State Institution "Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine", Kyiv
Introduction. Constant epidemiological studies of occupational diseases and their causes are an effective basis for development of prevention and reduction of occupational risks. In Ukraine, a long-term (more than 50 year) experience in conducting epidemiological research among the working population has been accumulated in order to identify regularities in formation of occupational health in specific contingents of workers in order to determine the causal relationships between morbidity and occupational activity, and availability of harmful factors. On the basis of the accumulated factual data on epidemiological manifestations of occupational diseases, theoretical generalizations of regularities in formation and prevalence of this pathology, development of prevention and reduction of occupational morbidity among workers have been made and national priorities in the health care of workers are determined. Epidemiological studies can form the basis for transition from medical statistics to introduction of new technologies in epidemiological surveillance and control of occupational diseases, to develop a system (or use it as a tool) for controlling the epidemiological process, regarding the prevalence of occupational pathology among employees.
The purpose of the study is to provide a description of epidemiological studies on occupational health in the population of Ukraine in the historical aspect: achievements and perspectives.
Materials and methods of research. According to the State Statistics Committee of Ukraine on the personal long-term observations of occupational morbidity, the characteristics of occupational health of the working population in the country, has been made. The collected and the processed data are presented in the "Maps on the account of occupational diseases (poisonings)" over the period of observation for more than 40 years. Along with epidemiological, combined hygienic, medical-statistical methods and systemic analysis were used. An analysis of scientific publications using electronic resources and databases WHO, ILO, PubMed has also been made. A descriptive analysis, single (cross-sectional, transversal), long-term (longitudinal), retrospective, prospective observations, cohort and case-control studies were used in the analysis of the data on the occupational morbidity of the working population.
Results. The regularities in formation of occupational morbidity among workers of various branches of industry and agriculture, including age-sex, professional, regional peculiarities, and medical support are revealed. The ways of solving the problems of occupational medicine in order to improve the occupational health of workers have been defined.
Conclusion. Large-scale, long-term epidemiological studies are being conducted in Ukraine on the study of the occupational health of workers of various industries and agriculture, using appropriate methodological approaches that are commonly used in epidemiology of non-communicable diseases. On the basis of the accumulated factual data on epidemiological manifestations of occupational diseases, the theoretical generalizations of regularities in the process of formation and prevalence of this pathology, development of preventive measures, decreasing the risks of occupational diseases have been made. Over the past 30 years there have been occurred negative changes in the occupational morbidity of the population: regions with high level of such morbidity in Donetsk, Dnipropetrovsk and Luhansk oblasts are formed; high levels of morbidity in the Sumy, Lviv and Kharkiv regions continue to be forming; coal, metallurgical and machine-building industry remain to be the main branches of the national economy, forming the occupational morbidity of the Ukrainian population. In the structure of occupational morbidity, diseases of respiratory organs of dust etiology, musculoskeletal system, caused by the influence of physical factors, continue to dominate; the incidence of occupational dermatoses and diseases of chemical genesis is decreasing; there is a reduction in the quality of medical care, including medical examinations of workers, which is the result of a late diagnostics of occupational pathology, when a permanent loss of working capacity is developed in patients. There are still problems to be solved by conducting epidemiological studies: studying the level of neuro-emotional strain at workplaces, psycho-emotional stress as a cause of an occupational disease. It is necessary to raise the level of epidemiological research of the effect of night and shift work, flexible labor regimes, professional activity of process operators in many industries, dispatchers, transport drivers, etc., the work of which require high tensions of the body. An epidemiological assessment of many new health-related factors is needed: new materials, types of energy, information loading on the body, chemicals, nanoparticles of industrial aerosols, the impact of which on the health of workers is not yet sufficiently taken into account in the diagnosis of occupational diseases.
Кey words: epidemiological research, occupational diseases, industries, occupational, tuberculosis, ways to overcome
ORCID ID of co-authors and their contribution to the preparation and writing of the article:
Nagorna A.M. (ORCID ID 0000-0003-3311-7523) - the idea of research, analysis of individual provisions, generalized conclusions, writing of an article;
Sokolova M.P. (ORCID ID 0000-0001-9590-1407) - collection and processing of materials, analysis of the results obtained, conclusions;
Kononova I.G. (ORCID ID 000-003-3483-9464) - collection and analysis of materials, statistical calculations.