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Technology of assessment of professional disadaptation of firefighters and rescuers in stratification of risk of development of cardiovascular diseases


S.V. Koroleva - Dr.Sc. (Med.), Associate Professor, Professor, Department of Bases of Civil Defense and Management in Emergency Situations, Ivanovo Fire and Rescue Academy of the State Fire Service of the Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters (IFRA of SFS of EMERCOM of Russia)
V.V. Zherdeva - Ph.D. (Biol.), Associate Professor, Department of Medical Devices, Russian Medical Academy of Continuing Professional Education of the Ministry of Health of the Russian Federation (Moscow)

Recently, there has been a significant increase in the demand for and importance of technologies aimed at the diagnosis.
In recent years, the demand on the technologies directed to pre-nosological diagnostics of stress-induced conditions and diseases as well as their significance have considerably grown. In the recommendations of the European society of cardiol-ogists the speed of distribution of a pulse wave (SDPW) along an aorta is included in the scheme of stratification of cardi-ovascular risk. A research objective – on the basis of studying of speed of distribution of a pulse wave in the modeled stressful influence to reveal and prove interrelations with disadaptation markers by results of heart rate variability (HRV), that will allow to improve the system of medical escort of firefighters and rescuers. The certified standard equipment and hardware and software «VNS-Mikro» produced by LLC Neyrosoft (Ivanovo, Russia) is intended for registration and the mathematical analysis of HRV, «Poli-Spektr-8» for registration of SRPV, «Reo-Spektr» for a rheoencephalogram research, and the additional author's module of objective assessment of professional adaptation «The adaptation traffic light» was used. The possibility of screening without participation of medical personnel in the offered module was solved by application of animation of «traffic light»: the conclusion about degree of suitability of the respondent to further work was based on the degree of deviation of the allocated disadaptive parameters of the HRV from those received in the daily routine. The novelty of technology is in her personalization: the indicators correspond to own result received under the conditions of daily activity («zero level»). Results of researches and polygon experiments on practical use of the program of objective assessment of professional adaptation are given in article.
Adaptive changes in blood flow under the influence of the simulated extreme load have affected the supplying link: a reliable decrease in the tone of the arterioles and vessels of the microcirculatory bed, reflecting the hypotensive response to stress-related effects (is WILD) and moderate increase in venous congestion was established (air defense). Key parameters like total power of the background sample spectrum (TPф), index of vagosympathetic interaction of an active orthostatic test (LF/HF), reactivity of reflex departments were used for assessment of stress-related effects. Correlative communication between indicators of LF/HF and RI, LF/HF and Vmax, LF/HF and Vcp, LF/HF and DIA, LF/HF is defined the average force of the return orientation and it is WILD, and both for assessment of a condition of an internal carotid, and for vessels of the vertebro-bazillyarny pool. Correlative communication a boundary by indicators K 30\15 and Vcp, K 30\15 and Vmax, K 30\15 and RI is revealed the average force of positive orientation.
The obtained data have confirmed the assumption of a parasympathetic component of steady functioning at stressful in-fluences.
It is statistically proved that 83% of cases of professional disadaptation at extreme loadings on indicators of HRV is followed by increase in the speed of distribution of a pulse wave (SDPW) on vessels of muscular type more age norms and in 64% of cases – higher than 12 m/s. It isn't established significant interrelations between HRV and SRPV with professional route duration to 5 years and more than 10. At the same time, correlation interrelations between SDPW and disadaption indicators of HRV in group lasting professional route of 5-10 years have turned out reliable (at the level r≤0,01) that the stress - active mechanisms of adaptation can be the certificate of extreme tension in formation.
It is shown that the technology of integration of a new technique in the generalized indicator of availability for service in emergency allows improving the system of medical escort of firefighters and rescuers.
The reported study was funded by RFBR according to the research project № 15-29-01068.

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