Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

10255

Conference Proceedings

Detection of oncological pathology in workers of carcinogenically hazardous industries in the Voronezh region

Sergeev

Ilya Aleksandrovich

Studentsergeevili03@mail.ruhttps://orcid.org/0009-0009-1725-8888Pak

Maksim Igorevich

Studentvampibook903@gmail.comhttps://orcid.org/0009-0008-7684-1718Malakhova

Anastasia Yuryevna

Studentmalahova.anastasia2017@gmail.comhttps://orcid.org/0009-0007-6531-363XPresnyakova

Margarita Yuryevna

Studentmargaret.prenyakova@yandex.ruhttps://orcid.org/0009-0003-8756-9100Beskо

Valentina Andreevna

Doctor of Medical Sciences, Associate Professor of the Department of Epidemiology36.vbesko@mail.ruhttps://orcid.org/0009-0009-2785-8019Samodurova

Natalia Yuryevna

Candidate of Medical Sciences, Associate Professor of the Department of Epidemiologynataly.samodurov@yandex.ruhttps://orcid.org/0000-0002-4065-2471

Voronezh State Medical University named after N.N. Burdenko

25042025

14S1125128

19022025

24022025

2025

Annotation Cancer pathology, characterized by high prevalence and mortality, particularly among the working-age population exposed to carcinogenic factors, remains understudied in the occupational context The aim of the study is to identify the reasons for the lack of detection of occupational cancer in the Voronezh region and to develop proposals for improving the situation Materials and methods A search of literary sources was conducted to identify the reasons for the low diagnosis of occupational cancer pathology in the Russian Federation. A retrospective analysis of suspected occupational cancer cases identified during periodic medical examinations of workers in hazardous industries was carried out based on the Final Reports of medical examinations in healthcare organizations in the Voronezh region. Materials related to the implementation of the program "Combating Oncological Diseases" were also studied Results: In the Voronezh region, as part of the regional program "Combating Oncological Diseases" (20122021), the incidence of malignant neoplasms was studied. The incidence rate increased from 382.45 to 401.59 cases per 100,000 population. The most common locations were skin cancer (18.8%), breast cancer (12.5%), bronchopulmonary system cancer (9.5%), prostate cancer (8.1%), and colon cancer (5.8%). The most disadvantaged districts are Ramonsky, Repyevsky, Nizhnedevitsky, Khokholsky, Paninsky, Vorobyovsky, and Anninsky Conclusion: Studies have revealed a lack of diagnosis of occupational cancer among workers exposed to carcinogenic substances at enterprises in the Voronezh region during mandatory preventive medical examinations. There is no established routing for workers with detected neoplasms or a framework for interaction between occupational pathology and oncology services

occupational oncological diseasescarcinogenically hazardous factors and industriesdetection of oncopathology

профессиональные онкологические заболеванияканцерогенно опасные факторы и производствавыявление ОЗН

