The article presents materials on the activities of employees of the V.A. Obukh Central Institute of Occupational Hygiene and Occupational Diseases of the USSR People's Commissariat of Health (currently Izmerov Research Institute of Occupational Health) during the Great Patriotic War, the role of occupational hygienists and occupational pathologists in developing issues of improving medical and sanitary services in the rear and in the army at the front.
ORIGINAL ARTICLES
Introduction. In 2012, the system of providing medical care to employees in various industries, construction, transport, and communications underwent major changes. As part of the reorganization, specialists have developed a new structure that includes a network of treatment centers at various levels designed to provide specialized medical care to those who work in harmful and dangerous working conditions. These changes were implemented on the basis of the order of the Ministry of Health of the Russian Federation dated November 13, 2012. No. 911n "On approval of the procedure for providing medical care for acute and chronic occupational diseases". Labor rationing plays a key role in healthcare management, especially in the context of the introduction of the latest medical care technologies. Currently, the basis for rationing the work of occupational pathologists is the "Methodology for calculating labor rationing in the system of occupational pathology centers", approved by the Decree of the Ministry of Health of the Russian Federation dated March 11, 1999, No. 99/40.
The study aims to explore existing approaches to rationing the work of occupational pathologists during mandatory preliminary and periodic medical examinations, when providing medical care in the field of "Occupational pathology" and conducting an examination of professional suitability and studying the relationship of the disease with the profession.
Materials and methods. The authors analyzed the legislative acts regulating the rationing of occupational pathologists, as well as the results of scientific research, statistical reports (including form No. 30 "Information about a medical organization", timekeeping charts and information on the labor costs of an occupational pathologist in the performance of his functional duties, calculated according to Methodology No. 99/40 (based on data from the centers of occupational pathology of subjects of the Russian Federation for the period from 2021 to 2023).
Results. According to the time-keeping charts of occupational pathologists, the doctor's expenses for the main type of activity (expert, advisory, professional examinations, expert work at the request of judicial authorities, conducting correspondence consultations) amounted to 154.9 minutes, or 70.5%, of the total activity time in occupational pathology centers, and 45.9 minutes (20.9%), for personal time — 19 minutes (8.6%). For comparison, in medical organizations, the doctor's expenses for the main type of activity amounted to 152.7 minutes (78.3%), for additional — 31.8 minutes, (16.3%) and for personal time — 12.1 minutes (6.2%). According to the timekeeping charts of the inpatient department, occupational pathologists at the occupational pathology center spend 56.6 minutes (or 67.7% of the total working time) on their main activities, additional (expert work at the request of judicial authorities, educational activities, development of new techniques) — 19.8 minutes (23.7%), personal time — 7.2 minutes (8.6%). In medical organizations, labor costs for an additional type of activity prevailed — 47.4 minutes (63%), while the main type of activity took 2 times less time, 25.5 minutes, or 33.9%, and personal time costs — 5.1 minutes (6.8%). The research results highlight the peculiarities of the professional activities of occupational pathologists. In outpatient settings, the share of expert work among occupational pathologists reaches 38%, while in inpatient settings this figure is at least 55.1%. This is due to the fact that more than 60% of patients are referred to specialized occupational pathology centers to resolve expert issues.
Limitations. The study examined the results of a limited number of time-lapse charts (14 time-lapse charts of an outpatient occupational pathologist and 7 time-lapse charts of an inpatient department for the period 2021–2023).
Conclusion. The methodology for rationing the work of specialists in the field of occupational pathology needs to be revised and improved based on current legislative documents regulating the Rules for developing standard labor standards, the duties of occupational pathologist, providing medical care in the field of «Occupational Pathology», as well as conducting mandatory preliminary and periodic medical examinations, assessing professional suitability and studying the relationship between diseases and professional activities.
Ethics. In carrying out the work, the authors adhered to the Ethical Principles of medical research described in the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting medical research with human participation as an object" of the latest edition (October 2024).
Contributions:
Kobyakova O.S. — editing, making fundamental changes, approving the final version of the article;
Chernov O.E. — data analysis and interpretation, text writing;
Panova I.V. — data collection, analysis and interpretation, text writing;
Zemlyakova S.S. — data analysis and interpretation, text writing.
