Nahorna A. M., Sokolova M. P., Vitte P. M., Kononova I. G., Pyatnitsa-Gorpynchenko N. K.
STATE OF OCCUPATIONAL MORBIDITY IN THE PERIOD OF LEGISLATIVE CHANGES IN UKRAINE
State Institution "Institute for Occupational Health of the National Academy of Medical Sciences of Ukraine", Kyiv
Full article (PDF), UKR
Introduction. The health care system, existing nowadays in Ukraine, does not provide for a priority medical and sanitary service for workers. There is now an urgent need to raise effectiveness in prevention and treatment of occupational diseases. With this in view it is necessary to develop a set of measures on health protection and organization of medical care of workers, based on the significant information on their state of health. Occupational morbidity is, at present, of a particular social importance, the significant information of which is very important for assessment and management of occupational risks.
Purpose of the study. To analyze occupational morbidity in Ukraine over the period of 200–2014 and to study possible ways for improvement of statistics in occupational morbidity on the basis of modern computed technologies for raising the effectiveness of management in prophylaxis of occupational diseases.
Materials and methods. The study and analysis of occupational morbidity in Ukraine over the period of 2005–29014 were conducted. There have been collected and processed almost all principle data, available in 64 418 "Cards for recording occupational diseases (occupational poisonings)". In order to solve the assigned tasks a combination of hygienic, epidemiological, medico-statistical methods have been used as well as systemic analysis. Also, an analysis of scientific publications with the use of electronic resources and WHO, ILO, PubMed databases has been made. The studies on recent possibilities for the use of medical information and analytical systems for recording and analysis of the information on occupational morbidity, based of the data of the scientific literature, have been conducted.
Results. A characteristic mark in the dynamics of occupational morbidity rates in the country over the last 12 years was its wave-like character. A peculiarity of this wave is the excess in the growth of the morbidity rate over rates of growth of the absolute number of patients. This is because, nowadays, the absolute number of workers in production sector with harmful work conditions has been decreased, whereas the number of patients with occupational diseases has been on the contrary increased. The state of the occupational morbidity in Ukraine is characterized by its peculiarities concerning rates and distribution of the suffered by branches. The largest number of occupational diseases is recorded in coal mining, machine building and metallurgy industries. The rates of occupational morbidity by regions per 1000 workers demonstrate that its highest rates are significantly higher than on the average in the country: in Donetsk (9,2–16,6) per 100 000 workers), Dnipropetrovsk (6,1–10,4) Lugansk (9,9–27,4) and Lviv (5,5–12,7) regions. The distribution of cases of occupational diseases according to main types of pathology shows that the largest number of occupational diseases falls on respiratory and musculoskeletal system. A comparative characteristics of functioning of the "Registry of individuals suffered from accidents at work and from occupational diseases", recorded in the "Fund of social insurance from accidents at work and from occupational diseases in Ukraine" and "Automated information system of the Ministry of Health of Ukraine" show that they do not make possible to compare the results of the analysis for detection and register occupational diseases by different approaches to the data storage on patients suffered from occupational diseases and for recording cases of occupational diseases by different classifiers. The both registries do not cover monitoring of the suffered.
Conclusion. Respiratory and musculoskeletal diseases are recorded mostly often. The regions, where there are available large enterprises of the leading branches of the national economy and where there are concentrated the significant number of workers, engaged in harmful conditions, are the most dangerous in respect of formation of the occupational pathology (Donetsk. Lugansk, Dnipropetrovsk, e. a. regions). The highest risk of development of occupational pathology is in coal mining, metallurgy, machine building, due to a combination of unfourable production factors (dust, noise, vibration etc.) in underground winning. Regarding the world and national experience the main difficulty in detection and recording occupational diseases is in inavailability and insufficiency of the system for collection and analysis of the data. The main shortcoming in the system for recording occupational disease in Ukraine is that it does not cover information on storage of the cases on occupational pathology over the whole period of registration and monitoring of the suffered. So, it does not make it possible to objectively assess the quality of medical care for workers and to eliminate, in time, potential work health hazards. The development of the "State registry on occupational diseases", based on high information technologies, will help to solve this problem on the scientifically grounded basis.
Key words: occupational morbidity, automated information system, detection, recording, registration, registry, software
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