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Ministry of the Public Health of Ukraine Zaporozhye State Medical University Chair of General Hygiene and Ecology METHOD OF HYGIENIC ASSESSMENT OF DANGEROUS AND HARMFUL FACTORS OF THE INDUSTRIAL ENVIRONMENT AND ORGANISM RESPONSE TO THEIR IMPACT. The author: Fedorchenko R.A. 2015

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CONTENTS 1. Hygiene of work. The basic section hygiene of work. 2.General hazards caused by industrial environment and occupational injuries and diseases as their consequences. 3. Methods and techniques for determination of the most common types of occupational hazards and their impact on worker’s organism and health. 4. Legislative, administrative, technical measures for health protection and prevention of occupational diseases.

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HYGIENE OF WORK: the section of hygiene studying influence process of work and harmful professional factors on an organism of the working person and developing preventive actions for decrease and prevention occupational diseases.

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THE BASIC SECTIONS HYGIENE OF WORK: Physiology of work - studying influence on an organism various kinds of work, estimation its weight and intensity, prevention exhaustion. Hygiene of work with adverse physical professional factors - studying influence on an organism noise, vibration, electro-magnetic fields, laser irradiation, etc. Radiation hygiene - studying influence radiation on an organism, development actions of antiradiation protection.

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PHYSIOLOGY OF WORK: boundary section of hygiene and the physiology, studying influence process of work on an organism of the person and developing actions for increase serviceability and the prevention development of early exhaustion.

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THE CLASSIFICATION KINDS OF WORK: 1. Physical work - demands the big physical activity and energy expenses (work of the loader etc.) 2. The mechanized work - needs significant muscular activity, but energy expenses are less (work of the turner, etc.) 3. Automated work - demands smaller energy expenses, but is characterized by monotony (the serviceman, the weaver etc.) 4. Work on the conveyor - the monotony, the imposed rhythm of work. 5. Intellectual kinds of work.

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Dangerous industrial hazards (Abstract from State Standard 12.0.003 - 74) According to this standard all dangerous industrial hazards are divided into 4 groups: 1. Physical 2. Chemical 3. Biological 4. Psycho-physiological

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INDUSTRIAL PHYSICAL HAZARDS ARE: hot or cold microclimate of the working zone, high levels of infrared radiation (hot shops in metallurgy industry, boiler shops etc.), hot water or steam; increased or decreased barometric pressure and its leaps;

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INDUSTRIAL PHYSICAL HAZARDS ARE:

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INDUSTRIAL PHYSICAL HAZARDS ARE: high noise level, vibration, infra- and ultra-mechanical fluctuations of air or hard surfaces; high levels of radio region electromagnetic oscillations, electric magnetic fields of commercial frequency, static electricity; high levels of ionizing radiation (X-radiation, gamma-radiation, corpuscular radiation);

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INDUSTRIAL PHYSICAL HAZARDS ARE: insufficient or excessive illumination of work places, low contrast, high luminosity, its dazzle, unevenness, pulsation of the light, stroboscopic effect; high dust content in the air, fuel and explosive gases (methane in the coal mines).

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GROUP OF CHEMICAL DANGEROUS INDUSTRIAL HAZARDS INCLUDES: according to their action on organism - irritant, general toxic, sensibilizing, carcinogenic, mutagenic and teratogenic; according to their penetration route into organism: through respiratory tract, digestive system, skin; according to their tropism: pneumo-, neuro-, hepato-, hemato-, nephro-, dermato- and polytropic; according to level of toxicity: extremely toxic (MAC in the air  0.1mg/m3), highly toxic (MAC 0.1–1.0 mg/m3), medium toxic (MAC 1.0–10.0mg/m3), low toxic (MAC 10,0mg/m3).

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GROUP OF BIOLOGICAL DANGEROUS INDUSTRIAL HAZARDS INCLUDES: zoonotic bacterial, viral, fungal infections (anthrax, foot-and-mouth disease, Bovine Spongiform Encephalophaty (BSE), tularemia), invasions, allergies (from animal and plant dust) etc.; plant toxins and venoms (like snake hunters) etc.; biological production objects: antibiotics, protein-vitaminous concentrates, growth agents, bioactive preparations etc.

