Periodic Medical Examinations Research Articles

INVESTIGATION OF A FOCUS OF BRUCELLOSIS AMONG ANIMALS AND PEOPLE IN THE REPUBLIC OF TATARSTAN

Over the past 3 years, the Russian Federation has seen an increase in the incidence of newly diagnosed brucellosis. The problem of brucellosis remains important in regions with developed livestock farming; however, cases of diseases in animals and humans can also be recorded in other regions of the country.
 The article describes an outbreak of brucellosis in a peasant farm in the Novosheshminsky municipal district of the Republic of Tatarstan, affecting 148 heads of cattle and 4 farm employees. The disease was caused by Brucella abortus. An analysis of maps of the epizootic and epidemiological survey of the outbreak, acts on the sanitary and epidemiological survey, and sanitary and hygienic characteristics of the working conditions of workers was carried out. Data from the case histories of 4 peasant farm workers with brucellosis are also presented.
 The most likely cause of the epizootic was the unauthorized import of cattle, and human diseases were caused by non-compliance with working conditions and personal protective measures for farm workers.
 Conclusion: Cases of brucellosis in our days are more often recorded in endemic areas. However, with defects in veterinary and sanitary control in any territory, epizootics are possible, which pose a serious danger both in terms of the damage they cause to the national economy and the possible infection of people, primarily belonging to professional risk groups. The disease does not have pathognomonic symptoms and can be suspected only if doctors are alert, evaluate the results of preliminary and periodic medical examinations with laboratory examinations of “at-risk” populations, and subject to a thorough collection of epidemiological history.

Smoking and determination of workworthiness in industrial enterprises of the highlands

The formation of an evidence base for regulatory documents in the field of preliminary and periodic medical examinations is one of the urgent tasks of occupational health in the coming years. In the process of transition to a risk-based approach in occupational health, including in determining suitability for work, objective verification of risk is necessary, and the decision on suitability should be made on its basis. Suitability for work in the unique conditions of the highlands remains one of the least studied topics, since there are only isolated observational studies, the results of which are also not taken into account in the traditional approach of determining suitability. The article provides a brief overview of the association of smoking with various outcomes when working in the highlands. Smoking significantly worsens the prognosis of all outcomes studied in these studies, including even the likelihood of quitting work. The article concludes that it is necessary to plan studies of various outcomes, which can be used as a basis for supplementing and changing the regulatory framework for conducting medical examinations of employees. Particular attention is paid to the need to take into account, among other risk factors, a comprehensive risk assessment when determining suitability for work in mining in the highlands.
 Ethics. The study did not require permission.

Vibration disease: assessment of erectile function and androgen balance

The article presents the data on the effect of vibration disease caused by exposure to local vibration on the state of male sexual function. The presence of erectile function in subjects with vibration disease, depending on its severity, is shown, which indicates the role of local vibration in the formation of erectile function and raises the problem of early prevention and timely treatment of identified disorders. Interaction disturbances in the hypothalamic-pituitary-gonadal system were identified in men with vibration disease caused by exposure to local vibration. Mandatory periodic medical examinations of enterprise employees whose work involves exposure to local vibra tion should be carried out once every 5 years at the occupational pathology center of a constituent entity of the Russian Federation (according to Order of the Ministry of Health of Russia No. 29n dated January 28, 2021). When conducting such medical examinations, we recommend involving neurologists and urologists-andrologists and expanding the list of instrumental research methods to include methods for assessing erectile function.

Safety measures in the workplace: a case study of Federal Road Safety Corps (FRSC) vehicle plate manufacturing plant, Ojodu – Lagos, Nigeria

