Harmful Working Conditions Research Articles

Risk factors for the development of bronchopulmonary pathology in workers producing synthetic polyacrylonitrile fiber

Aim of the study was to assess the risk of bronchopulmonary pathology in workers of the production of synthetic polyacrylonitrile fiber as a result of exposure to harmful chemicals and smoking tobacco products . Material and methods . During the periodic medical examination , the function of external respiration and adherence to smoking in 137 employees were studied , medical records were analyzed (025/u accounting form ). Hygienic assessment of working conditions was carried out on the basis of the results of in-situ sanitary and hygienic studies . Results and discussions . As a result of a hygienic assessment of working conditions , it was found that workers engaged in the production of polyacrylonitrile fiber are subject to the combined intermittent effects of harmful chemicals of hazard classes 1–3 ( acrylonitrile , methyl acrylate , hydrocyanide , ammonia , sodium rhodanide , sulfuric acid , methanol , isopropyl alcohol , ethylene glycol ), the content of which in the working area exceeded the maximum permissible concentrations in 1.6% of samples . The occupational risk of developing bronchopulmonary diseases in groups of workers who smoke is assessed as unacceptably high , while in people exposed to harmful chemicals , its level is 28.46 times higher than in people who are not exposed to these effects . The risk of the formation of ventilation disorders in groups of smoking workers is unacceptably high , while its level is 2.46 times higher in workers exposed to harmful chemicals than in non-workers in such conditions . In groups of workers exposed to harmful chemicals , the occupational risk of obstructive disorders is unacceptably high , in the group of smokers the risk is 2.32 times higher . Conclusions . Among the employees of the enterprise producing synthetic polyacrylonitrile fiber , the influence of tobacco smoking on the development of bronchopulmonary pathology is higher than the influence of harmful working conditions , and the use of smoking tobacco products significantly increases the negative effect of chemical pollutants .

УСЛОВИЯ ТРУДА И ПРОФЕССИОНАЛЬНЫЙ РИСК ЗДОРОВЬЮ РАБОТНИКОВ ЦЕХА ПО ПРОИЗВОДСТВУ ПРОТИВООПУХОЛЕВЫХ ЛЕКАРСТВЕННЫХ СРЕДСТВ

Background. Ensuring safe working conditions in the production of medicines is a guarantee of maintaining labor resources and sustainable socio-economic development of the state as a whole. Objective: to study the working conditions and morbidity rates with temporary disability of workers in the shop for the production of anticancer drugs and establish the level of occupational risk to their health. Material and methods. Based on the data of industrial laboratory control of factors of the working environment and the labor process, the results of certification of workplaces, a comprehensive hygienic assessment of working conditions was carried out at 10 main workplaces of the workshop for the production of anticancer drugs in the form of freeze-dried powders and solutions for injections. The source of information for the study of morbidity with temporary disability of workers was the certificates of incapacity for work for a five-year period. The study of morbidity with temporary disability was carried out on two formed groups of workers (the main group - shop workers and the comparison group - employees of management departments). A quantitative assessment of the magnitude of occupational risk was carried out using the results of a study of working conditions, health indicators of employees, data from checking a business entity according to a checklist. Results. The main contribution to the formation of harmful working conditions at a number of workshop workplaces is made by contact with unregulated chemicals, noise, unsatisfactory microclimate parameters in the cold season, and excessive indicators of the severity of the labor process. The level of morbidity with temporary disability of workers in the shop for the production of anticancer drugs was assessed as "medium". The integral indicator among shop workers, taking into account cases and days of temporary disability, did not have statistically significant differences with the average annual indicator in the republic, however, it was higher than in the comparison group (t=2.97, p<0.05). The numerical value of the indicator of the actual level of occupational risk was 1.7. Conclusion. The value of the indicator of the level of occupational risk established in the course of the study indicates the average degree of occupational causation of health disorders among workers in the shop for the production of anticancer drugs in the form of freeze-dried powders and solutions for injections.

Development of a set of priority measures for the integration of tools for assessing working conditions for the formation of occupational risk levels

