Lyudmila M. Bezrukavnikova

Introduction. The profession of a subway train driver places high demands on the physical health and mental state of the employee. A sudden deterioration in the driver's health can trigger an emergency situation that poses a threat to the lives of passengers, so regular monitoring of the health status and analysis of the morbidity pattern of electric train drivers in the subway are of paramount importance. The study aims to analyze the prevalence of general somatic diseases, identify the main nosological forms, and evaluate the overall health status of metro drivers based on data from periodic medical examinations. Materials and methods. Specialists have conducted a clinical and laboratory examination of 2,642 electric train drivers (men) of Moscow Metro State Unitary Enterprise as part of preventive medical examinations in the clinic of Izmerov Research Institute of Occupational Health. Results. Among the drivers of electric trains, 89.7% had one or more somatic pathologies, of which the main ones were respiratory diseases, diseases of the ear and mastoid process, and diseases of the cardiovascular system. 87.4% of the surveyed needed constant dispensary supervision, 74.1% needed further outpatient examination and treatment, and 9.2% needed sanatorium treatment. A significant (p<0.05) violation of carbohydrate metabolism and indicators of the functioning of the cardiovascular system was revealed in workers with more than 20 years of experience compared with groups with less than 10 years of experience and 10–19 years of experience. Arterial hypertension is significantly more common in employees with more than 20 years of experience than in employees with less than 10 years of experience (p=0.043). Limitations. The drivers of electric trains were examined only by the State Unitary Enterprise "Moscow Metro". Conclusion. The results obtained indicate the presence of changes in the cardiovascular system of electric train drivers under prolonged exposure to adverse factors, which necessitates a more detailed and specialized diagnosis of cardiovascular pathology in order to preserve the longevity of this category of workers. Ethics. The study was conducted in compliance with ethical standards for conducting medical research involving humans in accordance with the requirements of the Helsinki Declaration of the World Medical Association. All the surveyed signed a voluntary informed consent to participate in the study. The study was approved by the conclusion of the local Ethics Committee of Izmerov Research Institute of Occupational Health (minutes of the meeting of the Ethics Committee of Izmerov Research Institute of Occupational Health No. 8 dated 11.11.2020).

Introduction. Lead is one of the proven risk factors for developing cardiovascular diseases, which is determined by its effect on vascular tone, lipid and carbohydrate metabolism, as well as the activity of the inflammatory process, and therefore monitoring of metabolic parameters is an important component of preventive measures for workers in contact with lead and its compounds. The study aims to analyze changes in carbohydrate and lipid metabolism in employees of a lead-acid battery processing plant to select informative markers for assessing cardiovascular risk. Materials and methods. The main group consisted of 62 men working at a lead-acid battery recycling plant with 8 (4; 10) years of experience. The control group consisted of 30 men who worked outside of contact with harmful industrial factors. The laboratory examination included the determination of blood lead levels, ALA in urine, carbohydrate (glucose, insulin) and lipid (cholesterol (HC), high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, apolipoproteins A1 and B, lipoprotein (a)) metabolism. Non-HDL cholesterol, atherogenicity index (IA), apo B/apo A1, TG/HDL cholesterol, metabolic index (MI), HOMA-IR were calculated. Results. Compared with the control group, individuals in the main group showed lower levels of HDL cholesterol, apo A1, higher levels of insulin, HOMA-IR, and MI. Correlations with work experience were revealed in the absence of age dependence for HDL cholesterol (r=–0.35, p=0.006), IA (r=0.258, p=0.043), apo A1 (r=–0.313, p=0.013), apo B/apo A1 (r=0.287, p=0.024), MI (r=0.262, p=0.04). It has been shown that at least 10 years of service, the levels of HDL cholesterol, apo A1 are lower, and the levels of IA, apo B/apo A1, TG/HDL-C, MI are higher compared with employees with less experience. There is an average degree of relationship between HOMA-IR and indirect markers of insulin resistance of TG/HDL cholesterol (r=0.525, p<0.001) and MI (r=0.568, p<0.001). Limitations. The study is limited to a sample of surveyed employees of a single lead-acid battery recycling facility. Conclusion. The influence of exposure to harmful production factors of a lead-acid battery processing plant on the development of lipid and carbohydrate metabolism disorders is shown, which determines the importance of studying additional laboratory parameters (HDL cholesterol, triglycerides) in employees of these enterprises to objectify the assessment of metabolic processes. Ethics. The study was conducted in compliance with Ethical standards for conducting medical research involving humans in accordance with the requirements of the Helsinki Declaration of the World Medical Association. The study was approved by the conclusion of the local Ethics Committee of Izmerov Research Institute of Occupational Health (protocol of the meeting of the Ethics Committee No. 5 dated 08/02/2023).

