Special Medical Examinations Research Articles

Noise exposure assessment of workers inspecting construction machinery vehicles in the Republic of Korea.

Previous studies have investigated the health hazards caused by exposure to the noise of heavy equipment used at construction sites. Korea's Ministry of Land, Infrastructure, and Transport operates a registration system for construction machinery, and regular safety inspections are mandatory. Although workers inspecting construction machinery vehicles are exposed to unwanted noise, no noise exposure assessment has been made regarding these workers in Korea. The time-weighted average (TWA) daily average noise exposure level among construction machinery inspectors at 18 inspection centers was 75.3 dB(A). Among the inspection steps, the exhaust gas inspection step was found to exhibit the highest noise exposure level, up to 100 dB(A). In Korea, if the noise level of a workplace exceeds 85 dB(A) as a TWA, workers are required to undergo special medical examinations. This study found that special medical examinations were required for two of the 18 target inspection centers (approximately 115 workers) as the 8-hour TWA noise level exceeded 85 dB(A). Therefore, regular noise exposure assessment and special medical examinations for noise are required to prevent inspectors from developing hearing disorders due to noise exposure.

교대근무 근로자의 대사증후군 유병률 및 관련요인 분석

Purpose: This study looks at the prevalence rate of such metabolic syndrome among shift workers and aims to figure out related risk factors. Method: Data from night duty workers who had special medical examinations in 2014, in a university hospital situated in Incheon, were used. Data of 343 people taking medicine for high blood pressure, diabetes and hyperlipidemia were discarded. Of the remaining 3,305 people, data on their blood pressure, diabetes, waist measurement, neutral fat level and HDL cholesterol level were used. Results: In this study, the prevalence of metabolic syndrome in shift workers was found to be 12.7% by applying NCEP's ATPⅢ diagnostic criteria. By analyzing the effects of subjects’ general characteristics, lifestyle and job-related characteristics on prevalence of metabolic syndrome using logistic regression analysis, we found out that prevalence rate was higher for those who are older, are men, smoke and do not exercise have worked in shift for over 10 years, work for over 52 hours a week on average, have worked for more than 4 consecutive days on night duty, have less than 11 hours of rest after work, are not allowed to sleep during working hours. Conclusion: It can be concluded from the result that it is important to help shift workers protect their health through setting reasonable working hours, improving working condition, promoting healthy lifestyle and providing customized management plans that take individual characteristics into consideration.

Rheumatoid Arthritis in Silica-Exposed Workers.

Few studies have examined rheumatoid arthritis (RA) risk and severity in Korean workers exposed to silica. We compared the hospitalization risk of RA between silica-exposed workers and the general Korean population. The study cohort consisted of male workers exposed to silica who had undergone at least one silica-associated special medical examination between 1 January 2000 and 31 December 2004 (N = 149,948). The data were from the Korea Occupation Safety and Health Agency. RA morbidity based on hospital admission records was estimated from 2000 to 2005 using the Korea National Health Insurance Service claims data. The standardized admission ratio (SAR) was calculated by dividing the observed number of admissions in silica-exposed workers by the expected number of admissions in the general reference population. For the sum of “Seropositive rheumatoid arthritis” (M05) and “Other rheumatoid arthritis” (M06), the SAR was higher in the silica-exposed group (1.34, 95% CI 1.08–1.64). For M05, workers with <10 years of silica exposure had a significantly higher SAR (2.54, 95% CI 1.10–5.01) than the general population. More silica-exposed workers without a diagnosis of pneumoconiosis were hospitalized for RA than the general population. Our analysis reaffirms the link between silica exposure and RA and suggests that the severity of RA is increased by silica. Further studies of silica-exposed workers with longer follow-up are needed.

Does Exposure of Lead and Cadmium Affect the Endometriosis?

