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Assessment of professional risk of employees of fuel and energy complex at production and use of coal
Studying the distribution of patients by the level of increase in neurohumoral factors in patients with CHF FC III showed that this group had high levels of BNP increase — 57.6% and aldosterone — 63.6% of the patients with III FC.
Conclusion. In patients with CHF FC II dominated mid-high levels of neurohumoral factors, whereas in patients with FC III noted the predominance of high levels of BNP and aldosterone.
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Adilov Utkir Khalilovich Research Institute of sanitation, hygiene and occupational diseases of the Ministry of Health of the Republic of Uzbekistan, Laboratory of industrial toxicology and occupational health, laboratory head, senior researcher Laboratory of industrial toxicology and occupational health, laboratory head, senior researcher E-mail: [email protected]
Assessment of professional risk of employees of fuel and energy complex at production and use of coal
Abstract: The increased prevalence of chronic bronchitis among employees of the energy industry in Uzbekistan that are affected various industrial dust it is being officially carried to number occupational diseases ("chronic dust bronchitis"). Occupational incidence among employees of energy industry remains to one of the highest in the republic and almost by 7-8 times exceeding in general in the country.
Keywords: production factor, working conditions, coal, health, professional risk.
Introduction. Follow modernization and technical re-equipment in Uzbekistan of the Fuel and Energy Complex (FEC) in case of extraction and coal using in production of heat power receipt, demand from employers more careful observance of occupational health rules and workers health protection.
Uzbekistan has explored coal storage in number of 1900 million tons which composed 0,2% from the world reconnoitered coal storage, including: reddish black — 1853 million tons, stone — 47 million tons [1, 8-13]. Coal extraction, in generally concentrated in the near Tashkent (Angren Coal mine) of the carboniferous area of reddish black coal and the Gissaro-Darvaz stone coal basin (Baysun and Shargun fields), used generally for an energy purpose.
An annual average fuel balance by system of the State-ownedJoint Stock Company "Uzbekenergy" has composed: natural gas — 86,7%,
mazut — 10,26%, coal — 3,04%. At the same time a coal share in fuel and energy balance of the republic will be increased by 2021 from 3,9% to 12%. Now reddish black coal is arrived to the Angren and the New Angren thermal power plants (TPP) ofthe following structure: the lowest warmth of combustion (1900-2020) kcal/kg, humidity — (36-45)%, content on the working mass of fuel — a mineral component (25-35)%, sulfur (1,5-,8)%. A coal share in fuel balance of the the New Angren TPP has constituted 16,93%, and the Angren TPP — 54,62%. At the same time the specific fuel consumption on released electro and heat power, respectively, has constituted: the New Angren TPP — 389,4 goe/kWh and 167 kgoe/Gcal, and the Angren — 439,0 goe/kWh and 186,6 kgoe/Gcal [2].
It is known that sanitary and hygienic value of coal dust is determined by the changes caused in respiratory organs [3, 77-85].
Section 7. Medical science
Bronchopulmonary diseases of an occupational etiology is continued to remain the most important problem of medicine by the extent of the caused medico-social damage that is connected first of all with insufficient study of mechanisms of fibrogenic effect of coal dust of various brands, and also actions of the combined factors of gases, aerosols, etc. [4].
Study goal is an occupational risk (OR) assessment and a health state of employees' energy industry of Uzbekistan.
Study materials and methods. Study ofworking conditions factors and a separate factors OR assessment of the production environment, according to the techniques approved by the Ministry health of the Republic ofUzbekistan (MH RUz) were carried out in underground mines "Shargun" (the Baysun coal basin) and "9 mine" (The Angren reddish black coal basin), and also in the Angren TPP, using coal.
Health state indicators assessment of energy industry employees depending on working conditions on a workplace was carried out based on recommendations of the International Labour Organization (ILO) — the HSEMS of ILO 2001/ILO-OSH 2001 [5]. 85 male miners and 40 employees of TPP aged from 25 till 50 years were surveyed.
Material analysis has been carried out by commonly accepted methods of variation statistics. Results and conclusions were received based on principles of evidential medicine.
Results and discussion. An OR management system of employees energy industry of Uzbekistan is included: work planning on identification of dangers and a risk assessment; a working conditions assessment in each workplace; workers health state assessment; actions for risk decrease; actions accomplishment control for decrease in risk.
