[FEDERAL CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS, PREVENTION AND TREATMENT OF PNEUMOCONIOSIS].

The purpose of development of this clinical practice guidelines was to provide evidence-based protocols that help the practitioner and the patient make the right decision for the health assessment, treatment and prevention of pneumoconiosis. Pneumoconiosis is the interstitial lung disease of occupational origin caused by prolonged inhalation of inorganic dust, characterized by chronic diffuse aseptic inflammation in lung tissue with the development of pulmonary fibrosis. Currently, thereare no treatment that provide a cure pulmonary fibrosis and changes in the dynamics of decline in lung function. Regular, individually tailored treatment should be directed to the pathogenic mechanisms and some clinical symptoms of pneumoconiosis, as well as the prevention of complications. To enhance the effect of pharmacotherapy is recommended to use non-drug therapies that enhance the functionality of the respiratory system.

[Topical aspects of contemporary forms of occupational bronchial asthma].

Occupational bronchial asthma is a variable, heterogenious disease. Occupational factors are triggers and inductors of the pathologic process, cause formation of various clinical phenotypes of asthma, on background of genetic predisposition, changed metabolic adaptation, energetic systems, neuro-humoral regulation, immune state.

[Occupational therapy: achievements and problems].

Occupational therapy is topical and attracts attention of various medical specialists, for being on junction between clinical, hygienic, social and economical sciences. The authors present major directions of research and practical work of the Institute from its foundation till nowadays.

[Contemporary aspects of maintenance and promotion of health of the workers employed at the aluminum production enterprises].

The exposure of the combined occupational hazards on the workers of aluminum plants results in the development of the occupational chronic diseases of bronchopulmonary and bone systems and oncopathology. Pathogenetic mechanisms of the toxic exposure of fluorides on the body as well as molecular and cellular structures are presented.

[Complex therapy of occupational respiratory tract diseases using multifunctional massage device: clinical criteria of efficiency].

Level of efficiency of CERAGEM MASTER CGM-M3500 treatment device applied for occupational patients suffering from bronchi and lung pathological states has been shown in the paper. Positive effects of treatment have been assessed as reliably high and were proved by improvement of clinical and functional indices, subjunctive self-evaluation of health by patients and positive signs in the clinical course of the diseases. Diagnostic complex has been analyzed, including hematological indicators of the peripheral blood, oxygenation of the capillary blood, immunology. Also dynamics of the clinical course has been studied along with the data on self-assessment of health by patients prior and after the therapy by the device. Prospects on treatment of occupational bronchi and lung pathologies with the help of multifunctional massage device are being discussed in the paper.

[New approaches to treatment of occupational bronchial asthma].

Clinical and biochemical studies considering pathogenetic mechanisms of bronchial asthma supported efficiency of "Singular" preparation and its promising quality for complex therapy of bronchial asthma.

[Pathomorphosis of contemporary forms of occupational diseases].

Studies on pathogenetic mechanisms of development, formation and course of occupational diseases revealed pathomorphosis of major specification forms (diseases of bronchopulmonary system, skin, nervous system, locomotory apparatus). Developing pathomorphosis of occupational and occupationally mediated diseases is caused by changed work conditions, lower acting concentrations and levels of occupational factors, influence of harmful ecologic factors, metabolic features, immune state, individual sensitivity to occupational and environmental factors.

[Contemporary variants of occupational diseases]. / Sovremennye formy professional'nykh zabolevanii.

Contemporary forms of occupational diseases are often characterized by many body systems involved, with response of specific and nonspecific effects. Due to observed transformation in character and course of the main occupational entities, specifying the new clinical classifications, new "List of Occupational Diseases" adapted to ICD-10, by specialists remains topical.

[Some features of gastric disorders in occupational diseases]. / Nekotorye osobennosti patologii zheludka pri professional'nykh zabolevaniiakh.

Some features were revealed after study of 185 patients with various occupational diseases: chronic lead intoxication, bronchial asthma, and disorders caused by fluor. Considering polyetiology and nonspecificity of gastric diseases, the authors could not determine the changes revealed as caused only by occupational exposure.

[Occupational factors and reproductive disorders]. / Faktory proizvodstvennoi sredy i patologiia reproduktsii.

The article covers literary data and observations concerning influence of occupational factors and working environment on workers' reproductive health. The authors stress common ground of pathogenetic mechanisms underlying pathomorphosis of reproductive disorders and other symptoms caused by occupational exposure. The materials emphasize importance of reproductivity studies in workers exposed to occupational hazards, as reproductive disorders are early and gentle signs of inner imbalance.

