Introduction. Currently, scientists consider occupational bronchial asthma as a phenotypically and genetically heterogeneous disease. The assessment of clinical data, features of immunopathogenesis and molecular genotyping opens up new opportunities in assessing the development, predicting the features of the course and a personalized approach to pharmacotherapy of occupational bronchial asthma, as well as in developing an individual strategy for its prevention.

The study aims to determine clinical, immunological and genetic markers of the risk of developing occupational bronchial asthma (OBA) under exposure to sensitizing substances based on the results of an assessment of polymorphic variants rs2069812 of the IL5 gene and polymorphic variants rs1837253 of the TSLP gene.

Materials and methods. The study included 170 patients with different OBA phenotypes and 50 people in the control group. The levels of cytokines IL-17, TNF-α, IFN-γ, VEGF, total IgE, C-reactive protein and fibronectin in blood serum were determined by solid-phase enzyme immunoassay using kits and reagents (Protein Contour LLC, Vector-Best, Diatex-E, DIA‑plus», «Pharmacologicia diagnostika», «eBioscience»). The authors have performed genotyping by polymerase chain reaction in real time using primers and probes developed using the PrimerQuest program (Integrated DNA Technologies, Inc.).

Results. For the first time, researchers established the features of clinical and immunological manifestations in allergic, non-allergic phenotypes of occupational bronchial asthma, as well as phenotypes of combination of occupational bronchial asthma with occupational chronic obstructive pulmonary disease and metabolic syndrome (MS), genetic markers of the risk of developing OBA when exposed to sensitizing substances were also identified: polymorphic variants rs2069812 of the IL-5 gene and polymorphic variants rs1837253 of the TSLP gene. This allows us to recommend the determination of these immunological parameters and genetic markers during in-depth periodic medical examinations in persons working under the influence of sensitizing and irritating substances for differential diagnosis in various phenotypes of occupational bronchial asthma.

Limitation. The study has regional (Samara region) and professional (in terms of detailing the working conditions in the studied comparison groups) limitations.

Conclusion. The revealed clinical, immunological and genotypic features in various phenotypes of occupational bronchial asthma, the established genotypic profiles of occupational bronchial asthma make it possible to optimize the approach to early diagnosis, prognosis, prevention and pharmacotherapy of this disease, as well as expand the list of immunological indicators and genetic studies used during preliminary and periodic medical examinations, in-depth examination of patients with occupational bronchial asthma in occupational disease clinics and occupational pathology centers, the use of new significant criteria for predicting the course of the disease.

Ethics. The study was carried out within the Framework of the complex topic of the Department of Occupational Diseases and Clinical Pharmacology named after Honored Scientist of the Russian Federation Professor V.V. Kosarev of Samara State Medical University «A systematic approach to early diagnosis, prevention and prediction of the impact of low-intensity production factors on the health of workers» (State registration number AAAA18-118122190069-6, date of statement registered on December 21, 2018). The study was approved by the local Ethics Committee of the Samara State Medical University of the Ministry of Health of the Russian Federation on 11/23/2021. Each participant of the study gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form in the journal «Russian Journal of Occupational Health and industrial Ecology» («Meditsina truda i promyshlennaya ekologiya»).

Contribution:
Strizhakov L.A. — the concept and design of the study, writing the text, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Babanov S.A. — research concept and design, data collection and processing, text writing, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Lavrentieva N.E. — writing the text, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Baikova A.G. — data collection and processing, approval of the final version of the article, responsibility for the integrity of all parts of the article
Agarkova A.S. — writing the text, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Melentyev A.V. — writing the text, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 12.03.2024 / Accepted: 09.06.2024 / Published: 20.08.2024

Introduction. Preserving and strengthening the health of the working population of Russia is a priority task of occupational health.

The study aims to research the features of polymorphism of the VEGFa G634C gene and expression of the vascular endothelial growth factor receptor (CD304⁺) as risk factors for angiogenesis disorders in workers exposed to rare earth elements.

