MAIN PROBLEMS OF OCCUPATIONAL HEALTH AND OCCUPATIONAL DISEASES AT THE PRESENT STAGE

13 Jan 2012

Abstract  In the strategy «Kazakhstan-2030» President of the Republic of  Kazakhstan  N.A. Nazarbayev, indicated the need of implementation of the state program «Health of the Nation», which basic principles are to ensure the sanitary and epidemiological welfare of the population, the responsibility of  the governmental for establishing conditions to ensure the preservation and strengthening of public health. The article reflects this questions and the ways of decision at the present stage.

Large industrial complexes of the chemical industry, ferrous and nonferrous metallurgy, military training grounds, testing of missile and nuclear weapons, mines for the extraction of uranium ore, oil companies and its processing disposed In Kazakhstan.

In recent years, industrial enterprises (coal, mining, metallurgy, oil refining, etc.) carried out an intensive introduction of new processes, powerful and heavy-duty vehicles, machinery and equipment. According to preliminary data, in recent years, industrial production in Kazakhstan increased by 7.4% of construction — more than 25%, agriculture by 5,6%, etc.

Industrial injuries and occupational diseases are a direct result of poor working conditions and safety. However, the detected levels of occupational diseases in Kazakhstan, despite the fact that they are significantly lower than in developed countries are falling. This is due to, in our opinion, incomplete and late detection of occupational pathology. We can assume that there is underreporting of injuries, acute poisoning, especially in small and medium-sized businesses, which often employ migrant workers without official registration. In this case, both the employer and the employee is not interested to register cases of industrial injuries and acute poisoning. Poor and unsafe working conditions are risk factors in the development of not only occupational diseases and injuries, but also promote the growth of the number of common somatic diseases, including those with persistent disability, and deaths from other diseases, probably related to working conditions, that is industrial or vocational-conditioned.

Among the population, there is an increase of the total number of persons with persistent disability, in which the main causes of primary disability are: circulatory system diseases, malignant neoplasms, diseases of the musculoskeletal system and connective tissue. According to Russian scientists, harmful and hazardous working conditions lead to reduced life expectancy of  workers in ferrous and non-ferrous metallurgy and chemical industry. In this case, the mean loss of anticipated life expectancy, each employee of the above-mentioned enterprises, accounts for more than a year, due to hypertension and coronary heart disease, and another six months due to cancer of the respiratory system. In the chemical industry, as a result of chemical factors including the presence of carcinogenic substances in concentrations many times higher than maximum permissible concentration (MPC), the life expectancy of workers, the population is lower on 5 years comparatively to the general population. It is mainly because of the high mortality from malignant neoplasms [1].

The research findings in Kazakhstan indicate that at present, many industrial enterprises are provided with sufficient safety devices, sanitary and social rooms and equipments, personal protective equipments. Depreciation of fixed assets in industry is 46,6%, transport — 37,5%, in mechanical engineering — 47,6%. From year to year, there is no significant reduction in the number of objects and  working place that do not meet sanitary requirements. In 40.8% of checked industrial air sanples, there is a significant excess of content in the air of dust and gases. By physical factors — do not meet sanitary standards 39.4% of the objects, the noise — 16,5%, on the vibration — 39,3%, according to the microclimatic conditions of work and lighting — 38,2% [4].

Dysfunctional state of working conditions, the prevalence of heavy physical work, violations of labor and leisure, low coverage and low-quality preventive medical examinations, an unjustified elimination of health units and dispensaries, a sharp decrease in the sanitary and spa services are responsible for violations of workers health [2].

State employees’ working conditions are directly reflected in terms of occupational diseases and disabilities. Despite the fact that occupational diseases are less common than other major diseases, the social significance of them as greater, since they affect a significant number of persons of working age and very often workers loss their workability.

In recent years, in the connection with the establishment of numerous joint-stock associations, associations, corporations, and structural changes in enterprise management, issues of accounting and statistics of occupational diseases in the country became much more complicated.

According to official statistics in 2009, from the total 16 million residents 9 million people are economically active population.

In 2008, industries, in agriculture and transport sectors 1,393,869 people (in 2007 — 1,466,569 people) have worked, 361,486 of them — women (in 2007 — 407,812 people).

