Analysis and assessment of morbidity with temporary disability among locomotive crew members in the Perm region in 2019–2024

Full Text

Introduction

The health of workers is an important factor in increasing labor productivity and improving quality of life, influencing the development of the economic and social spheres of society. In today's world, where the pace of life and stress levels are steadily increasing, maintaining the health of the working population is becoming a key task for both employers and the state. Every year, statistics show a decline in the health of the working population [1–8]. According to the International Labor Organization (ILO), approximately 3 million people die in the workplace each year, with more than 75% of deaths related to work activities – cardiovascular and respiratory diseases, malignant neoplasms1.

Experts from the World Health Organization (WHO) [2] and the ILO2 have created global strategies to prevent and mitigate disease risk factors, improve health, national security, medicine and occupational health. The new National Projects "Long and Active Life" and "New Health-Saving Technologies"3 are being implemented in the healthcare system of the Russian Federation (RF), in accordance with modern development goals4. These projects are aimed at preserving and strengthening health, improving professional well-being, and the effectiveness and efficiency of medical research and development.

Railways are the most popular means of transport for passenger and freight service in the regions of the Russian Federation. The first group of people directly responsible for railway traffic are locomotive crew members (LCMs), engineers, and their assistants. The work of locomotive drivers involves a high level of responsibility for the lives of passengers, the safety of cargo and rolling stock, the safety running of traffic, and the reduction of the risk of significant economic losses [5]. Every day, LCMs are exposed to complex factors of the production environment and the work process [6; 8; 9]. Analysis of temporary disability morbidity (TDI) in this category of individuals is very important for a comprehensive assessment of health status, identification and correction of risk factors, and improvement of medical prevention.

The objective of the study is to analyze the incidence of temporary disability among locomotive crew workers in the Perm region serving the Sverdlovsk Railway of JSC Russian Railways from 2019 to 2024 in order to determine the dynamic series indicators and forecast the incidence rate for 2025.

Materials and Methods

The incidence assessment is based on data from Federal Statistical Observation Form No. 19-VN and was conducted at the Perm Clinical Hospital "Russian Railways-Medicine." Statistical processing of the obtained data was performed on a PC using the Excel® 2016 MSO spreadsheet program (© Microsoft, 2016).

The statistical series indicators were determined [7]:

• absolute increase or decrease is the difference between the previous and subsequent levels;
• growth (decline) rate – shows the percentage of increase or decrease of a level. It is calculated by dividing the next level by the previous one and multiplying by 100 %;
• growth (decline) rate – shows the relative rate of change in data. It is determined by dividing the absolute growth (decline) by the previous level and multiplying by 100 %. The growth rate is equal to the growth rate minus 100;
• absolute value of 1 % growth characterizes the value of 1 % of the phenomenon being studied. It is calculated by dividing the absolute growth by the growth rate or by dividing the previous level by 100;
• obviousness indicator – demonstrates the dynamics of the phenomenon relative to the initial level, which is taken as 100 %. It is determined by dividing each subsequent level by the initial level and multiplying by 100 %.

The calculation of expected indicators (forecast) for 2025 was carried out on the basis of regression analysis [10]:

Y₇ = a₀ + a₁ ∙ t;

a₁ = σ_Y /σ_t ∙ R_Yt;

a₀ = MY – Mt ∙ a₁,

where Y₇ – forecast for 2025. year number 7), a₁ – regression coefficient, a₀ – free term of the regression equation, σ_Y – standard deviation of a series Y, standard deviation of a series t (years), R_Yt – coefficient of linear correlation of values Y and t, MY – arithmetic mean of a series Y, Mt – arithmetic mean of the series t.

Results and Discussion

According to statistics, the number of LCMs in the Perm division of the Sverdlovsk Railway service of “JSC Russian Railways” increases annually (2019 – 2,810 people, 2020 – 2,808, 2021 – 2,861, 2022 – 2,896, 2023 – 3,004, 2024 – 3,050), and in terms of illnesses, there has been a decrease in absolute days since 2022 (2019 – 36,373 days, 2020 – 40,923, 2021 – 48,719, 2022 – 46,457, 2023 – 37,570, 2024 – 29,160, and absolute cases – since 2023 (2019 – 3246, 2020 – 3448, 2021 – 4113, 2022 – 4489, 2023 – 3714, 2024 – 2912). When calculating the expected indicators for 2025 for all diseases, an increase of up to 35,028.4 absolute days and 3,604.1 absolute cases was obtained compared to the data for 2024.

