[Age factors in the study of the olfactory function].
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Biomedical subjects
Publications and source records attributed to V B Pankova.
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The paper presents the data of clinical and hygienic studies of railway cashiers' health. The main deleterious factors of their working conditions are poor microclimatic conditions, bacterial inoculation of the working area air, a forced working posture, and a high vocal load under mental stress. There is a significant prevalence of nervous, obstetric, gynecological, thyroid, and vocal diseases and oral dysbacteriosis among the workers of this professional group. There is evidence for the necessity of including the job of a railway cashier into the List of decreed contingents for periodical medical examinations.
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The paper presents data characterizing the working conditions of railway workers. It shows that there is the greatest levels of noise and vibration, the burden and intensity of work. The worst working conditions are noted in energy supply, car, locomotive services and track facilities. The working conditions determine a significant industrial risk of railway workers since the prevention of health abnormalities by using chemical protective means is a topical problem. The priority lines of hygienic rationale for optimization the choice and use of chemical protective means for workers exposed to occupational hazards are determined.
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The paper reflects the priority role of preliminary and periodic medical examinations in the system of measures implemented by therapeutic-and-prophylactic institutions of the Ministry of Railway of Russia. It gives a comprehensive assessment of the medical, social, and economic aspects of the efficiency of preventive medical examinations. Emphasis is laid on the necessity of elaborating methods to evaluate the economic efficiency of medical measures under the conditions of market economy. At the same time, light is shed on the difficulties available when a full-scale, within the whole industry, economic evaluation of periodic medical examinations is made. The role of a cost-effect analysis is shown as the most flexible existing principle in the evaluation of the efficiency of medical preventive measures.
The paper discusses the present working conditions on railway transport, by using the results of employee rating, characterizes railway services showing the greatest magnitude of adverse and dangerous factors of working conditions. It also characterizes occupational morbidity in railway transport workers over 5 years (1999-2003) and by hazards problems of occupational morbidity and by basic services: locomotive, wagon, and track ones. The paper also presents the rates of disability due to occupational diseases, characterizes the priorities of prevention of occupational diseases on the railway transport.
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Medical deontology plays an important role in the improvement of medical care. Deontological aspects of occupational pathology in otorhinolaryngology are deeply involved in physician's activities, beginning with preliminary and regular medical examinations and ending with determination of the relationship between disease and occupation, development of therapeutic recommendations and subsequent rehabilitation. All these problems are of personal and social importance of which an ENT-doctor should always be aware.
Hearing measurement of 6,784 workers exposed to industrial noise helped to determine the prevalence of occupation-related hypoacusis, which was estimated to vary from 4.5 to 53%. The work record of 10 to 14 years was found to be most risky for the development of cochlear neuritis. During the first 10 years of exposure to industrial noise occupation-related hypoacusis developed in 2% workers, which is within the 5% limits of noise susceptible subjects. Considering hearing integrity during 10-year exposure to industrial noise, it can be assumed that maximaly allowable levels equal to 85 dB are acceptable. Numerous observations of the hearing condition allow the conclusion that the zero degree of hearing impairment, i.e. "signs of noise effects on the hearing organ", should be viewed as an initial form of occupational disease (prenosological form), which requires close follow-up of such workers.
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