In 2008, the proportion of population worked in harmful and adverse working conditions has increased from 38.9% to 46.1% in comparison with 2007. This figure exceeds the average for the Aktobe (50,4%), East Kazakhstan (57,5%), Qyzylorda (82%), Mangistau (72,4%), Pavlodar (50.7%), South Kazakhstan (80 5%) areas and in transport (76,9%).

Unsatisfactory state of labor conditions, prolonged exposure of workers to harmful factors,  were the main cause of occupational disease.

In 2008, there were 577 cases of occupational diseases and poisoning, 54 of them — women (10,3%) and 469 (89,6%) — in men.

In the republic made 3,9 per 10000 workers (in 2007 — 3,7), the rate of occupational diseases.

Analysis of  occupational diseases rate by industry showed that the highest rates of occupational diseases were in a non-ferrous metallurgy – 61,7%, coal – 24,7%, and ferrous metallurgy — 3,3%.

Most registered occupational morbidity among workers in the East Kazakhstan region «Kazzinc and its subsidiaries — 129 cases;» Kazakhmys Corporation «- 20, in the mines of JSC» Arcelor Mittal Steel Temirtau — 119; in Zhambyl branch Kazphosphat — 13. The number of cases of occupational diseases in 2008 was 577, that is significantly higher than in 2007 (523). In total, there were 324 new cases of occupational disease lead to disability, that accounts for 62.5% of the number of cases of occupational diseases  (2007 — 57,5%).

Currently, the pace of social, technological, ecological changes is increasing this requiries quick adaptation of the human body to the factors of occupational environment. Features of the modern socio-ecological situation in the context of economic reforms and the country’s transition to new forms of management have changed the structure and motivation to work for all professional groups of working age population. Note that modern society has on the one hand, sharply changed conditions of human existence, and has developed sophisticated technologies, that demands highly state from their health status on the other.

To take full labor in difficult working conditions, to successfully compete in the labor market, the modern worker, must possess beside of  professional knowledge and skills  a sufficient level of health and high workability. It is known that the decrease of the functional reserves of the organism leads to the formation of pathological conditions, which significantly affect not only the quality of life, but also on productivity.

Therefore, one of the general tasks of preventive medicine at present is not only preventing disease but also the assessment of health on the stage of preexisting disease, which marks the stage of poor adaptation. It is known that 40-50% of the population is exposed to various harmful occupational factors. Number of persons in a «third state» of health is more than half of the total population (52-80%), and the greater number accounts for most working age from 20 to 40 years.

According to the International Labour Organisation (ILO), due to injuries, deaths and illnesses that cause disability, absence from work, the need for treatment or compensation in connection with the death of a breadwinner, 4% of gross domestic product are lost around the world.

Each year as a result of accidents around the world die two million women and men registered approximately 270 million occupational accidents, there is 355,000 accidents in the workplace. Every day due to accidents or diseases of productive die on average 5000 people [3].

If the reasons for the high-level injuries, such as in the mining industry, official authorities tend to assume non-safety by the miners, the independent experts see the problem in a slightly different plane. In their view, the high level of injury is caused, first of all, the drive for profit with depreciation of equipment and lack of modernization.

The number of accidents with fatalities per 1000 employees in recent years in Kazakhstan is 0.09. This figure is much higher than in Denmark (0.03), Sweden (0.03), Norway (0.06) [3,4].

In Kazakhstan, annually more than 3000 accidents are registered at work, of which 300 to 355 are with a fatal outcome. Most of the casualties of occupational diseases occurs in the primary sector of economic — in transport and mining industries, in agriculture and construction. The main causes of workplace injuries and deaths are lack of the health protection of labor by employers, and insufficient training in safety. Thus, despite the official statistics only for the last 2004-2007 years on the Karaganda mines to ”Mittal Still Temirtau’’ more than 120 fatal accidents occurred. In total, only in Karaganda region 588 cases of occupational accidents are recorded, 89 people killed.

