Structure Of Occupational Diseases Research Articles

Отруєння фосфором як професійне та екологічно обумовлене захворювання в умовах війни у світлі рекомендацій Міжнародної організації праці 2022 року

Abstract. The issue of diagnosis, registration and monitoring of diseases related to phosphorus poisoning is extremely important, taking into account Russia’s use of phosphorous ammunition on the territory of Ukraine. The system of recognition and monitoring of occupational and environmentally determined diseases needs to be adapted to modern requirements of European legislation. Aim. Analysis of the system for determining occupational phosphorus poisoning in Ukraine and its comparison with modern requirements of The International Labor Organization. Materials and Methods. The analytical review of scientific publications is carried out using abstract databases of scientific libraries PubMed, Medline and text databases of scientific publishers Pub Med, Central, BMJ group and other VIP databases. The analysis of reporting materials of The State Labor Service of Ukraine (SLSU), methodological approaches of The International Labor Organization (ILO) is carried out. Methods of system, comparative, and content analysis are used. Results. The results obtained in the study indicate an extremely low prevalence of toxic lesions of occupational and environmentally determined genesis in Ukraine: chemical intoxication accounts for less than 0.2% in the structure of occupational diseases, and phosphorus poisoning has not been registered in the last 20 years. Significant discrepancies were found in the system of recognition of occupational phosphorus poisoning in Ukraine in comparison with the methodological recommendations of The International Labor Organization-2022. In contrast to the instructions for the application of the list of occupational diseases (LOD) of The International Labor Organization-2022, similar documents in Ukraine do not provide a characteristic of phosphorus properties, its toxicological profile, the minimum duration of exposure that causes occupational disease, the duration of the latent period, which complicates the recognition of occupational diseases, objectification of the diagnosis, and also leads to a distortion of statistical indicators regarding occupational morbidity. Conclusions. The recognition system of occupational phosphorus poisoning in Ukraine needs to be adapted to the European recommendations and requirements recommended by the ILO. First of all, this concerns the list of occupational diseases and instructions for its use, bringing them to the norms of international legislation will allow unifying the diagnostic system, objectifying it and establishing a system for registering occupational diseases at the proper level. The problem is particularly relevant given the high risk of phosphorus intoxication of the population, military and certain professional groups on the territory of military operations in Ukraine. Keywords: phosphorus, occupational poisoning, military operations, list of occupational diseases.

Features of the immune status in occupational chronic obstructive pulmonary disease of varying severity in coal mine workers

Introduction. The peculiarities of the clinical course of bronchopulmonary diseases, which occupy a large place in the structure of occupational diseases in coal mine workers, are largely due to a violation of immune reactivity, which is important to take into account for the development of effective preventive and therapeutic measures.
 The study aims to explore the features of the immune status in occupational chronic obstructive pulmonary disease of varying severity in coal mine workers.
 Materials and methods. The scientists have conducted a survey of 110 miners, who worked in underground conditions with an average concentration of aerosols of predominantly fibrogenic action at the workplace up to ten or more times higher than the maximum permissible concentrations, with an established diagnosis of occupational chronic obstructive pulmonary disease. The control group consisted of 89 trained miners who also worked in dust conditions above the maximum permissible concentrations, without bronchopulmonary pathology. The above groups had no statistical differences among themselves in age and work experience in dusty conditions. The authors also conducted an immunological examination.
 Results. Researchers have identified the features of the immune status in occupational chronic obstructive pulmonary disease — the development of combined immune insufficiency with damage to the humoral link of immunity (decrease in serum immunoglobulin G) and phagocytic activity of neutrophils. At the same time, we have an increased level of proteins of the acute phase of inflammation (C-reactive protein and haptoglobin) and an increased level of circulating immune complexes as an indicator of a high antigenic load. In patients with severe occupational chronic obstructive pulmonary disease, the suppression of the humoral link of immunity increases (a decrease in the relative and absolute amount of CD20+ and the level of serum immunoglobulin G), as well as the phagocytic activity of neutrophils compared with patients with chronic obstructive pulmonary disease of moderate severity and a comparison group that can contribute to the development and recurrence of the infectious and inflammatory process not only in the lungs, but also in other organs.
 Conclusion. The authors revealed the development of combined immune insufficiency with damage to the humoral link of immunity (decrease in serum immunoglobulin G) and phagocytic activity of neutrophils in miners with chronic obstructive pulmonary disease. With a severe degree of the disease, there are more pronounced violations of the humoral link of immunity and phagocytic activity of neutrophils.
 Ethics. This medical study with the participation of a person as a subject was carried out in compliance with the Ethical principles presented in the latest version of the Helsinki Declaration, developed by the World Medical Association.

