Identification of the negative impact of a complex of non-ionizingradiation on the human body (on the example of medical personnel)

AP09259923

Objective: to establish the negative effects of non-ionizing radiation exposure fromhigh-tech equipment on the human body at the cellular and subcellular levels to justify preventive programs.

Relevance

The rapid and widespread introduction of insufficiently researched technologies (MRI,ultrasound ) into medical diagnostic and treatment processes, USD is due to the urgent need to combat the pandemic, which causes some caution in terms of individual health not onlyof patients, but also of medical personnel. The introduction of modern medical diagnostic equipment inspecialized institutions of the Karaganda region, the use of various protective systems of ionizing and non-ionizing radiation sources in terms of power and quality, requiresan integrated epidemiological and hygienic assessment. Its implementation will allowidentifying all external risk factors that contribute to the development to f certain pathologicalprocesses and syndromes in personnel engaged in setting up and operating such equipment.The study of the structure of the main nosologies during an in-depth medical examination ofemployees will be based oncytochemical and biochemical, psychophysiological and clinical, and sociological studies toidentify risk groups experiencing the greatest adverse effects, confirmed by modern statistical analysis methods. Based on the results, calculated tests forreducing medical and social losses will be presented-technologies for reducing health risks aimed at ensuring the sanitary well – being of personnel.

Expected results.

Sanitary and hygienic, clinical and laboratory (cytogenetic, biochemical, and immunological) parameters will be evaluated in employees who come into contact with nonionizing radiation from high-performance diagnostic complexes (MRI, ultrasound).

Regularities of disorders in the functioning of psychological stability, cytogenetic immunological status of medical workers in magnetic and electromagnetic fields of a complex spectrum will be established.

Predicting and managing occupational risks in MRI, and ultrasoundrooms.

  1. Ibraeva L.К. - Doctor of Medical Sciences, Professor of the Department of Internal Diseases NC JSC" ҚМУ " – project manager, https://orcid.org/0000-0002-9917-0258
  2. Omarkulov B. K. -: Сandidate of Medical Sciences, Associate Professor, Director of theInstitute of Public Health an d Professional Health NAO "ҚМУ". https://orcid.org/0000-0002-3955-4452
  3. Zharylkasyn Zh.Zh. - Candidateof Medical Sciences, Associate Professor, Head of theresearch Sanitary and hygienic Laboratory NC JSC "ҚМУ".https://orcid.org/0000-0001-5432-4842
  4. Grebeneva O.V. - Doctor of Medical Sciences, Associate Professor, Chief Researcherof the Sanitary and Hygienic Research Laboratory NC JSC "ҚМУ" https://orcid.org/0000-0002-1758-3009
  5. Rybalkina D.H. - Doctor of Medicine, Associate Professor of the Department of InternalDiseases NC JSC "ҚМУ", https://orcid.org/0000-0002-2041-1259
  6. Bacheva I.V. - PhD, Associate Professor of the Department of Internal Diseases NC JSC"ҚМУ"https://orcid.org/0000-0002-5576-8637
  7. Shadetova A.Zh. – Candidate of Biological Sciences, leading researcher of the researchsanitary and hygienic laboratory NC JSC "ҚМУ" https://orcid.org/0000-0003-3029-855X
  8. Rusyaev M.V.-Master's degree, research associate of the Research Sanitaryand hygienicLaboratory NC JSC "ҚМУ". https://orcid.org/0000-0003-3212-4211
  9. Alekseyev A.V.- PhD, Research Associate of the Sanitary and Hygienic Research Laboratory NC JSC "ҚМУ", https://orcid.org/0000-0002-8988-3609
  10. Sabirov Zh.B. - PhD, researcher at the Sanitary and Hygienic Research Laboratory NC JSC "ҚМУ".

1. The main adverse occupational factors are as follows:

- For MRI medical staff - electromagnetic fields (EMF) of radio frequency 30-300 MHz by the magnetic component (at 41.2% of workplaces, 4.6-16.2 A/m) and industrial frequency EMF by the electric component (up to 1.3 kV/m at 47.1% of workplaces), in combination with elevated noise levels (up to 64.3 dBA at 50% of workplaces) and unfavorable microclimate conditions (at 58.9% of workplaces, air temperature exceeds the maximum permissible level by 4.6°C; at 47.1% of workplaces, relative air humidity drops to 33.1%; low air movement speed -0.02-0.08 m/s).

