The main factors of the working environment that harm a woman’s health in the course of work are considered to be physical exertion and functional overstrain, noise, chemical and biological factors, and microclimate. The most unfavorable sectors of the economy in the Republic of Bashkortostan are manufacturing, construction and the agricultural sector, where the largest number of jobs are registered that do not meet the hygienic standards for the above-mentioned production factors, which undoubtedly serves as the main cause of the development of occupational diseases among women. Material and methods.According to the medical records of the inpatient patient, the acts on the case of occupational disease and the registration form No. 30, the etiological causes and the structure of occupational morbidity by industry sectors of the Republic of Bashkortostan among women for 2016–2020 were studied. Results. Among the subjects of the Russian Federation, the Republic of Bashkortostan for the analyzed fiveyear period ranked 25–27th in terms of employment of women in jobs with harmful and (or) dangerous working conditions, and among the 14 regions of the Volga Federal District — 3–5 places. If in the period 2016–2019 among all the primary established occupational diseases from 32.4 to 43.0 % were women, then by 2020 more than half of all occupational diseases (54.7 %) were detected among women. Of the 114 cases of occupational diseases identified to 85 female workers, a third of them worked in health care (32.9 %), a slightly smaller part (30.6 %) — in mechanical engineering (manufacturing) and a fifth — in the agro-industrial complex (21.1 %). The leading place in the structure of occupational pathology of women was occupied by diseases associated with high physical overload and overstrain of individual organs and systems (54.2 %). The reason for the change in the structure of occupational diseases in the region in 2020 there was a new coronavirus infection-Covid-19 in medical workers, which brought diseases from the influence of a biological factor to the second position. Conclusion. The state of working conditions and occupational morbidity among women workers indicates the lack of an effective mechanism for protecting women’s labor and the need to develop effective legislative documents for the protection of their labor and health.
Introduction. The working population health is the basis of human capital, which is a factor in the country’s sustainable economic development. The conditions of occupational activity rank first in the structure of health factors of a working person. Materials and methods. The working conditions and the structure of the newly identified occupational morbidity at a metallurgical enterprise located in the territory of the Republic of Bashkortostan are analyzed based on statistical reporting documents on newly established occupational diseases for the period 2011-2019 and the hygienic characteristics of labour assessment presented by Rospotrebnadzor specialists with suspicion of an occupational aetiology of the diseases. Results. Over the past number of years, workers in manufacturing industries of the Republic of Bashkortostan (RB) have been diagnosed annually from 2.16 to 6.76 cases of occupational diseases per 10 thousand workers, which makes it possible to attribute these industries to a high level of occupational risk. Over the past decade, 117 cases (11 to 26 cases per year) of occupational diseases were detected at the enterprise for the first time. In the structure of nosological forms, musculoskeletal system diseases and connective tissue rank first. Limitations of the study. The limitation of this study is the lack of complete information about working conditions in the presented sanitary and hygienic characteristics. In recent years, there has been a decrease in registered occupational morbidity against the background of minor changes in working conditions. The identification of occupational diseases is often associated with the level of competence of employees of medical institutions who examine the relationship of the disease with the occupation and certain attitudes of the employee and employer. Conclusion. The working conditions of metallurgical workers are characterized by the impact of a complex of occupational factors, the leading of which is the intensity of the work process. The working conditions of this process are considered to be harmful Class 3 (3.3). Between 2011 and 2019, the link between the disease and occupational activity was established in 117 cases, mainly in workers (wire drawers, wire winders, repairmen, metal sorters) experiencing significant physical dynamic loads.