Prospects of using Securinega suffruticosa (Securinega suffruticosa (Pall.) Rehd.) as a dietary supplement for theprevention of occupation-caused polyneuropathy (literary review)

Polyneuropathy is the syndrome of vibration disease, which occupies one of the leading places in the structure of occupational diseases in industrialized regions. Vibration impact on the body causes a change in neurohumoral control, functional parameters of the nervous system, leads to the development of tissue hypoxia and damage to the cells of various organs. The key direction in the elaboration of means for the prevention of these disorders is the search for new biologically active compounds with adaptogenic properties. Of particular interest as a medicinal raw material is suffruticous Securinega (Securinega suffruticosa (Pall.) Rehd.). In the extracts of this plant there were found following biologically active compounds: alkaloids, terpenoids, unsaturated styrenes, glycosides, saponins, phenolic compounds, flavonoids, etc. The most studied alkaloid, securinine, has a wide range of pharmacological activity: anticancer, antimicrobial, and stimulating effects on the central nervous system.
 The review describes the molecular and cellular mechanisms of the adaptogenic action of Securinega in various pathological conditions. In vitro and in vivo experiments extracts from Securinega suffruticosa (Pall.) Rehd. were shown to exhibit anti-inflammatory activity, improve cell metabolism, and have antioxidant properties. It has been established that Securinega can be a potential therapeutic agent for early atherosclerosis, for the treatment of neurodegenerative diseases associated with systemic neuroinflammatory processes. Continuing the study of the biological effect of the plant can become the base for its scientifically justified preventive use when workers are exposed to harmful production factors, including local and whole-body vibration. 
 The review was prepared using the MedLine, PubMed, Web of Science, Scopus, Google Scholar, CyberLeninka, and RSCI databases.

Occupational and medical aspects of occupational morbidity in men with neurosensory hearing loss

Introduction. Occupational neurosensory hearing loss is one of the most common occupational diseases. So far, there have been no studies in the scientific literature devoted to a retrospective analysis of professional conditions and conditions of medical care organization in case this pathology is detected in workers served by the system of health care institutions of FMBA of Russia.Materials and methods The study used data from the "Industry register of persons with occupational diseases", accounting documents and regulations that allow an analysis of working conditions and medical care.Results The rate of neurosensory hearing loss was 31.3 % in the structure of occupational diseases among employees of enterprises and organizations served by FMBA health care institutions of Russia in 2010-2020. The frequency of continuous use of anti-noise personal protective equipment decreased from 77.8 % (2010–2015) to 75.4 % (2016–2020). Occupational neurosensory hearing loss was diagnosed in 79.4 % of workers based on periodic medical examinations and in 20.6 % of workers based on self-referrals. The decision to refer an employee for determination of the degree of disability was made in 16.5 % of cases.Discussion On the basis of the scientific literature and the results of our study, a proposal to take into account not only physical, but also chemical occupational hazards that aggravate the impact of industrial noise on employee health, as well as the anamnesis of tobacco smoking, cardiovascular disease, diabetes mellitus and atherosclerosis.Conclusion The risk group for occupational neurosensory hearing loss is men over 50 years of age. The duration of formation of this pathology is 34,1 ± 1,1 years at the PS level of 90,6 ± 1,0 dB. The importance of optimal organization of periodic medical examinations and the need to control the use of anti-noise personal protective equipment in the workplace is noted.

Occupational morbidity and its features in the Samara Region in the context of the pandemic of the novel coronavirus infection COVID-19 in 2020–2021

In the context of the spread of the novel coronavirus infection, occupational health is facing problems that require the solution of the issues of maintaining and strengthening the health of workers and their ability to work. Severe complications and high mortality associated with the novel coronavirus infection among medical workers make relevant its analysis and improvement of diagnosis, prevention,treatment, and rehabilitation. Occupational morbidity rates in the Samara Region remain t a high level and exceed the national average, including among healthcare workers. Until 2020, pathology associated with the impact of vibroacoustic factors steadily ranked first in the structure of occupational diseases. Since 2020, diseases associated with the impact of biological factors have taken the leading position in the structure of nosological forms of occupational diseases, among which the diseases caused by the novel coronavirus infection rank first. In 2021, there were 6 diagnoses of chronic occupational diseases associated with a previous coronavirus infection, which caused the permanent disability.

