Introduction. Cardiovascular diseases (CVD) are a leading cause of morbidity and mortality. The role of occupational hazards in the CVD prevalence remains to be clarified. Material and methods. Here we report the results of the study of risk factors and CVD prevalence in 590 workers at the largest copper production plants in the Sverdlovsk region, exposed to heavy metals in the workplace. The workers` health information was obtained during a regular medical examination in 2018. The lead concentration increase to 1.3-1.8 occupational exposure limits was registered in the working areas of the concentrating mill (for bunkerman) and copper smelting workshops (transporter, smelter, converter, non-ferrous metal spreader, repairman, electrician). Results. We studied the exposure indices (Pb level in blood), the response markers (reticulocyte count, erythrocytes basophilic stippling, coproporphyrin, and aminolevulinic acid in the urine), and their correlation to a working tenure. Based on this analysis, we attributed CVD risk factors and cardiovascular diseases to the occupation, in order to potentially modify some of those risk factors and ultimately inform the risk management. Hypertension occurred in 57% of the examined workers, which is higher than in the general population. We calculated relative risk, confidence intervals and attributable fraction. We developed a predictive mathematical model (stepwise logistic regression) to predict high-stage hypertension and identified the risk factors associated with its development. Conclusions. Correlation analysis revealed direct correlations between stages 2 and 3 hypertension and a working tenure over 20 years. We think it’s reasonable to consider the documented CVDs as related to the toxic effects of heavy metals (lead and cadmium).
Introduction. Chronic fluorine intoxication prevails among the newly discovered occupational diseases in aluminum industry workers. Mathematical modeling is one of the helpful tools in ensuring better risk management with respect to the development of occupational fluorosis. Objective. Developing a logistic regression model predicting a probability of occupational fluorosis development in an occupational staff of aluminum plants in order to suggest adequate prophylactic strategies. Material and methods. A logistic regression model predicting a probability of the development of occupational fluorosis in aluminum industry workers of the Sverdlovsk region was constructed. The model embraced the results of a univariate analysis conducted with respect to major occupational exposures and health characteristics of 201 workers. Results. Six major factors were identified as being predictive of occupational fluorosis development in aluminum industry workers: age (fluorosis risk increases with age); type 2 diabetes mellitus; atrophic gastritis; kidney cysts; X-ray examination data (fluorosis risk increases with the stage as determined by X-ray); the hydro fluoride concentration increases by more than 2 occupational exposure limits. The developed model was verified by clinical cases and showed a high predictive ability (86.2 %). Both sensitivity (true positive rate) and specificity (true negative rate) of the model amounted to 86.2 %. Conclusion. By multivariate analysis the significant, mutually independent factors were identified, their combination being associated with chronic fluorine intoxication in an occupational staff of aluminum plants. The developed mathematical model has a high predictive ability and can be recommended as a sure tool to forecast the course of occupational fluorosis development in the workers at the aluminum industry.
Introduction. The attribution of certain medical conditions in industrial workers to hazardous exposures at the workplace remains a challenging issue of occupational health. Material and methods. In order to identify cardiovascular conditions associated with occupational lung diseases in workers exposed to fibrogenic dust, we conducted a medical check-up examination of individuals employed in refractory production and asbestos industry. The main group consisted of the patients with a confirmed diagnosis of lung fibrosis (asbestosis, silicosis); the reference group was age- and tenure-matched workers without occupational fibrosis. Results. We established a significantly higher prevalence of arterial hypertension, left ventricular hypertrophy, sinus tachycardia, obesity, hypertriglyceridemia and impaired fasting glycemia in workers with silicosis and asbestosis if compared to those without work-related diseases. Based on the relative risk and attributable fraction estimates, we assume there is moderate occupational causation for arterial hypertension and a strong one for left ventricular hypertrophy, sinus tachycardia, and obesity. Very strong causation was found between occupational exposure to fibrogenic dust and carbohydrate metabolism disorders. High-stage hypertension, dyslipidemia and left ventricular hypertrophy were found to have a statistically significant impact on the timing of silicosis. Whereas high-stage hypertension, coronary artery disease, left ventricular hypertrophy and obesity were found to impact the timing of asbestosis. Conclusion. Cardiovascular and metabolic disorders are statistically more occurrent in workers with silicosis or asbestosis. Therefore, the disease can be regarded as work-related. We established cardiovascular and metabolic disorders to have a statistically significant impact on the timing of silicosis and asbestosis. Therefore, a timely CVD prophylaxis could reduce the risk of occupational lung fibrosis in workers exposed to fibrogenic dust.
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