Nosov A E, Vlasova E M, Novoselov V G, Perevalov A Ya, Uhabov V M, Agafonov A V
Med Tr Prom Ekol. 2016(8):10-15.
Workers of titanium and magnesium production, under occupational exposure to complex of chemical (chlorine, hydrochloride, sulfur dioxide) and physical factors (industrial noise, work hardiness), have arterial hypertension as occupationally related disease, when length of service over 15 years (EF = 71,5%), and nasopharyngitis for length of service over 10 years (EF = 65%). Arterial hypertension risk is mostly associated with increased industrial noise level (F = 1621; R2 0.95; p < 0,001; noise 70,1 dB). Mathematic modelling of nasopharyngitis development probability demonstrated dependence of concentration of chlorine, hydrochloride, sulfur dioxide, chlorine and hydrochloride combination (F = 37-281; R2 = 0,37-0,73; p < 0.001; chlorine 0,63 mg/m3). Complex of parameters (leucocytosis, eosinophilia, increased IgA level), activated cellular immunity (increased CD 16+56+, CD3+CD25+) and absolute phagocytosis characterized nonspecific inflammatory reaction, immunity tension as a response to a complex of chemical factors of titanium and magnesium production. Markers of endoihelial dysfunction and cardiovascular risk (uric acid, VEGF, homocystein, LDLP) and stress marker (cortisol) demonstrate potential effect of occupational factors on vascular wall, metabolic processes and central nervous system, with involvement of <pituitary - hypothalamus - adrenals? axis. Changes of these parameters in workers with long length of service indicate risk of occupationally related disease on preclinical stage.
钛和镁生产工人在职业上暴露于化学物质（氯、盐酸、二氧化硫）和物理因素（工业噪声、工作强度）的综合环境中，当工作年限超过15年时，动脉高血压是与职业相关的疾病（暴露率=71.5%），工作年限超过10年时会患鼻咽炎（暴露率=65%）。动脉高血压风险主要与工业噪声水平升高有关（F=1621；R2=0.95；p<0.001；噪声70.1分贝）。鼻咽炎发病概率的数学模型表明，氯、盐酸、二氧化硫、氯和盐酸组合的浓度存在依赖性（F=37-281；R2=0.37-0.73；p<0.001；氯0.63毫克/立方米）。一系列参数（白细胞增多、嗜酸性粒细胞增多、IgA水平升高）、激活的细胞免疫（CD 16+56+、CD3+CD25+升高）和绝对吞噬作用表征了非特异性炎症反应、免疫应激，这是对钛和镁生产中化学因素综合作用的反应。内皮功能障碍和心血管风险标志物（尿酸、血管内皮生长因子、同型半胱氨酸、低密度脂蛋白）以及应激标志物（皮质醇）表明职业因素对血管壁、代谢过程和中枢神经系统有潜在影响，涉及垂体-下丘脑-肾上腺轴。工作年限长的工人这些参数的变化表明在临床前期存在与职业相关疾病的风险。
