CC BY
27
Industrial traumatism among «Ferganaazot» workers and systematic analysis methods for determination of priority measures.
Khashirbaeva Dinora Makkambaevna, 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, academic secretary, senior researcher E-mail: dkhashirbaeva@mail.ru
Industrial traumatism among «Ferganaazot» workers and systematic analysis methods for determination of priority measures for its prevention
Abstract: In this article is given main reasons, indicators of injury, among main occupational groups of "Ferghanaazot" workers. In order to prevent occupational injuries, improve an efficiency of the implemented preventive measures, development of targeted activities it is necessary to carry out a systematic analysis of occupational injuries causes, based on certainty and relevant registration acts on accidents at work.
Keywords: injuries, production, working conditions, workers, methods of analysis, risk, labor protection.
One of the main tasks of labor protection in production is creation of healthy and safe labour conditions that causes need of a high-quality preparation for this area of the working personnel, in particular performing activities in workplaces with especially dangerous and dangerous labour conditions.
According to an assessment of International association of social safety and the International Labour Organization (ILO), in the world annually there are 125 million occupational accidents as a result of which 1,1 million people, 25% from them of impact of hazardous and dangerous substances are died. In the European Union countries annually there are about 7 million cases of an industrial traumatism [1, 860-867]. In Russia in production 650 people monthly are died, 1000 people reach disability and about 20% of people work in the conditions which are not answering to sanitary and hygienic regulations. Therefore, it is possible to make a conclusion that a specific weight of workplaces with harmful and dangerous labour conditions grows and owing to an industrial traumatism leading to economic losses in raises production [2].
An industrial injury (labor mutilation) is a consequence of action on an organism of various external, dangerous production factors. More often the industrial injury is determined as a result of mechanical impact in case of tripping-over, falls or contact with mechanical equipment. By nature impact, industrial injuries can be mechanical, thermal, chemical and electric. Basic reasons of an industrial traumatism are technical which arise owing to design shortcomings, machines defects, mechanisms, engineering procedure imperfection, lighting insufficiency, protective equipment defect, lack protective facilities, mechanization and automation insufficient of hard and harmful work. Sanitation hygienic reasons which are connected with requirements violation of sanitary standards (temperature humidity regime), lack of sanitary and amenity facilities and devices, lack of a workplace organization, etc. The organizational reasons, are connected with abuse of regulations of vehicle operation and equipments, a bad organization of handling works, violation of a work-rest schedule (overtime works, idle times, etc.), abuse of safe engineering regulations, untimely instructing, low labor and productive discipline, lack of proper control of production process, lack ofwarning labels, etc. [3, 13-15]. Besides, for female workers of many productions leading to an injury rate the psychophysiological reasons connected with labor discipline violation, intentional self-traumatizing, over fatigue, bad health, family problems, etc. are the most frequent reasons.
According by studying goal of the reasons of an industrial traumatism in production ofJSC "Ferganaazot" features oflabour conditions and engineering procedure have been revealed. A labor activity of the primary professions occupied in this production are characterized by high work rate, use of a manual work in labor-intensive processes, adverse sanitary and hygienic conditions, implementation of chemical reactions at high temperatures, getting in a height which in a complex are created a risk for an industrial traumatism. Professional groups of service technicians, masters, cars drivers ofvarious brands, being a risk group, are exposed to mechanical impact of technical shortages: engineering, machines defects, devices, aggregates, transporters, imperfection of engineering procedure, insufficient mechanization and automation of hard and harmful work. Besides, violations by workers of safety regulations and production instructions also lead to an injury rate in production. When studying an industrial traumatism for 2014-2015 among the examined workers, it has been revealed that most often there were closed fractures of the upper extremities at service technicians of various sites — 15,7%, urea production equipment operator — 11,8%. The highest rates of an injury rate by closed fractures of the lower extremities were revealed at riflemen and equipment operators with identical value — 11,8%. Cases of an industrial traumatism were revealed: rib fractures at engine drivers, service technicians in 2014; isolated cases of a vertebra fractures at the equipment operator and a burn at the electric welder in 2015. Established cases of an industrial traumatism in JSC "Ferganaazot" were indicated a need of systematic analysis, with a subsequent development of precautionary actions.