The most frequently recorded diseases are identified by the number of absolute days and absolute cases: diseases of the respiratory system, musculoskeletal system, injuries and poisoning, diseases of the digestive system and the blood circulatory system.

In terms of the number of absolute cases for 2019–2024 (Table 1, Fig. 1): the respiratory diseases group leads annually, with an increase observed since 2021 and a decrease since 2023, with a downward trend in the remaining categories. An increase in absolute cases of respiratory diseases is projected for 2025 compared to 2019–2021 and 2024, while in 2025 the trend toward an annual decrease in the number of absolute cases in the circulatory system diseases group continues.

Based on the number of absolute days for 2019–2024 (see Table 1, Fig. 2), cases of respiratory diseases were the longest lasting. The blood circulatory system disease group showed an increase in 2019. According to the forecast for 2025, the number of absolute days in respiratory disease groups will increase, but in other groups, a trend toward an annual decrease is observed.

 

Table 1. Absolute days and absolute cases from 2019 to 2024 and assumed forecast for 2025

Diseases	Abs.	2019	2020	2021	2022	2023	2024	Forecast for 2025
Respiratory system	Days	15983	18385	19435	18673	17844	14364	16399.3
	Cases	1829	1824	2033	2213	2190	1735	2051.5
Digestive system	Days	2399	2059	1915	1993	1781	1531	1436.7
	Cases	185	174	175	200	174	144	157.3
Blood circulatory system	Days	2736	2473	2263	2391	1935	1794	1645.7
	Cases	200	192	168	199	168	159	156.4

 

Fig. 1. Number of absolute cases for 2019–2024 and forecast for 2025

 

Fig. 2. Number of absolute days for 2019–2024 and forecast for 2025

 

Respiratory, circulatory, and digestive diseases lead in terms of sick days per 100 employees (Table 2, Fig. 3). According to the forecast, the number of sick days in respiratory disease groups is expected to increase in 2025, while the annual trend of decreasing sick days per 100 employees for circulatory and digestive diseases continues.

Respiratory diseases predominate in cases per 100 workers (see Table 2, Fig. 4). Estimates suggest an increase in the number of cases per 100 workers in respiratory disease groups in 2025. A slight increase, compared to 2024, is noted for diseases of the digestive system. In the circulatory system disease group, the trend toward a decrease in cases per 100 workers annually continues.

The calculation of the dynamic series indicators for morbidity in the groups of respiratory, digestive, and circulatory diseases was carried out based on the number of cases per 100 workers. Over the past six years, the incidence of respiratory diseases has decreased by 12.6 % (or by 8.2 ‰). The rate of decrease/increase in this group changed unevenly over the years, the absolute value of 1 % of morbidity increased from 0.667 to 0.729. According to calculations, it was established that over six years, the incidence in the group of digestive diseases decreased by 40.43 % (or by 1.9 ‰), the rate of decrease/increase changed unevenly over the years, and the absolute value of 1 % of morbidity decreased from 0.066 to 0.058.

 

Table 2. Days and cases per 100 workers from 2019 to 2024 and forecast for 2025

Diseases		2019	2020	2021	2022	2023	2024	Forecast for 2025
Respiratory system	Days	568.7	654.7	679.2	644.9	594.1	471	Respiratory system
	Cases	65.1	65	71	76.4	72.9	56.9	66.7
Digestive system	Days	85.4	73.3	66.9	68.8	59.3	50.2	Digestive system
	Cases	6.6	6.2	6.1	6.9	5.8	4.7	5.1
Blood circulatory system	Days	97.4	88.1	79.1	82.6	64.4	58.8	Blood circulatory system
	Cases	7.1	6.8	5.9	6.9	5.6	5.2	5.0

 

Fig. 3. Number of days per 100 employees from 2019 to 2024 and forecast for 2025

 

Fig. 4. Number of cases per 100 workers from 2019 to 2024 and forecast for 2025

 

Over six years, the incidence in the group of circulatory diseases decreased by 36.54 % (or by 1.9 ‰), the rate of decrease/increase changed unevenly over the years, and the absolute value of 1 % of morbidity decreased from 0.071 to 0.056.