Materials and methods. The observation group included 46 people — employees of a non-ferrous metallurgy enterprise exposed to harmful chemical production factors — lanthanides (class of working conditions 3.1). The comparison group included 64 people who are not in contact with harmful production factors (administrative workers). The researchers have used immunological methods in the work: allergosorbent test with enzyme label, membrane immunofluorescence on a flow cytometer, IFA. For statistical processing of the study results, the authors have used the following criteria: Student’s t-test, Mann–Whitney U-test, coefficient of determination (R²), relative risk index (RR), odds ratio (OR) and 95% confidence interval (CI). The authors considered the reliability of the differences to be significant at p<0.05

Results. In the observation group, the following were found: overexpression of lanthanide-specific IgG with an increase in the concentration of yttrium and cerium in the blood (R²=0.44 at p<0.05; OR=2.05; 95% CI=1.03–5.05) (RR=1.32; 95% CI=1.17–6.75); an increased expression level in relation to the comparison group of the neuropilin-1 CD304⁺ semaphorin receptor, which is also a receptor for vascular endothelial growth factor (VEGF), associated with an increase in the concentration of neodymium in the blood (R²=0.94 at p≤0.05; OR=1.27; 95% CI=1.06–3.84; RR=1.22; 95% CI=1.09–4.24). According to the results of the evaluation of the frequency of alleles and genotypes of the gene of the vascular endothelial growth factor VEGFa G634C (rs2010963), which controls the effects of the innate immune response (dendritic cells), the expression level of the G allele was significantly increased in relation to administrative workers (by 1.4 times), while the minor CC genotype was completely absent.

Limitations. The limitations of this study were the limited sample size and the number of literary sources on the issue under study.

Conclusion. In people working under the influence of harmful chemical factors — lanthanides (hazard class 3.1), experts have established the features of the expression of the VEGF gene and receptor: overexpression of the CD304⁺ lymphocyte cluster (HR=1.22; 95% CI=1.09–4.24), increased frequency of the G allele of the VEGFa gene (hazard class 3.1). The VEGFa G634C gene (OR=2.87; CI=1.16–7.07; OR=1.64(1.03–2.38); p<0.005), as well as an increase in the concentration of lanthanide-specific IgG (OR=2.05; 95% CI=1.03–5.05), which forms the risk of developing immunoassociated angiogenesis disorders associated with contamination of the biological environment with rare earth elements.

Ethics. The work was carried out in accordance with the principles of the Helsinki Declaration. The protocol and design of the study were approved by the local committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, dated 07/13/2023, Protocol No. 14.

Contribution:
Dolgikh O.V. — concept and design of the study, data collection and processing, text writing, editing;
Zaitseva N.V. — concept and design of the study;
Letyushev A.N. — concept and design of the study;
Chelakova Yu.A. — data collection and processing, text writing, editing.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 17.06.2024 / Accepted: 11.06.2024 / Published: 20.08.2024

Introduction. Dyslipidemia is one of the most common risk factors for cardiovascular disease (RFCVD). In coal industry workers, working conditions are considered as an additional risk factor to the well-known RFCVD.

The study aims to analyze the prevalence of RFCVD in coal industry workers in comparison with the general population of the Kemerovo region.

Materials and methods. The study included 2,356 male respondents, 1,656 (70.3%) coal industry workers (the main group) and 700 (29.7%) people from the population sample of participants in the multicenter epidemiological study of ESSE-RF included in the territory of Kuzbass (control group). The traditional FSSR was evaluated, including the parameters of lipid metabolism (total cholesterol (TCH), triglycerides (TC), low-density lipoproteins (LDL) and high-density lipoproteins (HDL)).

Results. A comparative analysis of the FSSRP of coal industry workers and the control group showed their high prevalence in the control group: the prevalence of diabetes mellitus by 12.3 times, previous stroke by 4.8 times, myocardial infarction by 4 times, arterial hypertension by 3.8 times, obesity by 1.8 times, dyslipidemia by 1.2 times. The average values of systolic (SBP) and diastolic (DBP) blood pressure and plasma glucose levels were within the normal range in both groups, but statistically significantly higher in the control group. There were 1.3 times more smokers among coal industry workers (60.4% compared to the control group). 45.7%, p<0.001). The median of TCH and its fractions, TC were within the limits of the normative values for workers in the coal industry, whereas in the control group the LDL level was statistically significantly higher. The incidence of hypertriglyceridemia (34.2% vs. 22.4%) and low HDL (15.8% vs. 2.0%) was statistically significantly higher in miners. The researchers observed hypercholesterolemia and high LDL levels in more than half of the patients (50.6% and 65.3%, respectively) of the control group. A correlation analysis of work experience in the coal industry and the FSSR demonstrated an association with age (r=0.83, p≤0.001), body mass index (BMI) (r=0.37, p≤0.001), SBP level (r=0.33, p≤0.001) and DBP (r=0.36, p≤0.001), concentration of TCH (r=0.65, p≤0.001), LDL (r=0.51, p≤0.001) and TC (r=0.84, p≤0.001). The authors found that coal miners had an 11.5-fold increased risk of HDL reduction, 2.3-fold increased hypertriglyceridemia, and 2-fold increased risk of smoking compared to the population of the region. The proportion of people with hypertriglyceridemia and low HDL prevailed in all age groups of coal industry workers. Taking into account the work experience of more trained individuals, the risk of hypercholesterolemia and high LDL levels increases by 2 times, the risk of hypertriglyceridemia and low HDL levels is slightly lower.

