[The main provisions of programs of medical and social rehabilitation of patients with occupational diseases of ent organs]. / Poryadok razrabotki i osnovnye razdely programmy reabilitatsii postradavshego na proizvodstve s professional'nymi otorinolaringologicheskimi zabolevaniyami.

The article discusses the main, modern provisions of the programs of medical and social rehabilitation of patients with occupational diseases of the ENT organs. The criteria of the degree of loss of professional ability to work in hearing loss and malignant neoplasms of the upper respiratory tract are presented. Rehabilitation programs and forms are developed taking into account the needs of the victim in medical, social and vocational rehabilitation, taking into account the potential capabilities and abilities of the victim to carry out professional, domestic and social activities.

[New criteria for professional selection and professional suitability by hearing to work in conditions of exposure to industrial hazards]. / Novye kriterii profotbora i profprigodnosti po slukhu dlya raboty v usloviyakh vozdeistviya proizvodstvennykh vrednostei.

New regulations of professional selection and professional suitability for the state of auditory function for persons entering for the first time and already working under the influence of harmful and (or) hazardous production factors are discussed.

[Coverage of issues of professional malignant neoplasms of the respiratory tract in modern clinical guidelines of the Ministry of Health of Russia]. / Osveshchenie voprosov professional'nykh zlokachestvennykh novoobrazovanii respiratornogo trakta v sovremennykh klinicheskikh rekomendatsiyakh Minzdrava Rossii.

OBJECTIVE: Analysis and comparison of clinical guidelines (CG) on malignant neoplasms of the respiratory system, placed in the CG rubricator of the Ministry of Health of Russia, for the information they contain on the role of factors and working conditions of the working environment in the etiology of respiratory diseases, including the upper respiratory tract, and comparison this information with published and regularly updated data from the International Agency for Research on Cancer (IARC). MATERIAL AND METHODS: Clinical recommendations from the heading of the Ministry of Health of Russia "Cancer of the laryngopharynx", "Cancer of the nasopharynx", "Cancer of the oropharynx", "Cancer of the nasal cavity and paranasal sinuses", "Cancer of the larynx", "Cancer of the trachea", "Cancer of the lung", and IARC data according to the List of Classifications by cancer sites with sufficient or limited evidence in humans dated 11/29/2019. RESULTS: The low level of registration of occupational cancer of the upper respiratory tract in Russia is due to an inadequate system of criteria for detecting this form of occupational pathology, a long latency period of diseases, and insufficient assessment of the history of information on the potential role of occupational carcinogens. The CGs developed to optimize the diagnosis and treatment of malignant neoplasms of the respiratory system do not contain up-to-date information on the role of professional potential carcinogens in the genesis of malignant neoplasms. CONCLUSION: Recognition of the professional nature of malignant neoplasms of the respiratory system implies, firstly, strengthening the role of otorhinolaryngologists in early diagnosis and rehabilitation of patients, and secondly, it has a pronounced preventive focus in the form of tasks facing the employer to reduce the carcinogenic load and develop preventive measures aimed to reduce and prevent the development of malignant tumors in workers, including the respiratory system.

[Upper respiratory tract infection with new COVID-19 coronavirus infection and aspects of occupational pathology examination]. / Porazhenie verkhnikh dykhatel'nykh putei novoi koronavirusnoi infektsiei COVID-19 i aspekty profpatologicheskoi ekspertizy.

The article discusses the issues of a new coronovirus infection CAVID-19, which suddenly appeared from the end of January 2020. in China and actively, widely spread around the world. The SARS-CoV virus is assigned to group II pathogenicity. The entrance gate of the pathogen is the epithelium of the VDP and epithelial cells of the stomach and intestines. The main source of infection is a sick person who transmits SARS-CoV-2 by airborne droplets and contact. There is a high risk of developing epidemic foci CAVID-19 in medical institutions in case of violation of sanitary and anti-epidemic regime and the risk of epidemic foci in groups of organizations with non-compliance with infection prevention measures. On the basis of the Decree of the President of the Russian Federation dated may 06. 2020 №313 of the Ministry of health of the Russian Federation, together with the FSS and Rospotrebnadzor, additional insurance guarantees are provided to doctors, middle and Junior medical personnel of medical organizations, drivers of ambulances who work directly with patients who have confirmed the presence of a new coronavirus infection (COVID-19). Insurance cases, when a one-time insurance payment is made, are persistent loss of working capacity by a medical worker as a result of complications after a previous illness caused by a new coronavirus infection (COVID-19), confirmed by laboratory research methods, if the disease occurred during the performance of their work duties.