Considering that one of the most important conditions offight against an industrial traumatism in JSC "Ferganaazot", so it is important to make a systematic analysis of the reasons of its origin which is based on reliability and care of registration of accidents. There are monographic, topographical and also statistical methods of an industrial traumatism analysis are widely used in practice [4, 90-91]. The monographic method provides a multilateral analysis of the injury reasons directly in workplaces. At the same time study an organization and labour conditions, equipment condition, stock, tools. This method is effective at statistical analysis of status of labor condition protection. The topographical analysis method allows establishing a place of the most frequent cases of an injury rate. For this purpose on the plan scheme of an entity where workplaces and equipment are designated, note a number of accidents for an analyzed period. It allows paying more attention to improve-
Section 7. Medical science
ment of labour conditions in workplaces where most often there are accidents. The statistical analysis method is based on studying of quantitative indices of reports about accidents at entities and in organizations. At the same time frequency coefficients and severity of an injury rate are used generally. The frequency coefficient (Cf) determines a number of accidents on 1000 workers for an accounting period and is calculated by a formula:
Cf=An1000/Aw, where are
An — a number of accidents for an accounting period with disability over three days;
Aw — an average number of workers.
A coefficient of injury rate severity (Cs) shows an average number of disability days, happens by one accident for an accounting period and identified by a formula:
Cs= Dt/An, where are
Dt — total days quantity of disability because of accidents;
An — a number of accidents for an accounting period.
Conclusions: Based of a comprehensive analysis of labour
conditions ofJSC "Ferganaazot" implementation of preventive actions for injury prevention in the following directions is necessary: organizational and technical, sanitary and hygienic, treatment-and-prophylactic. Carrying out these actions in the production shall be included: observance of requirements of regulatory legal acts for labor protection; corresponding sanitary consumer services of workers; a constant control and automation of production processes in the most life-threatening workers sites; providing and an operating control behind serviceability of the equipment, ensuring protection with individual protective equipment, overalls, etc.; to bring the standard indicators by KMK 2.01.05.-98 illumination levels, noise, microclimate parameters in a workplace. Obligatory in the production to organize training and knowledge examination again gone to work workers, workers of especially hazardous occupations by the main methods of a safe labour conditions organization in the field of labor protection, carrying out introduction training in a workplace, periodic (repeated), unplanned and current instructing of workers in safe engineering.
2.
References:
Судак С. Н. Анализ производственного травматизма в России и Мурманской области за 2005-2009 годы//Вестник Мурманского Государственного технического университета - Мурманск, 2011. Выпуск № 4, Т. 14, - С. 860-867. Производственный травматизм и профессиональные заболевания.
Khudaybergenov Shukhrat Nurmatovich, Republican Specialized Center of Surgery named after academician V. Vahidov, Doctor of medical sciences Irisov Ortikali Tulaevich, Republican Specialized Center of Surgery named after academician V. Vahidov, Doctor of philosophy e-mail: tulaevich@mail.ru Tursunov Nasriddin Toshtemirovich, Republican Specialized Center of Surgery named after academician V. Vahidov Mustafaev Azizjon Toshmuhammadovich, Republican Specialized Center of Surgery named after academician V. Vahidov E-mail: aziztm25@gmail.com
Algorithm of diagnosis and surgical treatment of postoperative chylothorax
Abstract: The analysis of 14 patients with postoperative chylothorax. Evaluated the effectiveness of the treatment of chylothorax. Developed an algorithm for the treatment of postoperative chylothorax.
Keywords: thoracic surgery, postoperative complications, triglycerides in pleural fluid, VTS.
Actuality of the problem. Chylothorax — a pathological condition characterized by the accumulation of lymph in the pleural cavity ofvarious etiology. The phenomenon was first described Bar-tolet in 1633 [5]. Chylothorax often a postoperative complication of thoracic surgery, catheterization subclavian vein [1; 2; 3], the frequency of which is from 0 1% to 2.5% of the patients with thoracic pathology. Less commonly, it can be due to malformation of the lymphatic system of the lungs or chest cavity. Also chylothorax may be a manifestation of malignancy, trauma of neck or thoracic cavity.
Remain not fully developed approaches to the treatment of
chylothorax: indications for conservative and surgical approaches, terms and methods of surgical interventions [4].
Objective: to develop the optimum tactics of surgical treatment of postoperative chylothorax.
Material and methods studied the results of examination and treatment of 14 patients with postoperative chylothorax: 12 of them among the 6895 operated patients in Center for thoracic surgery of the Krasnodar Regional Clinical Hospital from 2003 to 2008 were 0.17% and 2 patients in the RSCS named after acad. V. Vahidov among 1899 operated on for different diseases