According to the National Ministry of  Occupational and Social Protection the mining company ‘’Kazakhmys’’ Corporation has still highest rate of occupational injuries and death. Thus, in 2005 at this company 75 people killed in 2006 — 445 people received various injuries in the workplace, including 33 fatal cases. For the most part, according to of the experts, the cause of accidents is the break of the safety rules. According to the occupational safety and  health inspectors at mines and factories of  this corporation equipment is outdated, legal regulations and documents are abcent.

In Aktobe region in 2006 59 accidents occured, when 23 people injured, six were killed. The main cause of injuries is a breaking safety rules.

Poor organization of production, the neglect of safety requirements and other  breaks, are characteristic of small and medium businesses enterprises, and became a cause of high rate of occupational injuries and deaths of workers. This gives basic to speak about the need to strengthen health protection and safety at work, about improving the state labor inspection in accordance with international standards and recommendations of the International Labour Organization.

Compliance with international standards in the professional selection of employees, organization and protection of their labor, of course, requires new methodological approaches to assessing the impact of traditional and new factors of production environment on the duration of professional work and quality of life and health of workers. This problem deals primarily with the men working on the most labor-intensive industries and experiencing an increase in length of professional activity accumulation of  load, risk factors, often realized in the development of psychological problems, psychosomatic, physical and occupational diseases that restrict their ability to work professionally. Detailed study of working conditions, scientific analysis of occupational risks, their causes their scales make it possible to carry out prevention of occupational diseases and improve health [5].

Occupational health of industrial workers in Kazakhstan is still high and presents a big issue for public health workers, health policy makers and employers.

 

Literature:

 

  1. Crombie J.K. The limitation of case – control studies in the detection of environmental carcinogens.//J.Epidem. Com. Health. — 1981. -V.35.  -P. 281-287 p.
  2. Harrington J.M. Epidemiology. / — Medicine. — Mc. Graw- Hill Co, 1998.- 845 p.
  3. Workmen at work in Europe the challenge of today and tomorrow.-1995.-117 p.
  4. Измеров Н.Ф., Гурвич Е.Б., Лебедева Н.В. Социально-гигиенические и эпидемиологические исследования в гигиене труда. –М.: Медицина,1985.192с.
  5. Выявление и профилактика болезней, обусловленных характером работ. Доклад комитета экспертов ВОЗ. Серия теоретических докладов.- ВОЗ, Женева, 1987.

 

Основные проблемы профессионального здоровья и заболеваемости на современном этапе

Тогузбаева К.К., Каракушикова А.С., Бекмагамбетова Ж.Д., Мадигулов А.Р., Нуршабекова А.Б., Ниязбекова Л.С., Жунистаев Д.Д.

 

В стратегии Президента Республики Н.А. Назарбаева «Казахстан-2030» указана необходимость решения государственной программы «Здоровье народа», основными принципами которой являются обеспечение санитарно-эпидемиологического благополучия населения, ответственность государственных органов за создания условий, обеспечивающих сохранение и укрепление здоровья граждан. В статье главным образом отражены эти вопросы и пути их решении на современном этапе.

 

Қазіргі кезеңде кәсіби денсаулық және аурушаңдылықтың негізгі мәселелері

Тоғызбаева К.К., Каракушикова А.С., Бекмағамбетова Ж.Д., Мадигулов А.Р.,

Нұршабекова А.Б., Ниязбекова Л.С., Жүністаев Д.Д.

           

Түйін  Республикамыздың президенті Н.Ә. Назарбаевтың «Қазақстан-2030» стратегиясында «Халық денсаулығы» мемлекеттік бағдарламасын жүзеге асыру қажеттілігі көрсетілген, оның негізгі мәселелері азаматтардың денсаулығын сақтау және нығайту үшін халықтың санитарлық- эпидемиологиялық салауаттылығын қамтамасыз ету. Мақалада қазіргі кезеңдегі ең басты ретте осы сұрақтар және оларды орындау мәселелері көрініс алған.


Toguzbayeva K.K., Karakushikova A.S., Bekmagambetova J.D., Madigulov A.R., Nurshabekova A.B., Niazbekova L.S., Junistaev D.D.

KazNMU named S.D.Asfendiyarov

MAIN PROBLEMS OF OCCUPATIONAL HEALTH AND OCCUPATIONAL DISEASES AT THE PRESENT STAGE

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