Introduction: Hazards associated with vehicle number plate manufacturing processes in developing countries have not been well elucidated. There is a need to investigate hazards in the vehicle number plate manufacturing plant. The study aimed to identify self-reported hazards in the vehicle plate manufacturing factory, explore their effect on workers’ health and recommend mitigation strategies. Methods: A descriptive cross-sectional study of workers in the vehicle plate manufacturing plant was done to identify hazards, protective measures and self-reported effects on workers’ health. Biochemical analysis of blood samples was also done and outliers were noted. ANOVA test was performed to determine differences in mean values of selected biochemical parameters. A p-value of less than 0.05 was considered statistically significant. Results: Exposure to toxic chemicals 38(69%), excessive noise 36 (65%) and heat 28 (51%) were the major hazards in the factory. Major health problems were stress and fatigue 41 (71%), skin disorders 28 (51%), respiratory problems 18 (33%) and hearing loss 16 (29%). More than one quarter, 17 (30 %) of the workers admitted not using personal protective equipment (PPE) regularly. Periodic medical tests were not done for 13 (24%) of the workers. Potassium (3%), Urea (10%), Creatinine (7%), Aspartate transaminase (18%) and Alanine transaminase (8%) were elevated among the workers but no significant association could be established between elevated levels and work post. Conclusion: Workers in the plate number manufacturing plant were mostly exposed to toxic chemicals and noise. Elevated electrolyte levels cut across departments. There is a need for better enforcement of safety rules, and periodic medical examinations should be conducted more consistently.

The influence of production factors on the formation of the health of workers in the production of synthetic rubbers, preventive measures

The petrochemical industry, which includes, along with the production of basic chemicals for the production of rubber, occupies one of the leading places in terms of potential chemical hazards to the health of workers. The high prevalence of CNID among workers of petrochemical industries is an important socio-economic problem. The issues of reducing the incidence of chronic non-communicable diseases, including those related to working conditions, the protection and preservation of the health of workers in petrochemical industries dictate the need to develop preventive measures. The aim of the study was to study the prevalence of chronic non-communicable diseases in synthetic rubber production workers. Clinical and hygienic studies have been carried out in the production of synthetic rubber. Harmful production factors were assessed at 80 workplaces based on the materials of a special assessment of working conditions and production control data. The health status of 674 employees was studied according to the results of periodic medical examinations. The surveyed workers were represented by apparatchiks (33.2 %), locksmiths for the repair of technological equipment (12.8 %), machinists of pumping and compressor units (10.7 %), locksmiths of KIP and A (9.1 %). A number of clinical and laboratory, functional research methods have been used to assess the state of health. At the workplaces of the production of synthetic rubber, an adverse effect of chemicals on the worker’s body in combination with industrial noise, the severity of labor and microclimate in certain working areas has been established. The working conditions of employees of the main professions are assigned to the third class of the first-second degrees of harmfulness (classes 3.1–3.2). It was found that there were 17.3 % of practically healthy individuals. Among the identified chronic non-communicable diseases, the leading place was occupied by diseases of the musculoskeletal system (31.1 %), disorders of the autonomic nervous system (28.7 %), myopia (22.0 %), hypertension (12.2 %) hearing impairment (10.3 %). When evaluating the results of biochemical blood tests, the most pronounced changes were found in the indicators of lipid metabolism. Excess values of total cholesterol were detected in 40.9 % of employees. A complex of therapeutic and preventive measures has been developed aimed at reducing the risk of the formation of chronic non-communicable diseases, including measures of primary and secondary prevention.

Problems of Occupational Injuries and Ways of Its Reduction on Example of Ukraine

Manuscript presents a study of the causes of accidents on the example of Ukraine in recent years, considering the peculiarities of the modern period. The relevance of this study is due to the high level of industrial injuries in Ukraine compared to the industrialized countries of the European Union. Data on the dynamics of the causes of accidents for the period from 2015 to 2022 are presented. Data for the study were taken from open sources of information. The most trauma-dangerous industries of the national economy are considered. Proposed measures to reduce the level of injury in Ukraine. The analysis of the obtained results showed a certain dependence of the causes of accidents on the coronavirus infection. An unchanging leading position in the organizational causes of accidents has been established. According to the results of the study, regularities were established regarding the most traumatic sectors of the economy in the presented years. The predominance of organizational causes of industrial injuries due to the low motivational component of occupational safety is shown. The need to improve training on occupational health and safety issues for employees at all levels was noted. It was established that the reduction of industrial injuries is impossible without the teaching of labor protection issues in institutions of higher education by future heads of structural divisions and leading specialists. Mandatory review and re-approval of the instructions, the violation of which led to an accident, is proposed. It is recommended to apply mandatory professional selection and more thorough control over periodic preventive medical examinations.

Assessing Workplace Violence: Methodological Considerations.

