Introduction. Currently, chlorine is widely used in industry and agriculture. There are thousands of industrial facilities located on the territory of the Russian Federation that have chlorine reserves in quantities that, in the event of an emergency, can lead to massive damage to people. Chlorine poisoning has stages of development of the toxic process with the development of toxic pulmonary edema (TPE). Respiratory therapy for TPE consists in the use of artificial lung ventilation (ALV) with positive pressure at the end of exhalation and an oxygen content in the inhaled mixture (FiO₂) of at least 40%. Currently, scientists are actively developing methods of liquid artificial lung ventilation (LALV) using perfluorocarbon (PFC) liquids as an alternative to gas artificial lung ventilation (ALV), in particular, in the treatment of toxic pulmonary edema. This article shows the possibility of sequential cyclic use of liquid and gas (intermittent gas-liquid) artificial ventilation in combination with hypothermia in a model of acute inhalation chlorine damage in rats.

The study aims to evaluate the prospects of using intermittent gas-liquid artificial lung ventilation combined with hypothermia for the treatment of severe inhaled chlorine lesions.

Materials and methods. The authors have conducted a study on male Wister rats aged 4 months and weighing 192.1±2.3 g. Toxic pulmonary edema was initiated by 15-minute inhalation of chlorine at an estimated dose of 35 mg/l. The animals were anesthetized and then randomized into two groups, control and experimental (6 individuals each) based on inclusion criteria: decreased oxygen saturation (SpO₂)<80 and increased heart rate (HR)>240 beats/min. The scientists performed artificial lung ventilation throughout the study in the control group. The animals of the experimental group were subjected to hypothermic liquid ventilation for an hour, after which they were switched to gas ventilation, and when SpO₂ and heart rate dropped below acceptable values, the cycle was repeated. At the same time, the authors continued to ventilate with gas until the end of the experiment. Scientists used perfluorodecalin as a PFU liquid. They recorded heart rate, SpO₂, rectal temperature, overall survival, and life expectancy.

Results. After inhalation, the researchers observed severe chlorine damage in all animals. 10 minutes after the start of ventilation in the animals of the control group, the authors observed an increase in saturation to 90% and a decrease in heart rate to 220–240 beats per minute, followed by 20–25 minutes. They also observed a rapid decrease in SpO₂ to extremely low values and an increase in heart rate, which indicated inefficiency of ventilation and caused the development of adverse outcomes. In turn, in the experimental group, during the first 5 minutes after the start of liquid artificial lung ventilation (LALV), the researchers recorded a sharp decrease in heart rate to 104±3.5 beats/min. and an increase in SpO₂ to 94±2.4%.

After switching to gas artificial lung ventilation (AVL), the time for lowering the controlled parameters below the permissible values was 45±7.9 minutes. 5 minutes after the start of the second liquid artificial ventilation session, all animals showed an increase in SpO₂ and a decrease in heart rate, while the values of these indicators did not differ from the values recorded during the first session.

After the 2^nd transfer to a gas ventilator, there was a short-term improvement in the studied indicators, followed by a deterioration that ended in an unfavorable outcome.

When studying survival, the authors found that the average duration of survival in the experimental group was 4.57 times longer than in the control group, and amounted to 190.0±6.3 and 41.6±3.0 minutes, respectively (p<0.001).

When assessing the amount of edematous fluid released during liquid artificial lung ventilation, the researchers found that during the experiment, that during the experiment, an average of 5.9±1.8 ml/kg was aspirated in animals of the experimental group. The average body temperature of the animals in the control group was 36.2±0.3°C. In turn, the animals of the experimental group showed a sharp decrease in temperature during the first 30 minutes of liquid artificial ventilation, by an average of 6.1±1.2°C. After that, the temperature stabilized and was in the range of 30–31°C until the death of the animals.

A pathoanatomic examination revealed that in the animals of the control group, a large amount of edematous fluid and foam was found in the respiratory tract and lungs, while in the experimental group, edematous fluid prevailed in the upper respiratory tract, and perfluorodecalin in the lower.

