ЗАБОЛЕВАЕМОСТЬ С ТРУДОПОТЕРЯМИ У СОТРУДНИКОВ ГОСУДАРСТВЕННОЙ ПРОТИВОПОЖАРНОЙ СЛУЖБЫ МЧС РОССИИ (1996-2015 гг.)1 Всероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС России (Россия, СанктПетербург, ул. Акад. Лебедева, д. 4/2); 2 Всероссийский ордена «Знак Почета» научноисследовательский институт противопожарной обороны МЧС России (Россия, Московская обл., г. Балашиха, мкр. ВНИИПО, д. 12)Актуальность. Профессия пожарных входит в десятку самых опасных. Экстремальные условия де ятельности способствуют развитию чрезмерного напряжения функциональных резервов организма специалистов и могут приводить к формированию расстройств здоровья или даже смерти.Цель -провести анализ заболеваемости с трудопотерями у сотрудников Государственной противо пожарной службы (ГПС) МЧС России за 20 лет с 1996 по 2015 г.Методика. По листкам нетрудоспособности изучили ежегодную заболеваемость с трудопотерями у 108 тыс. пожарных, которые составляли не менее 80 % от всех сотрудников, имеющих специальные воен ные звания в ГПС МЧС России. Унификацию учета и анализа заболеваемости достигали с использованием классификации болезней, травм и причин смерти Международной статистической классификации болез ней и проблем, связанных со здоровьем, 10го пересмотра (МКБ10). Рассчитали уровень заболеваемости с трудопотерями на 1000 сотрудников или в ‰. Динамику показателей нарушений здоровья оценивали по методу анализа динамических рядов, для чего использовали полиномиальный тренд 2го порядка.Результаты и их анализ. Среднегодовой уровень случаев трудопотерь у сотрудников ГПС МЧС России в 1996-2015 гг. составил (525,4 ± 38,7) ‰, дней трудопотерь -(6520,6 ± 460,4) ‰, отношения день/слу чай -(12,5 ± 0,1) дня. Полиномиальные тренды при высоких коэффициентах детерминации показывали уменьшение данных. По сравнению с 1996 г. уменьшение случаев трудопотерь в 2015 г. было на 363,5 ‰ или на 49,2 %, дней трудопотерь -на 4082 ‰ или на 46,3 %. Выявлены высокие корреляционные связи числа случаев трудопотерь с профессиональной нагрузкой (по количеству пожаров, r = 0,90; p < 0,001) и макроэкономическим положением в стране (по данным валового внутреннего продукта, r = -0,95; p < 0,001). Ведущими классами в структуре случаев трудопотерь стали X (46,9 %), XIX (12,5 %), прочие (10 %), XIII (9,2 %) и XI (4,9 %), в структуре дней трудопотерь -X (34,2 %), XIX (20,1 %), прочие классы (11,3 %), XIII (10,3 %) и XI класс (6,1 %). Представлены уровни заболеваемости по регионам России. Определена эпи демиологическая значимость болезней и травм по классам МКБ10. 1й ранг значимости составила забо леваемость с трудопотерями X класса МКБ10 (болезни органов дыхания), 2й -XIX (травмы, отравления и некоторые другие последствия воздействия внешних причин), 3й -прочие классы болезней, 4й -XIII (болезни костномышечной системы и соединительной ткани), 5й -XI (болезни органов пищеварения).Заключение. Акцент мероприятий на профилактике болезней ведущих классов будет способствовать повышению состояния здоровья пожарных.