Introduction. The increase in life expectancy, a decrease in mortality rates of the working-age population requires the development of a set of priority measures and justification of their effectiveness in the occupational risk management system based on the transition to a personalized assessment of working conditions and the health status of employees. The study aims to develop a set of priority measures to integrate tools for assessing working conditions and to justify their effectiveness in the occupational risk management system to determine the levels and groups of occupational risks in the workplace, depending on the complex of harmful and/or dangerous factors of the production environment and the labor process and the health status of employees. Materials and methods. The researchers have conducted the analysis of qualitative and quantitative indicators of occupational risk, including indicators of health disorders of employees. We have analyzed the materials of periodic medical examinations to substantiate the algorithm for the formation of risk groups for the development of occupational diseases. Scientists have performed a cross-epidemiological study to assess the risk of developing chronic general somatic diseases in workers. We have calculated the indicators of the total risk of fatal cardiovascular diseases. Experts have studied the features of the current situation with indicators of occupational morbidity in the Russian Federation. Results. There are two groups of qualitative and quantitative indicators at the level of state supervision and enterprise, which allow assessing the effectiveness of the risk management system. Scientists have identified qualitative and quantitative indicators for early detection of violations in the employee's body from the effects of production factors. We have substantiated the algorithm and criteria for the formation of risk groups for the development of occupational diseases. Assessment of the risk of developing general somatic diseases in workers with constant exposure to high levels of harmful factors: vibration, severity and labor intensity, showed a high prevalence and increased risk of diseases of the endocrine, musculoskeletal and circulatory systems, as well as a significant increase in these indicators with an increase in work experience in harmful working conditions, which allows us to consider these diseases as production-related diseases. Individuals with endocrine diseases are significantly more likely to have a very high, high and medium overall risk of developing fatal cardiovascular diseases (CVD). With an increase in work experience, the percentage of people at high risk of developing fatal CVD increased. The level of occupational morbidity calculated for the number of employees employed in harmful working conditions is 32% higher than the indicator calculated for all employees of the enterprise. A similar recalculation of occupational morbidity indicators for individual nosologies also completely changes the picture. Conclusion. We have substantiated the necessity of transition to a personalized assessment of occupational risk among employees. Researchers have developed proposals for adjusting legislation in order to integrate tools for assessing working conditions and improving the effectiveness of the occupational risk management system. Ethics. This study did not require the conclusion of the Ethics committee.

THE STEPS OF PRODUCTION RISK IDENTIFICATION AT THE INDUSTRIAL ENTERPRISE TO PROVIDE OCCUPATIONAL SAFETY

Problem statement. The development and implementation of key provisions to harmonize principles, methods, and risk assessment criteria for workers’ health with international approaches is a necessary condition for social and economic development of the state in order to integrate into global community. Moreover, the internal audit of occupational safety for the departments of the enterprise, according to the law of Ukraine «About occupational safety», should provide quantity assessment of professional and production risks for workers’ safety and health, taking into account the effect of hazardous factors for the workplace with harmful working conditions, as well as for production departments and the enterprise in general. The purpose of the research is to develop an algorithm to identify the level of production risk step by step for the workplace with admissible working conditions, for production departments with harmful working conditions and for the manufacturing enterprise in general. Conclusions. The research conducted has shown that the importance of professional and production risks should be taken into account to characterize not only occupational safety in the workplace with harmful and admissible working conditions, but also in the production departments and the manufacturing enterprise. The algorithm was developed to identify the level of production risks for the workplace with harmful and admissible working conditions, for the production departments considering all working places in order to compare accurately the risk level among production departments. The methods suggested for the annual internal audit of occupational safety at the enterprise departments allow taking high-priority actions for providing occupational safety, as well as developing enterprise policy in the field of occupational and production safety, and arranging necessary preparation for production certification according to the requirements of DSTU ISO 45001:2018 standard.

Динамика профессиональной заболеваемости в субъектах Северо-Западного федерального округа Российской Федерации в 2011–2020 годов

The aim of this paper was to analyse a 10-year dynamics of occupational disease incidence in 8 entities of the Northwestern Federal District (NWFD) of the Russian Federation. Materials and Methods. The authors used data on occupational disease incidence from the Federal Statistical Survey (form no. 24) of the Federal State Statistics Service (FSSS). Results. It is shown that in 2020 in the NWFD, 37.3 % of the total number of employees worked under harmful and/or hazardous working conditions, which is comparable to the national data. However, in some entities of the NWFD this indicator significantly exceeded the district’s average: in the Arkhangelsk (55.1 %), Vologda (50.1 %) and Murmansk (48.8 %) Regions. Noteworthy, during the period from 2011 to 2020, the NWFD as a whole saw a positive trend towards reducing the percentage of workplaces failing to meet the sanitary standard requirements for noise, vibration, illumination and microclimate. It should be emphasized that over the past 10 years, the NWFD has seen a moderate downward trend (coefficient of determination = 5.3) in the number of patients with newly diagnosed occupational diseases per 100,000 able-bodied population, while the nationwide indicator has followed a strong downward trend (R2 = 9.0). At the same time, in three entities (Komi Republic, Murmansk Region, and Republic of Karelia) this indicator was higher than the average for the NWFD. Thus, in spite of the general positive trend towards reduction in the number of workplaces failing to meet the sanitary standard requirements and towards a decrease in occupational disease incidence during the 10-year period in the NWFD as a whole, some of its entities need to further optimize the working conditions and increase workers’ functional reserves to maintain the health of the able-bodied population.

