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Russian Journal of Occupational Health and Industrial Ecology

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No 2 (2020)
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https://doi.org/10.31089/1026-9428-2020-2

ORIGINAL ARTICLES

74-80 727
Abstract

Introduction. Depression and anxiety, observed in general medical practice, can lead to maladaptive states that reduce performance, and contributes to the manifestation of various psychosomatic disorders. Therefore, timely diagnosis of these disorders in many cases becomes an important condition for the success of medical care and the patient’s return to work. Clinical manifestations of occupational and work-related diseases are often accompanied by anxiety and depressive symptoms, which can occur as a comorbid mental disorder or be affective inclusion.

The aim of the study is to explore the distribution and severity of secondary anxiety and depression in the provision of special inpatient medical care in the field of occupational pathology by conducting a screening examination and develop practical recommendations for diagnosis.

Materials and methods. The hospital’s HADS anxiety and depression scale and Beck’s depression scale were used to test for indications of secondary anxiety and depression in the incoming patient stream (n=260). Correlation analysis was used to study the dependence of the severity of anxiety values on the severity of depression values and the severity of anxiety and depression on the age of patients. Using the Mann-Whitney criterion, a comparison was made between a sample of respondents with anxiety and depression values and a control group with normal indicators for all disease groups according to ICD–10. Also, in the General sample and separately for a group of men and women, three groups of diseases were compared — professional, production-related, and others.

Results. In the risk group of 94 patients with severe symptoms of anxiety (10.9±2.84) and depression (10.2±1.9), 67% were women. This group has higher rates of anxiety and depression in the HADS survey compared to the group of men (33%, p<0.001). The dependence of the severity of anxiety signs on the severity of depression signs for the joint sample of men and women was 0.337 (p≤0.05). Separately, for a group of women, 0.251 (p≤0.05) and for a group of men, 0.252 (p≤0.05). This suggests that as anxiety increases, the severity of depression may also increase. The relationship between the patient’s age and the severity of his symptoms of anxiety 0.144 (p≤0.05) and depression 0.1199 (p≤0.05) confirms the trend towards this relationship. The distribution of anxiety and depression indicators among patients with occupational and work-related pathology showed a predominance of anxiety values in professional (10.5±2.4) and work-related (11.8±3.2) diseases in the group of women. The prevalence of depression in professional (10.5±2.4) and production-related (10.4±2) diseases was also detected in the group of women. Criterion for the difference between a sample of respondents with anxiety and depression values and a control group with normal indicators for all disease groups according to ICD–10 (p<0.001). Differences in depression indicators between groups of occupational and work-related diseases (p=0.08) indicate that patients with occupational diseases have more pronounced values on the depression scale. Women with occupational and work-related diseases have much higher depression values than women with other diseases (p=0.02). Thus, women with occupational and workrelated diseases have higher indicators of anxiety and depression scales than men.

Conclusions. Screening examination for signs of anxiety and depression in the provision of special inpatient medical care in the profile of occupational pathology, revealed increased indicators of anxiety and depression in the group of women. As the severity of anxiety indicators increases, so does the severity of depression indicators. The dependence of anxiety and depression indicators on the age of patients confirms the tendency to this dependence. The distribution of anxiety and depression indicators among patients with occupational and work-related pathology showed the predominance of the value of anxiety in professional and work-related diseases in the group of women. The predominance of indicators of depression in occupational and work-related diseases was also found in the group of women. In the female group, patients with occupational and work-related diseases have much higher rates of depression than patients with other diseases. Thus, women with occupational and work-related illnesses are more likely to experience anxiety and depression than men. The development of practical recommendations for the diagnosis of signs of anxiety and depression is reduced to psycho-educational work to prevent negative stigmatization of issues related to mental health, conducting timely examinations with elements of bioinformatics modeling and using a system to support medical decision-making.

81-88 828
Abstract
Introduction. At present, despite scientific and technical progress and the introduction of modern safe technologies in production related to dust formation and dust emission, an increased risk of developing dust pathology of the lungs is noted in the machine-building and mining industries. Chronic lung diseases, including occupational diseases, are one of the most urgent problems of modern respiratory medicine and cause a decrease in the quality of life, working capacity and increased mortality of the working population. The features of the course of dusty lung diseases at the early stages of the pathological process are insufficiently studied, and functional and biological markers — criteria for individual prognosis of the patient’s condition-have not been identified.

The aim of the study is to assess the immunological profile, growth factors, early diagnosis and prognosis of current forms of occupational lung diseases.

