Medical Examinations Of Workers Research Articles

Phenotypes of occupational bronchial asthma from the standpoint of immunopathogenesis

IIntroduction. Currently, occupational bronchial asthma is considered as a phe notypically and genetically heterogeneous disease. The assessment of clinical data, func tional features, and immunopathogenesis opens up new opportunities in assessing the development, predicting the characteristics of the course, and working out a personalized approach to pharmacotherapy of occupational asthma, as well as in developing an individ ual strategy for its prevention. The purpose of the study was to determine clinical and immunological markers of the risk of developing occupational asthma under conditions of exposure to sensitizing substances in various phenotypes of this disease. Materials and methods. The study included 170 patients with various OA phenotypes and 50 participants in the control group. The pulmonary function test was carried out on the CareFusion MicroLab Desktop Spirometer (Great Britain). The levels of IL-17, TNF-α, vas cular endothelial growth factor (VEGF), MCP-1, IFN-γ, and total IgE in blood serum were determined by solid-phase enzyme immunoassay using kits and reagents (OOO «Protein contour», «Vector-Best», «Diatex-E», «DIA-plus», «Pharmacia diagnostika»). Results. For the first time, the features of clinical and immunological manifestations in allergic and non-allergic OA phenotypes, as well as phenotypes of OA combination with occupational chronic obstructive pulmonary disease and metabolic syndrome were es tablished; the features of formation, immunopathogenesis, and prognosis in various phe notypes of occupational bronchial asthma were revealed. This allows recommending the determination of these immunological parameters during in-depth periodic medical exam inations of workers under conditions of exposure to sensitizing and irritating substances for differential diagnosis of various phenotypes of occupational bronchial asthma in a specialized inpatient examination. Limitations of the study. The study has regional (Samara region) and professional (in terms of detailing the working conditions in the studied comparison groups) limitations. Conclusion. The identified clinical, immunological, and genotypic features in various OA phenotypes and the established profiles of OA genotypes can optimize the approach to early diagnosis, prognosis, prevention, and pharmacotherapy of this disease, as well as expand the list of immunological study indicators used during preliminary and periodic medical examinations, in-depth examination of patients with occupational bronchial asth ma in occupational disease clinics and occupational pathology centers, and the application of new reliable criteria for predicting the course of the disease.

The Effect of Smoking on Work-Related Diseases and the Consequences of Exposure to Occupational Harmful Agents at Workplace

Background: Cross-sectional studies have shown that smokers have lower mental and physical health status than non-smokers. Smoking also has aggravating effects on workers who were exposed to the harmful factors of the work environment, noise, and asbestos. Materials and Methods: The present study is a review and similar to other review studies, it was done by examining the findings and results of other studies. In order to search for related materials, keywords and their synonyms were searched in medical databases and their contents were analyzed and classified into three areas. Results: These areas include "aggravating effects of smoking in workers exposed to noise", "aggravating effects of smoking in workers exposed to asbestos" and "the effects of smoking on cognitive performance of workers". Conclusion: The results of the studies showed that education about the aggravating effects of smoking on occupational diseases, medical examinations of workers, elimination or limitation of asbestos use, and conducting psychological tests can be suggested as suitable solutions that fit the culture and capabilities of the country’s health system.

Assessing the effectiveness of periodic medical examinations of workers working in harmful and hazardous working conditions in the Republic of Bashkortostan during the pandemic COVID-19

In recent years, throughout the Russian Federation, in the conditions of the Covid -19 pandemic, there has been a sharp deterioration in the demographic situation, the mortality rate of the able-bodied population is increasing, the growth of which is undoubtedly influenced by harmful/dangerous working conditions. In the conditions of the COVID-19 pandemic, conducting and organizing periodic medical examinations proved to be a very difficult task, as a result of which their quality continued to deteriorate. The final acts and annual reports on the results of medical examinations in the Republic of Bashkortostan for 2019–2020 were used to perform the work. At the enterprises of the republic, out of 1 million 190 thousand employees, 32.4 % work in conditions that do not meet hygienic standards. In the context of the COVID-19 pandemic, the percentage of coverage of employees with periodic medical examinations in 2020 decreased sharply compared to 2019 and ranged from 70.0 to 95.6 % in different regions; the detection of persons with signs of occupational disease also decreased by 20 %, which led to a sharp decrease in occupational morbidity rates. Despite the difficult epidemiological situation, conducting medical examinations should remain the most important task of general practitioners and occupational pathologists. A decrease in the quality of inspections directly negatively affects the health of workers and causes significant economic damage.

