In recent years, the importance of the biological factor of production and the environment has undoubtedly increased due to the intensive growth of cities and urban-type settlements. Biological pollution includes pathogenic bacteria and viruses, opportunistic microorganisms of anthropogenic and zoogenic origin, producing microorganisms, biotechnological products (antibiotics, antibiotic-containing drugs, vitamins, enzymes, fodder yeast, etc.) and biological plant protection products.
As is known, a biological factor is understood as a set of biological objects, the impact of which on a person or the environment is associated with their ability to reproduce in natural or artificial conditions or to produce biologically active substances. The main components of the biological factor that have an adverse effect on humans are a wide variety of microorganisms and their metabolic products, as well as some organic substances of natural origin.
The ever-increasing role of the microbiological industry associated with the production of amino acids, vaccines, immunogenic preparations, food additives, protein and vitamin concentrates is accompanied by an increase in the level of anthropogenic biological pollution of environmental objects. The use of yeast, mold fungi, actinomycetes, bacteria in industrial production has led to the emergence of a qualitatively new type of biological pollution - producer microorganisms and their metabolic products, which also pollute the air of industrial premises and the environment.
Based on the foregoing, it is extremely important not only to identify the sources and ways of spreading biological contaminants, but also to clarify the role of each of the individual biological factors in the occurrence of human pathology in order to develop measures to limit their harmful effects on the health of workers and the population living in the immediate vicinity. from enterprises of the agro- and bioindustry (Figure No. 25).
Drawing No. 25 |
Principles of hygienic regulation of biological factors. A scientifically based quality control system for environmental objects in relation to bacterial and viral contamination, based on hygiene requirements formulated in sanitary legislation and aimed at ensuring epidemic safety, is the basis for non-specific prevention of infectious diseases. In this regard, the issues of development and scientific substantiation of hygienic regulation of microbial pollution of the environment have been and remain relevant, both in the present and in the future.
Water of various types of water use, soil and indoor air can be factors in the spread and transmission of a number of infectious diseases of a bacterial and viral nature (mainly intestinal and respiratory). Data on the epidemiology of intestinal infections (cholera, typhoid, paratyphoid, dysentery, etc.) show a significant role of the water factor in their spread. The greatest epidemic danger is represented by violations in the centralized water supply system, which cause up to 80% of outbreaks of infections of water origin. The water factor, along with food chain, also contribute to the spread of Salmonella toxicoinfection.
The soil can also have a harmful effect on human health when pathogenic enterobacteria and intestinal viruses enter it with wastewater, when there is direct contact between a person and the soil during field work, and through contaminated vegetables, shoes, etc. Work in greenhouses and greenhouses, regardless of the season, can lead to certain infectious diseases if sanitary and hygienic working conditions are not observed.
Household, hospital and some types of industrial wastewater are the main sources of microbial pollution of water bodies. The greatest epidemic danger is represented by insufficiently purified and disinfected wastewater from infectious diseases hospitals, as well as children's medical institutions in which there are patients with chronic intestinal diseases. In this case, one should take into account the species and strain characteristics of pathogenic microorganisms entering the water. An increased viability of synthomycin-resistant strains of Sonne and Flexner bacteria was found compared to synthomycin-sensitive strains.
In order to assess the sanitary significance of various and indicator microorganisms and determine their normative levels, quantitative dependencies and correlations between their content in water and water pollution by pathogens of intestinal infections have been established. Thus, a high degree of direct correlation was obtained between the content of Salmonella and bacteria of the Escherichia coli group, Salmonella and lactose-positive Escherichia coli, Salmonella and E. coli, Salmonella and Escherichia coli phages, as well as intestinal viruses and phages in water.
The level of microbial contamination for various indicator microorganisms, at which pathogenic bacteria and intestinal viruses are not isolated from the water of reservoirs under the conditions of their industrial and domestic pollution and during the disinfection of discharged wastewater, is adopted as a normative one: LCP, E. coli no more than 1000 per 1 liter, enterococci no more than 100 in 1 l, phages of Escherichia coli no more than 1000 cells/l.
V state standards For drinking water, in order to increase its epidemic safety, requirements have been introduced that provide for the purification and disinfection of water to an extent that guarantees the maximum removal of intestinal viruses from it. So, according to GOST 2874-82 "Drinking water", the concentration of residual free chlorine in water, when it is disinfected, must be at least 0.3 mg / l with contact for at least 30 minutes or combined chlorine - at least 0.8 mg / l on contact 1 hour. The content of residual ozone after the displacement chamber should be 0.1-0.3 mg/l upon contact for at least 12 minutes. A significant overall effect of water purification from saprophytic microorganisms, bacteria of the Escherichia coli group, as well as phages is achieved at semi-production installations by coagulation, settling and filtration.
In the spread of respiratory infections of a bacterial and viral nature, atmospheric air under normal conditions is not essential. The main factor in the spread of aerogenic infections is the air of enclosed spaces, primarily hospitals. As a rule, outbreaks of nosocomial infections in maternity hospitals, children's and surgical departments are most often caused by epidemic strains of St.pyogenes. The possibility of air pollution of residential and medical premises by such pathogens of bacterial and viral infections as hemolytic streptococci, meningococci, influenza viruses, smallpox, etc.
The contamination by microorganisms of the air environment of hospital premises largely depends on the amount of air exchange, observance of the deregime, the nature of cleaning, and so on.
Hygienic standards for indoor microbial air pollution are established only for operating units of surgical departments and maternity hospitals. The total bacterial contamination of the air of operating units before the operation should not exceed 500 cells/m and 1000 cells/m - by the end of the operation. The presence of Staphylococcus aureus is not allowed.
The existing MPCs for producing microorganisms, as a rule, are maximum, and most of them have pronounced sensitizing and allergenic properties. Being present in the air of the working area in the form of aerosols, the values of the hygienic standards of microorganisms-producers are expressed in microbial cells per cubic meter (c/m). The maximum allowable MAC for producing microorganisms in the air of the working area is limited to 50,000 cells/m.
Most of the microorganisms-producers and products of their vital activity can have an adverse effect both on people engaged in production and on the population living in the zone of influence of these industries. However, to date, for most products of microbiological synthesis, temporary (OBUV) and permanent (MPC, MPD) hygienic standards have not been developed, there is no scientific justification for sanitary protection zones, there are no hygienic regulations for microbiological industry preparations in the atmospheric air for microorganisms -producers, and for such an important environmental object as soil, there are no hygienic standards at all.
It should be noted that biological factors have not only a toxic and allergenic effect on the body, but also a specific effect. Based on this, the biological factor, as one of the harmful and dangerous factors of the working environment, is included in the corresponding hygienic classification of labor. Therefore, an important measure of the health authorities is the organization of a clear and prompt control over the contamination of the production and environment with microorganisms and biologically active substances. Methods for controlling the biological factor in the air are regulated by many regulatory documents and guidelines.
In accordance with the guidelines for the hygienic regulation of microbial preparations in the production environment, as well as when studying working conditions, the health status of workers in the production of microbiological preparations, the following points should be taken into account: 1) more carefully approach the assessment of the technological process and the duration of exposure to dust; 2) assess the state of aggregation of the biological product, its activity and duration of storage; 3) methodologically correctly determine the number of microbial bodies in one gram of a biological product, as well as give a toxicological and hygienic characteristic of the filler used; 4) to derive a detailed sanitary and hygienic characteristic of dust content, including microbial bodies in the workplace, taking into account the characteristics of technologies and the time of year.
