Occupational multimorbidity in the nickel industry workers.

The purpose of the study was to obtain new data on the causes, development, prevalence and nature of occupational multimorbidity in the nickel industry workers. We extracted data from the register of occupational disease and intoxication cases in the population of the Murmansk region and the Krasnoyarsk Territory in 2007-2021. In 2007-2021, 24.6% of nickel industry workers with newly diagnosed occupational diseases developed a multimorbid pathology. Its prevalence rose from 0% in 2007 to 83.3% in 2021, and the number of occupational diseases increased by 3.17 times. Two diagnoses were found in 66 (14.9%), three in 22 (5.0%), four in fifteen (3.4%), five in eleven (2.5%), and six in three (0.7%) employees. Respiratory and musculoskeletal diseases were the most prevalent disorders, accounting for 31.5% and 23.0% of cases, respectively. Occupational multimorbidity resulted from the increased combined exposure to occupational hazards, outdated technological processes, and the working conditions in the finished product cleaners and crane operators. Multimorbid diseases can be better prevented with improvement in working conditions and better quality of periodic medical examinations.

Occupational disease predictors in the nickel pyrometallurgical production: a prospective cohort observation.

BACKGROUND: Pyrometallurgical nickel production exposes workers to a wide range of occupational risk factors, including nickel aerosol, occupational noise and heat, but occupational (compensation) claims do not get enough attention in the literature. We, therefore, aimed to identify and analyze new occupational disease predictors in order to tailor prevention measures in the nickel pyrometallurgical production workers. METHODS: In a prospective observational study, a cohort of workers grouped in 16 occupations (N = 1424, 88% males, median age 39 (interquartile range (IQR) 31-47 years)), was fixed in 2007 at a large nickel production plant in the Russian High North. We then followed the cohort until 2021 and analyzed the association of selected predictors, including exposure to nickel and occupational group, with the risk of an occupational (compensation) claim in a Cox regression analysis. RESULTS: With 18,843 person-years of observation, occupational disease claims were confirmed in 129 workers (9% of the initial cohort, N = 108 men (84%)). Top three diagnoses were chronic bronchitis (3.81 cases/1000 workers/year), sensorineural deafness (2.36 cases/1000 workers /year) and musculoskeletal disorders (1.90 cases/1000 workers/year). Smoking was significantly associated with each diagnosis (adjusted hazard ratio (HR) ranged from 2.56 (95% confidence interval (CI) 1.17-5.57) for bronchitis to 6.69 (95% CI 1.46-30.64) for chronic obstructive pulmonary disease (COPD)). High nickel exposure was associated with occupational bronchitis and occupational asthma, whereas associations of occupational groups were also identified for COPD, asthma and musculoskeletal disorders. CONCLUSION: Smoking, high exposure to nickel and specific exposure in the occupational groups increase the risk of occupational disease claims and should be prioritized directions for targeted intervention.

Retrospective assessment of occupational disease trends in Russian Arctic apatite miners.

For many years in Russia, apatite ore mining has been associated with high levels of occupational morbidity. The aim of the study was to retrospectively assess occupational disease trends in Russian Arctic apatite miners. We analysed data from routine health screening of 2 649 underground apatite miners in 2007 and data of social-hygienic monitoring "Working conditions and occupational morbidity" in 2008-2020. In 2007, according to the results of routine health screening, 6 778 chronic diseases were diagnosed in 2 649 miners, the most prevalent being musculoskeletal (34.4%) and eye (16.0%) diseases. In the next 13 years, 572 occupational diseases were first diagnosed in 300 (11.3%) miners, most prevalent being musculoskeletal diseases (47.2%). The risk of developing occupational diseases in tunnellers exceeded that in all other miners, including timber-men (RR = 1.56; CI 1.06-2.30), vibration-loading machine operators (RR = 1.67; CI 0.99-2.80), drillers (RR = 1.51; CI 1.08-2.11) and blasters (RR = 2.12; CI 1.55-2.84). We conclude that ongoing modernisation of ore mining processes and medical preventive measures should include more effective health-improving interventions for underground apatite miners. Findings from the analysis of data can be used by health professionals and policy makers to address these problems.

Occupational disease claims and non-occupational morbidity in a prospective cohort observation of nickel electrolysis workers.

