RESUMEN
To design forecasting system, the authors studied occurrence of atherosclerosis and its risk factors in 152 workers of coal mines in South Kouzbass (tunnellers, cleaning pit-face miners, mining excavator operators), suffering from anthracosilicosis. Atherosclerosis was revealed in 124 (81.6%) workers with anthracosilicosis. With Bayess method for independent signs and Wald's sequential analysis method, the authors created a way to forecast atherosclerosis with coronary, extracranial and peripheral arteries involvement in miners with anthracosilicosis. Maximal risk of atherosclerosis in miners with anthracosilicosis is associated with following parameters: age 45 years and over, arterial hypertension, smoking, abdominal obesity type, diabetes mellitus, metabolic syndrome, respiratory failure, family history of IHD, hypercholesterolemia, increased LDL cholesterol, decreased HDL cholesterol, increased atherogeneity coefficient, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increased C-reactive protein, hypersthenic type according to Reese-Isenc index, andromorphic type according to Tanner index, blood group. markers A (II) and B (III), rhesus negative, MN and NN. Through increased number of factors analyzed and selected additional markers, accuracy of atherosclerosis forecasting is increased - that enables to proceed with opportune treatment and prevention.
Asunto(s)
Antracosilicosis/complicaciones , Aterosclerosis/etiología , Minas de Carbón , Enfermedades Profesionales/etiología , Adulto , Antracosilicosis/epidemiología , Aterosclerosis/epidemiología , Humanos , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Federación de RusiaRESUMEN
In workers employed in the aluminum industry, the main harmful production factor is exposure to fluoride salts, which can cause chronic fluoride intoxication. For the assessment of the impact of chronic fluoride intoxication on the development of atherosclerosis, we conducted a comprehensive survey of 87 aluminum-metal makers with chronic fluoride intoxication and 43 aluminum-metal makers without occupational diseases, mean age--52.1 ± 0.4 years. There were considered the presence and severity of atherosclerosis of brachiocephalic arteries, and the arteries of the lower extremities in the studied group, there was evaluated the effect of other risk factors for atherosclerosis (smoking, presence of hypertension, diabetes, dyslipidemia). With the use of Doppler ultrasound of the arteries it was revealed that in metallurgists with chronic fluoride intoxication atherosclerosis was detected in 73.6% versus 55.8% in persons of the comparison group. The performed analysis of the prevalence of main risk factors for atherosclerosis showed that in metal makers with chronic fluoride intoxication in combination with atherosclerosis hypertension is more common (in 54.7%) than in metallurgists with chronic fluoride intoxication without atherosclerosis--only 26.1%. According to the frequency of occurrence of smoking, diabetes mellitus, hypercholesterolemia, and hypertriglyceridemia, there were no significant differences between the metallurgists with chronic fluoride intoxication, with and without atherosclerosis, and the control group, the increase in LDL cholesterol occurs significantly more often in metal-makers with chronic fluoride intoxication in combination with atherosclerosis if compared to workers without occupational diseases. Thus, chronic fluoride intoxication acts as a risk factor in the development of atherosclerosis: atherosclerosis in metal-makers with chronic fluoride intoxication occurs more frequently than in workers who do not have professional pathology. Hypertension and elevated levels of LDL cholesterol were established to increase the relative risk of developing atherosclerosis in metallurgists with chronic fluoride intoxication. At that there are no significant differences in the prevalence of common risk factors for atherosclerosis (smoking, diabetes, hypercholesterolemia, hypertriglyceridemia).