Introduction.Production-related morbidity occurs as a result of nonspecific effects on the human body increased fatigue and overfatigue. However, there are no studies of the links between the General morbidity of workers with their acute fatigue and chronic fatigue.The aim of the studywas establishment of pattern of connection of acute fatigue with chronic fatigue and with the general morbidity of workers revealed at periodic medical examinations of workers.Material and methods. Fatigue and fatigue were studied using a standardized questionnaire. As an integral assessment of fatigue we used two indicators “degree of usual fatigue” (Fsub) and the duration of the employee in a state of fatigue, hours per week (Hweek). The Hweekindex considers the Fsub, frequency, time of occurrence and disappearance of fatigue, the duration of the working week. In research took part 1733 of different professions. 396 people underwent medical examination.Results.Among the surveyed workers, 5% of women and 2% of men had severe fatigue (Fsub=3). We have shown that the total annual duration of morbidity with temporary disability in very tired workers (Fsub=3) is an average of 24.9 days, and a little tired (Fsub=1) an average of 5.1 days. 38% of women and 20% of men are at risk of fatigue (Hweek>24 hours). The Hweekindicator allows to differentiate the occupational risks associated with fatigue among workers with the same Fsub. At Hweek>24 hours in men and women, all health indicators obtained from both the survey and the medical examination are worsened.Conclusions.Fsubis the most simple, operational and reliable indicator for the etiological study of the risks of fatigue and the causesof professionally caused diseases. In women with Fsub=3, compared with non-tired workers (Fsub=0), the risks of health deteriorationduring the year are repeatedly increased, in moderately tired women (Fsub=2) there is also a significant increase in all risks, but to alesser extent. Hweekallows you to differentiate risks among workers with the same Fsub. With Hweekmore than 24 hours, there is a significant increase in health risks, detected both according to the survey and according to periodic medical examination. The leading cause ofFsub=3 is the share in working time of the periods of stay of workers in a state of increased attention and intensity of the labor process.

Introduction. In Russia, as in other countries, the share of the population engaged in professions in which the leading source of the health risk of workers is organizational and psychogenic causes is continuously increasing. Among them, the leading place is occupied by the physiologically inadequate workload. The aim of the research was to establish the relationship patterns of acute and chronic (professional burnout) fatigue with the workload, which was characterized by a combination of the intensity and quality of the work. Material and methods. The index used was generalizing the time-weighted average density (N) and temp (T) employment action: I = P∙T. evaluation of the physiological intensity was carried out in the relation to the level obtained for 1, which was made value I=0.84 (a comfortable temp T=1; the share of breaks and pauses in work to 0.16, P=0.84). Results. Functional overvoltage in doctors occurs during the working day with the intensity of labor is 1.4-1.5 times higher than the level at which the fatigue they have absent or small. The change in labor productivity (number of admissions, number of bets, etc.) in more than the stated range is only possible due to, changes in the quality of work (saving the physical, mental, emotional effort). Increased physiological labor intensity of doctors is the most common source of the risk to their health. Discussion. The most common causes of stress and fatigue including “volume and intensity of work” and “working hours” characterize the level of labor intensity. The factor of “imbalance of effort and reward” is also associated with the intensity of work and health risk. In the case of physical, visual and mental labor, the acute functional overstrain of the worker occurs at a labor intensity 1.4-1.5 times higher than the level at which he has little or no fatigue. The increase in labor productivity in excess of the specified range is possible only due to behavioral adaptations - saving of physical, visual, mental and emotional efforts spent on the fulfillment of a unit of standardized labor, which is inevitably reflected as a result of the activity of the doctor. Сonclusion. The established quantitative characteristics of the main indices of the workload-the physiological intensity of labor and the length of working time are the starting point for the analysis, prediction and primary prevention of the risk of chronic fatigue and professional burnout of medical workers due to the lack of rest that occurs under working conditions, inadequate recovery ability of the human body.

1 ФБУН «Северо-Западный научный центр гигиены и общественного здоровья» Роспотребнадзора, Санкт-Петербург, Россия; 2 Медицинский центр АО «Адмиралтейские верфи», Санкт-Петербург, Россия;3 Автономная некоммерческая организация высшего образования «Университет при Межпарламентской ассамблее ЕврАзЭС», Санкт-Петербург, Россия © Г.А. Сорокин, В.Л. Суслов, Е.В. Яковлев, 2018 Целью исследования было установить закономерности взаимосвязи острого и хронического утомления врачей (или профессионального выгорания, ПВ) с рабочей нагрузкой, которая определялась продолжи-тельностью рабочей недели и интенсивностью трудового процесса. В исследовании приняли участие 325 женщин-врачей. Использовали специальный опросник по оценке симптомов острого и хронического утомления, продолжительности и интенсивности работы, профессиональных и непрофессиональных причин обычного утомления на работе. Установлено, что средняя рабочая нагрузка врачей составила 44,9 часа в неделю, с учетом физиологической интенсивности труда -50,3 нормированных часа (НЧ). Частота большинства симптомов ПВ повышается в 2-3 раза при НЧ более 58 часов по сравнению с на-грузкой при НЧ менее 42 часов. При НЧ более 47 часов на ежедневное утомление врачей большое влияние оказывают и такие факторы, как работа в вечернюю и ночную смену, дисбаланс усилий и воз-награждения, неопределенность обязанностей, внерабочая нагрузка, недостаток свободного времени. На ежедневное утомление врачей существенно влияют также их индивидуальные характеристики -состояние здоровья и тревожный тип поведения.Ключевые слова: врач; рабочая нагрузка; острое утомление; хроническое утомление; профессио-нальное выгорание. The purpose of the research was to establish the relationship patterns of acute and chronic (professional burnout, PV) fatigue of doctors with the workload that was characterized by a combination of the length of the working week and the intensity of the labor process. The study involved 325 women doctors. A special questionnaire was used to identify the symptoms of acute and chronic fatigue, duration and intensity of work, to assess the professional and non-professional causes of usual fatigue at work. It was found that the average workload of doctors was 44.9 hours per week, taking into account the physiological intensity of labor -50.3 normalized hours (NH). The frequency of most of the symptoms of PV increases by 2-3 times at NH > 58 hours, compared with the load at NH < 42 hours. In case NH > 47 hours on a daily fatigue doctors are largely influenced by the factors: work in evening and night shifts; the imbalance of effort and reward; the uncertainty of the obligations; extra-working load; lack of free time. The daily fatigue of doctors is also significantly affected by their individual characteristics -health and anxiety type of behavior. PROFESSIONAL BURNOUT AND WORKLOAD OF DOCTORSG

The development of Fatigue Risk Management System (FRMS) in various industries and transport is an indicator of the relevance of the issue of professionally caused fatigue, the importance of which for the safety and health of shipbuilding workers has been poorly studied. The aim of the study was to characterize the effect of organizational, psychosocial, environmental and non-occupational factors affecting fatigue and health indicators of shipyard workers. There is an prevalence of the risk of severe fatigue among 8,8 ± 2,8 % of workers, 15,4 ± 7,2 % of foremen, 7,7 ± 7,7 % of engineers. The main fatigue causes are indicators of the labor regime and the working environment in workers and increased labor intensity, negative characteristics of functional duties and psychosocial climate, extra-curricular load in foremen. The risk of reducing the efficiency of workers, foremen and engineers due to their being at the workplace in a state of severe fatigue is 8–12 % of working time. The total deficit of rest formed during working hours and free time is the main source of risks of acute and chronic fatigue. The data obtained are the justification for the relevance of the introduction of FRMS to improve the efficiency, safety and reliability of labor processes in shipbuilding enterprises.