PRACTICAL DIMENSION OF MANAGEMENT PROCESSES IN THE FIELD OF ORGANIZING SAFE AND HEALTHY WORKING CONDITIONS

Occupational health and safety management is a complex process, which purpose is to ensure appropriate technical, organizational and human resources for the organization of the company’s operations, leading to the elimination of occupational risk, causes of accidents at work and hazardous and harmful working conditions. One of the management methods in this area is to develop and implement a system, whose effective methods will ensure the achievement of the assumed goals. The technical, organizational and behavioural dimension of work organization, may affect the effects of ensuring safe working conditions as a result of the implementation of appropriate management processes. The basic elements of the management structure in this area include processes such as: ensuring appropriate conditions for technical safety at work, ensuring a culture of work safety and appropriate work organization, which is reflected by the organization of workstations heaving regard to the principles of ergonomics, organization of workstation supervision, ensuring the service’s activities OHS, implementation of training in the field of occupational health and safety, identification of risk and analysis of the causes of accidents and occupational diseases, ensuring prevention of health protection in the field of occupational medicine, enabling emergency first aid measures and introducing procedures for fighting fire and implementing fire prevention in the plant work. The indicated processes are the basic elements of building a health and safety system and, at the same time, are fundamental areas of management, which determine the level of commitment of the top management to health and safety at work.

Working conditions and the state of health in teachers of secondary schools (literature review)

Modern studies point to extremely low indicators of the teachers’ physical and mental health as an occupational group. Literature data shows that teachers of general educational organizations can be classified as workers who are subject not only to occupational stress, but also to the influence of factors of the labour process that do not meet hygienic standards. According to the severity of the labour process, due to being in a standing position up to 80% of the lesson time, their work belongs to the harmful class 1 degree (class 3.1), in terms of tension, due to intellectual, emotional, and sensory loads - to harmful working conditions 1-2 degree (class 3.1.-3.2). Analyses of teachers’ health showed that out of 40% of employees has had pathology required outpatient examination and treatment during initial examination, and almost 50% of the examined teachers needed dispensary observation. Diseases of the eye and adnexa (43.6%), diseases of the respiratory system (36%), diseases of the digestive system (31.1%) are leading in the structure of morbidity. According to medical documentation, the most often detected morbidities are diseases of the cardiovascular system (35.6%), diseases of the digestive system (15.9%), and diseases of the genitourinary system (11.8%). An increase in the number of diseases with age and length of service was noted. In addition, with an increase in teaching experience, there is a gain in maladjustment processes and psychopathological states of a neurotic or psychopathic nature. Information was collected using the databases Scopus, Web of Science, MedLine, The Cochrane Library, PubMed, RSCI, Cyberleninka.

Maternal risk factors for a child’s health prior to and during pregnancy (results of long-term cohort monitoring in Vologda region)

The work presents the results of the 26-year monitoring with its focus on children’s health. Pre-school children living in the Vologda region were selected as a research object. The aim was to assess health risks for children caused by certain maternal factors and conditions. The study was accomplished as an intra-cohort analysis of data on 1454 children from five cohorts (born in 1998, 2001, 2004, 2014 and 2020) by calculating a relative risk rate. Negative effects produced by sociodemographic, socioeconomic and environmental conditions as well as maternal harmful occupational factors during pregnancy are significant health risk factors for a child. It is true not only for the neonatal period but also during pre-school years. Such health-related factors as stillbirths in case history, complications of a present pregnancy (up-to-date reproductive technologies being applied to achieve it, eclampsia, multiple pregnancy, dangerous fetus position, prematurity, postmaturity, anemia, edemas, protein in urine) and birth (rapid labor, use of vacuum extraction) do the most severe damage to a child’s health at birth and their influence persists as a child grows. Other significant risk factors that influence children’s health in their pre-school years include diseases of the genitourinary and endocrine systems diagnosed in a mother prior to pregnancy; a mother being single; low incomes; electromagnetic radiation at a place where a family lives; harmful working conditions at a mother’s workplace (gases in workplace air, work on a conveyor belt, radiation exposure). A mother’s young age is also a health risk factor for a fetus during the prenatal period but its influence reduces as a child grows. In contrast, if a mother is older than 40, this factor protects a child’s health during pregnancy but increases likelihood of retarded neuropsychic development by the school age (due to a mother’s low health potential). Overwhelming majority of health risk factors we detected in this study are quite manageable. Our results can be used in creating programs aimed at preserving health of a mother and a child at any level, from individual to national one.

