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. Professional firefighters are exposed to high levels of physical and emotional stress which impacts their functional reserves and makes the susceptible to erroneous actions and occupational traumas. The objective is to assess the decade-long (2012 to 2021) risk of occupational injuries and to establish its correlation with nosologies of external causes under Chapter XIX of the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10).Methods. We analyzed occupational injuries across different categories among Federal Fire Service (FFS) officers of the EMERCOM of Russia (emergency response squads, prevention, technical and administrative workforce), their causes (technical, organizational, psychophysiological and hazardous fire-related factors), and performed occupational activities (firefighting, training, sport or daily activities). Based on the ICD-10, injury risks and exposure of particular body areas to external factors were calculated per 10,000 people according (×10–4).Results and Discussion. Over a 10 year’s timespan, 1,769 occupational injuries have been registered among Federal Fire Service officers EMERCOM of Russia. The occupational injury rate for firefighters was (9.19 ± 0.54)•10–4 injuries/(person•year), which was statistically significantly lower (p < 0.001) than for male workforce employed in Russian economy sectors – (16.50 ± 1.09)•10–4. The overall average diagnose per injury rate was 1.5, including 1.7 in firefighting and other emergency response activities, 1.4 in combat training activities, and 1.5 in routine activities. The weighted average risk of body injuries was (11.96 ± 0.89)•10–4 injuries/(person•year); in particular, cumulative injury risk rate was (10.01 ± 0.83)•10–4 responsible for 83.6% of the total value, with burns (1.39 ± 0.23)•10–4 (equal to 11.6%), poisoning by combustion products (0.39 ± 0.09)•10–4 (equal to 3.3%), heat fainting (0.18 ± 0.04)•10–4 (equal to 1.5%) respectively. The congruent risk trends for occupational injuries, industrial head and body injuries, including burns, are positive and statistically significant, which suggests the trends are driven by identical (unidirectional) parameters. For determination coefficients of different significance, the polynomial trend of body injuries risk shows a downward trend of data reduction; the risk of burns resembles an inverted U-curve; while the risk of poisoning by combustion products demonstrates an increase in indicator values. Risks of injuries to the head (S00–S09 in ICD-10) showed rank 1 of significance among occupational body lesions in the entire cohort of firefighters, reaching the level of (2,49 ± 0,32)•10–4 injuries/(person•year) equal to 20.8 % of all occupational injuries; knee and shin injuries were assigned rank 2 (S80-S89) – (1.87 ± 0.24)•10–4 equal to 15.6 %; ankle and foot area were assigned rank 3 (S90–S99) – (1.11 ± 0.15)•10–4 equal to 9,3 %; rank 4 injuries were injuries of the thorax (S20–S29) – (0.91 ± 0.13)•10–4 equal to 7.6 %; wrist and hand injuries were assigned rank 5 (S40–S49) – (0.88 ± 0.07)•10–4 equal to 7.4 % respectively. Overall, these body traumas amounted to 60.7 % of all occupational injuries of external causes. In the genesis of damages of body areas of firefighters during occupational injury, the leading place is given to head injuries, which contribute to loss of balance and create conditions for falling, as a result of which other areas of the body are injured. The analysis of occupational injuries and nosologies across different workforce categories was effectively performed taking account of injury causes and types of activity.Conclusion. The analysis of cause-and-effect relations of all injuries among heads of subdivisions, occupational safety officers, fire engineers, firefighters and doctors allows to improve prevention of occupational injuries among officers of the Federal Fire Service of EMERCOM of Russia.
