelligence. Using the chosen mathematical apparatus, a method for the synthesis of fuzzy models of forecasting and diagnosis of occupational diseases is proposed.Results. As a concrete example, the problem of predicting and diagnosing ischemic heart disease (CHD) in electric train drivers has been solved with the allocation of such classes of conditions as: "healthy and the appearance of CHD is not expected"; "healthy, but the appearance of CHD is expected after the predicted time"; "early stage of CHD"; "CHD disease has been detected". As a result of expert evaluation, it was shown that the confidence in the correct classification is at the level of 0.9. The same result was confirmed by the results of statistical tests on representative control samples in terms of diagnostic sensitivity and specificity.Conclusion. The proposed method of synthesis of hybrid fuzzy models makes it possible to synthesize hybrid decision rules that improve the quality of prediction and early diagnosis of the studied class of diseases both in the presence of training samples and in their absence by compensating for the lack of statistical material by methods of formalization of clinical thinking. As a concrete example, the problem of predicting and diagnosing ischemic heart disease in electric train drivers has been solved. It is shown that the confidence in the correct classification is at the level of 0.9, which allows us to recommend the results obtained for practical use in occupational pathology.

Priority directions for preserving the health of underground coal mining workers

Introduction. An increase in life expectancy, a decrease in the mortality rate of the working-age population and an extension of working longevity are the most important components in the development of the human potential of the Russian Federation. We observe the most unfavorable situation with the achievement of the above-mentioned targets in coal mining.
 The study aims to substantiate the priority directions for preserving the health of workers engaged in underground coal mining in modern production conditions based on an assessment of occupational risks to prolong their working longevity.
 Materials and methods. The authors have carried out the analysis of official statistics data (state reports of Rospotrebnadzor and the annual report of Rosstat) for 2021–2022 on the state of working conditions and occupational morbidity in the coal industry. We have summarized the materials of Rosugleprof for 2006–2022 on occupational morbidity in coal industry organizations. We have presented the data of epidemiological studies in a cohort of coal miners on the example of the Rostov region.
 Results. The authors note the largest proportion of cases of occupational pathology among employees of mining enterprises — 40.3%. The most at risk are: sinkers (10.2% of all newly identified cases of occupational diseases in 2022), miners of the treatment face (6.5%), excavator drivers (4.5%). In the structure of occupational morbidity of miners, the leading place is occupied by radiculopathy — 27.0%; sensorineural hearing loss — 22.9%; vibration disease — 22.0%; respiratory diseases (occupational bronchitis, pneumoconiosis, COPD) — more than 15.5%. In a cohort of miners with an established diagnosis of occupational diseases, it was shown that the standardized relative risk (SRR) of death from diseases of the circulatory system was 1.55 times significantly higher compared with the control population.
 Mortality from malignant neoplasms in miners was 44% higher than mortality in the population (SRR=1.44). At the same time, the death rate from the subclass malignant neoplasms of the respiratory system was 2.02 (95% CI 1.85–2.20), and from malignant neoplasms of the bronchi and lungs 2.24 (95% CI 2.04–2.46). The risk of death from respiratory diseases in the cohort of miners was more than 2 times higher than the population indicator (SRR=2.18). A significantly higher frequency of deaths from this class of diseases indicates a causal relationship with dust loads. The prevalence of coronary heart disease (CHD) among coal mine workers is higher than among the unorganized population of large cities and other groups of industrial workers.
 Conclusion. Scientists have recorded the most unfavorable working conditions in underground coal mining, which is due to the technologies used and production conditions. The prevention of diseases among miners requires the creation of health groups and the improvement of medical examination methods. Development of an integrated information system for health monitoring and personalized preventive and rehabilitation measures. To solve this problem, it is necessary to study working conditions, scientifically substantiate preventive measures, harmonize special assessment of working conditions and develop criteria for severity and intensity of work, as well as improve the technology for assessing working conditions and personalized risk assessment.
 Ethics. The study did not require the conclusion of the Ethics committee.

