Clinical recommendations (CR) are one of the tools for introducing the principles of evidence-based medicine into healthcare practice, the application of which will allow practitioners to provide high-quality and safe medical care using optimal clinical practices.

The special features of clinical recommendations in the field of occupational health are their focus not only on the diagnosis, prevention, treatment and rehabilitation of occupational diseases, but also on highlighting issues related to the organization of medical care, the examination of professional suitability and the connection of the disease with the profession.

The analysis of the current state of the development of clinical recommendations on the main nosological forms of occupational diseases is carried out. Clinical recommendations that are at different stages of development are presented, both in the form of independent reviews and as sections on the occupational etiology of various nosological forms in general clinical recommendations. The prospects of creating clinical recommendations in the field of occupational medicine, their approval and further application are presented.

The authors noted the main stages of the development and implementation of clinical recommendations, which are the main tool for supporting decision-making and ensuring the proper quality of medical care. Experts have identified the need to develop local regulations in medical organizations that define the procedure for implementing clinical recommendations, algorithms for the actions of medical personnel in the process of their application, protocols for treatment, diagnosis, and rehabilitation, including criteria for the quality of medical care.

Funding. The study had no funding.

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

Received: 27.01.2025 / Accepted: 05.02.2025 / Published: 05.03.2025

Introduction. The development of malignant neoplasms (MNs) in people who have worked in contact with industrial aerosols is a complex mechanism associated with exposure to carcinogens and chronic occupational respiratory diseases, including chronic obstructive pulmonary disease (COPD). The heterogeneity of occupational-related chronic obstructive pulmonary disease suggests differences in the predisposition to oncogenesis.

The study aims to determine the clinical, functional, and cellular-molecular characteristics of OCOPD in combination with malignant neoplasm (MN).

Materials and methods. Design: a single-center, one-step comparative study. The main group consisted of patients with OCOPD, which occurs as a result of exposure to silicon-containing dust in combination with malignant neoplasms. The comparison group consisted of patients with OCOPD without malignant neoplasms, patients with COPD in tobacco smokers with malignant neoplasms and without MN (in each group n=30 people, the comparison groups were selected by the pseudorandom method, the parameters for comparison were age, duration of respiratory symptoms). The authors evaluated the symptoms, lung function, fibrobronchoscopy, brush biopsy of the bronchial mucosa with cytological and immunohistochemical examination, as well as the study of blood molecular factors by solid-phase enzyme immunoassay. Statistical data processing included standard methods of descriptive statistics, group comparison — the Kruskall–Wallis test, and relationship analysis — logistic regression.

Results. Occupational-related COPD, in combination with malignant neoplasm, was characterized by a decrease in lung diffusion capacity — Me (Q2–Q3) by 39 (35–42)% in the comparison groups 51 (48–55)%, 60 (56–63)% and 58 (55–62)% — frequent exacerbations, small-cell type of inflammation, severity bronchial atrophy, increased Ki-67 expression by epithelial cells — 35 (30–44)% ; in comparison groups 10 (8–12)%, 17 (14–18)% and 15 (13–19)%, serum concentrations of procollagen type 3 N-terminal propeptide (PIIINP) — 162.3 (155.4–173.5) pg/ml, in the comparison groups — 95.0 (83.7–98.1) pg/ml, 31.9 (25.6–35.2) pg/ml and 28.3 (24.8–34.6) pg/ml, 8-hydroxy-2-deoxyguanosine (8 OHdG), D-dimer. In a multifactorial analysis, the most significant independent factors associated with squamous cell carcinoma in OCOPD were work experience (OR 1.9, 95% CI 1.5–2.4, p=0.001), Ki-67 expression by epithelial cells (OR 1.5, 95% CI 1.1–6.2, p=0.001), D-dimer (OR 1.4, 95% CI 1.03–2.7, p=0.003). Work experience (OR 1.7, 95% CI 1.4–5.9, p=0.001), PIIINP concentration in blood (OR 1.6, 95% CI 1.3–1.9, p=0.001), 8 OHdG (OR 1.3, 95% CI 1.04–4.9, p=0.005) were associated with adenocarcinoma.

Limitations. Limitations of the study relate to the recruitment and examination of patients at a single center. Environmental factors assessments included only assessments of working conditions and smoking status.

Conclusion. Under the conditions of exposure to silicon-containing dust, occupational-related chronic obstructive pulmonary disease in combination with malignant neoplasms is characterized by a decrease in the diffusional ability of the lungs, the frequency of exacerbations, small cell inflammation, the severity of bronchial atrophy, increased expression of Ki-67, serum concentrations of PIIINP, 8 OHdG and D-dimer.