Exposure to nickel aerosol in the nickel production is associated with greater occupational risk, yet little is known how many workers will develop an occupational disease and claim compensation. The aim of this analysis was to prospectively observe a cohort of nickel electrolysis workers and quantitatively assess confirmed occupational disease claims. We observed a cohort of nickel electrolysis workers (N = 1397, median age 39, 68% males) from 2008 till 2020 in one of the largest nickel producers in the Russian High North. Cumulative incidence of confirmed occupational disease claims in seven occupational groups, including electrolysis operators, hydrometallurgists, crane operators, final product cleaners, metalworkers, electricians and 'other' was analyzed and supplemented with Cox proportional hazards regression, yielding hazard ratios (HR) with their 95% confidence intervals (CI) of occupational disease claims for each group. N patients with occupational disease claims varied from 1 in 2016 to 22 in 2009, and in total 87 patients developed one or more occupational diseases (cumulative incidence 6.2%, p < 0.001 between seven groups). Accounting for 35,527 person-years of observation in total, cleaners exhibited the greatest risk (HR 2.58 (95% CI 1.43-4.64)), also adjusted for smoking, number of non-occupational diseases and group 2 (hydrometallurgists). Smoking was independently associated with having an occupational disease claim in all groups (p < 0.001), as was the number of non-work-related diseases in six groups of seven. Despite consistent improvement in the exposure control measures in nickel production, occupational morbidity persists. More effort is needed to reduce exposure in final product cleaners.

Features of Occupational Health Risks in the Russian Arctic (on the Example of Nenets Autonomous Okrug and Chukotka Autonomous Okrug).

Working in the Arctic increases the risk of occupational diseases, which is especially important in the context of acute shortage of manpower in the region. The purpose of the study was to comparatively evaluate the working conditions and occupational pathology in Nenets Autonomous Okrug (NAO) and Chukotka Autonomous Okrug (ChAO) of Russia. We analyzed the results of socio-hygienic monitoring "Working Conditions and Occupational Morbidity" in 2008-2018. Despite similar climatic and socio-economic conditions, significant differences exist in the health risks of the working populations of the two regions. In NAO two-thirds of workers were employed at facilities with satisfactory sanitary and epidemiological well-being, while in ChAO only 13% of workers had such conditions. In NAO, almost all occupational diseases (93.2%) were due to exposure to noise among civil aviation workers. In ChAO, health problems mainly occurred among miners (81.5%). The most common of these were noise effects on the inner ear (35.2%), chronic bronchitis (23.1%), and mono- and polyneuropathies (12.5%). In 2008-2018, the occupational pathology risk in ChAO was higher than in NAO: RR = 2.79; CI 2.09-3.71. Thus, specificity of technological processes and forms of labor organization create significant differences in health risks for workers. It is necessary to use modern mining equipment to decrease the occupational morbidity in ChAO. In NAO, this effect can be achieved by updating the fleet of civil aviation.

Occupational Medicine and Environmental Health in the Border Areas of Euro-Arctic Barents Region: A Review of 30-Year Russian-Norwegian Research Collaboration Outcomes.

This year marks 30 years of close collaboration between a consortium of institutions, namely, the Northwest Public Health Research Center, Saint-Petersburg (NWPHRC); the Institute of Community Medicine (ICM) of UiT (The Arctic University of Norway, Tromsø); the National Institute of Occupational Health (NIOH), Oslo; the University Hospital of Northern Norway (UNN) at Tromsø; and McMaster University (MU), Hamilton, ON, Canada. During the early years of cooperation, Dr. Chashchin was the Director of the Scientific Laboratory of the North-West Public Health Centre Branch of the NWPHRC located in the town of Kirovks in the Murmansk Region. The primary focus of this long-standing collaboration was to assess and address issues that are important for maintaining the health of the population living in the border areas of Russia and Norway and included the reduction of occupational health risks among workers employed in mining, metallurgical and machine-building enterprises located in the north-western region of Norway and the adjoining Kola Peninsula in Russia. These industrial activities constituted essential components of the local industries. The ongoing Russian-Norwegian cooperation in the field of occupational medicine is an excellent example of the effective combination of intellectual potential and research technologies of multiple countries. It has resulted in the development of a scientifically based set of measures for practical implementation, contributing to the improvement of working conditions and preservation of the health of workers employed at enterprises where the joint research was carried out.