Limitation. The design of the study did not allow to determine the causal relationship between the profession and the RFCVD. The analysis of the nature of nutrition, intake/abuse of alcoholic beverages was not carried out and metabolic syndrome was not diagnosed as possible causes of dyslipidemia. Inclusion in the main and control groups was carried out for different periods of time.

Conclusion. Smoking and dyslipidemia are among the most common RFCVD among workers in the Kuzbass coal industry. The largest proportion is hypercholesterolemia, one third has hypertriglyceridemia and elevated LDL, half as often as low HDL. The duration of work in underground conditions is associated with age, BMI, SBP, DBP, concentrations of TCH, LDL, TC. The proportion of people with hypertriglyceridemia and low HDL prevails in all age groups of coal miners. In more trained workers, the risk of hypercholesterolemia and high LDL increases by 2 times, the risk of hypertriglyceridemia and low HDL is slightly lower.

Ethics. The study was performed in accordance with the standards of good clinical practice and the principles of the Helsinki Declaration. Prior to inclusion, all respondents signed an informed consent form.

Contribution:
Bazdyrev E.D. — research concept and design, writing, editing;
Tsenter I.M. — collecting material and processing data, writing text;|
Chasskikh E.V. — collecting material and processing data, writing text;
Nakhratova O.V. — data processing, text writing;
Tsygankova D.P. — data processing, text writing;
Indukaeva E.V. — data processing, text writing;
Artamonova G.V. — concept and design, editing;
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts.

Funding. The study was conducted within the Framework of the fundamental theme of the Research Institute of the CPSU No. 0419-2022-0002. Development of innovative models for managing the risk of developing diseases of the circulatory system, taking into account comorbidity, based on the study of fundamental, clinical, epidemiological mechanisms and organizational technologies of medical care in the industrial region of Siberia.

Conflict of interests. The authors declare no conflict of interests.

Received: 17.05.2024 / Accepted: 19.06.2024 / Published: 20.08.2024

Introduction. The pandemic of a new coronavirus infection has become an emergency of international importance due to the high risk of developing life-threatening conditions and complications. Long-term cardiovascular outcomes after COVID-19 remain poorly understood, especially among professional groups, including those related to transport management, which account for a large number of people. Employees of locomotive crews in the course of their professional activities work under the influence of various factors of the industrial environment (noise, vibration), occupational stress (shift work, violation of work and rest, monotony of work) and also non-productive factors: smoking, increased body weight, high blood pressure, which affect the development of cardiovascular diseases, and coronavirus infection can worsen cardiovascular complications. Currently, the use of echocardiography allows timely detection of structural and functional disorders of the heart, which helps both in the early and late postinfection period.

The study aims to evaluate echocardiographic indicators in locomotive crew workers who had suffered a coronavirus infection, depending on the severity of the course and the presence of non–occupational risk factors for the development of cardiovascular diseases.

Materials and methods. The study included 20 male employees of locomotive crews, aged 44.7±6.4 years, who suffered COVID-19 in the first and second quarters of 2022, and are currently continuing their work. The research was conducted in the period 2022–2023. Depending on the severity of the coronavirus infection and non-professional risk factors, the researchers divided the workers into 2 groups: the 1^st group consisted of workers who had suffered a severe form of COVID-19 and had risk factors: smoking, increased body weight, high blood pressure; the 2^nd group consisted of workers who had suffered a mild form of COVID-19 without non-occupational risk factors. Employees underwent echocardiography with Doppler examination, measurement of blood pressure and heart rate every three months, for a year, after the closure of the employee disability sheet. Archival studies of echocardiography, blood pressure and heart rate measurements performed before COVID-19 disease were taken from outpatient records.

Results. Experts have identified in workers of group 1 (severe form), with existing non-occupational risk factors for the development of cardiovascular diseases (smoking, increased body weight, high blood pressure), in contrast to echocardiography indicators of group 2, signs of remodeling of the left ventricular myocardium, due to a slight increase in the linear size of the heart (thickness of the interventricular septa in the diastole, final diastolic size) with preserved systolic function of the left ventricle, ejection fraction of more than 60% (according to the Teicholz method), but with impaired relaxation of the left ventricular myocardium (E/A<1, DT>240 ms, IVRT>90 ms). When comparing systolic blood pressure and heart rate, the authors noted an increase in both groups. In workers who have suffered a severe form of coronavirus infection, blood pressure indicators correspond to «grade I hypertension» and require the appointment of antihypertensive therapy on an ongoing basis. In group 2 workers, blood pressure indicators correspond to «high normal blood pressure» and do not require the appointment of regular antihypertensive therapy.