Materials and methods. To assess the cytokine profile of dust lung diseases (varying degrees of severity of chronic dust bronchitis, silicosis and pneumoconiosis from exposure to welding aerosols), 161 people were examined in the main groups: 1 group–35 people who had long-term industrial contact with industrial fibrogenic aerosols, who did not show clinical and radiological signs of lung damage (contact); 2 group–39 people with chronic dust bronchitis; Group 3–56 patients with silicosis (mainly interstitial form, x-ray characteristics of the process corresponded to categories from s1 to u2); group 4–31 patients with pneumoconiosis from exposure to highly dispersed welding aerosols (mainly nodular form, x-ray characteristics of the process corresponded to categories P1, P2, q1, q2). The 5 (control) group included 60 people-donors of the Samara Regional Clinical Blood Transfusion Station, as well as employees of industrial enterprises and institutions who did not have contact with industrial fibrogenic aerosols (healthy).

Serum levels of immunoglobulins A, M, and G were determined by radial Manchini immunodiffusion. Evaluation of total immunoglobulin e (IgE), immunoglobulins A, M, G (Ig A, M, G), cytokines: interleukins 1α, 1β, 4, 8 (IL–1α, IL–1β, IL–4, IL–8), interferon γ (ifny), tumor necrosis factor α (TNFa), fibroblast growth factor (FGF2), vascular endothelial growth factor (VEGF) in blood serum it was carried out by the method of solid-phase Enzyme immunoassay.

in the machine-building and mining industries. Chronic lung diseases, including occupational diseases, are one of the most urgent problems of modern respiratory medicine and cause a decrease in the quality of life, working capacity and increased mortality of the working population. The features of the course of dusty lung diseases at the early stages of the pathological process are insufficiently studied, and functional and biological markers — criteria for individual prognosis of the patient’s condition-have not been identified.

The aim of the study is to assess the immunological profile, growth factors, early diagnosis and prognosis of current forms of occupational lung diseases.

Materials and methods. To assess the cytokine profile of dust lung diseases (varying degrees of severity of chronic dust bronchitis, silicosis and pneumoconiosis from exposure to welding aerosols), 161 people were examined in the main groups: 1 group–35 people who had long-term industrial contact with industrial fibrogenic aerosols, who did not show clinical and radiological signs of lung damage (contact); 2 group–39 people with chronic dust bronchitis; Group 3–56 patients with silicosis (mainly interstitial form, x-ray characteristics of the process corresponded to categories from s1 to u2); group 4–31 patients with pneumoconiosis from exposure to highly dispersed welding aerosols (mainly nodular form, x-ray characteristics of the process corresponded to categories P1, P2, q1, q2). The 5 (control) group included 60 people-donors of the Samara Regional Clinical Blood Transfusion Station, as well as employees of industrial enterprises and institutions who did not have contact with industrial fibrogenic aerosols (healthy).

Serum levels of immunoglobulins A, M, and G were determined by radial Manchini immunodiffusion. Evaluation of total immunoglobulin e (IgE), immunoglobulins A, M, G (Ig A, M, G), cytokines: interleukins 1α, 1β, 4, 8 (IL–1α, IL–1β, IL–4, IL–8), interferon γ (ifny), tumor necrosis factor α (TNFa), fibroblast growth factor (FGF2), vascular endothelial growth factor (VEGF) in blood serum it was carried out by the method of solid-phase Enzyme immunoassay.

Results. The features of the flow of dust lung diseases: the peculiarities of the immunological profile, increasing the level of factors allows to characterize the occurrence, course and progression of dust diseases of the lungs.

Conclusions. Determining the immunological profile allows not only to improve the quality of early diagnosis, but also to optimize strategies for primary and secondary prevention in this pathology, to predict the course of the disease, and to reduce the number of disabling forms.

89-92 976
Abstract

Introduction. In the structure of occupational diseases of medical workers, respiratory pathology occupies a leading place, accounting for 60% in the Republic of Tatarstan. The most common are diseases from exposure to infectious agents in the form of various forms of respiratory tuberculosis. Most often, an infiltrative form is diagnosed, accompanied in 48.6% of cases by bacilli discharge.

The aim of the study is to explore the structure of occupational respiratory diseases in workers of the healthcare industry of the Republic of Tatarstan, to identify factors that affect their early diagnosis during medical examinations.

Materials and methods. A retrospective analysis of cases of occupational respiratory diseases in health care workers according to the office of Rospotrebnadzor of the Republic of Tatarstan and the register of patients of the Republican Center of Occupational Pathology.

Results. In the structure of occupational diseases of the respiratory system, the leading place is occupied by pulmonary tuberculosis, amounting to 86%, followed by bronchial asthma–8%, chronic toxic bronchitis–4% and subatrophic rhinopharyngolaryngitis–2%. Analysis of cases of occupational respiratory pathology showed that only tuberculosis was detected during periodic medical examinations. Other respiratory diseases were diagnosed by applying for medical care, when there was a pronounced negative trend and when the disease was initially associated with the profession, we had to talk about sending it to the Bureau of medical and social expertise.