- For ultrasound (US) medical staff - industrial frequency EMF by the electric component (at 50% of workplaces, 0.55-1.1 V/m) in combination with elevated noise levels (at 61.1% of workplaces, ranging from 51.6 to 63.1 dBA), inadequate lighting (at 83.3% of workplaces, less than 153 lux), and unfavorable microclimate conditions (at 77.8% of workplaces, air temperature exceeds the maximum permissible level by 6.5°C; at 66.7% of workplaces, relative air humidity drops to 30.1%; low air movement speed - 0.03-0.08 m/s)

- For ophthalmology medical staff - increased noise levels (at 33.3% of workplaces, ranging from 50.4 to 57.9 dBA), insufficient lighting (at 74.1% of workplaces, less than 252 lux), and unfavorable microclimate conditions (at 92.6% of workplaces, air temperature exceeds the maximum permissible level by 6.5°C, and relative air humidity is below the maximum permissible level by 17.2%; low air movement speed - 0.015-0.08 m/s).

2. The dose loads of chemical substances on the bodies of medical staff working in MRI, ultrasound, and ophthalmology clinics due to inhalation at workplaces of low hazard for the development of specific diseases.

Based on the results of the study of the quality of life of medical staff using the WHOQOL-BREF questionnaire, it was found that the overall quality of life of the medical staff included in the study is rated as "high." Medical personnel, regardless of their field of activity, demonstrate high subjective well-being, with respondents reporting that their basic needs and quality of life are satisfactory.

Medical personnel in all three study groups exhibit sufficient physical and psychological well-being and a subjective sense of success in social interactions. Although the indicators of the "Physical and Psychological Well-being" domain of quality of life for MRI medical staff were 82.0±2.0%, for ophthalmological staff - 79.2±3.1%, which are higher than the corresponding domain levels for ultrasound staff, which were 68.8±2.8%, with statistical significance levels of p=0.0004 and 0.008, respectively.

However, 7.3% of respondents reported a slightly decreased quality of life and possible negative emotional states (anxiety, tension, emptiness, and boredom) with a sense of monotony in their daily lives and high workloads.

Medical staff working with MRI and ultrasound equipment subjectively note the presence of factors significantly affecting their work performance, such as various frequency EMF, noise, personal protective equipment, inadequate lighting, and suboptimal air temperature.

The results of psychophysiological research indicate that mild depression may develop due to the work-related stress, such as night shifts and the responsibility for accurate diagnostics among MRI specialists. On the other hand, a high level of depression may be associated with professional burnout among ultrasound specialists and ophthalmologists.

Medical staff working in MRI clinics demonstrate a slower aging process, a younger actual age, and lower biological age compared to staff in ultrasound and ophthalmology clinics. This may be due to intermittent exposure to low EMF values and can be considered a stimulating and favorable effect on the human body, provided that safety requirements for work operations are strictly observed.

Lower average values of attention, verbal short-term memory for words, and visual shortterm memory for numbers were found among MRI specialists compared to the control group. This indicates a high intensity of risk factors affecting their psychofunctional activity, leading to fatigue. The mental work productivity and accuracy among MRI specialists were also lower than in the other study groups.

Analysis of hemodynamic parameters of the examined medical staff in the main and control groups indicates an earlier deterioration of vascular functional status and a potential initial formation of hypertension and atherosclerosis. Decreased activity of the parasympathetic nervous system was observed in the MRI and ultrasound staff based on heart rate variability analysis.

Biochemical and immunological research results did not reveal significant metabolic changes among medical staff in MRI and ultrasound clinics compared to the physiological norm. The heat shock protein (HSP 60) values in the studied group did not differ from those in the control group, indicating no differences in immune reactions between the compared groups and in the structural configuration of molecular enzymes. The functional activity of these enzymes was not reduced (creatine kinase and nitric oxide synthase).

Epidemiological research revealed that the average rate of oncological diseases among ultrasound specialists exceeded that of ophthalmologists by a factor of 2.33. The incidence rate of urogenital diseases among ultrasound specialists was significantly higher, especially in the middle-aged group, compared to the control group. In the pre-retirement age group, musculoskeletal system diseases were more prevalent among ultrasound specialists, significantly surpassing ophthalmologists. During the COVID-19 pandemic in 2020, when comparing the incidence of COVID-19 among the adult population of Kazakhstan with the incidence rate among professional cohorts of medical staff in the Karaganda region (ophthalmologists, specialists in ultrasound and radiology), significant increases were identified, ranging from 7 to 11 times.

The target audience will include scientific researchers in biological laboratories and university departments, developers of modern diagnostic systems, professionals in regional healthcare authorities, and sanitary inspection organizations. Predicting and managing the occupational, deterministic risks of cardiovascular, nervous system diseases, new growths, and reproductive disorders among medical workers will have a significant impact on preventing years of life lost. An information database containing quantitative and qualitative parameters of environmental hazards and predictions of their impact on the health of medical personnel exposed to a complex mix of non-ionizing radiation, noise, vibration, microclimatic, and lighting factors can be provided (on commercial terms) for the creation of extensive databases for further scientific research.

