scholarly journals Features of metabolic disorders in chromium mine workers

2021 ◽  
Vol 100 (10) ◽  
pp. 1095-1102
Author(s):  
Nina V. Zaitseva ◽  
Vitalii G. Kostarev ◽  
Konstantin P. Luzhetskiy ◽  
Alexander E. Nosov ◽  
Olga Yu. Ustinova ◽  
...  

Introduction. Working conditions, clinical and laboratory status of 236 workers of a chromium mine were investigated. Materials and methods. The observation group included 162 underground employees working in conditions of the combined impact of negative occupational factors (dust, noise, vibration, tension and severity there, cooling microclimate) - class 3.3-3.4. The comparison group included 74 mine employees working in acceptable working conditions - class 2. Results. In the observation group, the pathology of the cardiovascular and endocrine system (ICD-10: I00-I99, E00-E07) was detected 2.8-3.3 times more often (p = 0.001-0.02), the relative risk of disease formation was 2.7-3.2 times higher than in the comparison group (RR = 2.7-3.2; DI = 1.44-9.2; p = 0.001-0.02). Under the conditions of the combined effect of negative production factors, as features of metabolic disorders, it was noted that the most unfavourable - abdominal form of obesity was diagnosed 1.4 times more often (42.0%, p = 0.013), the atherogenic index was 1.2 times higher, and the level HDL is 1.2 times lower than in the comparison group (p = 0.017-0.047); “Metabolic indices” - lipid accumulation coefficient (LAP) and visceral obesity index (VAI) were 1.2-1.4 times higher than the values in the comparison group (p = 0.001-0.048). Conclusions. To implement a complex of medical and preventive measures aimed at increasing life expectancy and working longevity, early prevention of CVD, including among those working in the extraction of chrome ore, it is advisable to consider the introduction of the calculation of early markers of metabolic disorders - VAI and LAP indices in the medical examination programs.

Author(s):  
M. M. Poroshina ◽  
E. M. Vlasova ◽  
A. Ya. Perevalov

The results of research carried out by theFederalScientificCenterfor Medical and Preventive Technologies of Public Health Risk Management Technologies for the period 2013–2018 showed that diseases associated with the combined effects of vibration and physical overload, employees of hazardous industries develop with experience of 15 years or more. The risk group is women older than 35 years and men older than 40 years. Pathology at the stage of detailed clinical manifestations is characterized by persistent pain syndrome, and, as a consequence, a decrease in the ability to work of workers.The aim of the study was to optimize the system of diagnosis of hand diseases in workers of industrial enterprises engaged in labor activities under the combined effects of vibration and physical overload, for the development of primary prevention programs.The observation group consisted of 32 employees aged 39.3±4.3 years, with an experience of 17.4±4.3 years; the comparison group consisted of 30 employees whose working conditions are not related to the studied factors; the average age was 40.6±3.4 years, experience was 19.1±3.1 years. The examination included analysis of the results of a special assessment of working conditions; assessment of neurological status; functional tests; laboratory studies (assessment of inflammation), hand dynamometry, stimulation electroneuromyography; x-rays of the hands and wrist joints, ultrasound examination of the hands.More than half of the surveyed persons of the observation group and 3/4 of the workers of the comparison group did not make complaints. Indicators of dynamometry of workers in both groups corresponded to physiological norm (p>0.05). Analysis of the results of dynamometer with data from previous years of PMO showed a decrease in strength of muscles of the hand leading hands on 2je,0–16. 7% and from 83.3% of the employees of the monitoring group and in 44.4% of the comparison group (p<0.05), in 50 % of the cases there was a decrease in the percentage of changes in the hand force variation (HFV) in the observation group, and in 38.9% of the cases the indicators remained unchanged. According to ultrasound of the hands, signs of tendinopathy were established in 85% of the employees of the observation group in the absence of persons with similar changes in the comparison group.In order to optimize the diagnosis of diseases of the hand in industrial workers who carry out their work under the combined effects of vibration and physical overload, in the case of a decrease in the rate of carpal dynamometry by 5% or more during the year, it is recommended to conduct ultrasound of the tendon-ligamentous apparatus of the hand, which will allow timely identification of early signs of tendinopathy.


2021 ◽  
Vol 100 (5) ◽  
pp. 464-470
Author(s):  
Olga Y. Ustinova ◽  
Nina V. Zaitseva ◽  
Vitalii G. Kostarev ◽  
Elena M. Vlasova ◽  
Alyona A. Vorobyova ◽  
...  