The following regulatory documents define comprehensive sanitary and hygienic requirements for the improvement of working conditions at enterprises associated with the impact of a biological factor: SanPiN
"Sanitary and epidemiological requirements for the maintenance and operation
production facilities vegetable oils» No. 277 dated May 15, 2008; SanPiN "Sanitary and epidemiological requirements for the maintenance and operation
granaries (elevators and grain receiving points)" No. 293 dated July 10, 2006; SanPiN "Sanitary and epidemiological requirements for working conditions with microorganisms of I-IV pathogenicity groups" No. 325 dated 05.07.2005; SanPiN "Sanitary and epidemiological requirements for the maintenance of facilities for the production of milk and dairy products, their storage and transportation" No. 201 dated April 28, 2005; SanPiN "Sanitary and epidemiological requirements for the maintenance and operation of livestock and fur farms" No. 143 dated March 24, 2005; SanPiN "Sanitary and epidemiological requirements for
maintenance and operation of facilities for the production of meat and meat products, their storage and transportation” No. 60 dated February 17, 2005; SanPiN "Sanitary-epidemiological and veterinary-sanitary requirements for the maintenance and operation of facilities intended for the procurement of milk" approved by orders No. 105/214 acting. Ministry of Health of the Republic of Kazakhstan dated March 09, 2005 and Ministry of Agriculture of the Republic of Kazakhstan dated March 18, 2005.
Preventive actions. Prevention of the adverse effects of biological factors consists of the fight against animal diseases, compliance with sanitary and hygienic standards and the fight against pollution of agricultural enterprises, sanitary and hygienic monitoring of working conditions for working contingents.
In this regard, it is of particular importance to improve technological processes. Improving the efficiency of cleaning systems industrial emissions, strict adherence to sealing regimes for sources of air pollution in the working area, ensuring effective work industrial ventilation, the introduction of waste-free technology play an important role in preventing pollution of industrial facilities, atmospheric air, water and soil by a biological factor.
What allowed man to stand out from the animal world? The main factors of anthropogenesis can be divided as follows:
· biological factors- upright posture, development of the hand, a large and developed brain, the ability to articulate speech;
· main social factors - work and collective activity, thinking, language and communication, morality.
Work of the factors listed above played a leading role in the process of becoming a person; his example shows the relationship of other biological and social factors. So, upright posture freed hands for the use and manufacture of tools, and the structure of the hand (distant thumb, flexibility) allowed the effective use of these tools. In the process of joint work, close relations developed between the members of the team, which led to the establishment of group interaction, care for members of the tribe (morality), and the need for communication (the appearance of speech). Language contributed development of thinking, expressing more and more complex concepts; the development of thinking, in turn, enriched the language with new words. The language also allowed the transfer of experience from generation to generation, preserving and increasing the knowledge of mankind.
Thus, modern man is a product of the interaction of biological and social factors.
Under it biological features they understand what brings a person closer to an animal (with the exception of the factors of anthropogenesis, which were the basis for separating a person from the kingdom of nature), - hereditary traits; the presence of instincts (self-preservation, sexual, etc.); emotions; biological needs (breathe, eat, sleep, etc.); physiological features similar to other mammals (the presence of the same internal organs, hormones, constant body temperature); the ability to use natural objects; adaptation to the environment, procreation.
Social features characteristic exclusively for man - the ability to produce tools; articulate speech; language; social needs(communication, affection, friendship, love); spiritual needs (morality, religion, art); awareness of their needs; activity (labour, art, etc.) as the ability to transform the world; consciousness; the ability to think; creation; creation; goal setting.
A person cannot be reduced solely to social qualities, since biological prerequisites are necessary for his development. But it cannot be reduced to biological features either, since one can become a person only in society. Biological and social are inseparably merged in a person, which makes him special. biosocial being.
Ideas about the unity of the biological and social in the development of man did not form immediately.
Without delving into distant antiquity, we recall that in the Enlightenment, many thinkers, differentiating the natural and the social, considered the latter as "artificially" created by man, including here almost all the attributes of social life - spiritual needs, social institutions, morality, traditions and customs. It was during this period that concepts such as "natural law", "natural equality", "natural morality".
The natural, or natural, was considered as the foundation, the basis for the correctness of the social order. There is no need to emphasize that the social played a kind of secondary role and was directly dependent on natural environment. In the second half of the XIX century. various theories of social Darwinism, the essence of which lies in attempts to extend to public life principles of natural selection and the struggle for existence in wildlife, formulated by the English naturalist Charles Darwin. The emergence of society, its development were considered only within the framework of evolutionary changes that occur independently of the will of people. Naturally, everything that happens in society, including social inequality, the strict laws of social struggle, were considered by them as necessary, useful both for society as a whole and for its individual individuals.
In the XX century. attempts at a biologizing "explanation" of the essence of man and his social qualities do not stop. As an example, one can cite the phenomenology of a person by the famous French thinker and naturalist, by the way, the clergyman P. Teilhard de Chardin (1881-1955). According to Teilhard, man embodies and concentrates in himself all the development of the world. Nature, in the course of its historical development, acquires its meaning in man. In it, it reaches, as it were, its highest biological development, and at the same time it also acts as a kind of beginning of its conscious, and, consequently, social development.
At present, the opinion about the biosocial nature of man has been established in science. At the same time, the social is not only not belittled, but its decisive role in the selection of Homo sapiens from the animal world and its transformation into a social being is noted. Now hardly anyone dares to deny biological prerequisites for the emergence of man. Without even referring to scientific evidence, and guided by the simplest observations and generalizations, it is not difficult to detect a person's enormous dependence on natural changes - magnetic storms in the atmosphere, solar activity, earthly elements and disasters.
In the formation, existence of man, and this has already been said before, a huge role belongs to social factors, such as labor, relationships between people, their political and social institutions. None of them by itself, taken separately, could lead to the emergence of man, his separation from the animal world.
Each person is unique and this is also predetermined by his nature, in particular, by the unique set of genes inherited from his parents. It must also be said that the physical differences that exist between people are primarily predetermined by biological differences. First of all, these are the differences between the two sexes - men and women, which can be attributed to the number of the most significant differences between people. There are other physical differences - skin color, eyes, body structure, which are mainly due to geographical and climatic factors. It is these factors, as well as the unequal conditions of historical development and the system of education, that largely explain the differences in everyday life, psychology, and the social status of the peoples of different countries. And yet, despite these rather fundamental differences in their biology, physiology and mental potencies, the people of our planet are generally equal. The achievements of modern science convincingly show that there is no reason to assert the superiority of any race over another.
The social in man- this is, first of all, tool-production activity, collectivist forms of life with a division of duties between individuals, language, thinking, social and political activity. It is known that Homo sapiens as a person and personality cannot exist outside of human communities. Cases are described when small children due to different reasons came under the care of animals, "brought up" by them, and when they returned to people after several years in the animal world, it took them years to adapt to the new social environment. Finally, the social life of a person cannot be imagined without his social and political activity. Strictly speaking, as noted earlier, a person's life itself is social, since he constantly interacts with people - at home, at work, during leisure. How does the biological and social correlate in determining the essence and nature of man? Modern science unequivocally answers this - only in unity. Indeed, without biological prerequisites, it would be difficult to imagine the appearance of hominids, but without social conditions, the formation of man was impossible. It is no longer a secret to anyone that pollution of the environment, the human habitat poses a threat to the biological existence of Homo sapiens. Summing up, we can say that now, like many millions of years ago, the physical condition of a person, his existence to a decisive extent depend on the state of nature. In general, it can be argued that now, as with the appearance of Homo sapiens, its existence is ensured by the unity of the biological and social.