Health risks from exposure to chemicals in Arctic enterprises

Introduction. Chemicals of various hazard classes are among the most common harmful production factors. We aimed to study conditions for the occurrence, prevalence and structure of occupational diseases from exposure to chemicals at enterprises in the Arctic in order to exclude cases of early restriction or complete termination of the labour activity of workers. The study design was to analyze data of social and hygienic monitoring “Working conditions and occupational morbidity of the population” in the Russian Federation in 2007-2020. Materials and methods. We studied the data of social and hygienic monitoring “Working conditions and occupational morbidity of the population of the Russian Federation” in 2007-2020. Results. In the Russian Arctic in 2007-2020, the share of chemicals in the structure of harmful production factors was 7.6%. They were the cause of 7.8% of occupational diseases, the number of which tended to decrease. Characteristic for this group of diseases is the predominant damage to the respiratory organs (74.6%) in workers in the nickel industry (68.3%). Also, a feature of the diseases was the formation in a shorter time (24.3±0.4 years); greater risk in women (relative risk (RR) = 3.48, confidence interval (CI) 2.91-4.16; p<0.001); greater risk of malignancy (RR=3.55; CI 3.13-4.02; p<0.001). Out of five hundred seventy one case of occupational pathology of nickel production workers, 355 (62.2%) were caused by water-insoluble nickel compounds. Other 188 (32.9%) and 28 (4.9%) cases were due to hydroaerosols of nickel salts and nickel tetracarbonyl, respectively. Out of 164 cases of intoxication, 138 (84.1%) had a chronic course and were mainly caused by nickel compounds (87.7%). The main cause of acute intoxication (n=26) was carbon monoxide (76.9%). Limitations. Methods for determining concentrations of chemicals in the air of work areas do not provide an accurate exposure assessment in workers who use personal protective equipment. Conclusion. To reduce the occupational health risks from chemicals, first of all, it is necessary, to decrease concentrations of nickel compounds in the air of the nickel enterprise working areas. In the prevention of certain forms of occupational pathology, priority should be given to respiratory diseases from exposure to water-insoluble nickel compounds, malignant neoplasms and acute carbon monoxide poisoning.

Asbestos danger in central Europe is not yet over - the situation in the Czech Republic

In the Czech Republic, asbestos has been classified as a known human carcinogen since 1984. The use of asbestos-containing products was limited to scenarios where the use of other materials was not possible. Since 1997, the manufacture of asbestos materials has been forbidden, and in 1999, the import, manufacture and distribution of all types of asbestos fibres was legally banned by Act No. 157/1998 Coll. Although the use of asbestos is forbidden, the risk of exposure still exists given the ongoing demolition and reconstruction of buildings in which asbestos has been used. In addition, a novel risk has arisen through the quarrying of asbestos-containing aggregates and their subsequent use. The aim of this paper was to describe and evaluate asbestos in terms of history, legislation, current risk of occupational exposure and its health consequences in the Czech Republic over the last three decades. This retrospective descriptive study used the collected data on occupational exposure and occupational diseases. The counts of workers occupationally exposed to asbestos were obtained from the Registry of Work Categorization; the numbers and structure of occupational diseases caused by asbestos were taken from the Czech National Registry of Occupational Diseases. Data on the total number of mesothelioma cases recorded in the Czech National Cancer Registry was provided by the Institute of Health Information and Statistics of the Czech Republic. A total of 13,112 subjects were registered as occupationally exposed to asbestos during the period 2001-2020. A total of 687 cases of asbestos-related occupational diseases were reported in the period 1991-2020 in the Czech Republic, comprising 178 cases of asbestosis, 250 cases of pleural hyalinosis, 168 cases of pleural or peritoneal mesothelioma, 90 cases of lung cancer, and one case of laryngeal cancer. The data from the Czech National Cancer Registry, available for a shorter period (1991-2018), reveal 1,389 cases of mesothelioma, of which only ~11% were recognised as occupational, despite the fact that the occupational causality of mesotheliomas is estimated to be up to 90% of mesotheliomas. Moreover, the latency of mesotheliomas since the last occupational exposure reached up to 50 years and this trend is still slightly increasing, unlike asbestosis, where a high cumulative dose of inhaled asbestos is needed. The real proportion of occupational lung cancers may obviously be even higher, especially in smokers, where occupational causes including asbestos are not suspected by most physicians. Czech data on asbestos-related occupational diseases, especially cancers, are grossly underestimated, which is most apparent through the low proportion of mesotheliomas diagnosed as occupational. Asbestos materials in older buildings remained in situ and may represent a danger during reconstruction works. The current source of exposure appears to be quarrying of asbestos-containing aggregate and its subsequent use. Awareness of the professional community is therefore crucial, not only for the possibility of compensating those affected, but also for the early detection of the diseases through the dispensary of exposed persons.