All authors — are responsible for the concept and design of the study.
Funding. The study had no funding.
Conflict of interest. The authors declare no conflict of interest.
Received: 01.04.2025 / Accepted: 30.05.2025 / Published: 05.07.2025
Introduction. Digital transformation is the process of transitioning to a management model based on primary healthcare data. This, in turn, has led to the recognition of the essential role of electronic medical documentation in digital healthcare. The use of structured electronic medical records (SEMR) is integral to the organization of healthcare as a component that ensures uniform standards for the creation and transmission of digital documents for all stakeholders in the healthcare system. One of the current priorities in the area of employee health protection is the development of a unified database system. This system will maximize the effectiveness of mandatory pre-employment and periodic medical exams for employees who work in hazardous or dangerous conditions, as well as those who are exposed to hazardous factors. It will also improve the results of expertise of professional suitability and expertise of the relationship between the disease and the profession. The need for such a system arises from the lack of consistency and continuity in employee health surveys which often necessitates the monitoring of a range of indicators related to health status, work conditions, and preventive measures over time.
The aim of the study is to examine existing structured electronic medical records in occupational health.
Materials and methods. The study was conducted using a combination of expert analytical methods. We analyzed SEMR (103) "Medical report based on the results of a preliminary (periodic) medical examination" Edition 1; SEMR (194) "Medical report based on the results of a preliminary (periodic) medical examination" Edition 2 and SEMR (230) "Medical report regarding employee medical examination for submission to the electronic personal medical record subsystem" Edition 1 for the period from 2023 until the first quarter of 2025. Additionally, and also information from statistical observation form No. 30 "Information about a medical organization" for the year 2023.
Results. From 2023 to the first quarter of 2025 a total of 3,145,512 medical examinations (SEMR) were conducted: 1,175,018 SEMR (103), 984,516 SEMR (194), and 985,978 SEMR (230). In 2023 a total of 412,465 supplementary annual medical examinations were conducted (SEMR): 64,233 SEMR (103) and 348,232 SEMR (194). In 2024 a total of 2,065,738 SEMR was conducted: 752,804 SEMR (103), 636,284 SEMR (194) and 676,650 SEMR (230). On the other side, in 2023 there were 7,932,523 workers in the Russian Federation who underwent mandatory preliminary and periodic medical examinations1, 7,727,117 of them were examined (97.4%). At the same time 412,465 SEMR were registered in 2023, which corresponds to only 5.3% of those examined. In 2024 1,389,088 SEMR were registered (increased by 70.3% compared to 2023). The largest number of SEMR (103) in 2023 was recorded in the Chuvash Republic, Kemerovo Region and Tambov Region: 30,170, 13,178 and 7,821 respectively. At the same time, according to the data from Rosstat, the following figures were obtained: 110,670 employees were examined in the Chuvash Republic, 173,048 employees were examined in the Kemerovo region and 59,051 employees were examined in the Tambov region. In 2023, a total of 348,232 SEMR (194) were formed in the Russian Federation. The largest number of SEMR (194) in 2023 was recorded in the Khanty-Mansiysk autonomous okrug — 42,506, in the Republic of Tatarstan 34,103 and the in Krasnoyarsk region 15,226 respectively. According to the data provided by Rosstat, in the Khanty-Mansiysk autonomous okrug 227,508 employees were examined, in the Republic of Tatarstan 366,318 employees were examined and in the Krasnoyarsk region 161,773 employees were examined.
Limitations. The study analyzed structured electronic medical records for the period from 2023 to the first quarter 2025. The data from Rosstat was used for the year 2023 as information for 2024 is expected to be published in the third quarter of 2025.
Conclusion. The occupational disease monitoring system will contribute to the enhancement of the health status of citizens in the Russian Federation by effectively identifying signs of exposure to hazardous and/or dangerous factors at an early stage. If medical contraindications for work are identified based on the results of mandatory preliminary and periodic medical examinations, or if an occupational disease is suspected, the system will allow for high-quality and timely examinations, and expertise of professional suitability, expertise of the relationship between the disease and the profession. These measures will enable the development of scientifically sound tactics and strategies for preventing occupational, occupation-related, and general morbidity. They will also help reduce employee disability, minimize labor losses due to occupational diseases and preserve long-term health, thereby increasing economic efficiency.
