The digital transformation of the economy and society prompts the renewal of methods in occupational health as well. There are outlined fundamentals of the draft revision of the “Guidelines for the Assessment of Occupational Risk to Employee Health. Organizational and methodological foundations, principles and criteria for the assessment». R 2.2.1766-03. The draft contains methods of occupational risk (OR) assessment supplied with information materials and software for working on the Internet in real-time. Algorithms and models for calculating the probability of impairment of health according to data of the Special Assessment of Working Conditions (SAWC) as well as causation algorithms - work-relatedness assessment according to data of periodic medical examinations (PME) for the validity of risk assessment from the standpoint of evidence-based medicine are presented. There are set out methods for calculating the probability of the formation of occupational diseases (OD) of the main nosological forms from the exposure of noise, hand-arm and whole-body vibration, heat and cool microclimate, fibrogenic dusts, physical labor (local, regional and general loads), strenuous work, standing work with the likelihood of varicose lower veins limbs, multi-factor exposure and low-back pain. Risk assessments for the reproductive health of workers are also discussed. The models are based on the documents of the WHO, ILO, ISO, domestic and foreign literature data that meet the principles of evidence-based medicine. The problems of work-related diseases (WRD) - the concept of WHO (1987) -basics of etiology, qualitative and quantitative criteria for causation, models of consensus and evidence-based medicine, as well as projects for integrated work on the detection systems for WRD in the European Union countries are considered. Single-digit indices of working conditions and health problems, moral harm caused to an employee suffering from OD or WRD. Hygienic recommendations to employers on OR management, prevention priorities, the role of personal protection equipment, the basics of corporate health promotion programs, and ethical and economic aspects are described. The calculation methods are provided by the software of the electronic online reference book “Occupational Risk” (URL: http://medtrud.com/) in order to ensure evidence-based decisions of hygienists. In conclusion, a turning point in occupational health is noted: a decrease in the detection of traditional ODs without compensation by the number of OD and WRD from new technologies, materials and risk factors; this problem requires urgent action.
The analysis of the medical and social aspects of occupational noise-induced hearing loss (NIHL) on the basis of its phenomenology is presented. The ear as an information receiver and frequency range of voice communication are considered. The NIHL classifications in Russia, starting with GOST 12.4.062-78 are described, and an overview of international (WHO, 2011; ILO, 2013; UKOOA, 2003) and national (Belgium, France, USA) NIHL criteria are outlined. As example a civil aviation pilot audiogram was compared to different criteria; it is shown that in 5 of 14 models used criteria were stricter than GOST 12.4.062-78. It is noted that for the medical fitness to work examination it is necessary to use criteria that differ from those for population. The modification of GOST 12.4.062-78 classification is proposed by subdivision of signs of the noise influence on the hearing into 2 groups: early and expressed signs with NIHL values at 4 kHz less than 20 dB and 20-40 dB, respectively, that is useful for monitoring and prevention. The use of PPE with a view to ensuring safety is considered. The proposal to improve NIHL evaluation criteria are proposed in connection with the adoption of SanPiN 2.2.4.335916 onphysical factors with PEL of noise and GOST R ISO 1999-2017 on assessment of noise-inducedhearing loss, taking into account the role of hearing health for safe and effective work.
The article characterizes occupational factors including acoustic ones that influence work conditions of civil aircraft crew members, presents methodic basis to evaluate parameters of aviation noise inside cabin, with consideration of additional load from aviaheadsets. To specify scientifically based method for calculating acoustic load on civil aircraft crew members in cabins, the authors measured noise parameters inside cabins of aircrafts used at present in Russia, and noise-proof properties of domestic and foreign aviaheadsets. Normalized values suggested: equivalent level of A sound over a month (L A,eq,m ), over a year (L A,eq,y ); suggestions for reference values: equivalent level of A sound (L A,eq,g ), over an arbitrary period of piloting length (L A,eq,T ); coefficient of piloting load. Principles of these calculations are determined. The method is designed as an addition to sanitary rules and regulations 2.5.1.2423-08, determining hygienic requirements to work and rest conditions for civil aircraft pilots.
The article deals with current and prospective documents on assessment of exposure to noisein crew members of civil aviation aircrafts. The authors suggestedto complete a method calculatingacoustic loadwith correction indexes for uncertainity of measurements concerning noise inside the cabin, for underestimation of noise levels in forced flight regime, forincreased radio talks and active listening time, and for acoustic efficiency of avia-headsets.