The problem of anthroposociogenesis. The rapid development of modern science, the emergence of new branches and methods of research, facts and hypotheses lead to a certain fragmentation of the problem, but this, in turn, exacerbates the need for their generalization and integration at the philosophical level. According to a number of experts, one of the aspects of this integrity is the dialectical connection the main interacting components of the process of anthroposociogenesis: ecological(external), anthropological(anatomical and morphological) and social. The connecting link of the first two components is mainly the restructuring of the life of higher anthropoids, and the anthropological and social factors are the emerging work, consciousness and speech.
The most important feature of anthroposociogenesis is its complex nature.. Therefore, it would be fundamentally wrong to assert that first "labor arose", "then" - society, and "even later" - language, thinking and consciousness.
Various schools, recognizing the role of labor, assign it different place in the process of becoming a person, but even if we recognize work as a central anthropogenetic factor, it only means that in connection with it, articulate speech, and community life, and the beginnings of rational thinking are formed. But labor itself has a genesis, turning into a full-fledged subject-practical activity only in interaction with such factors of socialization as language, consciousness, morality, mythology, ritual practice, etc. So, for example, there is evidence that the production of the simplest tools began 1–1.5 million years earlier than speech and thinking appeared. For a long time it developed in "animal form", i.e. inside a herd of hominids, not yet similar to the human community. However, it would probably be unjustified to attribute a direct socio-creative function to such production. It only created an objective need in society, which could not be realized without the help of language, the simplest cultural and moral norms, and developing categorical thinking.
Soviet psychologist A.S. Vygotsky showed that language, understood in the narrow sense as a specialized information-sign activity (speech), on the one hand, has a pronounced objective character, on the other hand, it itself ensures the successful development of the subject-practical activity of people. Language does not just passively fix objects and meanings that have appeared independently of it, but participates in the creation of an objective environment and the social unity of people. In primitive societies, one of the simplest speech acts - naming - was a sacred, ritual act that brought the participants together, thereby contributing to the creation of sociality. In addition, with the help of naming, the external environment was for the first time divided into groups of practically significant objects, such important practical categories as housing, clothing, utensils, etc. were singled out. And this means that object-practical activity in the full sense of the word could not have been formed before the appearance of language.
A huge role in the process of anthroposociogenesis was also played by the radical change in the marriage system. There are striking differences in reproduction between the animal herd and the simplest form human community - a primitive tribal community. The herd is based on endogamy, which severely limits the ability of its members to choose mating partners among members of other herds. As a result, offspring are reproduced due to closely related sexual relations. The community is based on the principles of agamy (the exclusion of closely related marital contacts) and exogamy. The reasons for the transition to exogamy are not yet clear. One of the hypotheses put forward by genetic anthropologists points to the possibility of powerful mutations, most likely caused by increased radiation exposure, since a herd with a fairly limited gene pool is most sensitive to mutagenic factors (mutations in herd animals usually lead to the most detrimental consequences). There is also reason to believe that the next exogamy was motivated by the need for an intra-herd world. In order to put an end to the murderous, gun-armed sexual competition of males, it was necessary to make the “harem of females” a draw, i.e. impose a ban on all sexual intercourse within their group (this was reinforced by totem cults). As a result, marriage ties ceased to be a means of reproducing the herd community and were subject to a certain socio-cultural order, although presented irrationally.
Taboo on closely related relationships- one of the first moral and social prohibitions that arose in antiquity and has retained its significance to this day. Moral and social prohibitions differ significantly from herd instincts of any degree of complexity: they concern all members of the tribal community, while in the herd prohibitions exist only for the weakest individuals; they are irreducible to the instinct of self-preservation, dictating actions to a person, sometimes individually harmful; the violation of the prohibition is followed by inevitable punishment (the community turns away from the criminal, expels him from the tribe, etc.). Already in the most ancient communities, such moral and social requirements as a ban on incest, on the murder of a tribesman, the requirement to maintain the life of any of the tribesmen, regardless of his fitness for life, are known. These requirements differ significantly from developed morality, but they still retain their significance, forming the foundation on which all the diversity of moral values and norms is created.
The development of the moral consciousness of mankind is at the same time continuity in relation to the simplest moral requirements, and overcoming their limited meaning. In this way, in the course of anthroposociogenesis, an irreversible transition to human moral existence took place.
The social and moral unity of the community and industrial and economic cooperation have opened up the possibility of meaningful work with strict collective discipline and devotion to the community. In the process of labor activity, the will and constructive abilities of people, their intellect and imagination were already formed, the variety of attitudes to the environment and to each other grew. Evidence of this is the so-called "neolithic revolution"- the transition from gathering and hunting to production life support (agriculture, cattle breeding, handicraft). Over the course of several millennia, people mastered fire, tamed animals, invented the wheel, switched from a nomadic to a sedentary lifestyle. Large tribal unions were formed, extensive migrations began, and so on. The "Neolithic Revolution" for the first time revealed an accelerating industrial and technological progress, which never stopped after that.
a person is initially active and his properties are closely related to the development of objective activity;
· A person separated from society (other people, from human tools, knowledge and skills) is absolutely helpless. Only as a member of society is man protected from the elemental forces of nature;
A person is distinguished by the supra-biological, supra-instinctive, conscious-volitional nature of life activity.
We know that a person has two programs - instinctive and socio-cultural. According to its bodily organization and physiological functions, man belongs to the animal world. The existence of animals is determined by instincts and they are not able to go beyond their instincts. Man has lost his original homeland - nature. sociality, cultural standards dictate to him other patterns of behavior. The development of culture has allowed man to overcome the voice of instincts and develop a unique system of reference points that are extra-natural in nature. That is why, as many Soviet philosophers believe, the instincts in a person are weakened. They are superseded by purely human needs and motives, "cultivated". But the latest research shows that the weak expression of instincts is not caused by the development of sociality (in any case, the human ancestor had "muffled" undeveloped instincts, this manifested his inferiority as a biological being). V.M. Vilchek proposed an original version of anthropogenesis, the essence of which is that man, as a biological being, was doomed to extinction, since his instincts were poorly developed even before the emergence of social history.
However, nature is able to offer every living species many chances, for a person this chance has become the ability to unconsciously imitate animals. Turning first into one, then into another creature, as a result, a person not only resisted, but gradually developed a system of guidelines that were built on top of instincts, supplementing them in their own way. The defect gradually turned into a virtue, in original remedy adaptations to the environment.
The uniqueness of man, according to many authors, in particular P.S. Gurevich lies not at all in the fact that he is the most perfect biological creation (we have just talked about the opposite), but in the problem of the correlation between the rational and emotional spheres of the human psyche.
In the history of philosophy, as we have seen, man is considered not only by analogy with an animal, but also by likening him to a machine. Essentially, the point is to find out how the intellectual and corporal correlate in a person. In modern philosophical and sociological literature, there is an attempt to connect the data of paleoanthropology with the latest information science. Thus, in an article by the Japanese scientist I. Masuda, it is noted that a person moved away from an animal only when he gained intelligence. In his opinion, the development of the frontal lobe, the complex speech organ and the extraordinary use of fingers are the anthropological features that characterize modern man. These qualities suggest an analogy with a computer. The original properties of the human mind, as the author believes, have created a well-known "fusion" of genetic evolution and cultural history. Human genes influence the formation of the mind. That, in turn, allows you to think about human nature and modify it. This is where the intellect comes into play. But the question arises: is man only an intelligent machine? Where, then, to attribute his ability to suffer, to show nobility, dignity, etc.? By singling out the gift of consciousness not only as the dominant, but also all-exhausting, we, in essence, erase other, purely human properties (this was also disputed by St. Augustine). In the existential-phenomenological tradition, the mind is not considered as the only sign of a person, an expression of his originality and indispensability.
