[Importance of occupational selection in prevalence of hypertension: effects of healthy and unhealthy worker].

The importance of occupational selection in prevalence of arterial hypertension in researches of professional cohorts is considered in the article. Because arterial hypertension represents not only the independent disease, but also one of the most important indexes of the functional status of a human body, prevalence of arterial hypertension in professional groups can be substantially caused by occupational selection. As an epidemiological phenomenon of occupational selection "healthy worker effect", known of scientific literature from the middle of last century is considered. Besides, it is offered to consider the regularities of professional selection opposite to "healthy worker effects", as "unhealthy worker effect". The professional conditionality of arterial hypertension considered from epidemiological line items can be distorted by occupational selection. Thus existence of "healthy worker effect" makes impression of absence of direct link between level of occupational influence and frequency of arterial hypertension. At the same time, the increase in prevalence of arterial hypertension not always testifies to its professional conditionality, and can be connected to "unhealthy worker effects". Possible solutions of problems associated with identification of relationships between occupational factors and prevalence of hypertension in the presence of "effects of the healthy" and "unhealthy worker" are discussed. The challenge of considered problem in occupational medicine despite the numerous offered methodological approaches of elimination or decrease in influence of occupational selection is noted.