Lviv clinical bulletin 2015, 1(9): 41-46

https://doi.org/10.25040/lkv2015.01.041

On the Necessity of Development of the Criteria of Professional Suitability of the Workers with Arterial Hypertension

Posted onAuthorAdminЗалишити коментар / Leave a comment

N. Grechkivska

Shupyk National Medical Academy of Postgraduate Education

Introduction. The problem of cardiovascular diseases is one of the most important in medical science and practical public health. The most urgent problem of hypertension is in groups of working population suffering from the harmful factors of production environment and labor process such as noise, vibration, harmful industrial climate and so on.

Aim. To develop the criteria of professional competence of employees with hypertension working under the harmful and dangerous factors of production environment and labor process.

Materials and methods. The analysis of general and occupational diseases were carried out on the results of periodic medical examinations of individuals working under the influence of the hazardous and dangerous conditions on the basis of the general medical reports. The analysis was provided by 35 medical commissions in Kyiv that carried out preventive medical examinations  for people working in hazardous and hazardous working conditions during 2009-2013. It was studied the main forms of general diseases taking into account ICD-10 and occupational diseases.

Results. The dynamics of the occupational diseases in the enterprises of Kyiv shows that in recent years there was a decrease of occupational diseases which is consistent with the general trend in Ukraine. General diseases were diagnosed in 30.5 % of employees. The analysis of the total morbidity of workers in Kyiv in recent years shows that the cardiovascular diseases (39.6 %) were the most widespread. The prevalence of hypertension was 42.3 %, vegetative-vascular dystonia – 31.4 % and coronary heart disease – 20.8 %. Therefore, in the diagnosis and treatment of hypertension, the modern clinical, laboratory and instrumental methods should be used, according to the unified clinical protocol of primary, emergency and secondary (specialized) medical care, clinical recommendations for arterial hypertension. The chairpersons of medical commissions conducting the periodic medical examinations and determining the proficiency of a worker with hypertension to a profession under the conditions of harmful and dangerous manufacturing factors, must use the criteria of professional suitability in accordance with the order of the Ministry of Health of Ukraine N 246 dated May 21, 2007 “On Approval of the Procedure for Carrying Out the Medical Examinations of  Employees of  the Certain Categories” and to form groups of dispensary observation.

Conclusions. It is necessary to adhere to the sanitary-and-gygienic requirements regulating the permissible level of production norms in the workplace; rational use of remedies of individual and collective protection; to introduce the principles of time protection, the system of the training of the administration, the services of the labor protection on the enterprises on the basis of healthy lifestyle, socio-psychological adaptation, the preservation of health in the workplace, etc. The requirements for further improvement of normative acts on the examination of the proficiency and performance of the certain categories of workers with existing the general and occupational diseases are needed.

References

  1. Basanets AV, Lubyanova IP, Timoshina DP. Occupational Diseases – the Actual Problem of the Modernity. Occupational Health. 2011;2:42-45. (Ukrainian).
  2. Grechkovskaya NV. Examination of the Professional Suitability of Workers with Arterial Hypertension under the Influence of Harmful and Dangerous Factors of the Production Environment. In: Scientific discussion: medicine questions: coll. of art. on the materials of the 28th International. Extramural Scientific-Practical. Conf. Moskow, 2013;7(14). p. 109-114. (Russian).
  3. Hrechkivska NV. Prevention and Examination of the Professional Competence of Employees of Certain Categories of Patients with Arterial Hypertension. Ukrainian Journal of Occupational Medicine Problems. 2013;2(35):16-22. (Ukrainian).
  4. Hrechkivska NV. Examination of the Professional Competence of the Certain Categories of Workers in the Presence of the Cardiovascular System Diseases. In: Innovative Technologies of the Prevention and Treatment of Arterial Hypertension in Outpatient Practice: materials of nationwide scient. and practical. conf. Kyiv, 2012. p. 134-136. (Ukrainian).
  5. Horbas IM. Epidemiology of the Main Risk Factors of Cardiovascular Diseases. Arterial Hypertension. 2008;2(2):13-18. (Ukrainian).
  6. Dorohoy A. P. Deadline of the “Program for the Prevention and Treatment of Arterial Hypertension in Ukraine” Is Over, the Problem Remained. What Next? Arterial Hypertension. 2011;3(17):29-36. (Ukrainian).
  7. Kovalenko VM, Sirenko YM, Dorohoy AP. Implementation of the Program on Prevention and Treatment of Arterial Hypertension in Ukraine. Ukrainian Cardiological Journal. 2010;1:3-12. (Ukrainian).
  8. Kundiyev YI, Nahorna AM, Chernjuk VI. Strategy to Ensure the Safe Working Conditions and Maintaining the Health of Workers in Ukraine in 2006-2010. Ukrainian Journal of Occupational Medicine Problems. 2005;3-4:4-10. (Ukrainian).
  9. Kundiyev YI, Nahorna AM. Occupational Health in Ukraine. Epidemiological Analysis. Kyiv: Avicenna, 2006. 316 p. (Ukrainian).
  10. Order of MOH of Ukraine N 676 from 2004 Dec 31 “On Approval of the Clinical Protocols for Obstetric and Gynecological Care”. (Ukrainian).
  11. Order of MOH of Ukraine N 436 from 2006 Jul 03 “Standards of Care of the Cardiological Patients”. (Ukrainian).
  12. Order of MOH of Ukraine N 246 from 2007 May 23 “On Approval of the Order of Medical Examination of Workers of the Certain Categories”. (Ukrainian).
  13. Order of MOH of Ukraine N 795/75 from 2009 Nov 03 “On Approval of the Harmonized Methodology for the Development of Clinical Guidelines, Medical Standards, Unified Clinical Protocols of Medical Care, Local Protocols of Medical Care (Clinical Pathways) on the Basis of Evidence-Based Medicine. Part 2”. (Ukrainian).
  14. World Report on Noninfectious Diseases. Geneva, WHO, 2012. (Russian).
  15. Sirenko YM. Guideline on Arterial Hypertension of the European Society of Hypertension and the European Society of Cardiology. 2013. Arterial Hypertension. 2013;4(30):5-160. (Ukrainian).
  16. Trachtenberg IM, Babayan EA, Kandaryan KA. Chemical Industrial Environment Factors and Cardiovascular System. Yerevan, 1992. (Russian).
  17. ADVANCE Collaboration. Lancet. 2007;370:829-840.
  18. Global atlas on cardiovascular disease prevention and control. Geneva: World Health Organization, 2011.
  19. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3(11):442. https://doi.org/10.1371/journal.pmed.0030442