Interdisciplinary publications suggesting an etiopathogenetic relationship between sensorineural hearing loss and some chronic non-communicable diseases were reviewed. A substantial amount of data on atherogenesis, thrombosis and immunological processes affecting the blood circulation of inner ear receptor cells has so far been accumulated. Various reasons for sensorineural hearing loss have been studied, such as changes in the rheological properties of blood; arteriole hypertonicity; precapillar sphincter dysfunction; impaired lipid metabolism leading to the lack of tissue oxygenation and dystrophy and necrosis of the organ of Corti. The definition of endothelial dysfunction has been given. The role of vasomotor, thrombophilic, adhesive and angiogenic forms of endothelial dysfunction in the development and progression of sensorineural hearing loss under the influence of harmful work-related factors, with arterial hypertension, coronary heart disease, diabetes mellitus with the most common and aggressive disorders of the microvasculature has been determined. A clear relationship between the development of sensorineural hearing loss in diabetic microangiopathy has been established. Historical data on the study of the mechanisms of sensorineural hearing loss were analyzed. The aim of this article was to conduct a literature review of interdisciplinary publications with a particular focus on the role of sensorineural hearing loss in the working population in predicting endothelial dysfunction in some chronic non-communicable diseases. The novelty of this article consists in the consideration of occupational and population risk factors for chronic non-communicable diseases in the form of their cascade, which also leads to sensorineural hearing loss.

The article presents data on harmful production factors for the development of the most common non-infectious diseases depending on the occupational category with a different number of them, with different leading factors and work experience in these working conditions among workers at an industrial enterprise. Materials and methods. A comprehensive study of 656 workers was carried out in 2016-2020. Their average age was 48.3 ± 14.2 years. In the study, the number of men (n = 453, 69.1%) prevailed over the number of women (n = 203, 30.9%), p < 0.001. Professional categories were determined according to the International Standard Classification of Occupations ISCO-08. Each profession is assigned to a 3 professional category, taking into account the number of harmful production factors, leading factors and work experience. The comparison group consisted of management professions (engineers, section chiefs, department heads, technologists) without harmful production factors – 66 people, in which there were 30 women and 36 men, average length of service was 27.1 ± 15.4 years. Group 1 consisted of foremen, inspectors, plasterers (painters), and drivers. In this group, there are 2-3 harmful production factors (M (SD) 2.3 ± 1.3), of which the leading harmful production factors are physical overstrain, work at height, in which 185 people work, of which 71 are women and 114 men, the average length of service in these conditions is 15.9 ± 14.3 years. Group 2 consisted of crane and bulldozer operators, repairmen, operators, metering operators, fitters, molders, assemblers, electric gas welders, and finishers. In this group, 4-6 harmful production factors (M (SD) 3.2 ± 1.6) are noted, of which the leading production factors are general vibration and industrial noise, industrial dust / welding aerosol, in which 405 people work, of which 102 women and 303 men, the average length of service in these conditions is 27.7 ± 13.8 years. The average age of workers in the groups is comparable; no statistically significant difference was found (p = 0.526). There were no statistically significant differences by gender (p = 0.527). To compare more than two groups, we used one-way ANOVA with Fisher’s test (F) and Post-Hoc with Tukey’s test (aqual variances) to avoid type I errors and “multiple comparisons effect”. Since in our study there are confounder factors that can affect the study result, contingency tables and Pearson’s χ2 criterion were used to analyze the relationship between qualitative characteristics; at p < 0.05, the probability of differences was 95% or more. Results and discussion. Thus, in our study, we found that general vibration, industrial noise, industrial dust and welding aerosol affect the development of arterial hypertension and chronic obstructive disease and their comorbid diseases in the professional category of workers with 11 years of experience, who are affected by several harmful industrial factors. at the same time, compared with a group without harmful production factors. These harmful production factors had a stronger effect on the development of arterial hypertension by 15% and on the development of chronic obstructive pulmonary disease by 2 times, increased systolic blood pressure and diastolic pressure than work at height and physical overstrain. Arterial hypertension is the most common factor in the development of comorbid coronary artery disease. The most frequent concomitant factors of hypertension in workers with general vibration, occupational noise, industrial dust and welding fumes were excess body weight, grade 1 obesity and smoking. The definition of occupational categories is an important socio-economic and medical determinant for patient-centered prevention of non-communicable diseases, comorbid pathology of non-communicable diseases and their risk factors in workers exposed to harmful production factors. Conclusions. The study carried out using Pearson’s criterion and regression analysis showed that the relationship with multiple occupational factors is significantly higher among workers, which allows us to conclude that general vibration, industrial noise, industrial dust / welding aerosol are additional factors for the development of arterial hypertension and chronic obstructive pulmonary disease. from workers. The obtained correlations also allow us to draw a conclusion about the influence of the combined effect of these factors, taking into account the length of service, on the likelihood of developing arterial hypertension and chronic obstructive pulmonary disease.

