Special Assessment Of Working Conditions Research Articles

Working conditions and their hygienic assessment in multidisciplinary medical organizations

At present, one of the main tasks of the state and society is preservation and strengthening of the health of the able-bodied population. Employees of medical organizations are exposed to the combined effects of a significant number of harmful production and professional factors. In particular, the factors of the working environment include biological, chemical, and physical factors, while those of the labor process involve tension and severity. Therefore, the study of working conditions of medical personnel is a priority in occupational health. The purpose of the study is to analyze the working conditions of employees of medical organizations and iden tify priority production-related and occupational pathologies arising from the impact of unfavorable production and occupational factors in order to develop preventive measures. Materials and methods. The object of the study was 1,443 reports of the special assessment of working conditions. We carried out our own studies of the parameters of the microclimate and lighting in the premises: the number of measurements was 5,398, measurements were carried out in 60 premises of medical organizations, and 727 air samples were taken to determine the microbial load. Results. According to the studies of the conditions and nature of work at the workplaces of medical workers in the examined medical organizations and according to the results of a special assessment of working conditions and our own research, the conditions corresponded to a harmful class of 1–3 degrees and of the 4th degree for workers of the oncological hospital. The level of maximum microbial load in the doctors' lounges and nursing rooms increased by the middle of the work shift and remained high until the end of the working day. Since the air movement speed in the studied rooms was very low, this criterion may be a risk factor for aggravation of the course of general somatic pathologies and, as a result, the development of work-related morbidity in medical workers. It can also be noted that fungi were found in 100 % of samples, with their number decreasing by the end of the work shift, while the number of the genus Staphylococcus representatives, on the contrary, tended to increase by the end of the working day. Conclusion. According to the results of the special assessment of working conditions, the conditions and nature of the labor of medical workers in the studied medical organizations corresponded to the harmful class of 1–4 degrees. The 4th degree of the 3rd class of working conditions was due to the personnel’s work with cytostatic drugs. Microclimatic parameters corresponded to hygienic standards (at low air speeds). Fungi and representatives of the genus Staphylococcus were found in 100 % of air samples. A detailed study of the species identification of micromycetes in the indoor air showed that the number of Penicillium and Aspergillus micromycetes significantly exceeded the number of other species.

Assessment of occupational a priori health risk at the workplace

Introduction. The results of the occupational risk assessment are additional to a special assessment of the working conditions for obtaining quantitative information on the likelihood of developing health disorders. Occupational risk models have not been approved yet, and the proposed approach allowed assessing a priori risk from various harmful factors and conditions, predicting workload, and elevating the effectiveness of preventive measures. Materials and Methods. The assessment of a priori occupational risk from exposure to noise, chemicals and stress-related risk factors was performed at the workshop No. 1 of the oil refinery «KINEF» LLC using the proven models. The results of studies and measurement, conducted in 2020 within the special assessment of working conditions, were used as an input data. Results. The levels of occupational risk caused by exposure to a chemical factor did not reach values significant for the development of occupational disease, regardless of service length. The levels of occupational risk from exposure to noise at individual workplaces formed a risk level significant for the development of occupational diseases with the work experience of more than 30 and 40 years. At individual workplaces, the risk associated with the work intensity is relevant for the work experience of more than 20 years. There were identified persons whose professional experience allows determining the risk levels significant for the development of occupational diseases. Limitations. The limitations of the study are uncertainties associated with conducting a special assessment of the working conditions. Conclusion. Occupational risk assessment makes it possible to supplement the existing approaches with a quantitative assessment of the probable damage to workers health, to identify the vulnerable groups of employees, to determine the length of service considering the exposure factors.

