Introduction. The urgency of the problem determines the high level of occupational morbidity in aluminum production workers and the prevalence of somatic pathology, which occupies one of the leading positions in the pathogenesis of fluorosis.

The aim of the study is to determine the clinical and genetic features of the nature of concomitant visceral pathology in workers with industrial fluorosis.

Materials and methods. A complex of clinical, biochemical, molecular, genetic, and instrumental research methods was used in patients with fluorosis (246 people) and in the control group (106 people).

Results. A high frequency of health disorders in workers engaged in the production of aluminum was determined during long-term monitoring. An extended clinical and genetic study of the state of somatic organs in workers with fluorosis and in control is presented. It is revealed that in the group of subjects with proven diagnosis, pathologies concomitant with the main disease were significantly more common: pathologies of musculoskeletal and articular systems, blood circulation, respiratory (rhinitis, chronic, toxic and dust-borne bronchitis, chronic obstructive pulmonary disease), hepatobiliary (steatosis, fluoride hepatopathy), gastrointestinal tract (chronic gastritis, cholecystopancreatitis), renal systems (pyelonephritis, urolithiasis), as well as a combination of several nosologies was in 43%. The association of GG VEGF genotypes with chronic pyelonephritis and TT Il1ß, GSTT 1 0/0 with fluoride hepatosis was revealed in patients with fluorosis.

Conclusions. The structure of occupational morbidity in workers of the main professions of aluminum production is dominated by concomitant pathology of functional systems against the background of bone destruction, determined by endogenous factors of the course of metabolic processes of the body.

The authors declare no conflict of interests.

Introduction. Long-term persistent hypertension can lead to heart failure. The study of its early markers, which include diastolic dysfunction of the left ventricle and reduction of longitudinal myocardial deformation, is of importance for workers engaged in harmful and dangerous working conditions.

The aim of the study is to evaluate the parameters of myocardial deformation and diastolic function of the left ventricle, as well as their interrelation with arterial hypertension in workers of the coal mining industry in the South of Kuzbass.

Materials and methods. 384 people were examined (men), including 266 workers of coal mines in the South of Kuzbass (drifters, stope miners, operators of rock removing machines) and 118 persons who were not employed in the coal industry, aged from 40 to 55 years. Arterial hypertension was detected according to the clinical recommendations for the diagnosis and treatment of arterial hypertension in 2019. The structural and functional state of the heart was studied by echocardiography with evaluation of the longitudinal deformation of the left ventricle by 2D-strain method and its diastolic function using pulse-wave and tissue dopplerography.

Results. The prevalence of persons with arterial hypertension in the group of workers employed in the coal industry was established: 43.2% against 26.3% in the comparison group (p=0.002). Longitudinal deformation of the left ventricular myocardium in all subjects was significantly less in the presence of high blood pressure: -21.0±0.18 vs. -19.2±0.22% (p<0.001) in the main group and -21.54±0.22 vs. -19.84±0.38% (p<0.001) in the comparison group. It should also be noted that there is a tendency to differ in subgroups of subjects without arterial hypertension towards a greater reduction in longitudinal myocardial deformation in coal miners (-21.54±0.22 and -21.0±0.18%, p=0.062). In miners, diastolic left ventricular dysfunction was significantly more common than in the group without occupational hazards: 52.5 and 39.3%, respectively, p=0.021. Its presence in the cohort of coal miners with arterial hypertension was detected significantly more often (58.9%) than in individuals with normal blood pressure (25.9%), p<0.0001. In turn, in the group of people not employed in the coal industry, diastolic dysfunction of the left ventricle was also more common in the presence of arterial hypertension: in 42.6 and 13.9% of cases, respectively (p<0.001).

Conclusions. The incidence of arterial hypertension among coal miners was significantly higher than in people who do not work at coal mining enterprises. In all patients with arterial hypertension, the longitudinal deformation of the left ventricular myocardium with the preserved ejection fraction was lower than in those with normal blood pressure. Diastolic myocardial dysfunction of the left ventricle was significantly more common among those examined with underground working conditions, especially in the group of people with arterial hypertension.

The authors declare no conflict of interests.

Introduction. The problem of high mortality from cardiovascular diseases is caused, among other things, by asymptomatic atherosclerosis, which proceeds latently for a long time and manifests itself as a serious vascular catastrophe, which is of particular importance for people working at production facilities with difficult and dangerous working conditions.

The aim of the study was to assess the risk factors for atherosclerosis and the state of the vascular wall in the workers of the main professions of coal enterprises in the South of Kuzbass.