Currently, there is sufficient evidence of the importance and clinical effectiveness of non-drug therapy. The scientific discussion on the priority of the clinical application of pharmacological and non-pharmacological methods of rehabilitation of patients with mononeuropathies has acquired particular importance against the background of neurological post-COVID complications in patients with COVID-19. The study aims to compare the effectiveness of drug therapy and non–drug technology of post-covid rehabilitation of workers with intensive computer workload based on the study of clinical and laboratory parameters. Scientists have conducted a survey of two groups of workers with intensive computer workload who underwent rehabilitation after COVID-19 with the use of drug therapy and non-drug technologies, including balneotherapy, drinking narcotherapy, aerosol inhalations, low-frequency magnetic therapy. The authors have evaluated the effectiveness of therapy based on the results of studies of asthenization, degree of fatigue, latent coronary insufficiency, the state of the blood microcirculation system, immune status, the state of the POL-AOSIS system and endogenous intoxication of patients. Asthenization, the degree of fatigue, and latent coronary insufficiency decreased in the majority of the examined patients after post-COVID non-drug measures. Whereas in patients of the drug group, a decrease in these indicators was noted in a small number of examined patients. The indicators of the immune status of patients after non-drug therapy returned to normal, after drug therapy they only approached the limits of the norm, but did not reach it. After the treatment, the indicators of lipid peroxidation in the group of patients undergoing post-COVID rehabilitation using non-drug technologies decreased more significantly than in the group receiving drug treatment. The content of the antioxidant enzymes catalase and ceruloplasmin and the fat-soluble antioxidant α-tocopherol after treatment increases in both groups, but in the group of drug treatment they do not reach the lower limit of the reference intervals. The decrease in the content of medium-molecular peptides is more pronounced when using non-drug technologies. The application of the proposed non-drug technology for the rehabilitation of patients with post-COVID syndrome who are subjected to intense computer loads during work showed a significantly more pronounced normalization of asthenization, fatigue, latent coronary insufficiency and the state of the blood microcirculation system, immune status, the state of the POL-AOSIS system and endogenous intoxication of patients. The data obtained indicate a high therapeutic effect of the use of non-drug technology. Limitations. The surveyed groups included only persons permanently registered in Kislovodsk. Ethics. The research was conducted in accordance with the principles of biomedical ethics and approved by the local Ethics Committee of the Izmerov Research Institute of Occupation Health, Moscow (Protocol No. 4 dated 04/14/2021). Each participant of the study submitted a voluntary written informed consent signed by him after explaining to him the potential risks and benefits.

According to leading experts of the World Health Organization, the threat of a new strain of SARS-CoV-2 coronavirus remains, which will lead to a sharp increase in morbidity and mortality. The severity of complications after COVID-19 depends not only on how severe the disease was, but also on other factors: genetic predisposition, age, concomitant diseases, and working conditions. This makes it urgent to conduct further scientific research on the ranking of the factors of the production environment that accelerate the spread of COVID-19. The study aims to determine the degree of occupational risk, taking into account the timing and frequency of manifestations of post-COVID syndrome (U09.9; U10.9 according to ICD–X) in specialists with intensive computer workload. In the period 2020–2024, the researchers conducted a survey at the workplaces of Kislovodsk enterprises and examined 556 people with an intensive computer load associated with servicing the flows of mass consumers during the pandemic and in the post-pandemic period. We have studied the timing and frequency of the occurrence of post-COVID syndrome, objectified by the degree of health risk factors in various categories of workers with intensive computer workload. The timing and frequency of seven post-COVID syndrome manifestations ranked (according to the degree of occupational health risk factors) (U09.9; U10.9 according to ICD-X) that occur in workers with intensive computer workload in the first two weeks after discharge from the hospital during hospitalization for COVID-19 (occupational health risk factors category A) or arising within three to four weeks after discharge from the hospital during hospitalization for COVID-19 (occupational health risk factors of category B). Based on statistical and clinical and hygienic data obtained in the period from 2020 to 2024, post-COVID manifestations in the gradations of "high" and "moderately high" occupational health risk for employees (n=556) with intensive computer load were ranked by the timing and frequency of occurrence of the named syndrome, as well as by the degree of risk of potential COVID-19 infections of the named groups of specialists associated with servicing mass consumer flows infected with constantly mutating representatives of enveloped RNA viruses. According to the degree of occupational risk to the health of persons with intensive computer workload, six groups of specialists associated with servicing mass consumer flows, potentially infected with COVID-19 and other representatives of enveloped RNA viruses, were ranked. Limitations. Post-COVID syndromes that occur within one to two and three to four weeks after discharge from the hospital have been studied. Ethics. Scientists have conducted research in accordance with the principles of biomedical ethics and approved by the local Ethics Committee of Izmerov Research Institute of Occupation Health, Moscow (Protocol No. 4 dated 04/14/2021). Each participant of the study submitted a voluntary written informed consent signed by him after explaining to him the potential risks and benefits.

