Relevance. Occupational factor nowadays is considered an important condition of cardiovascular risk increase, including arterial hypertension growth. With this, study of work conditions infl uence on probable arterial hypertension development and other cardiovascular risk factors appears topical.

Objective. To construct prognostic model of probable arterial hypertension development in workers of asbestos-concentrating plant, who are exposed to higher concentration of fi brogenic dust containing chrysotile.

Materials and methods. Main group (161 individuals) comprised patients with diagnosed occupational disease (asbestosis), reference group included workers (222 individuals) with long length of service, without occupational diseases. Th e groups matched in age, sex, length of exposure to hazards, smoking index.

Results. Findings are high occupational conditionality of left  ventricle hypertrophy (relative risk 3.217, att ributable fraction 54.32%). Revealed factors that promote occupationally conditioned arterial hypertension (asbestosis, obesity, increased serum glucose, coronary heart disease, increased heart rate, lower saturation) served as a basis for prognostic model design by logic regression.

Conclusion. Mathematic modelling helps to define contribution of occupational and non-occupational factors into arterial hypertension development in workers exposed to fi brogenic dust. Dust factor is an additional risk factor in arterial hypertension development am ong workers engaged into asbestos-concentrating production. 

Introduction. Occupational exposure to dust in concentrations sometimes exceeding allowable norms, infl uence of associated hazards (irritating gases, toxic chemicals, unfavorable microclimate at workplace, heavy physical work) cause occupational and occupationally conditioned bronchopulmonary diseases and lower work capacity in workers with main occupations of refractory materials production.

Objective. To study functional state of respiratory system for diagnosis of early disorders of pulmonary ventilation and gases exchange in workers of moulded refractory materials production.

Materials and methods. Prospective randomized study included apparently healthy male workers (n = 61) of refractory materials plant producing chamott e-silica and spinel-periclase-carbon refractories. Clinic of Ekaterinburg medical research center in 2017–2018 provided examination of carriers (n=21) in spinel-periclase-carbon refractories production shop and pressmen (n=40) of moulding area in chamott e-silica refractories production, aged 27 to 60 years, with length of service in hazardous conditions from 4 to 37 years. Bodyplethysmography helped to assess general lung capacity (GLC), residual lung volume, ratio of residual lung volume to general lung capacity, functional residual lung capacity, bronchial resistance and diff usion lung ability by carbon oxide via single inspiration method. For nonventilated lung volume, the authors used ∆ GLC value that is a diff erence between GLC values measured via bodyplethysmography and via helium dilution in single inspiration maneuver.

Results. Obstructive syndrome (6.5%) was a main type of ventilation disorders among the examinees, and equally frequent among the workers engaged into spinel-periclase-carbon refractories production (9.5%) and in those engaged into chamott esilica refractories production (5%). Th e workers engaged into spinel-periclase-carbon refractories production had obstructive syndrome associated with lung hyperinfl ation, and those engaged into chamott e-silica refractories production had also a tendency to restrictive disorders. Lung gases exchange disorders were seen in one third of the examinees, equally frequent in both workers engaged into spinel-periclase-carbon refractories production and those engaged into chamott e-silica refractories production, manifested in 2 variants: lower diff usion lung capacity (fi rst variant) and lower diff usion lung capacity with increased ∆ GLC (second variant).

Conclusion. Th e study results prove necessity of bodyplethysmography and diff usion lung capacity diagnosis  to reveal perfusion and ventilation disorders at early stages in workers engaged into spinel-periclase-carbon refr actories production over 8 years and in those engaged into chamott e-silica refr actories production over 12 years. 

Relevance. In contemporary occupational pathology, diagnosis of occupational fluorosis is based on locomotory apparatus disorder such as fluorine osteopathy. Other significant consequences of negative effects of fluorine compounds are deactivation of enzymatic systems, metabolic disorders — that results in pathologic involvement of many organs and systems (hepato-biliary, cardiovascular, respiratory, nervous, endocrine, gastrointestinal). Topical issue is search of a complex of factors influencing development of the occupational disease, to optimize management of occupational fluorine intoxication risk.

Objective. To determine spectrum of factors that promote development of occupational fl uorine intoxication in workers exposed to inorganic fl uorine compounds, for forecasting the disease outcome and selecting main trends of preventive measures.

Materials and methods. Single-factor analysis methods helped to carry retrospective cohort study of occupational fl uorine intoxication development in 201 workers of aluminum production in Ural region. Th e study covered infl uence of main occupational factors and somatic health parameter s on occupational fl uorosis development.

Results. Findings are reliable infl uence of age (k=0.532, p<0.001), length of service in hazardous work conditions (p<0.001), hydrofl uoride level (p<0.001) and constant magnetic fi eld (p=0.005). Besides that, analysis of immune and metabolic state of the workers revealed signifi cant infl uence of disordered lipid, carbohydrate, purine metabolism, altered immune parameters on occupational fl uorosis development. Other evidence was reliable dependence between concomitant cardiovascular diseases and period of occupational chronic fl uorine intoxication development.