Aim of the study. To analyze the patterns of the comorbidity pathology formation in employees occupied in oil production. Materials and methods. Observation group - 292 employees of the oil production enterprise (100% men). The average age was 39.4 ± 10.6 (20-65) years. Average work experience is 13.1 ± 9.6 (3-22) years. The comparison group included 65 employees working in the management of the enterprise. The average age is 40.2 ± 9.8 (20-65) years. Average work experience is 18.5 ± 9.5 (5-23) years. Observation group - 292 oil and gas production operators (OGP) - 100% men. The study involved a comprehensive research program, results analysis, and mathematical modeling. Results. It is typical for oil and gas production operators to be exposed to a complex impact of harmful production factors: industrial noise, the intensity of work, and physical overload combined with chemical factors. A prior occupational risk to the employees under mentioned working conditions was classified from low (moderate) risk to medium (significant) risk. The age of employees with developed comorbid pathology in the observation group was 31.7 ± 5.4 years, work experience in the specified working conditions was 4.6 ± 1.1 years; the age of workers in the comparison group was 35.4 ± 3.9 years, work experience was 7.4 ± 2.7 years. The results of functional studies have demonstrated a complex of abnormalities in workers with little expressed clinical symptomatology. Analysis of comorbid pathology showed an increase in n according to CIRS score, increasing the working experience among oil and gas operators. Conclusion. Comorbid pathology occurs in oil production workers within ten years of working experience under conditions of combined occupational and non-occupational factors. In the comorbid pathology development, both induced intrasystemic and intersystemic disorders significantly worsens the working life prognosis.


Author(s):  
E. M. Vlasova ◽  
E. A. Polevaya ◽  
M. M. Poroshina ◽  
M. I. Tiunova ◽  
V. B. Alekseev

Introduction. The relevance of the study of cardiovascular diseases (CVD) as a production-related pathology in workers at industrial enterprises is due to the presence in the technological process of production factors (noise, general vibration, microclimate, severity of labor, chemical factors), potentially capable of provoking the development of CVD.The aim of the study was to assess respiratory and metabolic disorders, which are risk factors for CVD, in workers exposed to dust, chlorine and hydrogen chloride.Materials and methods. 139 patients working under the influence of dust, chlorine and hydrogen chloride were examined. Among the surveyed 74 women and 65 men. The comparison group (45 people) consisted of 20 women and 25 men who were not exposed to harmful factors of production during their working life.Results. In the group of workers exposed to occupational exposure to dust, chlorine and hydrochloride vapors, it was revealed that the proportion of workers with arterial hypertension was 33.3%, in the comparison group–17.6%, p<0.05 (RR 1.99; 95% CI 1.01–3.93; EF=47%; the degree of professional conditioning is average). The volume of forced exhalation per 1 second (FEV1) in the observation group was 3.18±0.14 l, and in the comparison group–4.1±0.20 l (p<0.001). The level of total cholesterol in the observation group was 5.72±0.13 mmol / l, and in the comparison group–5.16±0.23 mmol / l (p<0.05). The observation group showed a decrease in HDL (1.35±0.04 mmol / l vs. 1.64±0.10 mmol / l in the comparison group, p<0.05) and an increase in triglycerides (2.3±0.17 mmol/l versus 1.51±0.16 mmol/l in the comparison group, p<0.05).Conclusions. In the group of workers exposed to professional dust, chlorine and hydrochloride vapors, a decrease in the speed parameters of the external respiratory function, the development of proatherogenic metabolic disorders, and an increase in laboratory indicators of inflammation were revealed. These changes can lead to early manifestation of cardiovascular and respiratory pathology in this category of workers.


