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Russian Journal of Occupational Health and Industrial Ecology

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No 11 (2019)
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https://doi.org/10.31089/1026-9428-2019-11

ORIGINAL ARTICLES

908-913 468
Abstract

Introduction. Th e study of immune and genetic indicators associated with functional pathology of the autonomic nervous system in workers engaged in mining operations for the extraction of chrome ore (Perm region).

The aim of the study was to study the characteristics of cellular immunity and genetic polymorphism in workers engaged in underground mining, suff ering from functional disorders of the autonomic nervous system.

Materials and methods. Th e state of various parts of the autonomic nervous system was assessed using cardiorhythmographic program according to the standard method. Markers of cell diff erentiation (CD95+, CD127-) were determined by fl ow cytometry on fl ow cytofl uorimeter. Determining the level of protein expression of Bcl–2 and membrane expression of the receptor for tumor necrosis factor TNF was performed using corresponding monoclonal antibodies and simultaneous procedure negative isotype control. Genetic features were detected by real-time polymerase chain reaction and allelic discrimination based on the diagnosis of single-nucleotide polymorphisms.

Results. The analysis of cardiointervalography indices showed that the predominant types of vegetative regulation of the initial vegetative tone in the observation and comparison groups were eitonia (37.5 and 45.8%, respectively, p=0.448). The sympathetic tone in the observation group were found 1.8 times more often than in the control group (35.4% and 20%, respectively, p=0,126). The study of indicators of the immune system in the working group of observation allowed to establish that the number of T-lymphocytes expressing the receptor apparatus of T-lymphocytes CD127- suppressors was significantly higher than the reference level. The number of T-lymphocytes carrying CD95+ cell death receptor did not significantly differ from the same index in the comparison group, at the same time, in relation to the physiological norm, their level was significantly lower. TNFR cells relative to physiological norm (p<0.05). When studying the system of transcription factors of apoptosis, inhibition of intracellular protein expression of Bcl–2 protein was established. A significant increase in the value of the index of specific sensitization to chromium (Ig E spec.), (1.63 times in relation to the comparison group). The genetic analysis revealed differences in the distribution of frequencies of alleles and genotypes in patients with diseases of the nervous system (polyneuropathy, disorders of the autonomic system, epilepsy, eitonia, etc.) on the genotypes of the following genes: gene detoxification of xenobiotics — coproporphyrinogen oxidase CPOX A/C rs1131857, serotonin receptor gene HTR2A A/G rs7997012, which forms a genetic predisposition to pathological immunoregulatory scenarios of allergization, hypersensitivity to intoxication, carcinogenesis, catecholamine regulation defects (asthenia, migraine, obesity, lability of blood pressure and pulse). Conclusions. Th e results of immunological and genetic studies indicate production conditionality in miners engaged in underground mining of chromium ore, with manifestations of functional disorders of the autonomic nervous system associated with an imbalance of immunoregulation and gene polymorphism variability.

914-919 579
Abstract

Introduction. Currently, endothelial dysfunction is considered as one of the initial stages of the pathogenesis of cardiovascular diseases. By isolating a number of biologically active compounds, the endothelium helps to maintain vascular tone and physiological rheology of the blood. Modern production of chrome ore is characterized by a variety of harmful occupational factors (chromium, dust, noise, vibration, severity and intensity of work, cooling microclimate), which can disrupt the normal functioning of the vascular endothelium and lead to the development of cardiovascular diseases.

The aim of the study was to study the features of endothelial function in workers engaged in underground mining of chrome ore in harmful working conditions.

Materials and methods. The study included 98 miners of the enterprise for the extraction of chrome ore. The comparison group (working in conditions outside the influence of the studied production factors) consisted of 75 employees-managers and specialists of administrative and managerial personnel of the enterprise, comparable in age and experience with the observation group. To assess the vasomotor function of the endothelium, a flow-dependent (endothelium-dependent) vasodilation test was performed using the D. S. Celermajer technique. Post-occlusive increase in brachial artery diameter, brachial artery sensitivity coefficient to endothelial shift change were evaluated.

