Sova S. G.2, Trembovetska O.M.1
VEGETATIVE DYSTROPHIC CARDIOMYOPATHY CAUSED BY COMBINED EFFECT OF PULSE VIBRATION AND INDUSTRIAL NOISE
1SI «M. M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine», Kyiv
2O. O. Bogomolets National Medical University, Kyiv
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Purpose. Improving the efficiency of diagnostics and prevention of vibronoising pathology by identifying signs of degenerative processes in the myocardium of workers with progressive autonomic failure caused by the combined influence of local pulse vibration and industrial noise.
Methods. In mechanical assembly departments of SE «Antonov» and SE «Factory 410 of Civil Aviation» physiological-hygienic examination and evaluation of working conditions at workplaces of fitter-assemblers and fitters has been conducted in accordance with current Ukrainian hygienic standards and standards of Health and Safety Executive (HSE).The clinical part of the work was carried out in the in-patient department of occupational diseases of the O. O. Bogomolets National Medical University and SI «M. M. Amosov National Institute of Cardiovascular Surgery of NAMS of Ukraine». The study included 52 workers of the main group, working in conditions of the prolonged exposure to local vibration and industrial noise. The control group consisted of 27 individuals, comparable with the main group by age and sex, who were not exposed to the combined effects of noise and vibration in the process of their work. The diagnostics of cardiac autonomic neuropathy was made using a battery of tool cardio-vascular tests by the author's method. The effect of coronarogenic pathology was studied by the method of selective cor- onarography by Judkins. The functional state of the myocardium was determined by two-dimensional vector echocardiography. The statistical processing of the digital material was performed, using the computer program Microsoft Office Excel 2007. Results. By the combination of psychophysiological indicators the work of fitter-assemblers and fitters can be referred to Class 3.2 (heavy and intensive). The main harmful factors of the work environment at workplaces of fitter-assemblers and fitters were industrial noise, exceeding the maximum permissible levels of SSN 3.3.6.037-99 by 8-30 dB, and local vibration, which levels did not exceed the standards of domestic SSN 3.3.6.039- 99, but, at the same time, ten times exceeding the normal standard of HSE. The disorders of segmental vegetative cardiac innervation, causing the development of noncoronary degenerative process in the myocardium of individuals, exposed to vibration and noise, have been proved.
Conclusions. The combined effect of industrial noise and the local pulse vibration, as well as heavy and intensive work can result in development of the syndrome of progressive autonomic insufficiency (cardiac autonomic neuropathy), which can be a cause of developing of painful types of noncoronary cardiomyopathy in fitter-assemblers and fitters at aircraft enterprises. Recommendations. Tin order to improve the diagnostics and prevention of vibration diseases and occupational sensoneural deafness it is proposed to consider this problem to include vegetative dystrophic cardiomyopathy in modern nomenclature of vibronoise pathology and to initiate a process of harmonization of the rating of the national hygienic standards on local vibration to European ones.
Key words: vibration, noise, progressive autonomic failure, degenerative processes, cardiomyopathy, prevention
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