Risk-based programme for the prevention of respiratory disease in workers at the titanium and magnesium plant

Working conditions of employees are characterized by concomitant exposure to chlorine and hydrochloride vapors, dust, industrial noise, total vibration, levels of microclimate indices higher than normal ones and the hardness of the labor. They are classified as hazardous: working conditions class 3.3 – 3.4. The combined exposure to PM₁₀ particles (most of the total suspended particles mass), irritants (sulfur dioxide, nitrogen oxide, hydrogen chloride, chlorine) results in the predominance of respiratory diseases in the morbidity pattern in employees (p < 0.05). A strong statistically significant causal relationship was established between the respiratory diseases and the working conditions (RR=2.9 95% CI=1.81-4.64; EF=65.49%). Higher prevalence of upper respiratory airway diseases (chronic rhinitis, nasopharyngitis) was observed (p < 0.05). The development of these diseases was found to depend on the length of employment, no statistically significant prevalence being observed in the control group. The assessment of the respiratory function showed no deviations from the physiological norm both in the study group and the control group, making it difficult to identify diseases of the lower respiratory airways during the routine medical examination. At the same time, diseases of the lower respiratory airways (simple chronic bronchitis; mucopurulent chronic bronchitis) were diagnosed in 25.6% of workers of the study group and 13.7% of workers of the control group (p < 0.05). The changes found during echocardiography, without any impairment of the respiratory function and clinical symptoms at the stage of the routine medical examination, indicate the lower respiratory airway diseases to be latent. For the workers there was proposed the program for the prevention of a risk-based respiratory disease, which involves the division of workers into 4 groups and the development of individual recommendations and program of the prevention for each group.