The risk of violence is present in all workplaces. It must be accurately assessed to establish prevention and protection measures tailored to the features of each situation. The risk management process requires compliance in a sequential order: 1) risk identification, 2) quantitative risk assessment, and 3) impact assessment. Gathering workers' experiences using lists, focus groups, or participatory ergonomics groups is necessary to identify the phenomenon. For risk assessment, spontaneous reporting of events is often insufficient. It may be complemented with two methods: systematic recording of violent events that occurred in the past year during periodic medical examinations of workers and targeted surveys. The epidemiological analysis of data from individual interviews and surveys provides the phenomenon's prevalence, incidence, and evolution. Moreover, reporting the harm suffered by victims of violence allows constructing impact matrices to allocate resources where they are most needed.

Phenotypic variants of occupational bronchial asthma (immune profile, cytokines, diagnosis and prognosis)

Currently, occupational bronchial asthma is considered as a phenotypically and genotypically heterogeneous disease. The assessment of immunological characteristics opens up new opportunities in assessing the disease development, predicting the characteristics of the course, and establishing a personalized approach to pharmacotherapy of occupational asthma, as well as in developing an individual strategy for its prevention. The purpose of the study is to determine immunological markers of the risk of developing occupational bronchial asthma under conditions of exposure to sensitizing substances for various phenotypes of this disease. Materials and methods. The study included 170 patients with various phenotypes of occupational asthma and 50 participants in the control group. The levels of immunoglobulins A, M, and G in serum were determined by the Mancini technique (radial immunodiffusion). The determination of the levels of cytokines IL-1β, IL-4, IL-6, IL-8, IL-10, IL-17, TNF-α, MCP- 1, and IFN-γ, total IgE, C-reactive protein, and fibronectin in blood serum was carried out by enzyme-linked immunosorbent assay using kits and reagents (OOO Proteinovy Kontur, Vektor-Best, Diateks-E, DIA-plus, Pharmacia diagnostika). To study the content of vascular endothelial growth factor (VEGF) in blood serum, we used a sandwich-type enzyme-linked immunosorbent assay with a set of reagents from eBioscience. Genotyping was performed by real-time polymerase chain reaction using primers and probes developed with the PrimerQuest program (Integrated DNA Technologies, Inc.). Results. For the first time, the study has established the features of immunological manifestations in allergic and non-allergic phenotypes of occupational bronchial asthma, as well as the phenotypes of the combination of occupational asthma with occupational chronic obstructive pulmonary disease and metabolic syndrome. The features of the formation, pathogenesis, and prognosis of various phenotypes of occupational bronchial asthma have been identified. This allows recommending the determination of these immunological parameters during in-depth periodic medical examinations of workers exposed to sensitizing and irritating substances for differential diagnosis of various occupational asthma phenotypes in a specialized inpatient examination. Limitations of the study. The study has regional (Samara Region) and professional (in terms of detailing working conditions in the studied comparison groups) limitations. Conclusion. The identified immunological features in various phenotypes of occupational bronchial asthma and the established profiles of occupational asthma genotypes can optimize the approach to early diagnosis, prognosis, prevention, and pharmacotherapy of this disease, as well as expand the list of immunological research indicators used during preliminary and periodic medical examinations, in-depth examination of patients with occupational asthma in occupational disease clinics and occupational pathology centers, and the use of new reliable criteria for predicting the course of the disease.

The relationship of polymorphisms of the SOD2, NOS3 and SIRT1 genes with hypertension in employees of the converter workshop of the ferrous metallurgy enterprise

