System Criteria for Differential Express Diagnostics of Prenosological Disorders of Occupational Health of Employees at Nuclear Power Facilities

Purpose: Development of complex criteria of differential express-diagnostics of pre-dosological disorders of occupational health of employees of nuclear facilities.

Material and methods: The study object was male workers of the main production facilities of the Electrohimpribor Combine undergoing periodic medical examinations and psychophysiological examinations. The state of health was assessed according to the employee’s belonging to the dispensary observation group in accordance with Order No. 404n of the Ministry of Health of the Russian Federation of April 27, 2021. The psychophysiological state was assessed using a hardware-software complex for group psychophysiological examination APK PFS-CONTROL. Additional testing techniques included assessment of vibraimage parameters, evaluated using computer programs HealthTest and VibraMI, developed in ELSIS (St. Petersburg). Totally 943 man-surveys were carried out with different combination of testing methods. The average age of the workers was (42.0 ± 1.7) years, total work experience was (23 ± 1.3) years, and work experience in the specialty was (13.0 ± 1.8) years.

Results: As a criteria of prenosological health disorders we used the characteristics of the worker’s adaptation to the factors of life activity. Adaptation disorders are evaluated according to three specific criteria: 1) assessment of the functional state of the cardiovascular system according to HRV data; 2) rapid assessment of the psychophysiological state according to vibraimage parameters; 3) assessment of personal and special abilities according to multiple intelligence assessment. For each of the criteria a “traffic light” of states and decisive rules of their formalized identification were developed. Characteristics of unfavorable states are given. Complex express-diagnostics of pre-dosological disorders of occupational health is carried out using integral index, which is a weighted sum of private “traffic light” indexes with a ball score. The formalized express-diagnostics of premalignant disorders is carried out using linear discriminant functions with an average recognition accuracy of 96.4 % or a probabilistic nomogram, which allows to graphically estimate the risk level of health disorders.

Conclusion: Improvement of medical-psychophysiological support of employees of nuclear facilities is connected with introduction of methods and criteria of differential express-diagnosis of prenosological disorders of health. The developed criteria of express-diagnostics of pre-dosological disorders of occupational health expand the existing methodological and criteria base of periodic medical examinations of nuclear industry workers, strengthen their preventive orientation with the purpose of timely application of medical, psychophysiological, organizational and other measures on preservation and maintenance of occupational health of personnel.