Diagnostic markers of exacerbation of chronic obstructive pulmonary disease in workers exposed to industrial aerosols and tobacco

Introduction. Chronic obstructive pulmonary disease (COPD) is one of the most common occupational diseases registered in workers exposed to dust for a long time. This disease significantly worsens the quality of life, requires constant monitoring in the centers of occupational pathology and regular preventive measures. The proportion of COPD in the structure of occupational diseases has not changed significantly for decades, high rates of disability and premature mortality characterized this disease. The study aims to research the diagnostic parameters of COPD exacerbation under the influence of industrial aerosols and tobacco in the clinic of occupational diseases. Materials and methods. Researchers examined 153 patients with occupational COPD (toxic gases and inorganic dust). The comparison group consisted of 103 patients with smoking COPD. We established the diagnosis of COPD in accordance with the criteria of GOLD 2011. The duration of the study was 5 years. The authors conducted a complex of clinical and laboratory studies in all patients with an emphasis on the diagnostic parameters of COPD exacerbation and lung function. The critical significance level is p=0.05. Results. The development of occupational COPD under the influence of industrial aerosols and tobacco affects the frequency and predominant phenotype of exacerbations. Rare but severe exacerbations, mainly with eosinophilic type of inflammation, are present in COPD from the action of toxic gases. They respond well to therapy with systemic GCS. With COPD from the action of dust, hospitalization is not necessary for short-term exacerbations with neutrophilic type of inflammation, since such exacerbations respond to therapy with bronchodilators, and a significant proportion of exacerbations require the use of antibacterial therapy. Also, in COPD from the action of toxic gases, the experience of exposure to aerosols and gases of the production environment is an independent predictor of any exacerbations. But we do not have data on the significance of the length of service and the intensity of dust exposure. Conclusion. The risks of exacerbations of occupational COPD and the predicted features of their course depend on the etiological production factor, its intensity and duration of exposure. Clinical features determine different tactics of treatment and prevention of health deterioration. With the severity of COPD exacerbation from the action of toxic gases, symptoms of emphysema and hypoxemia are characteristic, with COPD from the action of dust, symptoms of bronchial obstruction, emphysema and hypoxemia are characteristic. Obtained results can use to construct risk meters of exacerbations and the scale of effectiveness of rehabilitation measures, to revise the standards of treatment and prevention of patients with COPD of professional genesis, as well as for the differential diagnosis of occupational obstructive pulmonary disease. Limitations. The study was conducted on the basis of Novosibirsk State Medical University and on the basis of the City Clinical Hospital No. 2. The limitations of the study may be the unidirectionality of the study performed and the small sample of patients participating in the research. Ethics. All patients have signed an informed consent form. The study program, the content of the informed consent, and the materials of the article were approved by the local ethics committee of Novosibirsk State Medical University and City Clinical Hospital No. 2.

The use of "Diaskintest" in the screening of tuberculosis infection among the staff in the Bureau of Forensic Medical Service: the results of a prospective study

In the Republic of Tatarstan (RT), as in the Russian Federation (RF), tuberculosis is the leading nosological form in the structure of occupational diseases (OD) from the effects of biological factors. Although tuberculosis, as a disease, is most common among medical workers (MW) of anti-tuberculosis institutions (80%), the remaining 20% of MW with diagnosed occupational tuberculosis are employees of the Bureau of Forensic Medical Service, neuropsychiatric institutions, and the Federal Penitentiary Service. The study aims to analyze the results of a sample with the tuberculosis recombinant allergen (TRA) "Diaskintest" in employees of the Bureau of Forensic Medical Service (FMS) for screening tuberculosis infection at periodic medical examination. Scientists conducted the study of the employees of the FMS Bureau by staging an intradermal sample with the drug "Diaskintest" (DST) in the conditions of a general medical network in the city of Kazan based on the State Autonomous Health Institution "City Polyclinic No. 18". The first stage of the study was the analysis of the results of tuberculin diagnostics using DST under the clinical recommendations "Latent tuberculosis infection (LTI) in children". The second stage of the study, prospectively, using a continuous method, taking into account contraindications to all employees responding to the TRA, conducted a comprehensive examination using computed tomography of the chest organs (CT CO) to exclude the tuberculosis process. We examined 64 employees of the Republican Bureau of the Forensic Medical Service of the Ministry of Health, Republic of Tatarstan, for tuberculosis infection with a breakdown of the TRA. The number of positive samples was 40 (62.5%), a negative result had 24 employees. In addition, the researchers conducted X-ray computed tomography of the chest organs. As a result, we diagnosed active tuberculosis in 4 employees, tuberculosis of questionable activity in 5, metatuberculous changes in 11 people, latent tuberculosis infection (without focal changes according to CT CO) in 14 people. We recommend using a skin test with the allergen tuberculosis recombinant DST at a periodic medical examination for the timely diagnosis of tuberculosis in the staff of the forensic medical examination.