Material and methods. In total, the study included 384 people (men), of whom 266 were the workers in coal mines in the South of Kuzbass and 118 people who were not employed in the coal industry, aged 40 to 55 years. The diagnosis of atherosclerosis was carried out on the ultrasound system “Vivid E9” of the manufacturing company GE using a linear sensor for measuring the thickness of the intima-media complex and visualization of atherosclerotic plaques. To identify significant risk factors, anthropometric, anamnestic data, indices of lipid and carbohydrate metabolism, and the presence of arterial hypertension were studied.

Results. Significant differences in the frequency of asymptomatic atherosclerosis in the form of an increase in intima-media thickness by more than 1 mm and / or the presence of atherosclerotic plaques in both groups were not found: 60.2% among the miners and 62.3% among non-coal mining workers (p=0.703); at the same time, the percentage of detection of atherosclerotic plaques in arteries was significantly lower among coal workers — 46.9% versus 60.5% among people in the comparison group (p=0.016). The common risk factors for all examined subjects were arterial hypertension and increased level of glycated hemoglobin; in turn, in coal miners additional risk factors were increased values of low density lipoproteins and waist-hip index, as well as burdened heredity for cardiovascular diseases, and among the individuals not employed in the coal industry it was smoking.

Conclusions. The most significant risk factors for atherosclerosis in coal industry workers were arterial hypertension, raised values of glycated hemoglobin, low density lipoproteins and waist-hip index, as well as burdened heredity for cardiovascular diseases. Significant differences in the frequency of asymptomatic atherosclerosis in the form of an increase in the thickness of the intima-media complex of the main arteries and the presence of atherosclerotic plaques in both groups were not established, but the percentage of the detection of atherosclerotic plaques was lower among coal miners.

The authors declare no conflict of interests.

Introduction. Active coal mining in Kuzbass, with its unfavorable climatic and environmental conditions, necessitates the study of occupational diseases of workers in this industry. One of the most common occupationally caused diseases of miners is polyneuropathy of the upper extremities.

The aim of the study is to assess the effect of autonomic disorders on the course of occupational upper limb polyneuropathy in workers of the Kuzbass coal industry using various methods of analyzing heart rate variability.

Materials and methods. 52 employees of coal enterprises aged from 43 to 64 years with the established diagnosis of “polyneuropathy of the upper extremities” were examined. The control group consisted of 16 healthy volunteers of the same age, engaged mainly in mental or light physical labor. Electroneuromyography was performed to assess the degree of damage to peripheral nerve fibers. Spectral and nonlinear parameters of heart rate variability were used to determine the state of autonomic regulation. The Mann-Whitney criterion was used to assess the statistical significance of differences between the study groups.

Results. 3 groups of patients with polyneuropathy were identified according to the severity of violations of impulse conduction in the peripheral nerves. In subjects with mild, initial disturbances of pulse conduction (n=8, 15.4%), a decrease in parasympathetic influence is determined, which is manifested by a statistically significant decrease in the power of high frequency oscillations of the heart rate variability spectrum. With moderate signs of polyneuropathy (28 cases, 53.9%), there is a shift in the autonomic balance towards sympathetic activation; a statistically significant increase in very low-frequency fluctuations in heart rate variability indicates an increase in the influence of suprasegmental autonomic centers. In subjects with gross violations of the peripheral nerve impulses (n=16, 30.7%), there is a decrease in the power of oscillations in all frequency ranges of heart rate variability.

Conclusions. The obtained data confirm the influence of autonomic regulation on the course of occupational polyneuropathy.

The authors declare no conflict of interests.

Introduction. The study of the problems of human stress resistance in various professions has shown that prolonged exposure to stress leads to such adverse consequences as a decrease in the overall mental stability of the body, the emergence of a sense of dissatisfaction with the results of their activities, the tendency to refuse to perform tasks in situations of increased demands, failures and defeats. Analysis of the factors that cause such symptoms in various activities has shown that there are a number of professions in which a person begins to experience a sense of internal emotional emptiness due to the need for constant contact with other people.

The aim of the study is to study the subdepressive symptoms in accordance with the phases of emotional burnout.

Materials and methods. The study involved 465 people, of whom 219 men and 246 women were representatives of various professional groups. The indicators of emotional burnout, including three phases-stages: “Tension”, “Resistance”, “Exhaustion” — each of which consists of 4 symptoms, are considered.

Results. The correlation coefficient of the level of formation of symptoms of emotional burnout according to the method of V.V. Boyko with the level of severity of each of the components of emotional burnout according to the MBI method are calculated.