This study aimed to investigate the effects of blood lead levels (BLLs) and lead and cadmium exposure on endometriosis (EM). The study cohort consisted of female workers who underwent a lead-associated special medical examination between 1 January 2000 and 31 December 2004 (n = 26,542). The standard admission rate (SAR) and admission odds ratio (OR) for EM were calculated using the general population and noise-exposed groups, respectively, for the same period as the reference standards. The SAR for EM was 1.24 (95% confidence interval (CI): 1.03–1.48) in lead-exposed workers and 1.44 (95% CI: 1.11–1.85) in workers with BLLs < 5 μg/dL when compared with that of the general population. Admission ORs of EM in lead-exposed workers and those with BLLs < 5 μg/dL were statistically higher than those of noise-exposed workers (OR, 1.40; 95% CI, 1.15–1.70 and OR, 1.48; 95% CI, 1.11–1.98, respectively). The relative excess risk due to interaction of lead and cadmium was 0.33. Lead exposure was associated with EM admission. EM admission in lead-exposed workers with BLLs < 5 μg/dL was statistically higher than that of the general population and noise-exposed workers. Co-exposure to lead and cadmium has a synergistic effect with EM.

Frequency and structure of endocrine diseases in young elite athletes

There is no data on the prevalence of endocrine disorders in young elite athletes in Russia.Objective: to assess the prevalence of endocrine pathologies and their structure in children and adolescents involved in elite sport.Materials and methods: the study included data from outpatient records of members of national sports teams, who underwent special medical examination. The data of a random sample of 1081 outpatient cards of young athletes, for 26 sports, were analyzed.Results: we found a high prevalence of endocrine pathology (18.6 %) in children and adolescents involved in high-performance sports. Thyroid diseases are most the most frequent in young athletes (in 57.3 % of cases). On second place is obesity (12.3 %). The frequency of weight deficiency and short stature is 8.4 % each. Autoimmune thyroiditis occupies a leading place in the structure of thyroid pathology in young elite athletes. Subclinical hypothyroidism takes the second place, and nodular goiter — the third place.Conclusion: young elite athletes are characterized by a high frequency of endocrine pathology, the leading place in which is occupied by thyroid diseases. It is necessary to further studies aimed at assessing the mechanisms of hormonal adaptation in elite young athletes to assess their impact on the development of the child and the correct interpretation of the hormonal profile obtained during a special medical examination.

The problem of the potentially danger of an aggressive autoimmune nature of immunity in women during the vaccination of sportswomen against the COVID-19 coronavirus: solutions

With the beginning of the mass vaccination against the coronavirus COVID-19, the problem of the potentially of the danger of the aggressive autoimmune nature of immunity in women during the vaccination of sportswomen against the coronavirus COVID -19 arose.&#x0D; Objective of the study: to determine ways to solve the problem potentially of the danger of an aggressive autoimmune nature of immunity in women when vaccinating sportswomen against the COVID -19 coronavirus. Research methods: methods of theoretical analysis of scientific literature are used: generalizations, synthesis, abstractions, formalizations. Research results and conclusions: ways were identified to solve the problem potentially of the danger of an aggressive autoimmune nature of immunity in women when vaccinating sportswomen against the COVID-19 coronavirus. The potential danger of aggressive autoimmune immunity in women can be a significant problem for vaccination of athletes against coronavirus COVID -19, especially if there is significant physical activity in their sports activities with manifestations of physical allergies. When determining the possibility of vaccination of female athletes against coronavirus COVID -19, it is recommended to conduct a special medical and allergological examination and survey of female athletes using special questionnaires and, if there are indications, send female athletes for consultation to an allergist. It was concluded that when vaccinating against the COVID-19 coronavirus, priority should be given to athletes to prevent them from developing allergic complications. If indicated, sportswomen must undergo a special allergic diagnosis.