How difficult is it to diagnose and report an occupational disease in a developing country? A modified delphi study

Aim: The roles of occupational medicine specialists are very important in the diagnosis and notification of occupational diseases. In this regard, the opinions of the parties are needed to identify the problems and propose solutions. Methods: This is a Modified Delphi exercise. It was conducted through an online survey in 2 rounds in Turkey between June 4, 2021 and August 31, 2021. The population of the research consists of occupational medicine specialists and sub-branch students in Turkey and some physicians working in the central organizational units of the Ministry of Health and the Ministry of Labor and Social Security regarding the diagnosis, registration and notification of occupational diseases. In both rounds, e-mails were sent to 127 people. The survey was sent via , and the response frequency was 27.5% and 18.1% in rounds 1 and 2, respectively. A survey form was created for the second round by evaluating the open-ended information obtained as a result of the first round using the thematic analysis method and making suggestions. This form was sent to participants via e-mail and questions were asked about participation in the proposals in the second round. Proposals with 70% or more participation were accepted unanimously. Results: The most important difficulties regarding the diagnosis and details of occupational diseases are; The lack of a national occupational disease surveillance system, the fact that the current occupational disease diagnosis and summary system is focused on pricing, and the difficulties people experience in diagnosis were determined. Conclusion: In order to increase the reporting of occupational diseases, a surveillance-oriented system should be switched instead of a compensation-based system. In addition, the deficiencies in manpower, financing, technical infrastructure and legislation in the occupational disease reporting system need to be rapidly revised.

Features of the occupational prevalence in health workers in the Republic of Bashkortostan over 2017–2022

Introduction. The labour of health workers (HW) is associated with the impact of adverse factors of various nature including chemical, physical, biological, high neuro-emotional stress, physical activity. All these factors, high workload, round-the-clock working with night shifts, unpredictability of the state of health and responsibility for the life of the patient, high olccupational activity, constant psycho-emotional and intellectual stress make the labour of HW to be a complex and responsible type of human activity. Over recent (2020–2021) years, due to the emergence of a highly contagious Covid-19 viral infection, health workers have been in direct contact with patients.
 Objective. To determine the features of occupational morbidity among the HR in the Republic of Bashkortostan over 2017–2022 including the COVID-19 pandemic.
 Materials and methods. Data on occupational diseases in HW over 2017–2022 were studied on the base of the materials of the Republican Center for Occupational Pathology of the Ufa Scientific Research Institute of Occupational Medicine and Human Ecology. There were evaluated reports of the final diagnosis of an occupational disease, acts of investigation of occupational diseases, sanitary and hygienic characteristics of working conditions, a consolidated annual report on the activities of the Center.
 Results. The level of occupational morbidity increased from 0.6‱ in 2017 to 5,6‱ during 2021, i.e. increased by 9.3 times. The nosological, gender, age, occupational and experience structure of morbidity has changed. In 88.8% of cases, the diagnosis of an acute occupational disease due to coronavirus infection was established posthumously: in 2020 – 100%, in 2021 – 86.3%. There were 0.72 deaths from this infection per 1,000 health workers.
 Conclusions. To preserve the health and occupational longevity of HW, especially in the context of an epidemiological rise in infectious diseases, it is necessary to strengthen priority measures for primary and secondary prevention, provide personal protective equipment, strengthen disinfection measures, establish a special regime of work and rest, and other preventive and social protection measures.

Pathological features and diagnostic significance of lung biopsy in occupational lung diseases

Objective: To investigate the clinicopathological characteristics of occupational lung diseases, to reduce the missed diagnoses and misdiagnoses of the diseases and to help standardize the diagnosis and treatment of these patients. Methods: A total of 4 813 lung biopsy specimens (including 1 935 consultation cases) collected at the Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, China from January 1st, 2017 to December 31th, 2019 were retrospectively analyzed. Among them, 126 cases of occupational lung diseases were confirmed with clinical-radiological-pathological diagnosis. Special staining, PCR and scanning electron microscopy were also used to rule out the major differential diagnoses. Results: The 126 patients with occupational lung diseases included 102 males and 24 females. All of them had a history of exposure to occupational risk factor(s). Morphologically, 68.3% (86/126) of the cases mainly showed pulmonary fibrotic nodules, dust plaque formation or carbon end deposition in pulmonary parenchyma. 16.7% (21/126) of the cases mainly showed welding smoke particle deposition in the alveolar cavity and lung interstitium while 15.1% (19/126) of the cases showed granulomas with fibrous tissue hyperplasia, alveolar protein deposition or giant cell interstitial pneumonia. The qualitative and semi-quantitative analyses of residual dust components in the lung under scanning electron microscope were helpful for the diagnosis of welder's pneumoconiosis and hard metal lung disease. Conclusions: The morphological characteristics of lung biopsy tissue are important reference basis for the clinicopathological diagnosis and differential diagnosis of occupational lung diseases. Recognizing the characteristic morphology and proper use of auxiliary examination are the key to an accurate diagnosis of occupational lung diseases on biopsy specimens.