Results. The endothelial function of mine workers did not differ significantly from the comparison group with work experience up to 10 years (the values of the relative increase in the diameter of the brachial artery 12.2% in the observation group and in the comparison group 12.6%, p=0.74). With experience of more than 10 years, the value of the relative increase in the diameter of the brachial artery in the observation group with experience of more than 10 years corresponded to the signs of endothelial dysfunction and amounted to 8.6%, while in the comparison group this figure was 12.4%, which corresponded to normal endothelial function (p=0.019). Endothelial function progressively deteriorated with increasing seniority in mine workers. 

Conclusions. For workers engaged in underground mining of chrome ore for more than 10 years, a reduced vasodilation reaction to reperfusion after an occlusion test and a low coefficient of sensitivity of the endothelium to shear stress are characteristic. There was no statistically significant decrease in increase in brachial artery diameter and the coefficient of sensitivity of endothelium to shear stress relative to the comparison group was selected only from persons with experience more than 10 years. The comparative analysis of the results of the evaluation of the functional activity of the endothelium in workers of the compared groups indicates that the change in the functional state of the endothelium in miners is associated not only with age, but also with working conditions. The revealed changes predispose to the development of cardiovascular pathology associated with atherosclerosis in workers of underground chrome ore mining.

920-925 603
Abstract

Introduction. The health of workers is determined by both social and individual, as well as production factors, including noise, vibration and dust, characteristic of technological processes in mining enterprises. Industrial noise above 90 dBA and dust in the form of suspended and fine particles causes dysfunction of the cardiovascular system and respiratory organs.

The aim of the study is to assess the impact of harmful physical factors and industrial dust on changes in some biochemical and functional indicators of the cardiovascular system and respiratory system of employees of the enterprise for underground mining of ore.

Materials and methods. The assessment of working conditions of workers engaged in underground mining and processing of chrome ores, the analysis of industrial dust on the dimension and quantitative content of fine particles PM10 and PM2. 5, the study of biochemical parameters of lipid metabolism, oxidant and antioxidant systems, indicators of respiratory function. 

Results. Harmful working conditions (class 3.1–3.4) in terms of noise and vibration were revealed at the workplaces of employees of the main specialties observation group. In the air of the working zone, the highest content of fine particles PM2.5 (2.68±0.54 mg/m3) and PM10 (4.64±0.93 mg/m3) was established at the site of drilling operations and cleaning of the bottom-hole space. Deviations of biochemical parameters characterizing intensification of free radical processes and antioxidant protection, imbalance of lipid spectrum parameters, and violation of functional parameters of external respiration were revealed. A high degree of connection with the working conditions of the frequency of increased levels of lipid hydroperoxide and antioxidant activity (EF=60.71–65.84%) was established.

Conclusions. In high noise level (more than 94 dBA), general and local vibration (more than 116 and 127 dB respectively) and the content of fine particles PM2. 5 (more of 2.14 mg/m3) and PM10 (over of 3.71 mg/m3) at underground mining of chrome ore workers have identified abnormalities in the form of increase 1.6 times the level of lipid hydroperoxides and total antioxidant activity, reducing to 1.2 times the level of high density lipoprotein, improving 1.2–1.3 times of low-density lipoproteins, triglycerides, and atherogenic index in blood serum, peak expiratory flow. A high degree of professional conditioning have the frequency of increasing the level of lipid hydroperoxide in blood serum and antioxidant activity of blood plasma.

926-930 489
Abstract

Introduction. The relevance of the study of cardiovascular diseases (CVD) as a production-related pathology in workers at industrial enterprises is due to the presence in the technological process of production factors (noise, general vibration, microclimate, severity of labor, chemical factors), potentially capable of provoking the development of CVD.

The aim of the study was to assess respiratory and metabolic disorders, which are risk factors for CVD, in workers exposed to dust, chlorine and hydrogen chloride.

Materials and methods. 139 patients working under the influence of dust, chlorine and hydrogen chloride were examined. Among the surveyed 74 women and 65 men. The comparison group (45 people) consisted of 20 women and 25 men who were not exposed to harmful factors of production during their working life.

