zurniimtpeМедицина труда и промышленная экологияRussian Journal of Occupational Health and Industrial Ecology1026-94282618-8945FSBSI “Izmerov Research Institute of Occupational Health”10.31089/1026-9428-2021-61-7-442-450zurniimtpe-2766Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESОсобенности стажевой динамики вариабельности ритма сердца у работников предприятия по переработке калийной рудыFeatures of the long-term dynamics of heart rate variability among workers of a potash ore processing enterprisehttps://orcid.org/0000-0003-0539-569XНосовАлександр ЕвгеньевичNosovAlexandr E.

Канд. мед. наук, зав. стационаром (отделение профпатологии терапевтического профиля).

e-mail: nosov@fcrisk.ru

PhD, Candidate of Medical Sciences, Head of the Center for Occupational Pathology Federal Scientific Center for Medical and Preventive Health Risk Management Technologies.

e-mail: nosov@fcrisk.ru

nosov@fcrisk.ruhttps://orcid.org/0000-0003-2356-1145ЗайцеваН. В.ZaitsevaNina V.noemail@neicon.ruhttps://orcid.org/0000-0001-5135-8385КостаревВ. Г.KostarevVitalii G.noemail@neicon.ruhttps://orcid.org/0000-0002-5671-3953ИвашоваЮ. А.IvashovaJulia A.noemail@neicon.ruhttps://orcid.org/0000-0001-5776-8182СавинковМ. А.SavinkovMaksim A.noemail@neicon.ruhttps://orcid.org/0000-0003-3344-3361УстиноваО. Ю.UstinovaOlga Yu.noemail@neicon.ruФБУН «Федеральный научный центр медико-профилактических технологий управления рисками здоровью населения» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека»РоссияFederal Scientific Center for Medical and Preventive Technologies for Managing Public Health Risks of the Federal Service for Supervision of Consumer Rights Protection and Human WellbeingRussian FederationФБУН «Федеральный научный центр медико-профилактических технологий управления рисками здоровью населения» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека»; ФГБОУ ВО «Пермский государственный национальный исследовательский университет»РоссияFederal Scientific Center for Medical and Preventive Technologies for Managing Public Health Risks of the Federal Service for Supervision of Consumer Rights Protection and Human Wellbeing; Perm State National Research UniversityRussian FederationУправление Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека по Пермскому краюРоссияOffice of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare in the Perm TerritoryRussian Federation202128092021617442450Copyright © Носов А.Е., Зайцева Н.В., Костарев В.Г., Ивашова Ю.А., Савинков М.А., Устинова О.Ю., 20212021Носов А.Е., Зайцева Н.В., Костарев В.Г., Ивашова Ю.А., Савинков М.А., Устинова О.Ю.Nosov A.E., Zaitseva N.V., Kostarev V.G., Ivashova J.A., Savinkov M.A., Ustinova O.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journal-irioh.ru/jour/article/view/2766Введение

Введение. В настоящее время нарушение вариабельности ритма сердца рассматривается в качестве одного из основных патогенетических механизмов повреждающего действия поллютантов, связанного с воздействием на сердечно-сосудистую систему.

Цель исследования — изучение особенностей влияния вегетативной нервной системы (ВНС) на вариабельность ритма сердца (ВРС) у работников предприятия по переработке калиевой руды, подвергающихся воздействию поллютантов промышленного происхождения (мелкодисперсные фракции пыли калия хлорида, формальдегид, гексан, гептан) с оценкой динамики изменений в зависимости от стажа работы, установление причинно-следственных связей нарушений вариабельности сердечного ритма с экспозицией химических соединений.

Материалы и методы

Материалы и методы. Объектом исследования были 140 работников предприятия по переработке калийной руды, отнесённые к группе наблюдения, и 76 работников административно-технического аппарата, составившие группу сравнения. Из воздуха рабочей зоны проводился отбор проб на содержание предельных углеводородов (гексан, гептан), определялась концентрация паров формальдегида, устанавливалось присутствие мелкодисперсных частиц РМ2,5 и РМ10. Исследование биологических сред (кровь, моча) работающих на предприятии включало определение формальдегида в крови, гексана и гептана в моче. Оценка вариабельности ритма сердца осуществлялась на компьютерном электрокардиографе «Поли-Спектр-8/ЕХ» с помощью кардиоритмографической программы методом временного анализа, вариационной пульсометрии и спектрального анализа.

Результаты

Результаты. Концентрация мелкодисперсных частиц в воздухе на рабочих местах группы наблюдения превышала по РМ2,5 в 12–111 раз, по РМ10 в 5,6–74,6 раза таковую для рабочих мест группы сравнения. Концентрация в воздухе формальдегида, гексана и гептана не превышала гигиенических нормативов. В группе наблюдения относительно группы сравнения концентрация формальдегида в крови была выше в 1,5 раза (р<0,001), концентрация в моче гексана — в 1,2 раза (р=0,011), гептана — в 1,3 раза (р=0,046). Установлено, что при стаже до 10 лет концентрация формальдегида в крови работников группы наблюдения было в 1,4 раза выше таковой в группе сравнения (р=0,011), при стаже более 10 лет — в 1,7 раза (р=0,005). В моче работников группы наблюдения со стажем работы до 10 лет установлено превышение относительно группы сравнения гексана в 1,3 раза (р=0,026). Анализ данных ВРС (временного, спектрального анализа, оценки типов исходного вегетативного тонуса) групп наблюдения и сравнения не выявил значимых межгрупповых различий (р>0,05). С увеличением стажа работы в группе наблюдения прослеживается достоверное уменьшение значений показателей временного анализа (SDNN, мс, RMSSD, мс, рNN50, %, СV, %), тогда как в группе сравнения статистически значимым было уменьшение только CV, %; значения индекса напряжения (ИН) усл. ед., АМо, % достоверно увеличивались (р=0,03 и р=0,003 соответственно). Установлена статистически значимая связь вероятности увеличения ИН в зависимости от содержания гептана в моче (b0=0,22; b1=10,6; F=21,5; R2=0,09; р=0,0001) и формальдегида в крови (b0=0,02; b1=6,55; F=69,6; R2=0,25; р=0,0001) у обследованных работников.

