Kononova I. Sanitary and epidemiological supervision at enterprises of machine building industry: ways of its improvement.

The thesis is devoted to studying sanitary and epidemiological supervision at enterprises of machine building industry. A thorough estimation of the problems in organization of a modern state sanitary and epidemiological supervision is given, main of which are: use of old normative documents; not full covering the subjects of non-governmental type of property; imperfect state of the modern legislation; lack of a dynamic surveillance of workers' state of health; imperfect type of the form on conclusion on the state sanitary and epidemiological expertise, concerning operation of industrial subjects. The results of medical and sociological questioning made by occupational hygienists and specialists in occupational health confirm the availability of great problems in the state sanitary supervision at industrial enterprises. A thorough hygienic assessment of work conditions at enterprises of the machine building industry is given. It is established that work conditions at these enterprises are characterized by the effect of a combination of harmful production factors of different origin. However, the assessment, according to the data of personal investigations of the author and the results of studies of laboratories are significantly different. The difference can reach about 50%. The peculiarities of occupational morbidity at enterprises of the machine building industry in Ukraine in general and in the city of Kyiv, in particular, have been revealed. According to the results of the calculation of occupational risks the highest relative risk of occupational diseases in machine building industry in Ukraine (RR>5,0) have been established for diseases of the osteo-muscular system and the connective tissue (RR=9,07, EF=89,0%) and for neuron-sensory deafness (RR=6,13, EF=83,7%). Also, high risk rates (R=2,0-4,9) were found for diseases of the peripheral nervous system (R=2,57, EF=61,1%) and for vibration disease (RR=3,03, EF=67,0%). A set of scientifically grounded hygienic and organizational measures have been developed and the role of departments of occupational health in the system of the sanitary and epidemiological supervision have been distinguished.