Problems of hygienic regulation of working conditions in civil aviation and ways to solve them (literature review)

The analysis of the current and cancelled documents concerning the regulation of working conditions in civil aviation (CA) is carried out. There have been established significant factors of working environment and workload, their relationship with indicators of the health status of flight personnel, the development of fatigue and the risks of aviation accidents (AA) has been proved. The design of the study included a multifactorial analysis of the impact of working conditions on the functional state, occupational morbidity and accident rate of CA pilots with the establishment of a list of mandatory factors for rationing and control of the production environment and the labour process. The analysis of sanitary and hygienic characteristics of working conditions, health data was carried out based on the results of retrospective studies of the clinic of the Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”, publications indexed in the databases Scopus, Web of Science, RSCI and official statistical collections. Own experimental studies were conducted among one hundred twenty pilots of the case-control type, including the analysis of 10324 standard operating procedures for aircraft management, 59670 studies within the framework of psychophysiological testing, as well as the analysis of 83 AA. The necessity of adjusting the regulatory framework with the expansion of indicators for the normalization of working conditions in terms of the intensity of the labour process is proved. New criteria are proposed to be used for assessing information, intellectual, emotional loads, expanding the boundaries of sensory loads with the allocation of class 3.3 - according factors working load. Proposals have been developed to make additions to SP 2.5.3650-20 for flight crew members and air traffic controllers concerning requirements for all missed and obligatory factors of working conditions; a list of production factors obligatory for control during a special assessment of working conditions at the workplaces of aircraft crew members; new methodological documents relating to the assessment of indicators of the intensity of the labour process, the assessment of the personal risk of fatigue in pilots, conducting psychophysiological studies using a video oculograph, the procedure for conducting special assessment of working conditions, a general assessment of professional risks intended for the implementation of regulatory requirements.

Corporate health preservation programs are the main element of the health-saving system of the working population

Introduction. Risk management is one of the main directions of occupational health at the present stage. At the same time, the analysis of factors affecting human health is an important component of this process. Many scientific papers have been devoted to the study of the health status of industrial workers, showing priority etiological factors contributing to the development of both occupational and chronic non-infectious pathology. Much less attention is paid to the study of the causes and consequences of health disorders of social workers, who make up a significant part of the able-bodied population. The purpose of the research is to develop modular corporate programs for industrial and social workers using scientifically based differentiated approaches. Materials and methods. The study of working conditions, socio-demographic factors, lifestyle characteristics, morbidity of nine hundred forty seven employees of various professional groups, clinical and functional examination and neuropsychological testing of 395 employees of the studied enterprises and institutions was carried out. The assessment of working conditions was carried out using data of sanitary and hygienic characteristics and charts for special assessment of working conditions, socio-demographic status, lifestyle and self-esteem of employees were studied using questionnaires, neuropsychological questionnaires were used, morbidity was analyzed based on data from outpatient charts and a functional survey. Results. The analysis of working conditions revealed priority production factors affecting the health of employees of the studied occupational groups: the noise vibration factor and the severity of labour in machine-building workers and miners, labour intensity in combination with other factors for social workers. The risk factors of lifestyle, risk diseases characteristic of workers of various industries and workers of the non-industrial sphere have been identified. Limitation: the study was conducted on a representative sample of 947 employees, 395 of whom underwent an in-depth examination, the limitation of the results of the study was the subjective assessments of respondents during the questionnaire. Conclusion. The obtained results made it possible to develop differentially directed medical and preventive effects, taking into account the peculiarities for each professional group.

Разработка шумозащитного костюма для снижения воздействия шума на работников молокоперерабатывающей отрасли на примере промышленных предприятий Республики Мордовии

In the work, a study was made of harmful production factors affecting a worker in the dairy industry. It established that in the modern production of dairy products, high-performance technological equipment is used, the operation of which leads to the appearance of hazardous and harmful production factors. Noise is not the last among them. The degree of negative impact of noise on people depends on its frequency range, intensity, duration of action and the nature of the personnel work. The zones of the greatest non-specific effect of noise on a person are identified. It is established that the operator of the dairy industry is in close contact with the process equipment. The most suitable solution for protecting personnel from noise is the use of personal protective equipment. The article evaluates the noise impact on the operators of the dairy processing industry of the Republic of Mordovia within the framework of a special assessment of working conditions using the Assistant noise meter of the first accuracy class. Exceeding the noise level is observed at all the same type of workplaces. To protect workers from increased noise, a noise protection suit was developed, consisting of a jacket, and trousers. Experimental studies of the noise-protective properties of this suit were carried out at the Department of Life Safety of FGBOU VO «Moscow State University nabbed after N.P. Ogarev» with the use of modern reverberation chamber BZD-16. This suit differs from the standard overalls in the presence of additional noise-protective inserts that allow to protect the most vulnerable parts of the worker body from the aggressive effects of noise.

