The digital transformation of the economy and society prompts the renewal of methods in occupational health as well. There are outlined fundamentals of the draft revision of the “Guidelines for the Assessment of Occupational Risk to Employee Health. Organizational and methodological foundations, principles and criteria for the assessment». R 2.2.1766-03. The draft contains methods of occupational risk (OR) assessment supplied with information materials and software for working on the Internet in real-time. Algorithms and models for calculating the probability of impairment of health according to data of the Special Assessment of Working Conditions (SAWC) as well as causation algorithms - work-relatedness assessment according to data of periodic medical examinations (PME) for the validity of risk assessment from the standpoint of evidence-based medicine are presented. There are set out methods for calculating the probability of the formation of occupational diseases (OD) of the main nosological forms from the exposure of noise, hand-arm and whole-body vibration, heat and cool microclimate, fibrogenic dusts, physical labor (local, regional and general loads), strenuous work, standing work with the likelihood of varicose lower veins limbs, multi-factor exposure and low-back pain. Risk assessments for the reproductive health of workers are also discussed. The models are based on the documents of the WHO, ILO, ISO, domestic and foreign literature data that meet the principles of evidence-based medicine. The problems of work-related diseases (WRD) - the concept of WHO (1987) -basics of etiology, qualitative and quantitative criteria for causation, models of consensus and evidence-based medicine, as well as projects for integrated work on the detection systems for WRD in the European Union countries are considered. Single-digit indices of working conditions and health problems, moral harm caused to an employee suffering from OD or WRD. Hygienic recommendations to employers on OR management, prevention priorities, the role of personal protection equipment, the basics of corporate health promotion programs, and ethical and economic aspects are described. The calculation methods are provided by the software of the electronic online reference book “Occupational Risk” (URL: http://medtrud.com/) in order to ensure evidence-based decisions of hygienists. In conclusion, a turning point in occupational health is noted: a decrease in the detection of traditional ODs without compensation by the number of OD and WRD from new technologies, materials and risk factors; this problem requires urgent action.
Introduction. Fatigue driving is one of the main causes of accidents. According to statistics, up to 30% of road traffic accidents occur due to driving in a state of fatigue or tiredness. To prevent the onset of accidents and injuries to drivers, it is necessary to study the functional capabilities of employees in order to optimize work modes and justify the duration of the working day depending on age and health group. The aim of the work is to study changes in the psychophysiological state of drivers of light vehicles of different age groups in the dynamics of work shifts. Materials and methods. To assess the work intensity of drivers, an analysis of the indicators of the central nervous and cardiovascular systems was carried out. Assessment of the state of the central nervous system was determined using a blank test with Landolt rings and a complex visual-motor reaction. The state of the cardiovascular system was determined by blood pressure indicators by the Korotkov method, registration of heart rate, the index of functional changes in the circulatory system according to Baevsky was calculated. A hygienic assessment of the heaviness and intensity of the labor process was carried out according to the Guidelines R 2.2.2006-05. Results. According to the results of the hygienic assessment, it was found that the work of drivers of light vehicles corresponds to class 3.1 in terms of heaviness and class 3.2 in terms of the intensity of the labor process. In the dynamics of the drivers' daytime work shifts, a deterioration in the indicators of attention and reaction speed was revealed. It was found that the highly stressful work of drivers negatively affects the indicators of body systems, this is confirmed by high levels of diastolic, systolic pressure and an increase in heart rate during the entire work shift, which exceed the physiological norms of working stress. Conclusion. The data obtained indicate an overstrain of the body of drivers of passenger vehicles in the dynamics of the entire period of their examination, which, with chronic exposure, can contribute to the development of industrial-related diseases of the cardiovascular system. It is necessary to further develop recommendatory documents for specific categories of drivers of light vehicles, containing a system of preventive measures aimed at maintaining their performance during the work shift, which can include both a specialized set of physical exercises, gymnastics for the eyes, and methods of self-regulation and relaxation, used to normalize sleep, relieve stress, restore psychophysiological state, etc.
The papers dwells on the results obtained during fatigue risk assessment as per subjective and objective parameters in civil aviation crew members. Our research goal was to assess fatigue and overfatigue risks as per subjective and objective cardiovascular system parameters and central nervous system parameters in workers with morning and evening biorhythms under neuro-emotional workloads and shift work performed by planes crew members, air traffic controllers, and operators. Our examined workers were mostly people aged 35-45 with working period equal to 5-15 years. Fatigue which occurred during flights was assessed subjectively by crew members questioning as per Epworth Sleep Scale, Karolinska Sleepiness Scale, and crew state control as per Samn-Perelli. Working efficiency was studied via PVT test (psychomotor vigilance test), sleep monitoring, and actigraphy. Circadian rhythms dynamics was examined as per changes in minimal body temperature which aircrew members had. We applied Ostberg's questionnaires to assess biorhythmologic activity type. Workers' functional reserves were assessed via stress testing. We calculated functional changes index to assess functional abilities of the circulatory system and adaptation state during a working shift in workers with various biorhythmologic types. The paper outlines the examination results for physiological reactions appearing in the cardiovascular system and central nervous system of workers with morning and evening biorhythms. We revealed that functional state peculiarities in operators when they performed their work tasks in a shift regime were closely connected with their biorhythmologic activity type. "Early risers" had more adverse physiological reactions during their work activities. We developed ways to lower risks related to fatigue and overfatigue caused by shift work. It was shown that regulatory mechanisms stress occurring in the circulatory system, lower labor motivation, and poorer health in people with the morning biorhythmologic type made it necessary to correct the body functional state during shift work, especially when labor was very intense.
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