[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.

[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.

[THE RISK OF DEVELOPING DISEASE IN FEMALE WORKERS INVOLVED IN MODERN SECTOR EMPLOYMENT AND THE HEALTH OF THEIR CHILDREN].

There was studied the state of health of females in modern sector employment: office workers (group 1) and managers (group 2), and the health of their newborns. There was established the increase of the risk for the development of extragenital disorders in groups 1 and 2 compared with the control. For adreno-genital syndrome OR = 3.83; (CI: 1.15-12.74) in group 1 and OR = 4,50 (CI: 1.24-16.28) Group 2; for respiratory diseases OR = 2.77-2.98 (CI: 1.82- 4.85) in groups 1 and 2; for digestive diseases OR = 2.45 (CI: 1.39-4.32) in group 1 and 2.77 (CI: 1.46-5.26)--in Group 2. The risk of infertility in the history of the group 2 was OR = 2.56 (CI: 1.33-4.92). The frequency of reproductive loss in the history is signficantly higher in group 1 (12,9 ? 1.28), is increasing in group 2 (20.19 ± 2.75) with 9.74 ± 2.12 in 100 females in the control. In complications of pregnancy the frequency of the threat of its interruption increases from 16.99 ± 2.31 cases per 100 females in the group 1 to 21.60 ± 2.82 in Group 2, with 11.79 ± 2.31 in the control (p < 0.01). In newborn of these female workers there was revealed an increase in the frequency of the congenital defects of development (CDD) of the circulatory system in group 1 by 1.5 times in the group 2-2.5 times if compared to the control (16.38 ± 1.41 and 24.88 ± 2.96, with 9.74 ± 2.12 cases per 100 infants (p < 0.01; p < 0.001), respectively, the frequency of congenital malformations of the urinary system in groups 1 and 2 (10.00 ± 1.14 and 10.80 ± 2.13), was significantly higher than in control--3.08 ± 1.24 per 100 births (p < 0.01); CDD of genitalia was significantly higher in group 1 (11.01 ± 1.19) with 5.13 ± 1.58 per 100 infants in the control (p < 0.01). Thus, disorders of reproductive health in females involved in modern sector employment depend on the degree of occupational hazard factors; can lead to congenital disease in their newborn, which requires the development of preventive measures.

[Occupational hearing loss--problem of health and safety].

On the basis of the literature review the critical analysis of the recommendations (the letter of Ministry of Health of Russia from 6/11/2012 N 14-1/10/2-3508) on occupation noise-induced hearing loss (HL) assessment is presented. Need of more strict criteria of HL assessment for workers, than for the general population according to ICF (WHO, 2001), in order to avoid growth of accidents and injury rate is proved. The illegitimacy of a deduction of statistical presbiacusia values from individual audiograms as human rights violation is stressed. Some terminological defects are noted. It is necessary to cancel recommendations and to develop the sanitary norms or state standard with the program of hearing conservation at work.

[Criteria for the assessment of the noise-induced occupational hearing loss: international and national standards].

The objective of the present paper was to review international and national standards for the criteria of assessment of the noise-induced occupational loss of hearing. The importance of healthy hearing for the occupational safety is emphasized which implies the necessity of the more rigorous criteria for hearing conservation in the workers engaged in the noisy technological environment compared with those for the general population. A rationale for the development of the standard program of hearing conservation in the workers engaged in the noisy technological environment is proposed including hygienic norms and rules or national state standards.

[Information as physical factor: problems of measurement, hygienic assessment and IT-automation].

The increasing flow of information, speeding up the progress of society, can impact the health that puts the task of its hygienic reglamentation. The physical aspects of information, parameters and units of quantities, aspects of measurement and evaluation with account of information quantity and quality as well as criteria of its permissible and optimal levels are considered. The results of measurements of quantity of text information produced per year on computer in 17 occupations of 10 economic sectors are presented. The principle of IT-automation of operator's work and of dynamic monitoring is proposed. On the basis of research performed the glossary of terms and guide on the problem with computer support are elaborated for the accumulation of experience and clarification of prospects.

[Information hygiene and regulation of information for vulnerable groups of the population].

Development of information society engenders the problem of hygienic regulation of information load for the population, first of all for vulnerable groups. There are presented international and Russian normative legal documents and experience in this area, there are described the negative effects of information (such as stress, depression, suicidal ideations). There are considered social-psychological characteristics of vulnerable groups that requires their best protection from loads of information, doing harm, particularly in terms of reproductive health, family relationships, children, etc. There was noted the desirability of improvement of sanitary, legislation on the regulation of the information load on the population, especially in vulnerable groups, in terms of optimization of parameters of the signal-carriers on volume, brightness and the adequacy of the volume and content of information in radio and television broadcasting, in an urban environment and at the plant to preserve the health and well-being of the population.

[Bases of information hygiene: concepts and problems of innovations].

The rising flow of information affects the health and affords ground for strengthening measures of hygienists. There is considered the place of information hygiene in preventive medicine. There are discussed physical and hygienic aspects of measurement and evaluation of information, there are considered some of their negative consequences. International and local regulations and guidance documents in this area are presented. In the light of the strategy of innovative development of Russia there are considered hygienic aspects of innovation and the improvement of hygienic standards.

