RU2697780C1 - Method for assessment of efficiency of therapeutic and preventive food rations for working priority occupations of copper metallurgy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to nutrition hygiene, and can be used for assessment of efficiency of medical and preventive nutrition rations for working priority occupations of copper metallurgy. Health status indicators are measured. Score of the health indicators obtained is measured. That is followed by taking the X1 – body weight index (BWI), BWI ≥30 is taken as 2, BWI 25–29.9 is taken as 1, BWI <25 is received as 0; X2 – waist circumference, male index ≥102 cm, in females ≥88 cm is taken as 2, male index 92–101 cm, in women 80–88 cm is taken as 1, male index <92 cm, in females <80 cm beyond 0; X3 – percentage of fat mass is taken as 2, percentage of fat mass is 20–29 % in males and 25–29 % in females are taken as 1, absence of trait per 0; X4 – percentage of active cell body weight <53 % in males and <50 % in females take 2, absence of trait 0; X5 is plasma glucose ≥7.8 mmol/l is taken as 2, value 6–7.7 is taken as 1, the absence of the attribute is taken as 0; X6 is blood cholesterol ≥5.6 mmol/l is taken for 2, blood cholesterol is 5.2–5.5 mmol/l is taken as 1, no trait is 0; X7 – triglycerides >1.81 mmol/l in males and >1.53 mmol/l in women is taken as 2, absence of trait as 0; X8 – high-density lipoproteins (HDLP) <1 mmol/l is taken as 2, 1–1.4 mmol/l is taken as 1, index more than 1.4 mmol/l per 0; X9 is delta-aminolevulinic acid (ALA) in urine <43 mcmol/l is taken as 0, exponent ≥43 mcmol/l after 2; X10 – resistance to hypoxia, Serkin test, maximal inhalation respiratory depression at rest <40 seconds are taken as 2, absence of attribute as 0; X11 – resistance to hypoxia, Serkin test, maximum inspiratory retention after physical activity in 20 sit-ups for 30 seconds <15 seconds are taken as 2, absence of attribute as 0; X12 – average result of three samples of peak exhalation rate below average age norm is taken as 2, absence of attribute as 0; X13 is result of six-minute walking test <550 m is taken as 2, absence of attribute as 0; X14 – Voitenko health self-assessment questionnaire, each positive answer to the question is taken as 1; X15 – number of metals in blood or urine within reference or mean group values is taken as 0 for each indicator: for copper in blood mcg/dmi, for lead in blood mcg/dmi, for copper in urine mcg/dmi, for lead in urine mcg/dmi, feature presence 1 point for each indicator. First integral index of the health status of X is calculated by the sum of the points. Upon completion of the period of stay in the clinic, the above-mentioned health assessment studies are repeated; the points are calculated as follows: if the changes occurred within the norm range, then 0 points; if the indicator is outside the normal range, then taking into account the number of points accepted for deviations of this level of values; if during primary examination the value was outside the range of the norm, then if it changes, 0.1 point is added to or subtracted from the previous test score depending on the direction of the dynamics. Second integral index of the health status Y is calculated by the sum of the scores. Analysis of the change in the integral index of the health status is carried out: if the second integral index Y decreases relative to the first integral index X, a conclusion is made on the effectiveness of the dietary intake, if the second integral index Y is increased relative to the first integral index X, a conclusion is made on the ineffectiveness of the dietary intake, and a decision is taken to correct the therapeutic and preventive nutrition, and individual nutrition recommendations are additionally given.

EFFECT: method provides higher accuracy of evaluating health changes of each analysed person by measuring 15 indicators in dynamics and comparative assessment of changes in these values in the main and control groups.

1 cl, 3 tbl, 3 ex

Description

The invention relates to the field of medicine, hygiene, namely food hygiene, and can be used to evaluate the effectiveness of therapeutic and preventive nutrition in working in conditions of exposure to the body of adverse production factors, metallurgical production.

