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INTRODUCTION: Health protection of railway workers of various professional groups increases the safety of railway transport, the prestige of the profession and reduces morbidity and mortality from the most common causes in this group of patients. AIM: To analyze the risk factors of sudden death among Russian Railways workers. MATERIALS AND METHODS: The design of the study is made according to the case-control type. Analysis was carried out of all cases of sudden death (SD) of employees of JSCo Russian Railways (RR) in the period from 2009 to 2021 (n = 412). The comparison group consisted of 411 employees of RR who were undergoing periodical medical examination. The groups were formed on the basis of age, employment period, gender, profession. To assess the diagnostic significance of the quantitative signs in predicting a certain outcome, the method of analysis of ROC curves was used. RESULTS: The chances of death for workers of RR increased in case of past myocardial infarction, and also depended on the type of intervention (p 0.001). The threshold value of the BMI index in the cut-off point, which corresponded to the highest value of Youden index, was 27.1 kg/m2. In the group of sudden deaths, there were 1.8 times more smokers and 2 times less individuals with total cholesterol level exceeding 5 mmol/l than in the comparison group (p 0.001). A prognostic model was developed by ROC-analysis to determine the probability of mortality. The sensitivity and specificity of the model were 79.5% and 91.9%, respectively. CONCLUSION: A prognostic model was developed to determine the probability of sudden death in Russian railway workers, with the sensitivity and specificity 79.5% and 91.9%, respectively. However, the present study did not permit to reveal predictors of sudden death specific of the workers of RR.
INTRODUCTION: Health protection of railway workers of various professional groups increases the safety of railway transport, the prestige of the profession and reduces morbidity and mortality from the most common causes in this group of patients. AIM: To analyze the risk factors of sudden death among Russian Railways workers. MATERIALS AND METHODS: The design of the study is made according to the case-control type. Analysis was carried out of all cases of sudden death (SD) of employees of JSCo Russian Railways (RR) in the period from 2009 to 2021 (n = 412). The comparison group consisted of 411 employees of RR who were undergoing periodical medical examination. The groups were formed on the basis of age, employment period, gender, profession. To assess the diagnostic significance of the quantitative signs in predicting a certain outcome, the method of analysis of ROC curves was used. RESULTS: The chances of death for workers of RR increased in case of past myocardial infarction, and also depended on the type of intervention (p 0.001). The threshold value of the BMI index in the cut-off point, which corresponded to the highest value of Youden index, was 27.1 kg/m2. In the group of sudden deaths, there were 1.8 times more smokers and 2 times less individuals with total cholesterol level exceeding 5 mmol/l than in the comparison group (p 0.001). A prognostic model was developed by ROC-analysis to determine the probability of mortality. The sensitivity and specificity of the model were 79.5% and 91.9%, respectively. CONCLUSION: A prognostic model was developed to determine the probability of sudden death in Russian railway workers, with the sensitivity and specificity 79.5% and 91.9%, respectively. However, the present study did not permit to reveal predictors of sudden death specific of the workers of RR.
Technogenic effects on the production of oil, coal tar, other hydrocarbons and products of their processing can lead to diseases of the sebaceous glands. Gum-related factors trigger common links in the pathogenesis of vulgar and oily acne, which are inflammation, increased sebum production, excessive follicular hyperkeratosis. There is a description of the clinical manifestations of severe oily acne in a railway worker on previously unchanged skin. We also have a description of the severe stage of the course of vulgar acne in the assistant engineer of the railway, who has a genetic predisposition, also has a history of juvenile acne of mild severity. Chemical factors such as a mixture of hydrocarbons, phenol, creosote, asbestos-containing dust can provoke oily acne in a railway worker. Oxides of nitrogen, carbon, sulfur, nitrogen dioxide, technical mixtures of hydrocarbons, violation of physiological rhythms of nutrition, sleep, rest, severity and intensity of the labor process, constant stress can lead to a relapse of vulgar acne with a more severe course in workers of locomotive crews. The given clinical examples reveal the need for interdisciplinary interaction of dermatologists-venereologists and occupational pathologists in the treatment of skin pathology in workers of harmful industries.
Over the more than three-year period of the coronavirus pandemic, researchers have identified the relationship between cardiovascular diseases and the severity of coronavirus infection, especially in people who have had COVID-19 in a hospital setting. One of the complications of patients with coronavirus infection is an increase in blood pressure, which can lead to the formation of hypertension. It is known that arterial hypertension occupies a leading position among workers in the transport sector, including electric train drivers, in our country. The cardiovascular system of machinists is influenced by industrial risk factors (noise, vibration, psycho-emotional stress, etc.) and often non-industrial: smoking, increased body weight. The combination of these factors: coronavirus infection, industrial and non-industrial risk factors can accelerate the development of cardiovascular diseases in electric train drivers. The study aims are the results of duplex scanning of brachiocephalic arteries in electric train drivers who have been ill with various forms of new coronavirus infection. The authors have conducted the study on an outpatient basis among 12 male machinists aged 43.4±5.0 years working in the Central Federal District, who who have been ill with COVID-19 in the first and second quarters of 2021, and are currently continuing their work as an "electric train driver". The subjects were divided into 2 groups: the 1st group consisted of workers who had suffered a mild form of COVID-19, the 2nd group consisted of workers who had suffered a severe form of COVID-19. Scientists conducted duplex scanning of brachiocephalic arteries with color Doppler mapping for workers, and they also studied outpatient charts of workers, analyzed blood pressure data. The research was conducted in the period 2022–2023. The employees involved in the studies had risk factors such as smoking, increased body weight and high blood pressure. Scientists have revealed higher blood pressure indicators in workers of the 2nd group (severe form), in contrast to the indicators of the 1st group (mild form), while both groups had "grade I arterial hypertension". Ultrasound examination of the brachiocephalic arteries in group 2 workers, unlike group 1 workers, revealed the initial signs of vascular remodeling at the extracranial level in the form of a diffuse increase in the echogenicity of the intima-media complex and its thickening to 1 mm in the common carotid artery, deformations of the common and internal carotid arteries, in the form of wavy C-S‑shaped tortuosity, initial ectasia of the common carotid arteries, a decrease in linear indicators of blood flow velocity, an increase in the resistance index. And also in workers who have had a severe form of coronavirus infection, when visualizing the vertebral arteries, an indirect linear course in the interosseous canal is traced, which is not observed in workers who have had a mild form of COVID-19. A study of the middle cerebral artery at the intracranial level in group 1 workers indicates the absence of hemodynamic changes, and in group 2 workers there was a decrease in speed indicators and an increase in the resistance index. In the machinists who suffered both severe and mild forms of COVID-19, scientists established "grade I arterial hypertension", which required the appointment of antihypertensive therapy. In workers who have undergone severe COVID-19, blood pressure indicators are higher, which led to remodeling of the brachiocephalic arteries in the form of thickening of the intima-media complex of the common carotid artery, minor ectasia and the development of deformities of the carotid arteries, increased resistance to blood flow, which is not present in workers who have undergone a mild form. Workers who have developed complications in the post-СOVID period need annual duplex scanning with color Doppler mapping of the brachiocephalic arteries, which will help identify abnormalities at the extra- and intracranial level. Limitations. There are quantitative limitations due to the number of COVID-19 patients. Ethics. The study was approved by the local Ethics Committee of the Izmerov Research Institute of Occupational Health (Protocol No.1 dated February 16, 2022).
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