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The main trends in occupational morbidity in Ukraine amid socio-economic changes in the labor market and the presence of military threats

The main trends in occupational morbidity in Ukraine amid socio-economic changes in the labor market and the presence of military threats

ISSN 2223-6775 Ukrainian journal of occupational health Vol.20, No 2, 2024


https://doi.org/10.33573/ujoh2024.02.107

The main trends in occupational morbidity in Ukraine amid socio-economic changes in the labor market and the presence of military threats

Nagorna A.M.1, Radionov M.O.2, Gavadziuk E.K.2
1 State Institution «Kundiiev Institute of Occupational Health of the National Academy of Medical Sciences of Ukraine», Kyiv, Ukraine
2 State Labor Service of Ukraine, Kyiv, Ukraine


Full article (PDF): UKR

Introduction. According to the latest estimates by the International Labor Organization (ILO), 2.93 million workers worldwide die each year from work-related accidents and diseases. This alarming number underscores the persistent challenges in protecting the lives of workers globally. The primary causes of these deaths are diseases of the respiratory and circulatory systems: chronic obstructive pulmonary disease ranks first, followed by stroke, and coronary heart disease. Occupational health indicators are crucial for assessing the dependency of loss of working capacity and worker mortality in industrial settings. The detection and analysis of occupational morbidity remain particularly relevant during periods of military conflict and significant socio-economic changes, such as legal, structural, digital, economic, medical, and demographic shifts, accompanied by large-scale population migration. Occupational morbidity is a key indicator of the health status of the working population. The formation of occupational morbidity indicators is influenced by occupational risks, innovative employment practices, medical-demographic and socio-economic conditions, social justice, and more.

Purpose: The primary objective of this study is to determine the dynamics of occupational morbidity and the factors contributing to its formation in Ukraine during a period of war threats.

Materials and Methods: The study analyzed the number of occupational diseases for 2019 (pre-COVID-19 and pre-war), for 2020-2021 (the COVID-19 pandemic period), and for 2022-2023 (the period of the full-scale military invasion by the Russian Federation in Ukraine). These periods significantly altered the perception and management of occupational morbidity and the socio-economic factors influencing its formation. The research was based on continuous statistical sampling of primary data for all registered cases of occupational diseases in Ukraine. Data were obtained from the Pension Fund of Ukraine, the State Labor Service of Ukraine, and the Institute of Industrial Economics of the National Academy of Sciences of Ukraine. The data were processed using standard methods of sanitary statistics and descriptive epidemiological analysis.

Results: The study found that the number of detected occupational diseases during the war decreased by 20.1% compared to 2019, particularly in regions located in the combat zone, areas adjacent to the front lines, or temporarily occupied territories (Donetsk, Dnipropetrovsk, Sumy, Chernihiv, Zaporizhzhia regions). These regions, previously known for their mining and processing industries (coal mining, metallurgy, machine building), experienced significant decreases in OM cases. The main reductions in occupational diseases were observed in Donetsk (23.9%) and Dnipropetrovsk (18.9%) regions, attributed to the destruction, closure, relocation of enterprises, housing stock damage, migration, and decreased employment.

From 2019 to 2023, there were notable changes in the detection, registration, and analysis of occupational morbidity, indicating a significant decrease (by 20.1%) during the martial law period. Respiratory diseases (34.0%), mainly chronic bronchitis, topped the list of occupational diseases, followed by musculoskeletal disorders (26.8%) and sensorineural deafness (19.7%). The highest incidence of occupational diseases was among workers in Dnipropetrovsk (37.0%), Lviv (20.7%), Donetsk and Luhansk (19.8%), Kirovohrad (6.4%), and Zaporizhzhia (6.0%) regions, collectively accounting for 91.65% of all cases. Significant decreases in specific diseases such as respiratory conditions (by 19.8%), including pneumoconiosis and chronic obstructive lung diseases, and musculoskeletal disorders (by 26.8%), including vibration disease (by 26.2%), were observed. This reduction is linked to socio-economic, medical, and demographic changes during large-scale population migration. Occupational health indicators remain vital for assessing the loss of working capacity and worker mortality in industrial settings. In 2023, 4,879 diagnoses of chronic occupational diseases were recorded for 1,920 individuals diagnosed with occupational diseases (several diagnoses per person), categorized by etiology: respiratory diseases (pneumoconiosis, chronic bronchitis, etc.) – 1,963 diagnoses; diseases caused by physical factors (vibration disease, sensorineural deafness, etc.) – 1,550 diagnoses; diseases linked to physical overload and strain (radiculopathy, etc.) – 1,345 diagnoses; and others – 37 diagnoses. This trend, with some variations, is observed annually. Combined causes of occupational diseases from multiple factors are rarely indicated in the P-5 forms (Professional Disease Registration Card).

Conclusions:

  1. The decline in occupational diseases during the martial law period is attributed to population decrease, migration, enterprise closure or relocation, reduced employment, deteriorating medical care, fewer medical institutions and occupational pathology specialists, and a prevailing interest in self-preservation, leading to delayed healthcare visits.
  2. The presence of multiple diagnoses among employees is due to poor quality of preventive medical examinations, inadequate staffing of medical commissions, lack of specific specialists, and necessary equipment. Recommendations from periodic medical examinations are often not implemented. In 2023, 572,636 workers underwent medical examinations, with 549 (0.09%) suspected of having chronic occupational diseases. Notably, only 13.0% of occupational diseases were diagnosed during medical examinations, with 87% identified through self-referral at healthcare facilities.

Keywords: occupational diseases, martial law, preventive medical examinations, socio-economic, demographic determinants, population employment.

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