ПРОГНОЗ СМЕРТНОСТИ В КОГОРТЕ РОССИЙСКИХ УЧАСТНИКОВ ЛИКВИДАЦИИ ПОСЛЕДСТВИЙ АВАРИИ НА ЧЕРНОБЫЛЬСКОЙ АЭС

Purpose: Analysis and prognosis of mortality rate, specific causes of death and mortality structure in the male cohort of the Chernobyl cleanup workers monitored from 1992 over 2017.&#x0D; Materials and methods: Analysis and prognosis of mortality among the Chernobyl cleanup workers for the follow up period 1992-2017 were based on personal death records stored at the National Radiation Epidemiological Registry (NRER). The workers entered the exclusion zone in 1986 and in 1987, who had documented dose records were included in the monitoring cohort. In 1992 the cohort size was 72432 persons , average radiation dose was 130.8 mGy. For the period of the cohort monitoring 27051 cleanup workers died with the following causes of death: malignant neoplasms – 4621 cases, circulatory diseases – 11410 cases, traumas and poisoning – 5110 cases, other –5910. To prognose mortality and mortality structure data on age-specific intensity of partial mortality and total mortality during the monitoring period were used.&#x0D; Results: The predicted size of the cohort will be 22,000 persons in 2030. Mortality structure in 2017: malignant neoplasms – 17%; circulatory diseases – 42%; traumas and poisoning – 19%, other – 22%. The mortality structure in 2030 will be: malignant neoplasms – 24%; circulatory diseases – 49%; traumas and poisoning – 11%, other – 16%. Cleanup workers’ the average time left to live estimated in 2017 was 11.1 years (their average age in 2017 was 62.4 years), it means that their average life expectancy will be 73.5 years. Average life expectancy of Russian males is 70.4 years. Increased life span of the cleanup workers can be due to their good health, social support including regular special medical examination, the effect of the natural selection cannot be excluded as well.&#x0D; Conclusion: Results of the study can serve as example of organization of high effective specialized medical examination of the Chernobyl cleanup workers. The research outcomes will be useful for analysis of mortality among members of a closed population following exposure to hazardous technogeneous factors.

Rheumatoid arthritis in low-level toluene-exposed workers based on nationwide medical surveillance data in Korea.

There is growing evidence that exposure to organic solvents can play a role in the etiology of rheumatoid arthritis (RA). This prospective cohort study aimed to investigate the association between RA and toluene exposure. The study cohort consisted of Korea Occupational Safety and Health Agency data from male workers exposed to toluene who had undergone a toluene-associated special medical examination at least once between January 1, 2000 and December 31, 2004 (n = 148,870). The morbidity from RA based on hospital admission records was estimated from 2000 to 2005 using National Health Insurance Claim Data. The standardized admission ratio (SAR) for RA was calculated with reference to the general population. Levels of urinary hippuric acid (HA), a metabolite of toluene, were measured and used for exposure assessment. Toluene-exposed workers were at an elevated risk of seropositive rheumatoid arthritis (ICD-10 code M05) with an SAR of 2.38 (95% confidence interval [CI]: 1.14-4.37) and other rheumatoid arthritis (M06) with an SAR of 1.22 (95% CI: 0.91-1.59). When data were stratified according to the duration of toluene exposure and by tertiles of urinary HA level, no significant difference was apparent. SARs of the toluene-exposed workers are higher than that of the general reference population, indicating that exposure to toluene may contribute to an increased risk of RA. Further studies of toluene-exposed workers with longer follow-up are needed.

Combined effects of occupational exposure to hazardous operations and lifestyle-related factors on cancer incidence.