Aim. Assess the prevalence of anxiety-depressive disorders during a pandemic in patients with a new coronavirus infection (COVID-19) and patientswho did not fall ill by infection in outpatient’s centers in Tyumen. Materials and methods. Analysis of anonymous questionnaires (n = 100 patients with previous coronavirus infection – study group, n = 100 patients who did not fall ill by infection – comparison group) at the generalist’s department using the HADS scale. Results. In the study group, the prevalence of increased levels of anxiety and depression was 72%, the prevalence of increased levels of anxiety and depression in the comparison group was 60%. The prevalence of anxiety and depression during a pandemic was 54.2% and 41.5%, respectively. Conclusion. Patients who hadinfected by new coronavirus infection have more often symptoms of clinically pronounced anxiety and depressive disorders, which is 2 times higher compared to the data for the Tyumen region in the period before the pandemic.

Introduction. Conducted a periodic medical examination of workers under the influence of harmful factors of production has shown a high prevalence of risk factors and chronic non-infectious diseases (NCDs).The aim of the study was to evaluate the effectiveness of patient-oriented prevention of NCDs in workers exposed to hazardous industrial factors in different occupational categories.Materials and methods The study included 656 workers who received one NCDs prevention program after a periodic medical examination. The effectiveness of the undertaken patient-centered prevention program was evaluated on the following grounds: the dynamics of primary NCDs morbidity, the prevalence of NCDs risk factors and NCDs control, temporary and permanent disability, frequency of visits for medical care, regularity and completeness of medical records, the frequency of preventive appointments with a therapist and cardiologist in the health center, cardiovascular and occupational risks.Results One year after the patient-oriented prophylaxis, the course of NCDs was monitored. Good result was achieved in 43 % of workers, after 5 years – in 29 %. At the same time higher results were obtained in the group with 4–6 harmful industrial factors. The leading factors were general vibration and industrial noise, industrial dust, welding aerosol. The reduction of cardiovascular risk by 47 % and occupational risk by 30 % was registered. Median temporary disability was 10.6 days (95 % CI: 6.2–12.3) after 1 year in group 2, which was 5.2 days less; the lowest median time of NCDs was 12.4 months (95 % CI: 7.7–15.1) in the comparison group.Discussion. Previously, there was already an organization of therapeutic and preventive work in shop floor health posts. Its application of new methods and tools proves the effectiveness of patient-oriented prevention of NCDs among workers at an industrial enterprise.Conclusion Patient-oriented prevention of NCDs was carried out in different occupational groups. The results demonstrated the effectiveness of this work in workers exposed to harmful occupational factors.

Aim. To establish the strength and direction of the correlation between the comorbidity index depending on the combined impact of harmful production factors in men working at a large industrial enterprise in Tyumen. Materials and methods. A single-stage retrospective cohort study of working men in industrial conditions was carried out. Anamnestic, clinical, laboratory, biochemical, instrumental methods were used. Diagnoses were made on the basis of modern clinical guidelines criteria. The groups were comparable in age and formed depending on the number of harmful production factors. Study group n = 52 – men with multiple 3-5 harmful production factors (industrial noise, general vibration, height at work, exposure to welding aerosol, night shifts, static stress) as the number of the following professions increases: crane operators, bulldozer operators, and compressor installations, fitters, electricians for maintenance of electrical equipment, batchers of concrete components. mixtures, electric and gas welders, Kamaz drivers of the 2nd class, locksmiths, repairmen, molders of reinforced concrete products and structures, loaders, operators of the equipment control panel, installers, plumber on duty; their average age in the group was 44.8 ± 14.7. Control group n = 50 – men with 1-2 harmful production factors (industrial noise, static stress) as the number increases in the presence of the following professions: site managers, janitor, auxiliary workers, class 1 bus drivers, construction and installation work foremen, fitters for the repair and maintenance of gas equipment, concrete workers, carpenters; their average age in the group was 43.8 ± 16.2. Results. Between the combined effects of harmful production factors with the comorbidity index, a direct strong correlation was established r = 0.841 ***, p < 0.001 (95% CI 0.672-0.926) according to the Pearson method in the study group, whose experience was 2.2 years longer, then as in the control group, no statically significant correlation was found r = 0.339, p > 0.05 (95% CI -0.065-0.647) according to Pearson’s method. Conclusion. The combined effect of 3-5 harmful production factors is statistically significant with an increase in length of service increases the risk of developing comorbid pathology in men of working age working at a large industrial enterprise, which increases the 10-year risk of fatal complications.