An expert evaluation of identifiability of cardiovascular diseases was carried out together with a clinical and functional examination of certain groups of miners of basic underground occupations at different ages and lengths of service, that showed a high incidence of cardiovascular diseases along with a low informative value of methodical approaches, indices and criteria used for their diagnosis in conducting preliminary and periodic health check-ups. To improve the quality of diagnosis of diseases of the circulatory system it is necessary that standardized methods of investigation should be employed together with consistent indices of high informative value as well as a purposive training of physicians.
Clinical and functional examination of the miners who suffered from coronary heart disease showed a higher ectopic activity of the myocardium during their work under underground conditions and during the subsequent 4 hours after its termination. It also indicated a significantly higher fatal cases of sudden coronary death in the miners in the aforementioned periods. To prevent the development of complications occurred in miners, the status of the cardiovascular system was proposed to be dynamically controlled.
Occurrence of coronary heart disease among workers of Donbass coal mines more than 2 times exceeds the values for matched general population (groups of males aged 20-49). Peculiarities of working environment and industrial process were proved to be risk factors for coronary heart disease among the miners.
The authors studied autopsy protocols, microscopic and histochemical data on the heart for miners who had died suddenly. No positive trend in the sudden coronary death incidence in miners was reported. A great number of sudden deaths were registered in mines. The deaths are attributed to severe atherosclerosis responsible for irreversible changes in the myocardium, coronary vascular spasms, emergence of pathological agitation triggering lethal ischemia.
As a result of epidemiological and clinico-functional studies occupational peculiarities of ischemic heart disease (IHD) among miners were detected. The role of a number of industrial factors in the development of arrhythmia with unfavourable prognosis was assessed. Persons at risk for development and progress of IHD were identified. A method of dynamic control over their cardiovascular system was suggested. The findings of the study formed the basis for a complex follow-up programme for miners with IHD.
In the process of carrying out medikal checkups of miners a shop physician must take an active part in forming groups at risk of ischemic heart disease (IHD) and in ensuring dynamic preshift and postshift monitoring of the state of miners' cardiovascular system through the use of comprehensive methodological complex and further health promotion of this occupational group. Those attributed to the groups of extreme risk must discontinue their work in a mine. It was necessary to find some appropriate employment for them in order to avoid their contact with colliery occupational conditions. Early conditions of IHD by means of the suggested complex and timely appropriate employment promoted better diagnosis of atypical early forms of IHD and prevention of its complications.