Факторы риска здоровью ребенка со стороны матери до и во время беременности (итоги многолетнего когортного мониторинга в Вологодской области)

The work presents the results of the 26-year monitoring with its focus on children’s health. Pre-school children living in the Vologda region were selected as a research object. The aim was to assess health risks for children caused by certain maternal factors and conditions. The study was accomplished as an intra-cohort analysis of data on 1454 children from five cohorts (born in 1998, 2001, 2004, 2014 and 2020) by calculating a relative risk rate. Negative effects produced by sociodemographic, socioeconomic and environmental conditions as well as maternal harmful occupational factors during pregnancy are significant health risk factors for a child. It is true not only for the neonatal period but also during pre-school years. Such health-related factors as stillbirths in case history, complications of a present pregnancy (up-to-date reproductive technologies being applied to achieve it, eclampsia, multiple pregnancy, dangerous fetus position, prematurity, postmaturity, anemia, edemas, protein in urine) and birth (rapid labor, use of vacuum extraction) do the most severe damage to a child’s health at birth and their influence persists as a child grows. Other significant risk factors that influence children’s health in their pre-school years include diseases of the genitourinary and endocrine systems diagnosed in a mother prior to pregnancy; a mother being single; low incomes; electromagnetic radiation at a place where a family lives; harmful working conditions at a mother’s workplace (gases in workplace air, work on a conveyor belt, radiation exposure). A mother’s young age is also a health risk factor for a fetus during the prenatal period but its influence reduces as a child grows. In contrast, if a mother is older than 40, this factor protects a child’s health during pregnancy but increases likelihood of retarded neuropsychic development by the school age (due to a mother’s low health potential). Overwhelming majority of health risk factors we detected in this study are quite manageable. Our results can be used in creating programs aimed at preserving health of a mother and a child at any level, from individual to national one.

Результаты оценки опасности производственной деятельности персонала компрессорных станций магистральных газопроводов

During gas transportation operations in extreme low-temperature natural and climatic conditions of the Far North, one of the urgent issues is the assessment of the probability of personnel death in the event of emergencies and occupational diseases during regular operation when operating the technological equipment of the compressor stations of main gas pipelines. The article discusses the results of an assessment based on the developed methodology for calculating integral indicators of the risk of damage to the life and health of employees of the compressor stations of main gas pipelines in the conditions of the Far North, aimed at ensuring the safety of personnel in the workplaces. When creating the methodological approach, specific features affecting the level of safety of life and health of personnel were considered, such as: microclimate, the mechanism of brittle destruction of equipment metal, temperature inversion, prolonged exposure to aggregates noise, etc. To determine the influence of each of the listed factors, a single criterion for assessing damage to the health of personnel (days of under-living) located directly at the investigated hazardous production facility (compressor stations of main gas pipelines) was selected and justified: machinists, automation and metrological support fitters, repair fitters. Based on the statistical data, the damage of under-living to retirement age is determined, adjusted for the conditions of the Far North in the event of the death of an employee of each profession in the event of an emergency at a compressor station. Further, in the range from the beginning of employment to the estimated age of death calculated above, the damage from occupational diseases is determined. These provisions of the methodological approach for assessing the cumulative damage to health allowed to develop recommendations for calculating insurance payments in the event of the death of an employee, calculating additional payments for harmful and hazardous working conditions and design changes in the form of the use of special coatings for pipelines for reducing the occupational risk of personnel of the compressor stations of main gas pipelines in given conditions.

Employees’ production risk factors for occupational diseases development of Bashkortostan Republic enterprises

BACKGROUND: Occupational morbidity, which is directly related to working circumstances is one of the primary markers that characterize occupational health risk. Thus, it is necessary to study the working conditions and occupational diseases, which form peculiarities in enterprises of various economic sectors, followed by the development and implementation of targeted interventions aimed at creating safe working conditions and preserving employees health.
 AIM: to study industrial risk factors, occupational pathology main forms, and the timing of its development among employees at enterprises of various economic sectors.
 METHODS: We studied the acts of occupational diseases investigation, sanitary, and hygienic characteristics of working conditions, and medical records of 339 patients who were diagnosed with occupational diseases by the Ufa Research Institute of Occupational Medicine and Human Ecology in 20152019.
 RESULTS: It was discovered that the highest prevalent occupational diseases were diagnosed among workers of manufacturing industries and enterprises who engaged in mining with harmful working conditions (3.13.3) while conducting a retrospective in-depth analysis of occupational disease cases. Musculoskeletal system and connective tissue disorders predominated in the structure of the occupational disease. The largest number of patients had 3035 years of work experience in harmful working conditions. Based on this research, targeted measures have been developed to create safe working conditions and alleviate the risk of occupational diseases.
 CONCLUSIONS: According to the available material, a retrospective in-depth analysis of occupational disease cases revealed that workers in the manufacturing industries and enterprises engaged in mining were more at risk of developing disorders (46.1, 20.6%). It was discovered that the development of occupational diseases depended on the exposure intensity of harmful production factors and exposure time. The risk of occupational diseases is raised with increasing time of working in harmful working conditions (class 3.13.4). The greatest risk of occupational diseases was observed within work experience from 3035 years. The structure of the analyzed occupational diseases cases was dominated by ailments of the musculoskeletal system and connective tissue (43.4%), injuries, poisoning, and some other consequences of external causes (17.5%), and diseases of the ear, and mastoid process (15%). The analysis of cases of occupational diseases should be used as the basis to measure development aimed at reducing the risk of their emergence and preserving employees health.

