Medical staff working conditions are characterized by a range of adverse workplace factors investigated primarily at hospital organizations. However, sanitary audit of working conditions and health risk factors for medical workers in the sanatorium- resort industry is also a task that needs attention. Aim. To analyze the results of the working conditions special assessment and identify the main work-related factors aff ecting health state of medical staff at sanatorium- resort organizations. Material and methods. Scientifi c search and analysis of publications on the safety of working conditions and health protection of medical workers. Systematization of research materials, statistical and comparative analysis of the results of working conditions special assessment carried out at branches of the Medical Research Center and data provided in publications. Results. Medical staff are exposed to a wide range of hazards. Work-related factors that do not meet established hygiene standards cause the greatest concern among medical workers. These are microclimate, lighting and working equipment (47.0%, 37.8% and 24.0%, respectively). A number of devices inspected in the physiotherapy room exceeded hygienic standards for alternating electric and magnetic fi eld intensity. Analysis of air pollution in the physiotherapy department working area showed that some of the harmful chemicals exceeded permissible exposure limits. The results of the special assessment of working conditions performed at branches of the Medical Research Center showed that a high percentage of medical workers was exposed to harmful biological factors and high severity of the labor process. Conclusion. Physical and chemical factors are the greatest workplace hazards for healthcare workers at health resorts. However, a special assessment of working conditions showed that the biological factor was the most signifi cant one across all professional groups.
sanatorium-resort organizations, medical staff , risk factors, working conditions
1. McDiarmid M. A. Hazards of the Health Care Sector: Looking Beyond Infectious Disease. Annals of Global Health. 2014; 80(4): 315-319. http://doi.org/10.1016/j.aogh.2014.08.001
2. World Health Organization & International Labour Organization (WHO & ILO). Caring for those who care: national programes for occupation- al health for health workers: policy brief. World Health Organization; 2020. Available at: https://apps.who.int/iris/handle/10665/336479 (data obrascheniya: 29.05.2021)
3. Zdravoohranenie v Rossii. 2017: Statisticheskiy sbornik. Rosstat. M. 2017: 170 s.
4. Zdravoohranenie v Rossii. 2019: Statisticheskiy sbornik. Rosstat. M. 2019: 170 s.
5. OK 029-2014 (KDES Red. 2). Obscherossiyskiy klassifikator vidov ekonomicheskoy deyatel'nosti (utv. Prikazom Rosstandarta ot 31.01.2014 N 14-st) (red. ot 12.08.2021) Available at: https://docs.cntd.ru/document/1200110162 (data obrascheniya: 15.01.2022)
6. Trudovoy kodeks Rossiyskoy Federacii ot 30.12.2001 N 197-FZ (red. ot 22.11.2021) (s izm. i dop., vstup. v silu s 30.11.2021) Available at: http://www.consultant.ru/document/cons_doc_LAW_34683/ (data obrascheniya: 15.01.2022)
7. State of the Sector - Healthcare and Social Assistance: Identifi cation of Research Opportunities for the Next Decade of NORA. A NORA report.
8. DHHS (NIOSH) Publication Number 2009-139. Department of Health and Human Services (DHHS), Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), 2009. Available at: http://www.cdc.gov/niosh/docs/2009-139/pdfs/2009- 139.pdf. (data obrascheniya: 29.05.2021)
9. VOZ: dlya obespecheniya bezopasnosti pacientov neobhodimo obespechit' bezopasnost' medicinskogo personala: press- reliz ot 17.09.2020. Zheneva; 2020. Available at: https://www.who.int/ru/news/item/17-09-2020-keep-health- workers-safe-to-keep-patients-safe-who (data obrascheniya: 29.05.2021)
10. Pravila po ohrane truda v medicinskih organizaciyah: Prilozhenie k Prikazu Ministerstva truda i social'noy zaschity Rossiyskoy Federacii ot 18.12.2020 № 928n «Ob utverzhdenii pravil po ohrane truda v medicinskih organizaciyah» (Zaregistrirovan 30.12.2020 № 61956). Available at: https://mintrud.gov.ru/docs/mintrud/orders/1807 (data obrascheniya: 29.05.2021)
11. Issakov A. Health care equipment: a WHO perspective. In: Medical devices: International perspectives on health and safety. Elsevier. 1994: 128-140.