Analysis of suspected occupational diseases cases and subsequent diagnosis follow-up investigation in Hubei Province from 2020 to 2021

Objective: To understand the epidemiological characteristics of suspected occupational diseases cases, and to track the subsequent diagnosis of suspected cases in Hubei Province from 2020 to 2021, and to provide theoretical basis for the supervision of suspected occupational diseases. Methods: In April 2022, the data of suspected occupational diseases cases and occupational diseases in Hubei Province from 2020 to 2021 were collected by the Occupational Diseases and Health Risk Factors Information Surveillance System. The distribution and diagnosis of suspected occupational diseases cases were analyzed. We investigated undiagnosed suspected occupational diseases by telephone. Results: From 2020 to 2021, a total of 1872 cases of suspected occupational diseases in 6 categories and 18 species were reported in Hubei Province. The top three suspected occupational diseases were suspected occupational noise deafness (36.75%, 688/1872), suspected coal worker's pneumoconiosis (33.07%, 619/1872) and suspected silicosis (20.99%, 393/1872). The diagnosis rate of suspected occupational diseases was 33.60% (629/1872). The rate of confirmed diagnosis was 63.59% (400/629). The diagnosis rate (26.86%, 456/1698) and rate of confirmed diagnosis (55.48%, 253/456) of suspected occupational diseases detected by occupational health examination were the lowest. The diagnosis rate of suspected occupational diseases detected by comprehensive medical institutions and private medical institutions were lower than disease prevention and control institutions and occupational disease prevention center (P<0.05). The main reasons for not entering the diagnostic procedure included that workers were not informed that they were diagnosed as suspected occupational diseases (31.55%, 124/393), workers were unwilling to apply for occupational disease diagnosis (18.56%, 73/393), and some workers planned to apply for diagnosis but had not yet applied (10.69%, 42/393) . Conclusion: Occupational noise deafness, coal worker's pneumoconiosis and silicosis are the main diseases of suspected occupational diseases in Hubei Province. In order to increase the diagnosis rate and confirmed diagnosis rate of suspected occupational diseases, it is suggested to strengthen management and supervision from the aspects of case management, information warning and worker notification.

A case of occupational explosive deafness caused by non explosive strong noise

Occupational explosive hearing loss is often caused by close exposure to blasting operations or the impact waves and strong pulse noise generated by explosions of flammable and explosive chemicals, pressure vessels, etc. in the workplace. This article analyzes the diagnosis of a case of occupational explosive hearing loss caused by non explosion, in order to improve the flexible application of diagnostic standards by occupational disease diagnosis physicians.

Features of the immune status in occupational chronic obstructive pulmonary disease of varying severity in coal mine workers