Conclusions. Early diagnosis of occupational respiratory diseases of allergic etiology and toxic respiratory lesions in medical workers at periodic medical examinations can be achieved by the quality of a special assessment of working conditions due to the mandatory assessment of the chemical factor-contact with allergens, antitumor drugs, hormones, enzymes of microbial origin, narcotic analgesics, regardless of the concentration of harmful substances in the air of the working area. It is also necessary to take into account the presence of substances with an acute irritant effect.

93-99 543
Abstract

Introduction. The growth of environmentally caused respiratory diseases is an urgent problem of respiratory medicine. The Sverdlovsk region is a large diversified industrial center, which determines the high level of dust pathology in the region. At the same time, many questions of nosological verification of dusty lung lesions remain insufficiently studied.

The aim of the study is to determine the structure of dust pathology and to develop criteria for morphological diagnosis of dust lesions of the respiratory organs on the material of lung resections in tumors.

Materials and methods. The work is based on the study of the pathomorphology of dust lesions of the respiratory organs in 315 cases of resections of the lungs and intra-thoracic lymph nodes in patients with primary lung cancer operated in the Thoracic Surgery Clinic of the Sverdlovsk regional anti-tuberculosis dispensary. Macroscopic and histological examination of the surgical material of the lungs and lymph nodes was carried out; polarizing microscopy was performed in all cases to identify anisotropic structures in dust clusters. In complex cases of expert evaluation, the most effective and reliable method scanning electron microscopy with x-ray spectral microanalysis-was used to study the elemental composition of dust in lung and lymph node tissue.

Results. Dust lesions of the respiratory organs were detected in almost all cases and are represented by non-professional dustchanges associated with smoking, household anthracoconiosis and dust lesions of a professional nature (pneumoconiosis). The frequency of dust lesions is determined and the criteria for morphological diagnostics of household and professional dust lesions are formulated. It is shown that in most cases, when examining surgical material for lung cancer, signs of “combined dusting” are detected, including morphological manifestations of pneumoconiosis of professional and household nature. Pneumoconiosis of a professional nature was detected in 34 (10.8%) cases in the presence of the corresponding dust experience in the history. On the resection material found morphological signs of silicosis and anthracosilicosis (5 cases, 1.6%), electric welder pneumoconiosis (13 cases, 4.2%), bauxite pneumoconiosis (8 cases, 2.5%), pneumoconiosis caused by titanium dust (2 cases, 0.6%), pneumoconiosis caused by exposure to mixed dust (6 cases, 1.9%) were found on the resection material. Asbestos-associated lesions were morphologically determined in 3 cases (2.2%). Attention is drawn to the relatively high frequency of bauxite pneumoconiosis, whose morphological criteria for diagnosis, including color features of anisotropy, are presented almost for the first time.

Conclusions. The “Algorithm of morphological diagnostics of dust lesions of the respiratory organs in lung tumors” has been developed. It should be emphasized that the morphological of pneumoconiosis requires clinical and radiological comparisons and mandatory confirmation by professional pathologists. Thus, the diagnosis of dust pathology of the lungs according to resections should be the result of joint multidisciplinary work of doctors of various specialties.

FOR THE PRACTICAL MEDICINE

100-116 645
Abstract
The article discusses the issues of adjustment, developed in 2007 and supplemented in 2009, of the methodology for evaluating the equivalent level of cabin noise of civil aviation aircraft in Russia. The relevance of the problem is due to high levels of professional hearing loss among the aircrew members of the air force, which is directly related to the lack of unified and competent approaches to assessing the acoustic load on the hearing organ of the aircrew members. The updated methodology contains full-fledged data on noise levels in modern domestic and foreign airliners, data on certification of acoustic efficiency of aircraft accessories, a direct algorithm and formulas for calculating the noise load for the selected periods of flight operation.
117-122 490
Abstract

Ensuring the preservation of the country’s labor potential has always been a priority for Russian health care. Analysis of the nutrition of a group of people united by a number of characteristics (gender, age, place of residence, peculiarities of labor activity) is an important direction in the implementation of therapeutic and preventive measures.

In order to develop preventive recommendations for rationalization of nutrition, an analysis of the nutrition of men of different ages in Novokuznetsk, whose work activity is characterized by a low level of physical activity, was carried out.

A retrospective one-step study of 169 men aged 23–48 years with low physical activity, living for more than 10 years in Novokuznetsk, was conducted. There are two groups: 1 group — up to and including 39 years (89 people) and 2 group–40 years and older (80 people). The actual nutrition of men was evaluated by the computer program “Analysis of the state of human nutrition” (Version 1.2. State Research Institute of Nutrition of the Russian Academy of Sciences 2003–2005).

