Background The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate cancer risk in relation to occupational exposure to chrysotile. Objectives The cohort of 35,837 people was followed-up for mortality using cause-of-death information from official death certificates issued by the Civil Act Registration Office (ZAGS) of Sverdlovsk oblast from 1976 to 2015. Data were also retrieved from the electronic cause-of-death registry of the Medical Information Analytical Centre (MIAC) of Sverdlovsk oblast, which was launched in 1990 and operates independently of ZAGS. The objectives were to compare the completeness of record linkage (RL) with ZAGS and with MIAC, and to compare the agreement of cause-of-death information obtained from ZAGS and from MIAC, with a focus on malignant neoplasms. Methods RL completeness of identifying cohort members in ZAGS and in MIAC was compared for the period 1990 to 2015. In the next step, for the comparison of the retrieved cause-of-death information, 5,463 deaths (1,009 from cancer) were used that were registered in 2002 to 2015, when causes of death were coded using International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) nomenclature by MIAC. For ZAGS, original cause-of-death text from the death certificates was obtained and then coded according to ICD-10 by the International Agency for Research on Cancer/World Health Organization (IARC/WHO). Agreement was evaluated at various levels of detail, and reasons for any disagreements between the MIAC and the IARC/WHO ICD-10-coded cancer diagnosis were systematically explored. Results A total of 10,886 deaths were obtained from all avenues of follow-up for the period 1990 to 2015 in the cohort; 10,816 (99.4%) of these were found in ZAGS. This percentage was 88.3% if only automated deterministic RL was used and 99.4% when deterministic RL was complemented with manual searches of cohort members. Comparison of the cause-of-death information showed agreement of 97.9% at the ICD-10 main group level between ZAGS (coded by IARC/WHO) and MIAC. Of 1,009 cancer deaths, 679 (67.3%) cases had identical coding, 258 (25.6%) cases corresponded at the three-character ICD-10 level, 36 (3.6%) had codes that were within the same anatomical or morphological cluster, and for only 36 (3.6%) cases were major discrepancies identified. Altogether, the agreement between IARC/WHO coding of cause-of-death information from ZAGS and MIAC coding of malignant neoplasms was therefore 96.4%. Conclusions RL completeness and agreement of cause-of-death information obtained from ZAGS and from MIAC were both very high. This is reassuring for the quality of cancer mortality follow-up of the Asbest chrysotile cohort. For future epidemiological studies in the Russian Federation, ZAGS appears to be a reliable information source for mortality follow-up, if the automated RL is complemented with manual searches of cohort members. MIAC is a good resource for prospective studies.
Currently, the normative acts do not define the priority and order of interaction (routing) between various types of medical examinations (examinations) working during mandatory, preventive medical examinations and medical examination. The order of action of doctors in the diagnosis of diseases at various stages of the examination has not been determined.
Introduction. Work of locomotive crew members (engine drivers and engine driver assistants) in railway transport is associated with exposure to complex of occupational hazards including psychoemotional stress and shiftwork (with night shifts) along with noise and vibration.Objective. To study influence of shift work (with irregular alternation of day and night shifts) on biorhythms disturbances in locomotive crew workers.Materials and methods. Polls, simulators of occupational activities with training complex «Cabin of engine driver EP1M», daily monitoring of blood pressure, statistic data processing by SPSS–20 software.Results. Findings are that 953 locomotive crew workers (94%) experienced sensations of temporary disorientation, slight dizziness, sleepiness, interpreted as monotony and sensor deprivation. 61% of the examinees demonstrated frustration signs, in 30% of the cases there were certain manifestations of mental ill-being — irritability, fatigue, weariness, absent-mindedness, anxiety; 27.2% of the testees experiences various sleep disorders; 13.8% of the workers complained of «light sleep», 2% of those — restless sleep, 0.6% — sleeplessness. In occupationally related biorhythms disturbance, the body undergoes occupational adaptation, with partial transformation for atypical schedule of sleep and wakefulness.Results. To preserve health, efforts should be aimed at adaptation to shifted occupational activities with safe adaptogenic medications, low-caloric diet for individuals working at irregular shifts, create conditions for adequate physical activity of the workers between shifts. Necessities also are individual norms for blood pressure parameters in engine drivers with night shiftwork, specification of antihypertensive treatment for patients with irregular shifted work.
Introduction. JSC "Russian Railways" monitors morbidity and changes in the health status of employees, including after the use of high-tech assistance methods (radiofrequency ablation, joint replacement, etc.). In some cases, JSC "Russian Railways made decisions on individual admission to training work of persons who have undergone such high-tech interventions, even if there are medical contraindications to work. The study aims to learn the feasibility of individual admission to work of train personnel after high-tech medical care. Furthermore, it makes the professional longevity of railway transport workers. Materials and methods. We analyzed the information for 2015-2020 about the identified medical contraindications in workers directly related to training traffic and shunting work, with rhythm and conduction disorders, surgical diseases, and lesions of large joints, including those aimed at high-tech assistance. In addition, the researchers evaluated the clinical and economic efficiency of their admission to work. Results. More than 70% of employees after radiofrequency ablation and joint replacement can return to train workers, which has brought an indirect economic effect of at least 150 million rubles over six years. It is a prerequisite for the revision of existing regulatory documents. Conclusions: The use of high-tech treatment methods makes it possible to prolong professional longevity through individual admission to train employees of the group of machinists, drivers, and their assistants. The research showed an indirect economic effect for the railway industry for at least 150 million rubles over six years, which is the basis for changing medical expert approaches and medical contraindications to work directly related to training traffic.
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