Occupational diseases associated with pain syndrome in the lower part are one of the most common causes of physical and psychological health disorders. Lower back pain (LBP) also affects labor productivity and the social sphere of life and is becoming an increasingly important factor in the growth of medical care costs. The study aims to research a comprehensive study of the impact of chronic LBP on the quality of life of workers in unfavorable conditions of metallurgical production. Experts have carried out a hygienic assessment of working conditions according to the data of the special assessment of working conditions cards, a questionnaire (a questionnaire of disorders of vital activity in Oswestrovsky's lower back pain, a questionnaire of McGill's pain) and a clinical examination of 132 employees (men) of various industries of the metallurgical enterprise. We analyzed the results of additional instrumental examination methods: radiography of the lumbar spine and electroneuromyography of the nerves of the lower extremities. Under the working conditions of workers of the leading professions of metallurgical production, combined and combined effects of harmful production factors are characteristic, the integral assessment of which corresponds to class 3.2. The severity of the labor process among employees of the studied professions was within classes 2.0.-3.1. According to the McGill questionnaire experts have found statistically significant differences in the main occupational groups: the highest pain indicators were in the group of wire-drawing workers (index - 7.5±4.9; rank - 14.6±10.2) and drivers of intra-factory vehicles (index - 6.9±4.4; rank - 15.1±11.3). After the treatment there were positive dynamics in the values of rank indicators on the affective and evaluative scales (p<0.05). Researchers have identified statistically significant differences between all the studied groups (F=2.55, p=0.041), when using the Oswestrovsky questionnaire. There were degenerative-dystrophic changes of the spine on radiographs of the lumbar spine. According to the results of an electroneuromyographic study, the authors revealed signs of dysfunction at the level of segments L5-S1-2 of the lumbosacral spine. As a result of the study, we have revealed the relationship between the early detection of disorders of the musculoskeletal system with the peculiarities of the labor process and the deterioration of the quality of worker’s life in the production of hardware. To assess the intensity of LBP in workers engaged in harmful working conditions, it is possible to use the McGill and Oswestrovsky pain questionnaires. The detection of pain syndrome and early rehabilitation in people with occupational diseases of the musculoskeletal system contributes to prolonging the working age and improving the quality of life in people with physical overload in the workplace.
The prevalence of occupational diseases and poisoning at work is one of the important indicators of the health of workers engaged in harmful and dangerous jobs. In 2012, the Order of the Ministry of Health and Social Development of the Russian Federation No. 417n dated April 27, 2012 "On approval of the list of occupational diseases" was issued, which implied, when solving issues of examination of the connection of occupational diseases with industrial activity, orientation to the 10th version of the International Classification of Diseases. In 2018, the World Health Organization published the 11th version of the International Classification of Diseases, which officially comes into force on January 1, 2022. Decree of the Government of the Russian Federation No. 2900-r of October 15, 2021, approved an action plan for the implementation of the eleventh revision of the International Statistical Classification of Diseases and Health-Related Problems (ICD-11). To date, the ICD is recognized as a standard for statistical accounting in the healthcare system, the basis for the formulation of clinical diagnosis, as well as the encoding of recorded data obtained during the analysis of morbidity, causes of injuries and harmful effects, cases of rare diseases, anatomical and histopathological data, assessment of the severity of conditions, professional or sports activity, the need to provide medical products, medicines, etc. There is no unequivocal opinion on the adaptation of the ICD-11 codes and this topic requires further study, but the transition of work on the new classification is only a matter of time. Thus, in this article we would like to consider the issues of the ICD-11 codes of occupational diseases, which can be used in relation to the most common diseases associated with the effects of industrial chemical and physical factors, as well as physical overload and functional overstrain of individual organs and systems. The main sections highlighted in the ICD-11 for various occupational diseases, on the one hand, reflect to a greater extent various pathological conditions associated with the effects of physical factors, but on the other hand, they do not fully represent diseases associated with the effects of industrial factors of chemical etiology. When switching to the 11th version of the International Classification of Diseases, occupational Pathology may face difficulties, since not all clinically important syndromes of occupational diseases are presented in the ICD-11. In this regard, it seems important and relevant to discuss this issue. Ethics. In preparing this article, no personal data of patients was used and no studies were conducted on laboratory animals. All used normative documentation is placed in the Garant system. The performed analysis, presented in the materials of the manuscript, corresponds to the generally accepted norms of morality and does not pose a risk.
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