Modern, problematic issues of prevalence, structure and high rates of hearing loss from exposure to industrial noise in the form of clinical stages of chronic sensorineural hearing loss are reflected. The possibility of harmonization of the List of occupational diseases of the ICD 10th and 11th reviews in hearing impairment is discussed
Preserving the working longevity of locomotive crew employees is one of the priority tasks of Russian Railways. The urgency of the problem is related to both the medical aspects of railway traffic safety and the importance of preserving human capital. The aim of study is to research the influence of occupational and behavioral risk factors on health disorders in drivers and their assistants. The study included the results of a survey of 9308 employees of locomotive crews on the presence of production and behavioral risk factors for health disorders, as well as on the presence of cases of temporary disability, hospitalization or unscheduled medical care in the previous year. Additionally, the results of clinical and laboratory studies were studied. Noise exposure is the main production factor affecting the unscheduled attendance of locomotive crew employees to the doctor, the number of cases of temporary disability and hospitalization. Only 13% of respondents have a high level of commitment to a healthy lifestyle. Among employees who are not exposed to industrial noise, the number of people who have a high commitment to a healthy lifestyle is 2 times higher than among those who complain about the presence of an acoustic factor. The main differences in adherence to a healthy lifestyle between people who have and do not have complaints about the negative impact of the sound factor are related to alcohol abuse (1.4 times more often used by people working in conditions of noise exposure), frequent use of semi-finished products and fatty foods (1.2 times more often). Among people exposed to industrial noise, a body mass index (BMI) exceeding 25 kg/m2 is 1.5 times more common than in people who do not have noise exposure. The frequency of occurrence of blood pressure is more than 130/80 mm Hg. and blood cholesterol more than 5 mmol/l, respectively, is 1.9 and 2.2 times higher in individuals with intra-cab acoustic load, compared with those without. An increase in the number of cases of temporary disability, hospitalization, and unscheduled visits to a doctor in people who report exposure to noise in the driver's cab may be associated with both occupational and behavioral factors: alcohol consumption, poor nutrition, and a high proportion of people with a BMI exceeding 25 kg/m2.
The article discusses the actual problem of professional hearing loss in members of the flight professions of civil aviation in Russia. The indices of this disease amounted of one-third of the prevalence rate values concerning occupational diseases of the hearing organ among all workers of “noise” professions, are registered with the highest frequency in pilots and aircraft commanders and have no tendency to decrease. As the only occupational disease among the persons of the flight professions of the main airlines of the Russian Federation, the persistent sensorineural hearing loss has not only medical but also socio-economic aspects. It is registered in working-age persons lost their professional aptitude. The main revealed causes of the gain of indices of the hearing loss in professional pilots are: the insufficient qualification of medical workers on the issues of early diagnosis of the negative impact of noise on the hearing organ; the lack of regulated criteria for the diagnosis and examination of the relationship between the hearing loss and the occupation; insufficiently clear algorithms of departmental logistics in the examination of occupational diseases of the hearing organ. The ways of optimization of the problem are shown as follows: the development and implementation of the method of speech perception in the conditions of competing the in-cab noise of the aircraft; objective criteria for decision-making on admission/non-admission to the flight work; adequate assessment of the indices of the in-cab noise and sound pressure arising in the aircraft headset during speech radio exchange; mandatory compliance with the requirements of accounting for the data of the Protocol of acoustic load for the entire period of the flight activity, with the indication of noise-protective characteristics of the used airguns in the implementation of the examination of the communication of the disease of the hearing with the profession.
Introduction. In the period from 2013 to 2021, industrial enterprises saw a reduction in jobs that did not meet sanitary and hygienic requirements for the level of exposure to noise, vibration, illumination, microclimate parameters and electromagnetic fields on the workers' bodies. However, the proportion of unfavorable workplaces that do not meet the standards for noise levels remains the largest, which determines the peculiarities of the structure of the occupational pathology of workers in the Russian Federation: professional pathology of the hearing organ - professional sensorineural hearing loss - remains in the first place. The transport industry is among the sectors of the economy with the most significant indicators of occupational diseases exceeding the average Russian indicator. The study aims to analyze additional causes of pathogenetic significance in the development of professional hearing loss using the example of employees of the driving professions of railway transport and flight professions of civil aviation aircraft. Materials and methods. We have analyzed the state of the auditory function in members of locomotive crews of JSC Russian Railways for 2017-2021 according to the Territorial Administration of Rospotrebnadzor for Railway Transport and persons of flight professions of civil aviation aircraft of the Russian Federation for 2010-2020 according to the data of the Federal Center for Hygiene and Epidemiology. Results. Professional sensorineural hearing loss prevails in the structure of occupational morbidity of railway and aviation transport workers. Despite the absence of excess in-cabin noise levels, the leading professional group for hearing loss in railway transport are locomotive drivers and assistants, in civil aviation - aircraft commanders and co-pilots. The complexity of the professional activities of persons of these professions, a high degree of responsibility for the safety of transportation of passengers and cargo, readiness to act in non-standard conditions, loads on visual and auditory analyzers, create a high degree of labor intensity that causes chronic stress. The factor of chronic stress causes a violation of adaptive mechanisms and causes a number of complex neuro-reflex and neurohumoral shifts in the body, as a result of which labor intensity need to consider as a pathogenetically significant factor in the development of professional sensorineural hearing loss. Conclusions. Chronic sensorineural hearing loss is a priority occupational disease in persons of driving and flying professions, it is registered even in persons working in conditions of regulatory levels of industrial noise and a high degree of labor intensity. It is necessary to discuss the possibility of including labor intensity indicators as an additional etiological, pathogenetically significant factor in the expert criteria for establishing the connection of hearing loss with professional activity.
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