To assess the effectiveness of therapeutic and preventive nutrition, an analysis of changes in the health status of workers is carried out according to the following indicators:

- body mass index is estimated by the results of measurements of anthropometric indicators (height, weight, waist circumference, hip circumference),

- body composition is determined using bioimpedanceometry (percentage of fat mass, weight of skeletal muscle and lean mass) with the analyzer of component composition of the body "MEDASS" or other device intended for this purpose that has a certificate of registration;

- indicators of carbohydrate and fat metabolism (blood glucose, cholesterol, triglycerides, high and low density lipoproteins) are determined by laboratory methods using biochemical analyzers,

- the content of heavy metals in biological media (blood and urine) of their markers (aminolevulinic acid, reticulocytes) is determined using certified methods,

- functional tests include assessment of resistance to hypoxia, peak flowmetry, six-minute walk test);

- subjective assessment of health with the help of a health self-assessment test according to V.P. Voitenko.

Known from patent No. 2444381 "Method of weight correction", published: 03/10/2012

The known method includes collecting an anamnesis and its analysis, reveals the type of eating disorders and personal psychological characteristics of the patient, followed by sessions of rational psychotherapy. A patient’s blood and saliva are sampled for a blood group, as well as its secretory or non-secretory status. They also measure bioimpedansometry and then compose a “health passport”. Make a list of allowed foods, form a motivation for new eating behavior.

The disadvantage of this method is the inability to form a persistent motivation for new eating behavior in 1-2 visits. Monitoring changes in health is reduced to monitoring changes in bioimpedance measurement data.

Known from patent No. 2501516 “A method for objective assessment of the psychosomatic status of paramilitary personnel”, published: 12/20/2013. The known method includes psychological testing, a general analysis of blood and urine, a biochemical blood test, determination of heart rate, blood pressure, ultrasound measurement the size of the liver, pancreas, kidneys and prostate, psychophysiological examination by the method of rapid diagnosis of the properties of the nervous system by psychomotor indicators E.P. Ilyin (Tapping-test) with the assessment of each characteristic on a scale and resolution of the question of fitness for further service or the need for rehabilitation.

The disadvantage of this method is the inability to assess the nutritional status, eating habits and the level of adaptation to adverse chemical environmental factors.

Known from patent No. 2204938, “Method of regional bioimpedansometry,” published: May 27, 2003.

A known method of regional bioimpedansometry is to pass a probing current through a portion of the human body, measure the magnitude of the voltage across it, calculate impedances to diagnose component composition of the body. The method allows you to control the dynamics of changes in body composition.

The disadvantage of this method is the inability to comprehensively assess the effectiveness of therapeutic and prophylactic nutrition on the dynamics of human health.

The technical result of the proposed method for evaluating the effectiveness of therapeutic and prophylactic nutrition is to increase the accuracy of changes in the health status of each person under study by 15 indicators in dynamics and a comparative assessment of changes in these indicators in the main and control groups.

The method of evaluating the effectiveness of diets of therapeutic and preventive nutrition for working priority professions of copper metallurgy by measuring health indicators, which consists in the fact that they carry out a point assessment of the health indicators obtained when measuring, is claimed.

X1 - body mass index (BMI), BMI ≥30 is taken as 2, BMI 25-29.9 is taken as 1, BMI <25 is taken as 0;

X2 - waist circumference, the indicator for men ≥102 cm, for women ≥88 cm they take for 2, the indicator for men 92-101 cm, for women 80-88 cm they take for 1, the indicator for men <92 cm, for women <80 cm for 0;

X3 - the percentage of fat mass is taken as 2, the percentage of fat mass is 20-29% in men and 25-29% in women is taken as 1, the absence of a sign is 0;

X4 - the percentage of active cellular body mass <53% in men and <50% in women take 2, the absence of a sign for 0;

X5 - plasma glucose ≥7.8 mmol / L is taken as 2, the indicator 6-7.7 is taken as 1, the absence of a sign is taken as 0;

X6 - blood cholesterol ≥5.6 mmol / L is taken as 2, blood cholesterol 5.2-5.5 mmol / L is taken as 1, the absence of evidence for 0;

X7 - triglycerides> 1.81 mmol / L in men and> 1.53 mmol / L in women are taken for 2, the absence of a sign for 0;

X8 - high density lipoproteins (HDL) <1 mmol / L is taken as 2, the indicator 1-1.4 mmol / L is taken as 1, the indicator is more than 1.4 mmol / L as 0;

