In the article there are presented the methodological approaches to the diagnosis, treatment and prevention of diseases associated with the exposure to environmental factors, based on the principles of risk assessment of existing risk factors, confirmed exposure, identification of biomarkers of effect with the use of cellular-molecular, proteomic and nanotechnology, the results of clinical and functional research, analysis of the system relationships, exposure markers with markers for the negative response. Sanitary-hygienic, epidemiological, clinical, functional and laboratory criteria underlying the proposed classification of specialized medical preventive technologies for risk management, allow to make a differential diagnosis of diseases associated with the exposure to environmental factors according to their severity and stage of clinical manifestation, identify target groups ofpopulation to provide them specialized treatment and preventive care, determine the volume, direction, content and form of implementation of curative and preventive measures.
There was executed a 6-years cohort study of 65 children divided into an observation group comprising of 45 cases residing in the conditions of atmosphere air contaminated by a complex of chemical substances of technogenic origin (suspended solids, phenol, formaldehyde), and a comparative group (20 children) from the area with beneficiary sanitary-hygienic conditions. In conditions of the impact of these chemical substances in children reaching of the age of 7-10 years the prevalence of allergic rhinitis and vegetative disorders was established to increase by 1.2-1.9 times, and the risk of getting sick with bronchial asthma is growing by more than twice; by 11-14 years the risk of spreading of allergic rhinitis is additionally growing by 1.4 times against the background of the decreasing in the probability of forming of chronic lympho-proliferative processes of nasopharynx and secondary immunodeficiency. The frequency of the development of vegetative dysfunctions increases twice over the 6 years period in children residing in conditions of persistent aerogenous combined impact of suspended solids, phenol and formaldehyde.
Sanitary and hygienic analysis of drinking water quality was carried out and health risk assessment of the population living in the industrial areas of the Perm region and consuming drinking water with high content of organochlorine compounds (Tetrachloromethane to 3.7 MPC, chloroform to 2.8 MPC). In the conditions of oral exposure to COC in the population formed unacceptable non-carcinogenic risk of endocrine system pathology (HI = 1.72, due to the influence of chloroform (85.7 %). In exposed children with high concentrations of chloroform and Tetrachloromethane in the blood, endocrine system pathology was diagnosed 2,0–2,4 times more often, the relative risk of obesity (E66.0) and redundant power supply (E67.8) 2.4 times higher than the indicators of the comparison group. A reliable causeand– effect relationship between the development of metabolic disorders (obesity and overweight) and the consumption of drinking water with high content of chos (OR = 2,4; DI = 1,05–6,8) was established; the proportion of the explained variance was R2 = 0,3–0,34; 85,4 ≤ F ≥ 112,8; p < 0,001. As features of the development of metabolic disorders in the population for a long time consuming drinking water with high content of chos (Tetrachloromethane, chloroform) revealed a sharp disharmony of physical development, early formation of excess body weight and obesity, an increase of 1,4–1,6 times the level Of C-peptide and leptin in the blood, insulin resistance index HOMA-IR, (p < 0,05).
Deep mining is widely spread in Russia; therefore, it is truly vital to determine how labor resources in the branch can be preserved. Adverse working conditions cause elevated risks of not only occupationally induced diseases, but also production-related ones, make medical and social consequences of such diseases even worse, and result in a decrease in overall labor potential of a society. Miners’ working conditions are ones of the most adverse. When participating in technological processes, workers are exposed to a set of adverse and dangerous industrial factors, both common for any deep mining and specific ones related to a type of mineral resources which are mined. We performed a complex assessment of working conditions existing in deep mining of chromic ores in order to detect risks of chronic diseases for miners as well as to determine an extent to which such diseases were production-related. We revealed that working conditions for miners involved in chromic ores mining were associated with joint negative effects exerted by physical and chemical factors of the working process; as per this combination of factors, they can be assigned into “adverse working conditions with 3–4 hazard degree” category. Workers involved in deep mining at chromic mines ran 1.5–5.2 times higher relative risks of cardiovascular system diseases, respiratory system diseases, endocrine system diseases, and hearing organs diseases, than personnel employed at mines but dealing with production processes on the surface. Nervous and respiratory system diseases, endocrine pathologies, and hearing organs diseases in miners employed at chromic mines were to a great extent production-related while cardiovascular system diseases less significantly depended on industrial factors.