Results. In the group of workers exposed to occupational exposure to dust, chlorine and hydrochloride vapors, it was revealed that the proportion of workers with arterial hypertension was 33.3%, in the comparison group–17.6%, p<0.05 (RR 1.99; 95% CI 1.01–3.93; EF=47%; the degree of professional conditioning is average). The volume of forced exhalation per 1 second (FEV1) in the observation group was 3.18±0.14 l, and in the comparison group–4.1±0.20 l (p<0.001). The level of total cholesterol in the observation group was 5.72±0.13 mmol / l, and in the comparison group–5.16±0.23 mmol / l (p<0.05). The observation group showed a decrease in HDL (1.35±0.04 mmol / l vs. 1.64±0.10 mmol / l in the comparison group, p<0.05) and an increase in triglycerides (2.3±0.17 mmol/l versus 1.51±0.16 mmol/l in the comparison group, p<0.05).

Conclusions. In the group of workers exposed to professional dust, chlorine and hydrochloride vapors, a decrease in the speed parameters of the external respiratory function, the development of proatherogenic metabolic disorders, and an increase in laboratory indicators of inflammation were revealed. These changes can lead to early manifestation of cardiovascular and respiratory pathology in this category of workers.

931-936 548
Abstract

Introduction. The city of Chita of Zabaikalsky region is one of the cities of Russia, priority on level of pollution of atmosphere. Of the order of 130 impurities emitted by the sources of the city, 12 are monitored at 5 posts of the Roshydromet network. Maximum monthly average concentrations are formed by benz (a) pyrene (up to 56.8 MPC), hydrogen sulfide (12.3 MPC), suspended particles (up to 4PDC), phenol (up to 3.6 MPC). Significant emissions (59.73 thousand tons in 2018) are aggravated by the use of coal as a fuel by heat and power enterprises and the private sector, climatic and geographical features. Within the framework of the Federal project “Clean Air” of the national project “Ecology”, it is envisaged to reduce the gross emission of pollutants into the atmosphere of Chita by 8.75 thousand tons by 2024, which should lead to a significant improvement in the safety and quality of life of citizens. It is necessary to identify the most “risky “components of pollution for health.

It is important to understand: whether the environmental monitoring system reflects the real picture of the dangers posed by pollution of the city’s atmosphere; whether there is a need to optimize the monitoring system for the subsequent assessment of the effectiveness and efficiency of measures; what impurities and at what points should be monitored in the interests of the population, administration and economic entities implementing air protection measures.

The aim of the study is to develop recommendations for optimizing the program of environmental monitoring of air quality in the city of Chita, taking into account the criteria of danger to public health for the subsequent evaluation of the effectiveness and effectiveness of the Federal project “Clean Air”.

Materials and methods. Justification of optimization of monitoring programs was carried out through the calculation of hazard indices, considering: the mass of emissions and toxicological characteristics of each chemical; the population under the influence. A vector map of the city with a layer “population density” was used as a topographic base. The indices were calculated for regular grid cells covering the residential area. For each cell, the repeatability of winds of 8 points from the priority enterprises and the population within the calculated cell were taken into account. As a result, each calculation cell was characterized by a total coefficient, taking into account the danger of potential impacts of emissions. Based on the results of the assessments, recommendations were formulated to optimize the placement of posts in the city and the formation of monitoring programs.

Results. Indices of carcinogenic danger to the health of the population of Chita ranged from 584,805. 96 to 0.03 (priorities: carbon (soot), benzene, benz (a) pyrene); indices of non-carcinogenic danger — from 1,443,558. 24 to 0.00 (priorities: sulfur dioxide, inorganic dust containing 70–20% SiO2, fuel oil ash). The greatest danger to public health stationary sources of emissions form in the North-Western, Western and South-Eastern parts of the city. Roshydromet posts in these zones are absent.

Conclusions. As part of the objectives of the project “Clean Air”, it is recommended to Supplement the existing state network of observations of atmospheric air quality in Chita with two posts; to include manganese, xylene, vanadium pentoxide in the monitoring programs, to carry out the determination of Benz(a)pyrene et all posts, which will allow to fully and adequately assess the danger of emissions of economic entities, as well as the effectiveness and efficiency of the provided air protection measures.

937-939 452
Abstract

Introduction. The assessment of the immune profile of employees of the oil-producing enterprise, the formation of the immunological status of which is determined by the conditions of harmful production factors affecting their health.

