This article presents data on the leading role of the biological factor in the formation of occupational diseases among health workers for an 18-year period of the work at the North-West Scientific Center for Hygiene and Public Health. The purpose of the study is to provide an objective assessment in establishing relationships related to the effects of a biofactor on the health of health workers. A retrospective analysis was made of a sample of case histories with established occupational diseases due to the impact of a biological factor. There were observed in dynamics 67 cases including 52 women (77 %) and 15 men (23%) aged 23-67 years. All of them were examined for the establishment of the relationship between the disease and occupation during the period of 2000-2017. The infectious agent is considered to be the leading harmful production factor when analyzing working conditions. The average work experience with an infectious agent was 14 years. The class of working conditions in most cases was estimated from permissible to harmful of the 1 degree. Based on the data of sanitary and hygienic characteristics of working conditions, the excess of the maximum permissible concentrations of harmful industrial substances in the air of the working area was recorded only in 8% of cases. The detectability of occupational diseases after periodic medical examinations was 6%; by clinical examination - 8%; when contacting a local physician 20%; to the pathologist 20%; as a result of self-reversal 46%. The biological factor is the leading harmful factor in the workplace of medical workers. As the main preventive measure for occupational diseases among physicians, systematic medical examinations followed by preventive, curative and rehabilitative measures are taken. The most effective way to reduce infectious diseases is the compulsory vaccination of medical staff.

No abstract

Introduction. This article presents the results on the detection rate of occupational diseases (OD) among health workers for an 18-year period (2000-2017) in the North-West Federal District (NWFD). The purpose of the study is to study the structure and dynamics of occupational diseases in medical workers during periodic medical examinations, to assess the effectiveness of the system of periodic medical examinations (PME), and to suggest ways to improve their effectiveness. material and methods. A retrospective analysis of archival data from 2000-2017 was performed on occupational morbidity of health care workers according to the materials of the North-West Scientific Center for Hygiene and Public Health and regional centers of occupational pathology of subjects of the North-West Federal District (N = 259), the average age of the surveyed is 46.1 ± 11.8 years, of which 231 (89%) women, 28 (11%) men, 80 surveyed (30.9%) have the status of a doctor, 124 (47.9%) - nurses and 55 (21.2%) - laboratory technicians, nurses, etc. Results. During the study period from 2000 to 2017 among the medical workers of the NWFD, 259 primary OD cases were officially identified. At the same time, the effectiveness of PME in medical workers was established to be very low. More than 7.2% of patients with OD signs were identified upon the fact that the patient actively sought medical attention. Even the system of clinical examination of the working population (where there is no explicit task to actively detect the OD signs) has a performance index by 3% higher than the PME. Conclusion. The problem we have touched upon is probably related to a complex of both medical (features of the organization of the PME system) and social factors (subjective assessments of the patient with respect to the prospect of benefits or negative effects in terms of continuing their professional career after official registration of the OD) in order to establish more accurately long laborious research.

Проанализированы данные эпидемиологической обстановки по распространенности внелегочного туберкулеза на территории РФ. Риск инфицирования наиболее высок у работников лабораторной диагностики. Приведены данные сравнительного анализа эпидемиологического благополучия с установленными случаями профессионального туберкулеза. Сделаны выводы об улучшении эпидемиологической обстановки в результате взаимодействия эпидемиологической и санитарно-гигиенической служб. Эпидемиологически значимыми за исследуемый период явились туберкулез костей и суставов и мочеполовой сферы. Отражена динамика профессиональных случаев внелегочного туберкулеза. Среди видов профессионального внелегочного туберкулеза преобладал туберкулез костей, суставов и лимфатических узлов. Ключевые слова: профессиональная заболеваемость; туберкулез; внелегочный туберкулез; работники медицинской сферы.

Introduction. This article presents typical drawbacks in the sanitary-hygienic characteristics of working conditions, aimed at examining the relationship of the disease with the occupation among medical workers for the period 2000-2017 in the North-West Federal District, and making it difficult to conduct this examination with a positive outcome for the patient. Ways to eliminate these drawbacks are proposed.The purpose of the study is to establish the main typical drawbacks of the operational conditions there when compiling the sanitary-hygienic characteristics and hindering the establishment of a causal relationship between the disease and the occupation in medical workers when resolving expert issues, suggest ways to address them.Material and methods. Based on the materials of the Federal State Budgetary Institution Scientific Center for Hygiene and Public Health and the Centers for Occupational Pathology (COP) of the subjects of the Northwestern Federal District of the Russian Federation (NWFD), a retrospective analysis of a sample of case histories of patients with established occupational diseases (n = 227) and unidentified cases (n = 32) employed in medical institutions of the North-Western Federal District and sent to the COP to examine the relationship between the disease and the occupation. Between 2000 and 2017 259 medical workers were sent to the central control center on the territory of the NWFD for the examination of the relationship between the disease and the occupation, 32 were not found to have a causal relationship with the occupational activity.Results. The analysis of sanitary and hygienic characteristics indicates an insufficient objective assessment of the operational conditions of medical workers. In most cases, the compilers of these characteristics did not critically transfer data from the documentation for a special assessment of operational conditions into them and did not take into account the leading role of the biological factor in shaping the risk of occupational pathology.Conclusion. To correct the situation, serious optimization of both the regulatory framework and the working methods of the Federal Service for Oversight of Consumer Protection and Welfare institutions, as well as other structures involved in assessing working conditions in healthcare institutions, is required.