We aimed to examine whether the number of types of hazardous operations at work experienced through a lifetime is associated with cancer incidence, and additionally examined the combined effects with lifestyle‐related factors. Using a nationwide, multicenter, hospital inpatient dataset (2005‐2015), we conducted a matched case‐control study with 1 149 296 study subjects. We classified the participants into those with none, 1, or 2 or more types of hazardous operation experience, based on information of special medical examinations taken, mandatory in Japan for workers engaged in hazardous operations. Using those with no experience as the reference group, we estimated the odds ratios for cancer incidence (all sites, lung, stomach, colon and rectum, liver, pancreas, bile duct, and bladder) by conditional logistic regression with multiple imputations. We also examined the effects of the combination with hazardous operations and lifestyle‐related factors. We observed increased risks for cancer of all sites, and lung, pancreas, and bladder cancer associated with the experience of hazardous operations. Multivariable‐adjusted ORs (95% CIs) of cancer incidence of all sites were 1 (reference), 1.16 (1.12, 1.21), and 1.17 (1.08, 1.27) for none, 1, and 2 or more types of hazardous operation experience, respectively (P for trend <.001). Potential combined associations of hazardous operations with smoking were observed for lung, pancreas, and bladder cancer, and with diabetes for pancreas cancer. Engaging in hazardous operations at work and in combination with lifestyle‐related factors may increase the risk of cancer. We highlight the potential for those engaged in hazardous work to avoid preventable cancers.

Сriminalizing drunk driving: experience of Ukraine

The article explores the issue of driving drunk drivers to criminal liability and the prospects for its development. Increasing the responsibility for drunk driving by transferring it to the criminal plane is logical, but does not have a mechanism for proceedings in cases of administrative offenses. Article 266 of the Code of Administrative Offenses and the Instructions defines the procedure for examining the state of intoxication at the stop of a vehicle and in a medical institution, i.e. to criminalize the relevant article in our opinion it is necessary to develop a new Instruction. The ability to prosecute perpetrators. Further, with regard to the new version of Article 130 of the operation of vessels in a state of intoxication, drugs or other intoxication, it is necessary to consider this issue in more detail, because on water the risk of driving in a state of intoxication is also too great, so we believe that it is necessary to criminalize this article in a complex. Another important point in the Vienna Convention on Road Safety, which has been ratified on the territory of Ukraine, is mentioned in Article 8 of the Vienna Convention on Road Safety, which has been ratified on the territory of Ukraine, entitled «Drivers»: «National legislation should provide for special provisions concerning the driving of vehicles under the influence of alcohol, as well as the legally permissible level of alcohol in the blood and, where appropriate, exhaled air, the excess of which is incompatible with driving». In all cases, the maximum level of alcohol in the blood in accordance with national legislation shall not exceed 0.50 g of pure alcohol per liter of blood or 0.25 mg per liter of exhaled air (0.25 ppm). Each country sets an appropriate limit on blood alcohol levels and the level of penalties for exceeding them. However, not only is the number of ppm a ground for punishment, for example, in Germany, if a driver demonstrates an inappropriate driving style or commits an accident recorded on a video camera, he may be deprived of his driver’s license for 6 months. However not only is the number of ppm a ground for punishment, for example? In Germany, if a driver for example, in Germany, if a driver demonstrates an inappropriate driving or commits an accident recorded on a video camera, he may be deprived of his driver` license for 6 months. When re-driving while intoxicated, criminal punishment is already provided. At the end of the period of deprivation of a driver`s license, the driver is obliged to donate blood for analysis every month. When the period 3 deprivation of a driver`s license expires, the driver gets his rights back only after passing a special medical and psychological examination, «test for idiocy». Key words: criminal liability, administrative liability, driver, vehicle, intoxication.

Uloga medicine rada u prevenciji saobraćajnih nezgoda

The aim of this study is the analysis of medical selection of drivers and candidates for car drivers sent to preliminary, periodic or special medical examination in the last ten years period. At the preliminary medical examination 2,3% of candidates were declared to be incapable, 8,2% of candidates had a limited driving ability. At the periodic medical examination 12,2% of drivers were declared to be incapable to driving and 28,7% of drivers had a limited driving ability. At the special medical examination 37,3% of drivers were declared to be incapable for driving and 53,9% of drivers had a limited driving ability. In our opinion, medical selection of drivers and candidates for car drivers is a significant preventive measure of traffic trauma.