In mine air a weighed coal and thoroughbred dust has dispersion: up to 40-80% of dust particles have sizes up to 1,3 mkm, 1535% — up to 2,6 mkm, 5-20% — up to 4 mkm and 3-10% — over 4 mkm which, getting into lungs in case of breath, are the reason of diseases development.
Occupational morbidity among employees of TPP, is remained one of the highest in the republic and almost by 7-8 times exceeding a level about the country in general. The main place among it is taken by chronic bronchitis of a dust etiology.
Dust bronchitis is represented a combined infectious and dust affect with prevalence of a role of this or that component. The increased prevalence of chronic bronchitis among employees of the energy industry of Uzbekistan which are affected various industrial dusts it is officially carried to number of occupational ("chronic dust bronchitis"). Along with coal dust impact to respiratory organs, it is exerted an impact on emergence of patulous skin diseases of hypodermic cellular tissue (furuncles, felons, abscesses), an acute gastrointestinal diseases and helminthoses that is connected with absence in a number of mines a correctly organized underground cesspool cleaning and promoted development of conjunctivitis, an eye cornea traumatization. The fine-dispersed dust is the much.
A research analysis among "9 mine" miners has shown that by course nature of lungs diseases of a dust etiology which are classified as slowly progressing pneumoconiosis form were occurred at 12,9% of persons with more than 15 service years. The received results of functional researches of respiratory system (EBF study) have been shown that among persons with revealed lungs diseases the EBF dysfunction in 75% cases which are precede occupational disease developments were observed and are reflexed reaction of an organism to impact of coal dust. Persons, with more than 15 service years were noted in 32,3% cases slow progressing of a disease in the form
of cough strengthening, in 25,8% cases an breathlessness, 12,9% in breast pain cases and in 9,7% cases on increased fatigue.
Fungal diseases spread at underground working mines was depended on the number of social factors: most of miners (77,5%) lived in private houses or in the house of barrack-type with lack of centralized water supply (69,8%), using an individual closed rubber footwear at work (50,2%) and visiting of a production shower, without observance of personal hygiene rules (96,4%).
Changes of functional and metabolic activity of leukocytes of blood are acted as sensitive indicators of disorders of a homeostasis in respiratory organs in case of early protective and adaptation reactions. Quantitative and high-quality shifts in blood elements, decrease in functional activity of leukocytes, destruction increase level were reflected an initial phenomena of a decompensation [6].
An occupational risk is a consequence of impact on the employee of energy industry of a complex of the technological, organizational, social and economic reasons and as a type of social risk is connected with occupational activity of the person. Social and occupational risks are caused by the nature of market economy which is shown in economic vulnerability hired and occupied with private workers entrepreneurship (or family entrepreneurship).
There are two standard reasons of this sort of stock outs: loss of employment (unemployment) place and loss of physical capacity to work as a result of an illness, accident, disability or retired achievement.
OR is bore for workers a danger of health loss, working capacity, a salary, and also additional costs on treatment and rehabilitation. At the same time losing livelihood maintenance finally leads to change of financial and social status not only for worker who was injured in production, but also for members of his family.
Wide spread of OR is explained by a high level of industrial labour development when active using of equipment and technology, chemical and biological substances, different types of energy and getting radiation leads to the fact that practically all spheres ofpeople activity (including non-productive too) are literally penetrated by risks. At the same time it is necessary to reveal OR factors, level of their impact on workers, to perform monitoring of health and safety in workplaces.
OR management of energy industry employees includes a set of mechanisms at management of the production environment, safety, occupational health and workers' health. OR can be studied from items of labour medicine, safe engineering and labor protection:
- OR from line items of occupational health and professional incidence (labour medicine) is considered as establishment of quantitative regularities of emergence of workers professional incidence and development of mechanisms of its prevention. Factors of working conditions as sources of workers' health damage are studied. Risk level is determined by comparison of diseases by certain professional groups working in specific conditions of work (an exposition of factors and a class of harm working conditions).
- OR from a line item of safe engineering and labor protection is considered in aspect of identification technical (techniques and equipments, engineering procedure and a type of production) and the organizational risk factors (job management, personnel professional training and carrying out scheduled maintenance at labor protection) influencing the level of an industrial traumatism.
