Occupational health care in regions with different levels of occupational morbidity in agricultural workers

Introduction. In recent years, special attention has been paid to the discrepancy between working conditions in different sectors of the Russian economy and the inadequately low level of registered occupational morbidity (OM). At the same time, as a rule, issues of access to occupational health care that are important for the rural population are not considered due to the lower potential of socio-economic and infrastructural development of rural areas compared to the city.

Material and methods. The paper uses updated data on 82 subjects of the Russian Federation on working conditions, the level of OM of agricultural workers, and indicators of occupational health care for the rural population in 2011–2017.

Results. The ranking of subjects of the Russian Federation by the level of non-infectious occupational morbidity of agricultural workers was carried out: group I (OM above the national average), group II (OM below the national average), group III (OM is not registered). It is shown that non-detection of occupational diseases in the regions of group III could be due to insufficient provision of rural health care by occupational pathologists (54.2%), low coverage of workers with periodic medical examinations (PME) (76.6%), as well as the absence of occupational health centers (OPC) in 5 territories. of the 18 regions. According to the criteria of availability of occupational pathologists (97.5%) and coverage of PME (95.5%), the highest availability of primary occupational pathology care occurred in the regions of group II. However, the high proportion of occupational diseases identified during self-treatment indicated a formal approach to conducting PME in this group. The most accessible specialized occupational health care was typical for the subjects of the Russian Federation of group I with a high level of OМ, on the territory of which the most significant number of OPC functioned with the possibility of extended pre-examination of employees with suspected occupational diseases in a hospital.

Conclusion. Along with harmful working conditions, the occupational morbidity of agricultural workers is primarily determined by the availability of specialized occupational health care, namely, occupational health centers’ availability, equipment, and capacity.