Ethics. During their work, the authors have adhered to the ethical standards for medical research as outlined in the Helsinki Declaration of the World Medical Association's "Ethical Guidelines for Medical Research Involving Human Subjects", the latest edition of which was published in October 2024.
Contributions:
Bukhtiyarov I.V. — editing, making fundamental changes, approving the final version of the article;
Kobyakova O.S. — editing, making fundamental changes, approving the final version of the article;
Kuzmina L.P. — editing, making fundamental changes, approving the final version of the article;
Kulikova I.B. — editing, making fundamental changes;
Nikolaev S.P. — data collection, analysis and interpretation, writing the text;
Zemlyakova S.S. — data analysis and interpretation, writing the text;
Sidorov K.V. — data analysis and interpretation, writing the text.
All authors — concept and design of the study.
Funding. The study had no funding.
Conflict of interest. The authors declare no conflict of interest.
Received: 27.05.2025 / Accepted: 30.05.2025 / Published: 05.07.2025
Introduction. Due to their unique properties, unmanned aerial vehicles (UAVs) are widely used in the civil and military sectors. Due to the growing demand for specialist UAV operators, there is an increasing need to assess the working conditions at the workplaces of UAV operators. At the same time, special attention is paid to the sanitary and hygienic control of microbial contamination of the controls of unmanned vehicles.
The study aims to execute a microbiological assessment of the qualitative and quantitative composition of microorganisms polluting the controls of unmanned aerial vehicles in order to further develop preventive measures aimed at preventing the spread of infectious diseases among operators of unmanned aerial vehicles.
Materials and methods. The study assessed the quantitative and qualitative composition of microorganisms on control panels, keyboards, video cameras and video helmets of operators of unmanned aerial vehicles using both personal and multi-user equipment.
Results. As a result of the study of microbial contamination of control panels, keyboards, video glasses and video helmets of operators of unmanned aerial vehicles, it was found that when operating equipment in multiuser access mode, the level of microbial contamination increases 2.9 times compared with personal use. In the course of the study, experts identified and ranked the main types of microorganisms living on the surfaces of video glasses, video helmets, keyboards and control panels of operators of unmanned aerial vehicles, with the aim of further developing and improving measures to preserve and promote the health of the aforementioned specialists.
Limitations. It is necessary to study the effectiveness and safety of various disinfection methods for materials (plastic, glass, rubber, etc.) used to create UAV controls. To date, the impact of the use of glasses and helmets on the visual organ of operators of unmanned aerial vehicles in the long term of their use in the professional activities of specialists has not been fully studied, which does not allow fully assess the risks to their health. It is necessary to develop new solutions to minimize the impact of adverse factors on the organ of vision, including microbiological ones, as well as to minimize the manifestations of conjunctival symptoms.
Conclusion. Multiuser equipment is most susceptible to microbial contamination, which increases the risk of infectious and inflammatory diseases among UAV operators. When using glasses and helmets, there are more pronounced manifestations of conjunctival symptoms due to their closer location to the organ of vision and the presence of additional fans in their design. The spectral composition of microorganisms contaminating UAV controls is mainly represented by representatives of opportunistic flora. The leading reason for contamination of equipment by opportunistic and pathogenic microorganisms is the limitation of the ability of UAV operators to comply with personal hygiene rules and insufficient treatment of equipment with disinfectant solutions.
Ethics. The study was approved at a meeting of the Independent Ethics Committee at the Kirov Military Medical Academy on December 17, 2024 (Protocol No. 297 dated December 17, 2024). The study was conducted in compliance with ethical principles and the voluntary consent of the participants.
Contributions:
Bokarev M.A. — research concept and design, text writing, editing;
Safonova S.S. — research concept and design, text writing, collection and processing of material;
Grebenkov S.V. — concept and design of research, editing.
Funding. The study had no funding.
Conflict of interest. The authors declare no conflict of interest.
Received: 29.04.2025 / Accepted: 07.05.2025 / Published: 05.07.2025
Introduction. Emergencies in railway transport cannot be completely eliminated only as a result of organizational or technical measures. The share of human error as the main cause of traffic accidents in the world has a growing trend. At the same time, insufficient attention is paid to the role of reducing the functional state of an employee in increasing the risk of accidents in the train safety management system.