Introduction. The peculiarities of the clinical course of bronchopulmonary diseases, which occupy a large place in the structure of occupational diseases in coal mine workers, are largely due to a violation of immune reactivity, which is important to take into account for the development of effective preventive and therapeutic measures.&#x0D; The study aims to explore the features of the immune status in occupational chronic obstructive pulmonary disease of varying severity in coal mine workers.&#x0D; Materials and methods. The scientists have conducted a survey of 110 miners, who worked in underground conditions with an average concentration of aerosols of predominantly fibrogenic action at the workplace up to ten or more times higher than the maximum permissible concentrations, with an established diagnosis of occupational chronic obstructive pulmonary disease. The control group consisted of 89 trained miners who also worked in dust conditions above the maximum permissible concentrations, without bronchopulmonary pathology. The above groups had no statistical differences among themselves in age and work experience in dusty conditions. The authors also conducted an immunological examination.&#x0D; Results. Researchers have identified the features of the immune status in occupational chronic obstructive pulmonary disease — the development of combined immune insufficiency with damage to the humoral link of immunity (decrease in serum immunoglobulin G) and phagocytic activity of neutrophils. At the same time, we have an increased level of proteins of the acute phase of inflammation (C-reactive protein and haptoglobin) and an increased level of circulating immune complexes as an indicator of a high antigenic load. In patients with severe occupational chronic obstructive pulmonary disease, the suppression of the humoral link of immunity increases (a decrease in the relative and absolute amount of CD20+ and the level of serum immunoglobulin G), as well as the phagocytic activity of neutrophils compared with patients with chronic obstructive pulmonary disease of moderate severity and a comparison group that can contribute to the development and recurrence of the infectious and inflammatory process not only in the lungs, but also in other organs.&#x0D; Conclusion. The authors revealed the development of combined immune insufficiency with damage to the humoral link of immunity (decrease in serum immunoglobulin G) and phagocytic activity of neutrophils in miners with chronic obstructive pulmonary disease. With a severe degree of the disease, there are more pronounced violations of the humoral link of immunity and phagocytic activity of neutrophils.&#x0D; Ethics. This medical study with the participation of a person as a subject was carried out in compliance with the Ethical principles presented in the latest version of the Helsinki Declaration, developed by the World Medical Association.

Prediction and Early Diagnosis of Bronchial Asthma in Workers Specializing in Argon Welding Based on Fuzzy Mathematical Models

The purpose of research is to develop fuzzy mathematical models for predicting and early diagnosis of bronchial asthma developing under the influence of toxic substances released during argon welding providing an acceptable quality of decision-making for practical medicine Methods. The paper uses the method of synthesis of fuzzy mathematical models of forecasting and early diagnosis of occupational diseases provoked by the action of industrial pesticides developed in the South-Eastern Federal University on the basis of the methodology of synthesis of hybrid fuzzy decision rules allowing to take into account the multiplicative nature of the links between the risk of occurrence and development of occupational diseases with the concentration and time of exposure to harmful chemicals. Results. Using the chosen method, fuzzy hybrid models of forecasting and early diagnosis of industrial bronchial asthma in welding workers were obtained in which, in addition to the effects of ozone, dust and fibrogenic risk factors on the human body, unfavorable environmental and ergonomic factors combined with individual health characteristics are taken into account. In the course of modeling and expert evaluation, it was shown that the obtained mathematical model provides confidence in the correct prognosis of the occurrence of industrial bronchial asthma in welding workers at least 0.85, and early diagnosis at least 0.9. Conclusion. Hybrid fuzzy models of forecasting and early diagnosis of industrial bronchial asthma in welding workers caused by the presence of ozone and fibrogenic dust in combination with individual, environmental and ergonomic risk factors were obtained, the quality of which was tested on representative control samples. During the control check, it was shown that the prognostic model provides diagnostic specificity and sensitivity at the level of 0.87, and the early diagnosis model - at the level of 0.92, which is a good result for the class of tasks under consideration.

Investigation and analysis of late reporting and under-reporting of occupational diseases from 2018 to 2020 in China

Objective: To understand the late reporting and the under-reporting of occupational disease from 2018 to 2020 in China and analyze the causes, so as to provide scientific evidence for improving the quality of occupational disease reports in China, timely acquiring the incidence of occupational disease, and assessing the occupational hazards. Methods: From May to December 2021, A total of 320 occupational disease diagnostic institutions were selected for investigation. The original documents of occupational disease diagnosis cases from 2018 to 2020 were compared with the online reported cases, and late reported and under-reported cases of occupational disease were analyzed. Results: A total of 32207 diagnosed cases from 2018 to 2020 were investigated, including 28934 confirmed cases and 3273 cases without occupational disease. The overall late reported rate and under-reported rate of confirmed cases were 20.2% and 2.1%, respectively. There were significant differences in the rate of late reporting and under-reporting of occupational diseases in different regions and different types of diagnostic institutions (P<0.001). The southwest region had the highest rates of late reporting and under-reporting, 61.6% and 7.9% respectively. The late reported rate of all kinds of occupational diseases was about 15.0%, and the under-reported rate was from 1.5.0% to 5.0%. Conclusion: At present, the phenomenon of late reporting and under-reporting occupational diseases is still obvious. It is necessary to strengthen the inspection of occupational disease reporting, improve the quality of occupational disease reporting, and provide scientific basis for the formulation of occupational disease prevention and control policies.