The sphere of the specifically human here is the boundless space of subjectivity. A person overcomes his nature through the most unexpected inclinations inherent in him (for example, the ability to fantasize). “Undoubtedly, the power of imagination is one of the main abilities of the human soul,” notes the phenomenologist E. Fikkona, which manifests itself in a night dream, in a semi-conscious day dream, in the represented drives of our instinctive life, in the ingenuity of conversation, in the numerous expectations that accompany and overtake, laying him path, the process of our perception. Considering the main existential phenomena, E. Fikkona comes to the conclusion that a person does not have a firmly fixed essence, i.e. it is difficult to single out such a human quality, which, being some kind of deposit, expresses the full extent of its originality. Hence the riddle arises; maybe the uniqueness of a person is not related to human nature itself at all, but appears in non-standard forms of his being, obviously, the essence of the issue is not that a person has undeveloped instincts, flawed physicality or intellect, but in a special interweaving of these qualities. A huge space of symbols and meanings has arisen between man and reality, which we call culture, because it is the sphere where the creative potential of a person is revealed. "Culture is specific human activity, - writes A. de Benois, - what characterizes a person as a species. The search for man before culture is in vain; his appearance on the arena of history should in itself be regarded as a phenomenon of culture. It is deeply connected with the essence of man, is part of the definition of man as such. Thus, the search for the uniqueness of a person in the sphere of his being can be more productive than the desire to find the dominant feature of his nature.
biological factors.
Biological factors are those associated with the impact of living objects. Based on the principle of expediency that prevails in nature, all living beings perform a certain role assigned to them. In relation to humans, some of them are dangerous.
Biological factors include the impact on humans of microorganisms, fungi, plants, animals.
Microorganisms are the smallest, mostly single-celled creatures. Sometimes they are simply called microbes. Οʜᴎ are characterized by a huge variety of species that can exist in different conditions. As the name implies, microorganisms are very small objects, in this regard, microbiologists use small units of measurement, such as a micrometer (10 -6 m), a nanometer (10 -9 m), an angstrom (10 -12 m). The science that studies microorganisms, their systematics, morphology, genetics, role in the cycle of substances in nature, pathogenic action leading to diseases of humans, animals and plants, is commonly called microbiology.
Microorganisms play a useful role in the cycle of substances in nature, are used in the food and microbiological industries. However, some types of microorganisms are pathogenic or pathogenic. Οʜᴎ cause diseases of plants, animals and humans. Diseases such as leprosy, plague, typhus, cholera, malaria, tuberculosis and many others are caused by microorganisms. In the absence of means of combating diseases caused by the action of microorganisms, especially those unknown to science, human infectious diseases sometimes become widespread, ĸᴏᴛᴏᴩᴏᴇ is usually called an epidemic or pandemic. The wide spread of contagious diseases of animals is commonly called epizootic, and of plants - epiphytoty.
Among pathogenic microorganisms, bacteria, viruses, rickettsiae, spirochetes, and protozoa are distinguished.
The protozoa are made up of one cell. Most of all, they live in water bodies. Despite their name, protozoa are even more complex; than a single cell. The usual dimensions of the simplest are 1/20 - 1/7 mm. They can be seen without a microscope (the human eye distinguishes objects up to 0.1 mm in size). They reproduce by division every 3 hours.
Representatives of microorganisms are also bacteria. Bacteria that have the shape of regular balls are called cocci. Groups of cocci are called staphylococci or streptococci. Cocci are the causative agents of various infectious diseases. A lot of bacteria are rod-shaped, for example, Escherichia coli living in our body is the causative agent of typhoid and dysentery.
Bacteria are ubiquitous and hardy. They are found in the water of geysers with a temperature of about 100 C, in the permafrost of the Arctic, where they have been preserved for 2 million years, in outer space, etc. Bacteria reproduce by the simplest division in two, in favorable conditions- every 20 minutes.
Some bacteria feed on ammonia, methane. They are trying to use them to "eat" methane in mines.
Bacterial diseases are plague, tuberculosis, cholera, tetanus, leprosy, dysentery, meningitis and others.
Bacteria and living cells of the body always contain two types of nucleic acids simultaneously: ribonucleic (RNA) and deoxyribonucleic (DNA) acids. Viruses contain only one type of nucleic acid, either RNA or DNA.
Viruses are capable of "imposing" their genetic information on the hereditary apparatus of the cell affected by them. Viruses infect a cell and force it to help them reproduce, which usually ends in cell death. Viral diseases are smallpox, rabies, influenza, encephalitis, measles, mumps, rubella, hepatitis and others.
Ancient manuscripts conveyed descriptions of terrible smallpox epidemics, in which up to 40% of patients died. It wasn't until 1980 that WHO announced that smallpox had been eradicated. Children born after 1980 are not vaccinated.
Rabies or rabies is a fatal disease of humans and animals, most often rabies occurs in dogs. Wolves, cats, rats, crows and other animals also suffer from rabies. Vaccinations are the only reliable modern facility against rabies. A sick person cannot be cured of rabies. The latent (incubation) period of the disease lasts from 8 days to a year. For this reason, with any bite of an animal, it is necessary to consult a doctor.
In 1981, in San Francisco (USA), people were found sick with unusual forms of pneumonia and tumors. The illness ended in death. As it turned out, these patients had a sharply weakened immunity of the body. These people began to die from microbes that, under normal conditions, cause only a slight malaise. The disease was called AIDS - Acquired Immune Deficiency Syndrome. The AIDS viruses were simultaneously discovered in 1983 by biologists in France and the United States. It has been established that the AIDS virus is transmitted by blood transfusion, non-sterile syringes, sexual contact, and also by breastfeeding. The first six months - a year, and sometimes for several years after infection, a person does not notice any signs of the disease, but he is a source of the virus (carrier) and can infect others. So far, no cure for AIDS has been found. AIDS has been called "the plague of the 20th century".
An influenza epidemic was described by Hippocrates as early as 412 BC. In the twentieth century, 3 influenza pandemics were noted. In January 1918, there were reports of an influenza epidemic in Spain, called the "Spanish flu". "Spanish flu" went around the world, infecting about 1.5 billion people, passed only a few islands lost in the ocean and claimed 20 million lives - more than the first world war. In 1957, about 1 billion people fell ill with the "Asian flu", more than 1 million people died. In 1968-1969 ᴦ. the "Hong Kong flu" raged on planet Earth. The number of influenza epidemics, oddly enough, is increasing every century. In the 15th century there were 4 epidemics, in the 17th century - 7, in the 19th century - already 45! Why are there still no reliable flu shots? It turns out that the flu virus changes very quickly. Before the doctors had time to make a vaccine against one form of influenza, the causative agent of the disease appeared in a new guise.
Rickettsia (on behalf of the American scientist Ricketts) are small pathogenic bacteria that multiply in the host cells (as well as viruses), excite typhus, Q fever in humans and animals. Man is infected by animals.
Spirochetes are microorganisms whose cells are in the form of thin winding filaments. They live in soil, stagnant and waste water. Pathogenic spirochetes - causative agents of syphilis, relapsing fever, leptospirosis and other diseases.
Actinomycetes are microorganisms with organizational features of bacteria and protozoan fungi. Distributed in soil, water, air. Some species are pathogenic, causing diseases such as tuberculosis, diphtheria and others. Some actinomycetes form antibiotics, vitamins, pigments, etc. Used in the microbiological industry.
Viability and death of bacteria are determined by environmental conditions:
microorganisms normally live at a temperature of 0-90 ° C, for some species this limit is much wider: from - 270 to + 400 ° C;
direct rays of the sun are fatal for most bacteria;
microorganisms are viable under conditions of very low (only 5 mm Hg) and very high (more than 5 atmospheres) pressures;
the viability of microorganisms is affected by the reaction of the pH medium - the most favorable is a neutral (pH = 7) or alkaline (pH > 7) medium.