At the same time, the mass coefficients of the lungs of the control and experimental groups were 1.89±0.08% and 2.70±0.03%, respectively.

Limitations. There are quantitative restrictions on the presence of animals in the sample, as well as qualitative restrictions in experiments with animals with pulmonary edema after inhalation chlorine poisoning.

Conclusion. Inhalation seeding with chlorine in a 200-liter chamber with an estimated dose of 35 mg/l for 15 minutes leads to the lightning-fast development of toxic pulmonary edema in small laboratory animals (bypassing the stage of primary clinical manifestations and the latent period). The use of liquid artificial ventilation with PFDs makes it possible to evacuate edematous fluid from the lungs in case of toxic edema caused by severe inhalation chlorine poisoning, and thereby preserve gas exchange in the lungs. The use of intermittent hypothermic gas-liquid ventilation makes it possible to maintain gas exchange in the lungs in the case when conventional mechanical ventilation is ineffective and thus significantly (p<0.001) increase the survival time of laboratory animals by 4.57 times. The results obtained indicate the prospects for further development of respiratory support methods based on hypothermic ventilation as a treatment for severe forms of acute respiratory distress syndrome, in the case when traditional ventilation is no longer effective.

Ethics. Studies involving laboratory animals were conducted in compliance with the following regulations: the Helsinki Declaration of 2000. "On humane treatment of animals", Order of the USSR Ministry of Health No. 755 dated 08/12/1977 "Rules for carrying out work using experimental animals", Order of the Ministry of Health and Social Development of Russia No. 199n dated 04/01/2016 "On approval of the rules of laboratory practice". The research protocol was approved by the Ethics Committee of the Izmerov Research Institute of Occupational Health. Protocol No. 4 dated May 25, 2022.

Contribution:
Isabekov N.R. — research concept and design, data collection and processing, text writing;
Tonshin A.A. — the concept and design of research, writing the text;
Krikunov O.V. — conducting inhalation priming, data collection and processing;
Bonitenko E.Yu. — concept and design of research, editing.

Funding. The work was performed within the Framework of the state assignment, the subject code FGFE-2024-0003.

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

Received: 24.12.2024 / Accepted: 14.01.2025 / Published: 07.02.2025

Introduction. The object of the study was the dynamics of the functional state of the human body when performing physical work using an industrial exoskeleton designed to unload the muscles of the back and arms when lifting, lowering, carrying and holding loads weighing up to 50 kg.

The study aims to assess the safety of using an industrial exoskeleton in labor modeling.

Materials and methods. The authors assessed the functional state of a person within the framework of the developed laboratory model of the labor activity of a potential consumer of an industrial exoskeleton using biomedical methods: medical examination, registration of biomechanics of movements and a questionnaire. The data obtained was subjected to statistical analysis.

Results. The use of an industrial exoskeleton does not affect the overall functional condition of the volunteer and does not restrict movement in the lower extremities, but it may partially restrict movement in the shoulder joints and make it difficult to perform movements in the thoracolumbar spine. The volunteer may experience local discomfort in the places where the exoskeleton parts come into contact with the skin: in the anterior surface of the wrist joint, the palmar surfaces of the hand, the anterior surface of the thigh, and the lumbar spine.

Limitations. Only 12 respondents participated in the study, which may limit the possibility of data dissemination among the general population, but statistical processing did not reveal conflicting values between the results of different participants. The authors conducted a safety study on the use of an industrial prov exoskeleton in laboratory conditions that did not fully reproduce real ones and overlooked some factors affecting an employee in production. But the conditions directly related to the use of an industrial exoskeleton were reproduced by the authors.

Conclusion. The study allows us to conclude that the use of an industrial exoskeleton is safe if the production operations performed in it are similar to the developed laboratory model. There was no negative effect on the general condition of the volunteers and the range of movements of the lower extremities. Limitations of the movements of the upper extremities and in the thoracolumbar spine were noted, related to the design characteristics of an industrial exoskeleton. It is necessary to change the features of an industrial exoskeleton, which can lead to the formation of microtrauma.

