The incidence of ischemic heart disease was detected in 18 (9.2%) coal mine workers (shaft sinkers, stope miners). Based on the determination of the most significant risk markers, a personalized system for ischemic heart disease predicting in miners has been improved allowing for timely carrying out treatment and preventive measures for them.

The influence of natural radon waters on the state of the respiratory tract mucosal cells in patients working in the coal and metallurgical industries with occupational chronic obstructive pulmonary disease was studied. The positive effect of common radon baths on the restoration of cytological changes in the respiratory mucosa was revealed. Indicators of local immunity of the respiratory tract mucosa in patients with occupational chronic obstructive pulmonary disease on the background of the use of general radon baths. The aim of the study is to explore the effect of natural radon water in the form of shared baths on epithelial cells of the respiratory mucosa in patients with occupational chronic obstructive pulmonary disease based on the analysis of cytological changes in the respiratory mucosa. Patients of the main group with professional chronic obstructive pulmonary disease were given general radon baths from a natural source in sanatorium conditions. Patients in the control group had shared freshwater baths. All patients before and after treatment studies were conducted cytologic changes in the smears from the mucous membrane of the nose and phlegm. The use of common radon baths in the main group revealed a pronounced corrective effect on the function of cellular protection of the respiratory mucosa, which was expressed in a significant decrease in destructive processes in cells of all types with an increase in their functional activity, normalization of mucociliary clearance. There were no significant changes in indicators in the control group. The use of common radon baths at the stage of rehabilitation in workers of the coal and metallurgical industry with professional chronic obstructive pulmonary disease leads to the restoration of the integrity of the cellular composition of the epithelial cover of the respiratory tract mucosa, preserves the functional activity of cells of local protection factors. The authors declare no conflict of interests.

The results of the use of natural radon water in the form of general baths in patients working in the coal mining and metallurgical industry, with occupational diseases of the joints and spine, at the stage of rehabilitation are presented. Studies have shown that the course application of radon therapy has a pronounced analgesic and anti-inflammatory effect, a general sedative effect helps to restore the volume of movements in the affected joints, normalizes the statokinetic functions of the musculoskeletal system, slows down the progression of the joint process and the development of dystrophic changes in the musculoskeletal system.Indicators of statodynamic functions of the musculoskeletal system in patients with occupational diseases of the joints and spine in the rehabilitation system against the background of course use of natural radon waters in the form of shared baths were studied. The aim of the study is to explore the effect of radon waters of natural origin on the dynamics of statodynamic parameters according to the data of a stabilometric study in patients working in the coal mining and metallurgical industry, with occupational diseases of the joints and spine.Patients with occupational diseases of the joints and spine in rehabilitation were prescribed general radon baths (the main group). The control group of patients received freshwater baths. Before and after treatment were carried out studies of the static-dynamic functions stabiiloplatform (soft ware-hardware complex for clinical motion analysis “Biomechanics” published by the scientific-medical firm MBN), with the help of which the indicator of the common center of mass, the flexor setting up of the thigh, the coefficient of weight load on the foot, the inter-limb asymmetry, the vertical stance was determined in the initial position and in the Romberg position.The use of common radon baths in the main group allowed to normalize the statokinetic functions of the musculoskeletal system in the form of reducing the period of alignment of the pelvic flexor installations and asymmetry of the distribution of weight load on the affected limb; increasing the level of adaptation of patients to functional loads against the background of reducing pain and inflammatory syndrome. There were no significant changes in these indicators in the control group. The use of general radon baths on the rehabilitation stage in patients working in the coal mining and metallurgical industry, with occupational diseases of the joints and spine, helps to restore the statodynamic functions of the musculoskeletal system, the disappearance of pain syndrome, and reduces inflammation.The authors declare no conflict of interests.

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.

Currently, the proportion of workers exposed to manganese compounds is quite high, but due to increased safety measures and changes in working conditions, the number of new cases of chronic occupational manganese intoxication has decreased significantly. an attempt has been madeAn attempt has been made to highlight the difficulties of differential diagnosis of occupational chronic manganese intoxication and other neurological diseases on the example of clinical cases of examination of persons with extrapyramidal system lesions in the form of early development of Parkinson’s disease. The assessment of complaints, medical history, neurological status, laboratory tests, and instrumental studies to find the probable cause of Parkinsonism was carried out. The interest of the observations lies in the difficulty of interpreting the data obtained and the importance of studying the professional route of patients. Magnetic resonance imaging of the brain, electromyography of the extremities, electroencephalography, echoencephalography, the study of the concentration of metabolites characteristic of Niemann-Pik disease, copper indicators in the blood help in making a correct diagnosis.When examining a contingent of people working in contact with manganese compounds, if they suspect chronic occupational manganese intoxication, it is important consider other diseases that lead to the development of Parkinson’s disease.The authors declare no conflict of interests.