Workers employed in ferrous metallurgy enterprises are affected by various oxidants, which lead to increased formation of free radicals, suppression of the antioxidant system, initiation of oxidative stress and the development of diseases characterized by high blood pressure. In this regard, the identification of polymorphisms of genes encoding enzymes that are associated with the formation and neutralization of free radicals is an important task of personalized medicine.
 The study aims to explore the relationship of polymorphisms rs4880 (SOD2), rs1799983 (NOS3) and rs7069102 (SIRT1) with hypertension in workers of the converter workshop.
 To conduct the research the authors used data from periodic medical examinations of men aged 30 to 59 years, including 116 employees of the converter shop and 169 representatives of administrative and managerial personnel (comparison group). Subsequently, we divided each group according to the principle of the presence or absence of a diagnosis of "hypertensive heart disease" (I11 according to ICD-10), established or confirmed during a periodic medical examination. DNA was isolated from peripheral blood using the Lumiere kit for the isolation of genomic DNA from whole blood and literal epithelium (Lumiprobe, Russia) in accordance with the manufacturer's instructions. The scientists performed genotyping using the optical PCR system with real-time optical detection QuantStudio 3 (Thermo Fisher, USA) and ready-made commercial sets "SNP-Screen" (Syntol, Russia).
 The ratio of the chances of developing hypertension in the personnel of the converter shop was increased in carriers of mutant genotypes of the SOD2 (TT) gene. Also, the values of blood pressure, total cholesterol and glucose levels were higher in carriers of the mutant TT genotype of the SOD2 gene compared with CC/CT, but only in the group of converter shop workers with hypertension. In addition, in the comparison group with hypertension, systolic and diastolic blood pressure significantly differed, the values of which were higher in carriers of the mutant GG genotype of the SIRT1 gene.
 Presumably, an excess of superoxide anion in the TT genotype of the SOD2 gene, together with exposure to harmful environmental factors, may contribute to the development of cardiovascular diseases in workers of the converter workshop.
 Ethics. The study was approved in accordance with Protocol No. 1 dated 02/26/2021 and the conclusion of the Local Ethics Committee of the Federal Budgetary Institution of Science "Yekaterinburg Medical Scientific Center for the Prevention and Health Protection of Industrial Workers" of Rospotrebnadzor.

Levels of work stress among information technology professionals during COVID-19 pandemic in an Indian metropolis.

Amid the ongoing Non-Communicable Disease and COVID-19 pandemic, understanding prevalence and characteristics associated with work stress is vital from a health and economic perspective, more so among information technology (IT) professionals. To estimate the prevalence and factors associated with work stress among IT professionals during the coronavirus disease 2019 (COVID-19) pandemic in Bengaluru, India. A cross-sectional study was undertaken on a convenient sample of 356 IT professionals in Bengaluru, India, between September 2020 and March 2021 to assess work stress. The weblink to TAWS-16 (Tool to Assess and classify Work Stress) was provided for IT employees to self-report their experience of work-related stressors and coping abilities in the past 6 months. The prevalence and specific prevalence of work stress were calculated. Multi-variate logistic regression was conducted to identify factors associated with work stress. Ethical clearance was obtained from the Institutional Ethics committee, National Institute of Mental Health and Neurosciences, Bengaluru. Informed consent was obtained from study subjects. The prevalence of work stress among IT professionals was 17.7% during the COVID19 pandemic, with higher rates among employees aged 31 years and above, among female employees, and among employees with 4-7 years of work experience. More than 80% of the professionals experienced deadline pressures, long working hours, regular multi-tasking, and difficulty in maintaining work-life balance. Based on the results, it is recommended to integrate work-stress assessment in periodical medical examination of IT employees from a health promotion and productivity improvement perspective.

ANALYSIS OF THE CAUSES OF VIRAL INJURIES THE WAYS OF YOGO'S DEGRADATION IN CURRENT REALITIES

In the presented work, an analysis of industrial injuries in recent years was carried out, taking into account the peculiarities of the modern period. The relevance of this work is due to the high level of industrial injuries and occupational diseases in Ukraine compared to the industrialized countries of the European Union. Data are given on the dynamics of the causes of accidents for the period from 2015 to 2022, taking into account changes in the classification of causes. The most injury-prone sectors of the economy in the above-mentioned period were considered and measures to reduce industrial injuries were proposed. Data for the study were taken from open sources of information. The analysis of the obtained results showed an unchanged leading position in the considered period of the organizational causes of accidents, despite the introduction of the fourth group of causes into the classifier. According to the results of the study, it was shown that the introduction of the fourth group of causes of accidents has an appropriate rationale, established patterns regarding the most trauma-hazardous branches of the economy in the years under review, and determined a low motivational component of occupational safety, which determines the predominance of organizational causes of industrial injuries. It was established that the reduction of industrial injuries is impossible without teaching occupational safety issues in higher education institutions by future heads of structural units and leading specialists. The need to improve occupational health and safety training for employees at all levels, as well as the use of mandatory professional selection and more thorough control over periodic preventive medical examinations, was noted.