Poisoning from tellurium and its toxic compounds in industry

Tellurium has been primarily used in the steel industry for the past 40 years. This material is used for the manufacture of solar cells, lasers, photoresistors, and counters of radioactive radiation. Cadmium tellurium batteries are the second most popular solar technology. Another important application of tellurium is in the manufacture of thermoelectric generators. In the metallurgical industry, tellurium is used as an additive to metals and alloys. Tellurium and its compounds enter the body mainly through the respiratory system, as well as through the mouth and skin. Penetration into the body through the respiratory tract causes nausea, bronchitis, and pneumonia. The tellurium compounds are restored to elementary tellurium or amenable to methylation (methyl telluride has a characteristic garlic odor; it is less toxic than tellurium) in the body. Tellurium is excreted through the kidneys and gastrointestinal tract. Methyl telluride is excreted from the body partially with exhaled air and with sweat. For the diagnosis of acute heavy metal poisoning, blood is mainly used. The use of updated algorithm-criteria for assessing the severity of clinical manifestations of systemic organ toxicity of poisons provides an appropriate level of diagnosis of disorders of vital body functions. Treatment of such patients should include antidote and symptomatic therapy depending on the severity of clinical manifestations. To prevent the development of telluric intoxication, first of all, it is necessary to apply maximum sealing and automation of production processes. It is also necessary to introduce ventilation in production facilities and to carry out preliminary and periodic medical examinations of workers without fail. The use of personal protective equipment is also required.

ОТЧЕТ САНИТАРНОГО ИНСПЕКТОРА О МЕДИЦИНСКОМ ОБСЛЕДОВАНИИ ТИПОГРАФСКИХ РАБОЧИХ ГОРОДА ОМСКА В 1923 Г.

This paper presents an unpublished source that examines the state of health of workers of Omsk printing houses in the period of the new economic policy. At present, the study of the social sphere of the early 1920s, when the origin and formation of social development in Russia took place, is of great importance. The authors review a range of studies devoted not only to the health care system and the influence of the principles of NEP in the formation of social policy of the Soviet government, but also the hygienic characteristics of work and health workers to identify occupations and disease risk, and so on. In the early 1920s, in the context of the difficult economic situation in the country, government agencies carried out activities aimed at studying jobs, the health of employees, and their medical care. During the study period, the work of labor protection was of great importance, the sanitary inspectors of which were engaged in assessing the sanitary and hygienic state of enterprises, as well as examining the state of health of workers together with doctors. The method of historicism was used in the work, which allowed us to analyze the material in accordance with the real meaning of the facts, to consider the report under study taking into account the specific historical conditionality. The published document is kept in the Historical archive of the Omsk region and contains information about the medical examination of workers of the printing industry in the summer of 1923. The report was compiled by the sanitary inspector of labor protection of Omsk based on the results of a survey of five printing houses, as a result of which 254 people were examined. Among the main diseases found in printing workers were: lung and heart diseases, lead poisoning, typhus. The publication is addressed to researchers of the history of industry, the development of health care, the sanitary state of cities and the health of workers in Western Siberia in the early 1920s.

Mandatory medical examinations of workers in the context of the COVID-19 pandemic

The experts of the Ministry of Labor, in their letter dated April 10, 2020, explained the procedure for conducting mandatory medical examinations of employees during the period of restrictions related to the spread of a new coronavirus infection.

