; 2 ФГБОУ ВПО «Башкирский государственный медицинский университет», Уфа Статья написана по результатам исследований, которые финансировались программой Академии Наук Республики Башкортостан «Здоровье населения Республики Башкортостан: профилактика заболеваний, медицинские технологии, здоровый образ жизни». Исследования проведены в подстанции скорой медицинской помощи крупного района мегаполиса. Изучали факторы производственной среды и трудовой деятельности (химические, физические, биологические, тяжесть и напряжённость труда) работников бригад скорой медицинской помощи. Проведён углублённый медицинский осмотр 136 врачей и фельдшеров с участием терапевта, невролога, оториноларинголога, офтальмолога, гинеколога и с применением лабораторно-инструментальных методов. Анализ клинико-гигиенических параллелей позволил выявить и обосновать три ведущих вредности в трудовой деятельности: длительное воздействие транспортной вибрации (более 8 часов), уровни которой превышали нормативы, высокую психоэмоциональную напряжённость и несбалансированное питание, обусловленное разъездным характером работы. Выявлена связь заболеваемости работников скорой медицинской помощи с ведущими вредностями. Клиническая и гигиеническая оценка указанной зависимости позволила разработать описательную и прогностическую модель профессиональных рисков. Предложены управленческие решения по оптимизации условий труда и снижения рисков здоровью медицинских работников станции скорой помощи. Ключевые слова: условия труда, здоровье, скорая медицинская помощь, профессиональные риски. Скорая медицинская помощь -это система круглосуточной экстренной помощи населению при угрожающих жизни состояниях на дому и/или в местах чрезвычайных происшествий, на путях транспортировки больных и поражённых в лечебно-профилактические учреждения [1]. CLINICAL AND HYGIENIC ESTIMATION PROFESSIONAL RISKS TO HEALTH OF MEDICAL WORKERS OF STATIONS
Introduction. Healthcare workers are at a high risk of emotional burnout due to their professional activities associated with constant mental and intellectual stress. The importance of timely diagnosed psychoemotional burnout syndrome (PEBS) determines the need to develop measures for its prevention. Material and methods. We have studied the working conditions, health status of healthcare workers; the indices of relative risk and etiological component of the contribution of work environment and the work process factors to the development of the identified pathology were calculated; the probability of the development of PEBS based on diagnostics of the emotional burnout level according to the method suggested by V.V. Boiko. Results. During occupational activities healthcare workers are exposed to chemical, biological, physical work environment factors, the severity and intensity of the work process. Indices of the work process intensity are assigned to the leading hazardous occupational factor according to which the class of working conditions is determined as hazardous Class 1-3. PEBS, diseases of the musculoskeletal, circulatory, digestive and respiration systems are classified as work-related ones. An assessment of the possibility of the development of PEBS has shown 35% of the healthcare workers to consider working conditions to be related to PEBS. The dependence of the development of somatic diseases on the presence or absence of PEBS is revealed. Conclusion. The working conditions of healthcare workers are characterized by the impact of a complex of occupational factors, the leading of which is the work process intensity. Diseases of the musculoskeletal system, circulatory and respiration systems, psycho-emotional burnout syndrome are classified as work-related diseases with a high degree of conditionality. The criteria for evaluating the effectiveness of preventive measures are the reduction of general, work-related and occupational morbidity, the preservation of psychosomatic well-being, and the prevention of economic damage from temporary and permanent disability.
Introduction. One of the major petrochemical complexes of the Republic of Bashkortostan is Limited liability company (LLC) «Gazprom Neftekhim Salavat». The normal operation of industrial enterprises requires the use of large volumes of water. Its water supply, water disposal, waste disposal, reclamation of sludge reservoirs, equipment repair, cleaning of oil sludge reservoirs is provided by LLC «PromVodoKanal». The main technological personnel are wastewater treatment operators, process plant operators, pumping plant operators, chemical analysis laboratory assistants, commodity operators. Their work is associated with exposure to harmful and / or dangerous production factors. Objective. Search and substantiation of laboratory markers of early health disorders in workers of water supply facilities of petrochemical enterprises. Materials and methods. Hygienic and clinical laboratory studies were carried out among workers of the main occupations of the «PromVodoKanal» station who have contact with various harmful derivative factors. A complex of hematological and biochemical research methods was used in the work. Results. A comparative analysis of the frequency of occurrence of deviations of hematological parameters from the norm in all examined (occupational) groups was carried out. A laboratory study showed that hematological parameters are characterized by an increased content of hemoglobin, erythrocytes, and hematocrit. Changes in the mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC), and thrombocytes count, were detected in every fifth worker. Over the years of work, the share of workers with high levels of glucose and cholesterol increases markedly, the correlation of which reaches from 0.90 to 0.97. Limitations. The article has limitations on the scientific study of working conditions, as periodic medical examinations are carried out by occupational pathologists. Conclusions. Red blood values are specific markers of workers’ health problems and require special attention during periodic medical examinations.
The article presents the results of complex hygienic and physiological studies of conditions of labor of workers of chemical industry. The age and seniority determinacy of health disorders. The alterations of cardio-vascular, nervous systems, ENT-organs, musculoskeletal system and connective tissue are established. In workers of main group unidirectional alterations are established concerning indices of peripheral blood characterized by anemic syndrome, neutrophil leukocytosis, lymphocytosis, eosinophilia and expressed thrombocytopenia.
Introduction. Medical workers in the process of labor are exposed to a complex of adverse factors: neuro-emotional, physical stress of a chemical, physical and biological nature. A long stay in a hospital environment with medical workers can lead to the formation of various diseases of microbiological etiology or the carriage of pathogenic and conditionally pathogenic flora and the development of dysbiosis. Objective. Give hematological and bacteriological characteristics of the health status of medical workers. Material and methods. The results of laboratory studies of blood and mucous membranes of the upper respiratory tract of medical workers performed during the performing occupational medical examinations are analyzed. Results. Hematological indices were found to be characterized by an increased hemoglobin content in one-fourth of the examined workers, as well as lymphocytosis, eosinophilia, cholesterolemia. The microflora of the mucosa of the upper respiratory tract is mainly represented by Staphylococcus aureus, Candida albicans, Streptococcus pyogenes in 65.2% of the workers; the remaining 34.8% were revealed to have a resident microflora. With the experience of work, the frequency of insemination increases and doubles by 10 years of the work. The structure of microflora is also changing. In the nosological form of occupational morbidity, allergic diseases prevail and account for 60.8%, tuberculosis - 26.0%, and hepatitis - 8,6%. Conclusion. All these changes in the body are the basis of pathogenetic manifestations in the formation of allergic and pathogenic pathologies, which make up to 70.0% of all occupational morbidity.
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