Varyvonchyk D. V.1,2, Kharkivska S. V.1,2
1SI «Institute for Occupational Health of NAMS of Ukraine, Kyiv
2P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv
Introduction. Manganese-ore industry (MOI) in Ukraine is one of the most powerful in the world. About 13,0 thousand people work at two enterprises nowadays (in 1990 these were 26,0 thousands). The results of earlier conducted hygienic studies showed that general conditions of work in MOI could be assessed as harmful (Class 3, 3—4 degree). The workers are exposed to: chemical substances (ore dust, containing SiO2, compounds of Mn, Fe, Al, Ca, Mg, Cu, Ni, Co; carbon oxides (II) and nitrogen), physical factors (noise, vibration — whole-body and local, microclimatic conditions, infra-red radiation, etc.), intensity and strain of work.
Purpose of the study: to determine pathological changes and their dynamics in target organs of MOI workers.
Materials and methods. A cohort (115 persons) was formed from workers of MOI, whom work-related or occupational diseases were diagnosed). Clinical, extended immunological studies with definition of inflammation biochemical markers, morphological and functional studies of organs of respiratory and nervous systems, neurophysiological studies have been conducted for all participants.
Results. The development of the two-phase reaction of T-cell and killer chain of immune homeostasis (hyperactivation — at earlier stages, secondary deficiency — at the latest) has been stated. A low symptomatic clinical course of respiratory organs pathology with formation of the lung insufficiency by the restrictive type has been established. It was found a frequent development of nonspecific pus-inflammation processes in organs of the respiratory system, caused by mix-infection - bacterial (gram-positive — St. aureus, Clostridium, gram-negative — Enterobacter, E. coli, Proteus) and micotic (Candidas), with dilated resistance to main groups of anti-bacterial and promicotic pharmacological preparations. Clinical and morphofunctional changes in brain (vegetative dysfunction of the somatic type, encephalopathy with the expressed cognitive deficit, Parkinson’s syndrome with morphological changes of basal nuclei and brain) have been distinguished. The mentioned changes were dose-dependent on the dust content of SiO2, Mn, Mn cumulation in tissues (hair, nails), on the effect of other harmful factors of the work environment, on the human health. Conclusion. It is desirable to include in the program of medical care for MOI workers the following: laboratory monitoring (by the state of immune homeostasis; level of biological mediators of inflammation; Mn level in biological tissues); objective methods of morphofunctional diseases of organs of the respiratory and nervous systems, monitoring of neurophysiological parameters.
Key words: manganese-ore industry, workers, pathological changes in target organs