Выводы

Выводы. У работников группы наблюдения с увеличением стажа работы происходит снижение ВРС, значимое увеличение вклада в регуляцию сердечной деятельности симпатического отдела ВНС, активация центральных эрготропных и гуморально-метаболических механизмов, тенденция к уменьшению парасимпатических влияний. Метод логистического регрессионного анализа установил статистически значимую связь вероятности увеличения индекса напряжения в зависимости от содержания гептана в моче и формальдегида в крови у обследованных работников.

Introduction

Introduction. Currently, the violation of heart rate variability as one of the main pathogenetic mechanisms of the damaging effect of pollutants, associated effects on the cardiovascular system.

The study aims to explore the dynamics of the influence of the autonomic nervous system (ANS) on heart rate variability (HRV) in workers of a potassium ore processing enterprise exposed to industrial pollutants (fine fractions of potassium chloride dust, formaldehyde, hexane, heptane) with an assessment of changes in dependence from work experience, establishment of cause-and-effect relationships of violations of heart rate variability with exposure to chemical compounds.

Materials and methods

Materials and methods. The object of the study was 140 employees of a potash ore processing enterprise, assigned to the observation group, and 76 employees of the administrative and technical apparatus, who made up the comparison group. Samples were taken from the air of the working medium for the content of saturated hydrocarbons (hexane, heptane), the vapors of formhehyde were considered, and the presence of fine particles PM2.5 and PM10 was established. Investigation of biological media (blood, urine) of workers at the enterprise determination of formaldehyde in blood, hexane and heptane in urine. Evaluation of heart rate variability was carried out on a computer electrocardiograph "Poli-Spectr-8/EX" using a cardiorhythmographic program using the method of time analysis, variation pulsometry and spectral analysis.

Results

Results. The concentration of fine particles in the air at the workplaces of the observation group was 12–111 times higher for PM2.5, and 5.6–74.6 times higher for PM10 than for the work places of the comparison group. The concentration of formaldehyde, hexane and heptane in the air did not exceed hygienic standards. In the observation group relative to the comparison group, formaldehyde blood was 1.5 times (p<0.001), in the urine of hexane — 1.2 times (p=0.011), heptane — 1.3 times (p=0.046). It was found that with an experience of up to 10 years, formaldehyde in the blood of workers in the observation group was 1.4 times higher than that in the comparison group (p=0.011), with an experience of more than 10 years — 1.7 times (p=0.005). In the urine of workers in the observation group with work experience of up to 10 years, an excess of 1.3 (p=0.026) relative to the comparison group of hexane was found. HRV data analysis. With damage to the length of service in the observation group, there was a significant decrease in the temporal analysis indicators (SDNN, ms, RMSSD, ms, pNN50, %, CV, %), while in the comparison group, only the CV, % decrease was statistically significant; the values of IN conventional units, AMo, % significantly increased (p=0.03 and p=0.003, respectively). A statistically significant relationship was established between the likelihood of an increase depending on the content of heptane in urine (b0=0.22; b1=10.6; F=21.5; R2=0.09; p=0.0001) and formaldehyde in the blood (b0=0.02; b1=6.55; F=69.6; R2=0.25; p=0.0001) in the surveyed workers.

Conclusions

Conclusions. Activation of central ergotropic and humoral-metabolic mechanisms, a tendency towards a decrease in parasympathetic influences. The method of logistic regression analysis established a statistically significant relationship between the probability of an increase in the stress index depending on the heptane content in the blood of the surveyed suppliers.

мелкодисперсные фракции пылиформальдегидгептангексанвариабельность ритма сердцаработникиfine dust fractionsformaldehydeheptanehexaneheart rate variabilityworkersReferencesAbdelnabi M.H. Cardiovascular Clinical Implications of Heart Rate Variability. Int. J. Cardiovasc. Acad. 2019; 5: 37-41. https://doi.org/10.4103/IJCA.IJCA_36_18Abdelnabi M.H. Cardiovascular Clinical Implications of Heart Rate Variability. Int. J. Cardiovasc. Acad. 2019; 5: 37-41. https://doi.org/10.4103/IJCA.IJCA_36_18Urbanik D., Podgórski M., Mazur G. Heart rate variability - clinical significance. Fam. Med. Prim. Care Rev. 2018; 20(1): 87-90. https://doi.org/10.5114/fmpcr.2018.73710Urbanik D., Podgórski M., Mazur G. Heart rate variability - clinical significance. Fam. Med. Prim. Care Rev. 2018; 20(1): 87-90. https://doi.org/10.5114/fmpcr.2018.73710Billman G.E., Huikuri H.V., Sacha J., Trimmel K. An introduction to heart rate variability: methodological considerations and clinical applications. Front. 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The authors declare that there are no conflicts of interest present.