Substantiation of the value of dermatoscopy methods for medical examinations in patients working with carcinogens

Introduction. Industrial carcinogens are one of the causes leading to malignancy of epithelial neoplasms of the skin. The aim of study to assess the importance of conducting dermatoscopic research methods during periodic medical examinations of workers with industrial carcinogens. Materials and methods. 108 employees of the enterprise of Moscow were examined at periodic medical examinations of KPO FSBSI Izmerov Research Institute of Occupational Health. According to the special assessment of working conditions for harmful factors and types of work, a contingent of 60 people who had contact with industrial carcinogens and 48 people who did not have contact with industrial factors was identified. A complex of clinical-anamnestic and diagnostic methods was performed. Clinical research-interview of the patient, study of the patient's medical history, complaints, heredity, Constitution, professional activity, skin type and harmful effects; duration of existence and dynamics of changes in the size of the neoplasm. Visual examination of the patient's skin under natural and side lighting using a magnifying glass with 7x magnification. Physical examination of the primary skin tumor: the shape, color, size, and boundaries of the neoplasm were preliminarily evaluated. Epiluminescent surface microscopy (dermatoscopy) of each suspected pigmented neoplasm was performed using a Heine Delta 20 Dermatoscope (Heine Optotechnik, Germany). During dermatoscopy, in order to make the surface layers of the skin more transparent, oil was applied to the surface of the neoplasm. Digital photos during dermatoscopy were taken using a Nikon D 3100 18-55 II Kit digital camera, which was connected to the Dermatoscope by a Nikon UR-E15 adapter ring. Industrial carcinogens are one of the causes leading to malignancy of epithelial neoplasms of the skin. Results. According to the results of the study in a group of patients, it was found that workers who had contact with industrial carcinogens, epithelial skin neoplasms were much more common and more common at a young age (from 18 to 39 years), compared with patients who did not have contact with carcinogens at work. It was also revealed that epithelial neoplasms of the skin are most often diagnosed with longer work experience. It is noted that in patients who have contact with industrial carcinogens, even with work experience of up to 10 years, epithelial skin neoplasms are more often detected. Conclusions. There are good reasons to believe that exposure to industrial carcinogenic factors significantly increases the risk of developing skin neoplasms. The use of dermatoscopic diagnostic methods will allow timely detection of benign skin neoplasms in persons who have contact with industrial carcinogens during preventive medical examinations and thereby reduce the risk of malignant neoplasms.

Erythrocyte and reticulocyte parameters during biological monitoring of lead exposure to the body

Introduction. The most susceptible to lead is the hematopoietic system of hematopoietic organs due to lead inhibition of heme and globin synthesis and cytotoxic effect on the membrane of Mature red blood cells. The aim of study was to evaluate the informative value of the study of erythrocyte and reticulocyte parameters determined on modern hematological analyzers in patients working in contact with lead during medical and biological monitoring. Materials and methods. 45 employees of the lead battery processing plant and 30 persons of control group were examined. The level of lead in the blood was determined by atomic absorption spectrometry, δ-ALA in the urine-by the reaction of pyrol formation with acetylacetone in terms of gram of creatinine, the study of hematological parameters was performed on a Sysmex HT-2000i analyzer. Statistical processing of the results was performed using the program STATISTICA 10.0. Results. Significant changes in erythrocytic (RDW) and reticulocytic (RET, IRF, LFR, MFR, HFR, RET-He) parameters, erythropoietin in workers in contact with lead compared to the control group, changes in MCV, MCH, RDW, RET indicators in the group working in dynamics after 2 years were revealed. Associations of hematological parameters with biomarkers of exposure and effect (lead level in blood and ALA in urine) were revealed. Conclusions. Assessment of erythrocyte (MCV, MCH, RDW) and reticulocyte parameters (RET% and their distribution by maturity) in dynamics during periodic medical examinations of workers in contact with lead allows us to detect the development of hematological disorders at early stages.