Conclusions. It was found that people whose personal and professional lives are filled with meaning are only slightly or moderately susceptible to burnout syndrome. On the contrary, subjects with an existential vacuum showed, according to the MVI test, a high degree of severity of burnout syndrome.

The authors declare no conflict of interests

Introduction. Vibration disease, affecting the autonomic-vascular regulation at different levels, disrupts the balance of sympathetic and parasympathetic influences with the formation of vasospasm. The development of cardiac autonomic neuropathy leads to a worsening of the prognosis for the life of patients, and therefore, the search for effective methods for correcting autonomic disorders is an urgent task in the treatment of vibration disease.

The aim of the study is to evaluate the effectiveness of ischemic preconditioning for the correction of neurovegetative manifestations of vibration disease.

Materials and methods. A comparative assessment of the initial parameters of heart rate variability was carried out in the main group of patients with an established diagnosis of vibration disease (32 people), and in the control group (25 people who had never worked under the influence of industrial vibration). The main group of patients underwent ischemic preconditioning of the upper extremities for 4 days, followed by monitoring of heart rate variability. The Mann-Whitney criteria were used to compare two independent samples and Wilcoxon to assess the significance of changes in indicators before and after exposure. Values at p<0.05 were considered statistically reliable.

Results. An initial decrease in the power level of all spectral parameters of heart rate variability in the main group with the formation of relative sympathicotonia and a decrease in the values of the approximated entropy was revealed. After ischemic preconditioning, heart rate variability significantly increases, which indicates a decrease in the severity of autonomous neuropathy and an improvement in the prognosis for life.

Conclusions. In patients with vibration disease, all parts of the peripheral and central autonomic nervous system are involved in pathogenesis with the formation of persistent sympathicotonia and violation of regulatory mechanisms. Ischemic preconditioning can affect the identified disorders by inducing an adaptive vagal response.

The authors declare no conflict of interests.

Introduction. Dust-induced lung pathology in miners is often combined with cardiovascular diseases such as coronary heart disease, hypertension, and atherosclerosis. In this regard, the search for ways to prevent the development of combined pathology with dust effects on the body is an urgent problem in occupational health.

The aim of the study was to explore the effect of a complex preparation with dihydroquercetin on the level of protective proteins and myocardial morphostructure in the dynamics of dust-induced pathology development when inhaling coal-rock dust.

Materials and methods. The study was conducted on white laboratory male rats weighing 200–250 g. The animals were divided into two groups: rats that inhaled coal-rock dust in the priming dust chamber daily for 4 hours for 1, 3, 6, 9 and 12 weeks; rats that received a daily complex drug with dihydroquercetin. The concentration of IL–6 proinflammatory cytokine and cardiomarkers (B-type brain natriuretic peptide, vascular endothelial growth factor, and fractalkin) was determined in the blood by enzyme immunoassay. In the cytosolic fraction of heart tissue, the level of expression of the hypoxia-induced transcription factor HIF — 1α, the inducible forms of proteins HSP72 and heme-oxygenase–1 was determined.

Results. Prolonged dust exposure in the early stages (1–3 weeks) increased the expression of HIF–1α transcription factor and stress-inducible proteins — HSP72 and HOx–1 — in the myocardium. An increase in the dust exposure period of more than 6 weeks was accompanied by a decrease in the level of the HIF–1α transcription factor to control values, but the intensive synthesis of HSP72 and HOx–1 was maintained. In addition, the dynamics of long-term dust exposure to the body changed the level of cardiomarkers in the blood serum: 1) increased vascular endothelial factor; 2) fractalkin and IL–6 decreased in the early stages, as well as brain natriuretic peptide type B — the entire period of the study. By week 12 of dust exposure in the myocardial tissue it was revealed: dystrophic changes of a protein nature, signs of apoptosis, atrophy of some fibers and the development of diff use cardiosclerosis. Daily administration of a complex drug with dihydroquercetin to laboratory animals with prolonged exposure to coal-rock dust for 12 weeks led to the restoration of the level of protective cardiomarkers to control values and reduced the severity of morphological changes in the heart tissue.

Conclusions. The administration of a complex drug with dihydroquercetin during prolonged dust exposure on the body has a cardioprotective effect, which is confirmed by the achievement of control levels of cell proliferation factors (B- type brain natriuretic peptide), angiogenesis (vascular endothelial factor), proinflammatory (IL–6) and anti-inflammatory response (CX3CL1), as well as a decrease in the severity of dystrophic changes in myocardial muscle fibers and almost complete disappearance of lymphocytic infiltration in heart vessels.

Th e authors declare no confl ict of interests.