The study aims to establish the role of the "human factor" in the occurrence of transport accidents based on the analysis of the results of pre-trip medical examinations (PTME) and psychophysiological examinations (PFE) of locomotive crew workers (LCW), and to evaluate the effectiveness of the existing system of measures to ensure train safety (ETS).
Methods and materials. The authors analyzed the causes and circumstances of 22 accidents and 343,510 disruptions in the work of locomotive crews at Russian Railways in the period 2022-2024 in accordance with official data and analysis results of the automated system "Trusted Environment" (AS TE). Specialists assessed the functional state of LCW: PFE in UPDC‑MK, OA Neurocom; PTME in KAPD-02-ST; dynamic control of the functional state (DCFS) with the definition of the groups "norm", "maladaptation", "failure of adaptation" based on the analysis of 542578 records of person-days (339,890 — the main group and 202,688 — the control group). Based on the results of the analysis of disorders and the level of functional status, an integrated risk group and a preventive group (RG/PG) were formed from the NBD-2 Automated control system, PTME, DCFS and PFE.
Results. An analysis of the incidents shows that frequent gross violations are cases of stop signal overrun (SSO). The risk of SSO is 1.6-3 times higher among machinists than among assistant machinists and trainees and is more often detected in the age group of 30-69 years compared with groups of 20–29 years and over 70 years, p<0.001. In the state of "failure of adaptation", the risk of violations is higher than in the state of "norm" OR=1.10 [1.07–1.12], p<0.001. It was found that 87% of violations are committed by 39% of LCW that were included in GR/PG 2 or more times within 3 months before the violation; 68% of violations are committed by 11% of LCW who were included in GR/PG 3 or more times; 49% of violations are committed by 1.7% of machinists who 4 times and more were included in GR/PG. 49.50 [7.74–99.23] hours of processing per year were detected in persons with violations, 32.50 [0.00–67.58] hours in persons without violations, p<0.001.
Limitations. The research conducted is limited in terms of taking into account the specifics of the detected violations and the severity of their consequences.
Conclusion. In the vast majority of cases, traffic jams, gatherings, fires and other gross violations are committed by drivers who are irresponsible, undisciplined and/or have a decrease in their functional state. A direct relationship was revealed between the forecast of the driver's inclusion in the PG/RG and the results of the automated pre-trip medical examination system.
Ethics. This study did not require the conclusion of the Ethics Committee, all data were presented in a depersonalized form.
Contributions:
Kostenko N.A. — fundamental elements of the article, such as concept, design, methodology;
Zibarev E.V. — research design, data collection and processing, text writing;
Borisova E.V. — data collection and processing, writing text;
Mezhkenov S.A. — data collection and processing.
Funding. The study had no funding.
Conflict of interest. The authors declare that there is no conflict of interest.
Received: 08.04.2025 / Accepted: 30.05.2025 / Published: 05.07.2025
Introduction. The enrichment of polymetallic ores at the present stage requires the introduction of new technologies for more complete extraction of metals from minerals, which may be accompanied by the release of concentrations of chemicals exceeding permissible levels into the air environment of industrial premises.
The study aims to carry out a hygienic assessment of the air of industrial premises during cobalt refining.
Materials and methods. The air environment was characterized at the workplaces of metallurgists engaged in pyrometallurgical and hydrometallurgical refining of cobalt at one of the metallurgical enterprises of the Murmansk region. The authors have conducted studies on the hygienic assessment of workplace air in a standard way using individual samplers during 75.0% of the work shift time. The metals were measured using inductively coupled plasma atomic emission spectrometry.
Results. At all stages of pyrometallurgical and hydrometallurgical processing of polymetallic ore, the presence of a complex of harmful substances of complex composition has been established, where the most significant are water-soluble and water-insoluble compounds of cobalt and nickel. Water-soluble cobalt and nickel compounds in the air of the production rooms of the extraction department were determined at concentrations of 0.110 and 0.011 mg/m3, exceeding the MPC by 11.0 and 2.3 times. In the air of the industrial premises of the department of electrical extraction — 0.029 and 0.005 mg/m3, exceeding the maximum permissible concentration by 2.9 and 1.03 times. The detected compounds of copper, lead, cadmium, iron, magnesium, manganese, molybdenum and zinc in the air of industrial premises at all stages of processing copper-nickel ore did not exceed the maximum permissible concentration.