The Effect of Special Medical Examination for Night Shift Workers and Follow-Up Management Against Hypertension.

Background: Special health examination is a screening program introduced in 1973 in Korea to examine health problems of workers who are regularly exposed to 177 hazardous substances and physical environments specified by the Occupational Safety and Health Act. Shiftwork was added as a risk factor in 2013. The purpose of this study was to analyze changes of hypertension status after a special medical examination and subsequent follow-up management. Methods: We used the data based on the special medical examination outcomes for night shift workers, performed at seven different health examination centers under the Korea Medical Institute (KMI) between 2014 and 2016. Workers who received special medical examinations for two consecutive years (2014–2015 and 2015–2016) were selected. A final study population of 2070 was evaluated. Results: Compared with the first-year examination, 1503 subjects (72.6%) received hypertension medication or showed improvement in blood pressure in their second-year examination. Older age (≥40s), women, larger workplaces (≥300 full-time workers), long-term workers (≥12 years), improvement in smoking habits, improvements for diabetes or dyslipidemia, normal or reduced BMI, and normal waist circumference were associated with proper management of hypertension. Conclusions: An appropriate follow-up management program should be developed to provide health management for night shift workers that need to focus on the factors identified in this study.

The effect of shift work on high sensitivity C-reactive protein level among female workers.

BackgroundThis study assessed the association between shift work and high-sensitivity C-reactive protein (hs-CRP) level, a risk factor for cardiovascular disease (CVD), in female workers in electronics manufacturing services (EMS).MethodsFemale EMS workers who received special medical examinations for workers in Gyeongnam, Korea between January 2017 and December 2017 were enrolled in this study. Their age, marital status, education level, alcohol consumption, smoking habit, regular exercise, quality of sleep, work stress, and depression were investigated, and blood tests were conducted. The t- and χ2 tests were conducted to compare the general and biochemical characteristics between daytime and shift worker groups. Age-adjusted partial correlation analysis was performed to examine the linear relationship between hs-CRP level and other risk factors for CVDs. In addition, the difference in hs-CRP levels according to work schedule was analyzed by ANCOVA after adjusting for variables that could affect the hs-CRP level.ResultsAlthough the average hs-CRP levels did not differ significantly between daytime and shift workers (0.92 ± 1.87 and 1.07 ± 2.20 mg/dL, respectively), shift workers tended to show a higher hs-CRP level (p = 0.067). After adjusting for variables that can affect the hs-CRP level, the estimated average hs-CRP level was significantly higher in shift workers (1.325 ± 0.156 mg/dL) than that in daytime workers (0.652 ± 0.350 mg/dL) (p = 0.003).ConclusionsThe results of this study identified a relationship between shift work and hs-CRP level increase in women. Because multiple studies have reported associations between increased hs-CRP and CVD, follow-up of hs-CRP may help early detection of CVD in shift workers.

Early recognition of lung cancer in workers occupationally exposed to asbestos

Despite the fact that working with asbestos and placing it on the market have been banned in Germany since 1993 according to the Ordinance on Hazardous Substances, asbestos-related diseases of the lungs and pleura are still the leading cause of death in occupational diseases. The maximum industrial usage of asbestos was reached in former West Germany in the late 1970s and in former East Germany the late 1980s. Occupational diseases, mainly mesotheliomas and lung cancer emerging now are thus caused by asbestos exposure which occurred 30-40years earlier. It is known that the combination of smoking and asbestos exposure results in a superadditive increase in the risk to develop lung cancer. No suitable screening methods for early detection of malignant mesothelioma are currently available and the therapeutic options are still very limited; however, the national lung screening trial (NLST) has shown for the first time that by employing low-dose computed tomography (LDCT) in heavy smokers, lung cancer mortality can be significantly reduced. According to current knowledge the resulting survival benefits far outweigh the potential risks involved in the diagnostic work-up of suspicious lesions. These results in association with the recommendations of international medical societies and organizations were pivotal as the German statutory accident insurance (DGUV) decided to provide LDCT as a special occupational medical examination for workers previously exposed to asbestos and with a particularly high risk for developing lung cancer.