Features of the occupational morbidity formation depending on working conditions in certain economic sectors in Bashkortostan Republic

The main indicator characterizing the occupational risk of health disorders is occupational morbidity, which directly depends on working conditions. In this regard, it is necessary to study working conditions, the peculiarities of the formation of occupational diseases at enterprises of various sectors of the economy of the Republic of Bashkortostan with the subsequent development and implementation of targeted measures to create safe working conditions and preserve the health of workers. The study aims to consider working conditions, dynamics, and structure of occupational morbidity among employees of enterprises in various sectors of the economy. The scientists carried out socio-hygienic studies on the working conditions occupational morbidity in the Republic of Bashkortostan for 2015-2020 based on official state statistics, reporting forms, and analytical materials. We have found that the employees of enterprises engaged in mining and manufacturing have the highest risk of health disorders. In the structure of occupational diseases in workers of the main sectors of the economy in 2015-2019, conditions from the effects of physical overload and overstrain of individual organs and systems prevailed. In 2020, due to a new coronavirus infection, occupational diseases had acute forms mainly caused by a biological factor in medical workers. The obtained results can serve as a basis for the development of measures aimed at creating safe working conditions, preventing the development of occupational diseases, and preserving the health of employees in enterprises of the various economic sectors.

New coronavirus infection as an occupational disease: complex expert cases

Introduction. The professional activity of medical workers (MW) is in close contact with daily contact with various factors of the production environment: physical, chemical, biological, and labor processes. Until 2020, tuberculosis and viral hepatitis prevailed in the structure of occupational diseases (OD) of the medical workers in the Russian Federation. According to the State report "On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020," the first ranking the second place in the structure of occupational diseases, depending on the impact of harmful production factor took the illnesses associated with the action of biological factors - 20,19%, while the main reason for the growth in the incidence of healthcare workers in coronavirus infection COVID-19 (further COVID-19). The study aims were to identify problematic aspects in the establishment of the COVID-19 work from MW. Materials and methods. We have given descriptions of clinical cases, as well as a retrospective analysis of issues of OD according to the patient registers of the following medical institutions: the Center of Occupational Pathology of Sechenov University, the Republican Center of Occupational Pathology of the Ministry of Health, Republic of Tatarstan, the Regional Center of Occupational Pathology of the Samara Region. Results. In 2020, COVID-19 was the most common OD with fatal outcomes and complications in healthcare workers. Today, difficulties in determining the connection of COVID-19 with the profession arise when assessing the epidemiological history, the consequences after a coronavirus infection, and the formulation of the diagnosis. Conclusions. For a qualitative examination of the connection of COVID-19 with the profession, it is necessary to develop a list of clinical conditions with the definition of the timing of complications.

Working conditions and occupational diseases of women in the Republic of Bashkortostan

The main factors of the working environment that harm a woman’s health in the course of work are considered to be physical exertion and functional overstrain, noise, chemical and biological factors, and microclimate. The most unfavorable sectors of the economy in the Republic of Bashkortostan are manufacturing, construction and the agricultural sector, where the largest number of jobs are registered that do not meet the hygienic standards for the above-mentioned production factors, which undoubtedly serves as the main cause of the development of occupational diseases among women. Material and methods.According to the medical records of the inpatient patient, the acts on the case of occupational disease and the registration form No. 30, the etiological causes and the structure of occupational morbidity by industry sectors of the Republic of Bashkortostan among women for 2016–2020 were studied. Results. Among the subjects of the Russian Federation, the Republic of Bashkortostan for the analyzed fiveyear period ranked 25–27th in terms of employment of women in jobs with harmful and (or) dangerous working conditions, and among the 14 regions of the Volga Federal District — 3–5 places. If in the period 2016–2019 among all the primary established occupational diseases from 32.4 to 43.0 % were women, then by 2020 more than half of all occupational diseases (54.7 %) were detected among women. Of the 114 cases of occupational diseases identified to 85 female workers, a third of them worked in health care (32.9 %), a slightly smaller part (30.6 %) — in mechanical engineering (manufacturing) and a fifth — in the agro-industrial complex (21.1 %). The leading place in the structure of occupational pathology of women was occupied by diseases associated with high physical overload and overstrain of individual organs and systems (54.2 %). The reason for the change in the structure of occupational diseases in the region in 2020 there was a new coronavirus infection-Covid-19 in medical workers, which brought diseases from the influence of a biological factor to the second position. Conclusion. The state of working conditions and occupational morbidity among women workers indicates the lack of an effective mechanism for protecting women’s labor and the need to develop effective legislative documents for the protection of their labor and health.