Author(s):  
Ju. A. Ivashova ◽  
E. A. Polevaya ◽  
T. A. Ponomareva

Vibration pathology, including disorders of the vascular, nervous and musculoskeletal systems, occupies one of the first places in the structure of health disorders in workers of vibration-hazardous industries.The aim of the study was to identify informative diagnostic criteria for identifying early signs of upper limb lesions.The observation group consisted of 90 workers aged 46.7±2.5 years (p>0.05), with experience of 22.4±3.9 years; the comparison group–60 workers whose working conditions were not associated with the studied factor; the average age of 45.8±2.4 years, experience of 24.1±4.1 years (p>0.05). The survey included the analysis of working conditions and professional route, clinical examination, questionnaires, laboratory and functional studies, statistical processing of the results, calculation of epidemiological indicators.The analysis of working conditions showed that the level of local vibration exceeded the maximum permissible level by 2–6 dB for the employees of the observation group. The survey showed that going to the doctor is a last resort for workers, even in the case of chronic pain. According to the results of the survey and examination, it was found that the formation of pain syndrome in employees of the observation group occurs against the background of the development of vascular and neurovascular disorders. There was an increase in the estimated age of the arteries of the upper extremities (5.3±2.8 years) in 23.3% of the observation group. Analysis of dynamometry results in dynamics for three years showed a slowly progressive decline in 21.1% of workers in vibration-hazardous professions with 11.3±3.4 years of experience, and only 3.3% of workers in the comparison group with 23.6±6.3 years of experience. In General, there is a high risk of decreased muscle strength, which is prognostically significant for the preservation of professional ability to work. The calculation of epidemiological indicators confirmed the connection of vasospastic reactions with the impact of local vibration (χ2=5.85, p<0.001; F=0.177, p<0.05; RR=2.5, 95% CI=1.7–3.7; EF=65%). Under the influence of local vibration, early signs of upper limb lesions develop with 5 years of experience and are characterized by vascular changes. Clinical syndromes characteristic of vibrational pathology are formed with an average length of service of 10 years. It is necessary to improve the complex of diagnostic measures aimed at identifying early signs of damage to the upper limbs, in order to improve the labor prognosis in workers under the influence of local vibration.


Author(s):  
N. V. Zaitseva ◽  
A. E. Nosov ◽  
Ju. A. Ivashova ◽  
A. S. Baidina ◽  
V. G. Kostarev

Introduction. Currently, endothelial dysfunction is considered as one of the initial stages of the pathogenesis of cardiovascular diseases. By isolating a number of biologically active compounds, the endothelium helps to maintain vascular tone and physiological rheology of the blood. Modern production of chrome ore is characterized by a variety of harmful occupational factors (chromium, dust, noise, vibration, severity and intensity of work, cooling microclimate), which can disrupt the normal functioning of the vascular endothelium and lead to the development of cardiovascular diseases.The aim of the study was to study the features of endothelial function in workers engaged in underground mining of chrome ore in harmful working conditions.Materials and methods. The study included 98 miners of the enterprise for the extraction of chrome ore. The comparison group (working in conditions outside the influence of the studied production factors) consisted of 75 employees-managers and specialists of administrative and managerial personnel of the enterprise, comparable in age and experience with the observation group. To assess the vasomotor function of the endothelium, a flow-dependent (endothelium-dependent) vasodilation test was performed using the D. S. Celermajer technique. Post-occlusive increase in brachial artery diameter, brachial artery sensitivity coefficient to endothelial shift change were evaluated.Results. The endothelial function of mine workers did not differ significantly from the comparison group with work experience up to 10 years (the values of the relative increase in the diameter of the brachial artery 12.2% in the observation group and in the comparison group 12.6%, p=0.74). With experience of more than 10 years, the value of the relative increase in the diameter of the brachial artery in the observation group with experience of more than 10 years corresponded to the signs of endothelial dysfunction and amounted to 8.6%, while in the comparison group this figure was 12.4%, which corresponded to normal endothelial function (p=0.019). Endothelial function progressively deteriorated with increasing seniority in mine workers. Conclusions. For workers engaged in underground mining of chrome ore for more than 10 years, a reduced vasodilation reaction to reperfusion after an occlusion test and a low coefficient of sensitivity of the endothelium to shear stress are characteristic. There was no statistically significant decrease in increase in brachial artery diameter and the coefficient of sensitivity of endothelium to shear stress relative to the comparison group was selected only from persons with experience more than 10 years. The comparative analysis of the results of the evaluation of the functional activity of the endothelium in workers of the compared groups indicates that the change in the functional state of the endothelium in miners is associated not only with age, but also with working conditions. The revealed changes predispose to the development of cardiovascular pathology associated with atherosclerosis in workers of underground chrome ore mining.


