THE ROLE OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF DEFORMING ARTHROSIS OF PROFESSIONAL ETIOLOGY IN MINERS

The paper analyzes the effectiveness of magnetic resonance imaging with cartilage diagram in diagnosing signs of professional deforming arthrosis of knee joints in miners working in conditions of significant physical loading. Aim of the research – to determine of diagnostic efficiency of indicators of magnetic resonance imaging of the knee joint and cartilage diagram in miners of the main occupations suffering from deforming arthrosis. Methods. The research is conducted in 30 miners of basic occupations: 20 mining workers of breakage face (MWBF) and 10 machinists of shearer mining machines (МSMM) have been treated in the inpatient department of occupational pathology of the Lviv Regional Clinical Hospital in 2015-2017 due to deforming arthrosis. Damages of the main anatomical elements of the knee joint with arthrosis were analyzed, visualized initially with the help of MRI, and then - cartilage diagram. Results. According to the MRI data, in miners of the main occupations with arthrosis of the knee joint the posterior cross-shaped ligament are most commonly affected (in 75.0±9.7 % MWBF and 70.0±14.5 % МSMM), damage to the medial collateral ligament are diagnosed less frequently (in 5.0±4.9 % in the MWBF and in 10.0±9.5 % in the МSMM). On average 3.8±0.4 modified elements of the knee joint are visualized in patients, whereas 4.8±0.1 affected areas are visualized on the cartilage diagram (р<0.05). In 86.7±6.2 % patients, in the analysis of cartilage diagram, changes in all five analyzed areas are diagnosed, indicating a higher efficiency of the diagnosis of changes in the structures of the joint with DA of the professional etiology of the method of cartilage diagram compared with MRI. According to the cartilage diagram the most significant changes are noted in the hypertrophy of the femur: among all miners 62.5±0.3 ms (medial) and 62.6±0.4 ms (lateral), in the MWBF group the average time of Т2-delay is the largest in the area of the medial hypertrophy of the femur is 60.9±2.3 ms, in the МSMM group – in the area of the lateral hypertrophy of the femur: 66.7±3.3 ms, which can be linked to the peculiarities of the forced working position of miners of these professions and the kinetics of joint structures. These results can be used to diagnose the initial lesions of joint structures with DA of professional genesis, as well as the creation of prognostic models for determining the the degree of risk of development of knee joint damage, which will allow to improve the system of personified approach to diagnostic and preventive measures in working persons in conditions of considerable physical activity and forced working position

A comparative assessment of major international disasters: the need for exposure assessment, systematic emergency preparedness, and lifetime health care

Abstract Background The disasters at Seveso, Three Mile Island, Bhopal, Chernobyl, the World Trade Center (WTC) and Fukushima had historic health and economic sequelae for large populations of workers, responders and community members. Methods Comparative data from these events were collected to derive indications for future preparedness. Information from the primary sources and a literature review addressed: i) exposure assessment; ii) exposed populations; iii) health surveillance; iv) follow-up and research outputs; v) observed physical and mental health effects; vi) treatment and benefits; and vii) outreach activities. Results Exposure assessment was conducted in Seveso, Chernobyl and Fukushima, although none benefited from a timely or systematic strategy, yielding immediate and sequential measurements after the disaster. Identification of exposed subjects was overall underestimated. Health surveillance, treatment and follow-up research were implemented in Seveso, Chernobyl, Fukushima, and at the WTC, mostly focusing on the workers and responders, and to a lesser extent on residents. Exposure-related physical and mental health consequences were identified, indicating the need for a long-term health care of the affected populations. Fukushima has generated the largest scientific output so far, followed by the WTCHP and Chernobyl. Benefits programs and active outreach figured prominently in only the WTC Health Program. The analysis of these programs yielded the following lessons: 1) Know who was there; 2) Have public health input to the disaster response; 3) Collect health and needs data rapidly; 4) Take care of the affected; 5) Emergency preparedness; 6) Data driven, needs assessment, advocacy. Conclusions Given the long-lasting health consequences of natural and man-made disasters, health surveillance and treatment programs are critical for management of health conditions, and emergency preparedness plans are needed to prevent or minimize the impact of future threats