The influence of underwater work on the functions of attention, thinking, fine muscle coordination and subjective assessment of the state of the body of divers

Introduction. Currently, there is an increasing need for the study and development of the World Ocean, including for the purpose of laying deep-water pipelines, searching for new sources of minerals, etc. The performance of special tasks by divers at great depths has its own characteristics. The high cost of error, harmful working conditions - all this dictate the need for continuous receipt and analysis of scientific material on the preservation and promotion of health, ensuring their longevity, as well as the adaptation of divers to the nature and conditions of professional activity in order to prevent the occurrence of errors. The study aims to explore the functions of attention and thinking of a person, his fine muscular coordination and subjective assessment of the state of the body of divers, as elements of the functional state of the body, when working underwater. Materials and methods. We examined 18 divers, divided into two groups: the first - ten people made daily descents to a depth of 18 m, the second group - eight people dived to a depth of 56 m. Before and after diving, the divers underwent a psychophysiological examination to assess the function of attention (the method of the correction test with Landolt rings), the function of thinking (the method of the arithmetic test "addition in mind"), fine muscle coordination (the method of macrography) and subjective assessment of the state (the SAN questionnaire (state of health - activity-mood)). Results. During diving operations, there was a decrease in subjective self-assessment of the state of the body (SAN test), an increase in the number of errors (correction test with Landolt rings - attention function) and the values of the height index of numbers (macrography technique - fine muscle coordination), a decrease in the speed of thinking depending on the depth, the multiplicity of diving descents, as well as the dive itself (regardless from depth and multiplicity) on the functional state of divers. There were most pronounced changes during prolonged work (3-5 days or more) and when diving to a depth of 56 m. Conclusion. The dynamics of objective indicators and subjective assessment of the state of the body indicates that with an increase in the depth of immersion (from 18 to 56 m), the multiplicity of diving descents (daily immersion for 5 days) and the dive itself, the self-esteem of the state, the speed of thinking, attention, fine muscle coordination decreases. Ethics. The study was conducted in compliance with the Ethical principles of conducting medical research with human participation as a subject, set out in the Helsinki Declaration of the World Medical Association.

On occupational causation of chronic diseases among workers in the mining of copper-zinc ores

The mining industry, with its harmful working conditions, remains difficult and dangerous for workers. Scientific studies indicate the existing high risk to the health of workers in the industry as a result of exposure to harmful production factors that are the causes of the development of many non-ommunicable and occupational diseases, disability and mortality. The stages of the study included studying the health status of 856 employees of the mining enterprise, assessing the degree of occupational causation of the identified diseases in terms of relative risk (RR) and etiological proportion (EF). The level of chronic non-infectious pathology among workers of the main professions was determined by the groups of diseases of the musculoskeletal system (43.5 % in the structure), the circulatory system (12.6 %), the digestive system (11 %), the ear and mastoid process (10.9 %), nervous system (10.8 %) and respiratory organs (5.8 %). When calculating the RR and EF indicators, a very high degree of occupational causation of J00–99 class diseases was determined (RR — 3.6, EF — 72.4 %); high degree — diseases of class M00–99 (RR — 3.0, EF — 66.1 %), including vertebrogenic dorsopathy (RR — 2.5, EF —60.6 %), K00–99 (RR — 3.1, EF — 67.5 %) and hearing impairment (RR — 2.6, EF — 61.7 %); average degree — diseases I00–99 (RR — 1.6, EF — 36.8 %), including hypertension (RR — 1.8, EF — 45.8 %). The features of occupational causation of diseases for certain professional categories of workers are determined. The problem of ensuring the safety of working conditions in order to preserve the health of workers in the industry requires the improvement of hygienic and recreational measures, the development of programs to protect and improve the health of workers, the implementation of which will help reduce the risks of workers’ health disorders.

