To the question of occupational polymorbidity (on the example of the Russian Arctic)

Abstract

Introduction. In recent years the researchers have noted an increase in the number of occupational diseases detected for the first time in one employee of mining and metallurgical enterprises in the Arctic. The study aims to obtain new data on occupational polymorbidity among employees of enterprises in the Arctic zone of the Russian Federation. Materials and methods. We have studied the results of social and hygienic monitoring under the section "Working conditions and occupational morbidity" of the population of the Russian Federation in 2007-2020. Results. Scientists first have diagnosed occupational diseases in 7685 workers in 2007-2020. The authors have identified one nosological form of occupational pathology in 6164 employees (80.2%), two forms - in 1128 employees (14.7%), three forms - in 243 employees (3.2%), four forms - in 92 employees (1.2%), five forms - in 41 employees (0.5%), six forms - 14 employees (0.2%). In addition, one employee had seven diseases, another had eight diseases and the third had nine diseases. The researchers have noted the minimum level of polymorbidity in 2007 (1,013±0.005 cases), and the maximum - in 2012 (1,502±0.040 cases). The highest polymorbidity rates were in charge workers (3,333±0.849 cases), drillers (2,215±0.025 cases) and cleaners of finished products (2,136±0.208 cases), and the lowest - in health workers (1,087±0.054 cases) and civil aviation flight personnel (1,011±0.011 cases). There was no professional polymorbidity among the education workers. Of the nine subjects of the Russian Arctic, the experts have observed the maximum level of polymorbidity in the Murmansk region (1,552±0.021 cases), exceeding the indicators of all other regions. Limitations. There is a possibility of different methodological approaches among occupational pathologists to the diagnosis of occupational pathology in nine remote Arctic regions belonging to four federal districts of Russia. Conclusion. The phenomenon of polymorbidity is due to the combined effect of harmful production factors and a complex of reasons leading to late diagnosis of occupational pathology and, as a result, its progression with the continuation of labor activity. To reduce the level of occupational polymorbidity, it is necessary to improve working conditions, upgrade the skills of occupational doctors and use additional research methods that allow to objectify the early clinical manifestations of diseases.

Occupational multimorbidity in the nickel industry workers

“…In recent years, a significant increase in the number of concurrent occupational diseases in one employee in the Russian Arctic has been reported and was also classified as “occupational multimorbidity” [ 14 ]. This fully applies to the Russian nickel industry, mainly located in the Krasnoyarsk Territory and the Murmansk Region [ 15 ].…”

“…Unlike general medicine, this phenomenon has not yet attracted the attention of occupational medicine doctors and occupational safety specialists, yetremaining undoubtedly important [ 14 ]. However, as in general medicine, multimorbidity in the occupational medicine reflects the unfavourable disease, which manifests with the spread of pathology beyond the target organ to other organs and systems resulting associated with occupational hazards.…”