X9 - delta-aminolevulinic acid (ALA) in urine <43 μmol / L is taken as 0, indicator ≥43 μmol / L for 2;

X10 - resistance to hypoxia, Serkin's test, the maximum breath holding on inspiration at rest <40 seconds is taken as 2, the absence of a sign as 0;

X11 - resistance to hypoxia, Serkin's test, the maximum breath holding on inspiration after exercise of 20 squats in 30 seconds <15 seconds is taken as 2, the absence of a sign as 0;

X12 - the average result of three samples of the peak expiratory flow rate below the average age norm is taken as 2, the absence of a sign as 0;

X13 - the result of a six-minute walk test <550 m is taken for 2, the absence of a sign for 0;

X14 - health self-assessment questionnaire by V.P. Voitenko, each positive answer to the question is taken as 1;

X15 - the amount of metals in the blood or urine within the reference or group average values is taken as 0 for each indicator: for copper in the blood μg / dmi, for lead in the blood μg / dmi, for copper in the urine μg / dmi, for lead in the urine mcg / dmі, the presence of a sign of 1 point for each indicator,

by the sum of the points, the first integral indicator of the state of health X is calculated,

at the end of the period of stay in the clinic, the above studies to assess the state of health are repeated, the scores are calculated as follows:

if the changes occurred in the normal range, then 0 points;

if the indicator is outside the normal range, then take into account the number of points adopted for deviations of this level of values;

if during the initial research the indicator was outside the range of the norm, then when it changes, 0.1 points are added to or subtracted from the previous study, depending on the direction of the dynamics,

the second integral indicator of the state of health Y is calculated by the sum of points

analyze the changes in the integral indicator of the state of health:

if the second integral indicator Y has decreased in relation to the first integral indicator X, then a conclusion is made about the effectiveness of the diet of therapeutic and prophylactic nutrition, if the second integral indicator Y has increased in relation to the first integral indicator of X, then a conclusion is made about the inefficiency of the diet of therapeutic and preventive nutrition and make a decision on the correction of therapeutic and prophylactic nutrition and additionally issue individual recommendations on nutrition.

The technical result of the proposed method is achieved in that each indicator is evaluated in points in relation to the recommended reference values of a healthy person. The obtained points are summarized and receive the first individual integral indicator of the state of health. At the end of the observation period, the studies are repeated. If during the second study changes occurred within the normal range, they are taken as 0 points. If, during the second examination, the indicator is out of the normal range, it is assigned the number of points accepted for deviations of this level of values during the initial examination. If during the initial research the indicator was outside the range of the norm, then when it changes, we add or subtract 0.1 points to the score of the previous study, depending on the direction of the dynamics (positive or negative). At the end of repeated studies, the points are summed up - the second integral indicator of the state of health is determined.

The treatment and prophylactic variant of the diet is considered effective in the case when the average integral indicator of the health status of the main group (total number of points) of the subjects during the second study significantly decreased from that of the control group. With a deterioration in the integral indicator of health status, i.e. an increase in the number of points in relation to the initial one (subject to observing the diet in the clinic), a decision is made on the correction of therapeutic and preventive nutrition and individual recommendations on nutrition are additionally issued.

The proposed method is as follows:

1. Choose a metallurgical industrial enterprise, which has in the list of harmful factors affecting workers, heavy metals (priority professions).

2. During the periodical medical examination by workers of this enterprise, 2 groups of heavy metals in contact with them during labor activity (the main and control groups) aged 30 to 60 years with work experience under these conditions for more than 1 year related to the main professions are selected clinical manifestations of diseases.

3. At the initial examination, the following indicators are measured in workers:

- body mass index is estimated by the results of measurements of anthropometric indicators (height, weight, waist circumference, hip circumference),

- body composition is determined using bioimpedanceometry (percentage of fat mass, weight of skeletal muscle and lean mass) with the analyzer of component composition of the body "MEDASS" or other device intended for this purpose that has a certificate of registration;

- indicators of carbohydrate and fat metabolism (blood glucose, cholesterol, triglycerides, high and low density lipoproteins) are determined by laboratory methods using biochemical analyzers,

- the content of heavy metals in biological media (blood and urine) of their markers (delta-aminolevulinic acid, reticulocytes) is determined using certified methods,

- functional tests include assessment of resistance to hypoxia, peak flowmetry, six-minute walk test);

–Subjective health assessment using the health self-assessment test on the V.P. Voitenko.