Ethics. The study was conducted in compliance with the protocol "Safety and Effectiveness study of industrial exoskeletons", approved by the Local Ethics Committee of Izmerov Research Institute of Occupational Health (Minutes No. 1 of the meeting of the Local Ethics Committee dated 01/25/2023).

Contributions:
Shuporin E.S. — research concept and design, writing, editing;
Chudova E.S. — writing, editing;
Ilyenko O.V. — research concept and design, writing;
Vaga I.N. — data collection and processing;
Motkova T.Y. — data collection and processing.

Funding. The funding was provided as part of the State Assignment for Basic Scientific Research. The study had no funding.

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

Received: 14.11.2024 / Accepted: 19.12.2024 / Published: 07.02.2025

Introduction. Mathematical models are widely used in various fields of science and practice, including medicine. The use of mathematical modeling is the only way to assess the simultaneous impact on the health of workers of many interrelated factors, including harmful production factors. Metallurgical production is one of the leading sectors of the region's economy, in which more than 70% of workers are employed in harmful working conditions. The task of using mathematical models to assess the impact of various risk factors on the development of circulatory system diseases in workers engaged in harmful working conditions remains urgent.

The study aims to build a predictive mathematical model to assess the contribution of risk factors to the development of diseases characterized by high blood pressure in metallurgical workers.

Materials and methods. The researchers examined the results of periodic medical examinations of 2,927 men in metallurgical production and their working conditions. They have created a database that includes information on the assessment of the class of working conditions, medical and biological indicators, and survey data. The authors also established the prevalence of the disease in the ICD-10 block (110–115) "Diseases characterized by high blood pressure", depending on the class of working conditions and length of service. To build a predictive model for assessing the impact of various risk factors on the development of diseases characterized by high blood pressure, the authors used the method of multiple linear regression. They determined the quality of the model by the value of the coefficient of determination.

Results. It was found that with increasing age and length of service, the rate of increase in the prevalence of diseases characterized by high blood pressure increased faster with worsening conditions. The most significant predictors of the development of diseases characterized by high blood pressure were the product of seniority on body mass index and seniority on blood glucose levels.

Limitation. A single-stage cross-sectional study was conducted, limited by the results of a one-year medical examination of employees.

Conclusion. It is advisable to use mathematical models to identify key risk factors in the development of a disease for the subsequent development of targeted medical and preventive measures aimed at its correction.

Ethics. The study was approved by the local Ethics Committee of the Yekaterinburg Medical and Scientific Center for Prevention and Health Protection of Industrial Workers of Rospotrebnadzor (conclusion No. 6 dated 12/11/2023).

Contributions:
Gazimova V.G. — concept and design of research, text editing;
Chaurina D.V. — collecting material and data processing, writing text;
Shastin A.S. — writing the text;
Konstantinova E.D. — statistical data processing, text writing;
Maslakova T.A. — statistical data processing, text writing;
Varaksin A.N. — statistical data processing, text writing;
Ogorodnikova S.Yu. — statistical data processing.
All co-authors — are approving the final version of the article.

Funding. The study had no funding.

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

Received: 28.11.2024 / Accepted: 08.12.2024 / Published: 07.02.2025

Introduction. The use of modern OMIC technologies and traditional research methods in personalized nutrition makes it possible to provide an integrated assessment of the nutrition and health of industrial workers in order to form individual dietary recommendations.

The study aims to develop a personalized approach to the assessment of nutrition biomarkers using the example of mining workers.

Materials and methods. The study included the results of a medical examination and a survey of 40 workers at a mining enterprise in the Sverdlovsk region, and an assessment of the individual nutritional phenotype and its clinical manifestations was carried out. The levels of 60 organic acids in the urine of these workers were studied by gas chromatography mass spectrometry (LLC Chromolab), and the polymorphism of 42 genes was evaluated (LLC Basis Genotech).

