Actual problems of prevention of production-caused pathology
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The risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies
Introduction. Heart disease has remained the leading cause of death in the world for the past 20 years. The development and progression of cardiovascular diseases, along with genetic, somatic, behavioral, socioeconomic, environmental, and other risk factors, are significantly affected by unfavorable industrial and professional aspects: physical-vibration, noise, temperature disturbance; ergonomic - inactivity, and monotonous work, physical overstrain, chemical, biological, stress, etc. The primary pathogenetic mechanism leading to the development of CHD and fatal complications - myocardial infarction, strokes, thrombosis, and other diseases of the cardiovascular system is atherosclerosis. The study aimed to assess the risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies Materials and methods. An in-depth examination of the health status of 50 employees of the service for the operation of radio equipment and communications was conducted. Blood serum levels of glucose, cholesterol, triglycerides, HDL, and LDL were determined, and the atherogenicity index was calculated. The probability of total risk of cardiovascular complications and five-year cardiovascular risk was calculated for all the examined patients according to the European SCORE scale and the ASCORE rating scale. The "Vascular age" was also calculated. Results. Based on the analysis of lipid metabolism indicators, a high cardiovascular risk was identified in 40% of the examined patients. Increased values of the atherogenicity index were already observed in middle-aged people (45-60 years). Analysis of the data obtained using the SCORE and ASCORE assessment scales revealed a high risk of developing cardiovascular complications in middle-aged (45-60 years) and elderly (61-74 years) individuals. The excess of the vascular age in comparison with the real (passport) age was established in middle-aged (45-60 years) and elderly (61-74 years) individuals, on average, 7 (p<0.001) and 5 (p=0.026) years, respectively. Conclusion. The most pronounced changes in lipid metabolism and the risk of cardiovascular risk were in people of the most working age (45-60). In this regard, it is necessary to develop preventive measures aimed at cardioscreening to detect early signs of health disorders, prevent the development of cardiovascular complications, and the formation of groups at increased risk of diseases.
The risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies
Introduction. Heart disease has remained the leading cause of death in the world for the past 20 years. The development and progression of cardiovascular diseases, along with genetic, somatic, behavioral, socioeconomic, environmental, and other risk factors, are significantly affected by unfavorable industrial and professional aspects: physical-vibration, noise, temperature disturbance; ergonomic - inactivity, and monotonous work, physical overstrain, chemical, biological, stress, etc. The primary pathogenetic mechanism leading to the development of CHD and fatal complications - myocardial infarction, strokes, thrombosis, and other diseases of the cardiovascular system is atherosclerosis. The study aimed to assess the risk of developing cardiovascular complications in employees who operate and maintain communication facilities based on wired and wireless technologies Materials and methods. An in-depth examination of the health status of 50 employees of the service for the operation of radio equipment and communications was conducted. Blood serum levels of glucose, cholesterol, triglycerides, HDL, and LDL were determined, and the atherogenicity index was calculated. The probability of total risk of cardiovascular complications and five-year cardiovascular risk was calculated for all the examined patients according to the European SCORE scale and the ASCORE rating scale. The "Vascular age" was also calculated. Results. Based on the analysis of lipid metabolism indicators, a high cardiovascular risk was identified in 40% of the examined patients. Increased values of the atherogenicity index were already observed in middle-aged people (45-60 years). Analysis of the data obtained using the SCORE and ASCORE assessment scales revealed a high risk of developing cardiovascular complications in middle-aged (45-60 years) and elderly (61-74 years) individuals. The excess of the vascular age in comparison with the real (passport) age was established in middle-aged (45-60 years) and elderly (61-74 years) individuals, on average, 7 (p<0.001) and 5 (p=0.026) years, respectively. Conclusion. The most pronounced changes in lipid metabolism and the risk of cardiovascular risk were in people of the most working age (45-60). In this regard, it is necessary to develop preventive measures aimed at cardioscreening to detect early signs of health disorders, prevent the development of cardiovascular complications, and the formation of groups at increased risk of diseases.