Changes in the left ventricle in workers with long work experience of the coal and aluminum industry

Introduction. The leading role in the industrial structure of Kuzbass belongs to the coal and metallurgical industry associated with exposure to harmful production factors and high risks to the health of workers. The main pathogenetic factors triggering occupational and production-related diseases are hypoxic conditions potent of promoting changes in the heart structure and function. Materials and methods. The study included one hundred sixteen miners and 84 workers in the main occupations of aluminum production. The average age of miners was 47.63±0.33 years, of workers in the aluminum production - 48.41±0.53 years, p=0.191. Work experience in harmful working conditions in the study groups exceeded 20 years and did not differ significantly (p=0.281). All subjects underwent echocardiography according to the standard technique with automatic calculation of the global longitudinal deformity of the left ventricle. Results. The left ventricular ejection fraction and its longitudinal deformation were lower in aluminum industry workers with arterial hypertension not only in comparison with metallurgists with normal blood pressure (p<0.0001), but also with miners with arterial hypertension (p=0.015). Longitudinal deformation of the left ventricle in aluminum workers without arterial hypertension was significantly lower than in miners with normal blood pressure (p=0.0062). The parameters of the diastolic function of the left ventricle changed in the study groups under the influence of arterial hypertension. Limitations. This investigation is limited to a selection of workers in the main professions of the aluminum and coal industries undergoing periodic medical examinations at the Research Institute for Complex Problems of Hygiene and Occupational Diseases. Conclusion. A decrease in global longitudinal left ventricular myocardial deformation in miners and aluminum industry workers was associated with the presence of arterial hypertension and with the specifics of the main adverse production factors. The indices of left ventricular contractile function in aluminum industry workers were significantly lower compared to those in miners, regardless of the presence of arterial hypertension.

Life expectancy of coal miners with an established diagnosis of occupational diseases

Introduction. It is known that workers employed in harmful and dangerous working conditions initially have better health characteristics compared to the population as a result of medical and professional selection. Harmful production factors cause significant damage to health and can lead to the formation of occupational diseases. Preventive medical and rehabilitation care for patients with occupational pathology, combined with social and economic support measures, contributes to maintaining health and increasing life expectancy. It is important to understand how medical and social assistance to patients compensates for the damage caused to the health of workers by harmful working conditions. The study aims to compare the life expectancy of coal miners with an established diagnosis of occupational disease (OD) and the male population of the same region. Materials and methods. The researchers formed a cohort of coal miners in the Rostov region based on the materials of the database of the State Medical Institution of the Rostov region "Medical and Rehabilitation Center No. 2". All surveyed coal miners have established occupational diseases in different years. The observation period was 26 years from 01.01.1990 to 31.12.2015. Of the total cohort at the end of the observation period, 1,898 people were alive, 8082 people died. The experts examined the working conditions of miners, the average age of registration of the OD, depending on the nosological form. The researchers have conducted a comparative assessment of their life expectancy and the life expectancy of the male population of the same region, calculated from mortality tables. Results. The calculation of the average life expectancy of miners showed that its value in subgroups with different forms of OD differed significantly depending on the diagnosis: from 58.7 to 68.2 years. A comparative analysis of the life expectancy of coal miners with an established diagnosis of OD and in population control revealed a lower life expectancy of miners. The smallest differences in life expectancy we have noted in those miners who have a diagnosis of pneumoconiosis. Their life compared to the men of the Rostov region was shorter by less than a year. At the same time, miners with a diagnosis of occupational bronchitis lived 5.3 years less and with a diagnosis of vibration disease - 4.8 years compared to the population control. Conclusion. The study showed that coal miners diagnosed with occupational diseases have a lower average life expectancy than in the population, despite the "healthy worker effect", which we have as a result of medical selection and self-selection of persons to work in contact with harmful production factors. The lower life expectancy of workers with a diagnosis of occupational diseases we trace both in total for all diseases, and for individual forms of OD. Ethics. The authors have conducted the study in compliance with Ethical standards.

