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“Survival at work”: RUDN medic named the main risk factors for high-altitude enterprises

Mining gold high in the mountains is a risky job. Not everyone can endure such workload, so a medical examination is essential for hiring. The RUDN medic with a colleague from Kyrgyzstan found out that the standard contraindications list needs an update. The usual physiological parameters practically do not affect the probability of whether a person will survive at the workplace, but smoking and some other factors can affect this. The results are published in the Scientific Reports.

Employees of high—altitude gold mines are exposed to a constant risk of inhaling industrial aerosol. Unlike other mining enterprises, mines high in the mountains expose workers to one more specific hazard of low atmospheric pressure. On shift completion, employees go home, where the atmospheric pressure is higher. Intermittent pressure surges can negatively affect health. Long-term work in such conditions, unfortunately, often leads to rapid aging, wear, so for employees it is literally about preserving health at work. Before applying for a job, a standard screening is carried out, but there is not much information on factors that can reduce “survival at work”. The RUDN medical and a colleague from Kyrgyzstan conducted a large-scale study and found out what should be paid attention to in the first place

“Employees of high-altitude gold mines are exposed to many hazards. This includes inhaled dust, noise, and some gases. A specific environment of low pressure is another hazard. Two or three weeks in such conditions shift with weeks off site at home in normal pressure. This exposes the cardiovascular respiratory and endocrine systems to chronic stress. Therefore, it is important to have an accurate examination before hiring. This will increase the efficiency of labor protection and prevent possible lawsuits of the employee if he or she is found fit, but there will be medical complications or death at site. There is a list of contraindications, but it is not known how they will change in altitude conditions. Qualitative studies can shed more light on whether the clinical prognosis of initially mild conditions will worsen at altitude,” Denis Vinnikov, MD, Professor of the Department of Biochemistry named after Academician T. T. Berezov at RUDN

Doctors conducted a study on the example of a gold mining enterprise in Kyrgyzstan, located at an altitude of 3600-4500 meters above sea level. The study lasted more than 10 years. The doctors of the RUDN monitored the indicators of all new employees of the mine, who were employed from 2009 to 2012. In addition to physical health indicators, the researchers took into account demographic and psychological factors. The total observation time was 5,190 person-years.

Whether a person will remain at work after 10 years was not affected by the physiological parameters and indicators of the cardiovascular and respiratory systems prior to employment. But smoking increased the risk of “non-survival” at work, and regardless of concomitant diagnoses. Among other diagnoses, rheumatism, hemorrhoids, adhesive otitis and obesity increase this probability more than others. RUDN doctors also noticed that some diagnoses, smoking and living in lower places increased the likelihood that an employee will quit earlier. 

“This is the first such study for highland gold mining companies. We have shown that physiological factors during screening before admission say little about the likelihood of “survival” at work. Smoking and living on a low mountain can lead to such an employee leaving such a job earlier than others. Some association of chronic diseases with this outcome has also been confirmed. The results suggest that adjustments or improvements in medical screening rules are needed,” Denis Vinnikov, MD, Professor of the Department of Biochemistry named after Academician T. T. Berezov at RUDN.