Comparison of Two Information Sources for Cause-of-Death Follow-up in the Russian Federation: The Asbest Chrysotile Cohort Study.

BACKGROUND: The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate cancer risk in relation to occupational exposure to chrysotile. OBJECTIVES: The cohort of 35,837 people was followed-up for mortality using cause-of-death information from official death certificates issued by the Civil Act Registration Office (ZAGS) of Sverdlovsk oblast from 1976 to 2015. Data were also retrieved from the electronic cause-of-death registry of the Medical Information Analytical Centre (MIAC) of Sverdlovsk oblast, which was launched in 1990 and operates independently of ZAGS. The objectives were to compare the completeness of record linkage (RL) with ZAGS and with MIAC, and to compare the agreement of cause-of-death information obtained from ZAGS and from MIAC, with a focus on malignant neoplasms. METHODS: RL completeness of identifying cohort members in ZAGS and in MIAC was compared for the period 1990 to 2015. In the next step, for the comparison of the retrieved cause-of-death information, 5,463 deaths (1,009 from cancer) were used that were registered in 2002 to 2015, when causes of death were coded using International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) nomenclature by MIAC. For ZAGS, original cause-of-death text from the death certificates was obtained and then coded according to ICD-10 by the International Agency for Research on Cancer/World Health Organization (IARC/WHO). Agreement was evaluated at various levels of detail, and reasons for any disagreements between the MIAC and the IARC/WHO ICD-10-coded cancer diagnosis were systematically explored. RESULTS: A total of 10,886 deaths were obtained from all avenues of follow-up for the period 1990 to 2015 in the cohort; 10,816 (99.4%) of these were found in ZAGS. This percentage was 88.3% if only automated deterministic RL was used and 99.4% when deterministic RL was complemented with manual searches of cohort members. Comparison of the cause-of-death information showed agreement of 97.9% at the ICD-10 main group level between ZAGS (coded by IARC/WHO) and MIAC. Of 1,009 cancer deaths, 679 (67.3%) cases had identical coding, 258 (25.6%) cases corresponded at the three-character ICD-10 level, 36 (3.6%) had codes that were within the same anatomical or morphological cluster, and for only 36 (3.6%) cases were major discrepancies identified. Altogether, the agreement between IARC/WHO coding of cause-of-death information from ZAGS and MIAC coding of malignant neoplasms was therefore 96.4%. CONCLUSIONS: RL completeness and agreement of cause-of-death information obtained from ZAGS and from MIAC were both very high. This is reassuring for the quality of cancer mortality follow-up of the Asbest chrysotile cohort. For future epidemiological studies in the Russian Federation, ZAGS appears to be a reliable information source for mortality follow-up, if the automated RL is complemented with manual searches of cohort members. MIAC is a good resource for prospective studies.

[Occupational morbidity of railway transport workers].

The authors present results of medical social monitoring of occupationalhazards that are the most prevalent in railway occupations workers, statistic data on occupational morbidity of railway transport workers over last 10 years. The article covers major causes of unfavorable effects resulting from occupational hazards in various workers categories. Dynamics of occupational morbidity parameters and its structure concerning separate nosologic entities are analyzed.

[Occupational fitness examination of individuals directly connected with train operation].

The article covers psychophysiologic aspects of work conditions and work safety in train operator occupations of railway transport. The authors consider problems of medical examination, occupational fitness analysis in these individuals if in various diseases or functional disorders.

[Contemporary reforms and optimization of medical examination committees in Russian Railways JSC].

The authors considered problems of restructurization and organization of medical examination committees in Russian Railways JSC, and their interlevel interactions. Detailed specification included documents circulation, order and terms of medical examination. Principles of conclusion on occupational fitness examination are specified. The article covers tasks of further development of occupational medical examination work in trade occupational medicine.

[The clinico-epidemiological and medical expertise characteristics of neuropsychic morbidity in draftee contingents]. / Kliniko-épidemiologicheskie i vrachebno-ékspertnye osobennosti nervno-psikhicheskoi zabolevaemosti prizyvnykh kontingentov.

Official statistics show unfavourable growth tendencies of psychoneurological morbidity in younger generation in Russia, which creates recruitment problems for its Armed Forces. The authors offer a number of measures for preliminary checking-up of the drafted personnel to prevent potential patients from joining the Army.

[Theoretical aspects of rehabilitation and occupational health of pilots]. / Teoreticheskie aspekty reabilitatsii i professional'noe zdorov'e letchika.

Some theoretical aspects of the rehabilitation problem and its interaction with the problem of professional health of pilot have been discussed in this paper. The authors have proposed methodologic approaches to the essence of medical and professional rehabilitation; classification of the main directions and types of rehabilitation, the principles of its application in flying practice as well as the question about economic advisability have been studied. As the main lines of medical rehabilitation there suggests the nosologic, psychologic and physiologic, professional (singly) rehabilitation with consideration of the labile and base components of professional health of pilot. As the base principle of rehabilitation there advances an etiopathogenic approach to the use of different means and methods of rehabilitation treatment and correction of a changed functional state. General requirements upon provision of multilevel, differential, individual, accessible and adequate rehabilitation are formulated. The method to calculate the economic effect of rehabilitation measures at the expense of savings in costs of pilot personnel by increasing the flight longevity and decreasing the number of flights necessary for maintaining the given level of combat effectiveness is proposed. The classifier of the main directions and types of rehabilitation is presented.

[Possibilities of psychotherapeutic and electrophysiological correction of psychosomatic disorders in pilots]. / Vozmozhnosti psikhoterapevticheskoi i élektrofiziologicheskoi korrektsii psikhosomaticheskikh narushenii u letnogo sostava.

The authors necessitate elaboration and application of psychotherapeutic and electrophysiologic means and methods to improve functional state of pilots. Many experimental studies concerning the psychosomatic disorders, "complicated" psychic states in pilots, features of the etiology and the pathogenesis helped to define main directions of control and correction for necessary level of psychophysiologic resources and occupational performance in pilots.

[Clinical variants of pneumococcal pneumonia and the characteristics of its course and outcome]. / Klinicheskie varianty pnevmokokkovoi pnevmonii, osobennosti ee techeniia i iskhody.

The authors relate the results of examining 92 patients with acute pneumococcal pneumonia (APP). The bacteriological methods of studying the tracheal contents and pleural exudate, performed before treatment turned out highly informative. As regards the course of APP, the bacteremic , classic (infiltrative) and pleurisy-complicated varieties were distinguished. It was established that the bacteremic variety of APP may be accompanied by bactericidal shock eventuating in a lethal outcome which is not observed in other varieties. 19.6% of patients with APP demonstrated abacterial fever and 27.1% severe pleuropulmonary complications. The development of the latter ones is predictable according to the presence of pleurisy and fever lasting over 5 days. An opinion is advanced that the continuance of antibacterial therapy over 5 days is not desirable whatever the APP variety.