Introduction. Determining the relationship between the impact of environmental factors and the health status of the population based on the risk assessment methodology is an urgent problem of preventive hygiene. The city of Novokuznetsk in the Kemerovo region, which is a major center of the metallurgical and coal industry, is characterized by a particularly difficult environmental situation.

The aim of the study is to assess the risk to population health from air pollution from the emissions of a coal-processing plant.

Materials and methods. The work used the volume of maximum permissible emissions of the central processing plant “Abashevskaya”. Calculations of maximum and average annual concentrations of pollutants were performed using the “EcoCenter-Standard” program, based on “Methods for calculating the dispersion of emissions of harmful (polluting) substances in the air”. Population health risks were calculated in accordance with the “Guidelines for assessing public health risks from exposure to chemicals that pollute the environment”. The resulting risk values were compared with acceptable values. Also, the values of risk levels were determined considering background concentrations.

Results. Priority pollutants were identified: nitrogen dioxide, nitrogen oxide, carbon monoxide, sulfur dioxide, carbon (soot), inorganic dust with a SiO2 content of less than 20%, inorganic dust with a SiO2 content of 20–70%, benzene, manganese and its compounds. The maximum and average concentrations of pollutants were determined and the MPC exceeded at the selected calculation points. It was found that the risk levels of immediate action are zero. The risk levels of chronic intoxication range from 3×10–8 (manganese and its compounds) to 0.003 (inorganic dust with a SiO2 content of less than 20%). The highest total level of risks of chronic intoxication (0.006) is observed in the Baidaevka district. This is due to the location of pollution sources. The highest hazard indexes are also observed in the neighborhood Baidaevka. The hazard coefficients for all substances do not exceed “1”, which indicates that the population is not significantly likely to develop harmful effects with daily intake of the substance during life, and such an impact is acceptable. According to the data obtained, soot and benzene as carcinogenic substances do not pose a danger. The total values of the risks of immediate action, chronic intoxication and carcinogenic risk do not exceed the acceptable level. The total values of the risks of chronic intoxication, taking into account background concentrations, exceed the acceptable level by 2.9–4.1 times.

Conclusion. Emissions from the coal-processing plant contribute to air pollution in the city, without significantly affecting the health of the population. The use of the risk assessment methodology is necessary to identify the most unfavorable areas of the city and pollutants that contribute most to the health of the population.

The authors declare no conflict of interests.

Introduction. The impact on the body of such factors of the production environment as coal-rock dust and fluorine compounds leads to certain shift s in strict indicators of homeostasis at the system level. Maintaining the relative constancy of the internal environment of the body is provided by the functional consistency of all organs and systems, the leading of which is the liver. Organ repair plays a crucial role in restoring the structure of genetic material and maintaining normal cell viability. When this mechanism is damaged, the compensatory capabilities of the organ are disrupted, homeostasis is disrupted at the cellular and organizational levels, and the development of the main pathological processes is noted.

The aim of the study is to compare the morphological mechanisms of maintaining structural homeostasis of the liver in the dynamics of the impact on the body of coal-rock dust and sodium fluoride.

Materials and methods. Experimental studies were conducted on adult white male laboratory rats. Features of morphological mechanisms for maintaining structural homeostasis of the liver in the dynamics of exposure to coal-rock dust and sodium fluoride were studied on experimental models of pneumoconiosis and fluoride intoxication. For histological examination in experimental animals, liver sampling was performed after 1, 3, 6, 9, 12 weeks of the experiment.

Results. The specificity of morphological changes in the liver depending on the harmful production factor was revealed. It is shown that chronic exposure to coal-rock dust and sodium fluoride is characterized by the development of similar morphological changes in the liver and its vessels from the predominance of the initial compensatory-adaptive to pronounced violations of the stromal and parenchymal components. Long-term inhalation of coal-rock dust at 1–3 weeks of seeding triggers adaptive mechanisms in the liver in the form of increased functional activity of cells, formation of double-core hepatocytes, activation of immunocompetent cells and endotheliocytes, ensuring the preservation of the parenchyma and the general morphostructure of the organ until the 12th week of the experiment. Exposure to sodium fluoride leads to early disruption of liver compensatory mechanisms and the development of dystrophic changes in the parenchyma with the formation of necrosis foci as early as the 6th week of the experiment.

Conclusions. The study of mechanisms for compensating the liver structure in conditions of long-term exposure to coal-rock dust and sodium fluoride, as well as processes that indicate their failure, and the timing of their occurrence, is of theoretical and practical importance for developing recommendations for the timely prevention and correction of pathological conditions developing in employees of the aluminum and coal industry.

The authors declare no conflict of interests.