On the relationship of anthropogenic air pollution by particulate matter with cancer risk

In the review the author highlights contemporary concepts about the relation between the air pollution by the particulate matter (PM) and human morbidity and mortality due to oncological diseases (OD). The author used materials of the articles indexed in the PubMed and RISC databases. The role of air pollution by PM as a risk factor of carcinogenesis in dependence on size, origin, chemical composition and concentration in air is discussed. PM of road-transport origin contains transitional metals acknowledged as most dangerous and is the result the operational wear of motor transport, road surface, and vehicle emissions. Long-term exposure to PM with an aerodynamic diameter ≤2.5 increases risk of appearance of OD of different localization. Dose-dependent action of PM was established. Reduction in air pollution by PM is accompanied by decrease of premature mortality of population, including from OD, and it can be examined as a modifiable risk factor. The results of the meta-analysis of literature data about the economic damage, caused by morbidity and mortality from OD led to the conclusion that reduction in PM concentration is the most realistic and effective method to decrease these social and economic losses. The accumulated carcinogenic risk provides for the lifelong probability of the development of OD, which requires the active medical examination of workers after the curtailment of work with carcinogens for early diagnostics and treatment of OD. The important preventive measure is to decrease the level of air pollution independently on their initial concentration.

Actual issues of medical examinations of workers in organizations using sources of ionizing radiation

Medical examinations for employees of organizations using sources of ionizing radiation, have a number of features, including the need for a «specialized» medical examination with mandatory psychophysiological examination.

Features of using the results of periodic medical examinations in the planning of preventive measures

The comparison of the results of periodic medical examinations of workers, which showed the presence of significant differences in the leading classes of diseases depending on the source of data that must be taken into account when planning disease prevention.

Features of the functional state of professionally significant body systems of operators and machinists of a petrochemical enterprise depending on their work experience

Introduction. As a result of large-scale modernization of technological processes, the organism of workers in the petrochemical industry is affected by low intensity factors. With an increase in exposure time under the influence of such factors, the response of the body is characterized by various changes in physiological status, however, until now, medical examinations of workers in petrochemical enterprises have a clinical focus. In this regard, it becomes extremely important to systematically study the physiological functions of workers, considering their working experience for early detection of the adverse effects of the work environment and the development of effective preventive measures.The aim of the study is to evaluate the features of the functional state of the organism of operators and operators of a petrochemical enterprise, depending on the length of service.Materials and methods. To identify the features of the functional state of the body, 78 operators and 68 drivers, depending on the length of service, were divided into three subgroups. The functional state of the central, autonomic nervous and cardiovascular systems was studied, and the level of biological adaptation and working capacity of workers were determined. The functional state of the central nervous system is assessed by indicators of the functional level of the nervous system, the stability of the nervous reaction, the level of functionality of the formed functional system and the level of performance on the hardware-soft ware complex.Results. It was revealed that with an increase in seniority, the operators of the petrochemical enterprise changed the indicators of the functional state of the body, as evidenced by a decrease in the time of simple visual-motor reaction by 1.5 times, an increase in the rates of sympathetic activity of the autonomic nervous system by 1.7 times, and an increase in 1.4 times the adequacy of regulation processes against a 1.7-fold increase in the vegetative rhythm indicator, which characterize increased disorganization in the intersystem interactions of central and an independent contour of regulation of physiological functions. With an increase in seniority, typists noted an increase in the parasympathetic activity of the autonomic nervous system by 1.3 times, as well as an increase in the autonomic regulation rate by 1.2 times, which indicates a strengthening of the autonomous regulation loop by physiological functions.Conclusions. The workers of the main professions of the petrochemical enterprise with an increase in their seniority noted the development of long-term adaptation, which is confirmed by a decrease in the number of workers with an unsatisfactory level of adaptation and an increase in operators and drivers with a normal level of working capacity.Funding. The study had no funding.Conflict of interests. The authors declare no conflict of interests.

Medical service as a part of everyday life of workers of the ferrous metallurgy enterprises in the first half of 1950s.