Main publications on the project topic.
  1. Ibrayeva L.K., Grebeneva O.V., ShadetovaA.Zh., RybalkinaD.Kh., MinbayevaL.S.,BachevaI.V.,AlekseyevA.V.EffectofNon-ionizingRadiationontheHealthofMedicalStaffof Magnetic Resonance Tomography Offices// Journal of Clinical Medicine of Kazakhstan.-2021.-№18(4). – Р. 16-22.
  2. Certificate of Copyright Registration No. 24448 dated March 17, 2022, "Comprehensive Assessment of Detecting the Adverse Effects of a Complex of Non-Ionizing Radiations on the Human Body (A Case Study of Medical Personnel)." Authors: L.K. Ibraeva, B.K. Omarqulov, Z.Z. Zharylqasyn, O.V. Grebeneva, I.V. Bacheva, D.Kh. Rybalkina, A.Z. Shadetova, A.V. Alexeyev, M.V. Rusyaev, Z.B. Sabirov.
  3. L.K. Ibraeva Medical and Social Health Problems of Medical Personnel Working in Conditions with Exposure to Non-Ionizing Radiation // International Scientific and Educational Conference "Development and Implementation of Innovative Methods in Education and Science". 11-12.11.2022. Almaty.
  4. D. Kh. Rybalkina Morbidity of Medical Personnel with Non-Ionizing Radiation Exposure Factors // International Scientific and Educational Conference "Development and Implementation of Innovative Methods in Education and Science". 11-12.11.2022.Almaty
  5. I.V. Bacheva Heart Rate Variability in Medical Personnel of MRI and Ultrasound Departments: Assessment of Physiological Phenomena and Prognostic Significance //International Scientific and Educational Conference "Development and Implementation of Innovative Methods in Education and Science". 11-12.11.2022. Almaty.
  6. A.Z. Shadetova, O.V. Grebeneva Assessment of Biological Age of Medical Workers Exposed to Non-Ionizing Radiation // International Scientific and Educational Conference "Development and Implementation of Innovative Methods in Education and Science". 11-12.11.2022. Almaty.
  7. Certificate of Copyright Registration No. 37337 dated June 20, 2023, "Methods for Assessing the Impact of a Complex of Non-Ionizing Radiations on Blood Metabolic Parameters." Authors: Z.B. Sabirov, Z.Z. Zharylqasyn, O.V. Grebeneva, L.K. Ibraeva, A.Z. Shadetova, B.K. Omarqulov, A.V. Alexeyev, M.V. Rusyaev, D.Kh. Rybalkina, I.V. Bacheva.
  8. Certificate of Copyright Registration No. 37427 dated June 22, 203, "Analysis of Allostatic Load in Medical Personnel Exposed to Non-Ionizing Radiation." Authors: D.Kh. Rybalkina, L.K. Ibraeva, O.V. Grebeneva, I.V. Bacheva, B.K. Omarqulov, Z.Z. Zharylqasyn, A.Z. Shadetova, A.V. Alexeyev, Z.B. Sabirov, M.V. Rusyaev.
  9. L.K. Ibraeva, O.V. Grebeneva, B.K. Omarqulov, D.Kh. Rybalkina, Z.Z. Zharylqasyn, I.V. Bacheva, A.Z. Shadetova, A.V. Alexeyev, Z.B. Sabirov, M.V. Rusyaev. Ergonomics of Workstations and Hygienic Safety of Working Conditions for Medical Specialists in Radiological Diagnostic Offices (MRI and Ultrasound) // Methodological Recommendations. Karaganda, 2023. - 31 pages.
  10. Z.B. Sabirov, L.K. Ibraeva, A.Z. Shadetova, B.K. Omarqulov, D.Kh. Rybalkina. Cognitive State of Medical Personnel Exposed to a Complex of Non-Ionizing Radiations // X International Scientific and Practical Conference "Modern Strategies and Digital Transformations of Sustainable Development in Society, Education, and Science". 26.06.2023.Moscow.Р. 421-424.
  11. A.V. Alexeyev, O.V. Grebeneva, Z.Z. Zharylqasyn, I.V. Bacheva, M.V. Rusyaev. Quality of Life of Medical Personnel Exposed to Non-Ionizing Radiation in Kazakhstan // X International Scientific and Practical Conference "Modern Strategies and Digital Transformations of Sustainable Development in Society, Education, and Science". 26.06.2023.Moscow.Р.415-420.