Introduction. Oncology is an important and dynamically developing field in both practical healthcare and medical science. The significance of this pathology is due to its high prevalence and mortality, including among individuals of working age. In the "Concept of Demographic Policy of the Russian Federation until 2025," approved by Decree of the President of the Russian Federation No. 1351 dated October 9, 2007, oncological diseases are identified as one of the main causes of high mortality among the working-age population. Among the multifactorial causes, a special place is occupied by carcinogenic factors in the work environment, which regularly and long-term affect workers during their professional activities. At the same time, the concentration of carcinogenic agents significantly exceeds their concentration in the environment [1]. In 2022, 20 million new cases of malignant oncological diseases (MND) and 9.7 million deaths from them were registered worldwide. According to the World Health Organization (WHO), 2% to 8% of malignant cases may be caused by exposure to occupational factors. In the Russian Federation, these figures are significantly lower, and the proportion of MND mortality in the structure of occupational diseases has remained at the bottom for many years, ranging from 0.32% to 0.55% of all cases (20142019). In the Voronezh region, since 2014, ten thousand new cases of malignant neoplasms have been detected annually. However, a retrospective analysis of the protocols of Expertise on the connection of diseases with the profession at the Center for Occupational Pathology of the Voronezh Regional Clinical Hospital No. 1 did not reveal a single case of occupational cancer. Meanwhile, the International Agency for Research on Cancer (IARC) has assessed the carcinogenic hazard of 600 chemical substances. More than 90 carcinogenic occupational factors and more than 10 occupational processes are included in the sanitary regulations in the Russian Federation [2]. The above highlights the particular relevance of the problem in occupational oncology: the identification and prevention of occupational cancer. The aim of the work. is to determine the reasons for the lack of detection of occupational cancer in the Voronezh region and to develop proposals for changing the situation. Materials and methods of research. A search of literary sources was conducted to identify the reasons for the low detection of occupational oncological pathology in the Russian Federation. A retrospective analysis of suspected occupational cancer cases identified during periodic medical examinations of workers in hazardous industries was carried out based on the Final Reports of medical examinations in healthcare organizations in the Voronezh region. Materials related to the implementation of the program "Combating Oncological Diseases" were studied. Research results. In the Voronezh region, the incidence of malignant forms of oncology in the entire population was studied as part of the regional program "Combating Oncological Diseases" under the implementation of the National Project "Healthcare" from 2012 to 2021 (before the period of the COVID-19 pandemic). The results of the study of incidence per 100,000 population in dynamics showed an increase in the number of oncological cases from 382.45 in 2012 to 401.59 in 2021. The structure of malignant neoplasms revealed the highest number of cases of skin cancer (18.8%), breast cancer (12.5%), bronchopulmonary system cancer (9.5%), prostate cancer (8.1%), and colon cancer (5.8%) among all localizations. The most disadvantaged districts in the Voronezh region in terms of oncological incidence are the following: Ramonsky, Repyevsky, Nizhnedevitsky, Khokholsky, Paninsky, Vorobyovsky, and Anninsky [3]. Measures to identify occupational oncological diseases among workers in hazardous working conditions were carried out as part of mandatory preliminary and periodic medical examinations. The number of workplaces classified as hazardous or dangerous at enterprises in the Voronezh region in 20212023 averaged 203,222. The largest number of workers were exposed to harmful occupational factors in the following economic sectors: <ul> <li>extraction of natural construction materials (56%);</li> <li>construction (36%);</li> <li>manufacturing (33%);</li> <li>sectors involved in the use and management of natural resources (32%);</li> <li>extraction, production, and distribution of energy resources (32%);</li> <li>transportation, distribution, and storage (30%);</li> <li>water management infrastructure, and waste processing (26%).</li> </ul> During the sanitary and hygienic certification of workplaces from 2017 to 2021, it was established that 2,485 workers were exposed to carcinogenic factors of chemical, physical, and biological nature. Work on identifying occupational oncology as part of the regional program "Combating Oncological Diseases" was carried out by the occupational pathology service of the Voronezh region. In 20212023, 179,693 workers were examined during periodic medical examinations in state medical organizations. For the first time, 937 neoplasms of various localizations were detected. During this period, the level of detection of oncopathology was 4.1, 6.7, and 4.5 per 1,000 examined, respectively. Based on the examination results, workers with newly identified neoplasms were further examined with the participation of an oncologist. In case of identifying contraindications for continuing work in the same conditions, recommendations for employment were formed. These patients were referred to the Voronezh Regional Oncology Dispensary. They did not return to the Center for Occupational Pathology, as there is no established procedure for interaction between oncology and occupational pathology services. Conclusion. The conducted studies revealed the absence of diagnostics of occupational oncological diseases among workers exposed to carcinogenic substances at enterprises in the Voronezh region during mandatory preventive medical examinations. There is no established routing for workers with neoplasms detected during medical examinations or a procedure for interaction between occupational pathology and oncology services. To change the current situation, it is necessary to: <ul> <li>Create a regional register of enterprises with carcinogenic hazardous production facilities;</li> <li>Raise oncological awareness among all specialists involved in preliminary and periodic examinations through advanced training courses;</li> <li>Include an oncologist trained in occupational oncology in the commission conducting medical examinations;</li> <li>Develop and implement a system of interaction between specialists of the Regional Oncology Dispensary and occupational pathologists at the primary and specialized levels of the regional occupational pathology service.</li> </ul>

Профессиональная патология: национальное руководство / под ред. И. В. Бухтиярова, - 2-е изд., перераб. и доп. – Москва: ГЭОТАР-Медиа, 2024. – 904 с.: ил. – (Серия «Национальное руководство»). – DOI: 10.33029/9704-8177-6-PP2-2024-1-904

СанПин 1.2.2353-08 «Канцерогенные факторы и основные требования к профилактике канцерогенной опасности»

Региональная программа Воронежской области «Борьба с онкологическими заболеваниями», утвержденная Постановлением Правительства Воронежской области 27 июня 2019 года, Приложение №8 к государственной программе Воронежской области «Развитие здравоохранения»