А ктуальность проблемы. Проблема сохранения здоровья работающего населения является основой социальной политики государства. Конституцией Российской Федерации и трудовым законодательством предусмотрены права работника на безопасные условия труда, получение информации о существующем риске повреждения здоровья. Интегральная оценка факторов производственной среды и трудового процесса большинства медицинских специальностей в соответствии с Руководством Р.2.2.2006-05 [1] по совокупности неблагоприятных факторов рабочей среды позволила оценить условия труда боль
The analysis of the professional incidence of the main nosological forms of professional diseases of workers ofJSC «KAMaz» in 2018
Реферат. Цель исследования-провести оценку эффективности периодических медицинских осмотров в Республике Татарстан за 2016-2018 гг. по данным заключительных актов, предоставляемых в Республиканский центр профпатологии Министерства здравоохранения Республики Татарстан. Материал и методы. Анализ годовых отчетов 45 территорий Республики Татарстан за 2016-2018 гг. Результаты и их обсуждение. Ежегодно периодические медицинские осмотры в Республике Татарстан проходят около 300 536 работников. В среднем охват медицинскими осмотрами составляет 97-98%. В 2018 г. в ходе проведения периодических медицинских осмотров не выявлено ни одного подозрения на профессиональное заболевание в 34 муниципальных образованиях Республики Татарстан (в 2016 г.-в 21, в 2017 г.-в 22). Практически не выявляют профессиональные заболевания частные медицинские организации: из 12 организаций, представивших заключительные акты в центр профессиональной патологии, подозрение на профзаболевание было установлено только в одной организации.
Presented was a review of the literature devoted to allergy to the components of latex among health care workers. Described were three types of reactions to natural rubber latex: (1), contact dermatitis, (2) type I allergic reactions associated with immunoglobulin E, and (3) type IV allergic reactions. Clinical symptoms of latex allergy can manifest as local [contact dermatitis (dermatitis from irritation), allergic contact dermatitis, contact urticaria] and/or systemic (rhinitis, conjunctivitis, difficulty in breathing attacks, widespread urticaria, Quincke’s edema to the extent of an anaphylactic shock) reactions. For the diagnosis of latex sensitization the applicational («glove») test is of particular importance, which consists of controlled wearing of latex gloves for 1 hour or more before the onset of symptoms of skin irritation, local and systemic allergic reactions become evident. Prick test - the most unified, technological and highly sensitive (up to 97% in the diagnosis of latex sensitization) method out of all the skin tests, virtually eliminates the occurrence of nonspecific reactions due to skin irritation or the reactions of its vessels. In the Russian Federation the prick test for the diagnosis of allergy to latex is not yet available, as the latex allergen has not yet been registered. There are publications, indicating the high sensitivity of the nasal provocation test in the diagnosis of latex allergy. The latex-specific immunoglobulin E is mainly detected by the radioallergosorbent test and enzyme immunoassay, sometimes by immunoblotting. The elimination of contact with latex products is the basis of the etiological treatment. The issue of the rational employment of health workers is very relevant. With latex allergy elimination diet is recommended to eliminate the products with cross-allergenic properties with latex: bananas, avocado, kiwi, chestnuts, peaches, tomatoes, shrimp, walnuts, etc. The usage of powder-free gloves with low allergenic potential led to a sharp reduction in the incidence of allergic reactions to latex among health care workers.
Objective. The aim was to assess the impact of production and non-production risk factors on the formation of mental health disorders in chemical workers. Materials and methods. 201 employees of the main and 352 employees of the group of control were examined by a clinical method using a clinical structured psychiatric interview; questionnaires to identify additional non-production risk factors; questionnaire of neurotization. The calculations were carried out in the environment of the statistical system R. For modeling dependencies and calculating probabilities, logistic regression models were built, factor analysis was carried out. Results. The dependence of the formation of prenosological mental disorders in workers on the temporal characteristics, the level of material support and the actual production factors was revealed. The proportion of persons with mental deadaptation MD) in the main group 72.5 %) and the group of control 27.5 %) significantly differ from each other p 0.001). Conclusions. 1. The structure and the actual risk of MD formation among workers in the production of gunpowder is determined by harmful labor factors, depends on economic security, evolves depending on time characteristics. 2. For persons working under the influence of a chemical factor of the production environment in combination with explosive and fire hazardous works, the leading is astheno-vegetative symptomatology in combination with the personality type of conversion reaction. In the first 9 years of experience, general neurotic reactions are observed with a pronounced contribution from all scales, indicating the tension of adaptation mechanisms up to the formation of decompensation. With an increase in the length of time, the reactions are transformed into a conversion type of response according to the somato-vegetative type with a phobic radical and obsessions, and subsequently manifest themselves in relative independence from characterological reactions. 3. The degree of severity of reactions is characterized by variability, significantly overlapping the types of disorders that can be considered in the framework of Other mood disorders F38.0 and F38.1), which does not give grounds to classify them as F30-F34, since they are not sufficiently pronounced and severe.
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