A Review on Complications of Sleep Apnea

Sleep apnea occurs when the upper airway repeatedly becomes blocked during sleep, reducing or entirely blocking airflow. This is referred to as obstructive sleep apnea. If the brain fails to provide the necessary impulses for breathing, the disease is known as central sleep apnea. Sleep apnea and other sleep breathing problems are a leading cause of medical, social, and occupational disability. Sleep apnea is also linked to pulmonary hypertension, cardiac arrhythmia and other neurocognitive effects, majority of individuals with sleep apnea go undetected, putting them at danger during surgery. It is critical to identify these patients so that relevant steps can be implemented as soon as possible. In this review article, we will discuss about sleep apnea issues and their possible causes. Keywords: Sleep apnea, Bradycardia, Tachycardia, Breathing, Hypercapnia

Avoiding Psychiatric Disability Overdiagnosis (Part 2): Improving Diagnosis and Assessment of Mental Health Disorders and Psychiatric Work Disability

Given the increase in psychiatric occupational disability claims over the past 20 years, better patient psychiatric assessment and management is critical. To minimize iatrogenic psychiatric disability and maximize positive outcomes, it is important to understand the issues involved and establish better procedures for diagnosing conditions and assessing any associated impact on function. This second article in a three-part series focuses on ways to improve the diagnosis and assessment of mental health work disability.

THE ROLE OF MAGNESIUM DEFICIENCY IN THE PATHOGENESIS OF THE FORMATION OF ARTERIAL HYPERTENSION IN WORKERS OF LOCOMOTIVE CREWS. CORRECTION METHODS

Purpose of the study: To assess the effects of magnesium deficiency on the indices of lipid metabolism in patients with an arterial hypertension locomotive crews. Purpose of the work: To assess the effect of magnesium deficiency on the pathogenesis of the formation of arterial hypertension in workers of locomotive crews. Correction methods. Materials and methods: This work presents an analysis of the results of clinical observation, special biochemical and functional studies of 136 male patients with arterial hypertension, workers of locomotive crews. Results: In workers of locomotive crews patients with hypertension, increased individual cardiovascular risk according to the SCORE scale, remodeling of the cardiovascular system, as well as the risk of developing occupational disability are interrelated with signs of magnesium deficiency. Conclusion: The inclusion of a complex preparation of magnesium and vitamin B6 in the therapy of arterial hypertension in workers of locomotive crews has a significant effect on the clinical manifestations of chronic stress, magnesium deficiency, improves the dynamics of lipid metabolism, the structural and functional state of the cardiovascular system, and professionally important qualities.

Avoiding Psychiatric Disability Overdiagnosis, Part 1: General Disability and Occupational Disability—Going Beyond Medical Impairment Assessments

Claims of occupational psychiatric disability have increased considerably over the past 20 years. To avoid psychiatric disability overdiagnosis, it is important to improve the clinical assessment of mental health work disability. This article discusses general disability issues and their impact on individual well-being, social participation, and frequently associated poverty. It defines the difference between impairment assessment and disability assessment, explores three common disability models, and raises issues about psychiatric disability and its potential overdiagnosis.

Military Occupational Disability Risk Surveillance: A Retrospective Cohort Study of Modifiable Risk Factors

Introduction Occupational disability among military service members is an important target for preventive screening. The specific aim of this study was to quantify disability risk levels among soldiers with selected risk factors (body mass index extremes, poor or absent physical fitness scores, and tobacco and opioid use) and combinations thereof, suggesting priorities for preventive actions. Materials and Methods This was a retrospective cohort study of 607,006 active-duty soldiers who served in the U.S. Army during 2011–2014. Official medical and administrative data were combined to produce a person-month-based panel dataset with identifiers removed. The subjects were observed longitudinally for incident disability (termed medical nonreadiness) during 1,305,618 person-years at risk. We employed Weibull parametric survival regression models to determine the adjusted medical nonreadiness hazard for selected variables. We then computed individual adjusted risk scores and the population proportions affected by risk factors and combinations thereof in postregression analyses. The project was approved by the Stanford University’s Institutional Review Board and underwent secondary review by the Human Research Protections Office of the Defense Health Agency. Results During the observed time, 81,571 (13.4%) of subjects were found medically not ready. High or low body mass index, low or missing physical fitness test scores, tobacco use, and the highest levels of opioid use were each associated with increased adjusted hazards of medical nonreadiness. The hazards increased substantially when multiple risk factors were present, albeit while affecting reduced population proportions. Conclusions We identified marked disability hazard increases, especially in association with opioid use and high body mass index. These factors, in addition to tobacco use and low physical fitness, are potential early prevention targets for clinicians who screen military service members.