Bronchial asthma and work in high-altitude mines

In occupational health, the management of patients with preliminary and periodic medical examinations for work in harmful conditions, for example, in high-altitude conditions, can be a difficult task. Bronchial asthma is one of the unequivocal contraindications to work in the highlands, however, in light of recent successes in achieving asthma control and the introduction of new types of therapy, this issue may require additional discussion. The article presents arguments both in favor of admitting patients with bronchial asthma to the highlands and against such a decision. The first group includes the elimination of allergens, long-term successes in the treatment of bronchial asthma in the highlands, as well as the fact that the decision not to allow it was popular in the era before the introduction of effective basic therapy for bronchial asthma with inhaled corticosteroids. The group of arguments "against" includes cold air, possible compensation only at relatively low altitudes, as well as remoteness, the inability to fully control compliance with patient requirements and the presence of typical industrial hazards in the form of allergens and irritants in production. It is particularly possible to emphasize the weakness of the evidence base, the extremely scarce number of published studies and the need for careful planning and conducting high-quality prospective observations of high-altitude mine workers, which can serve as a basis for the formation of an evidence base for adjusting admission conditions in the future.
 Ethics. The study did not require permission.

Functional disorders of the peripheral nervous system in metallurgical workers

Introduction. Early detection of functional changes in the nervous system makes it possible to clarify the etiopathogenetic effect of a whole set of adverse industrial factors, form a group at risk of occupational diseases, and develop preventive programs for given the main structural targets. 
 The purpose of the study was to identify characteristics of functional disorders of the peripheral nervous systems in metallurgists exposed to occupational hazards.
 Materials and methods. We examined two cohorts of workers: a control cohort of forty men unexposed to occupational risk factors and a case cohort of 60 male employees of a metallurgical plant situated in the Sverdlovsk Region. The cohorts were matched by age (mean: 38.8±7.6 years) and work experience (5.1±4.7 years). The mean duration of exposure to occupational hazards was 7.1±6.0 years. We included 38 cases in the program of in-depth neurophysiological examination that consisted of assessment of neurological status, electroneuromyography (ENMG).
 Results. 73.9 % of the cases had no complaints. Functional disorders of peripheral nerves were diagnosed as distal polyneuropathy of the upper and lower extremities (47.4 %), median neuropathy (42.1 %), ulnar neuropathy (23.7 %), and radiculopathies (9.6 %). Noteworthy is the presence of additional damages of the median nerve at the carpal tunnel in 55.6 % of the cases having signs of distal polyneuropathy.
 Conclusions. A comprehensive neurophysiological examination, not required by the current order for periodic medical examinations, helps to identify dysfunctions of the nervous system at their early stages. It is necessary to form high-risk groups of patients to monitor the development of work-related nervous diseases.

ASSESSMENT OF BIOLOGICAL AGE AND AGING RATE OF FOOTWEAR ENTERPRISES WORKERS

Biological age (BA), as a criterion for assessing health, can also be viewed as a marker of material aging resulting from occupational exposure to factors in the industrial environment.
 Aim. To determine the biological age and aging rates of workers in the footwear industry.
 Materials and Methods. The research group included 200 workers from footwear enterprises (119 males and 81 females) aged 25-62. They were distributed based on their primary workshops and occupational hazards as follows: isolated exposure to occupational noise (Group 1): 61 males and 35 females, combined exposure to occupational noise and chemicals (Group 2): 57 males and 47 females. The control group - 54 workers: 26 males and 28 females who were not exposed to these production factors during their work activities. Additionally, the workers were divided into groups based on their work experience in the profession: up to 5 years, 6-14 years, and 15-21 years. BA and aging rates were determined using the methodology developed by the Institute of Gerontology of the Academy of Medical Sciences of Ukraine.
 Results and Discussion. The presence of unfavourable occupational factors in constant workplaces, particularly in isolated (occupational noise) and combined (occupational noise and chemical substances) conditions, is a significant contributing factor to premature aging among workers engaged in footwear production. In Group 1 of male workers, the BA-NBA (normative biological age) index exceeded 5.22 [4.81; 6.11], in Group 2 - 7.79 [6.29; 9.11], compared with the control - 3.96 [3.21; 4.2]. For female workers, this difference is 4.81 [4.29; 5.22] and 5.84 [5.26; 6,44]. The maximum aging rates were observed in work experience groups up to 5 years, regardless of the combination of occupational factors and young workers (age group up to 30 years) in both gender groups were for Group 1 - 8.11 [7.55; 8.29] (male) and 6.37 [6.15; 7.01] (female); Group 2 - 11.68 [11.18; 12.49] (male) and 8.81 [8.39; 9.54] respectively. Aging rates drop down with age and job experience, which can be attributed to workers' improved capacity to adapt to challenging working conditions.
 Conclusions. The determination of BA in workers can be utilized at the preliminary and periodic medical examinations to determine occupational risk groups and profession selection, as well as to evaluate the effect of elements in the production environment and labour process on the functional state of the body.

