Introduction. A healthy lifestyle is one of the most eff ective methods of preserving health and preventing non-infectious diseases. The mechanisms and factors that infl uence the formation of motivation for health and a healthy lifestyle in employees engaged in harmful working conditions have not been suffi ciently studied. The study of these mechanisms will allow us to more eff ectively shape health-saving behavior.

The aim of the study is to study negative aff ectivity, social suppression and anxiety in the formation of motivation to maintain health and a healthy lifestyle in coal industry workers.

Materials and methods. A survey was conducted of 75 employees of mines and sections in the South of Kuzbass with an established diagnosis of occupational diseases, as well as 54 people who do not work in harmful working conditions (engineering and technical workers). Surveys were conducted using the method “Index of motivation to health and a healthy lifestyle”, the presence of personality type D was conducted using the DS14 questionnaire, the level of personal and situational anxiety was assessed using the Spielberger — Hanin questionnaire.

Results. Th e level of motivation for health and a healthy lifestyle among patients with occupational diseases is signifi cantly lower than the level of motivation for the health of engineering and technical workers. Th e infl uence of negative reaction and social suppression on the level of motivation for health and a healthy lifestyle was not found. Th e level of situational anxiety also has no eff ect on health motivation. A higher level of personal anxiety among people with a high level of motivation for a healthy lifestyle was determined.

Conclusions. Personal anxiety aff ects the level of motivation for health and a healthy lifestyle in people with occupational diseases. 

Introduction. Th e development of the metallurgical industry in Novokuznetsk, Kemerovo region, has led to a diffi  cult environmental situation. Determining the relationship between exposure to atmospheric emissions and the health of the population based on the risk assessment methodology is an urgent hygiene issue.

The aim of the study is to assess the risk of health problems from emissions from rolling production of a metallurgical plant.

Materials and methods. We used data from the volume of maximum permissible emissions of the enterprise. Calculations of maximum single and average annual concentrations of pollutants were carried out using the program “ECOcenter-Standard”. Public health risks were calculated and compared with acceptable values. Th e work also determined the values of risk levels taking into account background concentrations.

Results. Priority pollutants were identifi ed: diiron trioxide, nitrogen dioxide, nitrogen oxide, sulfur dioxide, carbon monoxide, benz(a)pyrene. Th e maximum one-time and average annual concentrations of substances at the selected calculation points were determined, and the maximum permissible concentration of diiron trioxide was found to be exceeded. Immediate action risk levels are zero. The highest risk levels of chronic intoxication, expressed as a percentage of a unit, are observed from exposure to diiron trioxide (0.004-0.043) and nitrogen dioxide (0.001-0.012). The maximum total level of risks of chronic intoxication (0.012) is observed at the point of exposure to concentrations #3 from the infl uence of nitrogen dioxide, which is due to the close location of pollution sources. The carcinogenic risk from exposure to benz(a)pyrene ranges from 1×10-8 to 9×10-8 (as a fraction of a unit). The combined values of carcinogenic risk and immediate action risk are below the acceptable risk level. In seven points of exposure to concentrations, the total risk of chronic intoxication exceeds the acceptable level by 1.10-3.45 times.

The greatest risk of immediate action, taking into account background concentrations, is observed from the action of carbon monoxide and benz(a)pyrene. Th e carcinogenic risk exceeds the acceptable level by 6-12 times. The risk of chronic intoxication, taking into account the background, exceeds an acceptable level. Th e highest total risk levels are typical for the Kuznetsky district of Novokuznetsk. 

Conclusions. Atmospheric emissions fr om rolling mill production contribute to air pollution in the city, increasing the risk of chronic intoxication.

Introduction. In the structure of occupational diseases of employees of the main professions of the coal industry, respiratory diseases are widespread, in the process of formation of which the key role belongs to the immune system of the body. Early manifestations of the development of professional pathology, as a rule, remain unnoticed, and therefore there is a need to study the pathogenetic mechanisms underlying its formation, not only in clinical, but also in experimental conditions, allowing to assess the premorbid state of the body for timely diagnosis and treatment and prevention.

The aim of the study is to study the immune-infl ammatory mechanisms of anthracosilicosis formation on the basis of clinical and experimental studies.