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GROUP OF PSYCHO-PHYSIOLOGICAL INDUSTRIAL HAZARDS INCLUDES: excessive physical activities: static (hold of heavy loads); dynamic (lifting and dis-placement of heavy loads and their intensity); hypodynamia, forced body posi-tion, overstrain of some organs; neuropsychic overstrains: mental over-strains, overstrains of attention and analyzers, very rapid change of production processes, information, work monotony, psychological and emotional overloads (like “chief- subordinate” interrelations).

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According to the character and extent of energy expenditure, physical labour is characterized by its weight and intensity, and mental activity, like operator’s–by its intensity. According to the State Standard 12.1.005 – 88 “General hygiene and sanitary requirements for air in the working zone” physical labour is divided into light one (energy expenditure – below 150 large calories per year), medium complexity (150 – 200 large calories per year), heavy one (200 – 250 large calories per year), and very heavy labour ( 250 large calories per year). According to its tension, mental, operator’s work is divided: non-tensioned, slightly tensioned, tensioned, super tensioned.

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Occupational diseases caused solely by industrial and occupational hazards, their consequences in the near and distant future as well as consequences of non-occupational diseases caused by occupational hazards (like arterial hypertonia caused by vibration) were put on the list. Acute and chronic occupational diseases and poisonings are recognized.

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OCCUPATIONAL DISEASES ARE DIVIDED INTO 7 GROUPS: 1. Diseases caused by chemical agents: acute and chronic intoxications of different tropism (neuro-, hemo-, hepato-, nephro-, poli-, dermatotropic, allergic etc.); 2. Diseases caused by industrial particulate pollutants: black-lung diseases, dust bronchitis, rhino-pharyngo-laryngitis, allergies; 3. Diseases caused by physical agents: ionizing radia-tions (acute, chronic radiation sickness, local radiation injuries, long-term consequences – malignant tumors); non-ionizing radiations (laser, ultraviolet, infrared);

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decompression - caisson sickness; acute, chronic overheating; noise, vibratory diseases etc.; 4. Diseases caused by overload and overstrain of certain organs and systems: coordination neurosis (at milkmaids, violin players, linotypes), radiculitis, tendovaginitis, arthrosis, bursitis, thrombophlebitis; laryngitis at singers, teachers, progressive myopia etc.; 5. Diseases caused by biological agents: infectious and parasitogenic diseases at stock-breeders, vets, infectiologists, bacterial laboratory assistants etc.;

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6. Allergic diseases: conjunctivitis, rhinitis, bronchial asthma, dermatitis, eczema, urticaria etc., that occur when one works with corresponding agents of plant or animal origin; 7. Neoplasms – malignant tumors when working with carcinogenic substances of physical (ionizing radiations, ultraviolet radiation) and chemical origin (3,4-benzpyrene).

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Industrial hazards and occupational diseases and poisonings Considering listed industrial hazards and occupational diseases and poisonings that they can cause, a task of the physicians – specialists in occupational hygiene, occupational pathologists, and physicians of different specialties of medical departments of industrial plants and patient care and preventive institutions is: to study hazards of industrial environment, engineering processes and their compliance with hygienic regulations;

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Industrial hazards and occupational diseases and poisonings to study impact of different hazards of industrial environment, (engineering process, air of the working zone, raw materials, half-products, end products, accompany products, wastes and industrial emissions); to study state of health of workers, their general occupational disease incidence; diagnostics and treatment of occupational diseases and poisonings, prevention and medical examination, sanatorium-and-spa treatment of the workers, participation in the work of Medical and Social Commission of Experts (MSCE), Medical Controlling Commissions (MCC), Medical and Labour Commission of Experts (MLCE) etc., examination commission of occupational pathology, ascertainment of disability etc.

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Preventive medical measures must include: participation in development of technical and engineering sanitation of working conditions (airing, packaging, automation, mechanization, remote control etc.); scientific development of hygienic regulations, different sanitary legislation; Industrial Engineering (IE).; preventive and running check by sanitary inspectors; health education and preventive work in the work collective (teaching sanitary regulations, use of overalls and personal protectors, clinical and preventive nutrition, water consumption schedule).