Limitations. The study is limited to 342 samples of industrial premises air.
Conclusion. Cobalt production, when switching to modern technology, can pose a real threat to the health of workers in this production. The need to develop a special methodology for the hygienic rationing of toxic metal compounds (nickel, cobalt, copper) in inhaled aerosol fractions of workplace air in enclosed industrial premises requires the use of correct models to assess and manage the risks of their harmful effects.
Ethics. The study does not require the submission of a conclusion from the biomedical Ethics Committee or other documents.
Contributions:
Shilov V.V. — concept, editing and approval of the final version of the article;
Nikanov A.N. — collection and statistical processing of the material, editing of the article;
Kovshov A.A. — statistical processing of the material and editing of the article;
Barinov V.A. — research concept and design, editing;
Gudkov A.B. — editing the article;
Ermolin S.P. — statistical processing of the material, editing of the article;
All co-authors — are responsible for the integrity of all parts of the article.
Funding. The study had no funding.
Conflict of interest. The authors declare no conflict of interest.
Received: 24.04.2025 / Accepted: 30.05.2025 / Published: 05.07.2025
Introduction. The relevance of the study is due to the high prevalence of degenerative-dystrophic changes and diseases of the musculoskeletal system in the structure of diseases in the general population and among people working in contact with harmful industrial factors, i.e. it can be a pathology to a large extent and professionally caused.
The study aims to optimize the X–ray diagnosis of heel spurs based on the use of sharp-focus digital radiography and a set of methodological techniques for posteriori radiometry (radiography and X-ray densitometry).
Materials and methods. The authors analyzed the results of clinical and X-ray examination of 135 miners (men) of the treatment faces: 65 people were patients with insertion endopathy, calcifications in the area of attachment of the plantar fascia (plantar heel spur) and Achilles tendon to the calcaneus (dorsal heel spur). The control group consisted of 70 people without clinical manifestations and instrumentally detectable signs of multifocal accumulation of calcium phosphate crystals in the periossal tissues of the feet. The specialist performed all measurements using Dr. LINS Machaon's workstation. The scientists evaluated the data at the initial stage of the study, before the use of therapy, immediately after treatment (3 months after the start and 12 months after the final session of extracorporeal shock wave therapy (SWT) using a piezo wave device (Richard Wolf, Austria), i.e. in dynamics according to the phases of rest, resorption and recovery.
Results. The use of a complex of modern medical technologies in the aspect of solving the problem of improving the diagnosis of heel spurs made it possible to objectify the intensity of disintegration processes in the process of evaluating the effectiveness of extracorporeal shock wave therapy at its various stages in the dynamics of observations.
Limitations. Numerical limitations and relatively large distance of patients (Eastern Siberia) from the site of in-depth examination (Moscow).
Conclusion. The use of digital diagnostic radiography in the acute focus mode followed by a posteriori rengenometry using the capabilities of research software expands the prospects for obtaining sufficiently objective radiometric (X-ray and X-ray densitometric) information (including from the working population in outpatient settings) without involving additional, expensive and not always available hardware diagnostics using CT and MRI. Radiometric parameters in assessing the condition of the periosteal soft tissue structures of the calcaneus and the phenomenon of calcinate decay in the areas of interest open up a real opportunity to accurately assess the effectiveness of the physiotherapeutic SWT method of heel spurs.
Ethics. The study did not require the conclusion of an Ethics Committee.
Contributions:
Druzhinin V.N. — research concept and design, data collection, text writing;
Suvorov V.G. — data collection and processing;
Slavinsky A.A. — editing;
Troynyakov S.N. — statistical analysis.
Funding. The study had no funding.
Conflict of interest. The authors declare no conflict of interest.