Materials and methods. We examined 204 miners working in underground conditions with a signifi cant dustiness of workplaces exceeding the maximum permissible concentration by 10 or more times. Th e main group consisted of 115 workers with a previously established diagnosis of “anthracosilicosis”. Th e comparison group was formed from 89 miners without a diagnosis of respiratory pathology, working in similar sanitary conditions. To assess the dynamics of immuno-infl ammatory mechanisms in the experiment, modeling of dust pathology of the lungs was performed on 310 white male laboratory rats (220-experimental and 90 — control).

Results. In patients with anthracosilicosis, the development of immune failure of humoral immunity mechanisms was revealed, which was manifested by a signifi cant decrease in the level of serum IgG against the background of an increase in the absolute and relative number of B-lymphocytes. Th e formation of anthracosilicosis is characterized by the active development of the immuno-infl ammatory process (an increase in the level of pro-infl ammatory cytokines and proteins of the acute phase of infl ammation), the severity of which increases when the disease is complicated by respiratory failure. Activation of the synthesis of anti-infl ammatory IL-4, which is a powerful inhibitor of macrophage infl ammation and slows down the processes of fi brosis in the bronchopulmonary system, acts as a protective mechanism that prevents the formation of respiratory failure in miners with anthracosilicosis. Experimental modeling of anthracosilicosis revealed phase changes in the immune response. In the early period of exposure to dust factor was observed activation of humoral (increased level of all classes of immunoglobulins) and the subsequent development of the inflammatory process (increased concentrations of acute phase proteins of inflammation) in the background of the balance between subpopulations of T-lymphocytes to ensure proper development of protective immune response. Long-term intake of antigen was characterized by violations of humoral immunity, the predominance of cell-type reactions and the chronization of the infl ammatory process.

Conclusions. Th e study of immuno-infl ammatory mechanisms of anthracosilicosis formation in clinical and experimental conditions indicates the activation of urgent adaptation and maintenance of compensatory and adaptive reactions of the body in the early period of contact with dust antigen. Th e chronic form of anthracosilicosis is characterized by an imbalance of regulatory mechanisms, ineffi  ciency of local immunity and the intensive development of generalized immune infl ammation, which increases with the addition of infection and complication of respiratory failure.

Introduction. Intensive development of coal mining in Kuzbass contributes to the growth of professional pathology. Production factors lead to autonomous dysregulation and damage to peripheral nerves, and the development of upper limb polyneuropathy. Analysis of heart rate variability is currently widely used to determine the features of vegetative maintenance, in the conditions of a clinoorthostatic test, it allows you to assess the safety of vegetative regulation, and makes it possible to predict the course of the disease.

The aim of the study was to study the dynamics of heart rate variability in clinoorthostatic samples in miners with professional upper limb polyneuropathy to assess the nature and level of vegetative disorders.

Materials and methods. Th e analysis of changes in spectral and nonlinear parameters of heart rate variability at the stages of performing an active clinoorthostatic test in 40 miners with the established diagnosis of upper limb polyneuropathy and 20 people who do not have harmful occupational factors and symptoms of polyneuropathy, who made up the control group, was carried out.

Results. Th e subjects with polyneuropathy had an initial decrease in high-frequency and low-frequency spectral parameters of heart rate variability as a sign of vegetative insuffi  ciency. Th e absence of an increase in the low frequency index for a sample with active orthostasis indicates a violation of the sympathetic link reaction, reduced sensitivity of baroreceptors. Changes in the spectral index of a very low frequency of heart rate variability remained in the range of normal values at all stages of the test.

Conclusions. Th e study of heart rate variability at the stages of a clinoorthostatic test allows us to determine the nature and level of violations of vegetative regulation in miners with professional polyneuropathy, as well as the possibility of compensatory mechanisms. 

Introduction. Th e aluminum industry occupies one of the leading positions among other branches of non-ferrous metallurgy in terms of the prevalence of occupational pathology, many questions of pathophysiological mechanisms of its development remain open. Among the concomitant somatic diseases in workers engaged in the production of aluminum, the fi rst place is occupied by the pathology of the cardiovascular system against the background of chronic fl uoride intoxication of the body.

The aim of the study is to identify some features of the formation of cardiovascular pathology in the conditions of prolonged exposure to high doses of fl uorides on the body.

Materials and methods. A complex analysis of the prevalence of cardiovascular pathology and specifi c features of the pathogenesis of arterial hypertension, coronary heart disease and atherosclerosis was performed based on clinical and genetic research methods in 246 workers with fl uorosis and in the comparison group (106 people). Experimental studies of the morphofunctional state of the myocardium and blood vessels in conditions of chronic fl uoride exposure with histological analysis of tissues were performed on white laboratory rats.