12. Boyarkina S. I. Usloviya truda rossiyskih vrachey: riski dlya zdorov'ya i infekcionnoy bezopasnosti. Vestnik Sankt- Peterburgskogo universiteta. Sociologiya. 2018; 11(3): 346-363. https://doi.org/10.21638/spbu12.2018.306
13. Aluko O. O., Adebayo A. E., Adebisi T. F., Ewegbemi M. K., Abidoye A. T., Popoola B. F. Knowledge, attitudes and perceptions of occupational hazards and safety practices in Nigerian healthcare workers. BMC Research Notes. 2016; (9): 71 p. https://doi.org/10.1186/s13104-016-1880-2
14. Senthil A., Anandh B., Jayachandran P., Thangavel G., Josephin D., Yamini R., Kalpana B. Perception and prevalence of work-related health hazards among health care workers in public health facilities in southern India. International Journal of Occupational and Environmental Health. 2015; 21(1): 74-81. https://doi.org/10.1179/2049396714Y.0000000096
15. Ob utverzhdenii nomenklatury medicinskih organizaciy. Prikaz Ministerstva zdravoohraneniya Rossiyskoy Federacii ot 6 avgusta 2013 g. N 529n s prilozheniem (s izmeneniyami i dopolneniyami) v redakcii Prikazov Minzdrava RF ot 08.08.2019 N 615n, ot 19.02.2020 N 106n) Available at: https://docs.cntd.ru/document/499038908 (data obrascheniya: 29.05.2021)
16. Che Huei1 L., Ya- Wen L., Chiu Ming Y., Li Chen H., Jong Yi W., Ming Hung L. Occupational health and safety hazards faced by healthcare professionals in Taiwan: A systematic review of risk factors and control strategies. SAGE Open Medicine. 2020; (8): 1-12. https://doi.org/10.1177/2050312120918999
17. Tipayamongkholgul M., Luksamijarulkul P., Mawn B., Kongtip P., Woskie S. Occupational Hazards in the Thai Healthcare Sector. New Solutions: A Journal of Environmental and Occupational Health Policy. 2016; 26(1): 83-102. https://doi.org/10.1177/1048291116633871
18. Bektasova M. V., Kiku P. F., Sheparev A. A. Faktory riska v processe trudovoy deyatel'nosti medicinskih rabotnikov. Dal'nevostochnyy medicinskiy zhurnal. 2019; (2): 73-8. https://doi.org/10.35177/1994-5191-2019-2-73-78
19. Dolzhenkova Yu. V., Kamneva E. V., Safonov A. L., Dzappala S. Upravlencheskie aspekty professional'noy bezopasnosti medicinskogo personala v byudzhetnom zdravoohranenii Rossii. Problemy social'noy gigieny, zdravoohraneniya i istorii mediciny. 2020; 28(S): 736-40. https://doi.org/10.32687/0869-866X-2020-28-s1-736-740
20. Dubel' E. V., Unguryanu T. N. Gigienicheskaya ocenka usloviy truda medicinskogo personala klinicheskih i paraklinicheskih otdeleniy stacionara. Gigiena i sanitariya. 2016; 95(1): 53-57. https://doi.org/10.18821/0016-99002016-95-1-53-57
21. Perepelica D. I. Social'no- gigienicheskie aspekty ohrany zdorov'ya medicinskih rabotnikov. Medicinskaya nauka i obrazovanie Urala. 2007; 8(1): 93-95. 21. Hodyreva L. A., Turzin P. S., Ushakov I. B., Komarevcev V. N. Usloviya i faktory, vliyayuschie na sostoyanie zdorov'ya medicinskih rabotnikov- zhenschin. Medicina ekstremal'nyh situaciy. 2019; 21(2): 268-275.