Conclusion. Using single-factor analysis helped to determine wide spectrum of factors associated with the workers’ health state and work conditions, that signifi cantly infl uence development of fl uorine intoxication. Th e authors proved that period of occupational chronic fl uorine intoxication is notably infl uenced by occupational factors (length of service, hydrofl uoride level, fl uorine load degree, magnetic fi eld) and somatic state characteristics as age, parameters of carbohydrate, lipid, purine metabolism, status of cardiovascular, excretory systems, kidneys and gastrointestinal tract functions. 

Introduction. Nanoparticles of NiO pollute air of workplace in metallurgic production of nickel and alloyed steel (during their use in electric welding). Toxicity of NiO nanoparticles was studied in some experiments, but mechanisms underlying their toxic eff ects are not understood and require wider base of experimental data.

Objective. To study toxic eff ects of NiO nanoparticles in chronic inhalation exposure.

Materials and methods. Outbred female rats were subjected to repeated low-level inhalation exposure to NiO nanoparticles of 99.99% purity, measured 23±5 nm, 4 hours per day, 5 days per week, up to 10-month duration in an “only nose” device with concentration 0.2±0.01 mg/m3. To select this concentration, preliminary pilot experiment included 5-fold exposure with concentration 1.00±0.12 mg/m3.

Results. NiO nanoparticles in short-term and chronic inhalation exposure aff ect lipids peroxidation, red blood parameters, liver and kidney functions, oxidation-reduction balance. All three terms of chronic inhalation experiment cause active alveolar phagocytosis reaction, and their high cytotoxicity is proved by relation of neutrophils to alveolar macrophages and by enzymes levels in bronchoalveolar lavage.

Conclusions. NiO nanoparticles if inhaled in concentration 0.2 mg/m3 cause moderate toxic eff ect in experimental animals.

Radon and its derivatives are a global natural factor of radiation infl uence on humans. New data on risk factors of lung cancer and signifi cant volume of epidemiologic and medical statistic data collected recently in various parts of the world prove that meta-analysis of information of link between lung cancer and radon exposure in living area is topical. Th e authors analyzed the most complete set of data on radon infl uence on human health, based on use of territory-wise aggregation of medical statistic materials and case-control research results. Summary covered also results of regression analysis of dependence of lung cancer mortality on average level of radon accumulation in buildings of Russian and US regions, and meta-analysis of over 30 case-control studies performed in various parts of the world. Th e study results support relations between lung cancer and radon irradiation in houses. To evaluate risk of lung cancer induced by radon, one can recommend value of 0.14 (with 90% confi dence interval 0.10–0.18) normalized for exposure to radon derivatives and corresponding to radon volumetric activity of 100 Bq/m3. Radon causes nearly 6% of lung cancer morbidity and mortality in Russia — that is over 3,000 new cases per year.

Th e authors reviewed literature on methodic evaluations of human requirements of protein, based on Russian and foreign data bases (Scopus, Web of Science, MedLine, RINTs, eLIBRA RY) via key words in article headings, and evaluated quality and quantity of protein in diets of workers exposed to occupational hazards. Average requirements of amino acids and their additional intake for bett er health state in certain occupational groups remains a topical problem. Th e article covers list of methods for quantitative and qualitative evaluation of proteins in foods and diets. Findings are diff erences in approaches to protein quantity regulation in Russian Federation and WHO/FAO/UNU (protein normal level in RF is higher, depends on physical exertion, with lower quantity of amino acids with branched chain in structure of essential amino acids). Th erapeutic and prophylactic diet corresponding to Order N46 of Russian Health Ministry for main occupations of metallurgic workshops can be considered as high-proteous and balanced in amino acid contents. Necessity is to study adequate intake of amino acids in workers exposed to occupational hazards, for improving protective and adaptative body mechanisms, and prevention of occupational and occupationally conditioned diseases.

Cancer is increasing worldwide. Th e Russian Federation is no exception in this regard with an increase of the total number of new cases predicted to rise from 529,062 in 2018 to 587,622 in 2040. Th e present high burden and increase in incident cases at the same time increases the pressure on healthcare infrastructure and related costs. Th us, primary and secondary prevention of cancer becomes essential. Occupational cancers related to exposure at the workplace are among the preventable cancer burden, due to the modifi ability of the risk through minimisation of occupational exposures and adequate worker protection. For the Russian Federation, some 20,000 cancers each year may be att ributable to occupation, but systematic recording is currently lacking. As information is also lacking on the absolute eff ect of various occupational carcinogens in the Russian workforce due to lack of large-scale epidemiological studies and because for many suspected occupational carcinogens the evidence may become stronger, the true burden may in fact be higher. Th e Russian Federation appears particularly suitable for research into occupational cancer given the sizable workforce, the heavy industr ialisation as well as the good documentation and workplace surveillance over time, so that results are both informative for the situation in the Russian Federation and on a global scale. Five challenging but not unfeasible steps of nationwide population-based cancer registration, development of a legal framework for record linkage of registries and data collections, recording of occupational cancers, large scale epidemiological occupational cancer research and rigorous implementation of worker protection on known carcinogens, lead the way to a continuously updated cancer control plan that includes the elimination of occupational cancer in the Russian Federation.

