Use of mathematical analysis to predict the risk of dust disease

A comparative analysis of period of the first X-ray signs of dust pathology (suspicion), establishing a definitive diagnosis, as well as the development of respiratory failure at a number of occupational diseases was conducted. The silika dust is the most aggressive for the development of toxic-dust bronchitis, as well as working conditions. The maximum duration of experience of the dust observed to the formation of dust bronchitis from exposure to chrysotile asbestos dust (43 years) and asbestosis and pneumoconiosis from exposure to mixed dust (33-34 years).Проведен сравнительный анализ сроков появления первых рентгенологических признаков пылевой патологии (подозрения), установления окончательного диагноза, а также развития дыхательной недостаточности при ряде профессиональных заболеваний. Наиболее агрессивной представляется силикозоопасная пыль, а также условия труда при развитии токсико-пылевого бронхита. Наибольшая длительность пылевого стажа наблюдается при формировании пылевого бронхита от воздействия пыли хризотил-асбеста (43 года), а также асбестоза и пневмокониоза от воздействия смешанной пыли(33-34 года

INFLUENCE EXERTED BY SOMATIC PATHOLOGY ON RISKS OF OCCUPATIONAL LUNG FIBROSIS IN WORKERS EMPLOYED AT REFRACTORY PRODUCTION

Occupational lungs and bronchial pathology occurs not only under exposure to dusts, their aerosol structure and aggression, but also depends on individual properties of a body. The latter can determine either increased body resistance or susceptibility to occupational pathology occurrence. Our research goal was to determine influence exerted by somatic pathology on occupational lung fibrosis occurrence as well as to estimate prevalence of risk factors for cardiovascular and metabolic pathology occurrence in workers employed at refractory production. At the first stage 449 workers employed at refractory production were examined at a periodical medical examination (PME). Patients' average age was 41.59 ± 0.45 and average work experience was 14.47 ± 0.39 years. At the second stage 172 workers were examined at an occupational pathology center; 75 out of them were workers who had silicosis and were included into the test group and the remaining 97 workers didn't have any occupational pathology and were included into the reference group. Both groups were comparable as per sex (p = 0.0052) and work experience under exposure to dusts (p = 0.862). Workers examined at a PME most frequently had overweight and obesity (68 %). Arterial hypertension (AH) prevalence amounted to 19.5%; carbohydrate metabolism disorders, 19.8 %; 48.1 % workers had hypercholesterolemia. Patients with silicosis had certain disorders significantly more frequently than workers with long work experience but without any occupational pathologies; those disorders were AH, cardiac muscle hypertrophy in the left ventricle, ischemic heart disease, heart rate disorders, as well as mixed (obstructive and restrictive) breath mechanics disorders. We determined some factors that authentically produced certain effects on occupational lung fibrosis occurrence in workers employed at refractory production. Median time of silicosis occurrence was significantly shorter (by 11.5 years) among workers with severe AH, arrhythmia (by 13 years), lower hemoglobin in blood (by 11.5 years). Besides, silicosis occurred significantly earlier (by 10.8) among women than among men. © 2020 Obukhova T.Yu., Budkar' L.N., Gurvich V.B., Solodushkin S.I., Shmonina O.G., Karpova E.A.,. All Rights Reserved

Cardiovascular and Metabolic Disorders Associated with Occupational Lung Fibrosis in Employees Exposed to the Dust at the Workplace

