Occupational diseases associated with pain syndrome in the lower part are one of the most common causes of physical and psychological health disorders. Lower back pain (LBP) also affects labor productivity and the social sphere of life and is becoming an increasingly important factor in the growth of medical care costs. The study aims to research a comprehensive study of the impact of chronic LBP on the quality of life of workers in unfavorable conditions of metallurgical production. Experts have carried out a hygienic assessment of working conditions according to the data of the special assessment of working conditions cards, a questionnaire (a questionnaire of disorders of vital activity in Oswestrovsky's lower back pain, a questionnaire of McGill's pain) and a clinical examination of 132 employees (men) of various industries of the metallurgical enterprise. We analyzed the results of additional instrumental examination methods: radiography of the lumbar spine and electroneuromyography of the nerves of the lower extremities. Under the working conditions of workers of the leading professions of metallurgical production, combined and combined effects of harmful production factors are characteristic, the integral assessment of which corresponds to class 3.2. The severity of the labor process among employees of the studied professions was within classes 2.0.-3.1. According to the McGill questionnaire experts have found statistically significant differences in the main occupational groups: the highest pain indicators were in the group of wire-drawing workers (index - 7.5±4.9; rank - 14.6±10.2) and drivers of intra-factory vehicles (index - 6.9±4.4; rank - 15.1±11.3). After the treatment there were positive dynamics in the values of rank indicators on the affective and evaluative scales (p<0.05). Researchers have identified statistically significant differences between all the studied groups (F=2.55, p=0.041), when using the Oswestrovsky questionnaire. There were degenerative-dystrophic changes of the spine on radiographs of the lumbar spine. According to the results of an electroneuromyographic study, the authors revealed signs of dysfunction at the level of segments L5-S1-2 of the lumbosacral spine. As a result of the study, we have revealed the relationship between the early detection of disorders of the musculoskeletal system with the peculiarities of the labor process and the deterioration of the quality of worker’s life in the production of hardware. To assess the intensity of LBP in workers engaged in harmful working conditions, it is possible to use the McGill and Oswestrovsky pain questionnaires. The detection of pain syndrome and early rehabilitation in people with occupational diseases of the musculoskeletal system contributes to prolonging the working age and improving the quality of life in people with physical overload in the workplace.
The prevalence of occupational diseases and poisoning at work is one of the important indicators of the health of workers engaged in harmful and dangerous jobs. In 2012, the Order of the Ministry of Health and Social Development of the Russian Federation No. 417n dated April 27, 2012 "On approval of the list of occupational diseases" was issued, which implied, when solving issues of examination of the connection of occupational diseases with industrial activity, orientation to the 10th version of the International Classification of Diseases. In 2018, the World Health Organization published the 11th version of the International Classification of Diseases, which officially comes into force on January 1, 2022. Decree of the Government of the Russian Federation No. 2900-r of October 15, 2021, approved an action plan for the implementation of the eleventh revision of the International Statistical Classification of Diseases and Health-Related Problems (ICD-11). To date, the ICD is recognized as a standard for statistical accounting in the healthcare system, the basis for the formulation of clinical diagnosis, as well as the encoding of recorded data obtained during the analysis of morbidity, causes of injuries and harmful effects, cases of rare diseases, anatomical and histopathological data, assessment of the severity of conditions, professional or sports activity, the need to provide medical products, medicines, etc. There is no unequivocal opinion on the adaptation of the ICD-11 codes and this topic requires further study, but the transition of work on the new classification is only a matter of time. Thus, in this article we would like to consider the issues of the ICD-11 codes of occupational diseases, which can be used in relation to the most common diseases associated with the effects of industrial chemical and physical factors, as well as physical overload and functional overstrain of individual organs and systems. The main sections highlighted in the ICD-11 for various occupational diseases, on the one hand, reflect to a greater extent various pathological conditions associated with the effects of physical factors, but on the other hand, they do not fully represent diseases associated with the effects of industrial factors of chemical etiology. When switching to the 11th version of the International Classification of Diseases, occupational Pathology may face difficulties, since not all clinically important syndromes of occupational diseases are presented in the ICD-11. In this regard, it seems important and relevant to discuss this issue. Ethics. In preparing this article, no personal data of patients was used and no studies were conducted on laboratory animals. All used normative documentation is placed in the Garant system. The performed analysis, presented in the materials of the manuscript, corresponds to the generally accepted norms of morality and does not pose a risk.
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