Introduction. The overwhelming number of publications contains only data on the content of individual antioxidants, but not on the overall antioxidant activity of the blood in patients with vibration disease.

The aim of the study was to determine the total antioxidant activity of blood serum in patients with vibration disease.

Materials and methods. Th e main group consisted of 30 people diagnosed with “Vibration disease” of 1 degree (n=21) and 2 degrees (n=9). Th e control group consisted of 30 clinically healthy men, comparable in age with the main group (p=0.66). Th e total activity of antioxidant systems of blood plasma was evaluated photometrically using the test system “Total antioxidant status-Novo” (“Vector-best”, Russia).

Results. The indicator of the total antioxidant status (TAS) was 1,038±0.232 mmol/l in the examined main group, against 1,456±0.225 mmol/l in the examined control group (p<0.000001). Th e coefficient of variation (CV) in patients with vibration disease was 22.35%, 1.45 times higher than in the control group (15.45%). In the main group there was a positive correlation between age and TAS (R=0.525), in the control group there was no such relationship (R=0.095). Th e degree of decrease depended on the severity of vibration disease.

Conclusions. 1. The development of vibration disease is accompanied by a decrease in the antioxidant status of blood serum. 2. Th e degree of decrease in the antioxidant status of blood serum correlates with the severity of vibration disease. 3. Reduction of TAS can serve as a pathogenetic justification of the need to include drugs and/or biologically active additives with antioxidant activity in therapy

Introduction. The problem of reducing the risk of cardiovascular disease among the working population today remains the most urgent. One risk factor for arterial hypertension (AH) is exposure to high levels of noise and vibration in the workplace. Along with occupational risk factors, hereditary predisposition makes a significant contribution to the development of AH. In the pathogenesis of AH, a special role is played by genes that determine the synthesis of angiotensinogen (AGT), angiotensin converting enzyme (ACE), angiotensin receptor type 1 (AGTR1), etc.

The aim of the study was to study the polymorphism of genes of the renin-angiotensin-aldosterone system in the development of hypertension in workers exposed to physical factors (noise and vibration) in the workplace.

Materials and methods. A survey of 123 men working in «Kolomna plant» (KP), 84 of them-workers who were exposed to physical factors, and 39 people who are not in contact with harmful industrial factors. Th e presence/absence of GD, the age of its beginning, blood pressure, heart rate, the total experience of work on the KP in harmful conditions were assessed on outpatient cards. Molecular genetic studies of polymorphic genes of renin-angiotensin-aldosterone system (ALU Ins/Del of ACE gene, M235T of AGT gene, a1166c of AGTR1 gene) were carried out for all examined patients.

Results. The results of correlation analysis showed the presence of a significant (р<0,05) relationship between AH and noise γ=0.42 p=0.0004, total vibration γ=0.57 p=0.002, heating microclimate γ=0.57 p=0.01. The correlation between the presence of polymorphic variant M235T AGT gene and GB γ=0.35 p=0.001, as well as levels of SAD γ=0.28 p=0.00054 and dad γ=0.29 p=0.00053 in the group of workers exposed to noise was revealed. A significantly higher prevalence of the SS genotype of the AGT gene was also found in the group of workers with AH compared to carriers of the TT variant χ2=6.18 p=0.013 and all carriers (SS+ST) of the C allele compared to carriers of the allele T χ2=6.0 p=0.014. An Association between increased SAD and the presence of the ACE gene allele D (Alu Ins/Del) and the AGTR1 gene allele C (A1166C) in individuals exposed to noise and vibration in the workplace was revealed.

Conclusions. The obtained results indicate the multifactorial nature of hypertension, the importance of occupational factors in the formation of AH, primarily noise and vibration, and genetic factors: homozygous variant of the CC gene AGT (Met235Th r), the presence of the d allele of the ACE gene (Alu Ins/Del) and the C allele of the AGTR1 gene (A1166C).