Limitation. The limitation of the study is the small number of observations of employees of locomotive crews currently working and who have had a coronavirus infection.

Conclusion. Structural and functional changes in the heart of locomotive crew workers who have had coronavirus infection and are currently working are associated with the severity of COVID-19 and the presence of risk factors (high blood pressure, smoking, overweight). In the mild form of coronavirus infection in workers, the authors revealed functional changes – an increase in heart rate and blood pressure to the level of «high normal blood pressure», in the severe form functional (increased heart rate, blood pressure, impaired relaxation of the left ventricle) and structural (initial manifestations of left ventricular myocardial remodeling). Employees of both groups who have suffered both severe and mild forms of coronavirus infection are currently continuing their work as an «electric train driver» and currently need the supervision of therapeutic and diagnostic specialists.

Ethics. This study was approved by the local Ethics Committee of the Izmerov Research Institute of Occupational Health (extract from Protocol No. 1 dated February 16, 2022).

Contribution:
Gerasimidi S.K. — research concept and design, material collection and processing, statistical data processing, text writing, text editing;
Glukhov D.V. — concept and design of the study, text editing.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 28.06.2024 / Accepted: 10.07.2024 / Published: 20.08.2024

The system of medical examinations is crucial for maintaining the health of the working population. The authors have conducted an analytical review of the regulatory framework for mandatory medical examinations and real clinical practice. They also have conducted a retrospective analysis of the history of the creation and development of the system of mandatory medical examinations of workers in the Russian Federation since 1921. The researchers have reviewed modern approaches to the organization of mandatory medical examinations of employees in accordance with regulatory and legislative documents and presented domestic experience in organizing and conducting mandatory preliminary and periodic medical examinations, outlined the prospects for optimizing medical examinations.

Contribution:
Gorblyansky Yu.Yu. — the concept and design of the study, writing the text;
Kontorovich E.P. — writing, editing;
Ponamareva O.P. — writing the text, design of the bibliography;
Syachina A.V. — writing a text.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 08.07.2024 / Accepted: 11.07.2024 / Published: 20.08.2024

In the diagnosis of occupational diseases, the primary, most saturated with the results of the body's natural interaction with the production environment,

In the diagnosis of occupational diseases, the primary, most saturated with the results of the body’s natural interaction with the production environment, mobile communication, is of high importance. However, official guidelines are not intended to identify it. Without this, the development of problems of individual occupational risk, occupational health, presenteeism and the development of productive forces cannot but be palliative, which makes it difficult to achieve the goal of occupational health — to provide everyone with healthy labor.

The study aims to substantiate an informative methodological approach for assessing individual occupational risk in physical labor.

The authors studied the work of 10 movers (men aged 30-35 years) who were engaged in loading and unloading furniture delivered to customers. The workers were divided into two groups of equal numbers, differing in the level of preliminary physical training. The first group consisted of five people who had previously regularly engaged in weightlifting, and the second consisted of people who had not previously engaged in such activities.

The experimental condition of the study consisted in the paired movement of a heavy load (50–60 kg or more) by two workers in one of these groups. The scientists used timekeeping, ergonomic, physiological and physiological-ergonomic methods to study the severity of labor. They also identified: the heart rate, followed by its transfer to the power of work, the mass of skeletal muscles involved in the work according to the physiological method with the determination of the value of the minute volume of respiration. The mass of skeletal muscles involved in the work was estimated by experts in the range from 5 to 90% in increments of 5% for each class of working conditions. The classes of harmful and dangerous working conditions were divided into two points (class 3.1 corresponded to points 3 and 4, class 3.2 — points 4 and 5, etc.).

The authors found that in comparable conditions, the severity of the work of movers in both groups can be assessed by the ergonomic method of class 3.2., but by means of physiological and physiological-ergonomic methods, the experts found that the severity of their work is significantly (p<0.001) different. For the movers of the first group, the average score is 3.2 points (6 points) with fluctuations per shift in the range 3.2 (5) — 3.3 (7), and for the movers of the second group — 3.3 points (8 points) in the range 3,3 (8) — 3,4 (9).

The researchers justified the need for the transition of occupational health from an extensive to a new intensive paradigm in the study of working conditions. In it, the actual and normative hygienic parameters of the load on the body emanating from the material production factor are combined and interact with the physiological parameters of the employee in a single indicator called the effective exposure of the material factor during the work shift, which mobile results in the current impact of heterogeneous characteristics of working conditions on health.