Results. The nutrition of all surveyed employees of the enterprise characterizes the European model using a large number of ultra-processed, high-calorie products with a low density of vitamins and minerals. The presence of deviations in the content of organic acids in urine indicates a change in the metabolic pathways associated with the metabolism of carbohydrates, amino acids, coenzyme Q10, B vitamins, and lipoic acid. According to the results of a genetic study, more than 60% of workers revealed high genetic risks of overeating, impaired carbohydrate metabolism, increased levels of triglycerides, low-density lipoproteins (LDL), blood pressure, metabolic disorders of vitamins D and A, lactose intolerance, and decreased detoxification. According to body mass index (BMI), waist size, total cholesterol, and triglycerides, more than a third of the surveyed have metabolic syndrome.

Limitations. A small sample and a frequency-based nutrition questionnaire reduces the accuracy of the results obtained.

Conclusion. The identified markers of unbalanced nutrition, as well as the studied genetic and metabolic (dietary) profiles of employees may indicate high risks of depletion of the body's energy resources, affect detoxification processes, functional capabilities, and increase individual risks of developing metabolic syndrome, which necessitates the development of personalized dietary recommendations and correction of corporate nutrition.

Ethics. The study received permission from the local Ethics Committee of the Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers of Rospotrebnadzor No. 5 dated 12.27.2021. All the surveyed gave voluntary informed consent.

Contributions:
Mazhaeva T.V. — research concept and design;
Dubenko S.E. — data collection, analysis and interpretation, text writing;
Chernova Yu.S. — data collection, analysis and interpretation, text writing;
Sutunkova M.P. — editing, making fundamental changes, approving the final version of the article;
Gurvich V.B. — editing, making fundamental changes, approving the final version of the article.

Acknowledgment. The authors express their gratitude to specialists of Basis Genotekh LLC, Yekaterinburg Branch of the Clinical Diagnostic Laboratory (KDL DOMODEDOVO-TEST LLC), Chromolab LLC, and doctors of the Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers for their assistance in conducting the study.

Funding. The study was conducted with the financial support of the company under study.

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

Received: 24.12.2024 / Accepted: 06.01.2025 / Published: 07.02.2025

Introduction. Arterial hypertension, due to its prevalence and severity of complications, is one of the leading causes of disability of the working population. Psychosocial factors, including negative emotional states, are recognized as independent risk factors for the development of cardiovascular diseases. The relationship between negative emotional states and arterial hypertension in miners of coal enterprises remains poorly understood.

The study aims to consider the relationship of negative emotional states and metabolic disorders with arterial hypertension in coal mining workers.

Materials and methods. The scientists examined 313 employees of coal enterprises with occupational diseases using questionnaires: DS14 to determine psychological distress type D, Spielberger-Khanin to establish the level of personal and situational anxiety and the N.I. Vlakh questionnaire to determine subdepression. The diagnosis of arterial hypertension was established in accordance with the clinical recommendations "Arterial hypertension in adults".

Results. The incidence of arterial hypertension among the surveyed miners was 30.9%. The authors found in patients with stage 1 hypertension an increase in the frequency of overweight to 80% (p<0.01; RR=2.57; CI=1.24–5.35) and an increase in the frequency of overweight to 87.9% (p<0.001; RR=3.99; CI=1.88–8.45), fasting hyperglycemia up to 53.4% (p<0.001; HR=2.67; CI=1.7–4.18), triglyceride levels up to 63.6% (p<0.005; RR=2.16; CI=1.32–3.54) in arterial hypertension of the 2^nd and 3^rd stages.

The frequency of negative emotional states among patients with arterial hypertension of stage 1 had no significant differences compared with those with normal blood pressure figures.

Among the examined patients with arterial hypertension of the 2^nd and 3^rd stages, the authors observed an increase in the frequency of personal anxiety to 40.8%, psychological type D — to 58.9%, subdepression — to 32.4% and situational anxiety — to 23.1%. The reliability of differences in the frequency of negative emotional states in the group with normal blood pressure and hypertension of the 2^nd and 3^rd stages has not been established.

Limitations. The study is limited to a sample of 313 miners with occupational diseases and arterial hypertension who were treated at the Clinic of the Scientific Research Institute of Complex Problems of Hygiene and Occupational Diseases.