Author(s):  
Inga N. Alikina ◽  
Olga A. Kazakova

Introduction. Studies indicate the high pathogenetic significance of the immune component in the development of atherosclerosis. The aim of the study is a comparative assessment of immunological parameters in workers of petrochemical production with varying degrees of imbalance in lipid metabolism and the development of the atherosclerotic process. Materials and methods. Men working at an oil production enterprise in the Perm Region were examined. The observation group consisted of oil production operators with a diagnosis of atherosclerosis, the comparison group - with dyslipidemia syndrome. To determine the parameters of lipid metabolism, the results of a biochemical blood test were used. CD-immunogram parameters were identified by flow cytometry. Specific antibodies to benzene were determined by the allergosorbent method. Results. The results of a comparative study of fat metabolism confirmed violations of the physiological ratio of lipids in the blood of oil production workers, which were expressed in a significant imbalance in the levels of lipidogram. There was an increased level of specific IgG antibodies to benzene in the observation group in relation to the comparison group. An imbalance of cellular immunity was found, which was characterized by signs of indicators activation of cellular differentiation clusters. Conclusions. Studies of immune system compartments demonstrate excessive activation of cellular and humoral immunity in oil production workers under the influence of a combination of harmful production factors. The simultaneously formed imbalance of lipid metabolism is associated with various degrees of clinical manifestation of atherosclerotic disorders, with the influence of harmful production factors, aggressiveness of cellular and humoral immunity, and smoking.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 515.1-515
Author(s):  
Y. Gorbunova ◽  
T. Popkova ◽  
L. Kondrateva ◽  
M. Cherkasova ◽  
E. Nasonov ◽  
...  

Background:Patients with rheumatoid arthritis (RA) and obesity have a lower risk of early death than patients with normal weight due to the so-called “obesity paradox”. Available publications discuss three phenotypes of obesity: classical obesity, metabolically healthy overweight/obesity, and latent obesity (normal weight associated with metabolic disorders, most importantly - with insulin resistance and adipocytokines imbalance).Objectives:To clarify the prevalence of obesity phenotypes and to identify factors predisposing to «latent obesity» in early RA without diabetes mellitus or hyperglycemia.Methods:The study included 35 pts (23 women, 12 men) with early RA (criteria ACR / EULAR, 2010), 56 [43,0; 60,0] years old, naïve to treatment with glucocorticoids and disease-modifying anti-rheumatics, without established diabetes mellitus. Pts were seropositive for IgM RF and anti-CCP, with highly active RA (DAS28 5,9 [5,2; 6,4]; SDAI 35,4 [27,0; 45,8], and CDAI 31,0 [26,0; 44,0]) scores, and median disease duration of 8.0 [6,0;15.0] months. Electrochemiluminescence assay Elecsys (Roche Diagnostics) was used to measure patients’ insulin levels, and ELISA (DBS – Diagnostics Biochem Canada Inc.) - for evaluation of serum leptin concentrations. Insulin resistance (IR) was defined as Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR) ≥2,77. Leptin levels were considered elevated at values ≥11,1 ng/ml for women, ≥5,6 ng/ml for men. The overweight/obesity status was determined by World Health Organization criteria in pts with body mass index (BMI) ≥25kg/m2.Results:Overweight/obesity were documented in 19 (54, 3%) pts with early RA, 4/19 (21%) had high leptin levels and IR, 11/19 (58%) had isolated hyperleptinemia. Normal BMI was found in 16 (45,7%) pts with early RA, 2/16 (12,5%) had elevated leptin levels and IR, and 6/16 (37,5%) – only hyperleptinemia. Four (21%) out of 19 overweight and 8 (50%) out of 16 pts with normal BMI did not show any metabolic disorders (p=0,02). Сlassical obesity was found in 15 (43%), and latent obesity – in 8 (23%) pts with early RA. Leptin levels correlated with waist circumference (r=0,58, p=0,02), BMI (r=0,71, p=0,0006), ESR (r=0,5, p=0,02) in the overweight/obese pts, and with waist circumference (r=0,59, p=0,03), IgM RF (r=0,58, p=0,03), triglyceride levels (r=0,77, p=0,003), and atherogenic index (r=0,62, p=0,03) in pts with normal weight.Conclusion:The classical obesity phenotype associated with abdominal obesity and inflammation was the most common and prevailing over other phenotypes in early RA. Latent obesity was less common and was associated with an unfavorable lipid profile and accumulation of abdominal fat, therefore increasing the risk of cardiovascular diseases in RA. Metabolically healthy overweight/obesity in early RA was really a rare phenotype.Disclosure of Interests:None declared


Author(s):  
Alexandr E. Nosov ◽  
Nina V. Zaitseva ◽  
Vitalii G. Kostarev ◽  
Julia A. Ivashova ◽  
Maksim A. Savinkov ◽  
...  