[Reformation of occupational health in France: state of the problem and new law].

The state of the problem and new law of France No 2011-867 on occupational health organization and two decrees are described. These introduce services of health at work mainly with prophylactic tasks and whose functions are performed by interdisciplinary teams including doctors, assistants and specialists on occupational risk prevention. The documents are based on ILO Convention No 161 "Occupational health services".

[The real-world effectiveness of personal protective equipment and additional risks for workers' health].

The effectiveness of personal protective equipment (PPE) of hearing, respiratory organs and hands is considered. It is shown that real effect of PPE is twice lower than declared by supplier; this presumes some derating system. The aspects of discomfort and additional risks are analyzed. The hygienic and physiologic evaluation of PPE is required along with elaboration of an official document (OSH standard or sanitary regulation) on selection, personal fit, organization of use and individual training of workers and their motivation.

[Paradigm shift in health: forecasting and causation as a basis for risk management].

The problem of occupational risk management (ORM) is discussed using the evidence-based medicine approach and bio- and IT-technologies. The prognosis and causation of work-related health disorders are analyzed as components of ORM system. The Web-based handbook "Occupational risk assessment" with software and information materials as practical tool is presented.

[Occupational risk management: prognosis, causation and bioinformational technologies].

Methodology of occupational risk management is outlined based on workers' health disorders forecast and causation (work-relatedness assessment). It originates from Labour Code of Russian Federation prescriptions and includes principles, methods and criteria of risk management and risk communication. The methodology is realized by means of bioinformational technologies as expert and analytical system in the form of interactive Web-based directory "occupational risk assessment" for practical use for occupational risk prevention.

[The issues of workers reproductive health protection from harmful occupational and enviromenral exposures].

The problem of workers reproductive health protection from harmful occupational and environmental exposures is amongst the national priorities due to demographic situation in Russia and decrease of the manpower. Some issues of women's reproductive health disorders are considered from occupational health standpoint. The demographic and epidemiological data on pregnancy course and outcome, birth defects, children's morbidity etc. are presented and discussed. Some proposal as to risk management and medical surveillance of reproductive health, including legal instruments are put forward.

[Occupational health in E.U.: strategy, directives, guides, statistics].

Review of official rules and guides of E.U. on occupational health. Considered is the EU strategy for 2007-2012 on health and safety at work, framework directive 89/391/EEC and particular directives, European schedule of occupational diseases and guide on their diagnosis, classification of causal agents of occupational diseases, methodology of occupational diseases statistics system, as well as regulation on statistics on public health and health and safety at work. Trends of occupational morbidity recognition are considered.

[ILO plan of action (2010-2016) on occupational safety and health and new list of occupational diseases].

ILO plan of action (2010-2016) to achieve widespread ratification and effective implementation of the occupational safety and health instruments (Convention No. 155, its 2002 Protocol and Convention No. 187) is discussed. ILO documents on recording and notification as well as new list of occupational diseases (revised 2010) are considered.

[Methodology to reveal and prevent diseases associated to work].

Based on legislation of RF, Occupational Health Ministry and WHO, the authors specified methodology to reveal diseases associated to work, in addition to present system of occupational diseases diagnosis. The article also covers terminology, premises and causation (determining relationships with work) principles. The authors presented models and criteria for causation in consensus and evidence based medicine with computerized and Internet technologies, described contemporary approaches to prophylaxis.

[The loudness and hazard of noise; phenomenology, measurement, and evaluation].

The loudness and hazard of noise as a determinant of sound undesirability are considered. Physiological and hygienic acoustics are compared in the context of biomechanics and psychoacoustics. Evaluation of pulse noises and a problem of the diurnal action of noise on working and non-working populations are considered. Despite an abundance of acoustic indices, no uniform theory exists pertaining to the population's complaints. The European Union noise regulations, unsolved problems, their solution, and prospects are outlined.

[Work conditions and health state of female medical staffers].

The authors studied work conditions of medical personnel and health state including reproductivity, according to periodic medical examinations data, transitory disablement morbidity, occupational morbidity, questioning, clinical, laboratory and instrumental investigations. Reproductive health was assessed through gynecologic observations, course of pregnancy and delivery, the authors evaluated their relationships with work and identified risk groups for target prophylaxis.

[Evaluating occupational risks for health disorders in workers of extraction and processing industry].

Analysis of thorough medical examinations with applied method assessing occupational health risks in ore-dressing and processing enterprise workers revealed increased risk of locomotory and nervous system disorders, diseases of respiratory tract (chronic bronchitis), ear and mastoid process, digestive system (peptic ulcer of stomach and duodenum), blood system, eyes (Uchaly town, Bashkortostan Republic). The data obtained prove high level of occupational influence of these diseases formation.

[Occupationally related morbidity and its evidence].

The article deals with problem of occupationally related diseases, examples and evidence. The authors analyzed role of periodic medical examinations in diagnosis of occupationally related diseases, considered a triad for their diagnosis: flow-chart, algorithm table and numerical scale. Suggestions on improving periodic medical examinations for diagnosing occupationally related diseases are presented.