Conclusions. The authors revealed a significant increase in the frequency of overweight in stage 1 hypertension in coal industry workers. With arterial hypertension of stages 2 and 3, there is a significant increase in the frequency of overweight, fasting hyperglycemia and hypertriglyceridemia. There are no significant differences in the frequency of negative emotional states in patients with stage 1 arterial hypertension and those with normal blood pressure figures. With arterial hypertension of stages 2 and 3, there is a tendency to increase the frequency of personal anxiety, subdepression, situational anxiety and psychological distress type D.

Ethics. The study was conducted in compliance with the Ethical Principles of conducting medical research with human participation in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical research with human participation as a subject" as amended in 2013.

Contributions:
Danilov I.P. — research concept and design, data collection and processing, text writing;
Vlakh N.I. — concept and design of research, data collection and processing, text writing;
Paneva N.Ya. — data collection and processing;
Logunova T.D. — the editing.

Funding. The study had no funding.

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

Received: 18.10.2024 / Accepted: 26.10.2024 / Published: 07.02.2025

Introduction. Harmful chemicals are often used in petrochemical production, which causes them to be in the air of the work area. Penetrating into the body of workers, chemical compounds can contribute to disorders of the body's health. The formation of chemically active metabolites during the biotransformation of xenobiotics leads to damage to the abdominal organs and causes changes in peripheral blood parameters, which can be used to search for new diagnostic markers of the effects of harmful factors on health.

The study aims to consider the prognostic possibilities of biochemical and genetic indicators for the early diagnosis of toxic liver damage in workers in the chemical industry.

Materials and methods. The experts conducted a study of the health status of 114 workers of petrochemical enterprises and they found toxic liver damage in 29 workers (cohort 1). The comparison group included 92 employees of enterprises in other industries who are not in contact with industrial chemical risk factors, of which 48 people were found to have non-alcoholic fatty liver disease (cohort 3). Scientists conducted clinical studies of the body in workers using biochemical, instrumental and genetic methods.

Results. A study of the prognostic capabilities of predictors of toxic liver damage demonstrated a good potential for biomarkers: the percentage of "comets" with fragmentation of more than 5% of DNA (cut-off=12.24%, Sen=79.3%, Spe=66.7%, AUC ROC=0.711; p<0.001), the average percentage of DNA in the tail of the "comet" (cut-off=2.95%, Sen=79.3%, Spe=60.5%, AUC ROC=0.727; p<0.001), aspartate aminotransferase (cut-off=25.5 U/L, Sen=86.2%, Spe=48.6%, AUC ROC=0.707; p<0.001), direct bilirubin (cut-off=3.05 mmol/L, Sen=72.4%, Spe=75.7%, AUC ROC=0.752; p<0.001).

Conclusion. The results of the study indicate the high prognostic capabilities of certain genetic biomarkers (the percentage of "comets" with fragmentation of more than 5% of DNA, the average percentage of DNA in the tail of the "comet") to differentiate cases of production-related toxic liver damage from cases of non-alcoholic fatty liver disease in the early stages of pathology formation.

Ethics. The study was carried out in accordance with the fundamental documents of the Russian Federation and the international principles of research ethics (minutes of the meeting of the bioethical commission of the Ufa Scientific Research Institute of Occupational Health and Human Ecology of Rospotrebnadzor No. 01-09 dated 30.09.2024).

Limitations. The results obtained are limited by the number of participants (223 workers) and the capabilities of the research methods used (clinical, sonographic, single-cell agarose gel electrophoresis, statistical, ROC analysis).

Contributions:
Kudoyarov E.R. — research concept and design, data collection and processing, text writing;
Ivanova D.P. — data collection and processing;
Bakirov A.B. — research concept and design, editing;
Kalimullina D.Kh. — editing;
Galiullina D.M. — data collection and processing;
Mironova G.R. — data collection and processing.

Funding. The study had no funding.

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

Received: 15.11.2024 / Accepted: 02.12.2024 / Published: 07.02.2025