肌肉骨骼和结缔组织参数作为健康指标在俄罗斯EMERCOM国家消防服务局联邦消防服务人员中的意义

Q3 Health Professions
S. Aleksanin, V. Evdokimov, V. Rybnikov
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The authors analyzed the research papers included in the Russian Science Citation Index mostly within the last 10 years and the studies carried out at the Nikiforov Russian Center of Emergency and Radiation Medicine and at the All-Russian Research Institute for Fire Protection of the EMERCOM of Russia. Morbidity was calculated in ppm (‰), industrial injury and primary disability rates were estimated per 10,000 (×104), mortality (deaths) – per 100,000 (×105) people. The indicators dynamics was estimated based on dynamic sets of data applying the 2nd  order polynomial trend; the Pearson correlation coefficient was utilized to verify consistency of the trends.Results and analysis. In 2003–2015 the average annual incidence rate of cases with labor losses (across all ICD-10 chapters of diseases) among the EMERCOM Federal Fire Service officers was (407.0 ± 30.4) ‰ which was statistically significantly lower than among the Russian armed forces officers (508.5 ± 35.6) ‰ (p < 0.05); the number of lost workdays was higher, i.e. (5139 ± 402) and (4174 ± 123) ‰ respectively (p < 0.05). Consistency in the dynamics of case number, rate of lost workdays, and day/incident ratio among firefighters and military officers is low and negative, potentially due to the impact of different factors on lost workdays rate. Assuming the macrosocial factors are identical, organisational  and/or occupational factors could be the key contributors to labor losses. Rates of injuries, poisoning and other external impacts (chapter XIX in ICD-10), as well as musculoskeletal and connective tissue diseases (chapter XIII) play the leading  role in morbidity dynamics among firefighters. The mortality rate among the Russian EMERCOM FFS officers with chapter XIX injuries was 8.5 times lower than that among the Russian male population, although the population cohort was 2.5 times more numerous. Occupational injury rate of (14.66 ± 2.01) • 10–4 of injuries/(firefighter • year) and firefighter fatalities (8.53 ± 0.83) • 10–5 deaths/(firefighter • year) in 2006–2020 were statistically significantly lower than among economically active working male population  in Russia: (22.73 ± 2.8) • 10–4 (p < 0.01) and (13.23 ± 1.12) • 10–5 (p < 0.05) respectively. Considering the work schedule of firefighters, the annual amount of work in extreme environments was carried out within 6 months; whereas the level of industrial traumatism due to fire extinguishing and elimination of other emergency situations calculated for 12 months should be doubled, to say the least. The level of primary disability among Russian Federal Fire Service employees was (15.98 ± 0.99) • 10–4, i.e. statistically reliably lower (p < 0.001) than among the working population of Russia aged 18–44 years (25.51 ± 1.19) • 10–4. On the one hand, the data demonstrates efficient labor set-up and labor protection of the EMERCOM FFS employees, whereas disability rate among the adult population of Russia stays at a high level, on the other hand.Conclusion. Although not entirely eliminated, negative occupational impacts (i.e. diseases, injuries) can be reduced to minimal rates. 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引用次数: 0