Relevance. Occupational Safety and Health Management System (OSHMS) should be improved and regularly adjusted based on continuous analysis of hazards and current risks.Intention. Development of approaches to determining the permissible level of risks to the personnel of the Federal Fire Service (FPS) of the EMERCOM of Russia when performing occupational duties.Methodology. Cases of injuries were analyzed in the staff of the FPS when performing occupational duties. Relative frequencies of injuries were calculated in the personnel of the FPS as follows: light damage (the number of days of temporary disability ≤ 3), moderate damage (the number of days of temporary disability from 4 to 30) and severe damage (the number of days of temporary disability more than 30, the onset of disability or death). Associations between injuries in the personnel of the FPS and the complexity of fires were assessed, including amount of the fire extinguishers used.Results and Discussion. It is proposed to allocate two levels of acceptable risk of injury for the personnel of the FPS when performing official duties: the maximum risk and acceptable risk. Estimates of acceptable and maximum risks of injury to personnel of the FPS were obtained using the relative index of the frequency of injuries to personnel: acceptable risk estimates R acceptable = (5 ± 1) • 10–5 and maximum risk estimates Rmaximum = (4,4 ± 0,3) • 10–4. It is proposed to use the values of acceptable risks of personal injury adjusted for the complexity of fires extinguished to assess the effectiveness of the OSHMS in fire protection units. Options for decision-making in the framework of the Occupational Safety and Health Management Systems, depending on the actual level of injury to personnel in the performance of official duties, are considered.Conclusion. The proposed model for assessing the effectiveness of the OSHMS is based on the planning of OSHMS activities depending on the degree of implementation of the OSHMS procedures and the risk of injury to the personnel of the FPS of EMERCOM of Russia in the performance of official activities.
Relevance.Profession of firefighters is considered to refer to extreme activities, which have high risks of health disorders, injuries and even death.Intention– to analyze occupational traumatism and deaths from injuries in Russian State Fire Service (SFS) (1996–2004) and the Federal Fire Service of EMERCOM of Russia (2005–2015) employees for 20 years and to compare these data with the indicators of Russian workers.Methods.Information on occupational traumas and deaths of employees and response personnel of Russian SFS was gathered. The annual number of examined firefighters of special military ranks (officer, warrant officer, sergeant, common soldier) was (108.8 ± 6.2) thousand people, which was not less than 80 % of personnel of Russian SFS. The levels of occupational injuries, deaths from occupational injuries of Russian workers, mortality in the XIX Chapter of the International Statistical Classification of Diseases and Health Problems, 10th edition (ICD-10) of men of working age in Russia were received from the official website of the Federal Agency for Statistics. Database «FDB «Fires» was used for the distribution of fires in Russia over time periods. The dynamics of indicators of health disorders of firefighters and of fire distribution was evaluated by the method of time series analysis, which used a polynomial trend of the 2nd order.Results and Discussion.The average annual level of occupational traumatism in 20 years (1996–2015) in Russian SFS staff amounted to (3.795 ± 0.390)‰, in response staff for 1999–2015 – (5.295 ± 0.644)‰. The level of occupational traumatism among Russian workers during these periods was (3.410 ± 0.351) and (3.000 ± 0.318)‰ respectively, which is significantly less than that of the response personnel (p < 0.05). A positive statistically significant relationship between the number of injuries and combat performances (r = 0.51; p < 0.05), the number of injuries and accident rate in the staff of Russian SFS with the complexity of fire-fighting tasks and number of use of personal respiratory protection (r = 0.53 and r = 0.46, respectively, p < 0.05). The cyclical nature of risks of traumatism in response staff of Russian SFS, depending on hours of the day, days of the week and months of the year, due to the nature of combat performance and other professional factors was found. This phenomenon requires additional research. The mortality rate of SFS staff from occupational injuries in 1996–2015 was (0.125 ± 0.011)‰, response personnel – (0.149 ± 0.014)‰. The mortality rate of Russian workers was statistically significantly less (0.116 ± 0.007)‰ compared to the response personnel (p < 0.05). There are decreases in occupational traumatism and deaths from occupational injuries in SFS staff and Russian workers.Conclusion.In general, level of occupational traumatism and mortality from occupational injuries in employees and response personnel of the Russian SFS can be comparable with level revealed among the Russian workers. It indicates, on the one hand, the effective organizational and technological measures for the prevention of occupational injuries and the death of firefighters, and, on the other hand, high level of occupational traumatism of the Russian workers.
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