Methodological and regulatory framework for ensuring health care in educational institutions

One of the main tasks of the state is to protect the health of the population as whole and individual socio-demographic groups. Due to the multifactorial nature of the formation of health and its disorders, a complex of various therapeutic, health-improving and, above all, preventive measures is used. To implement the above, in most cases, a regulatory and legal framework is necessary, which also dictates the economic basis for such activities. The analysis of the methodological foundations and normative legal acts on the implementation of the state policy in the field of health saving in educational organizations shows the existence of an adequate socio-economic conditions of the system of health protection of participants in the educational process. There is a certain, quite justified, «preponderance» of health care towards the younger generation. One of the elements of the system of health protection of children and adolescents is the actively discussed and intensively implemented direction «school medicine». It is noted that the theory and practice of health-saving education in universities are at the initial stage of their formation. Attention is focused on the problems of teachers\teachers. The peculiarities of professional activity are fraught with not only potential, but also a real risk of the formation of somatic and mental health disorders, which is confirmed by the literature data and the results of our own research. The issues of special assessment of working conditions are discussed. It is suggested that it is necessary to allocate teachers of secondary schools to a separate group in order to obtain specific information about the peculiarities of their health formation as a basis for the development of specific health-saving technologies. The significant contribution of lifestyle to health has led to the need to strengthen the responsibility of citizens directly for maintaining their own health through the formation of a healthy lifestyle. In this aspect, the teaching staff has a double task and a double responsibility.

The elaboration of preventive measures when working in an open area during the cold season of the year

Introduction. The extraction of minerals is associated with a permanent or periodic stay of workers at open production sites. However, there is an underestimation of the impact of working meteorological factors on the health both in the system of regulation and control over working conditions. The aim of the study is to scientifically substantiate approaches to the development of preventive measures to minimize the risk of health disorders and inform about the risk when working in an open area during the cold season. Materials and methods. The study included employees of the oil-producing enterprise of Western Siberia Samotlorneftegaz, performing labour operations in open areas during the cold season (operators, machinists, repairmen). The study included three stages: a priori risk assessment, a posteriori risk assessment, and an assessment of the individual characteristics of employees. The a priori risk assessment based on production control data and a special assessment of working conditions for the period from 2014 to 2018. A posteriori risk assessment based on data from periodic medical examinations. Personal characteristics based on the results of a questionnaire, in natural and model tests. Results. A quantitative assessment of a priori and a posteriori risk made it possible to identify groups of workers with a significant risk of developing occupational and general pathology, as well as to prioritize preventive measures aimed at preventing the harmful effects of working environment factors and the labour process on the health of an employee. The assessment of local and general violations of thermoregulation in workers performing labour operations in open areas during the cold season made it possible to establish individual risk factors: prolonged work in open areas (more than 60% of working time), the presence of chronic pathology, smoking habit and work experience. Limitations. As part of this study, the assessment of the health status of workers based on data from periodic medical examinations. At the same time, the study does not include the results of medical examinations at the place of residence of workers, which can expand data on the health status of workers and be the subject of further research. Further research on the stated topic may be associated with the need to assess an additional list of individual characteristics when working in an open area during the cold season, taking into account genetic and biochemical markers. Conclusion. The results obtained made it possible to substantiate a set of measures to minimize the risk of health disorders at the level of primary prevention, as well as to propose measures at the level of secondary prevention.

