[THE RISK OF THE DEVELOPMENT OF OCCUPATIONAL CHRONIC FLUORIDE POISONING].

On the basis of individual occupational fluoride loads (IOFN) it was established that under current levels of air pollution of the working area by fluorine compounds, occupational fluorosis can occur in mostly sensitive workers with 66 or more years of accumulated period of work, while the most vulnerable are workers with of 9.4 or more years of accumulated period of work. The results obtained in comparison of clinical data with individual fluoride load, testify that in the high-risk group for the development of occupational fluoride intoxication include workers with an average accumulated period of work of 10.5 years or more and Individual Occupational Fluoride Load (IOFL) as 67,7 or more grams. In the high-risk group there are included workers with an average accumulated period ofwork of 13.7 years and IOFL as 89.8 grams or more. With the use of ultrasound densitometry there was revealed a clear cut dynamics of the increase of the speed of ultrasonic wave with the rise in the accumulated period of work at the plant, which indicates to a gradual increase in bone tissue density.

[Clinical and pathogenetic aspects of the chronic occupational intoxication with fluorine compounds in modern reality].

Multi-year follow-up of 358 workers of aluminum pot rooms, including 165 individuals suffering from fluorosis, has shown significant changes in the clinical picture of the chronic occupational fluorine intoxication, developed under modern conditions of production, at lower concentrations of fluorine compounds in the air of working area. In this connection, the pathology of the musculoskeletal system plays the dominating role in this clinical picture and has the large variability of combinations of the individual sections destructions of the bone tissue. The main criterion to establish the phase of the disease is still the number and severity of the signs of this destruction. The visceral pathology in contemporary production circumstances is registered with less frequency and loses a number of the previously described clinical manifestations, however, is still of some importance to identify the early signs of the disease and to prevent the dental fluorosis on time.

[Biologic markers of exposure to and effects of fluorine compounds in workers engaged into aluminum industry].

The study in 727 workers exposed to inorganic fluorine compounds revealed through ultrasound densitometry changes in fluorine excretion and bone tissue density in accordance with the length of service, through markers of bone destruction and synthesis features of bone remodelling were specified.

[Regional "occupational medicine" system--effective model of occupational risks evaluation and management].

Sverdlovsk regional government specified and approved a concept of diversified system "Occupational medicine" to preserve and improve health of workers in Sverdlovsk region. Implementation of the concept enables to put new organizational approaches into practice for improved management of available medical care for all workers, for increased quality of this care, for better clinical work and better health of economically active population in Sverdlovsk region.

[Assessment and management of risk to the working population's health in the occupational medicine system].

The multidisciplinary harmonized "Occupational Medicine" system established in the Sverdlovsk Region makes it possible, firstly, to analyze and assess occupational risks at both the regional and municipal levels; secondly, at each of the above level, to take specific managerial decisions including the packages of organizational, informational, preventive, and other measures to minimize risks on the cost-benefit basis.

[Organization of medical service to working people at the municipal level].

To improve availability of primary health care and to strengthen a preventive trend in public health, the authors propose a model for organizing medical aid within the concept of the occupational health system adopted by the Sverdlovsk Regional Government under No. 73-[Russian characters: see text] on February 2, 2004, which is being implemented at the municipal level, namely in the Berezovsky City District.

[Topical problems of preliminary, periodic and additional medical examinations of workers exposed to hazardous and/or dangerous occupational environment, in accordance with occupational risk factors].

The article covers main problems encountered during preliminary, periodic and additional medical examinations of workers exposed to hazardous and/or dangerous occupational environment. The authors suggested main approaches to the solutions.

["Industrial Hygiene" system as a basis of medical service for workers in Sverdlovsk region]. / Sistema "Meditsina truda" kak osnova meditsinskogo obsluzhivaniia rabotaiushchikh Sverdlovskoi oblasti.

The authors suggest a concept of multifield specialized "Industrial Hygiene" service based on integrated system of medical and social care, that includes monitoring of work conditions, evaluation of occupational risk and its management for prevention of and lowering general and occupational morbidity, transitory disablement morbidity, disability and premature deaths, for preservation of labour force in Sverdlovsk region.

[Features of chronic occupational bronchitis in nonferrous metallurgy workers]. / Osobennosti khronicheskogo professional'nogo bronkhita u rabochikh proizvodstsv tsvetnoi metallurgii.

The authors summarized results of periodic medical examinations and deep clinical studies of metallurgy workers with bronchial and pulmonary disorders. The article covers clinical and functional characteristics of toxic and dust bronchitis, clinical course and manifestations.