The influence of natural radon waters on the state of the respiratory tract mucosal cells in patients working in the coal and metallurgical industries with occupational chronic obstructive pulmonary disease was studied. The positive effect of common radon baths on the restoration of cytological changes in the respiratory mucosa was revealed.

Indicators of local immunity of the respiratory tract mucosa in patients with occupational chronic obstructive pulmonary disease on the background of the use of general radon baths.

The aim of the study is to explore the effect of natural radon water in the form of shared baths on epithelial cells of the respiratory mucosa in patients with occupational chronic obstructive pulmonary disease based on the analysis of cytological changes in the respiratory mucosa. Patients of the main group with professional chronic obstructive pulmonary disease were given general radon baths from a natural source in sanatorium conditions. Patients in the control group had shared freshwater baths. All patients before and after treatment studies were conducted cytologic changes in the smears from the mucous membrane of the nose and phlegm. The use of common radon baths in the main group revealed a pronounced corrective effect on the function of cellular protection of the respiratory mucosa, which was expressed in a significant decrease in destructive processes in cells of all types with an increase in their functional activity, normalization of mucociliary clearance. There were no significant changes in indicators in the control group.

The use of common radon baths at the stage of rehabilitation in workers of the coal and metallurgical industry with professional chronic obstructive pulmonary disease leads to the restoration of the integrity of the cellular composition of the epithelial cover of the respiratory tract mucosa, preserves the functional activity of cells of local protection factors.

The authors declare no conflict of interests.

The results of the use of natural radon water in the form of general baths in patients working in the coal mining and metallurgical industry, with occupational diseases of the joints and spine, at the stage of rehabilitation are presented. Studies have shown that the course application of radon therapy has a pronounced analgesic and anti-inflammatory effect, a general sedative effect helps to restore the volume of movements in the affected joints, normalizes the statokinetic functions of the musculoskeletal system, slows down the progression of the joint process and the development of dystrophic changes in the musculoskeletal system.

Indicators of statodynamic functions of the musculoskeletal system in patients with occupational diseases of the joints and spine in the rehabilitation system against the background of course use of natural radon waters in the form of shared baths were studied. The aim of the study is to explore the effect of radon waters of natural origin on the dynamics of statodynamic parameters according to the data of a stabilometric study in patients working in the coal mining and metallurgical industry, with occupational diseases of the joints and spine.

Patients with occupational diseases of the joints and spine in rehabilitation were prescribed general radon baths (the main group). The control group of patients received freshwater baths. Before and after treatment were carried out studies of the static-dynamic functions stabiiloplatform (soft ware-hardware complex for clinical motion analysis “Biomechanics” published by the scientific-medical firm MBN), with the help of which the indicator of the common center of mass, the flexor setting up of the thigh, the coefficient of weight load on the foot, the inter-limb asymmetry, the vertical stance was determined in the initial position and in the Romberg position.

The use of common radon baths in the main group allowed to normalize the statokinetic functions of the musculoskeletal system in the form of reducing the period of alignment of the pelvic flexor installations and asymmetry of the distribution of weight load on the affected limb; increasing the level of adaptation of patients to functional loads against the background of reducing pain and inflammatory syndrome. There were no significant changes in these indicators in the control group. The use of general radon baths on the rehabilitation stage in patients working in the coal mining and metallurgical industry, with occupational diseases of the joints and spine, helps to restore the statodynamic functions of the musculoskeletal system, the disappearance of pain syndrome, and reduces inflammation.

The authors declare no conflict of interests.

Currently, the proportion of workers exposed to manganese compounds is quite high, but due to increased safety measures and changes in working conditions, the number of new cases of chronic occupational manganese intoxication has decreased significantly. an attempt has been made

An attempt has been made to highlight the difficulties of differential diagnosis of occupational chronic manganese intoxication and other neurological diseases on the example of clinical cases of examination of persons with extrapyramidal system lesions in the form of early development of Parkinson’s disease. The assessment of complaints, medical history, neurological status, laboratory tests, and instrumental studies to find the probable cause of Parkinsonism was carried out. The interest of the observations lies in the difficulty of interpreting the data obtained and the importance of studying the professional route of patients. Magnetic resonance imaging of the brain, electromyography of the extremities, electroencephalography, echoencephalography, the study of the concentration of metabolites characteristic of Niemann-Pik disease, copper indicators in the blood help in making a correct diagnosis.

When examining a contingent of people working in contact with manganese compounds, if they suspect chronic occupational manganese intoxication, it is important consider other diseases that lead to the development of Parkinson’s disease.

The authors declare no conflict of interests.