Substrates (carriers) of biological hazards are any elements of the environment: air, water, soil, plants, animals, people, equipment, tools, raw materials, processed materials, etc. Bacteria live in water, incl. and in hot springs, in ice, in the air at various heights from the ground. Especially a lot of bacteria in soils. One gram of arable soil contains from 1 to 20 billion microbes. Microbes accompany a person all his life.
Life is impossible without microbes. But pathogenic microbes are dangerous for humans, in connection with this, a person is persistently looking for ways to protect against them. The Italian priest Lazar Spallanzani proved that when liquids are boiled for a long time, the microbes in them die. German scientist Theodor Schwann found that heat kills germs in the air. The English physicist John Tyndall found that microbes in liquids die after several repeated boilings. Repeated short-term heating of a liquid to the boiling point, proposed by Tyndall, is called tyndalization. All methods of destruction of microbes under the influence of high temperature have a common name - sterilization. Partial sterilization of milk by heating to 60 ° C for 30 minutes is commonly called pasteurization.
To capture microbes from liquids and gases, special filters with very small pores are used.
Bactericides are chemicals that kill bacteria. Bacterio-sitasis is a temporary stop of bacterial reproduction under the influence of various substances (including drugs).
A person has a good natural defense against pathogenic microbes. The first line of defense is the skin. But the slightest wound opens access to microbes in the body. In the nasal cavity, microorganisms are retained by small hairs. V oral cavity bacteria are trapped in saliva, which contains a bactericidal substance known as lysozyme. Lysozyme is found in tears. Lysozyme dissolves the cell walls of a number of bacteria, destroying them. But if microbes manage to penetrate the body, then they are waiting for the acidic environment of the stomach, which destroys most microorganisms. Some microbes still penetrate the intestines. Here they face another obstacle. In 1883, the outstanding Russian microbiologist I.I. Mechnikov showed that white blood cells (leukocytes) are able to actively capture and absorb foreign microbes that have entered the body. This phenomenon I.I. Mechnikov called phagocytosis, and white blood cells - phagocytes. Based on these facts, the phagocytic theory of immunity has been developed. Immunity can be acquired and natural, or innate. Innate immunity is a species trait that is inherited. In 1796, the English physician Jumper discovered a method of preventive vaccination, which he called vaccination, and the material for vaccination vaccine (from vacca - cow). Immunity to infections created artificially is called immunization.
In the fight against microbes great importance has hygiene. Sweat, dust, dirt - a good breeding ground for microorganisms. An effective remedy germ control is disinfection. As disinfectants, tincture of iodine, ultraviolet rays, chlorine and others are used. Disinfection is a direct means of combating microbes, and disinsection and deratization are directed against carriers of microbes. Disinsection is a way to control insects. Rodent control is called deratization. In this case, chemical, mechanical and biological means are used.
Mushrooms are a separate group of lower plants, devoid of chlorophyll and feeding on ready-made organic substances. They are isolated in a special kingdom of the organic world. There are over 100 thousand species of mushrooms. Fungi differ from bacteria by having a nucleus in the cell.
Most poisonous mushroom- death cap. The poison of the pale toadstool is not destroyed either by boiling or by frying. This fungus is a mortal danger to humans. A person can be poisoned by a red fly agaric, but deaths rare. Almost every edible mushroom has its inedible or poisonous counterpart.
Plants. We note the most common of the poisonous plants.
Belœna. The fruits of black henbane are dangerous to humans. Οʜᴎ contain alkaloids that cause clouding of the mind. This is where the expression "belœny ate too much" came from.
Tobacco. The emergence of tobacco in Europe in the 15th century is associated with the name of the Frenchman Jean Nicot, who allegedly brought the seeds of this plant from the island of Tobago. Hence the Latin name for tobacco is Nikotiana tabacum. Tobacco contains the poisonous alkaloid nicotine. A lethal dose of nicotine is contained in about 20 cigarettes, but since it enters the body gradually, the death of a smoker does not occur. Nicotine is very quickly spread through the body of a smoker. It enters the brain 5-7 seconds after the first puff. The tar formed when tobacco is burned causes tumors. There was a time when in Russia smoking was punished with whips. But tobacco dust is used with benefit in agriculture to combat harmful insects.
Hemp. From the resinous secretions of hemp, dangerous drugs are obtained, known as hashish, marijuana, marijuana, the use of which leads to the development of a serious disease - drug addiction.
Poppy. Man began to breed poppies for the sake of edible seeds, in which more than 50% is oil. But already in ancient times, people made incisions on immature poppy boxes, from which white juice protruded. The dried juice was scraped off and a bitter brown powder was obtained - opium. Since ancient times, opium has been used not only as a medicine, but also as a drug. Opium smoking has claimed thousands of lives and even fueled the Opium Wars. Today, the sowing of opium poppy varieties is prohibited by a UN decision.
Animals that pose a potential danger to humans .
Scorpions. For small animals, a scorpion sting is fatal. For a person, an injection of a scorpion sting is very painful (a swelling occurs, chills, the temperature rises), but it does not threaten life. Only a few deaths of children bitten by large tropical scorpions are known for certain.
Spiders. The spider karakurt (translated as "black death"), a little more than one centimeter long, is one of the most dangerous. Mortality from its bites is about 4%. The bite of a karakurt causes mental excitement of the bitten, pain in the whole body, disruption of the heart and difficulty breathing. V field conditions it is recommended to cauterize the wound with a match immediately after the bite. Spider venom breaks down when heated. Other dangerous spiders (for example, a tarantula) do not pose a serious threat to humans, although their bite is painful.
Ticks. They feed on the blood of large animals and humans. A sucked tick cannot be pulled out. Its head remains in the skin and causes inflammation, more dangerous than the bite itself. It is better to moisten the tick abundantly with alcohol or cologne and the tick will fall off by itself. Very harmful tiny scabies mites that cause the disease - scabies. The main harm of ticks is not in their bites, but in the diseases they carry, for example, tick-borne encephalitis.
Locust. It is dangerous by the destruction of crops, vegetation, dooms the animal world and man to starvation.
biological factors. - concept and types. Classification and features of the category "Biological factors." 2017, 2018.
In the process of studying the working conditions of workers, the criteria for assessing the impact on workers of factors of a biological nature are perceived ambiguously. For example, a number of questions arise when assessing the working conditions of employees of general practice medical institutions (hospitals, hospitals, general and dental clinics, clinical laboratories, etc.) in contact with patients. As a general rule, direct contact with infectious agents is ruled out, but the potential for contamination of workers appears to remain.
In Guideline R 2.2.2006-05, the expert is asked to evaluate these working conditions either only as acceptable (2nd class) or only as harmful (3rd degree, 3rd class). Assessing the conditions of these types of work as acceptable, the expert deprives the employee of benefits and compensation for harmful working conditions, as harmful - creates a basis for the employee to receive complete set compensation. This entails serious economic costs. Should the working conditions of medical personnel of general practice institutions, by biological factor, be classified as class 3.3, equating them to the working conditions of employees of specialized institutions, in which the likelihood of contact with specific infectious agents is significantly higher (medical institutions of an infectious, tuberculosis, dermatovenerologic profile)?
R. Popova
Indeed, the criteria for attributing working conditions to a certain class according to a biological factor in contact with pathogenic microorganisms are not entirely unambiguous. It should be clarified that, in contrast to the "Guidelines for the hygienic assessment of factors in the working environment and labor process. Criteria and classification of working conditions ”R 2.2.2006-05 the concept of“ especially dangerous infections ”in modern epidemiology of infectious diseases is practically not used. More importantly, it is neither in the current legislative and by-laws of the Russian Federation, nor in international documents of the relevant profile.