ГИГИЕНИЧЕСКИЕ АСПЕКТЫ СПЕЦИАЛЬНОЙ ОЦЕНКИ УСЛОВИЙ ТРУДА ПРИ РАБОТЕ С ИСТОЧНИКАМИ ИОНИЗИРУЮЩЕГО ИЗЛУЧЕНИЯ

Purpose: Substantiation of hygienic approaches to assessing the working conditions of personnel when working with sources of ionizing radiation. Material and methods: The article considers one of the most important components of the complex of measures to solve the problem of ensuring radiation safety – conducting a special assessment of the working conditions (SAWC) of workers exposed to radiation from ionizing radiation sources (IRS) in the course of production activities. The issues of assessing occupational risks for workers in working conditions when working with IRS at nuclear energy use facilities are touched upon. Results: At present, the Procedure for conducting the SAWC is determined by Federal Law No. 426-FZ dated December 28, 2013 «On special assessment of working Conditions» and the Methodology for conducting a special assessment of working conditions (approved by the order of the Ministry of Labor of the Russian Federation dated November 14, 2016, No. 642n). The established procedure for carrying out the SAWC is based on the hygienic criteria for the classification of working conditions defined by the Guidelines P 2.2.2006-05 and P 2.6.5.07–2019. Working conditions when working with ionizing radiation sources, unlike the effects of other harmful production factors, are characterized by the presence of harmful production factors that do not exceed hygienic standards, and the degree of harmfulness of working conditions is determined not so much by the severity of threshold deterministic effects in workers when irradiating individual organs, but primarily by an increase in the risk of stochastic non-threshold effects. Conclusion: When conducting the SAWC of workers exposed to radiation from ionizing radiation sources in the course of production activities, it is necessary to take into account the following distinctive characteristics of the effects of ionizing radiation: – in contrast to the principles of classification of working conditions set out in P 2.2.755-99 and Federal Law No. 426-FZ, when working with IRS, harmful working conditions are characterized by the presence of production factors that do not exceed hygienic standards; – when working with ionizing radiation sources, the degree of harmfulness of working conditions is determined not only by the severity of the manifestation of threshold deterministic effects in workers, but mainly by an increase in the risk of stochastic threshold-free effects; – the correct conduct of the SAWC and assessment of working conditions according to the indicators of harmfulness and danger when working with IRS are a prerequisite for the quantitative assessment of the occupational risk of employees of the nuclear energy use facilities.

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.

Medical activity in the health care system of workers in the Russian Federation

Medical activity in the health care system of workers in the Russian Federation

ПОКАЗАТЕЛИ ОЦЕНКИ ПРОФЕССИОНАЛЬНЫХ РИСКОВ РАБОТНИКОВ ОБЪЕКТОВ ИСПОЛЬЗОВАНИЯ АТОМНОЙ ЭНЕРГИИ

Purpose: Substantiate the indicators of occupational risks of employees of nuclear energy use facilities. Material and methods: In order to methodologically substantiate the indicators of professional risk assessment, data from literary sources and normative and methodological documentation were used. Results: It is established that the existing system of professional risk assessment in the nuclear industry needs to be improved. The currently used results of a special assessment of working conditions for harmfulness and danger should be supplemented with the results of a special assessment of working conditions for the radiation factor, taking into account the category of potential radiation hazard of the object. When choosing biomedical indicators of occupational risks, the data of periodic medical examinations and mandatory psychophysiological examinations should be taken into account first of all. At the same time, the health status of the employee should be assessed not only by the presence/absence of nosological forms of diseases, but also by prenosological criteria. It is proposed to use as such indicators the level of psychophysiological adaptation of an employee and his cytogenetic status, estimated according to the buccal micronucleus test of the frequency of occurrence of cells with pronounced genome damage (chromosomal aberrations, micronuclei, nuclear protrusions). Conclusion: A conceptual model of indicators of occupational risks of employees is proposed, which includes: 1) class of working conditions according to the harmfulness and danger according to the results of the special assessment of working conditions; 2) class of working conditions according to the effects of IR according to the results of the Special assessment of working conditions; 3) category of radiation hazard of the object; 4) health group according to the results of periodic medical examinations; 5) class of prenosological condition according to the results of periodic psychophysiological examinations. The scientific novelty of the proposed model lies in its complexity and taking into account the early signs of an employee’s health condition, which makes it possible to increase the effectiveness of professional risk assessment and management.

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.