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Methods and means of measurement of industrial hazard Methods and means of measurement of industrial hazards and working conditions (microclimate, noise, vibrations, natural and artificial illumination, electromagnetic radiation etc.) were learnt by students in the corresponding hygiene sections, therefore they are just mentioned in this lecture. Methods and indications of environmental impact on organism and health were learnt by students in the previous sections of hygiene and physiology, pathologic physiology, biochemistry, lectures of clinical chairs, therefore in this lesson they are just listed. Personal protective equipment of body, respiratory tract, eyes and ears are considered in “Personal hygiene” section.

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Optimal standards of temperature, relative humidity and air movement in the working zone of workshops

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Allowable standards of temperature, relative humidity and air movement in the working zone of the workshops during cold and transitional seasons

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Maximum allowable concentration of the aerosols with the fibrogenic activity

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Maximum allowable concentrations of hazardous substances in the air of working zone

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Maximum allowable concentrations of hazardous substances in the air of working zone

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Method for assessment of fatigability during physical labour Dynamometry. To measure muscle strength of the hand, spring-type hand dynamometer is used. Maximum hand power is defined by dynamometer scale in kg. Static muscle endurance of the hand is measured by the period during which tested person is capable to keep fast dynamometer at 75 % of maximum hand strength. Muscle strength and static muscle endurance of the whole body is measured by stationary dynamometer, which is very easy in operation: power of the hand measured by “lifting” facility, fixed by legs.

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Figure. 1. Dynamometers (a – hand; b – stationary)

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Ergography Ergography is defined as measurement of muscle efficiency using ergograph – device of desk-size. Еrgograph is twine sheave fixed on a special support, on one end of which hangs a load of a definite mass and another end has a loop for finger or a hand of the tested person. A twine is connected to a pen that records ergogram on a kymograph – frequency and flexion degree of a finger of a hand when lifting a load.

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Ergography Decoding of ergograms that were taken at the beginning and at the end of the working shift allows determining muscle strength, fatigability resistance, fatigability, level of fatigability resistance resumption, content of done work and level of resumption of the done work content

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Fig. 2. Ergogram (1, 2) according to M.V. Lanyk

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Ergography These data are calculated according to depth of myograms in mm and their changes with time in seconds or minutes in the process of research. Metering of strength and static endurance of muscles is also carried out by special device – dynamo-chromo-reflex meter. Force and duration of pressing hand dynamometer is registered by pointer microammeter. Physical working capacity and fatigability development are also determined by dynamic analysis of cardiovascular system:

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Ergography heartbeat frequency (pulse) before and after load and its restitution; systolic and diastolic blood pressure, systolic and minute blood volume, oxyhemometry. Also electric cardiography is used (students study it in the department of physiology and in clinical departments) for determination of lung capacity, respiratory minute volume, respiration rate, ventilation of lungs by Douglas or Orsay-Fisher techniques, energy expenditure by means of the respiratory metabolism detection.

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Electric tremormetry is detection of frequency amplitude of involuntary shaking of hands, inferior limbs allows to assess both level of physical fatigue and functional state of nervous system. Tremor of hands is determined using a special device ‑ electric tremormeter, which consists of metal plate of circa 20 х 30 cm area with narrow figured slots and metal probe with ebonite handle that are connected to voltage source and electric meter.

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Electric tremormetry Tested person conducts the probe along figured slots trying not to touch their edges and meter detects how many times the probe touched the plate during certain period of research. Tremor of hands of not tired person is less than 3-5 swings (touches) per second, and of tired person ‑ 8-12 and even more swings per second. Fatigue at mental and operator’s work is detected by series of psycho-physiological tests.

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Fig. 3. Electric tremormeter

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Attention analysis by search of numbers Method gives an idea of extent and tempo of psychical processes. Its principle of operation is: tested person must find out numbers in ascending (and descending) orders on the table, where they are placed random, to point them and to call them as quickly as possible. For the examination, it is necessary to have a stopwatch, a pointer and tables with numbers. A table is shown at the distance of 70 cm from the eyes at uniform illumination. The tested person obtains instruction: “You’ll see a table.