Introduction. Currently, the violation of heart rate variability as one of the main pathogenetic mechanisms of the damaging effect of pollutants, associated effects on the cardiovascular system. The study aims to explore the dynamics of the influence of the autonomic nervous system (ANS) on heart rate variability (HRV) in workers of a potassium ore processing enterprise exposed to industrial pollutants (fine fractions of potassium chloride dust, formaldehyde, hexane, heptane) with an assessment of changes in dependence from work experience, establishment of cause-and-effect relationships of violations of heart rate variability with exposure to chemical compounds. Materials and methods. The object of the study was 140 employees of a potash ore processing enterprise, assigned to the observation group, and 76 employees of the administrative and technical apparatus, who made up the comparison group. Samples were taken from the air of the working medium for the content of saturated hydrocarbons (hexane, heptane), the vapors of formhehyde were considered, and the presence of fine particles PM2.5 and PM10 was established. Investigation of biological media (blood, urine) of workers at the enterprise determination of formaldehyde in blood, hexane and heptane in urine. Evaluation of heart rate variability was carried out on a computer electrocardiograph "Poli-Spectr-8/EX" using a cardiorhythmographic program using the method of time analysis, variation pulsometry and spectral analysis. Results. The concentration of fine particles in the air at the workplaces of the observation group was 12-111 times higher for PM2.5, and 5.6-74.6 times higher for PM10 than for the work places of the comparison group. The concentration of formaldehyde, hexane and heptane in the air did not exceed hygienic standards. In the observation group relative to the comparison group, formaldehyde blood was 1.5 times (p<0.001), in the urine of hexane - 1.2 times (p=0.011), heptane - 1.3 times (p=0.046). It was found that with an experience of up to 10 years, formaldehyde in the blood of workers in the observation group was 1.4 times higher than that in the comparison group (p=0.011), with an experience of more than 10 years - 1.7 times (p=0.005). In the urine of workers in the observation group with work experience of up to 10 years, an excess of 1.3 (p=0.026) relative to the comparison group of hexane was found. HRV data analysis. With damage to the length of service in the observation group, there was a significant decrease in the temporal analysis indicators (SDNN, ms, RMSSD, ms, pNN50, %, CV, %), while in the comparison group, only the CV, % decrease was statistically significant; the values of IN conventional units, AMo, % significantly increased (p=0.03 and p=0.003, respectively). A statistically significant relationship was established between the likelihood of an increase depending on the content of heptane in urine (b0=0.22; b1=10.6; F=21.5; R2=0.09; p=0.0001) and formaldehyde in the blood (b0=0.02; b1=6.55; F=69.6; R2=0.25; p=0.0001) in the surveyed workers. Conclusions. Activation of central ergotropic and humoral-metabolic mechanisms, a tendency towards a decrease in parasympathetic influences. The method of logistic regression analysis established a statistically significant relationship between the probability of an increase in the stress index depending on the heptane content in the blood of the surveyed suppliers.


2018 ◽  
Vol 20 (6) ◽  
pp. 899-904
Author(s):  
E. A. Otavina ◽  
O. V. Dolgikh ◽  
K. G. Starkova ◽  
O. A. Kazakova ◽  
A. A. Mazunina

Evaluation of the immune system parameters can be used in order to assess capacity to adapt under conditions of increased external chemical load, including exposure to metals, which can exert either activating and inhibitory effects upon immune regulation parameters. The aim of this work was the analysis of immunoregulatory markers in a children’s population who consumed water with high strontium content (a sample from the Perm region). We carried out immunological evaluation of the children aged 7 to 12 years, living at a territory with a high strontium content in the drinking water. The comparison group included children from the conventionally clean region. We studied differential changes in cellular immunity (phagocytosis rates), humoral factors of immune defense (serum immunoglobulins), development of specific sensitization for strontium, as well as the processes of apoptosis triggering and regulation. A 3.68-fold increase in strontium levels was shown in fresh water within observation area, and the average  blood strontium content in the children of appropriate observation group was 1.55-fold higher than in children of the comparison group. At the same time, 1.2-fold increase in phagocytic activity determined as phagocytic number and phagocytic index was found, as compared to the control group. In 80% of the subjects, a reduction in serum IgG level was observed when compared to physiological norm, as well as a significant decrease in IgG and enhance in IgM production against the levels found in the comparison group. Wehave also shown an enhanced total sensitization in 55.0% of the observation group as shown by the total IgE test compared with normal age ranges, as well as excessive specific sensitization to strontium by 2.49 times, according to the IgG criterion. Disturbance in apoptosis triggering was associated with decreased number of CD95+ lymphocytes and TNFR1+ cells (2.8-fold compared to reference values), shifted balance in apoptogenic proteins, an average of 2.6-fold decrease in Bcl-2 expression, a 2.8-fold reduction of the p53 transcription factor expression relative to the reference interval. Thus, we have shown an ability of strontium excess in drinking water to influence the most important indices of immune regulation in pediatric population. These changes may serve as indices of populational health status under of external strontium exposure.


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