Introduction: Smoking is a risk factor that contributes the most to premature mortality and disability from a whole range of malignant neoplasms, cardiovascular and respiratory diseases. Industrial workers are more likely to smoke compared to the general population, which may lead to a greater risk of their health impairment. Objective: To analyze the relationship between the prevalence of smoking and the risk of developing diseases of the cardiovascular system in power grid workers. Materials and methods: 2,651 men were examined at the clinic of Izmerov Research Institute of Occupational Health and divided into two groups of 1,107 non-smokers and 1,544 smokers. The examination included collection of a medical history, height and weight measurements, calculation of the body mass index (BMI), systolic and diastolic blood pressure measurements, and blood testing for glucose, cholesterol, and high-sensitivity C-reactive protein levels. The data were analyzed using Statistica 10.0 with the calculation of the means, their standard errors, minimum and maximum values for all indicators in the study groups; the analysis of the contingency tables was carried out using the chi-square test. Results: The prevalence of hypertension in the smokers was significantly higher than in the non-smokers of all age groups, but for those aged 30 to 39 years. The number of workers with high total cholesterol (≥ 6.2 mmol/L) and, therefore, increased cardiovascular risks was statistically higher among the smokers aged 50–59 years (χ2 = 5.323, p = 0.022) and 60 years and older (χ2 = 4.475, p = 0.035). The level of high-sensitivity C-reactive protein posing a high cardiovascular risk (> 3 mg/L) was statistically higher in the smoking than in non-smoking workers. Conclusion: Our findings show the necessity of considering smoking habits within pre-employment and periodic medical examinations in order to prevent risks of developing new or exacerbating already existing cardiovascular diseases.

Introduction. With the growth of urbanization processes, the problem of professional exposure to electric and magnetic fields of industrial frequency is an increasingly relevant topic. Recently, the scientists paid a special attention to the long-term health consequences associated with prolonged exposure to harmful physical factors. The previously obtained data on the increase in the levels of lipid metabolism and hormonal and metabolic disorders in workers exposed to electric and magnetic fields of industrial frequency determine the relevance of studying adipokine metabolism and assessing genetic risk factors for predisposition to cardiovascular pathology in employees of the electric power industry. The study aims to research the relationship of biochemical and molecular genetic markers of adipokine metabolism with indicators of hormonal and metabolic disorders for a comprehensive assessment of cardiovascular risk in workers exposed to electric and magnetic fields of industrial frequency. Materials and methods. The researchers examined 144 employees of the main group engaged in the repair and operation of power grid facilities and 40 employees of the control group who are not exposed to electromagnetic fields of industrial frequency.The concentration of leptin and adiponectin was determined in blood serum samples. The authors have calculated the ratio of adiponectin to leptin. We have performed a molecular genetic study of single nucleotide polymorphisms of leptin (LEP) G2548A (rs7799039), leptin receptor (LEPR) A668G (rs1137101) and adiponectin type two receptor (ADIPOR2) G795A (rs16928751) genes. Results. The staff of the main group revealed a higher level of leptin (8.1 (3.7; 14.4) ng/ml) relative to the same indicator in the control group (6.0 (4.1; 11.1) ng/ml), p<0.028. Levels of leptin and adiponectin moderately and weakly correlate with hormonal and metabolic parameters. In the group of employees with less than 10 years of experience, a higher level of adiponectin was established compared to the group with 11–20 years of experience (6.1 (4.6; 9.1) mcg/ml and 4.5 (3.6; 6.4) mcg/ml, respectively); with an increase in work experience of more than 20 years, a significant increase in the concentration of leptin was found (p<0.05). Scientists have identified the significance of single-nucleotide polymorphisms of the LEPR, LEP, ADIPOR2 genes in the development of abdominal obesity, an increase in cholesterol levels and a decrease in the level of total testosterone in workers exposed to electric and magnetic fields of industrial frequency. Limitations. The study is limited to the number of surveyed (144 employees). Conclusion. The results of the study indicate the relationship of biochemical and molecular genetic markers of adipokine metabolism with indicators of hormonal and metabolic disorders in employees exposed to electric and magnetic fields of industrial frequency. When examining workers exposed to electric and magnetic fields of industrial frequency, the use of clinical and laboratory markers of adipokine metabolism (biochemical, molecular genetic) is informative in a comprehensive assessment of cardiovascular risk. Ethics. The work complies with ethical standards developed in accordance with the Helsinki Declaration of the World Medical Association "Ethical Principles of conducting Scientific medical research with human participation" as amended in 2000 and the "Rules of Clinical Practice in the Russian Federation" approved by Order of the Ministry of Health of the Russian Federation No. 200n dated 01.04.2016. Informed consent to participate in the study was received from each of the surveyed, approved in accordance with the established procedure by the local ethics committee of Izmerov Research Institute of Occupational Health (minutes of the meeting of the Ethics committee of Izmerov Research Institute of Occupational Health No. 4 dated 12/25/2013).