摘要

的相关性。俄罗斯联邦消防委员会国家消防局联邦消防局官员的工作是全球十大职业之一,具有明显的健康功能储备枯竭、早期职业病流行、受伤甚至死亡风险。传统上,调查人员关注循环系统疾病及其如何影响消防员的职业健康。目的是提供基于研究的证据,表明肌肉骨骼和结缔组织参数为俄罗斯联邦消防服务人员的健康状况提供了可靠的估计。作者分析了俄罗斯科学引文索引(Russian Science Citation Index)收录的研究论文,主要是近10年来的研究论文,以及在Nikiforov俄罗斯急救和辐射医学中心和俄罗斯EMERCOM全俄消防研究所进行的研究。发病率以ppm(‰)计算,工伤和初级致残率估计为每10万人(×104),死亡率(死亡)-每10万人(×105)。采用二阶多项式趋势对动态数据集进行指标动态估计;利用Pearson相关系数验证趋势的一致性。结果和分析。2003-2015年,EMERCOM联邦消防人员(ICD-10所有章节疾病)的年均劳动损失病例发生率为(407.0±30.4)‰,低于俄罗斯武装部队军官(508.5±35.6)‰(p < 0.05);损失工作日数较高,分别为(5139±402)‰和(4174±123)‰(p < 0.05)。在消防员和军官中,案件数量、工作日损失率和日/事故率的动态一致性较低且为负值,这可能是由于不同因素对工作日损失率的影响。假设宏观社会因素是相同的,组织和/或职业因素可能是劳动力流失的关键因素。受伤、中毒和其他外部影响的比率(《国际疾病分类-10》第十九章)以及肌肉骨骼和结缔组织疾病(第十三章)在消防员的发病率动态中起主要作用。受第19章伤的俄军应急部队FFS军官的死亡率是俄军男性人口死亡率的8.5倍,尽管男性人口数量是男性人口的2.5倍。俄罗斯2006-2020年职业伤害率为(14.66±2.01)•10-4 /(消防员•年),消防员死亡人数为(8.53±0.83)•10-5 /(消防员•年),分别低于经济活动男性人口的(22.73±2.8)•10-4 (p < 0.01)和(13.23±1.12)•10-5 (p < 0.05),具有统计学意义。考虑到消防员的工作进度,极端环境下的年度工作量在6个月内完成;而灭火和消除其他紧急情况所造成的工业创伤,按12个月计算,至少应该增加一倍。俄罗斯联邦消防局雇员的初级残疾水平为(15.98±0.99)•10-4,即统计可靠地低于俄罗斯18-44岁工作人口(25.51±1.19)•10-4 (p < 0.001)。一方面,数据表明EMERCOM FFS员工的劳动设置和劳动保护是有效的,而另一方面,俄罗斯成年人口的残疾率仍然处于较高水平。虽然没有完全消除负面的职业影响(即疾病、伤害),但可以将其减少到最低限度。预防职业病,特别是创伤和肌肉骨骼疾病的早期发病,具有巨大的健康保护潜力,可确保应急管理机构FFS雇员的职业寿命。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Significance of musculoskeletal and connective tissue parameters as health indicators in Federal Fire-Fighting Service officers of the State Fire-Fighting Service of the EMERCOM of Russia
Relevance. The job of Federal Fire-Fighting Service (FFS) officers of the State Fire-Fighting Service of the EMERCOM of Russia is among the global top 10 occupations with evident risk of health functional reserves depletion, prevalence of early occupational diseases, injuries and even death. Traditionally, investigators focus on circulatory diseases and how they affect firefighters’ occupational health.The objective is to provide  research-based evidence showing that musculoskeletal and connective tissue parameters provide a reliable estimate of the health status in Russian Federal Fire-Fighting Service officers.Methodology. The authors analyzed the research papers included in the Russian Science Citation Index mostly within the last 10 years and the studies carried out at the Nikiforov Russian Center of Emergency and Radiation Medicine and at the All-Russian Research Institute for Fire Protection of the EMERCOM of Russia. Morbidity was calculated in ppm (‰), industrial injury and primary disability rates were estimated per 10,000 (×104), mortality (deaths) – per 100,000 (×105) people. The indicators dynamics was estimated based on dynamic sets of data applying the 2nd  order polynomial trend; the Pearson correlation coefficient was utilized to verify consistency of the trends.Results and analysis. In 2003–2015 the average annual incidence rate of cases with labor losses (across all ICD-10 chapters of diseases) among the EMERCOM Federal Fire Service officers was (407.0 ± 30.4) ‰ which was statistically significantly lower than among the Russian armed forces officers (508.5 ± 35.6) ‰ (p < 0.05); the number of lost workdays was higher, i.e. (5139 ± 402) and (4174 ± 123) ‰ respectively (p < 0.05). Consistency in the dynamics of case number, rate of lost workdays, and day/incident ratio among firefighters and military officers is low and negative, potentially due to the impact of different factors on lost workdays rate. Assuming the macrosocial factors are identical, organisational  and/or occupational factors could be the key contributors to labor losses. Rates of injuries, poisoning and other external impacts (chapter XIX in ICD-10), as well as musculoskeletal and connective tissue diseases (chapter XIII) play the leading  role in morbidity dynamics among firefighters. The mortality rate among the Russian EMERCOM FFS officers with chapter XIX injuries was 8.5 times lower than that among the Russian male population, although the population cohort was 2.5 times more numerous. Occupational injury rate of (14.66 ± 2.01) • 10–4 of injuries/(firefighter • year) and firefighter fatalities (8.53 ± 0.83) • 10–5 deaths/(firefighter • year) in 2006–2020 were statistically significantly lower than among economically active working male population  in Russia: (22.73 ± 2.8) • 10–4 (p < 0.01) and (13.23 ± 1.12) • 10–5 (p < 0.05) respectively. Considering the work schedule of firefighters, the annual amount of work in extreme environments was carried out within 6 months; whereas the level of industrial traumatism due to fire extinguishing and elimination of other emergency situations calculated for 12 months should be doubled, to say the least. The level of primary disability among Russian Federal Fire Service employees was (15.98 ± 0.99) • 10–4, i.e. statistically reliably lower (p < 0.001) than among the working population of Russia aged 18–44 years (25.51 ± 1.19) • 10–4. On the one hand, the data demonstrates efficient labor set-up and labor protection of the EMERCOM FFS employees, whereas disability rate among the adult population of Russia stays at a high level, on the other hand.Conclusion. Although not entirely eliminated, negative occupational impacts (i.e. diseases, injuries) can be reduced to minimal rates. Preventing the early onset of occupational diseases, especially traumas and musculoskeletal diseases, has a huge health sparing potential to ensure professional longevity of the EMERCOM FFS employees.
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