[Occupational pathology: present and future]. / Profpatologiia (nastoiashchee i budushchee]

Formed 75 years ago, occupational pathology has defined structure of occupational morbidity, determined principles of occupational diseases' pathogenesis and pathomorphosis, demonstrated dependence of occupational entities on acting occupational hazards, described clinical manifestations of occupational diseases, emphasized informative diagnostic complexes. Diagnosis in occupational pathology now is established on basis of etiology. Manifold activities helped to form a system preventing health disorders caused by occupational hazards. Topical problem is to elaborate and put into practice some criteria for compensation of occupational damage with differential expert assessment of functional disorders caused either by occupational disease or by general one. Prospective trend could be to create a system organizing and managing workers' health on workplace and to put "protection by time" principle into practice with forecasting risk of occupational diseases and dose-effect dependence. Another prospect is to elaborate and put into practice a training in social and psychologic adaptation for occupational managers and industrial workers.

[Biologic monitoring of the health status of workers exposed to lead]. / K voprosu o biologicheskom monitoringe sostoianiia zdorov'ia rabotaiushchikh v kontakte so svintsom.

Use of biologic monitoring for workers exposed to lead is the most efficient means preventing lead intoxication all over the world. Considering WHO recommendations and personal research, the authors specified national system of biologic monitoring for workers exposed to lead. The system covers mandatory control of serum and urinary lead levels. The authors based biologic MAC for lead in serum-50 mg/dl (males) and 30 mg/dl (females).

[Materials for adjusting MAC of lead in the workplace air]. / Materialy k korrektirovke PDK svintsa v vozdukhe rabochei zony.

The authors present materials of clinical and hygienic study checking MAC for lead in the air of workplace. The study covered 506 workers of printing, nonferrous metallurgy plants and storage battery production. The study included examination of cardiovascular, nervous, digestive systems and laboratory values and revealed high diagnostic value of serum lead level and low one of urinary lead level. High number of the groups examined and mathematical processing of incomplete selects (Caplan--Meyer assess) proved that intoxication resulted from higher lead concentrations (0.58-0.8 mg/m3). The lead levels of 0.2 mg/m3 in 23.7% of cases induced changes of 2-3 laboratory values-first signs of lead intoxication--and in 5.2% of cases some symptoms of vegetative sensory polyneuropathy were seen. These lead levels are therefore determined as minimally acting. Calculations of probability parameters for health risk helped to set MAC for lead in the air of workplace at 0.05 mg/m3 (this value is accepted by Russian Health Ministry) with mandatory control of serum lead level.

[The toxicological, hygienic and clinical aspects of the action of low levels of organic solvents]. / Toksikologicheskie, gigienicheskie i klinicheskie aspekty deistviia nizkikh urovnei organicheskikh rastvoritelei.

The article presents experimental data showing that Average Shift Concentration (ASC) and Maximal Single Concentration (MSC) for some solvents (tetrachloromethane, tetrachloroethane, dimethylformamide, benzene) are expedient to be justified. Clinical and hygienic materials proved significant health parameters (nervous system, peripheral blood) and urine levels of main metabolites to depend on chlorbenzene and toluene concentrations influencing the workers. Having analyzed the results, the authors recommended following hygienic norms in the air of workplace: for chlorbenzene ASC--50 mg/cu m, MSC--100 mg/cu m; biologic MAC for urine 4-chlorcatechol--0.05 g/l; for toluene ASC--50 mg/cu m, MSC--150 mg/cu m; biologic MAC for urine hippuric acid--1.5 g/l. The article shows some features of ASC and MSC practical application.

[The clinico-pathogenetic aspects of chronic exposure to organic solvents]. / Kliniko-patogeneticheskie aspekty khronicheskogo vozdeistviia organicheskikh rastvoritelei.

Retrospective and prospective epidemiologic studies revealed features of pathomorphosis and response, defined various pathogenetic mechanisms induced by complex, combined exposure to poisons at work. The article determined main neurologic and hematologic syndromes considered as early and sensitive diagnostic criteria of poisons influence on workers exposed to them. The authors described some variants of course and long-term complications of prolonged exposure to poisons.

[Effect of organic solvents on functional nervous system disorders]. / Funktsionalnye rasstroistva nervnoi sistemy pri vozdeistvii organicheskikh rastvoritelei.

Examination of 953 workers exposed to low concentrations of chlorbenzene, tricresol and dimethylfonnamid revealed such functional neural disorders as cardiovascular neurosis. Chlorbenzene and tricresol resulted in hypertonic cardiovascular neurosis, dimethylformamid--in hypotonic one. Occurrence of cardiovascular neurosis grew with the longer length of service.