[Actual problems of technical and metrological support of the extreme medicine service in Russia].
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Biomedical subjects
Publications and source records attributed to I B Ushakov.
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The authors present results of theoretic and experimental analysis of ecologic safety in Russia. New composite discipline--"human ecology"--takes an important place in solution of medical and ecologic problems associated with correlation between natural and occupational factors influencing humans. Present medical, social and ecologic circumstances define the most vital scientific and applied directions covering medical and ecologic humanization of occupational and natural environment for humanity nowadays. Those directions are prophylaxis of ecologic stress, specification of informational technology for medical and occupational monitoring, creation of data bank on human ecology.
The authors present concept of occupational reliability of an operating human. The concept is based on systemic approach to analysis of erroneous acts as results of stochasticity of inner human traits and outer interferences. The authors justify universal, systemic criterion to analyze reliability of occupational activities (potential unreliability of acts). The criterion helped to solve practical problems of quantitative evaluation and forecast of outer influence on occupational reliability of a pilot. The criterion is adequate for analysis of "risk-profit" correlation to optimize material expenses among the components of "human-machine" system being under elaboration, preparation and in use.
The article covers scientific and applied aspects of ergonomic (physiologic, hygienic, engineering and psychologic) improvement of protective and salvage means for aviation specialists in up-to-date ecologic circumstances. The authors justify and present a concept of higher ergonomic efficiency of those means when exposed to combined hazards. The concept suggests possibility of considerably increased occupational readiness and occupational health in aviation specialists owing to more complete consideration of operator's personal characteristics.
The article deals with methodic approaches to health state evaluation of pilots who participated in liquidation of events following accidents at nuclear power objects. The main approaches are indeterminancy principle for late radiation effects, economic approach to evaluation of radiation risk, principle of risks comparison, consideration of summarized effect of environmental factors, etc. Some authors' viewpoints are presented.
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A conceptual strategy of increasing tolerance to the unfavorable factors of flyer's profession is specifically aimed at keeping-up professional vision. The reason for this strategy is associated with the need to develop an integrated system of expert-prognostic, ophthalmoergonomic, psychophysiologic, functional and rehabilitative measures with the goal to enhance the visual performance and to prolong the professional longevity of flyers. The paper offers deliberations on the concept of "professional vision of a pilot".
Effects of voluntary hyperventilation (2 h, 70-80% of maximal lung ventilation) on external breathing, gas exchange and blood circulation were studied in 12 healthy male volunteers. Hyperventilation was shown to change structure of the respiratory cycle as variation and expiration time were decreased. Indices of the external breathing did not reduce but, on the contrary, there was a significant increase in the alveolar ventilation and a reduction in the dead space ventilation. Considerable losses of carbon dioxide with the expired air were noted only during initial 10-15 min of intensive breathing. The angular coefficient for the most steep section of the CO2 loss curve ranged from 150 to 200 ml/min as a result of which the total CO2 deficit in this period (i.e. the CO2 release exceeds the O2 consumption) was about 2 l. Hereafter, the CO2 deficit did not virtually increase despite intensive functioning of the external breathing system. This became apparent from the regain of the respiratory coefficient, a significant and gradually growing CO2 ventilation coefficient. Values of PETO2 and PETCO2 remained stable throughout the experiment with quite substantial hypocapnia: up to 15-20 mm Hg. Thus, the cardiorespiratory system has a powerful defence mechanism to prevent exacerbation of hypocapnia despite intensive ventilation of the alveolar space. This mechanism comes into action at the very first minutes of hyperventilation, reaches maximal efficiency within 10-15 min and maintains this level during the whole period of investigation (about 2 h).
It has been established that work efficiency of persons occupied by machine operating duties degrades markedly under the action of an acute alcoholic intoxication--less on real machines and more on simulators and when operating simple technical devices. Work efficiency degradation is manifested by the task execution time increase (to a lesser degree) and by erroneous action quantity increase after taking alcohol, i.e. by work reliability decease. Most heavily it is manifested during the first 0.7-1.5 hr. After taking alcohol. And direct work efficiency index is usually improved 12-16 hr. after taking alcohol. Increase of erroneous action quantity is caused probably by a series of physiological, psychophysiological and psychological changes in the condition of a man under the action of alcohol. Time of the day when the activity takes place after taking that dose of alcohol is practically non valid for changing work efficiency index.
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Rationale is given to the proposition that aviation medicine including psychophysiology and ergonomics is a peculiar kind of aviation anthropoecology as a variety of the present-day integrative science of human. This is grounded, firstly, on analysis of any scientific finding of aviation medicine in the light of two principles of the contemporary occupational medicine, i.e. human health and reasonable risk (which is an equivalent of safety) and, secondly, systemic study from this angle of all, from molecular to social, levels of the biological integration man of flying.
Proposed are new quantitative criteria of the functional state of erythrocytes based on automated recording parameters of the acid hemolysis erythrogram. Extended analysis of adaptation of the red blood system in rats exposed to ionizing radiation (60CO, 1.25 MeV, 0.5, 1.0, and 6.0 Gy) pointed out that the normally existing stimulating effect of diuretic products on accumulation of juvenile cellular forms was not changed by the dose of 0.5 Gy but ceased after exposure to higher doses. A distinct interrelation (r = 0.83 and 0.61 at p < 0.003, respectively) was revealed between the number of low-resistant erythrocytes (EZR) and subsequent (4 to 7 days later) amount of reticulocytes in the norm and following exposure to 0.5 Gy of ionizing radiation. After exposure to 1.0 Gy and 6.0 Gy r values were below 0.3 at p > 0.2. A "reference cascade" of regression equations on the order of Rt = a + b x EZR could be developed for individual evaluation of different stages of impairment of one of the normal regulatory mechanisms of hemopoiesis in humans systematically exposed to ionizing radiation.
Taking long-term clinical and epidemiologic observation of rescue team (helicopter pilots) as an example, the authors defined principal concepts concerning prophylaxis, social security and rehabilitation of Chernobyl plant accident liquidators. Methodology and methods of the liquidators' health care are discussed.