[Key points of 'Noise-induced hearing loss' clinical guidelines]. / Osnovnye polozheniia klinicheskikh rekomendatsii 'Poteria slukha, vyzvannaia shumom'.

In this article we present the key points of 'Noise-induced hearing loss' clinical guidelines, which are included to the Clinical Guidelines Classifier of the Ministry of Health of Russia (2018). We give the definition of 'Noise-induced hearing loss', disclose the main causes and pathogenetic features of hearing impairment in employees who are affected by intensive noise at work. We state the main clinical and diagnostic criteria, treatment and rehabilitation principles; present the basics of primary and secondary prevention of hearing impairment in 'noise-hazardous' workers. We also disclose in detail the algorithm of expertise of hearing diseases connection with the profession on the stages of preliminary and final professional disease. Professional suitability issues are also discussed. Clinical guidelines contain a unified classification of noise-induced hearing loss severity complied with international approaches and medical and social expertise criteria.

Evaluation of arterial hypertension risk under exposure to noise and chemical occupational hazards.

The article covers studies on determining priority risk factors for health of female workers of heat-and-power engineering enterprise, risk groups revealed, suggestions for medical examinations with investigations in early diagnosis of cardiovascular system dysadaptation.

[The occupational risk of hearing impairment associated with cardiovascular pathologies in the subjects engaged in 'noisy' industries]. / Professional'nyi risk narushenii slukha na fone serdechno-sosudistoi patologii u rabotnikov «shumovykh¼ proizvodstv.

The objective of the present study was to analyze the structure of concomitant somatic pathology in the subjects experiencing the occupational hearing problems. The study demonstrated the increase in the frequency of concomitant chronic diseases and the prevalence of polynosological conditions with the increasing severity of hearing impairment. It was shown that cardiovascular pathologies tend to enhance the risk of hearing loss in the employees engaged in «noisy¼ occupations. The cause-and-effect relationships were elucidated as the contribution of the "vascular" factor to the formation of occupational pathology of the organs of hearing. The clinical audilogical features of co-morbid occupational hearing impairment associated with vascular pathology were characterized by the accelerated development and progression of the hearing disorders with the gradual disappearance of the audiological signs characteristic of noise-induced lesions.

[Adaptation potential of cardio-respiratory system in dust diseases].

The article covers results of cardio-respiratory system evaluation in workers exposed to dust, on basis of adaptation potential evaluation via calculation of functional changes index and 6 minutes' walk test with continuous assessment of blood oxygenation and heart rate. Adaptation disorders are supported by results of external respiration assessment and echo-cardiography.

[FEDERAL CLINICAL RECOMMENDATIONS IN DIAGNOSIS, TREATMENT AND PREVENTION OF HEARING LOSS DUE TO NOISE].

Noise induced hearing loss is a slowly developing hearing impairment, caused by occupational exposure to excessive noise levels, constitutes a lesion of the auditory analyzer and clinically manifested as chronic bilateral sensorineural hearing loss. Currently, there is not a treatment that provide a cure of sensorineural hearing loss. Regular, individually tailored treatment should be directed to the pathogenic mechanisms and specific clinical symptoms of hearing loss, as well as the prevention of complications. We recommend using non-drug therapies that can improve blood flow in labyrinth, tissue and cellular metabolism.

[Clinical and hygienic evaluation of health state of copper production workers in Far North].

The article covers disclosure of fuctional and clinical, laboratory markers of health disorders among workers engaged in major occupations of copper processing enterprise. These markers are used for early diagnosis and prevention of respiratory diseases.

[Modern approaches to carrying out preventive examinations of workers of vibration-dangerous occupations].

The article presents scientific evidence showing the relevance and importance of addressing the issues of improvement of methods and approaches to the implementation of routine inspections of the working population, particularly the workers of vibration-dangerous occupations; the studied interrelationships between the exposure dose of vibration and noise will allow to include these investigations in a program of regular medical examinations of employees to detect early changes in the body of workers exposed to the vibration-dangerous impact.

[The methodological approaches to the evaluation of the risk of developing pathology of the upper respiratory tract in the employees engaged in the dust-producing industries].

The objective of the present work was to develop the scientifically sound criteria for the evaluation of the occupational risks bearing in mind the high frequency of pathological changes in the ciliary epithelium of the upper respiratory tract in the employees engaged in the dust-producing industries. It was proposed to consider an increase of the SIgA level, alkaline shift in nasal secretion pH, elevation of body temperature, slowdown of the mucociliary transport, disintegration of the epithelial mucous membrane, and high frequency of its inflammatory and dystrophic changes as the criteria for early diagnostics of developing pathology of the upper respiratory tract. We have developed the method for the score-based evaluation of the risk of formation of pathological changes in the upper respiratory tract of the employees engaged in the dust-producing industries. This method can be used to enhance the effectiveness of the preventive and health-promoting measures.

