[The dynamics of indices of professional self-evaluation and social status of physicians: the first results of reforms in health care system].

In Russia, an active transformation of national health care system takes place and one of the most important of its activities became approval of the "road map". In 2017, survey of physicians was carried out that revealed a number of patterns and problems in the field of physicians perception of their own lives, social self-implementation. In 2019, survey was re-carried out covered 311 specialists from the Republic of Bashkortostan. The purpose of this study was to analyze the dynamics of indices of professional self-assessment and social status of physicians in 2017-2019. The results testify a number of significant changes that took place by 2019: 1) number of specialists evaluating their own competence as "Excellent" statistically significantly increased (p=0.015); 2) percentage of specialists of second qualification category significantly decreased (p=0.0068) and previously observed relationship between professional self-assessment and qualification category lost its significance; 3) physicians began to statistically significantly more often identify themselves with highest stratum of society (p=0.012); 4) situation associated with lack of free time (p=0.021) and fears of losing job (p=0.044) worsened significantly. The research data mainly testify positive changes in social well-being of physicians in 2017-2019 and can be considered as first results of reform of national health care system. Nevertheless, increase of deficiency of free time and fears of losing job requires development and implementation of appropriate preventive measures.

[The analysis of factors effecting professional self-assessment of physicians].

To explore the factors potentially related to professional self-assessment of physicians, sociological survey on the basis of sampling of 223 respondents who underwent professional training in 2017 was organized. The physicians with the first qualification category more often assessed themselves as "good" than other respondents (p=0.049). On the contrary, physicians with no qualification category rated their work as "good" less often and as "satisfactory" more often than other respondents (p=0.041 and p=0.010, respectively). The rate of professional self-assessment as "excellent" significantly increased among physicians identifying themselves with highest stratum of society (p=0.00034). Statistically significant differences in age, total duration of service in profession between physicians assessing their work for "excellent", "good" and "satisfactory" were not detected (p>0.05). The most frequent problems complicating life of physicians and their families were "Fatigue, overwork" (69.06%), "lack of free time" (60.09%), "low income" (44.39%). The reliable relationship between these factors and professional self-assessment was not detected (p>0.05). The relationship between professional self-assessment and availability of qualification category, as well as stratum of society to which they relate themselves, was established.

Production and genetic risk factors for cardiovascular diseases among petrochemical industry workers.

AIM: To study the production and genetic factors affecting the cardiovascular system (CVS) in the petrochemical industry workers. MATERIALS AND METHODS: There was carried out an assessment of the working conditions and the state of health of 860 workers of petrochemical plants males, including 548 apparatchiks (main group) and 312 fitters of instrumentation and automation (comparison group). The main risk factors with subsequent assessment of cardiovascular risk (SSR) on the scale SCORE (Sistematic COronary Risk Evaluation) were studied. The analysis of the frequency distribution of deletion polymorphisms of GSTM1 and GSTT1 glutathione among the workers of the basic trades involving patients with cardiovascular disease (CVD) and practically healthy workers. RESULTS: The development and progression of CVD in petrochemical production workers affects a complex working environment hazards and the labor process, corresponding, according to R2.2.2006-05, classes, working conditions 3.1-3.3 Labor intensity. The most common form of cardiovascular nosology was hypertonic disease (HD), identified in 46,9% of apparatchiks and 29,2% of fitters of instrumentation and automation. Determination of the relative risk etiological share of the working environment factors in the development of HD showed high degree of professional conditioning of the disease in a group of apparatchiks (RR=1,58, and EF=36,7%). Molecular genetic factor predisposing to the development of CVD, is the deletion of the GSTM1 gene. This genetic marker could be used as a predictor of individual risk criterion CVD. CONCLUSION: A comprehensive assessment of working conditions of workers of petrochemical plants showed that the priority factors of occupational risk for apparatchiks are air pollution of the working area with harmful substances (class 3.1-3.2), noise (class 3.1) and labor intensity (class 3.1). It has been established that in the formation of cardiovascular diseases under the influence of production factors, genetic factors can participate.

[Major risk factors and cardiovascular disease prevalence among petrochemical workers].

Objective. Based on the assessment of occupational and non-occupational risk factors, development of preventive measures for the reducing of cardiovascular diseases (CVD) prevalence among petrochemical workers. Material and Methods. A total of 2,634 petrochemical workers have been examined. To identify modified and unmodified risk factors for cardiovascular diseases, comprehensive hygienic and clinical laboratory studies have been carried out. Results. The obtained results have shown a higher riskfor the development of cardiovascular disease among operators as compared to metal workers for instrumentation and automation repairs. Based on the assessment of risk factors, preventive measures implemented at personal and corporative levels have been developed.

[Peculiarities of air pollution in the production of continuous glass fiber].

With the use of a one-stage method we have carried out hygienic studies of the air of work area of the production of continuous glass fiber. There was revealed the emission of epichlorohydrin, formaldehyde, ethane acid, hydrochloride, spray of mineral petroleum oil, fine glass fiber dust in air of the work area. There was established the combined effect of hazardous substances of unidirectional action with the summation effect on the body. Hazardous substances containing in glass fiber sizers in combination with dust of glass fiber against the background of microtraumatization of the hand skin contribute to the development of occupational skin neoplasms. The studies became the basis of the development of preventive measures aimed at the reduction of risks of the impact of the chemical factor impact on workers.