Introduction. At the present economic stage of development of the industry there is a technological modernization of productions, decrease in operating concentrations of chemical substances in this connection reduction of frequency of occurrence of classical forms of intoxications is observed. Th is applies to the lead, occupying the leading position among industrial and environmental contaminants, which has one of the highest indexes of technological social and environmental significance.

The aim of the study was to assess the impact of metal (lead) as a trigger of various nosological forms of diseases of the circulatory and respiratory organs.

Materials and methods. Clinical and functional, laboratory examinations of 130 persons were carried out: among them 90 employees of the plant for the processing of lead batteries and cables. Th e comparison group included workers who had no contact with lead (40 people), comparable in age and experience.

Results. Analysis of the structure of non-professional diseases of internal organs showed that the leading place is occupied by diseases of the upper and lower respiratory tract (58% and 26%), circulatory organs (40%).

Conclusions. Th e results of the clinical and laboratory examination of workers of the lead batt ery recycling plant indicate the importance of combined exposure to lead as an important risk factor for cardiovascular diseases, pathology of the upper and lower respiratory tract.

Introduction. It is known that in industrial workers, working conditions and climatic features of the Arctic create an increased risk of occupational diseases. Th e purpose of the study was to investigate the impact of working conditions on the structure and prevalence of occupational pathology among the working population of the gas and oil producing region in the Arctic.

The aim of the study is to explore working conditions, the structure and prevalence of PP in the working population of the gas-oil-producing region in the Arctic.

Materials and methods. The data of social and hygienic monitoring in the section “Working conditions and occupational morbidity” of the population of the Nenets and Yamalo-Nenets Autonomous Districts from 2007 to 2017 were studied.

Results. It was found that employees in the Arctic gas and oil producing region were most frequently exposed to noise (24.0%), poor microclimate parameters (10.1%), non-ionizing electromagnetic fields and radiation (9.7%). Th e combined effect of several factors was found in 24.8% of workers. Th ere were 285 patients with newly diagnosed OD, 67.0% of whom were air transport workers, and 14.4% were employed in the gas and oil industry. Th e structure of the occupational pathology was dominated by sensorineural hearing loss (77.9%). In 2017, the regional level of occupational morbidity exceeded the national level by 1.7 times, among air transport workers — by 1.9 times, while among employees of gas and oil producing enterprises it was 5.3 times less than the national industry indicator. Th e risk of OD development among air transport workers was higher than in the region as a whole (RR = 45,88; CI 38,3–54,9), in oil and gas companies workers (RR=141,0; CI 100,8–197,2) and in workers of all types of transport, except air transport (RR =68,3; CI 39,8–117,4).

Conclusion. In the Arctic gas and oil producing region, most often occupational pathology is recorded among air transport workers, which necessitates the use of a comprehensive program for its prevention. It is necessary to explain the low levels of occupational morbidity in the gas and oil production and other economic activities in the region.

Objective. To analyze the application of screening questionnaire on chronic obstructive pulmonary disease (COPD) and pulmonary function test on dust-exposed migrant workers.

Methods. According to 149 eligible objects of study selected in medical outreach, the real situation on them threaten by COPD and influential elements are analyzed in depth.

Results. 73 workers are suspected to be suffered COPD by pulmonary function test. Th e detection rate (62.6%)of suspected COPD in the population with total score of more than 5 is significantly higher than that of the population with total score of less than 5 (14.3%). Th e result has the statistical significance (X2=28.19, p<0.000). Age, working years, stage of pneumoconiosis, smoking or not, smoking index are all the factors influencing the positive results of pulmonary function tests, and pneumoconiosis stage is the biggest influencing one.

Conclusion. By using questionnaires and pulmonary function tests, the early diagnosis and intervention of COPD are available.

The results of the analysis of methodical literature are presented and the most informative methods and the optimal order of their implementation for the assessment of special professionally important physiological functions of persons associated with diving are recommended for practical application. The procedure of carrying out and criteria of an estimation of recommended tests is stated: checks of barofunction; estimations of stability to decompression intravascular gas formation; toxic action of oxygen, narcotic action of nitrogen, a functional condition of divers at carrying out hypoxic test. A promising technique for assessing resistance to hypercapnia is recommended. This is undoubtedly important for medical personnel providing medical care to persons working in conditions of high pressure. Th e proposed unification of expert test effects will improve the safety and efficiency of diving and caisson operations, will contribute to the prevention of professionally caused diseases.