Current aspects of occupational hearing loss in agricultural workers

Introduction. Agricultural workers belong to the cohort of increased risk of developing occupational hearing loss (OHL). When studying occupational sensorineural hearing loss (SHL), researchers usually limit themselves to stating its share in the structure of occupational diseases without a comprehensive analysis of the initiating occupational factors and the relationship between the development of the disease with the age of employees and occupational experience. Materials and methods. The study is based on data on working conditions and occupational diseases by type of economic activity “Agriculture, forestry, hunting, fishing and fish farming” in the Saratov region from 2000 to 2019. The assessment of the factors of working conditions was carried out using the methods of the current hygienic classification. Generally accepted indicators were used to characterize occupational diseases. Linear regression analysis and polynomial equations were used to describe trend models of the prevalence of occupational diseases. Calculations and data analysis was carried out based on Microsoft Excel and Statistica application software packages. Results. Occupational hearing loss occupied the fourth rank after dorsopathies, vibration disease and chronic brucellosis in the nosological structure of accumulated occupational diseases. The level of primary incidence of SHL was in the range of 0.11 - 0.71 per 10000 workers. All cases of OHL were detected in agricultural machine operators whose harmful working conditions were characterized by a synergy of industrial noise (classes 3.1-3.3) and general vibration (classes 2-3.2). For the most part, SHL was diagnosed in workers aged 50 to 60 years with a work experience of 8 to 42 years in the profession and acted as the second or third concomitant occupational disease associated with dorsopathy, vibration disease or bronchopulmonary diseases. Conclusion. The absence of a statistically significant decrease in the level of PPP among agricultural workers during the observation period indicates the insufficient effectiveness of preventive measures to minimise occupational noise exposure.

Modern trends in the formation of occupational pathology when working on mobile agricultural machinery

Introduction. There are currently several works in the scientific literature devoted to studying the influence of working conditions on mobile agricultural machinery on the occupational morbidity of workers on the example of individual regions. Still, Russian Federation did not conduct such studies before. The study aims to analyze working conditions and current trends in the formation of occupational pathology when working on mobile agricultural machinery in the Russian Federation. Materials and methods. The paper uses the results of long-term sanitary-hygienic and ergonomic studies of working conditions when working on mobile agricultural machinery and data on the level of occupational morbidity (PZ) of farmworkers of the Russian Federation in 2011-2017. Results. Microclimatic discomfort, dustiness and gas contamination of the working area air, industrial noise, general and local vibration, physical overload, forming harmful operating conditions (classes 3.2-3.4), occupational risk categories from medium to very high characterize working on mobile agriculture machinery. From 2011 to 2017, researchers have identified 960 agricultural machine operators with 1052 occupational diseases in the Russian Federation, formed mainly under the influence of physical factors and physical overloads. In the nosological structure of occupational diseases (OD), the first place is occupied by vibration disease (VD), the second by radiculopathy (RP), and the third by sensorineural hearing loss. Researchers characterize the current trends in the nosological structure by a significant increase in the prevalence of radiculopathy against the background of a decrease in diagnosis cases of vibration disease. Conclusions. Working conditions when working on mobile agricultural machinery remain harmful and pose a high risk of developing occupational radiculopathy, vibration disease and sensorineural hearing loss. It should be taken into account when developing measures to prevent occupational pathology for agricultural machine operators.

Occupational morbidity and injuries in Health care of the Irkutsk region

Introduction. Health care belongs to a group of economic activities with a high risk of occupational diseases (OD) and occupational injuries (OI), which harm workers and are one of the reasons for the decline in the share of the working-age population. Material and methods. The analysis of OD and OI in Health care has been carried out for 2010-2020. Alignment of the dynamic range and linear regression analysis was performed. The results are extensive and intensive variables, absolute and average values, minimum and maximum values, calculated coefficients. Results. During the observed period in the Irkutsk region, the occupational morbidity rate significantly decreased (from 4.27 for the 2010 year to 2.25 for the 2020 year per 10000 employees). In Health care, this trend is not observed (3.1 for the 2010 year and 6.5 for the 2020 year per 10000 employees). The share of occupational morbidity rate in Health care workers was 6.7-16.5% in the overall structure of OD. The analysis of the OI dynamics indicates a steady decrease in the total number of accidents at the enterprises of the Irkutsk region by 1.3-1.5 times. In Health care, OI levels do not change significantly (1.28 and 1.29 for 2010 and 2019, respectively); the average long-term level of OI risk was 1.20. The share of injuries in the Health care sector is comparable to the number of accidents in the leading sectors of the economy. During the analyzed period, the OI share among healthcare workers increased (from 3.5% for 2010 to 15.3 % for 2019, p<0.01). Conclusion. The dynamics of the relative indicators of injuries in the Healthcare of the Irkutsk region is characterized by instability for the period 2010-2019; therefore, it is necessary to take systemic measures to manage occupational risks.