4. A point-based assessment is obtained when measuring health indicators (X):

X1 - body mass index (BMI). Calculation of BMI was carried out according to the formula: BMI = weight (kg) / height (m) ² . ^. The presence of a BMI regardless of gender ≥30 is taken as 2, the presence of a BMI of 25-29.9 is taken as 1, a BMI of <25 is taken as - 0;

X2 - waist circumference, measured with a calibrated centimeter tape. The indicator for men ≥102 cm, for women ≥88 cm they take for 2, the indicator for men 92-101 cm, for women 80-88 cm they take for 1, the indicator for men <92 cm, for women <80 cm - for 0;

X3 - the percentage of fat mass according to bioimpedance analysis of body composition ≥30% regardless of gender is taken as 2, the percentage of fat mass of 20-29% in men and 25-29% in women is taken as 1, the absence of a sign is taken as 0;

X4 - percentage of active cell mass according to bioimpedance analysis of body component composition <53% in men and <50% in women take 2, the absence of a sign - for 0;

X5 - plasma glucose ≥7.8 mmol / L is taken as 2, the indicator 6-7.7 is taken as 1, the absence of a sign is taken as 0;

X6 - blood cholesterol ≥5.6 mmol / L is taken as 2, blood cholesterol 5.2-5.5 mmol / L is taken as 1, the absence of a sign is taken as 0;

X7 - triglycerides> 1.81 mmol / L in men and> 1.53 mmol / L in women are taken for 2, the absence of a sign - for 0;

X8 - high density lipoproteins (HDL) <1 mmol / L is taken as 2, the indicator 1-1.4 mmol / L is taken as 1, an indicator of more than 1.4 mmol / L is taken as 0;

X9 - delta-aminolevulinic acid (ALA) in urine <43 μmol / L is taken as 0, indicator ≥43 μmol / L - for 2;

X10 - resistance to hypoxia (Serkin test). The maximum breath holding on inspiration at rest <40 seconds is taken as 2, the absence of a sign is taken as 0;

X11 - resistance to hypoxia (Serkin test). The maximum breath holding after inspiration (20 squats in 30 seconds) - <15 seconds is taken as 2, the absence of a sign - as 0;

X12 - the average result of three samples of peak expiratory flow rate (peak flowmetry) below the average age norm is taken as 2, the absence of a sign is taken as 0;

X13 - six-minute walk test. A result <550 m is taken for 2, the absence of a sign - for 0;

X14 - health self-assessment questionnaire by V.P. Voitenko, each positive answer to the question (answer “YES”) is taken as 1;

X15 - the amount of metals in the blood or in the urine, within the reference or group average values, is taken as 0 for each indicator (for copper in the blood μg / dmi, for lead in the blood μg / dmi, for copper in the urine μg / dmi, for lead in urine mcg / dmі), the presence of a sign - 1 point for each indicator.

5. The data on the assessment of the state of health are entered in table 1 and the first integral indicator of the state of health (X) is calculated by the sum of the points.