Features of the frequency distribution of alleles and genotypes of the IL5 gene polymorphism rs2069812 in various phenotypes of bronchial asthma of professional genesis

Despite the fact that occupational bronchial asthma has long been considered as a separate, independent disease, in recent years, more and more attention has been paid to its heterogeneity. Phenotyping of occupational asthma was initially based on identifying combinations of clinical characteristics of the disease, but now an increasing amount of data is emerging making it possible to understand the cause of clinical differences at the molecular genetic level. Thus, molecular genotyping opens up new opportunities in the search for a more targeted and personalized approach to the treatment of occupational bronchial asthma, as well as in the development of an individual strategy for its prevention. The purpose of the study is to determine genetic markers of the risk of developing occupational asthma under conditions of exposure to sensitizing substances by assessing the IL5 rs2069812 polymorphism. Materials and methods. The study was conducted on the basis of the Department of Occu pational Diseases and Clinical Pharmacology named after honored scientist of the Russian Federation professor V. V. Kosarev, FSBEI HE Samara State Medical University of the Ministry of Health of Russia, and the Department of Occupational Pathology, Regional Center of Occupational Pathology, SBHI SR Samara Medical and Sanitary Unit No. 5 of the Kirov District. The study was carried out on 170 patients with various phenotypes of occupational bronchial asth ma and 50 participants in the control group: group 1 (42 patients) — phenotype «occupational asthma, allergic form», group 2 (36 patients) — phenotype «occupational asthma, non-allergic form», group 3 (58 patients) — phenotype «occupational asthma — occupational chronic obstructive pulmonary disease», group 4 (34 patients) — phenotype «occupational asthma — metabolic syndrome», group 5 — control group (healthy), 50 participants. As part of the study of genetic predisposition to occupational bronchial asthma, IL5 rs2069812 polymorphism was determined. DNA samples were isolated from peripheral venous blood lymphocytes using phenol-chloroform extraction. Genotyping was performed by real-time polymerase chain reaction using primers and probes designed using PrimerQuest (Integrated DNA Technologies, Inc.). Results. Thus, for the first time, the genetic markers of the risk of occupational asthma under exposure to sensitizing substances, i.e. IL5 rs2069812 polymorphism, have been identified, which makes it possible to recommend the determination of this genetic marker during indepth periodic medical examinations of individuals working under conditions of exposure to sensitizing and irritating substances in the presence of clinical, functional, and immunological changes. Conclusion. The identified marker profiles of genotypes of occupational bronchial asthma can optimize the approach to diagnosis, treatment, and prevention of this pathology, as well as expand the range of criteria for predicting the course of the disease. When IL-5 polymorphism is detected during molecular genetic studies, patients need to be linked to care and undergo repeated pulmonary function tests once every 6 months and in-depth periodic medical exami nations in a specialized occupational pathology center with the mandatory participation of a pulmonologist, allergist/immunologist, and occupational pathologist, as well as with conducting extended functional and immunological studies once every 2 years.