Limitations. The small number of subjects — 10 people, the inability to more fully reflect the developed physiological and ergonomic methodology of research, rationing and assessment of the severity of work.

Ethics. In preparing the article, the authors were guided by the ethical principles of medical research set out in the Helsinki Declaration of the World Medical Association of the latest revision. This study did not require the conclusion of the Ethics Committee.

Contribution:
Ustyantsev S.L. — development of a new paradigm of hygienic research, data collection and processing, text writing, editing;
Kishka O.S. — data collection, analysis and interpretation, text writing;
Protasova O.S. — data collection, discussion of results, formulation of conclusions;
All authors — the concept and design of the study.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 08.07.2024 / Accepted: 17.07.2024 / Published: 20.08.2024

The COVID-19 pandemic has had a significant impact on the working environment in healthcare worldwide. Health care workers ended up being the most vulnerable category of the working population, directly faced with a new coronavirus infection. The impact of the SARS-Cov-2 virus on different organs and tissues, particularly on the cardiovascular system, is well known. Considering also the cardiovascular pathology retains the first place among the morbidity and mortality rates of the working-age population, it is relevant to assess the risk of developing cardiovascular pathology in health care workers who suffered the new coronavirus infection COVID-19.

The study aims to research the prevalence and impact of risk factors of the cardiovascular pathology development in health care workers after suffering a new coronavirus infection COVID-19.

According to the data of periodic medical examinations in medical organizations in Ulyanovsk, specialists have conducted a screening examination of 196 medical workers. Two groups of subjects participated in the study — the main group, which included 98 medical workers who had suffered a new coronavirus infection, and a comparison group represented by 98 medical workers who had no history of COVID-19 infection. As part of the survey, specialists conducted clinical, instrumental and laboratory studies, as well as anonymous questionnaires of medical workers. Based on the data obtained, they assessed the levels of overall cardiovascular risk according to the updated SCORE-2 scale (assessment of the risk of fatal and non-fatal cardiovascular events in the next 10 years) and studied the contribution of risk factors to the development of cardiovascular pathology in the studied groups.

In the main group of patients, the main factors constituting the overall cardiovascular risk were significantly higher than in the comparison group. The authors identified arterial hypertension in 72.5% of patients in the main group. 51.4% had high total cholesterol, 39.6% LDL cholesterol, and 62.3% triglycerides in medical workers who had a new coronavirus infection. In 64.4% of patients, hypertrophy of the left ventricle was detected, in 35.8% — thickening of the intima-media complex, in 26.5% in the main group — atherosclerotic plaques in the brachiocephalic arteries. The analysis of the results showed that a very high risk of cardiovascular complications was found in 40.5% of medical workers in the main group, and a high risk in 31.2%. Moderate risk values were found in the main group in 14.5%. Only 13.7% had low cardiovascular risk.

The obtained results indicate the need for a thorough assessment of cardiovascular pathology risk factors, dynamic monitoring of health indicators, as well as the consequences of the new coronavirus infection COVID-19 in health care workers, the prevention of chronic non-communicable diseases, and the rehabilitation of health care workers.

Limitation. The study has professional limitations — the sample is presented by medical workers of medical institutions who have undergone medical examinations.

Ethics. This study was carried out in accordance with the rules of good clinical practice and the Helsinki Declaration, did not require the conclusion of an ethical committee. Informed voluntary consents of all study participants were obtained.

Contribution:
Shapoval N.S. — study concept and design, text writing, editing;
Rebrovskaya M.M. — collection and processing of data, writing text.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 27.03.2024 / Accepted: 22.04.2024 / Published: 20.08.2024

The article reflects the issues of the formation of the women’s health care system, starting from factory legislation to the present day. The problem of preserving and strengthening the reproductive health of working women has been studied for 50 years by the staff of the laboratory, which was created in 1974. The developed concept of the problem and scientific directions of research, developed documents, incl. legislative direction, the main prospects for the development of the laboratory are formulated taking into account modern requirements.

Contribution:
Fesenko M.A. — research concept and design, data analysis and interpretation;
Sergeev V.N. — search literature, writing text, editing;
Golovaneva G.V. — research concept and design, data analysis and interpretation, writing text, editing;
Vuicik P.A. — collecting and processing material, writing text.

Funding. The study had no sponsorship.

Conflict of interest. The article authors report that there is no conflict of interests.

Received: 18.07.2024 / Accepted: 22.07.2024 / Published: 20.08.2024