Updates on the Evaluation, Diagnosis, and New Manifestations of Occupational Lung Disease.

More than 10% of all lung diseases are estimated to result from workplace exposures. This includes diseases caused almost exclusively by work which can be identified with careful medical surveillance, and those that also occur in the general population which are often missed due to the lack of a careful occupational history. Pulmonary specialists must be vigilant in recognizing and managing these preventable diseases. Success in doing so requires familiarity with the latest in surveillance and diagnostic tools and techniques, as well as knowledge of diseases, resulting from newer or previously unrecognized workplace exposures.

Pocket Consultant Occupational Health

The five authors of this edition are all authorities in occupational hygiene and occupational health and are affiliated with universities in South Africa, Canada, the USA and the UK. Two of them are emeritus. According to previous editions this book is intended for use by occupational health professionals, including occupational physicians, anywhere in the world. From its long-standing history (first edition published in 1983), I infer that this book was first meant to be kept in your pocket to have it at hand when you encounter a problem in practice. With the current edition with almost 500 pages this is not possible anymore. The book counts 20 chapters covering occupational health topics that vary from sampling strategies for exposure measurement to ethical aspects of occupational health. It deals both with topics of occupational medicine such as the diagnosis of occupational disease and of occupational hygiene such as risk assessment. The range of topics makes the book valuable for all occupational health professionals.

Present situation and countermeasures of technical support system of occupational disease prevention and control in China

Objective: To analyze the current situation and existing problems of the technical support system for occupational disease prevention and control in china, and to put forward development measures and suggestions. Methods: In January 2021, a cluster method was used to conduct a questionnaire survey on the relevant institutions of national occupational disease prevention and control technology support. Mainly investigate the development of occupational disease prevention and control centers (institutes) , municipal and county-level disease control centers, occupational health examination, occupational disease diagnosis and occupational health intermediary services. Data are described by number and composition ratio (%) , and descriptive analysis is made on the data. Results: As of December 2020, there were 140 occupational disease prevention and control centers (institutes) nationwide, an increase of 65 compared with 2019. There were 323 municipal and 2704 county-level centers for disease control and prevention, accounting for 97.00% (323/333) and 95.01% (2704/2846) of the total number of centers for disease control and prevention. There were 4520 occupational health examination institutions, 587 occupational disease diagnosis institutions, 1093 occupational health technical service institutions and 623 radiological health technical service institutions. Conclusion: The supporting force and ability of occupational disease prevention and control technology need to be improved, and the strength of occupational disease prevention and control hospitals (institutes) is still weak; The municipal and county-level centers for disease control and prevention need to further improve their conditions and capabilities; The number of occupational health examination, occupational disease diagnosis, treatment and rehabilitation institutions was relatively insufficient.

Genetic toxicology in hygiene

The article discusses the directions of research in the field of genetic toxicology, which allow solving problems important for hygiene, aimed at ensuring the genetic health of the population. The main areas of research are: assessment of the genetic hazard of environmental factors and the level of pollution by genotoxicants; analysis of the total mutagenic activity of mixtures of chemical pollutants; control over mutational events in the somatic cells of people working in hazardous production conditions, which is necessary to improve the prevention, diagnosis and treatment of occupational diseases and multifactorial pathology; study of individual genetically determined human sensitivity to the impacts of adverse environmental factors in order to improve professional selection and development of personalized preventive medicine; assessment of mutagenicity in short-term tests to predict the carcinogenicity of the studied substances; search for antimutagens. The methods used in genetic toxicology are described. The main directions and results of the work of the Department of Genetic Toxicology of the FBES “Federal Scientific Center of Hygiene named after F.F. Erisman” of the Rospotrebnadzor are given. Conclusion. The results of genotoxicological studies allow us to evaluate and establish hazard classes of the tested substances, predict possible long-term effects. Monitoring of mutational events in the somatic cells of people exposed to various environmental factors, assessment of individual human sensitivity to specific factors or their combinations make it possible to identify and evaluate potentially dangerous factors for genetic health, develop preventive measures and carry out reasonable professional selection of persons to work in harmful production conditions.