Introduction. The attribution of certain medical conditions in industrial workers to hazardous exposures at the workplace remains a challenging issue of occupational health. Material and methods. In order to identify cardiovascular conditions associated with occupational lung diseases in workers exposed to fibrogenic dust, we conducted a medical check-up examination of individuals employed in refractory production and asbestos industry. The main group consisted of the patients with a confirmed diagnosis of lung fibrosis (asbestosis, silicosis); the reference group was age- and tenure-matched workers without occupational fibrosis. Results. We e stablished a significantly h igher prevalence of arterial hypertension, left ventricular hypertrophy, s inus tachycardia, obesity, hypertriglyceridemia and impaired fasting glycemia in workers with silicosis and asbestosis if compared to those without work-related diseases. Based on the relative risk and attributable fraction estimates, we assume there is moderate occupational causation for arterial hypertension and a strong one for left ventricular hypertrophy, sinus tachycardia, and obesity. Very strong causation was found between occupational exposure to fibrogenic dust and carbohydrate metabolism disorders. High-stage hypertension, dyslipidemia and left ventricular hypertrophy were found to have a statistically significant impact on the timing of silicosis. Whereas high-stage hypertension, coronary artery disease, left ventricular hypertrophy and obesity were found to impact the timing of asbestosis. Conclusion. Cardiovascular and metabolic disorders are statistically more occurrent in workers with silicosis or asbestosis. Therefore, the disease can be regarded as work-related. We established cardiovascular and metabolic disorders to have a statistically significant impact on the timing of silicosis and asbestosis. Therefore, a timely CVD prophylaxis could reduce the risk of occupational lung fibrosis in workers exposed to fibrogenic dust. © 2020 Izdatel'stvo Meditsina. All rights reserved.The work of Solodushkin was supported by Act 211 Government of the Russian Federation, contract No 02.A03.21.0006

Mathematical Modeling of the Development of Chronic Fluorine Intoxication in Aluminium Industry Workers

Introduction. Chronic fluorine intoxication prevails among the newly discovered occupational diseases in aluminum industry workers. Mathematical modeling is one of the helpful tools in ensuring better risk management with respect to the development of occupational fluorosis. Objective. Developing a logistic regression model predicting a probability of occupational fluorosis development in an occupational staff of aluminum plants in order to suggest adequate prophylactic strategies. Material and methods. A logistic regression model predicting a probability of the development of occupational fluorosis in aluminum industry workers of the Sverdlovsk region was constructed. The model embraced the results of a univariate analysis conducted with respect to major occupational exposures and health characteristics of 201 workers. Results. Six major factors were identified as being predictive of occupational fluorosis development in aluminum industry workers: age (fluorosis risk increases with age); type 2 diabetes mellitus; atrophic gastritis; kidney cysts; X-ray examination data (fluorosis risk increases with the stage as determined by X-ray); the hydro fluoride concentration increases by more than 2 occupational exposure limits. The developed model was verified by clinical cases and showed a high predictive ability (86.2 %). Both sensitivity (true positive rate) and specificity (true negative rate) of the model amounted to 86.2 %. Conclusion. By multivariate analysis the significant, mutually independent factors were identified, their combination being associated with chronic fluorine intoxication in an occupational staff of aluminum plants. The developed mathematical model has a high predictive ability and can be recommended as a sure tool to forecast the course of occupational fluorosis development in the workers at the aluminum industry. © 2020 Izdatel'stvo Meditsina. All rights reserved.The work of Solodushkin was supported by Act 211 Government of the Russian Federation, contract No 02.A03.21.0006

The influence of different concentrations of dust of chrysotile asbestose and hazardous length of employment on terms of developing asbestosis among employees of the OJSC "llralasbest"

An objective of this study is to provide a comparative assessment of influence of the “harmful seniority” and various levels of aerosol concentrations of chrysotile asbestos in the work area air as well as of duration of the “dust seniority” on the risk of developing asbestosis.Цель исследования: дать сравнительную оценку влияния «вредного стажа» и различных уровней концентраций аэрозолей хризотил-асбеста в воздухе рабочей зоны и длительности пылевого стажа на риск развития асбестоза

Carbohydrate metabolism disorders in patients suffering from asbestos causing diseases