Results. In the clinical pilot study with the assessment of pathological disorders of the cardiovascular system in terms of fl uoride intoxication revealed the structure and frequency of cardiovascular disease metallurgists main and auxiliary workers, employed in the production of aluminium. Th e Association of VEGF, IL1β, GSTT 1, GSTM1,  СYP1А1, CYP1A2 genes with concomitant coronary, obliterating and multifocal atherosclerosis, heart rhythm disorders, arterial hypertension, coronary heart disease complicated by pyelonephritis and liver steatosis was determined. Th e experiment shows the toxic eff ect of fl uoride on the myocardium and coronary vessels.

Conclusions. In the ranking structure of professionally determined morbidity in workers engaged in the production of aluminum, cardiovascular pathology prevails, in particular, arterial hypertension, coronary heart disease, atherosclerosis against the background of pronounced multi-organ manifestations, violations of bone metabolism, confi rmed by experimental data. 

Introduction. Fluorine compounds in small doses, but with prolonged exposure, cause various disorders in organs at the cellular and molecular levels. Activation of free-radical processes plays an important role in the damaging eff ect of fl uorides. Th erefore, one of the most eff ective ways to limit fl uorine-induced damage is to directly aff ect free-radical processes using herbal preparations with antioxidant properties.

The aim of the study is to study the eff ect of a dihydroquercetin-based drug on the activity of free radical processes in brain tissue under subchronic exposure to sodium fl uoride (NaF).

Materials and methods. Th e work was performed on white male laboratory rats weighing 200-250 g. Th e rats were divided into 3 groups: 1 — control; 2 — rats with chronic exposure to sodium fl uoride (NaF) for 9 weeks; 3 — rats receiving a NAF solution with simultaneous administration of a complex drug based on dihydroquercetin at a dose of 3 mg/kg in 1% starch gel for 3, 6 and 9 weeks. The activity of free radical oxidation and antioxidant defense enzymes — superoxide dismutase (SOD) and catalase-was determined in the cerebral cortex. Th e level of expression of hypoxia-induced transcription factor HIF — 1A and inducible forms of proteins HSP72 and HSP32 were determined in the cytosolic fraction of brain tissue.

Results. In the early stages of subchronic fl uoride exposure (1-3 weeks), the expression of protective proteins HIF-1α, HSP72, HSP32 and catalase was shown in the rat cortex, as a result of which the activity of free-radical processes was maintained at the control level. An increase in the timing of fl uoride intake to 9 weeks led to a decrease in antioxidant protection and signifi cant activation of free radical oxidation in brain tissue. Daily administration of a complex drug with dihydroquercetin for 3, 6 and 9 weeks to rats with subchronic fl uoride exposure led to a decrease in the severity of pro- and antioxidant balance disorders in the cerebral cortex. At the same time, the greatest protective eff ect of dihydroquercetin with fl uoride exposure was manifested by the 9th week of its administration.

Conclusions. When subchronic intake of fl uorides in the body, the drug based on dihydroquercetin has a neuroprotective eff ect, which is manifested by an increase in the activity of antioxidant enzymes of fr ee radical oxidation and catalase and the resistance of the cortex to induced fr ee radical oxidation.

Introduction. Extending professional longevity, preventing diseases and improving the quality of life of railway transport workers are the priority areas of activity of RZhD-Meditcina medical institutions. However, the infl uence of production factors on the prevalence and course of skin and subcutaneous tissue diseases in employees of this important branch of the national economy has not yet been suffi  ciently studied.

The aim of the study is to study the hygienic features of working conditions in railway transport workers that aff ect the course of skin and subcutaneous tissue diseases.

Materials and methods. Materials for hygienic and statistical research were sanitary and hygienic characteristics of working conditions of railway transport workers and statistical reports of the private healthcare institution «Clinical hospital» RZhD-Meditcina « of Barnaul for 2014-2018. A retrospective analysis of the incidence of temporary disability, the number of days of disability, and the number of exacerbations in employees of harmful professions in the Altai region of the West Siberian railway with chronic skin and subcutaneous tissue diseases was conducted.

Results. According to the sanitary and hygienic characteristics of working conditions, the most unfavorable working conditions of all railway specialties are employees of locomotive crews and track fi tt ers. Combined eff ects of chemical, meteorological, and physical factors of the production environment and the severity of the labor process belong to class 3 (with a high risk of occupational diseases). Th is leads to a signifi cantly higher (p=0.010944) number of days of disability (27.8±0.83) and the number of exacerbations of chronic skin diseases in railway transport workers than in the rest of the adult population not in contact with occupational hazards (25.32±1.2).