22. Panyushova E. P., Kiryushin V. A. Gigienicheskaya ocenka uslovii truda i sostoyaniya zdorov'ya medicinskih rabotnikov paraklinicheskih otdeleniy. Nauka molodyh (Eruditio Juvenium). 2019; 7(1): 129-38. https://doi.org/10.23888/HMJ201971129-138
23. Pankov V. A., Kuleshova M. V., Meschakova N. M., Sorokina E. V., Tyutkina G. A. Professional'nyy risk medicinskih rabotnikov. Byulleten' Vostochno- Sibirskogo nauchnogo centra Sibirskogo otdeleniya Rossiyskoy akademii medicinskih nauk. 2010; 1(71): 49-53.
24. Saldan I. P., Nagornyak A. S., Balandovich B. A., Poceluev N. Yu., Krasikov A. A., Tulin N. Yu., Kudryavskiy S. I. Gigienicheskie aspekty bezopasnosti medicinskogo truda i problema ocenki professional'nogo riska. Gigiena i sanitariya. 2019; 98(1): 49-54.
25. Saldan I. P., Balandovich B. A., Poceluev N. Yu., Nagornyak A. S., Krasikov A. A., Tulin N. Yu. Gigienicheskaya ocenka professional'nyh riskov vozdeystviya elektromagnitnyh poley i radona na medicinskiy personal sanatoriya. Byulleten' Nacional'nogo radiacionno- epidemiologicheskogo registra. 2018; T. 27.(4): 133-140. https://doi.org/10.21870/0131-3878-2018-27-4-133-140
26. Oborina S. V. Ocenka sostoyaniya zdorov'ya medicinskih rabotnikov kliniko- laboratornoy sluzhby v zavisimosti ot faktorov proizvodstvennoy sredy i trudovogo processa. Medicina truda i ekologiya cheloveka. 2018; 2(14): 22-28.
27. Kondrova N. S., Shayhlislamova E. R., Sandakova I. V., Simonova N. I., Karpova N. N. K voprosu o professional'nyh zabolevaniyah rabotnikov zdravoohraneniya i ih vyyavlenii pri periodicheskih medicinskih osmotrah. Gigiena i sanitariya. 2018; 97(4): 325-331. https://doi.org/10.18821/0016-9900-2018-97-4-325-331
28. O special'noy ocenke usloviy truda. Federal'nyy zakon ot 28.12.2013 N 426-FZ (red. ot 30.12.2020) (s izmeneniyami i dopolneniyami, vstupil v silu s 01.01.2021). Available at: https://docs.cntd.ru/document/499067392 (data obrascheniya: 15.01.2022)
29. Lahno V. A., Lahno D. N. Gigienicheskaya harakteristika usloviy truda medicinskih rabotnikov sanatorno- kurortnyh organizaciy Kryma. V sb.: Problemy mediciny v sovremennyh usloviyah. Sbornik nauchnyh trudov po itogam mezhdunarodnoy nauchno- prakticheskoy konferencii. Kazan'. Izdatel'stvo: Innovacionnyy centr razvitiya obrazovaniya i nauki. 2017: 39-44.
30. Kim D. D., Kimura A. Jr., Pontes D. K.L., Oliveira M. L.S., Cumino D. O. Evaluation of anesthesiologists’ knowledge about occupational health: Pilot study. BMC Anesthesiology. 2018; (18): 193. https://doi.org/10.1186/s12871-018-0661-y
31. Bektasova M. V., Zhuravskaya N. S., Gul'tyaeva L. A. Analiz struktury professional'noy zabolevaemosti i ocenka usloviy truda rabotnikov zdravoohraneniya Primorskogo kraya. Obschestvennoe zdorov'e i zdravoohranenie. 2020; 2(66): 42-48.