Working conditions, occupational morbidity, risks of violation health of drivers of mining machines in quarries

Introduction. Recent studies have shown that working conditions at mining enterprises remain harmful and dangerous. We characterize the working conditions by a set of factors of the production environment that affect the functional state of the body of workers and their working capacity. It depends on the equipment used, technologies, objects, products of labor. They are specific to each enterprise. In these conditions, the definition of occupational risks of violation of the health of miners becomes particularly relevant. The study aims to assess the current working conditions, the state of professional performance, to determine the risks of health disorders of the drivers of mining machines at ore quarries. Materials and methods. The researchers have conducted hygienic studies to assess production factors at ore quarries. We have presented an analysis of materials for a special assessment of working conditions at workplaces for ore quarries belonging to the Mining and Metallurgical Trade Union of Russia. Experts have summarized materials on occupational morbidity of employees over the past five years. The researchers have performed a cross-sectional epidemiological study to assess the risk of developing chronic general somatic diseases in mining machine drivers. Results. The article provides a hygienic assessment of working conditions in modern quarries, shows the complex impact on workers of the dust and gas factor, noise and vibration, microclimate. The authors present classes of working conditions for employees of the main professions, the results of a special assessment of working conditions. We have given an analysis of occupational morbidity in the quarries included in the GMPR and GOK “Lebedinsky” over the past five years. Researchers have found that diseases of the musculoskeletal system and connective tissue, as well as diseases of the circulatory system are production-related in workers engaged in open-pit mining. Conclusion. In the conditions of using high-performance mining equipment for open-pit mining of ores, a complex of production factors affects workers of leading professions. The authors give a general assessment of the working conditions at the workplaces of these professions: this is a harmful third class with varying degrees of harmfulness. The current set of production factors determines the level of occupational morbidity, which has been trending downward in recent years. The leading place belongs to vibration sickness, it is closely related to the increased values of the maximum permissible levels and the equivalent adjusted level of vibration velocity at the workplaces of drilling rig drivers, excavators and drivers of heavy-duty dump trucks. The high prevalence and risk of developing chronic diseases of the musculoskeletal system and connective tissue and diseases of the circulatory system, as well as a significant increase in indicators with an increase in work experience in harmful working conditions, allow us to speak about the production conditionality of these diseases in workers engaged in open-pit mining. Ethics. This study did not require the conclusion of the Ethics committee.

Evaluation of labor conditions for medical workers during the pandemic

The paper analyzes the labor conditions for medical workers (using the example of a medical institution in Irkutsk) during the COVID-19 pandemic which increased the workload on medical personnel and the number of contacts with infected patients. An extremely high work load, a round-the-clock work regime with mandatory duty calls intensified the body activity of medical workers. Professional overstrain caused neurosis in doctors, diseases of the heart and blood vessels, and dysfunctions of the gastrointestinal tract. Constant neuro-emotional stress was caused by a high level of responsibility for own results. For full-fledged work, medical workers need positive motives, vivid emotions, and rest which are difficult to combine, especially during the pandemic. Such working conditions contribute to the development of the burnout syndrome and anxiety disorders. The measured aimed to create less harmful working conditions are described.

The current state of working conditions and health of vegetable growers of protected soil

Introduction. Innovative low-volume technologies for soilless cultivation of vegetable crops are changing the nature and working conditions of workers, contributing to their transition to a qualitatively new level of health safety. However, modern aspects of the formation of the health of greenhouse workers remain insufficiently studied. Material and methods. Comprehensive studies of working conditions and morbidity (general, primary, accumulated, nosological structure and its dynamics) were carried out according to periodic medical examinations (2013-2017) of greenhouse vegetable growers working under the conditions of using innovative technologies for soilless cultivation of vegetable crops. Results. Working conditions of modern greenhouse vegetable growing were shown to remain unfavourable. They not meet the hygienic standards for the content of chemicals and aerosols of predominantly fibrogenic action (APFD) in the air of the working area, the parameters of the microclimate and the severity of the labour process, forming harmful working conditions (class 3.3), representing high risk to the health of workers. The overall incidence of vegetable growers in different years of observation ranged from 845.6 to 1129.0‰ with the frequency of detection of incidence in the range of 181.8-231.9‰. The first ranking places in the nosological structure of general morbidity were occupied by diseases of the circulatory system (Essential (primary) hypertension), genitourinary (Benign mammary dysplasia) and musculoskeletal systems (Dorsalgia of the lumbosacral and cervical levels). Limitations. The boundaries of the study are determined by studying the prevalence of diseases detected during periodic medical examinations among workers in protected ground in the vegetable grower profession and by studying the production factors that cause their occurrence. Conclusion. Working conditions in greenhouse vegetable growing continue to be harmful, presenting a risk of development and progression of chronic general somatic diseases among workers, which indicates the need for further research, including the identification of statistical patterns between indicators of the levels of exposure to factors and the likelihood of negative changes in health status.