Conclusions. Th e combined impact of factors of the production environment and the severity of the labor process, despite the systematic comprehensive prevention, leads to a more severe course of chronic dermatoses in railway transport workers. 

Drastic transformations of the social and labor sphere have led to the emergence of new health risks and sanitary and hygienic problems associated with unreliability of employment. A new socio-economic and psychological phenomenon “precarity” has emerged, which has aff ected the employment conditions of employees, so the description of the phenomenon “precarity” needs to be clarifi ed.

The forms of labor employment that diff er from the typical model and worsen the employee’s situation are considered. The criteria based on which non-standard employment is considered unstable are given.

Generalized types of unstable employment are identifi ed, the specifi city of which is determined by a combination of two factors: working time and the term of the contract. Unstable working conditions are possible not only in informal employment, but also in legal labor relations. Unreliability and instability of labor has an objective character and is a natural manifestation of the emerging economic and social order. The phenomenon of “precarity of employment” appears as a new determinant of the health of employees. The main feature when referring employment and labor relations to the phenomenon of “precarity” is their unreliability.

Specifies the terms used: “precariat”; “precarious work”; precompact; the precariat. An essential characteristic of precarious employment is the violation of social and labor rights and lack of job security. A significant indicator of precarity is underemployment. Precarity induces the potential danger of dismissal of the employee and the resulting stress, psychosomatic disorders and pathological processes in the psyche.

Precarious employment and related labor relations have become widespread. Many employees are deprived of social guarantees, including those related to labor safety, payment for holidays and temporary disability, and provision of preventive measures. Th is leads to a violation of the state of well-being, as well as the deterioration of individual and public health.

Introduction. Adverse working conditions can contribute to the development of not only occupational pathology, but also diseases with complex multifactorial etiology, such as hypertension, coronary heart disease, disorders of the musculoskeletal system, chronic non-specifi c respiratory diseases, as well as the formation of combined pathology, which worsens the course of these diseases and leads to the development of complications.

The aim of the study is to study the manifestations of somatic pathology in coal industry workers with vibration disease.

Materials and methods. We examined 144 coal mine workers with vibration disease caused by local vibration, and 161 control group miners who have been working in contact with local vibration for a long time (15 years or more) and do not have professional pathology.

It was found that employees of coal mines with vibration disease more often (70,8%) than workers of the control group (27,3%) (p<0,001), there is a pathology of internal organs: diseases of the cardiovascular system (mainly arterial hypertension), diseases of the digestive system (functional disorders of the biliary tract and non-alcoholic fatt y liver disease), kidney diseases (mainly chronic pyelonephritis), as well as a combination of these diseases. With a more severe course of vibration disease (II degree), pathology of internal organs is more common (81.2%) than in patients with vibration disease of I degree (46.5%) (p<0.001).

Conclusions. In miners with vibration disease, more oft en than in the control group, there is a pathology of internal organs: the cardiovascular system, digestive organs, kidneys, as well as a combination of several somatic diseases. In individuals with grade II vibration disease, internal organ pathology is more common than in patients with grade I vibration disease. Th e results obtained should be considered when developing treatment and rehabilitation measures for medical examinations and conducting preventive medical examinations of coal industry workers. 

Th e results of using natural radon waters in the form of General or four-chamber baths and ozonopuncture in patients with occupational diseases of the joints and spine at the rehabilitation stage are presented. Studies have shown that the course use of radon therapy in combination with ozone therapy has a pronounced analgesic eff ect, anti-infl ammatory eff ect, stimulates the general sedative eff ect on the central nervous system, helps to restore the volume of movements in the aff ected joints, prevents the weighting of the joint process and the development of dystrophic changes in the musculoskeletal system.

The aim of the study is to study the eff ect of natural radon waters combined with ozone therapy on the dynamics of functional indicators based on motor activity data in patients with occupational diseases of the joints.