The relevance of the study is due to the high prevalence of degenerative-dystrophic changes in the bone-articular apparatus and periarticular tissues in the structure of diseases in General in the population and in persons working in contact with harmful production factors. The most common in clinical practice diseases of the shoulder girdle with lesions of bone-cartilage and tendon-muscle structures include arthrosis and changes in periarticular tissues, including: periarthritis, tendinitis, tenosynovitis (tendovagines, entezity), enthesopathy, bursitis, ruptures of the rotator cuff of the humerus, the symptom of “collision” — impingement sholder syndrome, lesions of the acromioclavicular and clavicular joints. Treatment of these conditions is not a solved medical and social problem, so perhaps their early diagnosis today is still relevant in the sense of primary prevention of disability of the population, including the working part of it-improving the quality of diagnosis of shoulder joint pathology today can be achieved through the use of new methodological techniques, objectifying the degree of severity of x-ray morphological changes on the basis of appropriate quantitative characteristics.

The aim of the study was to optimize the diagnosis of osteopenia (osteoporosis) using digital reference osteodensitometry to objectively assess the effectiveness of therapy for ostearthritis and periarthritis of the shoulder joint.

A comparative analysis of the results of clinical and radiological examination of the condition of the shoulder joint engineering plants workers with the presence of the clinic osteoarthritis and periarthritis shoulder joint and assessment of mineral status of humerus at primary diagnosis and in the dynamics of observations on the basis of use of new technologies for digital osteodensitometry.

The use of reference digital osteodensitometry made it possible to objectively assess the levels and topography of mineral distribution in the proximal humerus in the control group and in patients with osteopathy at various stages of clinical observation.

The mineral density of the proximal humerus has differences depending on the sector and zone of study, being an objective criterion for the orientation of the restructuring of their structure and, consequently, the effectiveness of therapeutic measures.

Digital reference osteodensitometry, as the most affordable method of early detection of osteoporosis or osteopennia, can be used in complex clinical and radiological examination of patients with suspected or already professionally caused osteopathy of the shoulder joint.

Sanitary and hygienic assessment of overalls for workers in a heating environment is currently carried out only on the physical, mechanical and hygienic properties of the materials from which it is made, not taking into account the effect of clothing on the thermal state of the human body and its heat and moisture exchange with the environment. Th e results of studies of the thermal and functional state of a person performing physical work in a heating environment showed differences in the formation of the thermal load on the body depending on the air temperature and the type of workwear used to protect against production hazards, as well as the significance of the thermophysical parameters of the materials (air permeability, vapor permeability, hygroscopicity) of which it is made. In addition, the development and manufacture of new materials with special protective properties, including using nanotechnology, expanding their assortment for the manufacture of workwear dictates the need to test their protective properties not only at the stands, but also in finished products in experimental studies involving humans. Th erefore, it is urgent to develop a methodology for evaluating workwear according to indicators of a person’s thermal state, which allows determining the degree of influence of the whole complex of environmental factors, labor process and workwear on the thermal state of people working in a heating environment in order to predict it and establish the work schedule in relation to specific conditions. Th e technique is intended for organizations involved in the design and development of workwear used in a heating environment, as well as materials for its manufacture; for testing laboratories performing sanitary-hygienic assessment of personal protective equipment.

The current legislation clearly declares the guarantee of insurance compensation to the employee in connection with the diagnosis of occupational disease. Meanwhile, in recent years there have been precedents of recognition by the Social Insurance Fund of established cases of occupational diseases not insured in connection with claims to the correctness of the procedure of their investigation.

The article analyzes court cases in which patients with an established diagnosis of occupational disease challenged the refusal of the insurer (Social Insurance Fund) in the appointment of insurance payments, motivated by a reference to violations of the established procedure for the investigation of occupational diseases.