[Dispensary registration groups and follow-up periods of patients with silicotuberculosis]. / O gruppakh dispansernogo ucheta i srokakh nabliudeniia bol'nykh silikotuberkulezom.

Silicosis is the most common and most frequently tuberculosis-complicated pneumoconiosis with poor prognosis. So a procedure for following up patients with silicotuberculosis requires revision and elaboration. Long-term follow-ups have made it possible to define early signs of this disease and to propose a number of techniques for its early diagnosis, such as chest computed tomography and polarization serum crystal microscopy. Specific recommendations on follow-ups of patients with silicosis and silicotuberculosis by a phthisiologist are laid down.

[Hygienic regulation of welding aerosols in air of workplace and pneumoconiosis in welders (review of literature)]. / Gigienicheskaia reglamentatsiia soderzhaniia svarochnykh aérozolei v vozdukhe rabochei zone i pnevmokonioz élektrosvarshchikov (obzor literatury).

The authors represent review of literature on fibrogenic effects of welding aerosols and results of own clinical and epidemiologic studies concerning pneumoconiosis course in electric welders compared to other occupational groups. In conclusion, the authors necessitate more strict control over total concentration of welding aerosol solid component (WASC) in air of workplace and determination of MAC for WASC.

[Occupational medicine in aluminum and copper alloy production]. / Meditsina truda v proizvodstve aliuminievykh i mednykh splavov.

Workers engaged into aluminum alloys production demonstrated high prevalence of occupational respiratory diseases caused by dust--pneumoconiosis and dust bronchitis, workers of copper alloys production were diagnosed as having early stage of chronic lead intoxication.

[Clinical and x-ray diagnosis and diagnosis and classification of occupational fluorosis]. / Kliniko-rentgenologicheskaia diagnostika i klassifikatsiia professional'nogo fliuoroza.

The authors summarize longstanding experience in studies of chronic occupational intoxication caused by fluoric compounds. Findings are that diagnosis and clinical classification of occupational fluorosis should base on osteosclerotic changes in compact substance of peripheral bones, primarily of forearms and legs. The authors give clinical classification of occupational fluorosis.

[25-year experience of Sverdlovsk regional occupational center on the basis of the research institute]. / 25-letnii opyt raboty Sverdlovskogo oblastnogo profpatologicheskogo tsentra na baze NII.

Sverdlovsk Regional Occupational Center based on the Research Institute has highly qualified staff, incorporates ambulatory department, hospital with modern diagnostic and therapeutic equipment. The Center performs multiple tasks, being an organizational and methodic, diagnostic and occupational examination institution using up-to-date advances in industrial medicine.

[Efficiency of computed tomography in diagnosis of silicotuberculosis]. / Effektivnost' komp'iuternoi tomografii v diagnostike silikotuberkuleza

The routine methods X-ray study and computed tomography (CT) were compared in a group of patients engaged in fireproof industry. CT yields valuable additional data in early silicotuberculosis, which makes it possible to follow the extent of a silicotuberculous process more completely, to make a better diagnosis of nodal and focal shadows, to identify small decay cavities in the foci and infiltrates. CT is the method of choice in following up patients with silicotuberculosis.

[Problems in the evaluation of predisposing factors to pulmonary tuberculosis]. / K probleme otsenki predraspolozhennosti k tuberkulëzu lëgkikh.

Genetic predisposition is an important factor in pulmonary tuberculosis. The pattern of dermatoglyphic indicators is thought a reliable marker of such predisposition. Selective character of the disease emergence is related with an unfavorable combination of genetic and extra-genetic risk factors in an individual. A comprehensive assessment of the above factors may contribute to a reliable prediction of a high risk to develop tuberculosis.

[The clinical characteristics of the early stages of occupational fluorosis under the combined and joint action of production factors]. / Klinicheskie osobennosti rannikh stadii professional'nogo fliuoroza pri kombinirovannom i sochetannom deistvii proizvodstvennykh faktorov.

Over 1000 workers of hydrofluoric and cryolite enterprises and electrolysis shops of aluminium enterprises were examined. Subjects exposed to soluble hydrofluorides presented in the early stage of chronic intoxication with a variety of syndromes, that was characteristic of intoxication with poisons of general toxic action with involvement of hepatobiliary, digestive, circulatory and autonomic nervous systems. Combined exposure to fluoric compounds, heating microclimate and electromagnetic fields results in a graver involvement of the circulatory and autonomic nervous systems. Clinical and experimental data show, that osteoarthrosis deformans of the major joints (primarily elbow joint) must be regarded as one of the symptoms of fluorosis, when other intoxication signs are present.