[On evaluating occupational fitness in railway workers with ventricular arrhythmias after coronary arteries stenting].

The authors studied prospects of work capacity preserving after coronary stenting in IHD and cardiac arrhythmias. Examination covered 158 railway workers underwent complete endovascular revascularization of myocardium for coronary stenosis; all of them had ventricular arrhythmias before coronary surgery. Findings are that in long-term period (in 16 months in average) after coronary stenting, grade I and III ventricular extrasystoles disappeared in 77.8 and 54.5% of cases respectively, but only in 11.9% of grade IV ventricular extrasystoles cases. Ventricular extrasystoles remained unchanged in 44.3% of cases. Reliable relationships were seen between unchanged grade IV ventricular extrasystoles and body weight index (OR = 5.49, 95% CI: 0.87-34.67), general cholesterol level (OR = 1.69; 95% CI: 1.06-2.69), low density lipoproteins (OR = 1.66; 95% CI: 1.00-2.76) and left ventricular ejection function lower 45% (OR = 1.61; 95% CI: 1.14-2.27), exertion ventricular extrasystoles before myocardium revascularization (OR = 3.1; 95% CI: 1.78-5.41). That necessitates correction of the mentioned risk factors of cardiac arrhythmias for restored work capacity.

[Structure of allostatic load in railway workers].

The authors studied allostatic load in railway workers, as an indicator of stress effect. Analysis covered biomarkers that form allostatic load index, and their ratio for variable allostatic load index levels. Moderate allostatic load appeared to prevail in the examinees group. Findings are that systolic and diastolic blood pressure, general cholesterol and hemoglobin make major contribution into allostatic load index. Comparison covered models of allostatic load index calculation for variable biomarkers sets.

[Occupational deafness in workers of locomotive crew and its association with risk factors].

The authors studied relationship between occupational neurosensory deafness and risk factors in locomotive crew workers. Examination covered 173 locomotive crew workers divided into 2 groups: group 1--with occupational neurosensory deafness (n = 85) and group 2--without occupational neurosensory deafness (n = 88). Study covered occupational factors and calculated effective dose connected to length of service for exposure assessment. Complex clinical and laboratory study was performed. For signs structure analysis, principal components method and chances ratio were used. Occupational neurosensory deafness appeared to be reliably connected with length of service, arterial hypertension, dyslipidemia--with OR equals 5.7 (95% CI: 2.98-11.00), 1.88 (95% CI: 1.03-3.43) and 2.79 (95% CI: 1.5-5.18) respectively. That necessitates correction of hypertension and dyslipidemia.

[Health and safety of worker (commentary to the draft ISo 45001)].

The standard ISO 45001 and poor translation of its title in Russian are discussed. The mortality rates from occupational diseases and injuries are compared as well as risk of sudden cardio-vascular death. The priority of occupational health as compared to safety is proven and some ways of amelioration of the system are suggested.

[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.

[On hi-tech cardiologic care model in medical support of train operation safety].

The article covers hi-tech cardiologic care model in system of medical support of train operation safety, with definition of structure blocks in this model. Discussion covers peculiarities of the model functioning in comparison with the governmental system of hi-tech medical care, including its closed cycle principle characteristics, wide patients selection among railway workers, continuous and close cooperation between various medical speicalities, with active involvement of occupational fitness specialists (medical examination committees of various levels, including Central Medical Examination Committee), major extent of interventional rentgenosurgical technologies applied in diseases without significant functional failure.

[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.