Morphometric and genetic studies of the mechanisms of damage to the cardiovascular system in Kuzbass miners with dust lung pathology
Introduction. The combined impact of unfavorable factors of the production environment in miners leads to the development of associated pathology of the bronchopulmonary and cardiovascular systems, the predisposition to which depends on the individual susceptibility of the body. In this regard, it is important to comprehensively study the pathogenetic mechanisms underlying the formation and course of occupational and work-related diseases for a personalized approach to the diagnosis, prevention and therapy of this pathology. The purpose of this study was to study the mechanisms of damage to the cardiovascular system in miners with dust lung pathology on the basis of morphological and genetic studies. Materials and methods. For genetic studies, venous blood drawing was conducted in 190 Kuzbass miners. The main group included 126 miners of the main professions with the previously proven diagnosis "dust lung pathology", the comparison group consisted of 64 workers without a proven diagnosis working in similar sanitary and hygienic conditions. Morphometric studies were carried out using autopsy material obtained during 80 forensic medical examinations of miners in the Kemerovo region. All the miners were divided into 4 groups depending on their underground work experience. The control group was formed from 20 cases of forensic medical examinations of men who died in road accidents and did not have organ pathology according to the results of autopsies. Results. The study of the autopsy material revealed the presence of morphostructural changes in the vascular walls of the miners’ hearts in the form of hypertrophy of the smooth muscle cells of the medial layers, thickening of the endothelial lining, and the development of fibroplastic changes in the perivascular zones. These changes began to form from the first years of work in the underground conditions and progressed with increasing work experience contributing to the "recalibration" of the heart vessels with the formation of the lumen "obstruction". One of the mechanisms of endothelial damage in miners was a change in the expression of the EDN1 gene, which regulates the synthesis of endothelin-1. The risk and resistance genotypes of the development of dust lung pathology for the rs5370 polymorphism of the EDN1 gene were identified. Morphostructural rearrangement of the endothelium in the combination with its pathological activation contributed to the occurrence of endothelial dysfunction in miners. Conclusions. The conducted studies of the parameters of the vascular endothelium indicate its key role in the pathogenesis of bronchopulmonary and cardiovascular pathology in miners of the main professions. Getting into the body of workers, particles of coal-rock dust lead to morphostructural rearrangement of the cells of the endothelial layer and its pathological activation. The contribution of molecular and genetic mechanisms to the development of occupational lung pathology and associated diseases of the circulatory system in miners is revealed. Ethics. The studies were carried out in compliance with the ethical standards of the Bioethical Committee of the Research Institute for Complex Problems of Hygiene and Occupational Diseases, elaborated on the basis of the Helsinki Declaration of the World Medical Association "Ethical Principles for Conducting Human Scientific Medical Research" as amended in 2013 and the "Rules of Clinical Practice in the Russian Federation" approved by the Order of the Ministry of Health of the Russian Federation No. 266 dated 19.06.2003. All workers were informed about their participation in the molecular-genetic study and gave written consent to carry it out. The research of the dead miners was based on the secondary examination of blocks and ready-made histological micro-preparations of the material of the Bureau for Forensic Medical Expert Examination of the cities of Novokuznetsk, Osinniki, and Prokopyevsk. The study of pathomorphological material was carried out in accordance with the Federal Law of 21.11.2011, No. 323-FZ "On the Fundamentals of Health Protection of Citizens in the Russian Federation", in particular, with Article 67 "Carrying out pathological and anatomical autopsies", Federal Law of 12.01.1996, No. 8-FZ "On burial and funeral business" (Article 5, paragraphs 1, 2), as well as on the basis of the Order of the Ministry of Health of April 29, 1994, No. 82 "On the procedure for conducting pathological and anatomical autopsy" (Annex to the Order of the Ministry of Health and Medical Industry of 29.04.1994 No. 82), the Order of the Ministry of Health of Russia of 24.03.2016. No. 179n "On the rules for conducting pathological and anatomical examinations".
Occupational risk of developing chronic non-communicable diseases in bearing production workers
Introduction. Prevention of chronic non-communicable diseases, maintaining health and prolonging the occupational longevity of the working population is the most important strategic direction of the state policy of the Russian Federation in the field of public health The purpose. Stratification of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings for the subsequent development of specialized targeted programs for the prevention of health disorders. Material and methods. An assessment of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings is given on the basis of complex studies of production factors, primary and general chronic morbidity using the methodology for assessing occupational health risk. Results. It has been established that the development of chronic non-infectious diseases in bearing production workers is determined by a complex of harmful (classes 3.2–3.4) factors of the working environment of various nature, which form an occupational health risk in categories from medium to very high. In the structure of the general chronic non-infectious morbidity of workers, diseases of the eye and its adnexa (24.4%), diseases of the musculoskeletal system and connective tissue (20.7%), diseases of the circulatory system (19.32%) and diseases of the endocrine system had the highest prevalence in systems of eating disorders and metabolic disorders — 15.1%. A causal relationship of varying severity with the work of the most common nosological forms of chronic was revealed as arterial hypertension (RR = 1.425; EF = 29.837%; C = 1.044–1.945), obesity (RR = 1.731; EF = 42.24%; CI = 1.219–2.459), presbyopia (RR = 2.443; EF = 59.071%; CI = 1.549–3.855), indicating their occupational conditioning. Limitations. The limitation of the study was the assessment of the occupational risk of developing chronic non-communicable diseases in one occupational cohort of workers. Conclusion. The development of specialized programs for the prevention of chronic non-communicable diseases among workers should include the study of causal aspects of health disorders and the rationale for measures to minimize the impact of occupational risk factors for occupationally determined pathology.
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