New procedure for training in labor protection

The article deals with issues related to the new requirements for training in labor protection. It is considered how to draw up training programs on labor protection. Samples of a training program on general issues of labor protection and the functioning of the labor protection management system, the impact of harmful and (or) dangerous production factors, hazard sources identified in the framework of a special assessment of working conditions and occupational risk assessment are given.

Hygienic assessment of priority factors of labor conditions in modern medical organizations

Currently, one of the main tasks of the state and society is to preserve and strengthen the health of the able-bodied population. Employees of medical organizations are exposed to the combined effects of a significant number of harmful occupational factors. In particular, factors of the production environment include biological, chemical and physical, factors of the labor process — tension and severity. Therefore, the study of working conditions of medical personnel is a priority in occupational hygiene. The purpose of the study is to identify the priority production-related and occupational pathology in a medical organization. The object of the study was 1443 maps of special assessment of working conditions, the results of laboratory and instrumental studies of microclimate parameters, lighting (5398 measurements in 60 rooms), air samples for the content of microorganisms (727 samples). According to studies of the conditions and nature of work at the workplaces of medical workers in the studied medical organizations, according to the results of a special assessment of working conditions and their own research, they corresponded to the harmful class 1–3 and for cancer hospital workers of the 4th degree. The level of maximum microbial load in the resident and nursing rooms increased by the middle of the work shift and remained high until the end of the working day. Since the air velocity in the studied rooms was at a very low level, this criterion may be a risk factor for aggravating the course of general somatic pathologies and, as a consequence, the development of production-related morbidity among medical workers. It can also be noted that in 100 % of cases, fungi were detected, with this number decreasing by the end of the working shift, representatives of the genus Staphylococcus, on the contrary, tended to increase from the beginning of the worker to its end. The conditions and nature of the work of medical workers in the studied medical organizations, according to the results of a special assessment of working conditions, corresponded to a harmful class of 1–4 degrees. The 4th degree of the 3rd class of working conditions was due to the work of staff with cytostatic drugs. The microclimatic parameters corresponded to hygienic standards (at low air speeds). In 100 % of cases, fungi and representatives of the genus Staphylococcus were found in all air samples. A detailed study of the species identification of micromycetes in the indoor air showed that the number of micromycetes of the genus Penicillium and Aspergillus significantly exceeded the number of other species.

Influence of working conditions on the function of external respiration in underground oil mine workers

Introduction. The article presents a non-combined observational cross-sectional retrospective study, which studied the functions of respiration of 3 categories of workers (sinkers, woodworkers, underground miners) depending on working conditions. Materials and methods. Analyzed depersonalized data from outpatient records of periodic medical examinations of underground workers from 2013 to 2017. The article presents only the analysis of spirograms. The study of respiratory function was carried out using an expert class spirometer SpiroLab III (MIR, Italy). The results were assessed by a doctor of functional diagnostics. Production factors were studied according to the results of a special assessment of working conditions carried out in oil mines according to the methodology for conducting a special assessment of working conditions, approved by order of the Ministry of Labour of Russia No. 33n dated January 24, 2014. Statistical methods were used to analyze the material: methods of parametric statistics (mean (M), standard deviation, error of the mean (m), Student’s test), the data are presented in the format M ± m, the differences were considered significant at p < 0.05. Results. An analysis of occupational morbidity among oil miners has been carried out, risk groups have been identified by profession, length of service and age. It was revealed that after 4-5 years of work in the profession, there is a tendency to impairment of the function of external respiration according to the obstructive type (decrease in forced expiratory volume in the first second (FEV1), formed vital capacity of the lungs (FVC), peak expiratory flow rate (PEF) , Tiffno index). This is suggested to be due to a combination of factors of the production environment such as oil hydrocarbons and the severity of labour. The analysis of working conditions made it possible to determine the list of harmful production factors affecting the development and occurrence of occupational diseases by workers involved in thermal mining of high-viscosity oil. Limitations. The smoking factor in the work is considered as a qualitative one, it is probably more logical to consider it as a quantitative one - smoking experience (number of years), then a connection with changes in the functions of external respiration may be revealed. Conclusion. After 4-5 years of work, oil miners show a tendency to obstructive disorders of the respiration function. The genesis of the identified changes requires further clarification.