Table 1 - Assessment of health indicators, in points

No. p / p Indicator Initial Examination (X) value point one body mass index (BMI) BMI 19-24.9 0 BMI 25-29.9
or BMI <19 one BMI ≥30 2 2 waist circumference in men <92 cm, in women <80 cm 0 in men 92-101cm,
in women 80-88 cm one in men ≥102cm,
in women ≥88cm 2 3 fat percentage in men <20%
in women <25% 0 in men 20-29% in women 25% -29% one in men ≥ 30%
in women ≥30% 2 four percentage of active cell mass ≥53% in men and ≥50% in women 0 <53% in men and <50% in women 2 five plasma glucose <6 mmol / l 0 6-7.7 mmol / L one ≥7.8 mmol / L 2 6 cholesterol <5.2 mmol / l 0 5.2-5.5 mmol / L one ≥5.6 mmol / L 2 7 triglycerides <1.81 mmol / L
in men
and <1.53 mmol / L in women 0 ≥1.81 mmol / L in men and ≥1.53 mmol / L in women 2 eight HDL > 1.4 mmol / l 0 1.4-1 mmol / L one <1 mmol / l 2 No. p / p Indicator Initial Examination (X) value point 9 urinary delta aminolevulinic acid <43 μmol / L 0 ≥43 μmol / L 2 ten maximum breath holding at rest > 40 seconds 0 ≤ 40 seconds 2 eleven maximum breath holding after physical exertion > 15 seconds 0 ≤15 seconds 2 12 average result of three samples of peak expiratory flow ≥ average age 0 below average age 2 13 six minute walk test result ≥ 550 m 0 <550 m 2 14 health self-assessment testing according to V.P. Voitenko each positive answer to the question (answer “YES”) one 15 the amount of metal in the blood or urine within reference or group average values 0 Above reference or group average one

6. During the observed period in the clinic, workers from the main group receive the main version of the standard diet with lunch replacement by the treatment and prophylactic complex, formed on the basis of the principles of balanced therapeutic and prophylactic nutrition, the control group - the main version of the standard diet for food in the hospital.

7. At the end of the period of stay in the clinic, the above studies are repeated to assess the state of health. Points are calculated as follows:

- if during the second study changes occurred in the normal range, they are taken as 0 points;

- if, during the re-examination, the indicator is out of the normal range, it is assigned the number of points accepted for deviations of this level of values indicated in table 1;

- if during the initial study the indicator was outside the range of the norm, then when it changes, we add or subtract 0.1 points to the score of the previous study, depending on the direction of the dynamics (positive or negative).

5. The obtained points are entered in the table and the second integral indicator of the state of health (Y) is calculated by the sum of the points.

6. The changes in the integral indicator of the state of health (IIPSZ) are calculated before and after the stay examined in the clinic (X – Y). The effectiveness of therapeutic nutrition will be proven if:

- the integrated indicator of the state of health has improved, i.e. integral indicator (Y) decreased in relation to the initial integral indicator (X);

- the average integral indicator of the state of health of the main group (total number of points) of the subjects during the second study decreased compared to the initial one and significantly differs from that of the control group.

With a deterioration in the integral indicator of health status, i.e. an increase in the number of points in relation to the initial one (subject to observing the diet in the clinic), a decision is made on the correction of therapeutic and preventive nutrition and individual recommendations on nutrition are additionally issued.

We selected 50 workers of the industrial enterprise, the main and control groups that meet the selected criteria, obtained positive dynamics. The integral indicator Y decreased compared to the initial X in the main group by 12 points, in the control group by 8 points i.e. the health status of the control group improved 1.5 times.

Examples of the method.

Example 1

Patient A. from the main group, 45 years old. He has been working at the enterprise for the production and processing of copper for 5 years. Initial examination Weight 77 kg, height 176 cm, waist circumference 89 cm (0 points), body mass index 24.9 (0 points). The percentage of fat mass is 18% (0 points), the percentage of active cell mass is 54% (0 points). Laboratory test results - plasma glucose 4.8 mmol / L (0 points), cholesterol 4.9 mmol / L (0 points), triglycerides 0.96 mmol / L (0 points), HDL 1.85 mmol / L (0 points). Delta-aminolevulinic acid in urine 30 μmol / L (0 points). The maximum breath holding on inspiration at rest is 30 seconds (2 points), after physical activity (20 squats in 30 seconds) - 15 seconds (2 points). The average result of three samples of peak expiratory flow rate (peak flowmetry) is 510 l / min (average age norm - 530 l / min) (2 points). The result of the six-minute walk test is 521 m (2 points). health self-assessment testing - all answers are negative (0 points).

The initial integral indicator of the state of health X = 8.