Ethics. The study was conducted in compliance with the Ethical principles set out in the Helsinki Declaration of the World Medical Association and in accordance with the ethical standards and regulations stipulated in the Bulletin of the Higher Attestation Commission of the Ministry of Education of the Russian Federation No. 3 of 2002. The study was approved by the Ethics Committee of the Federal State Budgetary Educational Institution of Higher Medical Education of the Ministry of Health of the Russian Federation, Protocol No. 121 dated 11/21/2019.

Contribution:
Shpagina L.A. — research concept and design, data collection and interpretation, text writing;
Shpagin I.S. — research concept and design, data collection and interpretation, text writing;
Kondyurina E.G. — data collection and interpretation;
Zelenskaya V.V. — data collection and interpretation;
Kotova O.S. — collecting and interpreting data, writing text;
Karmanovskaya S.A. — data collection and interpretation;
Kuznetsova G.V. — data collection and interpretation;
Kamneva N.V. — data collection and interpretation;
Smarzh T.M. — data collection and interpretation;
Lushnikova V.D. — data collection and interpretation;
Zemlyukova M.I. — data collection and interpretation.

Funding. The study had no funding.

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

Received: 05.02.2025 / Accepted: 17.02.2025 / Published: 05.03.2025

Introduction. At the State level, the Russian Federation pays unprecedented attention to preserving the health of the working population. One of the most important mechanisms for achieving real success is the implementation of new federal-scale national projects "Healthcare" and "Demography". A system for monitoring the health status of the working population and medical examinations in medical centers is important.

The study aims to develop proposals for optimizing the occupational pathology service of the Siberian Federal District (SFD) based on the analysis of the health monitoring system for employees.

Materials and methods. The researchers analyzed the structure of the occupational pathology service, the reports of the occupational pathology centers of the Siberian Federal District, and the final acts of periodic medical examinations (PME).

Results. Based on the analysis of the work of the occupational pathology centers of the Siberian Federal District, specialists optimized the development system of the occupational pathology service in large industrial regions of the country and also developed programs to optimize its work for the early detection of occupational diseases and the routing of patients with occupational sensorineural hearing loss (OSHL).

Conclusion. An integrated approach to the study of the frequency and structure of occupational diseases in the Siberian Federal District, the quality of periodic medical examinations in the comparative aspect of occupational pathology centers and private medical organizations (MO) has revealed the main areas of optimization of occupational pathology services in the Siberian Federal District. This will allow timely implementation of preventive and rehabilitation programs, which will ultimately reduce the rates of temporary and permanent disability, mortality, and, consequently, labor loss in working groups and increase the longevity of the working population.

Limitations. Geographical specifics: the authors have carried out the analysis on the basis of data from the centers of occupational pathology at the Siberian Federal District, which may limit the applicability of the results to other regions.

Ethics. This study did not require the conclusion of an Ethics committee.

Contribution:
Poteryaeva E.L. — research concept and design, editing;
Shpagina L.A. — research concept and design, editing;
Panacheva L.A. — data collection and processing, writing text;
Smirnova E.L. — data collection and processing, writing text;
Novikova I.I. — writing the text;
Karmanovskaya S.A. — data collection and processing;
Kuznetsova G.V. — data collection and processing.

Funding. The study had no funding.

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

Received: 07.02.2025 / Accepted: 21.02.2025 / Published: 05.03.2025

Introduction. The leading adverse factor in the production of ethylene oxide is air pollution in the work area (ethylene oxide, ethylene glycol, dichloroethane, ethylene) during technological operations related to equipment depressurization. Oxides are highly toxic compounds with a risk of acute inhalation poisoning and have irritating, narcotic, general toxic, mutagenic and carcinogenic effects. The identification of early signs of exposure to low concentrations of ethylene oxide on the body of workers in order to timely carry out therapeutic and preventive measures is relevant.

The study aims to explore laboratory biomarkers, criteria of changes when exposed to ethylene oxide on the body of workers.

Materials and methods. The scientists conducted a study at a petrochemical plant. To identify early signs of the influence of environmental factors on the body of the examined, the authors conducted an in-depth hematological, biochemical and immunological examination of 219 ethylene oxide production workers.

Results. Experts identified informational laboratory markers when exposed to harmful industrial factors in the production of ethylene oxide: excess of the average content of reticulocytes (9.9%), lymphocytes (34.2%), monocytes (6.9%) from the control values, increased alkaline phosphatase (29.8%), total protein (25.9%), decreased albumin levels (by 17.8%), α₁‑globulins (by 32.8%), α₂-globulins (by 19.0%), β-globulins (by 15.5%), with a simultaneous increase in the level of γ-globulins (by 6.9%), a decrease in the average level of class A immunoglobulins (36.1%), Class M (22.9%), Class J (38.1%), phagocytosis (75.5%), increased lysozyme activity (by 97.5%).

Limitations. The study is limited by the number of respondents (219 workers).