The practice in applying and ways to improve criteria for establishing the degree of occupational disability in the territory of the Russian Federation

Aim. To assess the practice in applying Temporary criteria of determination of extent of loss of professional working capacity currently in force in various constituent entities of the Russian Federation and to substantiate the main directions for their improvement. Methods. The analysis of expert decisions to establish the degree of occupational disability, adopted in the period from 2015 to 2017, was carried out in 77 subjects of the Russian Federation for two nosological forms: (1) consequences of lower limb injuries (T93) and (2) bilateral sensorineural hearing loss (H83.3). A comparative analysis of expert decisions made using current and proposed by the authors criteria in 2 constituent entities of the Russian Federation in 2018 was carried out. For data analysis, we used descriptive statistics methods. Results. Taking into account a high variability in expert decisions making in the constituent entities of the Russian Federation for similar cases (coefficient of variation 21.6%), the authors conclude that it is necessary to change approaches to the methodology for assessing the type of professional activity (qualifications, quality and volume of work, ability to perform it). Using the authors propose criteria based on the concept of reasonable accommodation allowed us to significantly reduce the variability of the decisions made in the pilot regions, the coefficient of variation decreased from 21.25 to 7.43%. Conclusion. High variability of decisions made during the examination of the degree of occupational disability is associated with the imperfection of the methods and criteria for assessing the victim's professional activities; the use of the criteria proposed by the authors allows for a higher reproducibility of the results of the examinations.

Assessment of professional ability to work in occupational diseases of the peripheral nervous system

According to Rosstat forecasts for the period up to 2026, in the next 15–20 years, the population will decrease due to a decrease in the number of people of working age due to a low birth rate, a high death rate of the working-age population, an increase in morbidity and disability. One of the most common diseases among employees is the peripheral nervous system, which is detected in 32.3–58.0% of the surveyed employees of industrial enterprises. They make up 55.7–66.0% of the total occupational morbidity.The purpose of the study is to assess the degree of professional disability in occupational diseases of the peripheral nervous system. The analysis of occupational diseases of the peripheral nervous system for the years 2015–2017, its structure on the materials of the Occupational Medicine Centre of the Republic and the results of their primary medical and social examination (MSE) according to the acts of examination the national Bureau of MSE to assess the occupational disability in occupational diseases of the peripheral nervous system.It was found that in 2015–2017, the average level of occupational morbidity due to diseases of the peripheral nervous system was 0.54 per 10 thousand working population of the Republic. The most frequent are sciatica of the lumbosacral level–0.29 o / o, which occupy more than half (53.4%) of the total occupational morbidity due to diseases of the peripheral nervous system. Occupational diseases of the peripheral nervous system were detected in the machine-building, metallurgical, mining, agricultural, oil-producing and construction sectors of the economy. Almost all (93.9 per cent) who applied to Bureau of MSE was installed, the percentage of occupational disability for a period of one year. The vast majority (73.2%) of those who applied to the MSE office found 30% loss of professional ability to work. In the year of establishment of an occupational disease, 65.0% of professional patients are referred to the Bureau of medical and social expertise (MSE). They continue to work at their previous workplace and are exposed to the same harmful and dangerous working conditions.Effective prevention of occupational diseases and labor losses from them requires building an integrated system that combines primary, secondary and tertiary measures (rehabilitation by individual program) of prevention with the development of clear measures of responsibility for all those interested in a healthy employee.