Ukrainian scientific-research Institute of industrial medicine, Krivoy Rog
Introduction. Risk assessment and management is the basis of modern medicine. In the process of their activity workers are exposed to hazardous and harmful work-related factors, which can have a significant effect on the type and quality of their work. The class of occupational risk depends on the level of occupational traumatism and occupational morbidity. The purpose of using a method for risk evaluation and management is to increase the validity of acceptance of administrative decisions in the field of ensuring sanitary-epidemiological welfare of the population.
The purpose of the study. Determination of regularities on risk formation of occupational morbidity in workers, employed in underground and open iron ore mining.
Materials and methods. According to the results of the study and evaluation of indicators on occupational morbidity it was defined and assessed risks of development of occupational diseases for workers, involved in the main production processes, according to the international methodology. There have been calculated indices of absolute risk (AR), relative risk (RR), confidence intervals (CI), odds ratio (OD), and etiologic fraction (EF). According to the degree of weight-of-evidence results on the assessment of occupational risks, personal studies can be classified as 1A (proven occupational risk).
Results. The obtained results on the assessment of risk of occupational diseases made it possible to reveal a contingent of workers with a high level of exposure to occupational factors, and to prove the relation of work conditions on occupational diseases in workers of mining and metallurgical industry of Ukraine. The highest relative risk of morbidity in occupational pathology is recorded in the underground iron ore extraction (RR = 5,45, CI 95 % 5,29-5,60 (p < 0,05), which is associated with high levels of harmful production factors. The study of the degree of relation on work conditions shows that there is a very high dependence of risk development of occupational diseases (EF: from 45,1 to 81,7 %). In the structure of occupational diseases in workers of underground iron ore mining there have recorded the highest risk of occupational hearing loss, radiculopathy and chronic obstructive pulmonary disease (RR = 60,8 CI 95 % 33,7-109,7, RR = 54,5 CI 95 % 51,0-58,2 and RR = 46,7 CI 95 % 37,9-57,6 (p < 0,05) with EF of harmful factors 81,7-98,4 % and a very high dependence on work conditions. In the structure of occupational diseases in workers of open pit mining of iron ore there was the highest risk of vibration disease, occupational deafness and pneumoconiosis (RR = 13,1 CI 95 % 10,5-16,3, RR = 10,0 CI 95 % from 8,1 to 12,3 and RR = 10,0 CI 95 % 2,5-39,7 (p < 0,05) with EF of harmful factors 55,6 - 92,4 % and higher morbidity due to work conditions (p < 0,05).
Conclusions. It is proved that a prolonged exposure to the main complex of adverse factors of occupational environment of various intensity levels can result in the growth of occupational diseases, which is directly dependent on work conditions. The studies open new perspectives to further research, aimed at establishing safer periods of work under the influence of adverse factors of the occupational environment. A monitoring of occupational risk is a necessary condition for risk management and assessing its effectiveness.
Key words: occupational risk, occupational diseases, workers engaged in iron ore mining