The aim of the study was to assess the state of cellular immunity in oil-producing enterprise employees (on the example of the Perm region).

Materials and methods. 60 men working at the oil-producing enterprise of the Perm region were examined. In the observation group (n=30) were included surveyed male workers-operators of oil production, in the comparison group — surveyed male workers — representatives of the administrative apparatus. The state of cellular immunity was assessed by indicators of cellular regulation and apoptosis. Cell differentiation marker T-reg-CD4+CD127 -, expression level of Bcl–2, Bax, p53 proteins, TNFR receptors and AnnexinV-FITC+7AAD negative cells were determined by flow cytometry.

Results. The comparative analysis with physiological norm indicators allowed to reveal reliable hyperproduction of membrane and intracellular factors of cellular immunity in oil production operators. Expression of regulatory marker CD127-, proteins Bax, Bcl–2 and p53, TNFR receptor content and AnnexinV-FITC+7AAD negative cells responsible for natural cell death (p<0.05) was established. The indicators of the observation group differed significantly from those of the comparison group. There was a significant inhibition of expression of CD-marker CD127-and apoptic protein Bcl–2 by more than 10%, an increase in TNFR, AnnexinV-FITC+7AAD negative cells, protein Bax and p53 by 1.3, 1.6 and 1.2 times, respectively.

Conclusions. The results of immunological screening allowed to establish an imbalance of cellular immunity in oil-producing enterprise workers — a deficiency of regulatory cells and a protein-controller of cell death with simultaneous excessive activation of cell reception, which later forms the phenomenon of cellular immunodeficiency. The high sensitivity of the membrane and cytoplasmic components of the immune profile allows them to be used as indicators of the health status of oil production operators, timely identify the development of regulatory imbalance of the immune system, early violations of cell-associated pathological processes (cellular immunodeficiency, autoimmune and proliferative processes), as well as timely and effective implementation of measures to prevent the development of production-related diseases working at oil production facilities.

940-944 386
Abstract

Introduction. Sanitary legislation of the Russian Federation provides for the organization of sanitary protection zones of industrial enterprises located in the industrial hub. However, the justification procedure, establishing and monitoring boundaries of a single sanitary zones not fully resolved. This determines the practice of organization by economic entities of individual zones separating production from residential development. This situation complicates the adequate assessment of real pollution, as well as the reasonable development of programs (plans) of environmental measures. Identification of the sources that create poor air quality and public health risks is becoming extremely problematic.

The aim of the study is to develop and test recommendations for the organization and methodological support of the design of a single sanitary protection zone of a group of enterprises in the current urban development.

Materials and methods. The object of the study is an industrial hub formed by 5 industrial enterprises and located on the territory of a large urban settlement with a population of more than 450 thousand people. The city administration carried out a number of organizational measures that ensured the simultaneous inventory of emissions of enterprises and the design of the general sanitary zone of the industrial complex. The design work was carried out in full accordance with the current regulatory framework.

Results. The verified unified database of 102 sources of chemical emissions and 113 sources of noise provided the possibility of summary calculations and obtaining the most correct results for surface concentrations in the zone of influence of the industrial hub. The program of quality control of atmospheric air defining the contribution of each economic subject to carrying out researches is formed. This made it possible to ensure the control of all priority contaminants at the outer border of the sanitary zone and reduce the costs of each separate economic entity. Zones of responsibility of each enterprise within borders of a uniform sanitary zone for tasks of maintenance of the standard maintenance of the territory are allocated.

Conclusions. The obtained results confirmed the feasibility of designing unified sanitary protection zones for economic entities located in the industrial hub.

945-949 524
Abstract

Introduction. The wide spread of mining in Russia determines the high relevance of the preservation of labor resources in this industry, the prevention of occupational and production-related morbidity, reducing cases of temporary and permanent disability. Mine mining is characterized by the impact on workers of several nonspecific harmful (dangerous) factors: industrial noise, general and local vibration, the severity of labor, heating or cooling microclimate, low light. The impact of these factors predisposes to the development of pathology of the cardiovascular system.

The aim of the study was to study the prevalence of hypertension among underground miners, clinical features and changes in the complex of biochemical risk factors for cardiovascular complications.