Formation of a healthy lifestyle as a tool to reduce the risk of developing chronic non-communicable diseases

Relevance. The formation of a healthy lifestyle is an important task facing not only the healthcare system, but also the state as a whole. Therefore, monitoring of risk factors and the attitude of the population to a healthy lifestyle is necessary for strategic decisions.The purpose of the study – assessment of the awareness of the population of Moscow about the importance of maintaining a healthy lifestyle for the prevention of the development of chronic non-communicable diseases.Materials and methods. A survey of 100 people (50 men and 50 women) aged 20 to 60 years was conducted. The attitude of the population to a healthy lifestyle, alcohol and tobacco use, the frequency of sports, resistance to stressful situations, as well as to periodic medical examinations were evaluated.Results. The data of the survey, as well as the growing incidence, confirm the irresponsible attitude of the population to their health, as well as the identification of risk factors for the development of chronic non-communicable diseases in a large number of patients.Conclusions. To form a unified preventive environment, it is necessary to improve the quality of the environment, working conditions, the availability of food of proper quality, income levels, housing conditions, as well as to develop urban infrastructure. It is also important to understand that in addition to the participation of all branches of the state in the formation of preventive medicine, it is necessary to instill in the population the need to take care of their own health independently. Rational nutrition, physical activity (walking, running, sports), restriction of alcohol and tobacco use, create a healthy behavior model and, as a result, reduce the risk of developing non-communicable diseases.

Оценка липидного спектра и C-Реактивного белка крови у работающих в Арктической зоне России

Adaptation to the extreme living conditions of the North causes dyslipidemia, a risk factor for cardiovascular diseases (CVD), in people working there. This study aimed to assess the level of lipids and C-reactive protein (CRP), a marker of inflammation in CVD cases, in the blood of men staying in the Arctic and Subarctic zones of Russia. Accordingly, the sample was divided into two group, Arctic and Subarctic, the former included 51 participants, aged 35.7 ± 0.6 years, the latter — 54 individuals, aged 34.2 ± 0.9 years (p = 0.167); the duration of their work/stay in the Arctic and Subarctic zones was 7.1 ± 0.2 and 6.4 ± 0.6 years (p = 0.447), respectively. We sampled blood of the participants and measured triglycerides, total cholesterol, low (LDL) and high (HDL) density lipoproteins, atherogenic index (AI), CRP content. Arctic group had higher levels of triglycerides (1.71 ± 0.03 and 1.38 ± 0.14 mmol/l, p = 0.021), total cholesterol (6.15 ± 0.08 and 5.47 ± 0.14 mmol/l, p =0.001), HDL (1.5 ± 0.06 and 1.1 ± 0.04 mmol/l, p = 0.001); the values of LDL did not differ significantly between the groups (4.07 ± 0.08 and 4.1 ± 0.15 mmol/l, p = 0.88), and AI and CRP values (3.41 ± 0.18 and 4.18 ± 0.2, p = 0.007; 3.41 ± 0.18 and 4.91 ± 0.22 mg/l, p = 0.006, respectively) were greater in the Subarctic group. By triglycerides, dyslipidemia was diagnosed in 49.0% and 18.4% of Arctic and Subarctic participants, respectively, by total cholesterol — in 98.0% and 57.8%, by LDL — in 94.1% and 88.0%. As for HDL, their level was lower than normal in 2.0% of the Arctic group subjects and 36.7% of the Subarctic group subjects, which means a higher risk of cardiovascular diseases in the Subarctic region. The level of CRP indicated that 90% of the Arctic group participants were at risk of CVD (moderate risk for 23.5%, high risk for 66.7%), and in the Subarctic group this number was 100% (moderate risk for 7.7%, high risk for 88.5%). The likely reasons behind this are the specifics of nutrition and living conditions. Program of prevention of CVD in the Arctic zone should include lipid profile and CRP tests as part of every periodic medical examination, regardless of age. It is necessary to implement dyslipidemia alimentary correction measures.

A systematic approach to assessing the effectiveness of personal protective equipment for the skin from the effects of industrial factors

