Biomedical subjects
Publications and source records attributed to N S Sorkina.
Contemporary forms of occupational diseases are often characterized by many body systems involved, with response of specific and nonspecific effects. Due to observed transformation in character and course of the main occupational entities, specifying the new clinical classifications, new "List of Occupational Diseases" adapted to ICD-10, by specialists remains topical.
Some features were revealed after study of 185 patients with various occupational diseases: chronic lead intoxication, bronchial asthma, and disorders caused by fluor. Considering polyetiology and nonspecificity of gastric diseases, the authors could not determine the changes revealed as caused only by occupational exposure.
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The article covers literary data and observations concerning influence of occupational factors and working environment on workers' reproductive health. The authors stress common ground of pathogenetic mechanisms underlying pathomorphosis of reproductive disorders and other symptoms caused by occupational exposure. The materials emphasize importance of reproductivity studies in workers exposed to occupational hazards, as reproductive disorders are early and gentle signs of inner imbalance.
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Formed 75 years ago, occupational pathology has defined structure of occupational morbidity, determined principles of occupational diseases' pathogenesis and pathomorphosis, demonstrated dependence of occupational entities on acting occupational hazards, described clinical manifestations of occupational diseases, emphasized informative diagnostic complexes. Diagnosis in occupational pathology now is established on basis of etiology. Manifold activities helped to form a system preventing health disorders caused by occupational hazards. Topical problem is to elaborate and put into practice some criteria for compensation of occupational damage with differential expert assessment of functional disorders caused either by occupational disease or by general one. Prospective trend could be to create a system organizing and managing workers' health on workplace and to put "protection by time" principle into practice with forecasting risk of occupational diseases and dose-effect dependence. Another prospect is to elaborate and put into practice a training in social and psychologic adaptation for occupational managers and industrial workers.
Use of biologic monitoring for workers exposed to lead is the most efficient means preventing lead intoxication all over the world. Considering WHO recommendations and personal research, the authors specified national system of biologic monitoring for workers exposed to lead. The system covers mandatory control of serum and urinary lead levels. The authors based biologic MAC for lead in serum-50 mg/dl (males) and 30 mg/dl (females).
The authors present materials of clinical and hygienic study checking MAC for lead in the air of workplace. The study covered 506 workers of printing, nonferrous metallurgy plants and storage battery production. The study included examination of cardiovascular, nervous, digestive systems and laboratory values and revealed high diagnostic value of serum lead level and low one of urinary lead level. High number of the groups examined and mathematical processing of incomplete selects (Caplan--Meyer assess) proved that intoxication resulted from higher lead concentrations (0.58-0.8 mg/m3). The lead levels of 0.2 mg/m3 in 23.7% of cases induced changes of 2-3 laboratory values-first signs of lead intoxication--and in 5.2% of cases some symptoms of vegetative sensory polyneuropathy were seen. These lead levels are therefore determined as minimally acting. Calculations of probability parameters for health risk helped to set MAC for lead in the air of workplace at 0.05 mg/m3 (this value is accepted by Russian Health Ministry) with mandatory control of serum lead level.
The article presents experimental data showing that Average Shift Concentration (ASC) and Maximal Single Concentration (MSC) for some solvents (tetrachloromethane, tetrachloroethane, dimethylformamide, benzene) are expedient to be justified. Clinical and hygienic materials proved significant health parameters (nervous system, peripheral blood) and urine levels of main metabolites to depend on chlorbenzene and toluene concentrations influencing the workers. Having analyzed the results, the authors recommended following hygienic norms in the air of workplace: for chlorbenzene ASC--50 mg/cu m, MSC--100 mg/cu m; biologic MAC for urine 4-chlorcatechol--0.05 g/l; for toluene ASC--50 mg/cu m, MSC--150 mg/cu m; biologic MAC for urine hippuric acid--1.5 g/l. The article shows some features of ASC and MSC practical application.
Retrospective and prospective epidemiologic studies revealed features of pathomorphosis and response, defined various pathogenetic mechanisms induced by complex, combined exposure to poisons at work. The article determined main neurologic and hematologic syndromes considered as early and sensitive diagnostic criteria of poisons influence on workers exposed to them. The authors described some variants of course and long-term complications of prolonged exposure to poisons.
Examination of 953 workers exposed to low concentrations of chlorbenzene, tricresol and dimethylfonnamid revealed such functional neural disorders as cardiovascular neurosis. Chlorbenzene and tricresol resulted in hypertonic cardiovascular neurosis, dimethylformamid--in hypotonic one. Occurrence of cardiovascular neurosis grew with the longer length of service.
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