[Diseases of the lymphopharyngeal ring in the employees engaged in dust-producing industries].

The objective of the present work was to study changes in the mucous membrane of the upper respiratory tract of the employees subjected to the action of industrial aerosols. The clinically and functionally significant mucosal changes in the nasal cavity and pharynx induced by industrially-derived irritants are described, the classification of nosological forms of the diseases of upper respiratory tract is proposed based on the character and extent of the pathological process, the criteria for occupational chronic rhinopharyngolaryngitis have been developed. The frequency of development of pathological changes in the mucous membrane of the upper respiratory tract (UPT) in the workers undergoing effects of industrial aerosols (IA) is shown to amount to 89%. The highest dust concentrations to which such persons were exposed are known to occur in coal, metal, timber, textile, and cotton industries as well as in certain branches of machine-building and agricultural industries. The industrial environment not infrequently contains dust of the mixed composition, such as mineral, metallic, organic, and synthetic particulate components. The authors propose the classification of pathological changes in the UPT mucosa. It is emphasized that rhinopharyngolaryngites are included in the List of occupational diseases approved by the Russian Ministry of Health on 27 April 2012.

[Current aspects of harmonization of classification of occupational hearing loss].

The objective of the present work was to develop unified criteria for the evaluation of the severity of noise-induced hearing loss. Current approaches to taking expert decisions based on the results of medical examination of the patients with impaired hearing are substantially different due to the considerable difference between the criteria for the estimation of hearing envisaged by the international classification, occupational pathology classification, and the national system of medico-social expertise. We undertook an attempt to correct and harmonize the existing criteria for the estimation of severity of occupational hearing loss based on the integration of all the three classification in order to "reduce them to a common denominator" and thereby to ensure the basis for the unified diagnostic and expert decisions for the cases of hearing impairment of any etiology. The project proposed in this paper makes it possible to use unified criteria for the assessment of the degree of hearing loss caused by occupational noises for diagnostic purposes and expertise compatible with the internationally accepted approaches.

[Risk assessment of respiratory diseases in industrial workers].

The paper assesses a dust factor and establishes its etiological proportion in the development of respiratory diseases in workers from mining enterprises in different regions of Russia. Service-length groups at risk for upper tract diseases, criteria for early diagnosis, and a risk for occupational respiratory tract diseases were identified in miners. Trends in humoral factors of immunity were revealed in the workers without bronchopulmonary abnormalities. The efficiency of a scientifically grounded management system for an occupational risk of respiratory tract diseases was evaluated in miners.

[The risk of occupational neurosensory loss of hearing in the workers employed in coal and ore mining industries].

This clinico-audiological study included 983 workers engaged in coal and ore mining exposed to combined effect of occupational noise and vibration. Pathogenetic mechanisms underlying the development of occupational deafness were shown to depend on intensity and duration of the action of these factors. Impedancometry was used to evaluate the functional state of the middle ear and to study protective and adaptive potential of ear muscles. Criteria are proposed for the identification of groups of workers at risk of development of occupational deafness. The relationship between individual features of cerebral hemodynamics and the functional state of the middle ear is established.

[Specific features of the development of pathology of the upper respiratory tracts in the workers employed in the ore mining industry in the subarctic regions].

Criteria for the risk of development of occupational pathology of the upper respiratory tracts in the workers employed in the ore mining industry have been proposed based on the results of evaluation of the occurrence of pathological changes, morpho-functional characteristics of upper respiratory tract mucosa, and immunological properties. These criteria provide a basis for the development of differential approach to the choice of priority hygienic and medical preventive measures designed to a lower the risk of respiratory organ pathology.

[Topical problems of occupational deafness].

The article covers up-to-date state of occupational deafness problem, its importance in occupational therapy. The authors defined topical directions of research in contemporary diagnosis, prognosis and treatment of "noise-related" deafness.

[Industrial aerosols are a risk factor of oncologic diseases in underground miners].

The paper contains new data on the carcinogenicity of industrial aerosol to miners engaged to underground extraction of sulphide copper and nickel ores. Earlier appearance of oncologic diseases (lung and stomach cancer) is typical of this category of workers, exposed to higher aerogenic concentration of nickel in mine atmosphere. This fact demonstrates that the leading role in the ethiology of these diseases is played by multicomponent industrial aerosol containing nickel in the form of complex sulphides.