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Physiological and hygienic assessment of work conditions and state of health of electric train drivers and their assistants on Ukrainian Railway

The purpose of the study was to assess working conditions of electric train drivers (ETD) and their assistants by severity and intensity of the working process, harmfulness and danger of factors of the work environment; and, using modern methods of mathematical analysis to develop a prognostic model for a comprehensive assessment of the effect of harmful factors of the production environment and work process as risk factors in development of pathological changes in the body of workers, cardio-vascular diseases (CVD), in particular. Materials and methods. Hygienic studies and assessment of work conditions were conducted in accordance with the normative documentation. Clinical and instrumental studies were performed with the use of modern diagnostic equipment. For prognostic assessing of development of pathology of the cardiovascular system (CVS), depending on the availability of individual clinical or production risk factors, a prognostic model of statistically significant risk factors has been developed with the assessment of their odds ratios and the following their generalization by principles of meta-analysis and determination of heterogeneity of the effect (Higgins's I2 test) on the health of workers. Results . According to the results of studies on drivers and their assistants their work can be referred to Class 3.2., Hygienic Classification of Work, 2014. The degree of expressiveness of pathological changes in ETD and their assistants was determined in corresponding sub-groups depending on the work experience. The most predicted nosologies in workers were: hypertension, metabolic syndrome, nonalcoholic fatty liver disease as well as comorbid pathology on the background of vegetative disfunction, being the basis for development of hepatocardial continuum. A prognostic estimation is presented in relation to the increase of the reliability in developing pathology of the СVS. A differentiation of dispensary groups and corresponding medical measures for workers were undertaken depending on the work experience. Conclusion . A wide implementation into practice of preventive measures, depending on the differentiation of dispensary groups, will enable to effectively decrease risks of developing pathological changes with account of the work experience.