The techniques existing in Uzbekistan are devoted to identification and reasons for communication between long impact of dangerous and harmful production factors (DHPF) of working conditions being factors of OR and to probability ofworkers' health and life dam-
Comparative evaluation of the colon microbiocenosis in children with chronic colostasis on the background of surgical treatment
nification are intended for identification of a number of correlation links, the most important of which are:
- cause and effect interrelations of OR factors and types of health losing and job capacity working in certain industries of economy, productions and employment a long time by the certain occupation causing risk of the production caused and occupational morbidity, an industrial traumatism as which consequences temporary and (or) fixed disability and a lethal outcome acts;
- a probability of manifestation of OR and degree (severity) of their consequences — in specific occupational groups and at an individual level is estimated when cases of approach losing of a temporary and/or fixed working capacity including resulting in disability are analyzed;
- an age of affected persons in production (because of DHPF or adverse psychophysiological factors of labor process), so-called an average age of disability because of an occupational accident or an average age of the dead in production;
- OR factors, probability of their manifestation and degree (severity) of their consequences, on the one hand, and types of provided compensation payments, and duration of benefits receipt or retiring income, on the other hand.
There are developments in the field of classification of labour conditions in a workplace with a description of consequences work-
ing in optimum, admissible or harmful working conditions in the Research institute of sanitation, hygiene and occupational diseases of the Ministry of Health of the Republic of Uzbekistan.
Conclusions. Thus, study results have been shown:
- a high prognostic importance of laboratory and functional researches in identification of before clinical signs of lungs diseases during a long work in the conditions of dust content of air coal dust;
- a prevalence of fungal diseases among miners depends on age, service years of underground work and working conditions, and also a great importance isolation of the production territories, general shower and changing rooms, wearing uniform and a closed footwear.
Recommendations. It is necessary for sorting out of a complex problems arising in case of an OR assessment of energy industry employees:
- to integrate characteristics of labour conditions factors by transition from regulation of separate parameters of factors to the complex indicators gathering parameters family which are mutually compensating or strengthening action of each other.
- to use algorithm of probability calculation oflosing by worker of working capacity depending on a condition of labour conditions in a workplace and individual OR depending on labour conditions and worker health state.
References:
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3. Измеров Н. Ф., Тарасова Л. А., Кузьмина Л. П. Проблема сердечно-сосудистой патологии в медицине труда. Гигиена труда и медицинская экология; 2004 (4): 77-85.
4. Хван Т. А., Хван П. А. Основы экологии. Серия «Учебники и учебные пособия». Ростов на-Д: Феникс; 2001: 256.
5. Международная организация труда МОТ-СУОТ. IL0-0SH:2001. Руководство по системам управления охраной труда. -Женева; 2003: 19.
6. Калмыков А. А. Иммунновоспалительные аспекты патогенеза профессионального бронхита в сочетании с артериальной гипертензией. Автореф. дисс. канд. мед. наук. - Харьков; 2007: 36.
Akilov Khabibulla Ataullaevich, d. m.s., professor, Head of Children Surgery Department of Republican Research Center of the Emergency Medical Care, pro-rector on education, Head of Children Surgery Department of Tashkent
Post-graduate Medical Institute Saidov Farkhod Khamidovich, Senior researcher of Children Surgery Department of Tashkent Post graduate Medical Institute, E-mail: [email protected]
Comparative evaluation of the colon microbiocenosis in children with chronic colostasis on the background of surgical treatment
Abstract: The results of the state of intestinal microflora were investigated and studied in 71 children with chronic colostasis. Of them in 12 (16,9%) children the dysbacteriosis of intestine of the 1st degree was found, of the 2nd degree — in 29 (40,8%) children, of the 3d degree — in 30 (42,2%) children. The 3-d degree of colostasis developed mostly often in the patients at the stage of decompensation (70,8%).
Keywords: chronic colostasis, microbiocenosis, dysbiosis, children.
Background. The multiple literature data indicate that colosta- clinical and laboratory methods of diagnosis of the patients with sis is increasingly being recognized both among children and adults colostasis and for determination of the need in operative treatment [3; 7; 9; 13]. In a number of works parallel with other diagnostic there is shown microbiological diagnosis, that is, determination of
