The analysis of the international and national documents and the review of scientific literature from positions of evidential medicine on overtime works (OTW). Conventions and recommendations of the ILO, the directives of the European Union and also the requirement of national documents for the OTW are reviewed. Questions of occupational risk at the OTW are considered and needs of additional protective measures and medical care of workers are noted.

Evaluation of workers' health was based on results of transitory disablement morbidity analysis. Studying complex influence of occupational factors on transitory disablement morbidity due to sickness, the authors used a method of normalizing intensive parameters. Findings are that occupational hazards negatively influence workers' health parameters. An equation received by normalizing intensive parameters enables to simplify a procedure of evaluation and prognosis of transitory disablement morbidity.

The study covered physiologic and biochemical features of human reactions during mental work towards exposure to psycho-emotional exertion, for scientifically based specification of methods to evaluate resistance to occupational stress and of preventive measures complex.

The authors evaluated work conditions and occupational morbidity in glass fiber production workers. Operators of continuous glass fiber production are exposed to combined influence of intense noise, unfavorable microclimate and chemicals incorporated into greasers and released into air of workplace. Overall class of work conditions is assessed as hazardous (class 3.3) - that corresponds to high category of occupational risk. Occupational hyperkeratosis appear in the operators with length of service averaging 12.6 ± 2.4 years with highly probable malignization during 5-8 years. Association of polymorph variants of TP53 (Ex4+119G>C, IVS3 16 bp Del/Ins and IVS6+62A>G) with increased risk of occupational skin neoplasms was demonstrated.

Study covered influence of occupational stress on hemodynamic and adaptive state of workers. Examination included 132 males aged up to 40 years, subjected over 1-5 years to occupational stress load varying in intensity and caused by operative work in law-enforcement organs. Reference group included the age-mates having no involvement into the operative work. In accordance with classification model of stress load by R. Karasek, T. Theorell (1990), the studied acitivity is associated with increased responsibility, time dificit, danger along with limitated possibility in personal decision making. Tests included diurnal monitoring of blood pressure in various days of week and evaluation of heart rhythm variability at rest and orthostasis. Findings are marked increase in time indexes of systolic and diastolic blood pressure both at daytime and night, as well as increased values of blood pressure morning rise and its speed. Changes were seen during the working day and disappeared during days off. Evidences were also changes in regulation balance with excessive sympathic adrenal influences not only during stress testing, but in initial rest state. Thus, the authors demonstrated possibility of neuro-vegetative and hemodynamic dysbalance development in young people exposed to quite short-time exposure to occupational stress load. Suggestions are more wide use of heart rhythm variability and blood pressure diurnal monitoring assessment during occupational examination of young men exposed to occupational stress load, for timely diagnosis of stress-associated dysregulatory syndrome with possible development of stable arterial hypertension in future.

For quantitative evaluation of working stress factors on a basis of international questionnaires JCQ (Job Control Questionnaire) and ERI (Effort-Reward Imbalance), a test system “Workplace and stress” (RAMIS) in Russian language is created. The authors studied influence of occupational factors on parameters of mental and physical state (scales of SF-36 questionnaire) and on microtraumatism. In comparison with analogous parameters of international sample, workers of Russian oil-processing enterprise demonstrated lower autonomy level, higher work demands, lower support from colleagues and authorities. Low autonomy, absence of social support and discontentment with work are shown as factors of stress-related health disorders. In spite of absence of legal regulation, evaluation of work stress should be included into prevention programs of enterprises.

The authors used correlation adaptometry and presented results of evaluating anthropo-ecologic stress level during long-term adaptation of workers to northern and industrial conditions. Periods and dynamic types of the stress were determined. Integral parameter of anthropo-ecologic stress degree - correlation graph (G) - demonstrates structure of relationships of WBC metabolism parameters and immune system functional level not only during long-term adaptation to extreme conditions of North in polar day, but with differences between groups of workers engaged into various industries. Changes of G value in workers not exposed to occupational hazards shows recovery of overstrain into adaptation, but in workers engaged into nickel production the overstrain state increases with longer length of service in North. Combined effect of nickel production hazards and physical factors of North causes orientation of metabolic processes to catabolism and therefore increased morbidity among metallurgic enterprise workers.

To improve results of treatment and restore ability to work in patients with degenerative vertebral canal stenosis in lumbar spine, the authors used new minimally invasive methods of rigid spondylosyndesis. Clinical efficiency and recovery of ability to work were evaluated in 77 workers of OJSC “RZhD” subjected to minimally invasive methods of rigid stabilization of lumbar spine.

The authors presented results of cytochemical studies of peripheral blood WBC in pilots of highly maneuverable aircrafts. Findings are that flight factors in such aircrafts cause in pilots activation of sympathic adrenal and pituitary-adrenal systems, with pre-stress and stress reactions. That is manifested by increased activity of extra-mitochondrial enzymes and transformation of cellular metabolic processes from mitochondrial oxidation to mostly glycolytic one - that suggests development of cellular hypoxia. Desadaptation disorders are characteristic mostly for pilots aged over 40 years and with length of service at least 2000 hours.