The aim of the study is to investigate the status of carbohydrate metabolism in patients with asbestosis and dust bronchitis. It has been revealed that the high prevalence of the carbohydrate metabolism disorders is specific for this kind of patients. Significant correlation relationship between some indicators of systemic inflammation and presence of the metabolic abnormalities has been also found. All this facts may indicate a possible role of the systemic chronic inflammation against the background of chronic bronchitis and asbestosis in the development of the carbohydrate metabolism disorders in patients suffering from «dust diseases» of lungs.Целью исследования явилось изучение состояния углеводного обмена у больных асбестозом и пылевым бронхитом. Установлена высокая распространенность нарушений углеводного обмена у данной категории больных и значимая корреляционная взаимосвязь между некоторыми показателями системного воспаления и наличием метаболических нарушений, что может свидетельствовать о возможной роли системного хронического воспаления при асбестозе и пылевом бронхите в развитии нарушений углеводного обмена у больных пылевыми заболеваниями легких

Clinical-functional assessment of patients' health after surgical myocardial revascularization at stage of medical rehabilitation

Carrying out medical rehabilitation after coronary artery bypass grafting in patients with coronary artery disease significantly improves the functional and adaptive parameters of the cardiorespiratory system in the process of rehabilitation.Проведение медицинской реабилитации после шунтирования коронарных сосудов у пациентов ИБС достоверно приводит к улучшению функциональных и адаптационных показателей кардиореспираторной системы в процессе реабилитации, реабилитация

The impact of donor factors on the results of kidney transplantation

Kidney transplantation is an optimal method of a renal replacement therapy of end-stage kidney failure. We have done the retrospective research of cohort 350 patients after kidney transplantations to disclose the predictors of the operation outcomes. We used methods of a single-factor and a multi-factor analysis. We found out that the predictors of the results of kidney transplantation are; a donor age, a type of donor kidney removal, perfusion time, reanimation time, kidney’s preservation time etc.Трансплантация почки является оптимальным методом заместительной почечной терапии терминальной почечной недостаточности. Проведено когортное, ретроспективное исследование, включившее 350 пациентов после трансплантации почки, для выявления предикторов исхода трансплантации почки по факторам, связанным с донором почки. Были использованы методы однофакторного и многофакторного анализа. Выявлен ряд предикторов исхода трансплантации почки таких как: возраст донора, тип изъятия донорского органа, длительность перфузии донорского органа, длительность пребывания донора в реанимационном отделении, время консервации почки и другие

Cardiovascular Toxicity in Copper Production Workers Exposed to Heavy Metals

Introduction. Cardiovascular diseases (CVD) are a leading cause of morbidity and mortality. The role of occupational hazards in the CVD prevalence remains to be clarified. Material and methods. Here we report the results of the study of risk factors and CVD prevalence in 590 workers at the largest copper production plants in the Sverdlovsk region, exposed to heavy metals in the workplace. The workers' health information was obtained during a regular medical examination in 2018. The lead concentration increase to 1.3-1.8 occupational exposure limits was registered in the working areas of the concentrating mill (for bunkerman) and copper smelting workshops (transporter, smelter, converter, non-ferrous metal spreader, repairman, electrician). Results. We studied the exposure indices (Pb level in blood), the response markers (reticulocyte count, erythrocytes basophilic stippling, coproporphyrin, and aminolevulinic acid in the urine), and their correlation to a working tenure. Based on this analysis, we attributed CVD risk factors and cardiovascular diseases to the occupation, in order to potentially modify some of those risk factors and ultimately inform the risk management. Hypertension occurred in 57% of the examined workers, which is higher than in the general population. We calculated relative risk, confidence intervals and attributable fraction. We developed a predictive mathematical model (stepwise logistic regression) to predict high-stage hypertension and identified the risk factors associated with its development. Conclusions. Correlation analysis revealed direct correlations between stages 2 and 3 hypertension and a working tenure over 20 years. We think it's reasonable to consider the documented CVDs as related to the toxic effects of heavy metals (lead and cadmium). © 2020 Izdatel'stvo Meditsina. All rights reserved.The work of Solodushkin was supported by Act 211 Government of the Russian Federation, contract No 02.A03.21.0006