[Problem of occupational risk criteria and of evaluating compensations for workers].

The article covers problem of occupational risk criteria and compensation of health damage, with consideration of domestic and international experience.

[Occupational medicine documentation as a basis for improving approaches to risk assessment and to workers' social welfare]. / Sovershenstvovanie podkhodov k otsenke riska i sotsial'noi zashchite rabotnikov na osnove dokumentov MOT po meditsine truda.

The article covers materials on medical and social problems associated with up-to-date improving the occupational medical service.

[Preparing new edition of the manual "Occupational health criteria for assessing and classification working conditions"]. / O podgotovke novoi redaktsii rukovodstva "Gigienicheskie kriterii otsenki i klassifikatsiia uslovii truda."

Revising the Manual P2.2.755-99 is due to new scientific data and to necessary additions and changes of some parts in Hygienic classification for work conditions. The authors received 74 appreciations from all of Russian Federation and suggestions on improving the hygienic criteria. Those suggestions are thoroughly analyzed.

[Methods to evaluate occupational risk in industrial medicine]. / Metodologiia otsenki professional'nogo riska v meditsine truda.

The authors present methods to evaluate occupational risk in industrial medicine. Those methods are based on MACs and MALs with consideration of WHO and ISO concepts, European instructions and other countries' experience. The authors justified hygienic criteria for evaluation and classification of working conditions, quantitative criteria to evaluate links of health disorders and work, methods to analyze structure and degrees of occupational risk, to analyze etiology relationships between work conditions and health disorders. The article covers based categories of occupational risks according to socially valuable medical and biologic parameters. Methodology is a basis for realization of new Federal Laws on safety and occupational medicine.

[The experience of the Department of Industrial Medicine of the Moscow I. M. Sechenov Medical Academy in training specialists at the postgraduate level]. / Opyt kafedry meditsiny truda Moskovskoi meditsinskoi akademii im. I. M. Sechenova v podgotovke spetsialistov na poslediplomnom urovne.

Occupational Medicine Department in Moscow Sechenov Medical Academy is based on RAMSc Research Institute for Occupational Medicine. The Department's general line is postgraduate education with qualification exam and certification in following specialties: industrial hygiene, occupational pathology, clinical laboratory evaluation and prophylactic toxicology. The Department elaborated many methodic documents and study guides, sample educational programs for doctors in industrial hygiene and for residents in occupational pathology. Correspondence study is also in practice. Now textbook in occupational medicine is oncoming.

[The organization of automated information systems on occupational diseases and of the hygienic monitoring of working conditions]. / Organizatsiia avtomatizirovannykh informatsionnykh sistem po professional'nym zabolevaniiam i gigienicheskogo monitoringa po usloviiam truda.

Creation of automated database "Archive of occupational diseases clinic" is an important task of informational support for occupational pathology centers. Constructing the database, the authors designed an "Accounting chart of patient with occupational disease for diagnostic survey in occupational pathology center" and a "Diagnosis of occupational disease" code book adjusted to X ICD with instruction. Analysis of the information obtained forms a basis for forecasting the course of pathologic process, for justifying a complex of treatment and prophylaxis.

[Problems of occupational risk. Evaluation and social welfare]. / Problema professional'nogo riska. Otsenka i sotsial'naia zashchita.

The authors suggested a complex evaluating occupational risk and tested it on enterprises belonging to various industries--machinery building, chemical, oil-processing, electronic, mining. The tests proved the complex to be useful in evaluation of health disorders probability. Integral parameters appeared to be the most valuable as considered not only occurrence, but also severity of the consequences. The study revealed high value of occupational morbidity, if assessed through morbidity with transitory disablement, in evaluation of occupational risk, as disability due to diseases associated with occupation is 2-4 times higher than occupational disability.

[Bases of risk management issues in health impairment in occupational medicine]. / Osnovy upravleniia riskom ushcherba zdorov'iu v meditsine truda.

Theoretical issues and practical implications of risk methodology as applied to occupational health with account for WHO, ILO and ISO concepts are discussed. Conceptual models of risk assessment, risk management and risk communication as well as hazard effective exposure approach and optimization criteria (min exposure and/or risk and optimum cost/benefit relation) are presented. Priority and urgency of risk management procedures are substantiated based on publications and standards of England, Germany, EC, etc for different grades of hazardness with numerical values of occupational morbidity index (N.F. Izmerov et al., 1993b) as quantitative measure of occupational risk for workers' health. The usefulness of risk methodology for occupational and environmental health with regard to more effective prophylaxis is stressed.

[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 problems of occupational risk and approaches to its evaluation]. / Problemy professional'nogo riska i nekotorye podkhody k ego otsenke.

Estimate of occupational risk is reliable only for the factors described by distinct dose-time-effect relationships and having specific clinical criteria of occupational exposure. Those factors are noise, local and general vibration, fibrogenic aerosols not combined with chemicals. Meanwhile, now risk of diseases induced by chemical and biologic hazards could not be evaluated. Combined effects of chemical and biologic hazards result in absence of definite correlation between pathologic signs and length of service. Risk of disorders caused by multiple factors one can assess through other medical and statistic parameters, occupational morbidity, mortality of able-bodied population, biologic age and others.

[Significance of immunocytochemical indices of body reactivity of workers engaged in the production of carbonic plastics on the base of formaldehyde-containing and epoxide resins]. / Znachenie immunotsitokhimicheskikh pokazatelei reaktivnosti organizma rabochikh, zaniatykh v proizvodstve ugleplastikov na osnove formal'degidsoderzhashchikh i époksidnykh smol.

Findings of the complex study carried out by means of hematologic, cytochemical and immunologic methods on 130 workers engaged for the 5-year period in carbonic plastic production on the basis of methanol-containing and epoxy resins are presented. Dependence of the trends and intensity of reactivity changes on the character of leading unfavourable occupational factors has been established. Immunotoxicity of carbonic plastic dust and prevalence of sensitization reaction under the impact of industrial chemical allergens (methanol, epichlorohydrine) are mainly demonstrated. The study has indicated immunocytochemical signs of forming skin allergic pathology under cytotoxic effect. Groups of workers have been registered for medical supervision on the basis of an individual analysis of functionally interdependent immunologic and cytochemical indices.