The caloric content of the diet exceeded the standards in group 1 by 1.6 times (by 1333 kcal), in group 2 — by 1.7 times (by 1367 kcal). Increased consumption of total fat in men up to 39 years and 1.4 times, 40 years and older is 1.5 times, and the proportion of saturated fatty acids (SFAS) above the norm by 1.3 times in males up to 39 years and aged 40 years and older, 1.6 times; cholesterol higher than normative values at the age of 39 years 175 mg , aged 40 years and older at 365 mg. Protein consumption in both groups was statistically significantly higher than normal (116 g at 68 g and 113 g at 65 g in group 1 and 2, respectively). There was a deficit of dietary fiber consumption by 12 and 10 g, respectively, in the study groups, with increased use of mono and disaccharides in the diet by 2 or more times. The consumption of mineral substances in men in both groups is statistically significantly exceeded in comparison with the norms of physiological needs (NFN) consumption of sodium (p1<0.001, p2<0.001); potassium (p1=0.001, p2=0.001); calcium (p1<0.02, p2=0.02); phosphorus (p1<0.001, p2<0.001), iron (p1<0.001; p2<0.001), vitamins a in retinol equivalents (p1=0.004, p2<0.001), B2 (p1=0.03, p2=0.02); C (p1=0.04, p2=0.002).

The diets of able-bodied men with low levels of physical activity, unbalanced in the direction of excess total caloric intake, amount of proteins and fats, simple carbohydrates, cholesterol, sodium, potassium, phosphorus, calcium, iron, vitamins A, C, B2, which is a serious risk factor for chronic non-infectious diseases (CNID) and should be considered when implementing prevention and treatment programmes in enterprises.

123-127 533
Abstract

The article presents scientifically based methods and techniques for determining the level of energy consumption, which are most appropriate and convenient for practical use in mass physiological and hygienic and experimental studies, depending on their goals and objectives.

Determination of the amount of human energy consumption should be carried out by monitoring studies during the shift, followed by the calculation of the weighted average heart rate, considering the different types of work performed, technological breaks and downtime. It is necessary to take into account the full range of environmental factors and the work process that contribute to the physical and thermal stress of working men and women in accordance with their age and body weight.

DISCUSSIONS

128-135 732
Abstract

In modern conditions, individualization and optimization of training and additional professional education of a wide range of specialists are increasing in order to strengthen the “personnel base” and solve complex internal and external tasks. Individualized training involves: 1) selecting people according to the criteria of personal predisposition to this type of professional activity; 2) building an adequate system of external training influence within the framework of specialized training and training of personnel. Occupational health and medicine as disciplines and practical areas are faced with the task of using labor as a factor of health and self-development of a person, increasing his vitality, adaptability and professional longevity. The purpose of the study is to identify individual typological profiles, considering professional activity and age, for improving professional selection, development and support of various professions ‘ specializations.

The sample included 389 people (average age–29.5±8.5 years), including 169 participants of the professional community “Institute for development of leaders” and 220 people-extreme specialists. Respondents belonged to the following professional profiles: administrative and managerial; information technology; research and security. The following methodological complex is used: o. SSS; o. TIPI; o. MMPI; o. Grasmika; o. BIS/BAS; o. EPQ; subjective scale for evaluating one’s own entrepreneurial skills.

It was revealed that the combination of a high level of activation system aimed at obtaining additional new stimulation, risk propensity and low emotional stability was characteristic for persons of administrative and managerial profile. Individual and typological characteristics of the security profile were similar to the previous group, except for a lower educational level and pronounced egocentrism. Persons with an information and analytical profile of professional activity were characterized by a low level of activation system and emotional instability. They were prone to risk. Individuals of the research profile were characterized by low self-control, emotional instability when focusing on subjective criteria.

The greatest information content of psychological variables was revealed for the age group from 16 to 21 years. Checking the predictive value of discriminant models, where the target variables were professional activity profiles, revealed the high quality of the model only when the subjects were assigned to the group of the security profile.

The information content of diagnostics of individual typological characteristics for solving problems of predicting behavioral response and professional selection is confirmed. The characteristics of specialists in various professional profiles have predictive value in relation to the risk of disadaptation and decompensation when changing their employment status.

BRIEF REPORTS

136-140 673
Abstract
Working conditions for drivers of vehicles are a health and safety concern. For hygienic and physiological assessment of real visual loads on a car driver, a method for simultaneous recording of information visual load (IVL) and heart rate has been developed and tested in situ. We used publicly available devices — a car DVR and a wrist pulse monitor. An example of timesynchronized recordings of the IVL stream and pulse is given. The efficiency of the method is shown and the correlation of video fragments and pulsogram to R = 0.4 (moderate on the Cheddock scale) is established. The systematization of factors of working conditions (external and internal in cabin at the workplace) that affect the perception of IVL is outlined. The results of the work are applicable for the hygienic assessment of the working conditions of vehicle drivers, when IVL is a leading factor in working conditions and workload, in order to prevent fatigue and traffic accidents.

INFORMATION



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