Medical Staff at Sanatorium-Resort Organizations: Working Conditions and Health Risk Factors

Medical staff working conditions are characterized by a range of adverse workplace factors investigated primarily at hospital organizations. However, sanitary audit of working conditions and health risk factors for medical workers in the sanatorium-resort industry is also a task that needs attention. Aim. To analyze the results of the working conditions special assessment and identify the main work-related factors affecting health state of medical staff at sanatorium-resort organizations. Material and methods. Scientific search and analysis of publications on the safety of working conditions and health protection of medical workers. Systematization of research materials, statistical and comparative analysis of the results of working conditions special assessment carried out at branches of the Medical Research Center and data provided in publications. Results. Medical staff are exposed to a wide range of hazards. Work-related factors that do not meet established hygiene standards cause the greatest concern among medical workers. These are microclimate, lighting and working equipment (47.0%, 37.8% and 24.0%, respectively). A number of devices inspected in the physiotherapy room exceeded hygienic standards for alternating electric and magnetic field intensity. Analysis of air pollution in the physiotherapy department working area showed that some of the harmful chemicals exceeded permissible exposure limits. The results of the special assessment of working conditions performed at branches of the Medical Research Center showed that a high percentage of medical workers was exposed to harmful biological factors and high severity of the labor process. Conclusion. Physical and chemical factors are the greatest workplace hazards for healthcare workers at health resorts. However, a special assessment of working conditions showed that the biological factor was the most significant one across all professional groups.

Noise as a Criterion for Designating Sanitary Protection Zones of Traffic Arteries

The article is devoted to the study of a possibility of designating the boundaries of sanitary zones (distancing) for traffic arteries outside settlements within the right-of-way.The study was conducted regarding the current Russian laws, projects of possible changes in legislation and draft amendments. It offers definitions of the right-of-way and of sanitary zone and highlights topics that have not yet been regulated.At the same time, the research methods are of universal character and after introducing other regulatory parameters may be applied for similar research in other countries as well.Calculations and field studies allowed to find that within the railway right-of-way and with the existing train traffic intensity, equivalent continuous sound pressure level in aggregate does not exceed the established maximum permissible level of 80dBA for personnel performing their labour functions within the railway rightof-way.A growth in the Leq/LAeq on the right-of-way from 80,0 to 95,0 dBA may lead to an increase in the hazard class (subclass).An analysis of the actual results of a special assessment of working conditions at JSC Russian Railways showed in the vast majority of cases the acceptability of working conditions evaluated according to noise factor measured at the workplaces of employees working during full or part-time shift on the right-of-way. Hazardous working conditions at the level of some subclasses for certain professions (operator of track measurement, railway track worker) arise rather due to indicators of severity of the labour process.

Improving the system of control (supervision) over the quality of a special assessment of working conditions

Improving the system of control (supervision) over the quality of a special assessment of working conditions