Conclusions

Despite the annual increase in the number of LCMs in the Perm division of the Sverdlovsk Railway service of “JSC Russian Railways”, there is a decrease in absolute days and cases for all diseases. However, when calculating the forecast for 2025, a significant increase in respiratory diseases, while digestive and circulatory diseases were observed mainly in 2021 and 2022, which, in our opinion, is related to the novel coronavirus infection and its complications.

For 2025, an increase in absolute cases of respiratory and digestive diseases is projected, while for circulatory diseases, a trend of annual decline is expected. In terms of absolute days, there is an increase in the number of respiratory diseases and a decrease in the digestive and circulatory groups. There is an increase in the number of days per 100 workers due to respiratory diseases and an annual decrease in other groups; however, there is an increase in the number of cases in the respiratory and digestive disease groups and a decrease in the circulatory group. It has been established that over the past six years, the incidence per 100 workers has decreased for respiratory diseases by 12.6 % (or 8.2 ‰), digestive diseases by 40.43 % (or 1.9 ‰), and circulatory diseases by 36.54 % (or 1.9 ‰). The rate of decrease/increase for all diseases varied unevenly over the years. The absolute value of 1 % of morbidity increased for respiratory diseases and decreased for digestive and circulatory diseases.

Morbidity analysis with the calculation of a forecast for 2025 is a rational tool for the practical implementation of preventive and therapeutic activities of medical institutions for the early diagnosis of diseases, which at the outpatient stage contributes to the creation of risk groups, as well as use in the development of corporate programs to strengthen the professional health of workers.

 

1International Labour Organization, available at: https://www.ilo.org/ru/resource/news/ neschastnye-sluchai-i-zabolevaniya-svyazannye-s-trudovoy-deyatelnostyu#:~:text=Guard.

2International Labour Organization (ILO). Global Strategy on Occupational Safety and Health and its Plan of Action (2024–2030), available at: https://www.ilo.org/ sites/default/files/2025-01/OSH_Globaly_Strategy_r6.pdf.

3 Decree of the President of the Russian Federation of July 21, 2020 No. 474 "On the national development goals of the Russian Federation for the period up to 2030": Garant.ru, available at: https://www.garant.ru/products/ipo/prime/doc/ 74304210; Decree of the President of the Russian Federation of May 7, 2024 No. 309 "On the national development goals of the Russian Federation for the period up to 2030 and for the future up to 2036": Garant.ru, available at: https:// www.garant.ru/ products/ipo/prime/doc/408892634

4 Unified plan for achieving national development goals of the Russian Federation for the period up to 2024 and for the planning period up to 2030, available at: http://static.government.ru/media/files/ZsnFICpxWknEXeTfQdmcFHNei2FhcR0A.pdf?clckid=8d4818d4.

About the authors

N. N. Malyutina

Ye.A. Vagner Perm State Medical University

Email: Dr-malyutina@yandex.ru
ORCID iD: 0000-0002-3475-2505

DSc (Medicine), Professor, Head of the Department of Faculty Therapy №2, Occupational Patho­logy and Clinical Laboratory Diagnostics

Russian Federation, Perm

O. Yu. Shilkova

Ye.A. Vagner Perm State Medical University; Perm Clinical Hospital «Russian Railways-Medicine Perm»

Author for correspondence.
Email: Dr.shilkova@gmail.com
ORCID iD: 0009-0004-5422-4277

Postgraduate Student of the Department of Faculty Therapy №2, Occupational Pathology and Clinical Laboratory Diagnostics, Cardiologist

Russian Federation, Perm; Perm

V. S. Sheludko

Ye.A. Vagner Perm State Medical University

Email: shelvs@rambler.ru
ORCID iD: 0000-0002-7080-9142

PhD (Medicine), Specialist of the Department of Scientific Research

Russian Federation, Perm

References

Supplementary files