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.

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.

Introduction. Th e high level of professional and production-related pathology among workers of the coal industry, as well as the frequent development of their combined pathology with an unfavorable prognosis determine the relevance of studying the prevalence of somatic pathology in miners with occupational diseases of the respiratory system.The aim of the study was to explore the prevalence of internal organs pathology in coal industry workers with occupational lung diseases (anthracosilicosis, chronic dust bronchitis, chronic obstructive pulmonary disease).Materials and methods. 788 store miners and shaft sinkers with previously diagnosed occupational respiratory diseases (anthracosilicosis, chronic dust bronchitis, chronic obstructive pulmonary disease) and 161 miners, working for a long time in harmful labour conditions and having no occupational pathology (the control group) were examined.Results. It was revealed that the workers of the coal industry with occupational diseases of the respiratory system pathology of internal organs occurs more often than the workers of the control group, including: diseases of the cardiovascular system (hypertension, angina pectoris I and II functional classes), diseases of the digestive system (nonalcoholic fatty liver disease and chronic pancreatitis), kidney disease (chronic pyelonephritis), as well as a combination of several somatic diseases.Conclusions. In miners with occupational diseases of the respiratory system more oft en than in the control group, there is a pathology of the internal organs: diseases of the cardiovascular system, digestive organs, kidneys, as well as a combination of several somatic diseases. Th e data obtained should be considered during periodic medical examinations and medical examinations for the development of timely therapeutic and preventive and rehabilitation measures.

Since 2017, a new stage of depopulation has begun in Russia related to a reduction in the birth rate. The consequences of the “demographic gap” of the 1990s have reached the present time and there has been a sharp decrease in the number of women of active reproductive age, especially from 25 to 29 years old. Objective. The aim is the analysis of the dynamics and prediction of natural reproduction of the population in the Siberian Federal District and its individual administrative territories at the beginning of the second wave of depopulation. Material and methods. Data on the birth rate, mortality and natural increase (decrease) per 1000 population of the Russian Federation, the Siberian Federal District and of individual territories of the Siberian Federal District are obtained on the website of the Federal Service of State Statistics. To analyze the dynamics of natural reproduction of the population of the Siberian Federal District for 2000-2018 and for a short-term prediction of indices, the capabilities of the Microsoft Office application (MS Excel) were used and several variants of approximation of birth rate, mortality rate and natural increase (decrease) in the population were considered using the following trends: linear, logarithmic, and degree (third degree polynomial). Results. A short-term prediction based on the trends indicates a continuation of the emerging trend: the birth rate in the Siberian Federal District will decrease, and the natural decline in the population will increase. With this approximation, the mortality rate of the population will increase. Conclusion. In the coming years, the containment of depopulation in the Siberian Federal District is possible due to the favorable ratio of birth rate and mortality rate in the Republics of Tyva, Altai, Buryatia, and Khakassia. Of particular concern is the significant natural decline in the population in the Kemerovo Region and the Altai Territory. The problem of reducing mortality and, accordingly, increasing life expectancy can be solved only with an increase in the level of culture, education, medical care and with a wide spread of healthy lifestyles.

Background. Ischemic heart disease is the leading cause of death in the majority of developed countries, including Russia. It determines the importance of elaboration of individual risk prediction of ischemic heart disease for primary prevention.Aim: to develop a strategy for predicting the ischemic heart disease in coal industry workers.Materials and methods. Ischemic heart disease incidence and its risk factors were studied in 196 coalmine workers (sinkers, stope miners). Rose Questionnaire, daily ECG monitoring and bicycle ergometry were used to detect angina. The indices of lipid metabolism, hemostatic system, the level of homocysteine, uric acid, C-reactive protein, constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems were studied.When elaborating the prognostic system, we used the Bayes method. A prognostic coefficient was calculated for each factor. Prediction of ischemic heart disease was carried out according to the sum of prognostic coefficients.Results. Ischemic heart disease was detected in 18 (9.2 %) miners. According to the above mentioned indices, a medical technology was elaborated to predict the ischemic heart disease, based on the determination of the most significant risk markers: age, work experience in harmful working conditions, type A behavior, arterial hypertension, fasting hyperglycemia, metabolic syndrome, hypercholesterolemia, decrease in the level of high density lipoprotein cholesterol, increase in the value of low density lipoprotein cholesterol, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increase in the level of soluble fibrin monomer complexes and C-reactive protein, abdominal obesity, hypersthenic constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems.Conclusion. Based on the most significant markers, a personalized strategy for ischemic heart disease prediction in miners was elaborated, which allowed timely undertaking therapeutic and preventive measures.