In the course of studying the impact of metal compounds on the functioning of the endocrine system and adaptation systems in children living in chronic low-level multi-environmental (atmospheric air, drinking water) effects of a complex of metals, the elevated content of lead, manganese, nickel, cadmium and chromium was established to be 1.5 - 9.4 times higher than the reference level and 1.3 - 2.2 times than indices of the comparison group). In this contingent, disorders of the physical development and malnutrition (ICD: E44-46) were detected by 1.2 - 1.7 times more often than in conditions of sanitary and hygienic well-being. In the course of the analysis of the effectiveness of methods of correction in children of physical development disorders and malnutrition (E44-46) associated with the effects of metals, there was shown the high efficiency of the complex application of elimination, membrane stabilizing, antioxidant and nootropic technologies, with methods of physiotherapy (Ultrasound therapy, inductothermy) and exercise therapy. With comparable economic costs with traditional approaches, the proposed correction technologies demonstrate a significant benefit (up to 3.3 times) for the economy of the country and the region. The prevented losses for Gross Domestic Product (GDP) for the observation group are 13246.0 rubles per person per year (2.25 rubles per 1 ruble of costs, in contrast to 0.7 rubles when using standard methods).
Introduction. Harmful working conditions, specific for titanium production enterprises, pose a potential risk to the workers health, and, primarily, concerning the development of respiratory pathology. Material and methods. The observation group consisted of 111 smelters of titanium alloys; the average age is 35.9 ± 2.7 years; the average term of service is 11.4 ± 6.3 years. The comparison group included 47 representatives of the enterprise administrative apparatus of the same age (37.4 ± 1.5, p> 0.05), having an average work experience of 12.8 ± 2.3 years (p> 0.05). The analysis of medical documentation, working conditions, a comprehensive survey of workers, static processing of the results was carried out. Results. Working conditions at workplaces for smelters are classified as “harmful”, the degree of harmfulness acconted of 3-4 (the class of working conditions 3.3 - 3.4). In the structure of the overall morbidity of the examined observation group, respiratory pathology ranked first and was characterized by a high degree of production causality (RR = 2.90; 95% CI = 1.81-4.64; EF = 65.49%). According to the ECHO-DKG data, 10.8% of titanium alloy smelters with 12.3 ± 3.5 years of experience had thickening of the interventricular septum, increased pressure in the pulmonary artery and the presence of right ventricular diastolic dysfunction. Discussion. Smelters have chronic catarrhal inflammation of the mucous membranes of the upper respiratory tract in the first year of operation; the activity of the pathological process increases significantly with the experience of 10 years and is accompanied by the predominance of the hyperplastic nature of inflammation with an increase in work experience of more than 10 years. Subsequently, the lower parts of respiratory tract are involved in the process. With an experience of 12.3 ± 3.5 years, reversible violations of the bronchial patency become persistent irreversible, which is accompanied by the development of basal emphysema of the lungs and morphological restructuring of the right heart. Conclusion. Because of combined long-term exposure to dust, a fine fraction and compounds of chlorine and chlorine vapor, causes the damage of the airways at all levels of the respiratory tract.
The article presents the study results conducted to study the level and structure of children morbidity of preschool age living in the territories in zone of influence enterprises for metallurgical alumina production. We obtained data indicating the formation of residential areas where the multiplicity exceeding of MPCad on aluminum, formaldehyde, fluoride compounds, phenol, benzo (a) pyrene, suspended matter in atmospheric air is 1.16-43.6 times and on aluminum, nickel and manganese in drinking water is 1.25-42.2 times. We found that the content of chemical compounds (aluminum, manganese, chromium, nickel, phenol, formaldehyde, and ion fluoride) in the biological media of children of the observation groups was up to 4.2 times higher than those of the children of the comparison group. The morbidity of respiratory diseases, diseases of the blood, hematopoietic organs and disorders involving the immune mechanism, diseases of digestive, musculoskeletal and nervous systems in children living in the area of anthropogenic influences, up to 8.0 times higher than those of children living in the territory in the absence of enterprises influence. We proved the dependence of the registration frequency of the revealed pathology on the concentration in biomedia of chemicals (aluminum, copper, manganese, chromium, nickel, phenol, formaldehyde and ion fluoride), tropic to the organs of the respiratory, digestive, nervous and musculoskeletal systems.
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