Thus, the International Health Regulations (IHR), approved by the 58th session of the World Health Assembly on May 23, 2005, do not contain the term "particularly dangerous infections". These rules introduce the concept of "communicable diseases that are included in the list of events that may constitute an emergency situation in the health care system on an international scale."
According to Annex 2 to the IHR-2005 they are divided into two groups.
First group- "diseases that are unusual and may have a serious impact on public health": smallpox, poliomyelitis caused by wild poliovirus, human influenza caused by a new virus subtype, severe acute respiratory syndrome (SARS, or SARS).
Second group- "diseases, any event with which is always considered dangerous, since these infections have shown the ability to have a serious impact on public health and spread rapidly internationally": cholera, pneumonic plague, yellow fever, hemorrhagic fevers (Passa, Marburg, Ebola, West Nile). The second group of the IHR-2005 also includes infectious diseases “that represent a special national and regional problem” (for example, dengue fever, Rift Valley fever, meningococcal disease or infection, etc.).
In Russia, the IHR were also put into effect by the Decree of the Chief State Sanitary Doctor dated May 11, 2007 "On the implementation of the International Health Regulations (2005)". The decree refers to infectious diseases “causing public health emergencies of international concern, including new emerging especially dangerous infectious diseases, the threat of an influenza pandemic, the etiological agent of which may be a new subtype of a virus highly pathogenic for humans.”
Deciphering the concept of "especially dangerous diseases”is not in the resolution, just as it is not in the Federal Laws of November 21, 2011 No. 323-f3 “On the Basics of Protecting the Health of Citizens in the Russian Federation” and of March 30, 1999 No. 52-FZ “On the Sanitary and Epidemiological Welfare of the Population”. At the same time, Federal Law No. 52-FZ contains only a definition of infectious diseases that pose a danger to others - these are "infectious human diseases characterized by a severe course, a high level of mortality and disability, and rapid spread among the population (epidemic)". Thus, in the current legislative acts there are no legal grounds for the formation of a clear list of employees who could be attributed to the first subparagraph of clause 5.2.3 and the second line of Table. 2 R 2.2.2006-05 on the impact of the biological factor.
At the same time, there are several by-laws in force in the country that could form the basis for an appropriate classification of working conditions. First of all, these are the Sanitary Rules “The procedure for accounting, storage, transfer and transportation of microorganisms of I-IV pathogenicity groups. SP 1.2.036-95". Appendix 5.4 to these SPs provides a classification of microorganisms pathogenic to humans. According to this classification, all microorganisms are divided into four groups. Their pathogenicity, that is, a danger to humans, decreases from the first group to the fourth.
In the development of SP 1.2.036-95, the Sanitary and Epidemiological Rules “Safety of working with microorganisms of I-II groups of pathogenicity (danger)” have been developed. SP 1.3.1285-03” and Sanitary Rules “Safety of working with microorganisms of III-IV pathogenicity groups and helminths. SP 1.2.731-99. According to the degree of danger and protection measures for workers, groups of pathogenic microorganisms that workers can come into contact with in the process of work can be combined, making two out of four.
So, among the pathogenic bacteria in groups I - II included the causative agents of plague, anthrax, brucellosis, tularemia, legionellosis, glanders, melioidosis, cholera; from rickettsia, these same groups include pathogens of typhus and rat typhus, spotted fever, Q fever and some other diseases. Among viruses, the most dangerous are the causative agents of hemorrhagic fevers, human smallpox, encephalitis, encephalomyelitis, meningoencephalitis, parenteral hepatitis, rabies, pseudorabies, foot and mouth disease, human immunodeficiency and a number of other less common infectious diseases. From chlamydia, the causative agent of ornithosis-psittacosis is included in group II, from fungi - causative agents of blastomycosis, coccidioidomycosis and histoplasmosis, and from poisons of biological origin - botulinum toxins of all kinds, tetanus toxin and venom of the karakurt spider.
As you know, in R 2.2.2006-05, the working conditions of workers who have contact with pathogens of other infectious diseases (in addition to especially dangerous ones) are classified as class 3.3, but how justified is this? In our opinion, special studies are needed to analyze the actual situation, taking into account the opinions of experts in the relevant field. It is advisable to indicate in the classification of working conditions that workplaces with contact with microorganisms of groups I - II of pathogenicity should be attributed to the 4th hazard class by analogy with R 2.2.2006-05, and in the presence of contact with microorganisms of III - IV groups of pathogenicity and helminths - for example, a class or two lower, that is, to classes 3.4 or 3.3.
It should be borne in mind that what has been said regarding contact with microorganisms with a sufficient degree of accuracy can only be attributed to employees of specialized laboratories and industries, that is, "organizations or their structural divisions performing experimental, diagnostic or production work with pathogenic biological agents" (SP 1.2 .731-99). As for the professional groups of medical workers involved in the treatment and care of people or animals suffering from infectious diseases, their working conditions can be attributed to the same classes as when working in laboratories, apparently, only in cases where it is on diseases that are directly transmitted from person to person, and for veterinary and agricultural workers - respectively, from animals to humans by airborne droplets or contact.
In this case, the number of medical workers (professions) who have contact with microorganisms of pathogenicity groups I-II and are at risk of infection in the process of work will decrease, since, for example, AIDS, parenteral hepatitis are transmitted from person to person only parenterally (through sexual contact or blood), and hemorrhagic fevers are generally not transmitted from person to person. In other words, when staying in therapeutic hospitals of infectious diseases hospitals and departments, such patients do not pose a danger to staff.
The exception is medical workers of surgical departments and obstetric hospitals, who are directly involved in the provision of medical care through surgical intervention with the risk of breaking the integrity of gloves. An assessment of the biological factor for this group of specialists should take into account the likelihood of a worker (surgeon, obstetrician-gynecologist, anesthesiologist-resuscitator, operating nurse, midwife) getting into the blood of a number of infectious diseases, primarily parenteral viral hepatitis B and C, AIDS and syphilis due to damage gloves and injury to the fingers during surgery or the presence of microscopic wounds on the hands of a medical worker.
It is known that during planned surgical and obstetric-gynecological interventions, patients are preliminarily examined for viral hepatitis, HIV and syphilis. However, even knowing that the operated patient has one of these diseases, medical workers, firstly, do not have the right to refuse the operation, and secondly, they do not have guaranteed protection against damage to gloves and fingers during surgery. Medical workers who provide emergency medical care in surgical and obstetric-gynecological hospitals are even more at risk, when surgery is performed according to the patient's vital indications without preliminary tests.
Since the causative agents of these diseases are mainly included in groups I - II of pathogenicity, and it is among medical workers in the country that a certain number of cases of occupational diseases with hepatitis B and C are detected annually, the working conditions of this group of people according to R 2.2.2006-05 should be classified as class 4 .
Now let's talk about medical workers who do not work in specialized (for certain infectious patients) medical institutions. Let us turn again to the Classification of pathogenic microorganisms for humans. Group III pathogenicity includes viruses of influenza, poliomyelitis, chicken pox, SARS, polyneuritis, pneumonia, bronchitis, bronchiolitis, mumps, measles, conjunctivitis, rubella and many other infectious diseases. Many of them are easily transmitted from person to person by airborne droplets, and most of the so-called childhood infections in adults are much more severe and often accompanied by complications. By the way, the causative agent of tuberculosis is also included in the pathogenicity group III, that is, in terms of the degree of danger to humans, all of the listed microorganisms are comparable.
Most of these diseases at the initial stage can proceed with an erased clinical picture. At the same time, any employee of a medical organization of an outpatient or inpatient type, from an emergency doctor and a registrar to the head of an institution, has the opportunity to become infected with them from a sick person.