Problems of formation of the toxic hepatopathy forming in the conditions of chronic fluoride intoxication of the body

Introduction. Aluminium production is characterized by the accumulation of impurities of various toxic and chemical compositions in the air of working areas, the predominant among which are fluoride compounds. The accumulation of fluorides in the body causes the development of osteoarticular and associated systemic pathology. The aim of the study was to evaluate the hygienic and medico-biological features of toxic liver damage in the conditions of chronic fluoride intoxication of the body. Material and methods. The hygienic working conditions of the workers of the primary professions in aluminium production were evaluated. The analysis of hepatobiliary dysfunction based on clinical and instrumental methods was carried out in 263 subjects with fluoride intoxication and a comparison group of 116 persons. Experimental studies of the morpho-functional liver state in modelling chronic fluoride intoxication were carried out based on toxicological, biochemical, pathomorphological methods with histological analysis of tissues. The toxic properties of sodium fluoride were studied in 117 white laboratory male rats with its peroral route intake into the body. Results. The qualitative composition of the air in the working areas in the electrolysis building was analyzed. The prevalence of pathological disorders of the biliary tract in metallurgists engaged in aluminium production was assessed. Clinical studies revealed a significant prevalence of toxic fluoride hepatopathy, fatty hepatosis, cholecystitis and other disorders in the group of patients with chronic fluoride intoxication. The harmful effect of sodium fluoride on hepatocytes, vessels of the portal tract was shown in an experiment. Hyperfunction of the reticuloendothelial system, Kupffer cell proliferation, irreversible destruction of hepatocytes, necrosis against the background of severe dystrophy, and decreased synthetic activity of the liver were determined. Conclusion. The structure of occupational diseases in the workers engaged in the aluminium production is dominated by hepatobiliary pathology caused by toxic liver damage with fluoride confirmed by experimental data on destructive violations of its morphostructure.

Hygienic aspects of the analysis of occupational morbidity of agricultural workers in the Kemerovo region

Unfavorable working conditions at the workplaces of agricultural enterprises are the reason for the development of occupational pathology, which makes it necessary to conduct a hygienic assessment of the occupational morbidity of workers in the agricultural sector of the Kemerovo region. The methods used are the analysis of primary statistical forms of accounting for occupational diseases, hygienic assessment of working conditions, and a comprehensive hygienic assessment of occupational morbidity in accordance with the «Methods of computer modeling of the sanitary and epidemiological situation with occupational morbidity in the Kemerovo region. Methodological recommendations» using the cluster analysis program «Cluster Analysis». For the period 2008–2018. In the region, only 58 cases of occupational diseases were registered among agricultural workers, while 90 % of enterprises are classified as objects of the 2–3 group of sanitary and epidemiological welfare. In contrast to the gradual decline in indicators in the country as a whole, the region recorded peaks in the incidence in 2009, 2011, 2013 and 2017. At the same time, the correlation analysis indicates a direct strong correlation between the dynamics of occupational morbidity in the region and in the Russian Federation (R = 0.862702; p < 0.05). The results of the analysis of the method of establishing the diagnosis indicate that in relation to diseases that arose as a result of exposure to physical overload, vibroacoustic factors, only 60 % were detected during periodic medical examinations. The structure of occupational diseases was dominated by radiculopathy — 33 %, vibration disease — 31 %, brucellosis — 25 %. The analysis of cause-and-effect relationships, the clusters of professions obtained using the method of mathematical modeling (driver and blacksmith-cluster distance 1,4, mechanic and plasterer-cluster distance 2,2, independent clusters-tractor driver and wood feller) and the similarity of the development of unfavorable sanitary and epidemiological situations in relation to them should be used in the activities of the Rospotrebnadzor Department as a basis for planning control and supervisory measures and for justifying preventive measures to preserve labor potential.

