The purpose of the study was to (1) compare measured and estimated hearing loss among forge hammering workers by applying models for risk assessment based on measurements of impulse noise, and (2) model the hazardous effects of impulse noise on hearing. Noise exposure and hearing loss among forge hammering workers were studied at two forge workshops of an automobile company, where the equivalent sound pressure levels (104 and 105 dB) were the same, but the peak levels and degree of impulsiveness were significantly different. The hearing threshold levels of selected groups of workers (97 and 235 workers) were determined. Comparison between the measured and expected hearing losses defined according to the ISO standard revealed 2 dB difference in excessive hearing loss (1 dB and 3 dB for the workers of workshop 1 and 2, respectively). The excessive hearing loss equals an increase of 3.5 years of exposure. The hearing loss of workers exposed to low impulsive noise could be predicted well using ISO 1999-1990. The hearing loss of workers exposed to high impulsive noise correlated significantly with the peak levels and the number of impulses in combination.
The digital transformation of the economy and society prompts the renewal of methods in occupational health as well. There are outlined fundamentals of the draft revision of the “Guidelines for the Assessment of Occupational Risk to Employee Health. Organizational and methodological foundations, principles and criteria for the assessment». R 2.2.1766-03. The draft contains methods of occupational risk (OR) assessment supplied with information materials and software for working on the Internet in real-time. Algorithms and models for calculating the probability of impairment of health according to data of the Special Assessment of Working Conditions (SAWC) as well as causation algorithms - work-relatedness assessment according to data of periodic medical examinations (PME) for the validity of risk assessment from the standpoint of evidence-based medicine are presented. There are set out methods for calculating the probability of the formation of occupational diseases (OD) of the main nosological forms from the exposure of noise, hand-arm and whole-body vibration, heat and cool microclimate, fibrogenic dusts, physical labor (local, regional and general loads), strenuous work, standing work with the likelihood of varicose lower veins limbs, multi-factor exposure and low-back pain. Risk assessments for the reproductive health of workers are also discussed. The models are based on the documents of the WHO, ILO, ISO, domestic and foreign literature data that meet the principles of evidence-based medicine. The problems of work-related diseases (WRD) - the concept of WHO (1987) -basics of etiology, qualitative and quantitative criteria for causation, models of consensus and evidence-based medicine, as well as projects for integrated work on the detection systems for WRD in the European Union countries are considered. Single-digit indices of working conditions and health problems, moral harm caused to an employee suffering from OD or WRD. Hygienic recommendations to employers on OR management, prevention priorities, the role of personal protection equipment, the basics of corporate health promotion programs, and ethical and economic aspects are described. The calculation methods are provided by the software of the electronic online reference book “Occupational Risk” (URL: http://medtrud.com/) in order to ensure evidence-based decisions of hygienists. In conclusion, a turning point in occupational health is noted: a decrease in the detection of traditional ODs without compensation by the number of OD and WRD from new technologies, materials and risk factors; this problem requires urgent action.
The digital revolution poses new challenges for hygienists. From hygienic positions, the essence of digitalization of economy and society, and also ethical problems and projects of legal regulation of robotics, systems of artificial intelligence (AI), augmented and virtual reality (AR-VR) are considered. The aim of the work is the analysis of digitalization from the standpoint of information hygiene, as well as the legal regulation of these new technologies for their hygienic regulation. The range of views of the luminaries of Natural Sciences and Medicine on ethical and philosophical issues of the society, labor, and hygiene is given. Of the 23 Asilomar principles of safe, productive, and moral development of AI systems there are selected 7 hygienically significant ones, that can serve as the scientific basis for the hygienic assessment of cyber-physical systems. The issues of the legal regulation of robotics and AI on the example of the UNESCO draft and the European Parliament resolution, as well as draft laws of the United Kingdom and the United States, are considered. The proposal of Russian specialists on the category of high-risk robots and the presumption of the danger of conscious interaction with AI is noted. The terminology on robots and co-robots in the fields of welfare, medicine, and healthcare is presented. The proposal is described to form a friendly behavior of the robot to implement the ethical norms of robotics for the benefit of man. The systems of AR-VR used in education, industry, architecture, health care, medical Sciences, and entertainment are mentioned, as well as risk factors and symptoms of motion sickness as a form of their manifestation are considered. The basic theory is that of sensory conflict and then activation of the optic-vestibular-spinal system; one talks about the "disease of virtual reality". Possible disorders of the human body functions when using AR-VR devices and medical contraindications, as well as health and safety requirements are systematized. The bases of information hygiene can serve as a tool to preserve the health of workers and the population in the digital age. Robots and AI systems are concluded to require hygienic assessment. Special attention should be paid to the AR-VR systems, which create specific health risks, especially for vulnerable groups. The methods and criteria for evaluating cyber-physical systems on the base of information hygiene and specialized hygiene regulations are urgently needed.
An analysis of the literature and an essay on the problem of recognizing the diseases of workers — diagnosis and causation(work-relatedness assessment) are given. A historical reference is made on the etiology of workers’ diseases and the statements of the classics about the causality in medicine. The main categories of occupational medicine and terminology of the WHO and ILO, the principles of evidence in occupational health are considered. The WHO concept of work-related diseases (WRD), occupational disease (OD) recognition systems under ILO Convention No. 121, features of the ILO occupational diseases list (revision 2010), and the criteria for inclusion of diseases in this list are presented.The general provisions of causation, types of causation algorithms in consensus and evidence-based medicine, as well as a generalized algorithm for analyzing periodic medical examinations data are considered. The European experience of recognition of WRD is considered. Based on experience and literature data, we propose a 10-step causation algorithm, including forecasting the probability of OD and WRD, as well as quantifying the degree of work-relatedness with computer support programs from the electronic directory «Occupational Risk» (http://medtrud. com/). It is concluded that legal recognition of WRD is needed for early diagnosis and prophylaxis of workers’ health disorders in conditions of digitalization of the economy and society.
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