Introduction. The sanitary and hygienic characteristics of the patient’s working conditions made in accordance with the current regulatory documents do not contain an unambiguous conclusion about the adequacy of the occupational risk’s degree for an unambiguous justification of the relation of the disease with the occupation. In this situation a search for new methods which could help to recognize the risk degree is urgent. Material and methods. As an example of a solution of this problem, two expert examinations are given: two patients, diagnosed adenocarcinoma of the lung and exogenous allergic alveolitis were observed in the Clinic of Occupational Pathology of North-West Public Health Research Center. The key aspect of this work was a refinement of the professional risk based on data specified in sanitary and hygienic characteristics of working conditions. The methods from the R 2.2.2006 - 05. “Guidance on hygienic assessment of working environment factors and working process. Criteria and classification of working conditions” were used. Discussion. The use of the described methodology was suggested in cases when it’s necessary to estimate the effect of the combination of unidirectional substances and carcinogens in low-dose rates by the long-term exposure. The participation of the occupational hygiene’s specialists in the expertise of the connection of the disease with the profession seems to be promisingly.

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.

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.

No abstract

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.