Occupational Respiratory Pathology in Russia: Current Trends and Challenges

In the morbidity structure of Russian adult population respiratory disorders are second only to circulatory system diseases. Point prevalence of respiratory diseases was registered at 38,945 per 100,000 people in 2013. 4% of all deaths annually in Russia are due to the respiratory pathology. Risk factors are numerous but principal among them are infections, workplace conditions, environmental pollution, behavioral patterns and socio-economic status. Occupational disease identification in Russia is based on combined efforts of 2 branches – physicians from departments or clinics of occupational diseases and governmental occupational hygienists. These two branches differ in educational background, as well as tasks performed, which could lead to hampered communication and interactions. Occupational respiratory diseases (ORD) are vastly underdiagnosed, with ORD incidence varying at 0.4–0.5 per 10,000 workers. Statistical reports show that while proportion of workers employed in hazardous and (or) dangerous working conditions increases, the rate of occupational diseases actually decreases, which can be explained by ineffective monitoring. Multidisciplinary occupational health services are strongly in need. COPD and chronic bronchitis are the most prevalent among the ORD followed by pneumoconioses, infection diseases, asthma, upper respiratory disorders and tumors. Pneumoconiosis morbidity tends to lower in recent years and severe silicosis cases are diagnosed rarely, although new types of the interstitial lung diseases have emerged, such as sarcoidosis and idiopathic fibrotic alveolitis. Hypersensitivity pneumonites are becoming more frequent as well. Among causative factors of occupational respiratory pathology in Russian population the most prevalent are aerosols, chemicals, biological hazards, and voice load.