Patients with occupational diseases of the joints in rehabilitation were prescribed general radon or four-chamber baths in combination with ozone therapy (the main group). A control group of patients received radon baths by a similar method without introducing ozone. Before and aft er treatment, studies of functional activity in the aff ected joints were conducted: the volume of movements, the functional Leken index, which takes into account the severity of pain at rest and under motor load, pain assessment on a visual analog scale, echography of the aff ected joints, adaptive response according to L.Kh. Garkavi. Th e use of general or four-chamber radon baths in combination with ozone therapy in the main group allowed to quickly and eff ectively normalize the functional activity of joints, relieve pain, increase the body’s adaptive reserves to external stress factors, normalize sleep and restore working capacity. In the control group, changes in indicators did not have a signifi cant degree of signifi cance.

The use of General or four-chamber radon baths in combination with ozone therapy at the rehabilitation stage in patients with occupational diseases of the joints causes an improvement in the functional activity of the musculoskeletal system, accelerates the disappearance of pain, relieves infl ammation, returns performance, normalizes the body’s adaptation to external infl uences. 

The results of determining adaptive responses to treatment of patients with industrial injuries in the early stages of rehabilitation are presented. Studies have shown that the preliminary determination of reactions by L.Kh. Garkavi allows you to individually plan the duration of stay, the nature of treatment procedures with their sequence for each patient.

The aim of the study is to study the adaptation indicators according to L.Kh. Garkavi in patients with occupational injuries before treatment, during rehabilitation and aft er its completion.

Patients with industrial injuries, aimed at early rehabilitation, were determined by L.Kh. Garkavi adaptation reaction using the blood formula with the ratio of white blood cells, eosinophils, rod-shaped neutrophils, segmentonuclear neutrophils, lymphocytes, monocytes three times — before treatment, fi ve days aft er the end of the program. Th e resulting adaptation system data was evaluated as “training”, “quiet activation”, “increased activation”, or “stress”.

The application of the scheme for diff erent periods of treatment according to the response of individually adapting the patient to begin rehabilitation contributed to the full year program: disappeared pain syndrome, restored the functional ability of the respective injured body, help prevent development of disability, decreased period of disability.

The highly informative adaptation response, determined by the blood formula, answers the question about the reserve capabilities of this patient, which ultimately provides a positive result in the form of recovery of working capacity in the case of a fl exible rehabilitation scheme. 

Cardiovascular pathology prevails in the structure of somatic diseases of miners. As a complication of pneumoconiosis, the development of a chronic pulmonary heart in workers against the background of pulmonary hypertension and congestive heart failure is considered. Data from clinical studies also indicate remodeling of the blood vessel wall, the formation of atherosclerosis, endothelial dysfunction and others. There are practically no in-depth comprehensive studies on the contribution of industrial dust to the development and course of this pathology. To implement this task, the simulation of occupational diseases in animals helps to trace the dynamics of the pathological process from the moment of exposure to the body of the production factor.

The aim of the study is to study the infl uence of coal-rock dust on the risk of developing morphological disorders of the cardiovascular system in an experiment.

Experiments were conducted on white non-linear male rats that were exposed to inhaled coal-rock dust of the “gas-fat” brand. For histological study in animals aft er 1, 3, 6, 9 and 12 weeks of exposure to the damaging factor, fragments of the brain, lungs, heart, liver and kidneys were taken. The quantitative content of matrix metalloproteinases, their inhibitor and vascular endothelial growth factor in blood plasma was studied using enzyme immunoassay.

Morphological changes in the heart muscle and blood vessels are a systemic response of the body to prolonged inhalation of coal-rock dust. Violations develop from the moment of exposure to the damaging factor, so they can be considered as one of the manifestations of pneumoconiosis, and not its late complication. In the early stages of the experiment (1-3 weeks), the development of diff use protein dystrophy of cardiomyocytes with pronounced thickening of some fi bers due to cell hypertrophy is noted in the heart muscle of experimental animals. Increasing the timing of seed leads to the progression of  pathological changes, increased apoptotic activity of cells and the accumulation of lipofuscin granules in the perinuclear zone, as well as the formation of atrophic damage in muscle tissue. By the 12th week of the experiment, diff use cardiosclerosis and pronounced dystrophy of cardiomyocytes with fragmentation and myocytolysis of individual sections of muscle fi bers develop in the heart muscle. Long-term inhalation of coal-rock dust causes progressive development in the wall of blood vessels, regardless of their organ affi  liation, of the same type of pathological changes in the form of endotheliosis, diff use hypertrophy of the smooth muscle component of the medial layer and perivascular fi brosis against the background of pronounced microcirculatory disorders.

The obtained results indicate the need for pre-nosological diagnostics of cardiovascular diseases and their prevention among miners working in harmful working conditions.