Introduction. Anthracosilicosis (AS) is a serious and common occupational disease of workers in the coal industry, and among somatic diseases in miners more oft en than in the General population, there is an arterial hypertension (AH). One of the complications of such diseases is the development of chronic heart failure, and diastolic heart failure precedes the reduction of contractile function.The aim of the studywas to develop a system of diagnosis of predisposition to the formation of diastolic heart failure in patients with AS and AH.Materials and methods.71 miners with AC in combination with AH aged 40 to 54 years with preserved systolic function of the left ventricle (LV) were examined. Determined by: the presence of diastolic dysfunction of the ventricles, the presence and degree of respiratory failure, obesity, blood group AB0, MN and Rh, mass index left ventricular, thickness of the interventricular septum, posterior wall of LV anterior wall of right ventricle, index of relative wall thickness of LV and the average pressure in the pulmonary artery.Results.The higher the detection rate of this complication in the combination of AS and AG in patients with respiratory failure, obesity, with an increased index of myocardial mass of left ventricle, index of relative wall thickness of LV sphericity index, thickening of the walls of the ventricles, increased pressure in the pulmonary artery, having blood group 0 (I), B (III), MM, NN, Rh-, R+. Th e method of predicting the development of diastolic heart failure is as follows: the survey is carried out once, 10 of the above markers are determined, the data are analyzed using a prognostic table.Conclusions.With the help of the proposed method of predicting the development of diastolic heart failure in miners with AS and AH, it is possible to quickly and with litt le material cost to identify a group of people with a high risk of developing this complication.

Introduction. The leading place in the Russian Federation and in the world is occupied by cardiovascular diseases (ischemic heart disease, hypertension, and peripheral vascular diseases), which are the main cause of disability and death worldwide. The aim of the research was to study the prevalence of cardiovascular pathology in workers of the aluminum industry. Material and methods. We examined 66 workers of the aluminum facility without occupational pathology and 135 employees who never worked in adverse working conditions (the control group). All the examined subjects were men; the average age accounted for 52.08±0.4 years. Results. The study showed the workers of the aluminum facility to develop such diseases of the cardiovascular system as arterial hypertension, atherosclerosis with lesions of peripheral and extracranial arteries, as well as multifocal atherosclerosis more often than in those who do not work in adverse working conditions (the control group). Conclusion. The unfavorable occupational factors of aluminum industry are an additional risk factor for the development of cardiovascular pathology.

The frequency and structure of ophthalmopathology in workers of the Novokuznetsk Metallurgical Combine (NMC) have been studied. In total 1911 workers of NMC have been examined. The control group comprised 1801 people working in hazardous industrial conditions. The experimental group consisted of employees dealing with management, engineering center, accounting (110 people). Their work was not connected with the impact of unfavorable factors of metallurgical production. In the control group, the hazard classes ranged from 3.2 to 3.4. The difference between the classes of hazard impact consisted in an increase of the intensity of the hazardous factors exposure. In the structure of conjunctival diseases we have diagnosed chronic conjunctivitis (198.3 ‰), chronic blepharoconjunctivitis (109.4 ‰), pinguecula (266.7 ‰) and pterygium (7.2 ‰) in metallurgical workers. Pengucules in the control group of workers was not only more often than in engineers, but also larger, often located in the inner and outer corner of the eye, and was detected in workers under 30–35 years. The workers of the main shops suffered more severely from the function of tear production and the stability of the pre-corneal tear film. The miners suffered from the highest frequency of cataract development — 301 ‰. Thus, a high incidence of inflammatory and dystrophic diseases of the eyelids and conjunctiva, cataracts in metallurgy has been established. An increase in the frequency of ophthalmopathology was noted with an increase in the length of service under harmful conditions of metallurgical production. The authors suggest the term “metallurgy ophthalmopathy”, which includes manifestations of chronic conjunctivitis and / or blepharoconjunctivitis against the background of unstable precorneal film and frequent formation of posterior-subcapsular opacities of the lens.

The authors analyzed changes in spectral parameters of heart rhythm variability during active orthostatic test in patients with vasovagal syncope, residing in Novokuznetsk city. Findings are that industrial city inhabitants even in yough age present disorders of sympathic vasomotor regulation, that manifest in orthostasis with decreased parameter of low frequency variations more than by 50% of initial value Relative sympathetic dominance is supported by more marked increased of parasympathetic activity (power of high-frequency variations is decreased more than by 80%). Decrease in tonic vagal influence enables to increase chronotropic heart function. Orthostatic tachycardia appears in increased power of very low frequency variations during the test — that proves increased serum catecholamines level. Thus, spectral analysis of heart rhythm variability is effective in finding the cause of orthostatic disorder.