Introduction. The causes of occupational skin diseases in 40% of cases are in the absence or unsatisfactory condition of dermatological personal protective equipment. Professional protective skin care remains the main requirement of occupational safety.
 The concept of skin screening is giving way to a new approach — the restoration of its own epidermal barrier. Etiopathogenetic prevention technologies are based on inactivation of irritating chemicals and allergens, binding and neutralization of heavy and alkaline earth metal ions, as well as platinoids. The safety assessment of dermatological personal protective equipment is regulated by the state and in accordance with TR CU 019/2011 "On the safety of personal protective equipment", and the effectiveness assessment is voluntary for manufacturers.
 The study aims to develop a scheme for conducting clinical testing of evaluation of dermatological personal protective equipment for workers exposed to certain production factors.
 Materials and methods. Skin tests are a standard method of allergological diagnosis.
 In order to exclude additional sensitization that occurs when taking skin samples with a production allergen, for the reliability of detecting preclinical manifestations of sensitization, the researchers used an in vitro diagnostic method (determination of specific immunoglobulin E — Ig E). To assess the effectiveness of dermatological personal protective equipment on persons working in contact with nickel-containing compounds, the authors determined the nickel content in the blood by atomic absorption method. They evaluated the barrier function of the skin using the "Skin-o-mat" device from "Cosmomed GmbH", Germany.
 Results. The specialists proposed a scheme for conducting clinical testing of the evaluation of dermatological personal protective equipment for workers, including an assessment of the barrier function of the skin and in vitro diagnostic methods. The authors evaluated the parameters in dynamics — before and after using. This scheme makes it possible to exclude additional sensitization of employees.
 Limitations. The study is limited by the number of workers who underwent periodic medical examinations at the clinic of Izmerov Research Institute of Occupational Health who have contact with nickel compounds in the workplace.
 Conclusion. The etiopathogenetic clinical approbation of the evaluation of the effectiveness of dermatological personal protective equipment on workers in production conditions includes an assessment of the skin and an assessment of the barrier-protective function of the skin with the fixation of indicators. To study the effectiveness of skin protection products, an important point is the rational and reasonable selection of groups of approbants on which the study of the protective properties of these products will be carried out.
 Ethics. The authors have carried out the study in accordance with the Ethical standard set out in the Helsinki Declaration of the World Medical Association of 1964 (with amendments and additions from 2013).

Состояние слизистой оболочки рта у рабочих города Рязани

INTRODUCTION: Malignant neoplasms are the cause of significant socio-economic losses of society, and therefore their early diagnosis, as well as the diagnosis of precancerous diseases and the identification of risk factors for their occurrence remain urgent tasks of medicine. AIM: To study the prevalence of precancerous and oncological diseases of the oral mucosa (OM) in workers of Ryazan State Instrument–Making Enterprise (RSIME). MATERIALS AND METHODS: In May–June 2022, 301 employees of RSIME aged from 19 to 74 years were examined for the first time. During the examination, a clinical dental check-up and autofluorescence stomatoscopy were performed. The results of the examination were recorded in a card for assessing the dental status of adults, approved by World Health Organization. RESULTS: After a preventive examination of the workers of RSIME, 30.6% of the examined patients were found to have diseases and pathological changes in the OM, 9.8% was diagnosed with leukoplakia. From the total number of examined patients: 25.9% have a sanitized mouth, 32.9% smoke, and the most of smokers are people from 19 to 44 years old. CONCLUSION: The data obtained confirm the expediency of regular periodic medical examinations using screening diagnostic methods.

Методические подходы к отбору персонала аварийно-спасательных формирований для ликвидации последствий радиационных аварий

Summary. The aim of the study is to develop methodological approaches and criteria of selection of specialists for participation in the work on liquidation of consequences of radiation accidents as part of emergency rescue formations. Materials and research methods. Due to the lack of detailed individual medical, psychophysiological and dosimetric data on persons involved in the elimination of consequences of radiation accidents in the available scientific literature, the study was conducted using theories of occupational risks and functional reliability, as well as mathematical modeling of data on the results of health assessment and professional and psychophysiological adaptation of personnel of radiation facilities. Results of the study and their analysis. A conceptual model and criteria of professional selection of specialists for participation in the work on liquidation of consequences of radiation accidents are proposed for selection of personnel. The criteria include an integral indicator of the suitability level and a probabilistic nomogram determining the acceptable range of its variation. This indicator takes into account accumulated dose load, level of health loss of worker from the impact of life factors and his/her functional reliability. It is proposed to use the data of periodic medical examinations and psychophysiological examinations, as well as individual dosimetry to assess the level of professional suitability. A proposal is made to use the results of the conducted research on assessment of professional suitability to eliminate the consequences of radiation accidents as one of the qualification indicators of workers required for preliminary authorization to work in emergency rescue formations under conditions of planned increased exposure.