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.
By means of epidemiological, clinico-functional, experimental, pathomorphological, histological and mathematical-statistical methods the authors showed that hard physical work under conditions of heating microclimate promoted quick development and advance of coronary heart disease in deeply working coal miners. Negative dynamics of sudden coronary death (SCD) rate was established, its pathophysiological mechanisms were specified. SCD risk factors were singled out and arranged accordingly to their importance. SCD in miners was suggested to be considered as professionally conditioned state.
Prevalence of ischemic heart disease (IHD) and of general population risk factors was studied on the basis of results of the epidemiological survey among miners (n = 6500) working in coal mines of Donbass with different mining and geological conditions and mining and technical characteristics. In the above series, there prevailed exertional angina and an arrhythmia form of IHD in which the pain syndrome was absent or was of atypical character. Recordable in the miners was an age-associated increase in IHD prevalence. There was also a relatedness of this parameter to the length of service in underground conditions. Direct correlation between the underground service duration and IHD rates was ascertained in all age groups. In 56 percent of cases unexpected cardiac death occurred at job or on the worker's way home, which event was in 63 percent of cases related to hard strenuous work, performing labour-consuming operations at high temperature. Furthermore, in 80 percent of cases the above events were preceded by psychoemotional overstrain.