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Attention analysis by search of numbers On the table you must point at and pronounce aloud all numbers from 1 to 25 in turn. Try to do this as quickly as you can. Let’s start!” A researcher puts a table on and turns on the stop-watch. Then, he turns it off when 25 is pointed at. Further he demonstrates another table, three ones in total. Examination results are evaluated as follows. Numbers’ search in one table, on average less than 45 sec. is a good result, 45-55 sec. – satisfactory, more than 1 min. – unsatisfactory.

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Attention analysis by search of numbers

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Examination of attention by search of numbers with switching This method is aimed to determine an extent, switching and distribution of attention. Red and black tables with figures from 1 to 24 are demonstrated to the tested person. He must find out black and red figures, calling in turn first black figure than red one. He must find out black figures in ascending and red ones in descending orders.

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Examination of attention by search of numbers with switching The tested person obtains instruction:” You’ll see a table where 24 black and 24 red figures are located random. On the table you must point at and pronounce aloud all black figures in ascending order starting from one and all red figures in descending order starting from 24. No need to call the color Try to do this as quickly as possible”. An operator controls performance of the task with a stopwatch.

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Examination of attention by search of numbers with switching When assessing results, time of the task performance, number and character of mistakes are taken into consideration. Fulfillment of the task during 2 minutes shows adequate quality of attention, more than 3 minutes – insufficiency of attention functions. Mistakes in color are not serious if they are minor. More serious are mistakes of the order called figures.

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Examination of attention by search of numbers with switching For example, some of the tested people in the middle of the table start calling figures of both number sequences in ascending or descending order. Such mistakes if the tested person does not correct them and continues to do them till the end of the examination testify about attention switch difficulties, i.e. about his physical or emotional fatigue.

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Examination of memory by memorization of geometric figures This method is used for assessment of functional state of central nervous system (CNS) at the time of work when researches are carried out during the whole working day. At that it is necessary to underline that this test helps to study short-term memory capacity. This method allows determining extent of fatigue of the workers of operators’ professions. The set of triangles with different hatch is shown to the tested person.

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Examination of memory by memorization of geometric figure His attention is paid to the difference between them. After that he is offered to remember 6 triangles with different geometric patterns during 8 seconds and after that to pick them out from the set that was shown at the beginning of the test. Decrease of number of figures picked out correctly after 8-second remembering during working day may testify about dominance of inhibition processes in CNS as the result of growth of fatigue.

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Quantitative assessment of intensity of physiological functions

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EXHAUSTION, theories of the mechanism of its development. Among many theories (more than 20) development exhaustion till now is not present universal. Now is most recognized central - nervous theory by Sechenov, Uchtomski, Vvedenski. The basic role in exhaustion is played decrease serviceability cells of a brain, so balance of excitation and braking in CNS are broken. Thus in CNS formed proof centers of excitation or braking - the theory of disbalance. This theory last years is added with the theory reticulary formation - frustration communications between supreme and lowest departments CNS.

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Quantitative assessment of intensity of physiological functions

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The basic directions of prevention exhaustion: 1. SCIENTIFIC SUBSTANTIATION and KEEPING HYGIENIC DEMANDS to WORKING CONDITIONS (Demands to a microclimate, irradiating, areas of workstation, absence exceeding MPC of the harmful professional factors) 2. SCIENTIFIC (RATIONAL) ORGANIZATION OF LABOUR PROCESS (Keeping regimen of work and rest, restriction duration, gravity and intensity of work, translation static physical work in dynamic etc.)

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The basic directions of prevention exhaustion: 3.TECHNICAL MEASURES ON ENRICHING WORKING CONDITIONS ON WORKSTATION: (Usage ERGONOMICS - science about relation of the man and devices, industrial art) 4. PSYCHOLOGIC MEASURES: (Psychology of work - industrial psychohygiene, psychologic selection on particular occupations, optimization psychologic climate in collective)