Problems of evidence in occupational medicine

We devoted this article to the problem of causation and evaluation of causality associations in the occupational epidemiology, exposure assessment, occupational health, and industrial medicine using methodological approaches of clinical epidemiology, for which the term "evidence-based medicine" is wider used in the Russian Federation. The researchers paid some attention to the historical aspects of causality assessment in occupational medicine in the Russian Federation. The authors discuss the issues of evidence in occupational medicine, planning, and implementation of epidemiological studies in occupational therapy using specialized questionnaires and clinical, functional, molecular, and genetic techniques. We analyzed the concept of the "risk factor" of the disease along with the organizational and methodological bases of assessment and management of occupational risks in industrial medicine. The paper also offers applied examples of the relative risk assessment, highlighting the advantages and perils of selected methods in a comparative analysis. Scientists have affected the contribution of systematic reviews aiming to mine evidence-based rationale in occupational epidemiology. The authors speculate and conclude on the importance of risk assessment in the overall morbidity reduction in occupational medicine through efficient prevention programs, along with the underpinnings to include work-related conditions in the national loss of occupational diseases.

EXPERT SUPPORT OF PERIODIC MEDICAL EXAMINATIONS BY OCCUPATIONAL PATHOLOGISTS AS AN ELEMENT OF THE EXTERNAL AUDIT OF THE INDUSTRIAL MEDICINE CORPORATE SYSTEM

The article analyzes the current medical regulations in Russia for conducting mandatory periodic medical examinations (PME) of employees engaged in harmful working conditions, which are compared with the system for assessing working conditions and the system for diagnosing occupational diseases. It is shown that the requirement to conduct mandatory PME of employees engaged in harmful working conditions in occupational pathology centers is not economically justified and is not socially beneficial. A variant of expert support of mandatory PME by specialists-occupational pathologists of occupational pathology centers in order to increase their effectiveness is proposed.

Epidemiological research in industrial medicine: the healthy / unhealthy worker effect and problems of causality

The author investigates issues related to the professional ability of a person, analyzes the current state of terminology, including the terms "healthy worker effect", "healthy migrant effect", concludes that it is necessary to unify the scientific and medical terminology used in scientific research into the "healthy worker effect.

Status of Professional Morbidity in the Pridneprovsk Economic Region during 2015-2019

The purpose of the study was to analyze the occupational morbidity in the Dnieper Economic Region, its structure in dynamics for 2015-2019, identify the main causes that lead to the formation of occupational pathology, and suggest ways to solve the problem. Material and methods. Based on the processing of the medical documentation of the clinic, the Ukrainian Research Institute of Industrial Medicine, we conducted a comparative analysis of occupational morbidity indicators in the dynamics of 2015-2019 was carried out taking into account the main forms of pathology and regional distribution. Results and discussion. The level of occupational morbidity among workers of the Dnieper Economic Region in 2015-2019 varies from 354 to 10307 cases. The leadership in the formation of professional pathology remains with the Dnipropetrovsk region, where large enterprises of the leading branches of heavy industry are located, in dangerous and harmful conditions of which a significant number of people work. In the structure of occupational morbidity, the first place is occupied by chronic obstructive pulmonary diseases of occupational etiology (31.7%), the second is cochlear neuritis (27.3%), the third is radiculopathy (23.7%), and the fourth is vibration disease (7.6%). Indicators of occupational morbidity indicate only the detection of occupational pathology. The statistics do not reflect the true situation, which is due to the imperfection of labor protection legislation, the lack of legal and economic sanctions for concealing occupational diseases, and the shortcomings of medical diagnostic and preventive work among workers. The solution to this problem, in our opinion, may consist in enhancing coordination of the entire complex of scientific and practical activities for the development and substantiation of strategies, tactics and implementation of national policies from the most important areas of occupational medicine. Conclusion. It is necessary to formulate a systematic approach to the prevention of occupational morbidity of the population, taking into account the characteristics of the current situation in the region and in the country as a whole. Comprehensive solution of problems in the health of workers, taking into account the interagency coordination of the system of measures, in the future will ensure the preservation of labor potential, prolong working life, and reduce general and occupational diseases

Why I became an occupational physician …

Why I became an occupational physician … briefly explores the reasons and influences behind H. Engel’s decision to pursue a career in occupational medicine. It takes us through his move from Nazi Germany to a British Medical School, service in the Armed Forces, and later move to industrial medicine.

Why I became an occupational physician …

Why I became an occupational physician … briefly explores the reasons and influences behind Ralph Aston’s decision to pursue a career in occupational medicine. It takes us through fifty years of his career as he ascends the ranks of ‘industrial medicine’ through changing motivations and the odd bit of advice.

Fifty years ago: ‘General practice and industrial medicine in the United States’

This series provides a selection of articles from the past. In Fifty years ago: ‘General practice and industrial medicine in the United States’ B.H. Pentney briefly explores the trend towards compensation in occupational medicine, and how it may be a hindrance to the practice.

Why I became an occupational physician …

Why I became an occupational physician … briefly explores the reasons and influences behind Roy Archibald’s decision to pursue a career in occupational medicine. It takes us through how his liking for clinical medicine, prevention, and administration could be combined in the new and largely unrecognized specialty of industrial medicine in the 1940s.