The aim of the study is to analyze medical aid given to the workers of ferrous metallurgy enterprises in the first half of the 1950s. Primary medical unit provided medical aid for workers of the ferrous metallurgical enterprises. Because of the lack of medical unit at the metallurgical plant or because there was no medical institutions in the organizational structure of the medical unit, local medical institutions provided the workers with medical care. During the first half of the 1950s, was the problem of the lack of medical staff in the medical institutions caused by insufficient material and household support. It did not allow implementing the shop principle of medical service of metallurgists. At the enterprises, individual shops did not have a factory’s sectorial doctor, or the number of workers assigned to a factory’s sectorial doctor exceeded the norm. Because the local hospitals, which controlled the health post at the ferrous metallurgy enterprises of the Zaporizhzhya region, were placed at a considerable distance, ‘the shop principle’ was not implemented there at all. The personnel problem also affected the formation of queues, which were a characteristic feature of the medical care provided to the workers. Work overload of physicians led to a quick examination of the patients, resulting in mistakes in the diagnosis. Contrary to accepted laws aimed at improving the quality of diagnosis, the periodic medical examinations of workers were not always carried out qualitatively, and the medical examination was carried out in a number of plants partly. In the first half of the 1950s the enterprises of the ferrous metallurgy of Zaporizhzhya region had a problem that the medical institutions were on a far distance and the percentage of patients needed medical help reduced. Lack of hospital beds had caused the untimely hospitalization of patients that prevented recovery of their. Many of the medical institutions were located in the old or non-specialized buildings with limited space, stove heating and primitive food units, without household premises and sewage. Characteristic of the medical services of metallurgists were depreciation of the material fund of medical institutions, lack of medicines, medical equipment. Not all medical institutions were provided with ambulances. There were cases of refusal to leave for a challenge or untimely provision of emergency care. It was concluded that the level of medical services given to the metallurgists in the first half of the 1950s was insufficient, despite the fact that they were workers of one of the leading branches of the Soviet economy.

The Quality Improvement of Periodic Medical Examinations of Working People and Professional Aptitude Expertise

Aims - to analyze the historical aspects of the formation of the national normative framework in the field of primary and periodic medical examinations, to discuss the existing problems in the carrying out of primary and periodic medical examinations of workers and also to make suggestions for quality improvement of primary and periodic medical examinations and for introduction of occupational risk assessment into the practice of primary and periodic medical examinations. Conclusion. For quality improvement of primary and periodic medical examinations, for efficiency improvement of primary and secondary prevention of occupational diseases it is considered to be necessary to take the following suggestions: - fuller coverage of working people by periodic medical examinations; - thorough selection of organizations that perform the special assessment of working conditions; - the use of the results of the special assessment of working conditions for improving working conditions and informing workers about working conditions; - implementation of occupational risk assessment into practice of primary and periodic medical examinations; - the use of modern methods of molecular and genetic screening;

A Possibility of study of vascular wall hardness during periodical medical examinations with the aim to reveal risk groups of cardio-vascular pathology

On basis of approbation of volume sphygmography method in group of 89 workers underwent periodical medical examinations, analysis of modern scientific literature, and experience of clinical department of FBSI «Nizhny Novgorod research institute for hygiene and occupational pathology» to conduct medical examinations of workers exposed to hazardous and dangerous working conditions; the authors demonstrated informativeness and non-high laboriousness of volume sphygmography method for revealing of an increased vascular wall hardness as a risk factor for of cardio-vascular pathology.

Сучасний стан та шляхи покращання організації та контролю за медичними оглядами працюючих у шкідливих і небезпечних умовах

Сучасний стан та шляхи покращання організації та контролю за медичними оглядами працюючих у шкідливих і небезпечних умовах

Prevalencia de los factores de riesgo cardiovascular en trabajadores de los sectores laborales secundario y terciario

The medical examination of workers is an opportunity for the early detection of factors of cardiovascular risk.

Clinical characteristics of the patients with occupational chronic carbon disulfide poisoning in a chemical fiber factory of Nanjing