The insurer motivated its refusal to assign insurance payments to patients with the following arguments:

— appeals of the patient to doctors at the time of establishment of the preliminary diagnosis of occupational disease were not entered in registers of rendering medical services;

— sanitary and hygienic characteristics of working conditions of the patient was not based on proper documents;

— examination of the connection of the disease with the profession was carried out on the personal application of the patient without registration of the direction from the medical organization;

— examination of the connection of the disease with the profession was carried out in the Department of professional pathology of a medical organization that is not a vocational center;

— the staff of the Department of professional pathology did not meet the requirements of normative documents;

— violation of rules of registration of the notice on establishment of the fi nal diagnosis of chronic occupational disease is allowed;

— the representative of the Social Insurance Fund was not included in the commission that drew up the act on the case of occupational disease.

In the vast majority of cases, the violations, if any, were of the nature of technical errors and did not affect the essence of the expert opinion on the existence of a connection between the disease and the profession. In such a situation, the categorical refusal to appoint insurance payments to the patient seems unreasonable. Th e claims of the Social Insurance Fund, with a constructive approach, could be settled without a court by contacting the insurer to medical organizations and health authorities. It is necessary to correct the regulations on compulsory insurance against accidents at work and occupational diseases. Th e rules of law should not allow categorical refusal in the appointment of insurance payments to the patient, whose diagnosis of occupational disease, which led to a decrease in working capacity, is established on the merits correctly. Claims of the insurer to the procedure of investigation of a case of occupational disease are most rationally considered in the pre-trial procedure within the framework of the dialogue of the Social Insurance Fund with local health authorities.

The article discusses the terminology of hearing loss from the effects of industrial noise. In modern regulatory documents — orders and clinical recommendations of the Ministry of health of the SR of the Russian Federation, the Ministry of health of the Russian Federation regulating work on diagnostics, examination of communication of disease of hearing with a profession and professional suitability for work in the conditions of influence of noise, there are terminological discrepancies and divergences complicating work of practical doctors. The current situation causes controversial decisions and conflicts that have not only medical, but also social and deontological significance. There is an urgent need to discuss the terminological aspects of hearing loss from noise.

The problem of studying the development of stroke in men of working age working in conditions of high occupational risk is relevant.

The aim of the study was to develop a method for predicting the development of stroke in men working under the influence of electromagnetic fields of industrial frequency.

We examined 98 men who had professional contact with the factor of electromagnetic radiation (EMI) of industrial frequency, aged 30 to 65 years, with work experience of 5 years or more. Two groups were identified: the first group — 56 stroke patients, the second group — 42 men diagnosed with chronic cerebral ischemia. Using the method of sequential inclusion of the studied risk factors (ForwardStepwise), those that made an independent significant contribution to the development of stroke were selected. Based on the results obtained, a logistic regression formula was created that determines the probability of stroke in patients working on installation, repair, maintenance of electrical networks and electrical equipment.

The presence of influence on stroke development of the following factors was established: patient’s age (β-coefficient=–0,112, p=0,013), total cholesterol level (β-coefficient=0,782, p=0,009), smoking factor (β-coefficient=–2,8, p=0,001), alcohol abuse factor (β-coefficient=3,84, p=0,0001), presence of arterial hypertension of 2–3 degrees (β-coefficient=2,63, p=0,002). In the patient, the values of these 5 parameters are determined, then these values are substituted into the appropriate formula to calculate the value of p (X). A p (X) value greater than 0.32 indicates a high risk of stroke. The sensitivity of the proposed method was 71.4%, specificity–73.8%.

The proposed method for predicting the development of stroke in men whose professional activity is associated with the installation, repair, maintenance of electrical networks and electrical equipment, can be used in medical practice: the patient is determined by the value of 5 parameters (patient’s age, total cholesterol, a history of exposure to smoke, factors alcohol abuse, arterial hypertension of 2–3 degrees), then these values are substituted into the appropriate formula. The calculation of the p (X) value can be implemented in the Excel table processor