Occupational diseases of health care workers from exposure to infectious agents: the current state of the problem

Introduction. Infectious diseases occupy a leading place in the structure of occupational diseases (OD) of health care workers (HCW). If until 2020, the main OD from exposure to a biological factor were tuberculosis and viral hepatitis (VH), then in 2020 the world faced another infectious disease of professional etiology - infection of health workers with a new coronavirus infection (COVID-19). The aim of the study is to identify problematic issues in establishing the connection of an infectious disease with a profession in health care workers. Materials and methods. A retrospective analysis of cases of occupational diseases was applied according to the data of the Department of Rospotrebnadzor for the Republic of Tatarstan (RT) and the register of patients of the Republican Center of Occupational Pathology. Results. Among the health care workers of the Republic of Tatarstan, mainly occupational infectious diseases are diagnosed (88.9%). Tuberculosis is the most common occupational disease among health care workers of the Republic of Tatarstan, accounting for 68.4%, and viral hepatitis accounts for 20.5%. In 2020, the most common OD from biological factors in the health care workers of RT was infection COVID-19. Conclusions. Currently, the most common disease of infectious genesis in health care workers is a new coronavirus infection. For a high-quality examination of the connection of an infectious disease with a profession, the list of documents must include a card of epidemiological examination, which must be filled in by an epidemiologist not after establishing the connection of the disease with the profession, but in parallel with the preparation of a sanitary and hygienic characteristic (SGC) of working conditions.

Health Risks of Mining in the Arctic

Introduction: Mining in the Arctic is associated with an increased risk of developing occupational diseases. The objective of the study was to investigate the risks, structure and prevalence of occupational diseases in workers engaged in extraction of oil and gas, coal, and ore raw materials in the Russian Arctic. Materials and methods: I analyzed the results of socio-hygienic monitoring “Working Conditions and Occupational Health” conducted in the Arctic zone of the Russian Federation in 2007–2018. Results: Significant differences in working conditions in the extraction of various types of minerals were established, the most favorable being in the oil and gas industry as opposed to the coal mining. The risk of occupational diseases in coal mining was higher than that in oil and gas production (OR = 366.7; CI 275.8–487.6) and ore mining (OR = 1.66; CI 1.58–1.73). Among oil and gas industry workers, the structure of occupational diseases was dominated by sensorineural hearing loss (50.0 %), radiculopathy (20.8 %) and vibration disease (18.9 %). In coal miners, the most prevalent diseases included radiculopathy (32.8 %), chronic bronchitis (26.9 %) and mono-and polyneuropathy (15.5 %), and in ore miners – vibration disease (44.8 %) and radiculopathy (16.3 %). In 2018, compared to 2007, the number of occupational diseases in ore and coal miners increased by 2.16 and 1.42 times, respectively. In 2007–2018, the proportion of occupational diseases diagnosed in miners of the Russian Arctic rose from 57.9 % to 75.6 %. Conclusions: In the mining industry of the Russian Arctic, the maximum health risk is observed in coal mining, and the minimum – in gas and oil industry. The number of occupational diseases in miners tends to increase, which requires improvement of preventive measures adapted to Arctic conditions.

Increased severity of labor is the most important risk factor of occupational diseases at enterprises in the Arctic

In Russia, in the structure of harmful production factors that cause the development of occupational pathology, the severity of labor takes the second place. The aim of the study was to investigate the effect of increased labor severity on the occurrence, prevalence and structure of occupational diseases in workers at enterprises in the Arctic. The analysis included results of the monitoring study “Working conditions and occupational morbidity” of the population of the Arctic zone of Russia in 2008 – 2018. It was found that in 2008-2018 there was a significant increase in the etiological significance of increased labor severity in the development of occupational pathology: the share of the factor in the total structure of harmful occupational exposures increased from 7.4% to 8.9% (p <0.001), and that of occupational diseases caused by increased labor severity - from 18.6% to 46.9% (p <0.001). Two thirds of occupational diseases caused by the increased severity of labor occur in miners, and diseases of the musculoskeletal system dominate in their structure (80.1%). The risk of developing this group of occupational health disorders in 2018 was higher than in 2008: RR=3,95; CI 3,13-4,99; χ2 =155,9; р<0,001. In contrast to the Russian Federation as a whole, where the increased severity of labor ranks second among the occupational pathology causing factors (24.7%), in the Russian Arctic it came out on top in 2018 (46.9%), exceeding the cumulative effect of all physical factors (44.0%). When carrying out recreational activities and prevention of occupational pathology at enterprises in the Arctic, special attention should be paid to achieving permissible levels of labor severity among workers engaged in mining operations.