Rodionova V. V., Khmel E. S., Sobko S. V., Glinyanaya L. A., Kovalenko E. N.
SI «Dnipropetrovsk Medical Academy of MH of Ukraine»
Purpose. To establish connection between frequency of arrhythmogenic syndrome occurrence and cardiovascular risk degree in patients, exposed to diffuse-reflected laser radiation in production.
Materials and methods. There have been examined 44 workers of metallurgical enterprises, exposed regularly to diffuse-reflected laser radiation in their work.
In order to evaluate the state of patients there have been used: general clinical examination, laboratory tests (routine clinical laboratory studies of blood, urine), biochemical tests (lipid spectrum of blood (general cholesterol) and glucose in blood), definition of systolic and diastolic arterial pressure (AP), Holter monitor of electrocardiogram of the high resolution with analysis of heart rhythm variability and a spectral analysis of microwave alternation of tooth T(mv AZT), definition of cardio-vascular risk, according to the SCORE scale (Systematic Coronary Risk Evaluation).
Results. There was found the increased level of AP in workers, exposed to the reflected laser radiation, as compared to the control group (141,00 ± 15,36; 122,00 ± 13,64, respectively) (p < 0,05). 72,7 % ofpatients showed cases of heart rhythm disorders during in twenty four hours: 56,25 % — supraventricular and 44,75 % — ventricular extrasystols of the I—V classes (according to B. Lown). The duration of Qt-corrected interval was prolonged in 61,3 % of patients. 18,2 % patients had late ventricular potentials (LVP).There were revealed the increased heart rate in comparison with the contol group (82,40 ± 3,87; 71,50 ± 2,58, respec¬tively) (p < 0,05) and the decreased high-frequency fluctuations (HF) (324,00 ± 81,57; 1154,00 ± 142,56, respectively (p < 0,05). Also, correlation have been established between the length of work experience and AP level (r = 0,4; p < 0,05); between the length of work experience and Valt values (r = 0,64; p < 0,05), RMS 40 (r = -0,43; p < 0,05), Las 40 (r = 0,61; p < 0,05), rMSSD (r = -0,64; p < 0,05), HFn.n. (r = 0,68; p < 0,05) and the common cardiovascular risk (r = 0,71; p < 0,05). According to SCORE scale the risk of fatal cardiovascular complications in all examined patients was increased (r = 0,64; p < 0,05): in 66 % — high risk and in 20,45 % cases — very high of 10-year risk of death from cardiovascular diseases.
Conclusions. Severity of cardiovascular disturbances depends on the length of work experience on laser machines. Even if employees of the laser industry don't have complaints and clinical manifestations of cardiovascular system disorders, they need careful examinations and appropriate preventive measures.
Key words: reflected laser radiation, Holter electrocardiogram, heart rate variability, 10-year-risk of sudden cardiac death