Epidemiology of chronic obstructive pulmonary disease: a population-based study in Krasnoyarsk region, Russia.

BackgroundKrasnoyarsk region is a territory with the widespread risk factors for chronic obstructive pulmonary disease (COPD) such as tobacco smoke, air pollution, and occupational exposure. An assessment of COPD prevalence based on medical diagnosis statistics underestimates the true COPD prevalence. This study aims to evaluate how medical examinations may increase the accuracy of estimates of COPD prevalence.MethodsTrue COPD prevalence was estimated as a number of patients with the established disease diagnosis supplemented by the additional disease cases detected during medical examinations per 1,000 inhabitants of the region. Official medical statistics data and the data collected from the Global Alliance against Chronic Respiratory Diseases program 2011 among 15,000 inhabitants of the region aged 18 years and older were analyzed.ResultsThis study revealed the COPD cases without official medical diagnosis. The true prevalence of COPD is estimated to be two times higher than the prevalence estimates based on medical diagnosis statistics.ConclusionUndiagnosed and untreated cases of COPD result in severe COPD forms as well as addition of severe comorbidities. Because of this, there is an increase in the index of potential years of life lost. Conducting special medical examinations may increase the number of COPD cases detected at the early stages of the disease. This, in turn, may reduce the overall burden of the disease for the population of the region.

소음에 대한 특수건강진단 및 작업환경측정 결과 분석

According to the analysis of special medical examination and work environment monitoring data, the rate of C1 and D1 on noise hazard exceeded 90 % among those of total hazardous factors. The rate of company exceeding noise exposure limit was also more than 90 %. The analysis result shows that main ages diagnosed with C1 and D1 was age of 50s. The majority scale company having diagnosed with C1 and D1 was the companies employing 5~49 workers. Types of industries which have a large number of companies exceeding noise exposure limit were automobile and trailer manufacturing, metal processing industry and primary metal manufacturing. A large number of work processes exceeding noise exposure limit were forming and processing work, cutting and bending work and grinding. To reduce the number of company exceeding noise exposure limit, the reduction counterplan should be focused on the type of industry and the work process which exceeded noise exposure limit frequently. However, the reduction counterplan is preemptively necessary to the type of industry and the work process which exceeded noise exposure limit consecutively if the purpose of reduction counterplan is not to merely reduce the number of company exceeding noise exposure limit but to abate workers suffering from noise.

Assessing the impact of ambient air pollution by cresol and phenol on disease incidence in children

Background / Aims: The areas influenced by electrical engineering companies are characterized by ambient air pollution typically including cresol and phenol. The aim of the study was to investigate disease incidence in children, who were chronically exposed to cresol and phenol. The average daily concentrations of cresol and phenol in ambient air were found to be 0.04 mg/m3 and 0.013 mg/m3, respectively. The performed health risk assessment determined hazard quotients for chronic exposure to cresol and phenol 10.0 and 2.1, respectively. Methods: Disease incidence in children aged 3-7 years (n=127), residing in the area influenced by the emissions from a cable producing company, and in a control group (n=88) was investigated based on outpatient visits during a one-year period and based on a special medical examination. The levels of n-, m-, o-cresols in the blood were determined using gas chromatography. Results: The study group children demonstrated higher concentrations of n-, m-, o-cresols in their blood (0.560±0.120) mg/dm3 in comparison with the control group (0.179±0.036 mg/dm3). Based on the odds ratio, we determined a relationship between chronic exposure to cresol and phenol and the incidence of vasomotor rhinitis (OR=8.85, CI 3.64 to 21.53), asthma (OR=2.07, CI 1.14 to 3.76), diseases of blood and blood-forming organs and immune disorders involving the immune mechanism (OR=1.56, CI 1.06 to 2.29), diseases of the nervous system (OR=3.34, CI 2.46 to 4.53). The performed medical examination confirmed the relationship between exposure to cresol and phenol and vasomotor rhinitis (OR=3.00, CI 1.71 to 5.26) and blood disorders (OR=2.56, CI 1.05 to 6.26), but identified no relationship between exposure and asthma and diseases of the nervous system. The assessment of the impact of air pollution by cresol and phenol revealed the relationship between the incidence of vasomotor rhinitis, asthma, diseases of blood and the nervous system and exposure to cresol and phenol, which coincides with the results of the health risk assessment.