Implementation of the provisions of the methodological platform standards for the assessment and management of occupational health risk for employees

Introduction. To substantiate and practical use of optimal management solutions to reduce risk levels, it is necessary to continue research on solving the main tasks of the scientific medical platform "Preventive Environment", aimed at creating technologies for early diagnosis of occupational and production-related diseases, an objective assessment of modern working conditions and the labor process, the development of biological monitoring system and risk management. The study aims to scientifically substantiate the model of interaction of individual elements of the working condition system and health of employees based on the risk level assessment of risk depending on the complex of harmful and/or dangerous factors of the production environment and the labor process in the main types of economic activity. Materials and methods. We have analyzed the results of a special assessment of working conditions at the workplaces of mining and coal industry enterprises, ferrous metallurgy plants and aluminum production. Experts have summarized the materials of occupational morbidity and its structure. To assess the risk of developing chronic general somatic diseases in workers the researchers have performed a cross-sectional epidemiological study. We have studied changes in biomarkers of exposure and effect in the conditions of professional exposure to mercury on the employee's body. Results. The analysis of modern working conditions of workers employed in mining (underground and open-pit mining), metallurgical enterprises (ferrous metallurgy plants, aluminum production), coal industry enterprises indicates that working conditions were and remain difficult and harmful, especially when performing underground mining operations. The assessment of occupational risk to the health of employees of mining and processing plants showed that the constant exposure to high levels of harmful factors - vibration, the severity of labor and the intensity of the labor process. This contributes to an increased risk of development and high spread of diseases of the circulatory system and diseases of the musculoskeletal system, as well as a significant increase in these indicators with an increase in work experience in harmful working conditions, which allows us to consider these diseases as production-related. Occupational morbidity at enterprises of the leading sectors of the economy decreased in 2020, most significantly at ferrous metallurgy plants. A comprehensive analysis of changes in biomarkers of exposure and effect in the conditions of professional exposure to mercury on the employee's body made it possible to identify groups at increased risk of developing health disorders. The analysis of a special assessment of working conditions, occupational and production-related morbidity of workers in certain sectors of the economy, as elements of the health risk assessment system, allowed us to develop Standards for enterprises in the mining and coal sectors of the economy, ensuring the preservation of workers' lives and health. Limitations. The studies have certain limitations, since they do not concern all sectors of the economy, but only the mining, coal industry, ferrous metallurgy plants and aluminum production. The period for which occupational morbidity was analyzed is 5 years (2016-2020). These limitations open the way for further research. Conclusion. The implementation of the developed provisions of the standards provides a risk-oriented approach in occupational health, being an important and necessary element of the formation of a preventive and preventive model of occupational risk management. Ethics. This study did not require the conclusion of the Ethics Committee.

HIGH LEVEL OF THE AMOUNT OF ECG PEAKS SV1+RV5–V6 PREDICT NEW CASES OF HYPERTENSION IN THE ORGANIZED POPULATION OF THE PETROCHEMICAL INDUSTRY WORKERS

Objective: Identify risk factors for new cases of hypertension according to a 10-year prospective study of the organized population of the petrochemical industry workers in Belarus. Design and method: New cases of hypertension were revealed according to a 10-year prospective study in 2004/2014 in the organized population of 1,431 workers of petrochemical industry. In 2004 871 subjects with normal blood pressure were divided into two groups. The first group included 260 workers without adverse working factors, the second group included 611 workers with adverse working factors. The survey included standard questionnaires for detection of cardiovascular risk factors, anthropometric measurements, data from instrumental and laboratory examination. Results: According to a 10-year prospective study, a high incidence of hypertension in the studied population was established (37.5%: 31.5% in persons without adverse working factors and 40.1% in persons with adverse working factors) (p < 0.05). A significant positive relationship was found between the incidence of hypertension and work in harmful working conditions (p < 0.05), the strongest connection of which had psycho-physiological factors of labor intensity (p < 0.01). There was revealed significant positive association between the amount of ECG peaks SV1+RV5–V6 (>24 mm) and the frequency of new cases of hypertension adjusted for age, sex and factor of working conditions (df = 1; x2Wald = 33,0; p < 0,001). There were identified other significant factors affecting new cases of hypertension after adjusting for age, sex and factor of working conditions: systolic (p < 0.001) and diastolic blood pressure (p < 0.001), heredity (p < 0.01), absence of higher education (p < 0.001), smoking in the past and present (p < 0.001), alcohol abuse (p < 0.001), low physical activity (p < 0.001), body mass index (p < 0,001), level of salt taste threshold (p < 0,001), level of triglycerides (p < 0,01), glucose (p < 0,001) and GFR (p < 0,001) according to multifactorial regression analysis. Development of hypertension was also associated with a lack of recreational activities (p < 0.001). Conclusions: In addition to classical risk factors level of the amount of ECG peaks SV1+RV5–V6 > 24 mm is a new predictor of development of hypertension in the Belarusian organized population.