Workers’ health should be considered as a strategically important component of governmental economic policy. Nowadays society economic damage due to lost vocational fi tness because of medical causes results mostly from general somatic diseases, but not from occupational diseases. In stable tendency to ageing able-bodied population, studies of medical causes of vocational unfi tness is a topical problem. To analyze causes of lost vocational fitness for work in jeopardy and (or) hazardous work conditions, to determine quantitative parameters of vocational unfi tness in mandatory medical examinations, to evaluate nosologic structure of medical contraindications to work in jeopardy and (or) hazardous work conditions, the authors studied demographic data of Federal service of governmental statistics and data on fi rst diagnosed occupational diseases by materials of Governmental reports of Federal service on supervision in consumers’ rights protection and human well-being. Studies also covered data of FBUN “Ekaterinburg medical research center of prevention and health care for industrial workers” of Rospotrebnadzor (EMNTs): database on fi rst diagnosed occupational diseases in Sverdlovsk region, conclusion reports on periodic medical examination results, and medical records of workers underwent periodic medical examination in EMNTs. Th e data were analyzed with descriptive and inductive statistic methods. In constant medical contraindications structure by nosologic types, according to periodic medical examinations in EMNTs, major part of refused permission  to the work was associated with diseases in ICD–10 class VII “Diseases of eye and its appendages”, on the 2nd place — diseases of ICD–10 class VIII “Diseases of ear and mastoid process”, on the 3rd place — diseases of ICD–10 class XI “Digestion diseases”. Recommendations are in Russian Federation Health Ministry to consider necessity of workers’ possibility to receive additional examination and special medical care within governmental program of guaranteed free medical care in cases when the diagnosed disease causes refused permission to work.

Inpatient examination covered 46 workers of main occupations in chrysotile asbestos production, with diagnosed occupational disease “asbestosis”, and reference group comprising 20 healthy workers of the same enterprise. Th e results present comparative analysis of clinical and anamnesis data in dependence on the past pneumonia, studies of immune state in the asbestosis patients and the healthy workers, data on high occurrence of pneumonia in the workers, comparative analysis of respiratory infections occurrence and concomitant diseases according to the outpatients records and medical examinations. Findings are reliable diff erences and earlier respiratory manifestations in the past-pneumonia workers exposed to chrysotile asbestos, higher occurrence (1.3-fold) of chronic bronchitis and severe disorders of bronchial patency. Immune response factors were characterized as pathogenetic links of pneumococcus infectious invasion. Additional risk factors of pneumonia appeared to be frequent respiratory infections, chronic diseases of upper respiratory tract and middle ear, lower functional state of neutrophils, increased auto-reactivity. To evaluate signifi cance of risk factors infl uence, the authors used fi tt ing criterion X2 (chi-square). Intensity of relationships between the risk factor and outcome was evaluated by contingency coeffi  cient of Pearson. Signifi cance level (p) for all the calculation was accepted less than 0.05.

Irkutsk region is among territories of intense industrial development. Considerable part of the regional population is long exposed to chemical pollutants of environmental objects. Th e authors evaluated carcinogenic risk for the population of industrial centers and rural area. Findings are that maximal carcinogenic risk is carried by the urban population. Aggregated carcinogenic risk parameters evaluation proved inhalation to be a priority route of exposure. Irkutsk region appeared to have territories with high carcinogenic risk for public health. Among a list of chemicals in the ambient air are priority carcinogens: six-valent chromium and lead. The evidences necessitate measures on the risks minimization. Due to absent data on carcinogens content of drinkable water in some rural area, the necessity is to evaluate risk for the rural population by studies of drinkable water quality that does not match hygienic regulations, because oral one is a main route of carcinogens intake.

Individual carcinogenic risk (ICR) was assessed in workers of main occupations in aircraft  construction industry of East Siberia. Levels of ICR were evaluated for the main occupations workers during 1 to 30 years of service. Th e workers’ exposure was assessed according to longstanding average shift  concentrations in the air of workplace, for the population — by average annual concentrations in the ambient air. To evaluate the risk not associated with occupation, the dose was taken for a period of 70 years life. Calculating dose of toxic chemicals in the air of workplace, the authors used “standard” parameters of pulmonary ventilation for adults, weight, days of exposure (240), working time (8 hours as a working day). Individual carcinogenic risk for Irkutsk population equaled 3.0E–04, in Ulan-Ude — 4.8E–04. Th e risk value for the general population is due to formaldehyde and chromium VI. Th e workers of main occupations in enterprises with carcinogenic jeopardy have ICR dozens of times higher than the general urban population. Considering a share in ICR, leading carcinogens for the aircraft  construction enterprise workers are: formaldehyde — vulcanizers, chromium and nickel — for other occupations. ICR is considered as unacceptable for occupational groups in 5–15 years aft er starting work under hazardous conditions. Despite high level of ICR, the occupational control incompletely covers monitoring of carcinogens. Existing system of occupational studies fails to disclose etiologic role of occupational factors in occurrence of malignancies.