To design forecasting system, the authors studied occurrence of atherosclerosis and its risk factors in 152 workers of coal mines in South Kouzbass (tunnellers, cleaning pit-face miners, mining excavator operators), suffering from anthracosilicosis. Atherosclerosis was revealed in 124 (81.6%) workers with anthracosilicosis. With Bayess method for independent signs and Wald's sequential analysis method, the authors created a way to forecast atherosclerosis with coronary, extracranial and peripheral arteries involvement in miners with anthracosilicosis. Maximal risk of atherosclerosis in miners with anthracosilicosis is associated with following parameters: age 45 years and over, arterial hypertension, smoking, abdominal obesity type, diabetes mellitus, metabolic syndrome, respiratory failure, family history of IHD, hypercholesterolemia, increased LDL cholesterol, decreased HDL cholesterol, increased atherogeneity coefficient, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increased C-reactive protein, hypersthenic type according to Reese-Isenc index, andromorphic type according to Tanner index, blood group. markers A (II) and B (III), rhesus negative, MN and NN. Through increased number of factors analyzed and selected additional markers, accuracy of atherosclerosis forecasting is increased - that enables to proceed with opportune treatment and prevention.

Complex medical examination covered 87 metallurgists of aluminium production with chronic fluorine intoxication and 43 metallurgists witout occupational diseases, aged 40 to 60, to evaluate factors associated with multi-focal atherosclerosis risk in aluminium production workers with chronic fluorine intoxication. Findings are increased incidence of ischemic heart disease and combined atherosclerosis of extracranial and peripheral arteries in workers with long exposure to fluorine compounds. Metallurgists with chronic fluorine intoxication appeared to have more frequent hyperfibrinogenemia and coronary personality type A, if compared to those without occupational diseases.

To design forecasting system, the authors studied occurrence of atherosclerosis and its risk factors in 152 workers of coal mines in South Kouzbass (tunnellers, cleaning pit-face miners, mining excavator operators), suffering from anthracosilicosis. Atherosclerosis was revealed in 124 (81.6%) workers with anthracosilicosis. With Bayess method for independent signs and Wald's sequential analysis method, the authors created a way to forecast atherosclerosis with coronary, extracranial and peripheral arteries involvement in miners with anthracosilicosis. Maximal risk of atherosclerosis in miners with anthracosilicosis is associated with following parameters: age 45 years and over, arterial hypertension, smoking, abdominal obesity type, diabetes mellitus, metabolic syndrome, respiratory failure, family history of IHD, hypercholesterolemia, increased LDL cholesterol, decreased HDL cholesterol, increased atherogeneity coefficient, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increased C-reactive protein, hypersthenic type according to Reese-Isenc index, andromorphic type according to Tanner index, blood group markers A (II) and B (III), rhesus negative, MN and NN. Through increased number of factors analyzed and selected additional markers, accuracy of atherosclerosis forecasting is increased - that enables to proceed with opportune treatment and prevention.

In workers employed in the aluminum industry, the main harmful production factor is exposure to fluoride salts, which can cause chronic fluoride intoxication. For the assessment of the impact of chronic fluoride intoxication on the development of atherosclerosis, we conducted a comprehensive survey of 87 aluminum-metal makers with chronic fluoride intoxication and 43 aluminum-metal makers without occupational diseases, mean age--52.1 ± 0.4 years. There were considered the presence and severity of atherosclerosis of brachiocephalic arteries, and the arteries of the lower extremities in the studied group, there was evaluated the effect of other risk factors for atherosclerosis (smoking, presence of hypertension, diabetes, dyslipidemia). With the use of Doppler ultrasound of the arteries it was revealed that in metallurgists with chronic fluoride intoxication atherosclerosis was detected in 73.6% versus 55.8% in persons of the comparison group. The performed analysis of the prevalence of main risk factors for atherosclerosis showed that in metal makers with chronic fluoride intoxication in combination with atherosclerosis hypertension is more common (in 54.7%) than in metallurgists with chronic fluoride intoxication without atherosclerosis--only 26.1%. According to the frequency of occurrence of smoking, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia, there were no significant differences between the metallurgists with chronic fluoride intoxication, with and without atherosclerosis, and the control group, the increase in LDL cholesterol occurs significantly more often in metal-makers with chronic fluoride intoxication in combination with atherosclerosis if compared to workers without occupational diseases. Thus, chronic fluoride intoxication acts as a risk factor in the development of atherosclerosis: atherosclerosis in metal-makers with chronic fluoride intoxication occurs more frequently than in workers who do not have professional pathology. Hypertension and elevated levels of LDL cholesterol were established to increase the relative risk of developing atherosclerosis in metallurgists with chronic fluoride intoxication. At that there are no significant differences in the prevalence of common risk factors for atherosclerosis (smoking, diabetes, hypercholesterolemia, hypertriglyceridemia).