An analysis of the literature and an essay on the problem of recognizing the diseases of workers — diagnosis and causation(work-relatedness assessment) are given. A historical reference is made on the etiology of workers’ diseases and the statements of the classics about the causality in medicine. The main categories of occupational medicine and terminology of the WHO and ILO, the principles of evidence in occupational health are considered. The WHO concept of work-related diseases (WRD), occupational disease (OD) recognition systems under ILO Convention No. 121, features of the ILO occupational diseases list (revision 2010), and the criteria for inclusion of diseases in this list are presented.

The general provisions of causation, types of causation algorithms in consensus and evidence-based medicine, as well as a generalized algorithm for analyzing periodic medical examinations data are considered. The European experience of recognition of WRD is considered. Based on experience and literature data, we propose a 10-step causation algorithm, including forecasting the probability of OD and WRD, as well as quantifying the degree of work-relatedness with computer support programs from the electronic directory «Occupational Risk» (http://medtrud. com/). It is concluded that legal recognition of WRD is needed for early diagnosis and prophylaxis of workers’ health disorders in conditions of digitalization of the economy and society.

The article covers main principles of improvement of health preservation system forKazakhstanRepublicworkers within «Kazakhstan–2050» strategy. In 2015, economically active population reached 9 million people, economic activity level equaled 71.7%. Share of workers subjected to hazardous and unsafe work conditions is 22.2%. Maximal shares of workers subjected to hazardous and unsafe work conditions are seen in mining and processing industries. Legal documents were specified inKazakhstanto provide medical care for occupational diseases and for patients’ rights protection. In 2015, Kazakhstan Republic Law set «examination of disease connection with workers’ occupational activities». Main directions of workers’ health care improvement inKazakhstanRepublicare presented.

Health of Kyzylorda region dwellers is influenced by following negative factors: physical — climate (sharply continental dry hot climate, winds, high solar radiation); chemical — biochemical components in water, soils, ambient air, radiation background; anthropogenic — overregulated river-bed of Syrdaria, insiccation of Aral sea, oil extraction, uranium ores extraction, etc.

Findings are that the maximal respiratory diseases prevalence is seen in a region neighboring toAral sea. Kyzylorda region used to take 3rd place in the republic for average longstanding mortality with respiratory diseases. High morbidity in Zhalagashsky and Zhanakorgansky districts, high mortality with respiratory diseases in Kazalinsky and Zhanakorgansky districts are seen in regions situated far fromAral sea.

Based on examination of 241 individuals in Maisky settlement nearSemipalatinsknuclear testing area, the authors demonstrated psychological health on somatic diseases basis. Findings are structural changes of asthenic syndrome, anxiety level and depressive disorders, influencing somatic diseases course in the examinees of the region under study. The results obtained determine state of psychological health in patients of the region, that is necessary in treatment and prophylaxis specification.

An important objective of environmental hygiene is to minimize consequences of technogenic and anthropogenic factors influence, that necessitates evaluation of their toxic properties including prenosologic and long-term mutagenic and carcinogenic effects. Human body pollution due to intake of subliminal but longstanding exotoxins decreases human resources, can cause various diseases and lower health of population. The article presents results of study concerning inhalation dose load of chemicals on cardiovascular system inAral searegion dwellers. The study covered 6984 individuals. Based on the models established, the authors revealed that such metals as nickel and zinc decrease myocardial contractility.

The article covers analysis of scientific and methodological literature and the authors’ research on studies of health-saving technologies in educational institutions including technical and professional educational offices. The authors presented physiologic and hygienic basis of health-saving technologies in technical and professional educational institutions, aimed to preserve and increase health state of professional technical college students, where mass occupations are mastered and active occupational fitness is formed.

The authors analyzed informational statistic materials of Occupational pathology center in Rostov region over 1960–2016 and information on retrospectively formed cohort of coal miners (1990–2015). Medical and demographic characteristics of the cohort covered work conditions, age at occupational disease diagnosis in the miners, structure and dynamics of occupational morbidity in various occupational groups. Over the stated time interval, unfavorable work conditions of the coal miners were associated with high risk of occupational disease development. The miners of the studied cohort appeared to have respiratory diseases and vibration disease at able-bodied age (70.4%) prevalent in occupational diseases structure.

The study covered workers of asbestos cement plants and miners (n = 214). Polymerase chain reaction method in real time helped to identify genotypes of genes XPD (rs13181, rs799793) and ERCC1 (rs11615).

The study results prove that XPD*C/C genotype is associated with bronchopulmonary disease risk (p≤0.02, χ2=4.97; OR=2.40; 95% CI: 1.03–5.64).Carriers of XPD*A/C genotype appeared to have relative resistance to bronchopulmonary diseases risk (χ2=3,52, р≤0,06; OR=0,57; 95%CI: 0,30–1,07).

The authors considered changes of peripheral blood parameters in female population exposed to suspended substances (РМ₁₀ and РМ_2,5) in ambient air on ecologic disaster territory — Kazakhstan part near Aral sea. RBC changes are revealed, these signs appeared to be prevalent among the females examined, correlation links are strong between the suspended substances (РМ₁₀ and РМ_2,5) in the ambient air and the blood parameters.

The article presents molecular genetic characteristics of M. tuberculosis circulating in Omsk region, as a biologic risk factor of tuberculosis morbidity among medical institutions workers. The authors used descriptive method of epidemiologic study, method of MIRUVNTR-typing of M. tuberculosis DNA. Findings are M. tuberculosis stains of Beijing genotype with VNTR-profile 233325173533424, isolated out of tuberculosis patients cluster being under stationary treatment. 65.2% of the stains had multiple drug-resistance to anti-tuberculosis medications. Respiratory tuberculosis was diagnosed in 85.4% of the cases, extra-pulmonary tuberculosis (urinary system, peripheral lymph nodes, eyes, CNS tuberculosis) equaled 14.6%. Nearly 30% of tuberculosis cases in the health care workers were associated with the bacterioexcretion.

Results of a study covering population of Maisk settlement near Semipalatinsk test site demonstrated possible thyroid diseases in 32.6% of the examinees. Predisposition to autoimmune diseases of thyroid gland (presence of antibodies to thyroid peroxidase) was revealed in 23% of the population. Increased production of stress hormone (cortisol) is characteristic for 39.4% of the females and 37.7% of the males — that is confirmed by changes in the body adaptation system of the third generation inhabitants, if ionizing radiation influence on the previous generations.

Health Survey scale SF–36 is one of the most popular methods assessing life quality associated with health. The questionnaire presents general well-being and degree of contentment with human functioning influenced by health state. In Maisky settlement referenced to a zone of Semipalatinsk nuclear test site, the studied adult population demonstrated satisfactory social life conditions. The examinees’ evaluation of their health state in general health scale at age 18–29 years averaged to 61.66±3.15 points, at the age 30–39 years — 59.27±2.11 points, at the age 40–50 years — nearly 2 times lower than normal values. Health state of all population is limited by role-oriented physical functioning and vitality — that promotes anxiety and psychological ill-being.