RISK FACTORS IN THE PROCESS OF EMPLOYMENT OF MEDICAL WORKERS OF THE DENTAL PROFILE

One of the most socially important types of work is the work of medical workers. Due to the presence of a significant number of harmful and dangerous factors, the medical profession is divided into a separate group, which in turn is characterized by unique aspects of work. The work of doctors and nurses of different specialties of the dental profile differs significantly in the density of the working day, the volume and nature of professional activities; responsibility for the life of the patient, which affects many physiological processes.
 The purpose. Assessment and comparative characterization of the presence of occupational risks in the dental field, which are daily exposed to factors of aggressive and dangerous nature, as well as the development of a set of preventive measures aimed at reducing occupational morbidity.
 Materials and methods. Hygienic research of working conditions of medical staff of the University Dental Clinic in the form of a questionnaire. Statistical analysis of data of special assessment of working conditions; sanitary and hygienic characteristics, acts, maps of cases of nosocomial diseases; laboratory and instrumental research conducted as part of production control; dosimetric control, air sampling with subsequent sowing on the nutrient medium of IPA.
 Results. It was found that in the studied premises, the total microbial count varied from 756 ± 0.8 CFU / 1m3 to 6497 ± 3.4 CFU / 1m3. In most medical institutions, the level of artificial lighting in the workplaces of medical workers was insufficient. The largest negative contribution was provided by such production factors as: labor intensity and intensity - 26.41%; physical: noise, vibration, non-ionizing and ionizing radiation - 25.32%; chemical - 12.77%. The total contribution of the main factors was 91.78%. Assessment of working conditions is based on hygienic criteria to assess the degree of deviations of the parameters of the production environment and labor process from the current hygienic standards, as well as after analysis and processing of data submitted by employees in the format of their questionnaires. In this regard, the distribution of harmful production factors and their degree of impact on the health of medical personnel was established with the help of multifactor analysis.
 Conclusions. Thus, the research interprets the results, which clearly in the format of a specific percentage, identify those factors that have a strong driving impact on the health of dental professionals. The most substantiated are such production factors as: chemical (exposure to drugs and chemicals), physical (noise and vibration, non-ionizing and ionizing radiation), the severity and intensity of the labor process, lighting (non-compliance with regulations for artificial lighting in the workplace) and microclimate and biological (work with biological, potentially contaminated material, samples, patients), non-ionizing and ionizing radiation, labor intensity (tension of the visual organs).

Adapting the Form of the sanitary and hygienic characteristics of working conditions to the new Sanitary Law

Introduction. The current Form No. 362-1/y-2001 "The sanitary and hygienic characteristics for the working conditions of an employee having suspicion of an occupational disease (poisoning)" does not meet the requirements of Sanitary Law developed within the framework of the "regulatory guillotine". It complicates the investigation of occupational diseases and carrying out an objective examination of the connection between the disease and the profession. The study aims to analyze the Form for the sanitary and hygienic characteristics (SHC) of working conditions and substantiate proposals for its adaptation to the current regulatory legal acts to objectify the investigation of occupational diseases cases and the examination of the connection between the disease and the profession. Materials and methods. We carried out the expert-analytical study. We analyzed and compared data from Rospotrebnadzor (2001-2020) on occupational morbidity and Rosstat (2014-2020) on employment in harmful and (or) hazardous working conditions. We also studied the SHC (503) submitted for examination of the connection between disease and profession (including forensic medical examination). The structure of the Form for the completeness of the presentation of issues on various aspects of working conditions, the quality of the compilation and content of the SHS was determined in accordance with the current Sanitary Law. The authors evaluated the structure of the Form for the presentation of questions on various aspects of working conditions, determined the quality of the compilation and content of the SHC in accordance with the current Sanitary Law. Results. With a decrease in the number of newly registered cases of occupational diseases over 20 years by more than 3.7 times, the share of workers in harmful and(or) hazardous working conditions in the main types of economic activity decreased in 2020 relative to 2014 in 1,1 time (37.3%). A comparative assessment of the standardized indicators of harmful production factors specified in the SHC and the ones approved in SanPiN 1.2.3685-21 revealed their complete inconsistency. The results of in-depth analysis of 503 SGH allowed us to determine the most typical errors in assessing production factors at workplaces: incorrect assessment of standardized single-digit noise indicators (equivalent sound level A for an 8-hour working day), vibration (equivalent level corrected along the Z-, Y-, X-axes ); lack of data on dust load and the average value of air temperature - THC-index; assessment of the labour severity without considering the technological operations performed, etc. We noted the predominant assessment of working conditions by the main factor developing an occupational disease, without considering the accompanying risk factors that aggravate its effect. We also noted a significant underestimation of the levels when assessing the general transport, technological and technological vibration due to the differences between hygienic standards and the norms adopted in the Methodology for conducting a special assessment of working conditions. SCH contains no information on lighting, biological factor, labour intensity in 67.0-75.0% of cases. Conclusion. We substantiated proposals for improving Form No. 362-1/y-2001 of the SHC of working conditions, considering an electronic form of the document, revising the instructions for filling out the SHC.