Influenza or SARS, unlike tuberculosis, is rarely considered as an occupational disease in a medical worker. However, influenza can lead to severe complications (with subsequent disability or death of the worker), or at least long-term disability. If a medical worker becomes infected at his workplace, then the case, of course, can and should be considered as insurance in the system of compulsory social insurance against industrial accidents and occupational diseases. This does not contradict either federal law"On Compulsory Social Insurance Against Industrial Accidents and Occupational Diseases", neither the List of Occupational Diseases nor Labor Code RF.
The same can be said about rubella in case of infection of a pregnant woman - a medical worker and the resulting severe complication for the fetus or child, etc. If in all these cases we refer the working conditions of medical workers to class 2, we are unlikely to be on the side of protecting their rights to compensation in case of loss of health or even life in the process of work. It is possible that the probability of such an insured event is somewhat lower than, say, the probability of contracting pneumonic plague from a sick person or a highly pathogenic virus in a specialized laboratory, although we are not aware of evidence-based studies in this regard. However, an employee of a specialized medical institution, as a rule, is better prepared in the field of labor protection and clearly knows what he may encounter in the course of his work. In addition, he is most often protected by special means individual and collective protection, a system of mandatory primary medical prevention and dynamic medical supervision.
At the same time, for example, a medical registrar in a municipal polyclinic, while issuing outpatient cards to patients with influenza during a seasonal epidemic, has practically no protection against infection. The possibility of complications after the flu is determined mainly by the state of his health, the body's response to the infection and the quality of subsequent medical care. This can be fully attributed to the employees of most other medical organizations - clinics, hospitals, dental departments, various medical centers and clinics, etc.
Note: a medical worker, of course, can become infected with the flu or any other infection, not only at the workplace, but also, for example, in public transport. At the same time, the data of numerous studies convincingly indicate that health workers are much more likely to become infected in the process of work.
Is it possible to equate the workers of the general medical network with the workers of the pathomorphological departments, prosectors and morgues in terms of the importance of the biological factor? It is difficult to answer this question unambiguously, since there are no special studies on this subject. We can only say that, most likely, pathomorphologists, like employees of other specialized institutions, are professionally more prepared for the danger of infection in the course of their work and have the opportunity to comply with safety requirements more carefully than, for example, surgeons, since the former do not have such a factor as lack of time due to the vital indications of the patient.
As for the comparison of workers of pathomorphological departments and medical workers of a therapeutic profile, then for a reasonable conclusion it would be necessary to conduct special studies with an assessment of the likelihood of infection with pathogenic microorganisms directly in the course of work. We believe that so far in the country it is unlikely that at least one case of an occupational disease of an infectious nature has been recorded in an employee of a prosector or mortuary. The presence in the practice of domestic occupational pathology of cases of occupational diseases of medical workers with tuberculosis testifies not so much to a higher danger of the causative agent of tuberculosis, but to the difficulty of contracting it outside of long-term contact with sick people due to the presence of natural resistance to the pathogen in the majority of the adult population.
In the near future, it is unlikely that you will be able to meet an insured event of infection in the process of work (that is, an occupational disease) of a pathologist, district therapist or patronage nurse. This, alas, does not mean that such cases do not exist.
Today, in a huge number of types of economic activity, even typical occupational diseases, for example, sensorineural hearing loss or vibration disease, have not been detected among workers for decades, with the unconditional presence of relevant harmful factors in the working environment at workplaces. This is a separate very painful topic: why in modern Russia the level of occupational morbidity is ten times lower than in the economically developed countries Oh.
Our society is not yet economically and socially ready to recognize the priority of the health of the working person over all other vital priorities, including the right to work and a decent wage. This is equally characteristic of both individual and social consciousness. As long as there is a job and a salary that satisfies for a given period, the Russian worker, apparently, will make every effort to ensure that an occupational disease is not detected in him, since as a result of this, the workplace and earnings will be lost, and the social compensation provided for by society will not provide the necessary quality of life.
Let's add to this the low legal literacy in the field of rights to health and social protection, which is typical for most employees, as well as relatively little experience of court decisions in this area. Medical professionals are no exception in this respect. The employer also thinks in similar categories - he does not need "extra worries" associated with an occupational disease, especially since the employee does not need them. Among other things, the employer may be seriously interested in improving the results of workplace certification (AWP). Poor results will entail not only and even not so much the identification of possible occupational diseases, but the cost of benefits and compensation, as well as an increase in the volume of periodic medical examinations, that is, significant financial investments. Both the Social Insurance Fund of the Russian Federation and medical organizations have their own interests in this matter.
In other words, despite the fact that the current level of occupational morbidity in Russia does not reflect the actual working conditions, the current situation is objective to a certain extent, since it is conditioned by the emerging socio-economic realities. However, for professionals it is obvious that such a situation cannot be maintained for a long time. This is primarily determined by the broad integration of the Russian economy into the world economy and the globalization of the majority social problems, including issues of protecting the health of the working population. Already in the next decade, in our opinion, we should expect a significant increase in the level of occupational morbidity in Russia. Ultimately, it should become comparable with the indicators of most developed countries. This may serve as one of the grounds for revising the amount of social compensation for health lost in the process of work.
It is this aspect, in our opinion, that is quite closely linked to the problem of so-called benefits and compensations for harmful and / or dangerous working conditions, which today are directly determined by the results of workplace certification (special assessment of working conditions - ed. note). This problem requires separate consideration. Let us only note that neither the additional payment to earnings, starting from 4% of wages, nor the shortened working day, nor additional leave compensate for the loss of health as a result of long-term work in harmful working conditions. Moreover, compensation contributes to its significant deterioration, since the employer, compensating for harmful working conditions to a minimum, is in no hurry to improve them, and the employee is not ready to spend meager additional payments and compensations on his own health improvement.
It can be assumed with high probability that if, in the social insurance system, the level of compensation for loss of health in the process of work provided the employee with the preservation of the usual quality of life, then it would be easier for him to accept the likelihood of developing an occupational disease than to defend the right to benefits and compensation for work during harmful working conditions.
Now about time protection. No one has proven that just this amount of time is enough for the action of harmful factors of the working environment and the labor process not to affect health. Domestic hygiene standards are based on an 8-hour working day and a 40-hour working week, however, no one can guarantee that reducing this time by 10% will reduce the adverse effect of the factor to a safe level.
Moreover, specialists are well aware that even when exposed to acceptable levels, some of the most sensitive people may experience occupational health disorders. For substances that have an allergenic effect, they even find an inverse relationship: the lower the concentration, the more severe the effect (although this is not directly related to biological factors).
From all of the above, in our opinion, we can draw the following conclusions.
If the modern paradigm of the classification of working conditions is preserved in the country, then Guideline R 2.2.2006-05 needs to be revised as soon as possible in many respects, including criteria and indicators of harmful biological factors in the working environment.
For medical workers employed in general medical organizations, the likelihood of contracting infectious diseases in the process of work remains. In most cases, in our opinion, this does not allow us to assess their working conditions at the level of class 2. To justify a differentiated approach to assessing the working conditions of medical workers in this group according to the severity of the impact of a biological factor, it is necessary to conduct special clinical and epidemiological studies.
The existing system of benefits and compensations for harmful working conditions in the country needs to be seriously reformed.
Obviously, the methods (and possibly the methodology) for assessing working conditions, for example, a neurosurgeon and a miner should be different. It is necessary to develop a series of by-laws for a clearer organizational and methodological support for certification of workplaces (special assessment of working conditions) in various types economic activity. Significantly more objective (and, more importantly, more effective than certification of workplaces in terms of working conditions) is the methodology for assessing and managing occupational risks. This determines the expediency of its wide approbation and implementation in the conditions of modern Russia. It seems appropriate to develop corporate (sectoral) regulations for assessing working conditions within the framework of local occupational risk management systems, taking into account the specifics of labor activity. In our opinion, this should be the concern of the relevant branch trade unions and employers' associations.
