Environment&Health (Dovkillia ta zdorovia)

13-21

Authors: Нагорна А.М., Савенкова Н.В.

Introduction: In recent years, there has been a gradual decline in occupational traumatism in Ukraine, but an in-depth analysis of the data shows that statistics does not fully reveal the complexity of the current situation on occupational traumatism and the quality of its registration and record-keeping, especially in case of sudden death at a workplace. According to the Resolution of the Cabinet of Ministers of April 17, 2019 № 337 on «Procedure for investigation and record-keeping of the incidents, occupational diseases, and accidents at the production» (with changes made in accordance with the Resolution of the Cabinet of Ministers № 1, 05.01.2021) the amendments were made where the circumstances of an accident and / or acute occupational disease (poisoning), cases of sudden death were recognized as related to production (according to the Article 52, paragraphs 6-8). Objective: We identified the regularities of the formation of the indicators of natural death at workplace of the employees over 2015-2020 in Ukraine. Materials and methods: According to the data of the State Statistics Committee of Ukraine and the State Labour Service of Ukraine, we performed the analysis of natural deaths of the employees at workplace in the dynamics of monitoring by the types of economic activity, occupations and causes over 2015-2020 and established the ways for the improvement of their record-keeping. Statistical data were evaluated with the help of rankings, methods of generally accepted statistical analysis. Results and discussion: From 2015 to 2019, the number of the accidents at production, registered and recognized as insured events, decreased from 4,260 to 3,876 (by 9.0%), and the number of the fatal traumatized increased from 375 to 422 (by 11.1%). In 2020, the number of the accidents (A) increased up to 6121 (by 30.4%), and the accidents with fatal consequences increased up to 653 (by 42.5%), mainly due to the diseases of circulatory system and COVID-19. In recent years, there has been an increase in sudden deaths (SD) and «rejuvenation» of the contingent of working people.The problem of natural death is actual worldwide and according to the WHO, makes up 5-7%. Among those who died of natural causes, young people aged 20-39 years make up a significant proportion, mainly due to circulatory diseases and COVID-19. It was established that in the dynamics of 2015-2020, there were 4861 cases of natural death (ND) at workplace in Ukraine, which are 8.0-16.2 per 100 thousand working population and 27.2-55.0 per 100 thousand population working under harmful working conditions against 5.3 and 14.1 in 2012. The analysis of cases of ND in terms of gender, age and length of service shows that more than 77.0% are men aged 20-60 years old. The distribution of cases of ND at the workplace in Ukraine by the branches of industry shows that the socio-cultural sphere (30.0-55.2%), transport (16%), engineering and metallurgy (10.5-6.6%), coal and mining industry (4.2-2.4%) are the main ones. The cases of ND at workplaces from diseases of the circulatory system in the employees of social sphere and transport, miners of coal mines have been analyzed in details. The methods of prevention of ND at workplace are proposed. Conclusions: 1. The problem of natural death at the workplace requires an additional legislation to determine the circumstances of death connected with the working conditions or the feautures of the production process. 2. The most frequent cases of ND at the workplace in Ukraine are registered among employees of the socio-cultural sphere (30.0-55.2%), transport (16%), mechanical engineering and metallurgical industry (10.5-6.6%), construction and road construction, agro-industrial complex , coal and mining industry (4.2-2.4%). 3. Diseases of the circulatory system (acute cardiovascular failure (heart attack, stroke), coronary heart disease, heart and lung failure on the background of nervous and emotional stress, lack of sleep, the presence of a complex work schedule (daily, 12 hours, night shifts, which requires a separate study of causation) and impact of the adverse factors of the working environment were the main causes of ND in the employees. 4. Prevention of ND is in the field of the restoration of the system of providing medical care to employees, improvement of the quality of preventive medical examinations, pre-shift control, occupational selection.

30-37

Authors: Bandazhevskyi Yu.I., Dubova N.F.