To analyze the clinical characteristics of 267 cases with occupational chronic carbon disulfide (CS(2)) poisoning and to provide the basis for revising the items of periodical medical examination of workers occupationally exposed to CS(2). The subjects of present study were 267 patients with mild CS(2) poisoning diagnosed according to "Diagnostic Criteria of Occupational Chronic Carbon Disulfide Poisoning (GBZ4-2002)" from April in 2006 to May in 2010. All patients were from the same chemical fiber factory. When a subject was diagnosed as patient with CS(2) poisoning, who should interview with questionnaire which included the illness and occupational history, symptoms, individual habits. The physical examination, nervous test, cardiovascular test, biochemical test and electromyogram were performed. The rate of decreased motor conduction velocity was 87.3% (233/267 roots). The highest detection rate of slowing conduction velocity was the common peroneal motor nerve which was 48.6% (138/248 roots) and the second was median motor nerve with delay rate of 37% (155/419 roots). The main symptoms of the patients were neurasthenia, numbness and paresthesia. The rates of abnormal achilles tendon reflex and knee jerk reflex in patients were were 79.4% and 49.8%, respectively. The detected rates of patients with ST-segment changes and hypertension were 19.1% and 27.5%, respectively. The rates of hypertension, systolic pressure and diastolic pressure were 27.3%, 22.5% and 21.1%, respectively. The rates of lactate dehydrogenase (LDH), triglycerides (TG) and low density lipoprotein (LDL) were high. The detected rates of urine acid, indirect bilirubin and total bilirubin in male patients were higher than those in female patients. In addition, the abnormal detected rate of urea nitrogen and indirect bilirubin increased with exposure years. Occupational chronic CS(2) poisoning mainly affects the nervous system, as well as liver and kidney function. Detecting the median and common peroneal motor nerve conduction velocities could be the screening indicators for the peripheral nerve injury induced by CS(2) in the occupational exposure population during the periodical occupational medical examinations.

Cost-Effectiveness of Safety Measures in Enterprises

Safety auditing is a systematic method to evaluate the company’s safety management system. The main task of auditing is to establish whether the correct types of safety methods are used and whether they are effectively implemented. The safety auditing in Estonian enterprises (on the basis of European Union legislation, Standards OHSAS 18001:1999 and BS 8800:1996) is only in the beginning stage. As the prerequisite to the paper the safety auditing in 12 medium- and small-scale enterprises in Estonia from 5 branches of industry (metal and wood processing, plastic, garment and printing) has been carried out. The modified Diekemper & Spartz (DS industrial hazard control; fire control and industrial hygiene; supervisory participation, motivation and training; accident investigation, statistics and reporting procedures. The maximum score was gained in the plastics industry: 62.9% and the minimum score in a printing industry: 40.9%. Economically developed enterprises have possibilities to pay also more attention to safety matters. The cost-effectiveness of the planned safety measures is calculated. The method considers the cost, the effectiveness and the uncertainty of the safety measure (Roed method). These three variables integrate the cost-effectiveness of a safety measure. The most cost-effective measures by investigated industries were: provide the workers with protective footwear in metal industry; the analysis of the spectrum of noise in printing industry; analysis of chemicals in the workrooms’ air (risk analysis of chemicals) in plastic industry; the analysis of chemicals and medical examinations of workers in wood processing industry; advanced training of workers to prevent the injuries with fingers in garment industry. The safety policy and safety plan that set the framework for health and safety activities in enterprises are usually not available in written form in Estonian firms. In addition, there is a need for raising the awareness of workers in the field of occupational health and safety. Supervisory participation, motivation and training were the activities that received quite low scores. The recommendations to the employers were given: to improve the information of workers, motivation to use the personal protective equipment and to carry out continuing training of workers as well as the leaders in work safety and health.

Epidemiologic and immunologic studies in processors of the king crab

Following the report of ten cases of respiratory illness in processors of frozen king crab, we investigated the conditions of work and the pulmonary and immunologic status of the workers in three crab-processing and one fish-packing (control) plant. Pulmonary function was measured before and after work, and skin tests were performed in subgroups matched for age, sex, and duration of current employment. The antibody response to king crab antigens was examined in sera from the subgroups and another (unrelated) control group. Extracts of crab meat, shell, and processing dust were used for skin testing and precipitin detection. FEV1, FVC, and MEFR decreased during the day in two crab processors, and precipitins were evident in sera from nine, but findings were normal in the fish packers. Crab meat elicited the strongest response, with multiple precipitin bands in some cases. Control sera showed no reaction. There was correlation between serology, results of skin tests, and symptoms. It is concluded that the inhalation of aerosolized crab antigen(s) may cause respiratory symptoms and can cause immunologic effects similar to those caused by other occupational respiratory allergens. We recommend preplacement and periodic medical examination of workers in crab-processing plants, improved ventilation in processing areas, and programs to discourage smoking.