Materials and methods. The observation group consisted of 98 employees of underground chrome ore mining. The comparison group (working in conditions outside the influence of the studied production factors) consisted of 75 employees of this enterprise. All employees surveyed are male. To study the impact of working conditions on the health of workers, workplaces with a characteristic set of harmful production factors (chrome, dust, noise, vibration, labor severity, labor intensity, cooling microclimate) and the same working modes (sliding three-shift schedule with a shift duration of eight hours) were selected. The study of laboratory parameters (markers of risk of cardiovascular disease) was performed by unified General clinical, biochemical and enzyme immunoassay methods.

Results. In the group of underground miners, the prevalence of arterial hypertension was established (in 31.3% in the observation group and in 17.2% of the surveyed in the comparison group, p=0.042), which becomes statistically significant when the work experience is more than 10 years. The study established the clinical features of the anamnesis and objective status of employees of the mine for the extraction of chrome ore. The laboratory study in the group of miners revealed the presence of a number of paraclinic syndromes: systemic inflammation and immune activation syndrome, dyslipidemia syndrome, oxidative stress syndrome, hormonal profile disorder, renal dysfunction syndrome.

Conclusions. Employees of underground mining of chrome ore are characterized by a high incidence of hypertension with experience of more than 10 years. The clinical and instrumental changes revealed in the work in the observation group give grounds for the development of directed preventive programs in this category of ore mine workers.

FOR THE PRACTICAL MEDICINE

950-955 425
Abstract

The results of research carried out by theFederalScientificCenterfor Medical and Preventive Technologies of Public Health Risk Management Technologies for the period 2013–2018 showed that diseases associated with the combined effects of vibration and physical overload, employees of hazardous industries develop with experience of 15 years or more. The risk group is women older than 35 years and men older than 40 years. Pathology at the stage of detailed clinical manifestations is characterized by persistent pain syndrome, and, as a consequence, a decrease in the ability to work of workers.

The aim of the study was to optimize the system of diagnosis of hand diseases in workers of industrial enterprises engaged in labor activities under the combined effects of vibration and physical overload, for the development of primary prevention programs.

The observation group consisted of 32 employees aged 39.3±4.3 years, with an experience of 17.4±4.3 years; the comparison group consisted of 30 employees whose working conditions are not related to the studied factors; the average age was 40.6±3.4 years, experience was 19.1±3.1 years. The examination included analysis of the results of a special assessment of working conditions; assessment of neurological status; functional tests; laboratory studies (assessment of inflammation), hand dynamometry, stimulation electroneuromyography; x-rays of the hands and wrist joints, ultrasound examination of the hands.

More than half of the surveyed persons of the observation group and 3/4 of the workers of the comparison group did not make complaints. Indicators of dynamometry of workers in both groups corresponded to physiological norm (p>0.05). Analysis of the results of dynamometer with data from previous years of PMO showed a decrease in strength of muscles of the hand leading hands on 2je,0–16. 7% and from 83.3% of the employees of the monitoring group and in 44.4% of the comparison group (p<0.05), in 50 % of the cases there was a decrease in the percentage of changes in the hand force variation (HFV) in the observation group, and in 38.9% of the cases the indicators remained unchanged. According to ultrasound of the hands, signs of tendinopathy were established in 85% of the employees of the observation group in the absence of persons with similar changes in the comparison group.

In order to optimize the diagnosis of diseases of the hand in industrial workers who carry out their work under the combined effects of vibration and physical overload, in the case of a decrease in the rate of carpal dynamometry by 5% or more during the year, it is recommended to conduct ultrasound of the tendon-ligamentous apparatus of the hand, which will allow timely identification of early signs of tendinopathy.

956-959 461
Abstract

The pathogenesis of hypertension is multifactorial and includes a number of interdependent mechanisms. One of the main triggers of hypertension is the activation of the sympathetic part of the autonomic nervous system against the background of chronic stress.

The aim of the study was to study the features of heart rate variability in workers of chrome ore mines.