Neurohumoral regulation under exposure to vibration and physical overloads

Introduction. In response to the action of various occupational factors, central regulatory mechanisms, including the hypothalamus, are involved. Clarification of the influence of the hypothalamus on the indicators of peripheral blood circulation, peripheral innervation and bone metabolism under the influence of vibration and physical overloads is relevant for the diagnosis and treatment of occupational diseases of a neurological profile. The aim of the study. To establish the relationship between hypothalamic disorders and functional indicators of occupational diseases of the peripheral nervous system under the influence of vibration and physical overloads. Material and methods. One hundred fifteen tunnellers and machinists of the drilling rig of JSC “KMAruda Combine”, 26 tunnellers of the drainage mine of JSC “Stoilensky Mining and Processing Plant”, 65 workers of auxiliary occupations were examined. Depending on the influencing factor, they were divided into four groups with occupational neurological pathology, the fifth group was control Examined cases were divided into subgroups: A - without hypothalamic disorders and B - with hypothalamic syndrome. The criteria for the diagnosis of hypothalamic syndrome are clinical. All the examined patients underwent rheovasography, stimulation electroneuromyography of the extremities, ultrasound densitometry. Results. It was found that in patients with vibration disease from the effects of local or general vibration, especially when combined with lumbosacral radiculopathy during rheovasography, there are decrements in pulse blood filling, changes in vascular tone in vessels of various calibers and venous dysfunction, which are aggravated against the background of hypothalamic disorders. Hypothalamic disorders contribute to the aggravation of peripheral nerve indices: a decrease in the amplitude of the M-response, the rate of propagation of excitation along sensory axons and an increase in the value of residual latency. Functional assessment of bone tissue revealed the greatest prevalence of osteopenia syndrome in patients with vibration disease and its combined forms with lumbosacral radiculopathy in subgroups with hypothalamic-pituitary dysfunction (up to 33.6%). The frequency of detected functional disorders was established to increase with the progression of occupational diseases. Limitations. The study was conducted in workers with neurological occupational diseases exposed to vibration and physical overloads. Conclusions. Neurohumoral disorders, manifested by hypothalamic syndrome caused by exposure to general and local vibration in combination with physical overloads, contribute to the development or aggravation of functional changes in the body of workers, aggravating the course of occupational diseases of the peripheral nervous system, which can be used to develop diagnostic and treatment methods, and study the pathogenesis of diseases.

Silicosis after short-term exposure.

Silicosis develops after inhalation of dust containing respirable crystalline silica (RCS) and is recognized as an occupational disease. Workers also develop accelerated and acute silicosis after shorter exposure to respirable silica dust at high concentrations. The objective of this study is to investigate and identify the occupational groups at the highest risk of silicosis due to short-term RCS exposure. All confirmed cases of silicosis reported to the Central Register of Occupational Diseases in Poland between 2000 and 2019 were included. Data analysis covered: gender, age at the time of occupational disease diagnosis, exposure duration to RCS and sector of the national economy. A total of 2066 confirmed cases of silicosis were analysed. Thirty-two cases occurred after RCS exposure shorter than 5 years. Median age was 50. Seventy-five per cent (n = 24) of these cases were diagnosed in industrial processing workers who were mainly employed in manufacturing of non-metallic mineral products (44%, n = 14) and metal production (19%, n = 6). 16% (n = 5) of cases were associated with employment in mining and quarrying, 6% (n = 2) in conservation of monuments and 3% (n = 1) in construction. The findings identify occupational groups at risk of silicosis due to short-term silica exposure. Medical professionals should be aware of early silicosis symptoms, and occupational health professionals and employers should improve protective and preventive measures in silica related industries.