Оbjective: The aim of the study was to identify interrelations between the state of folate cycle genetic apparatus and blood levels of homocysteine, thyroid and adenohypophysis hormones in the blood among the children from Ivankivskyi and Poliskyi districts, Kyiv region, bordering the Chornobyl exclusion zone (СhEZ). Methods: Immunochemical, genetic, statistical ones. Results: We measured blood levels of homocysteine (Hcy), pituitary thyroid-stimulating hormone (TSH), free triiodothyronine (T3), free thyroxine (T4) in 158 children from Poliskyi district and 178 children from Ivankivskyi district and assessed the state of a genetic system of the folate cycle (FC). The average age of the examined was (15.2 ± 0.9) years old (95% CI 15.0-15.4 years old). Taking into account the FC genotypes, genetic subgroups were formed, they were based on 100% representation of one specific genotype. The laboratory examination was carried out twice: in April and December 2015 (before and after the fires in the ChEZ). It was found out that in the total group of the children, as well as in most of analyzed genetic subgroups, the level of Hcy and thyroid hormones (TG) in the children from Ivankivskyi district was statistically significantly higher than in those from Poliskyi district. At the same time, a direct association between Hcy and TSH was observed in the total group, as well as in most of the genetic subgroups of children from Ivankivskyi district, and this ssociation was absent in the children from Poliskyi district. The blood level of Hcy both in the children from Poliskyi district and in the children from Ivankivskyi district was statistically significantly higher in the subgroup containing only homozygous variants of the T allele of the MTHFR:677 genetic polymorphism in comparison with the subgroups containing neutral C alleles of the same polymorphism. At the same time, there were no differences for TSH, T3 and T4. Сonclusions: The analysis enabled to establish a synchronous reaction of metabolic cycles ensuring the metabolism of Hcy and thyroid hormones in the adolescents, regardless of the FC genotypes. Correlation analysis, as well as the results of statistical analysis, indicate that an increase in the level of Hcy in the blood of children induced the synthesis of TSH and T3. The results show a close relationship between thyroid hormone genesis and the metabolism of methionine sulfur-containing amino acids and Hcy. A forest fire, containing long-lived radioactive elements, is the most likely reason for the increase of Hcy level and, as a result, the hormones of the pituitary-thyroid axis in the blood of the children living in the districts, bordering the ChEZ.

44-48

Authors: Думанський В.Ю.1 Козярін І.П., Івахно О.П.

Objective: We performed the eco-hygienic assessment of electromagnetic fields as an environmental factor under modern conditions. Materials and methods: We determined a range of issues on the significance of electromagnetic fields of various frequencies and intensities in human vital activity on the basis of the analysis of scientific literature. Results and discussion: Taking into account the further development of the national economy of the country, safety and protection of the population from the effects of electromagnetic fields both in industry and everyday life remain one of the urgent problems, taking into consideration that their biological effect on the human organism is very complex and has not been completely studied. In this regard, special attention should be paid to the use of hand-held telephones and computers which are used by the people of different age, gender and physiological state of the organism. Therefore, the existing protection measures against the negative effect of EMF require further improvement and refinement. Conclusions: Protection of the population from the adverse effects of electromagnetic radiation of various frequencies and intensities has been and remains an urgent eco-hygienic problem of mankind, and medical workers, engineers, biologists, ecologists and other specialists should participate in its solution.

56-63

Authors: Яворовський О.П., Скалецький Ю.М., Брухно Р.П., Риган М.М., Зінченко Т.О., Таран Н.В.

Objective: We identified the main occupational hazards in the hospital environment and determined their role in the formation of the safety of medical personnel at healthcare institutions. Materials and methods: We applied the bibliosemantic, questionnaire, hygienic and statistical research methods. Results: In the course of the labour activity at the health care institutions (HCI), the medical workers are exposed to the risk of negative effects of biological, psychophysiological, chemical, physical and social harmful and dangerous factors. The biological and psychophysiological factors are the most harmful factors. The adverse occupational factors of the hospital environment do not have an isolated effect, but have a complex, combined and joint effect, and their priority varies depending on the specificity of medical speciality. Under conditions of COVID-19 pandemic, the risk of the negative impact of production environment factors on the medical personnel at the HCI has been increased. In particular, the risk of infection with pathogens of infectious diseases increases, the work load, psycho-emotional tension, the duration of the use of personal protective equipment and the frequency of contact with the disinfectant solutions increase, the probability of violence, harassment, stigmatization, and discrimination related to the professional affiliation of health care personnel increases. The lack of a safety culture is one of the most important mechanisms for launching and realizing the dangers of a hospital environment, and just a creation of positive practice of a safety culture at work can significantly reduce the risks of realizing potential hazards that exist at health care institutions. Conclusion: The identification of the dangers of the hospital environment with the formation of a comprehensive understanding of their importance for the ensurance of the safety for medical personnel is an urgent task for modern medical science and will make it possible to develop reasonably the measures aimed at the ensurance of the safety of the hospital environment in terms of the safety of medical personnel.

71-73

Authors: Яворовський О.П., Парій В.Д., Шуляренко В.П., Шуляренко І.Ф.

На прикладі життя і наукової діяльності Уваренка А.Р. висвітлю- ються етапи становлення і розвитку у незалежній Україні соціаль- ної гігієни та управління охорони здоров’я, формування центру науково-медичної інформації та патентно-ліцензійної роботи і створення менеджменту охорони здоров’я, наукові підвалини яких закладалися за його найактивнішої участі.

76-77

Authors: Яворовський О.П.

Рецензія на монографію Махнюк В. М., Сердюка Є. А., Чорної В. В., Гаркавого С. С., Лаптєва В. Е. за загальною редакцією академіка НАМН України Сердюка А. М. та редакцією член-кореспондента НАМН України Польки Н. С.