Internal radiation exposure of Ground Self-Defense Force members involved in the management of the Fukushima Nuclear Power Plant disaster

When the Great East Japan Earthquake occurred on March 11, 2011, the Ground Self-Defense Force (GSDF) was dispatched nationally to Northeast area in Japan. The highly trained GSDF members were simultaneously assigned to various missions for the Fukushima Nuclear Power Plants disaster. The missions of GSDF terminated on August 31, 2011. Special medical examinations were conducted for the members as they returned to each military unit. GSDF members who were assigned to the nuclear power plant were at risk of radiation exposure; therefore, pocket dosimeters were used to assess external radiation exposure. A few months after the mission was terminated, measurements of internal radiation exposure were performed. This is the first report of the internal exposure of GSDF members who worked in the restricted radiation contamination area. Here, we report the amounts of internal and external exposure of and the equipment used by the GSDF members.

A Longitudinal Study on Raynaud's Phenomenon in Workers Using an Impact Wrench

The purpose of this study was to clarify the occurrence of Raynaud's phenomenon among workers using an impact wrench for a long time. The subjects were 704 workers regularly using an impact wrench and taking special medical examinations for vibration syndrome from 1981 to 2008. Raynaud's phenomenon was observed in 39 subjects during the observation period. The mean operating years at the occurrence of Raynaud's phenomenon was 25.5 ± 8.3 (standard deviation) yr. The mean total operating time (geometric average) at the occurrence of Raynaud's phenomenon was 11,689 h. By the person-year method, the incidence rate of Raynaud's phenomenon was 6.27 persons per 1,000 person-years. The estimated risk of developing Raynaud's phenomenon did not increase until 12 years after starting to operate an impact wrench but increased exponentially after that. The vibration level of an impact wrench (from 4.9 m/s(2) to 22.6 m/s(2)) exceeded the occupational exposure limit value (4.9 m/s(2)). Various countermeasures, such as introducing automatically apparatus and keeping the working environment warm to protect from cold exposure, were taken at the factory. These findings showed that the rate of occurrence of Raynaud's phenomenon was not high, although the vibration level of the impact wrench was high. This may result from various countermeasures to prevent the occurrence of Raynaud's phenomenon. A long period of exposure to vibration had the potential to lead to the occurrence of Raynaud's phenomenon even under various countermeasures.

Functional Body Capacities under the Conditions of Various Concentrations of Carbon Dioxide and Oxygen

We determined a permissible ratio between carbon dioxide and oxygen concentrations during accidental situations. The experiments (n = 138, 10 h each) on the effect of various concentrations of carbon dioxide and oxygen in the inhaled air were conducted on male volunteers aged 20–40 years subjected to a special medical examination. All experiments were divided into five series: hypercapnia + normoxia, hypercapnia + hyperoxia, hypercapnia + hypoxia, normocapnia + hypoxia, and ambient air (control). The results showed that functional capacities of the body are less impaired under the conditions of hypercapnia combined with hyperoxia. Thus, in accidental situations associated with rapid accumulation of carbon dioxide in the atmosphere of airtight chambers, a synchronous increase in pO2 to 220–230 torr can provide for the highest work capacity.