The study included 98 miners of the enterprise for the extraction of chrome ore. The comparison group (working in conditions outside the influence of the studied production factors) consisted of 75 employees-managers and specialists of administrative and managerial personnel of the enterprise. All the examined patients underwent a study of heart rate variability by cardiointervalography. A statistically significant predominance of persons with arterial hypertension was revealed in the group of underground chrome ore miners. The results of a comparative study of heart rate variability showed a predominance of the initial sympathicotonia, a decrease in parasympathetic effects on the heart rate in workers engaged in underground mining of chrome ore. The revealed changes in heart rate variability in workers of underground mining of ore minerals exposed to a complex of harmful factors of production contribute to an increase in the risk of production-related hypertension.

960-965 440
Abstract

Vibration pathology, including disorders of the vascular, nervous and musculoskeletal systems, occupies one of the first places in the structure of health disorders in workers of vibration-hazardous industries.

The aim of the study was to identify informative diagnostic criteria for identifying early signs of upper limb lesions.

The observation group consisted of 90 workers aged 46.7±2.5 years (p>0.05), with experience of 22.4±3.9 years; the comparison group–60 workers whose working conditions were not associated with the studied factor; the average age of 45.8±2.4 years, experience of 24.1±4.1 years (p>0.05). The survey included the analysis of working conditions and professional route, clinical examination, questionnaires, laboratory and functional studies, statistical processing of the results, calculation of epidemiological indicators.

The analysis of working conditions showed that the level of local vibration exceeded the maximum permissible level by 2–6 dB for the employees of the observation group. The survey showed that going to the doctor is a last resort for workers, even in the case of chronic pain. According to the results of the survey and examination, it was found that the formation of pain syndrome in employees of the observation group occurs against the background of the development of vascular and neurovascular disorders. There was an increase in the estimated age of the arteries of the upper extremities (5.3±2.8 years) in 23.3% of the observation group. Analysis of dynamometry results in dynamics for three years showed a slowly progressive decline in 21.1% of workers in vibration-hazardous professions with 11.3±3.4 years of experience, and only 3.3% of workers in the comparison group with 23.6±6.3 years of experience. In General, there is a high risk of decreased muscle strength, which is prognostically significant for the preservation of professional ability to work. The calculation of epidemiological indicators confirmed the connection of vasospastic reactions with the impact of local vibration (χ2=5.85, p<0.001; F=0.177, p<0.05; RR=2.5, 95% CI=1.7–3.7; EF=65%). 

Under the influence of local vibration, early signs of upper limb lesions develop with 5 years of experience and are characterized by vascular changes. Clinical syndromes characteristic of vibrational pathology are formed with an average length of service of 10 years. It is necessary to improve the complex of diagnostic measures aimed at identifying early signs of damage to the upper limbs, in order to improve the labor prognosis in workers under the influence of local vibration.

BRIEF REPORTS

966-969 500
Abstract

Introduction. Identification of markers of genetic variability that determine the formation of professionally caused diseases of the cardiovascular system will allow to identify potential risk groups among workers and optimize the program of preventive and diagnostic measures.

The aim of the study was to analyze the features of polymorphism of eNOS and HTR2A genes and regulatory indicators in workers at the mine mining enterprise with diseases of the cardiovascular system.

Materials and methods. The men working at the enterprise on mine extraction of ore minerals, with pathology of cardiovascular system are examined. Real-time polymerase chain reaction and allelic discrimination were used to identify genotypes. Regulatory markers nitric oxide and serotonin were determined by enzyme immunoassay.

Results. In the observation group, an increase in the frequency of polymorphic variants of eNOS G894T genotype GG 1.4 times and allele G 1.2 times, significantly associated with the development of cardiovascular disease (OR=3.16; Cl 95%=1.14– 8.76), as well as the presence of excessive frequency of minor allele G gene HTR2A (rs7997012) relative to the comparison group (1.8 times) due to mutant homozygous genotype GG (2.7 times) (OR=2.45; CL 95%=1.03–5.87), acting as risk FACTORS for cardiovascular disorders in the group of miners. At the same time, polymorphism of eNOS and HTR2A gene variants was combined with an imbalance in the level of CCC regulatory markers — nitric oxide and serotonin.

Conclusions. Genetic variations of the eNOS g894t and HTR2A (rs7997012) genes can be recommended as sensitivity markers in monitoring and identification of risk groups among workers in underground mining.



ISSN 1026-9428 (Print)
ISSN 2618-8945 (Online)