Relevance. The extreme conditions of activity of the personnel of operational units of the EMERCOM of Russia, carrying out duty for urgent mitigation of consequences of accidents, disasters, fires and other emergency situations (ES), likely cause excessive consumption of the body functional reserves, occurrence of erroneous actions, injuries and even death.Intention is to analyze rates of occupational injuries in personnel of operational units of the EMERCOM of Russia for 10 years (2012–2021).Methodology. Indicators of injuries among personnel (military personnel, employees with special ranks, and other employees) of operational units of the EMERCOM of Russia in 2012–2015 were obtained from the bank of statistical data on morbidity, injuries, disability and death of personnel of the EMERCOM of Russia when performing official duties; in 2016– 2021 – from report forms for the EMERCOM of Russia. Injuries were correlated with activities of the personnel: liquidation of the consequences of emergencies, training, sports and daily activities. Circumstances of injury were grouped by causes as follows: technical, organizational, psycho-physiological and dangerous factors of emergency situations. Rates of occupational injuries were calculated per 10 thousand (×10–4) personnel. This represented risks of personnel of operational units of the EMERCOM of Russia to be injured on the duty. Arithmetic means and their errors (M ± m) are indicated.Results and Discussion. During 2012–2021, 2471 injuries on the duty were reported among the personnel of operational units of the EMERCOM of Russia with rates of occupational injuries (11.57 ± 0.68) • 10–4; for male Russian workers over 9 years (2012–2020) these rates were statistically significantly (p < 0.01) higher (16.89 ± 1.14) • 10–4. Rates of occupational injuries decrease over time. The congruence of injury rates for 9 years is strong, positive and statistically significant (r = 0.816; p < 0.01), which may indicate influence of similar (unidirectional) factors in the development of injuries. In the general group of personnel, technical causes accounted for 2.6% of injuries with an injury rate of (0.30 ± 0.08) • 10–4; organizational ones, 13.9 % and (1.60 ± 0.14) • 10–4, psychophysiological ones, 60.5 % and (6.98 ± 0.47) • 10–4; dangerous factors of emergency situations, 23 % and (2.68 ± 0.30) • 10–4, respectively. Rates of occupational injuries among the EMERCOM of Russia personnel amounted to (4.46 ± 0.38) • 10–4; (2.13 ± 0.18) • 10–4; (4.98 ± 0.46) • 10–4 during operational activities, training and sports, and daily activities, respectively. Proportions and rates of injuries were 66.7% and (11.45 ± 0.83) • 10–4; 3.7 % and (6.37 ± 0.74) • 10–4; 14.2 % and (12.63 ± 1.47)• 10–4; 17.2 % and (12.88 ± 1.01) • 10–4, respectively, among the operational, prevention-oriented, technical and administrative personnel of the EMERCOM of Russia. Occupational injuries among the personnel of operational units of the EMERCOM of Russia amounted to (58.08 ± 7.24) • 10–4 in the rescue military units; (33.16 ± 4.66) • 10–4 in search and rescue and emergency rescue units; (23.90 ± 9.14) • 10–4 in Militarized mine rescue units; (9.19 ± 0.54) • 10–4 in Federal Fire Service; and (4.46 ± 1.42) • 10–4 in State Inspection for small boats.Conclusion. Occupational injuries can become manageable only when all injuries are taken into account and causes and consequences of each injury case are analyzed with participation of labor protection specialists, firefighters, rescuers, engineers, doctors and managers.
Relevance.Despite the decrease in the absolute indicators of emergencies, accidents and catastrophes, and the reduction of related injuries in Russia, there is still a high level of mortality and injuries associated with the impact of external causes, surpassing similar indicators in the leading countries of the world. Therefore, research to optimize the provision of first aid and emergency medical care to the injured is needed.Intention.To conduct a content analysis of domestic articles within the branch of knowledge “Disaster Medicine. Service of Disaster Medicine” and to reveal their scientometric indicators.Methodology.The object of research was an electronic database of domestic publications (scientific articles, reviews and brief reports) indexed in the Russian Scientific Citation Index in 2005–2017.Results and Discussion.During the electronic search, 2431 publications on the disaster medicine were found. The polynomial trend with a high coefficient of determination (R2 = 0.90) showed an increase in indicators. Over the research period, the average annual number of publications was (186 ± 23) articles. The general provisions of the disaster medicine were covered in 10.1 % , tasks and organization of the service of disaster medicine – in 5.8 %. forecasting and modeling of health consequences in emergencies – in 16.6 %, organization of health care – in 25.3 %, medical care and treatment of injured – in 13.5 %, medical control, examination and rehabilitation of rescuers – in 4.1 % , training of specialists in disaster medicine – in 9.4 %, biological problems – in 5.3%, psychiatric and psychological aspects – in 9.9 % of articles. The average weighted impact-factor of the journals in which the articles were published is 0.302, the average number of articles per 1 co-author was 0.40, the average number of citations per article is 1.54, for 1 co-author 0.55, the number articles quoted at least once, 43.8 %, the number of self-citations, 19.2 %, the Hirsch index was 19. The median of the chronology of citations was 4.5 years. Scientometric analysis of articles on leading authors, journals and organizations was conducted.Conclusion. The performed analysis helps to optimize scientific research on disaster medicine. The electronic database of the Scientific Electronic Library provides great information opportunities, for example, on May 12, 2018, 70.5 % of articles within the created collection of publications had the full text, including 60.2% of articles that were provided free charge to registered readers of the library.
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