Chapter 5
Chapter 5
5.1. Infectious diseases and their spread
Infectious diseases do not appear immediately after the pathogen enters the body, but after a certain, so-called incubation (latent) period. For various diseases, it can last from several hours to tens of days. For example, for typhoid fever, the incubation period is on average 14 days, for scarlet fever - 3-6 days, and for influenza - 2 days.
Usually, an infectious disease in a person after a latent period manifests itself very rapidly: the body temperature rises quickly, weakness appears, efficiency decreases sharply, and a serious condition often occurs. Infectious diseases are also dangerous because they can cause serious complications.
An important feature of many severe infectious diseases is their rapid spread. Depending on the breadth of coverage of the population with infectious diseases, sporadic diseases, epidemics, pandemics, and endemics are distinguished.
sporadic diseases are single; they show up on a case by case basis. Epidemic- this is a mass spread of infectious diseases among the population, covering significant contingents of people interconnected by a chain of infection. Pandemic- extremely widespread
infectious diseases affecting entire continents or the entire globe. endemic- systematic occurrence among the population of any infectious diseases, associated mainly with local conditions.
Unfavorable socio-economic and hygienic living conditions contribute to the emergence and spread of infectious diseases, as well as adversely affect their course and outcome. The spread of infectious diseases occurs in the form of an epidemic process. It can be schematically represented as the following links: 1) the source of infectious agents; 2) infection transmission factors; 3) a susceptible organism.
The source of infection is most often a sick person. In some cases, a person can excrete pathogens even after recovery (convalescent). There are also healthy people (carriers) who excrete pathogens. Infected animals can also be a source of infectious agents.
The transmission of infections is a complex process that consists of phases following one after another: 1) removal of the pathogen from the infected organism; 2) stay of the pathogen in external environment; 3) the introduction of the pathogen into the human body. The excretion of the pathogen from the infected organism is associated with its location in the body. When the pathogen is localized in the intestine, it is excreted with feces and sometimes with vomit. If the pathogen is present in the respiratory system, it is excreted with exhaled air and droplets of saliva. From the skin and mucous membranes, the pathogen enters directly into the surrounding objects. In cases where the pathogen is in human blood, it can be transmitted by blood-sucking insects (mosquitoes, lice, ticks, etc.).
Pathogens that have entered the environment can pass from an infected person to a healthy person. The set of factors that ensure the spread of certain infectious diseases is called the route of transmission of infection. It should be noted that some infectious diseases are spread by direct contact when pathogens are transmitted from an infected person to a healthy person without entering the environment. For example, sexually transmitted diseases (syphilis, gonorrhea) are spreading.
Air is a factor in the transmission of pathogens of a number of infectious diseases (influenza, diphtheria, whooping cough, tuberculosis, etc.). During a conversation, coughing, sneezing, pathogens, together with the smallest droplets of saliva and mucus, enter the air and form
the so-called bacterial aerosol, which spreads with air currents with great speed and over considerable distances. In addition to the airborne method, pathogens can also be transmitted through dust. Droplets of bacterial aerosol settle on surrounding objects and are then easily carried by the air stream.
The water way of transmission of infection is very dangerous, since water is widely used for drinking and other purposes, in particular in swimming pools, and pathogens can stay in it for a long time. Typhoid fever, dysentery, cholera, etc. are mainly transmitted through water. In addition, pathogenic protozoa and helminth eggs can enter the body with water.
Various pathogens of wound infections, anthrax and some helminths can be transmitted through the soil. Especially many pathogens are found in soil contaminated with excretions of humans and animals. The transmission factor of infection can also be various household items e.g. common utensils, toilet bowls, handles in toilets.
The susceptibility of the organism is determined by nonspecific general resistance and immunity. Nonspecific general resistance of the body can be increased with strict adherence to the regime of work and rest, rational nutrition, the use of various hardening procedures and other hygiene factors. Immunity- this is the ability of the body to immunity to certain pathogens of infectious diseases. Immunity is associated with hereditary or individually acquired factors that prevent the penetration and reproduction of pathogens in the body, as well as the action of toxins. Immunity is diverse in its origin, manifestation and other features. It can be antimicrobial, antiviral, antitoxic, etc.
An important role in immunity is played by specific protective factors of blood serum - antibodies. They are formed in the body in response to the ingress of pathogens into it. The main feature of antibodies is the ability to specifically interact with the corresponding pathogen. When toxins enter the body, they form in the blood serum antitoxins.
By origin, the following types of immunity are distinguished: hereditary (species), acquired (natural, artificial, active and passive).
Hereditary immunity is a specific feature of the organism. So, a person has hereditary immunity
to a number of infectious animal diseases, and they, in turn, are not susceptible to a number of human infectious diseases.
Acquired immunity is not transmitted, but occurs in the process of life.
Natural acquired immunity occurs after an infectious disease, when antibodies or antitoxins are formed in the body, which make the body insensitive to this pathogen or bacterial toxins. Artificially acquired immunity occurs when special drugs are introduced into the body to create it. This immunity is divided into active and passive.
Active artificial immunity occurs after the introduction of vaccines and antitoxins into the body, which contain special antigens (specially processed pathogens and toxins). This leads to the active formation of protective factors in the body against pathogenic microbes and toxins. Active immunity develops in 2-4 weeks. after protective vaccinations (vaccination) and persists for a long time. Usually, to consolidate active immunity, repeated vaccinations (revaccination) are required.
Passive artificial immunity is created by introducing immune sera or gamma globulin into the body. With sera, the body receives ready-made antibodies taken from immune people or vaccinated animals. Passive immunity usually appears after a few hours and lasts 2-4 weeks.
The creation of artificial immunity is a powerful means of increasing the specific immunity of the body.
5.2. Prevention measures
infectious diseases and their control
Prevention of infectious diseases includes a set of measures, among which the most important are:
1) state measures to eliminate the causes and spread of infectious diseases; 2) measures related to raising the level of sanitary culture of the population.
State measures provide for the constant improvement of working and living conditions of the population, the construction of various facilities, taking into account sanitary and anti-epidemic requirements. All this, as well as extensive housing construction and improvement of cities and villages, the construction of water pipes and sewerage, leads to a sharp decrease in infectious diseases. Medical measures are carried out in a complex manner. One of the most important preventive measures is the identification and neutralization of sources of infection. An infected person (patient, carrier) as a source of infection is isolated from people, hospitalized and treated. Infected animals are usually destroyed.
Measures aimed at disrupting the transmission of infection are closely related to the improvement of housing, the removal and neutralization of sewage, and proper water supply. All of them are carried out by medical workers constantly and include systematic sanitary and hygienic monitoring of water supply, sewerage, cleaning of populated areas, the operation of public catering facilities, etc. , physical and other means. Disinfection is aimed at the destruction of pathogenic microbes in the environment. Disinsection is carried out to kill insects that can transmit the infection. Deratization is carried out in order to exterminate rodents that are dangerous in an epidemic sense. The active participation of the population in this matter, the implementation of special measures, the observance of personal hygiene rules, etc. is important for the effective break in the transmission of infection.
The specific immunity of the population to infectious diseases can be increased by vaccination (vaccination), which is carried out in a planned manner and according to epidemic indicators.
Raising the level of sanitary culture of the population is carried out through the widespread use of various means mass media: talks, lectures, press, radio, television, etc. Coaches, physical education teachers and athletes should be well aware of the causes and characteristics of the spread of infectious diseases and skillfully apply preventive measures.