Conclusion. Based on the data obtained, the researchers identified biomarkers characterized by high diagnostic information content when exposed to harmful industrial factors, reflecting changes in peripheral blood parameters, biochemical status, cellular and humoral immunity in ethylene oxide production workers. The identified diagnostic complexes make it possible to justify measures to establish monitoring of the health status of employees.

Ethics. The study was approved at the meeting of the bioethical Commission of the Ufa Research Institute of Occupational Health and Human Ecology dated 04/18/2024 No. 02-04.

Contribution:
Gimranova G.G. — research concept and design, text writing, editing;
Masyagutova L.M. — data collection and processing, text writing, editing;
Shaikhlislamova E.R. — writing the text;
Karimova L.K. — data collection and processing, writing text;
Beigul N.A. — writing the text;
Volgareva A.D. — data collection and processing;
Zaidullin I.I. — writing the text.

Funding. The study had no funding.

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

Received: 10.02.2025 / Accepted: 12.02.2025 / Published: 05.03.2025

The studies of health impacts of high ambient temperatures have gained particular importance in the context of continuing climate change, gradual rise in summer temperatures, increasing frequency and severity of heat waves. The exposure of outdoor workers to high ambient temperatures may cause hyperthermia and heat-related illness which may ultimately lead to death.The second most important health effect, after heat sickness, is kidney disease. In addition, exposure to high temperatures increases the risk of occupational injury, reduces working capacity and labor productivity. The main purpose of this review is to summarize the results of foreign studies on the effects of high ambient temperatures on the health of workers, since no such studies have been conducted in Russia. The order of presentation of the material corresponds to the degree of severity of the effects on the health of workers in various specialties. The most vulnerable group are agricultural workers, followed by construction workers, then workers of other professions who are characterized by heavy physical work outside the premises — these are miners, traffic policemen, public utilities workers, the tourism sector, etc. The review also briefly examines studies on the economic assessment of damage caused by exposure to high air temperatures on the health of workers, and Russian research in a related field — the effect of a heating microclimate inside industrial premises on the health of workers.

Ethics. This study did not require the conclusion of an Ethics committee.

Contribution:
Revich B.A. — research development and design, text writing;
Shaposhnikov D.A. — collecting and processing material, writing text, editing.

Funding. The study had no finding.

Conflict of interests. The author declares no conflict of interests.

Received: 18.02.2025 / Accepted: 24.02.2025 / Published: 05.03.2025

The examination of the professional suitability of employees is important in addressing the issues of maintaining professional health and longevity of the working population. Based on the analysis of literature data and regulatory documents, the domestic and foreign experience of organizing and conducting an examination of the professional suitability of employees is presented. The main stages of the formation and improvement of the system for determining the suitability of employees to perform various types of work are described. Modern approaches and ways to optimize employee retention in the workplace are considered.

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

Funding. The study had no funding.

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

Received: 08.02.2025 / Accepted: 20.02.2025 / Published: 05.03.2025

The profession of a cosmetologist, which every third resident of the country turns to, is one of the most in demand at the present time. There are no publications on the working conditions of cosmetologists.

The study aims to substantiate the professional risk factors for the health of cosmetologists.

The authors conducted the study on the bases of three cosmetology clinics in Volgograd. The researchers carried out measurements and assessments of working environment factors in accordance with the requirements of current regulatory documents.

It is shown that the parameters of the microclimate, illumination, and intensity of laser radiation corresponded to hygienic standards. The content of fine particles of PM₁₀ and PM_2.5 in the air of the cosmetologist's working area exceeded the maximum permissible concentrations by 6–11 times. A number of substances (ammonia, sulfur dioxide, hydrogen sulfide, methanethiol, ethanoic acid, and others) have a pronounced odor and cause numerous complaints from cosmetologists. Excess of the normalized maximum single concentration was noted for sulfur dioxide, ethanoic acid, ozone and methanethiol.

The total microbial contamination at the end of the working day exceeded the normalized value. Experts found a significant number of staphylococci (444 CFU/m³), including those with lecithinase activity, as well as fungi (320 CFU/m³).

The production risk factors for the health of cosmetologists are chemical and biological factors. The content of harmful chemical substances and pathogenic microorganisms in the air of the working area of doctors of this specialty exceeded hygienic standards (class of working conditions — 3.2), which necessitates preventive measures. It is necessary to continue studying the "intrusive odor" factor, which causes numerous complaints from cosmetologists, as well as determining the microbial contamination of the air in the work area by the level of actual contamination by microorganisms.

Ethics. This study did not require the conclusion of an Ethics Committee.

Contribution:
Latyshevskaya N.I.— concept, writing, editing;
Krainova I.Yu.— data collection and processing, writing text;
Shestopalova E.L.— research design, text writing;
Davydenko L.A. — editing, writing text;
Belyaeva A.V. — data collection and processing, writing text;
Rourua L.P.— data processing, editing.

Funding. The study had no funding.

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

Received: 24.12.2024 / Accepted: 04.02.2025 / Published: 05.03.2025