Received: 24.04.2025 / Accepted: 30.05.2025 / Published: 05.07.2025
Introduction. Essential oils have a multifaceted health and therapeutic effect, including antiseptic, anti-infective, anti-inflammatory and even antibiotic effects. Lavender and coriander essential oils also have antihistamine, immunostimulating effects, affect neurological activity — they act as analgesics, sedatives, antispasmodics, etc. Along with the positive pharmacological effects, there is literature evidence of their negative effects on humans with prolonged exposure in relatively high concentrations. Thus, the lack of hygiene standards in the air of the work area poses a threat to the health of workers who come into contact with these oils in production conditions.
The study aims to substantiate hygienic standards in the air of the working area for lavender and coriander oils based on their comparative toxicological characteristics.
Materials and methods. The authors used laboratory animals in their experiments: these are harmless white mice of both sexes, white male rats, Chinchilla rabbits, and white guinea pigs. The average lethal doses (DL50) were determined when the substances were injected into the stomach and abdominal cavity. The scientists evaluated the local irritant effect on the mucous membranes of the eyes with a single application to the conjunctival sac of the rabbit's eye, the effect on the skin with a single and repeated application of oils to the depilated skin of the rabbit's back for 4 hours. Cumulative properties were studied in male mice with daily intragastric administration of the substance for 24 days at a dose of 1000 mg/kg. The experts studied the sensitizing effect of oils on guinea pigs in a combined way. The study of the inhalation hazard of oil vapors in conditions of the maximum possible saturation concentration was carried out under static conditions on white mice in desiccators with a volume of 18 liters at an exposure of 2 hours. The researchers evaluated subchronic toxicity with repeated intragastric administration of essential oils to rats at a dose of 1/10 DL50 for 30 days.
Results. When injected into the abdominal cavity of male mice, according to the OECD and K.K. Sidorov classification, lavender oil belongs to the 5th class of toxicity, and coriander oil belongs to the 5th or 6th class of toxicity. Both oils cause mild irritation of the mucous membranes. With a single application to the skin, lavender oil has a moderate irritant effect, coriander oil has a mild irritant effect. When inhaling the saturating vapors of lavender essential oil, mice showed a tendency to decrease their respiratory rate. The skin-resorptive effect of the studied substances has not been revealed. The study of cumulative properties showed a weak cumulative activity of both oils. No sensitizing effect was detected. When studying subchronic toxicity, it was found that both oils had no significant effect on body weight dynamics, daily intake of feed and water, rectal temperature, respiratory rate, ECG parameters and peripheral blood parameters. The authors found changes in the parameters of the nervous system, an increase in the activity of alkaline phosphatase (ALP), a decrease in the pH of urine, an increase in the level of urea in urine, the excretion of protein and urea in urine, and an increase in urea clearance.
Limitations. In hygienic rationing, the method of justification by analogy is applied.
Conclusion. Taking into account the similarity in the nature of the action of lavender and coriander essential oils and the main component — linalool, as well as by analogy with other similar terpene derivatives, the maximum permissible concentrations of lavender essential oil and coriander essential oil in the air of the working area at the level of 5 mg/m3; vapors; hazard class 3 have been established and approved.
Ethics. The experimental study was conducted in compliance with the necessary regulations (Helsinki Declaration of 2013, GOST 33044-2014 "Principles of good laboratory practice"; Order of the Ministry of Health of the Russian Federation No. 188n dated 04/01/2016 "Rules of good laboratory practice"). The research protocol was approved by the University Commission for the Control of the maintenance and Use of Laboratory Animals of the Pirogov Russian National Research Medical University of the Ministry of Health, Russian Federation, with permission No. 9 dated September 20, 2023, to work with laboratory animals.
Contributions:
Tonshin A.A. — preparation of literature data, writing of text, editing;
Golubeva M.I. — collection and processing of material, data analysis, writing, editing;
Sheina N.I. — research concept and design, text writing, editing;
Bidevkina M.V. — collection and processing of material, statistical data processing, writing text;
Bobrineva I.A. — conducting research, statistical data processing, description of research results;
Fedorova E.A. — conducting research, statistical data processing, description of research results;
Bobrinev E.V. — preparation of literature data and a list of literary sources, statistical data processing.
Funding. The study had no funding.
Conflict of interest. The authors declare no conflict of interest.
Received: 02.04.2025 / Accepted: 26.05.2025 / Published: 05.07.2025
ISSN 2618-8945 (Online)