По данным Международной организации труда 50–60% всех потерянных рабочих дней связаны с производственно обусловленным стрессом. Ещё в конце 80-х, начале 90-х годов прошлого века Ю.В. Мойкин подчёркивал, что перед физиологами труда возникает необходимость выявления психофизиологических и нейрофизиологических механизмов перехода от нормы до возникновения нервного перенапряжения под влиянием хронического эмоционального стресса. В настоящее время признано, что продолжительное влияние гормонов гипофизарно-надпочечниковой, симпатоадреналовой, тиреоидной систем, участвующих в развитии стресс-реакции и вызывающих изменения липидного, углеводного, электролитного обменов и других метаболических процессов в организме приводит к развитию заболеваний. Стресс-лимитирующие системы, включающие ГАМКергическую, опиоидную, дофаминергическую, серотонинергическую обеспечивают защиту организма от чрезмерного влияния стресс-факторов. Сопряжение между стресс-реализирующей и стресс-лимитирующей системами генетически детерминировано. Современная концепция профессионального стресса связана с необходимостью анализа как внешних факторов, так и индивидуальных характеристик, которые играют важную роль в развитии стрессовых реакций и их фиксации в виде устойчивых негативных проявлений. Анализ генетического соответствия индивидуума должности и характеру выполняемой работы будет способствовать оптимальной реализации профессиональных умений и навыков человека. Участие авторов: Кузьмина Л.П. — концепция и дизайн исследования, редактирование; Безрукавникова Л.М. — сбор и обработка данных, написание текста. Финансирование. Исследование не имело спонсорской поддержки Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов. Дата поступления: 16.03.2022 / Дата принятия к печати: 20.03.2023 / Дата публикации: 10.04.2023

Introduction. The safety of exposure to the population of a growing number of sources of electromagnetic fields everywhere, both in work and at home, has become a public health problem. This article presents the results of research on the study of the potentially adverse effects of electromagnetic fields of industrial frequency on the reproductive system of personnel of energy supply institutions. The aim of the study is to explore the possible adverse effects of electromagnetic fields of industrial frequency on the male reproductive system. Materials and methods. The object of the study was 144 employees engaged in the repair and operation of power grid facilities and 40 employees who are not exposed to electromagnetic fields of industrial frequency. To assess laboratory parameters, blood samples were taken, followed by determination of the levels of total testosterone, free testosterone and globulin binding sex hormones. Results. The subjects of the main group revealed a high incidence of prostatic hyperplasia and chronic prostatitis. The employees of the main group had lower concentrations of sex hormones (p<0.05) in relation to similar indicators of the control group. A negative correlation was revealed between the levels of total, free testosterone and sex hormone binding globulin with experience (r=-0.36 p=0.009; r=-0.264 p=0.06; r=-0.349 p=0.01, respectively). Limitations of the study. The study is limited by the number of highly trained workers exposed to electromagnetic fields of industrial frequency. Conclusions. The results of the study indicate the negative impact of electromagnetic fields of industrial frequency on the reproductive system of employees engaged in the repair and operation of power grid facilities. With an increase in the length of service of employees, a decrease in the concentration of globulin binding sex hormones, total and free testosterone was found. Among workers exposed to electromagnetic fields of industrial frequency, a high prevalence of prostate pathologies was revealed.

Alcohol abuse is one of the main lifestyle factors affecting the health of the Russian population and determining the level and dynamics of morbidity and mortality from chronic non-communicable diseases. Alcohol addiction is one of the most difficult and dangerous diseases for humanity due to the enormous medical, social, moral, ethical, economic and spiritual losses. Alcohol damage is associated with medical expenses, reduced labor productivity, premature death. In the Concept of the implementation of the state policy to reduce alcohol abuse and prevent alcoholism among the population of the Russian Federation for the period up to 2020, it was stated that "alcohol abuse causes a particularly high mortality rate among men 40-60 years old, who at this age have the most valuable professional skills; their premature death damages the workforce with professional experience, reduces the amount of investment in human capital". Conducting an anti-alcohol program within the framework of occupational medicine seems to be an effective method of solving the problems of both the drinker himself and society as a whole. Alcohol risk management of Russian enterprises is a very promising and in-demand area of scientific and practical activity, which is of great interest to physicians, managers, economists and representatives of many other fields and professions.