Subsequent examination after staying at the clinic for 14 days. Weight 77 kg, height 176 cm, waist circumference 90 cm (0 points), body mass index 24.9 (0 points). The percentage of fat mass is 18% (0 points), the percentage of active cell mass is 54% (0 points). Laboratory test results - plasma glucose 5.2 mmol / L (0 points), cholesterol 4.8 mmol / L (0 points), triglycerides 1.1 mmol / L (0 points), HDL 1.8 mmol / L (0 points). Delta-aminolevulinic acid in urine 25 μmol / L (0 points).

The maximum breath holding on inspiration at rest is 40 seconds (0 points), after exercise (20 squats in 30 seconds) - 16 seconds (0 points). The average result of three samples of peak expiratory flow rate (peak flowmetry) is 545 l / min (average age norm - 530 l / min) (0 points). The result of a six-minute walk test is 560 m (0 points). Health Self-Assessment Testing by V.P. Voitenko - all answers are negative (0 points). Systolic blood pressure 120 mmHg Static balancing 6 sec.

Integral health score Y = 0.

Table 2 - Calculation of the integral indicator of the state of health in patient A from the main group

Indicator X initial examination Follow-up Examination Y Value point value point Body mass index 24.9 0 24.9 0 Waist circumference 0 0 Fat percentage 18% 0 18% 0 Plasma glucose 4.8 mmol / L 0 5.2 mmol / l 0 Cholesterol 4.9 mmol / l 0 4.8 mmol / L 0 Triglycerides 0.96 mmol / L 0 1,1 mmol / l 0 HDL 1.85 mmol / L 0 1.8 mmol / l 0 ALA in the urine 30 μmol / l 0 25 μmol / l 0 Maximum breath holding at rest 30 seconds 2 40 seconds 0 Maximum breath holding after exercise 15 seconds 2 16 seconds 0 The average result of three samples of peak expiratory flow 510 l / min 2 545 l / min 0 Six minute walk test 2 0 Health Self-Assessment Testing by V.P. Voitenko no positive answers 0 no positive answers 0 Copper content
in blood
in urine
Blood lead
in urine μg / dmі, μg / dmі
mcg / dmі
mcg / dmі Total eight 0

IIPSZ = X (8) - Y (0) = 8

Thus, during the observation period, a positive dynamics of the state of health was obtained; the integral indicator of the state of health Y decreased by 8 points.

Example 2

Patient B. from the control group 45 years. He has been working at the enterprise for the production and processing of copper for 5 years. Initial examination Weight 99.1 kg, height 176 cm, waist circumference 105 cm (2 points), body mass index 32 (2 points). The percentage of fat mass is 35% (2 points), the percentage of active cell mass is 54% (0 points). Laboratory test results - plasma glucose 6.2 mmol / L (1 point), cholesterol 5.9 mmol / L (2 points), triglycerides 2.2 mmol / L (2 points), HDL 0.95 mmol / L (2 point). Delta-aminolevulinic acid in urine 45 μmol / L (2 points). The maximum breath holding on inspiration at rest is 50 seconds (0 points), after exercise (20 squats in 30 seconds) - 15 seconds (2 points). The average result of three samples of peak expiratory flow rate (peak flowmetry) is 510 l / min (average age norm - 530 l / min) (2 points). The result of a six-minute walk test is 560 m (0 points). Health Self-Assessment Testing by V.P. Voitenko - 7 positive answers (7 points).

Subsequent examination after staying at the clinic for 14 days. Weight 98.5 kg, height 176 cm, waist circumference 103 cm (1.9 points), body mass index 31.8 (1.9 points). The percentage of fat mass is 33% (1.9 points), the percentage of active cell mass is 54% (0 points). Laboratory test results - plasma glucose 5.9 mmol / L (0 points), cholesterol 5.8 mmol / L (1.9 points), triglycerides 1.9 mmol / L (1.9 points), HDL 0.93 mmol / l (2.1 points). Delta-aminolevulinic acid in urine 35 μmol / L (0 points). The maximum breath holding on inspiration at rest is 47 seconds (0 points), after exercise (20 squats in 30 seconds) - 15 seconds (2 points). The average result of three samples of peak expiratory flow rate (peak flowmetry) is 545 l / min (average age norm is 530 l / min) (0 point). The result of a six-minute walk test is 560 m (0 points). Health Self-Assessment Testing by V.P. Voitenko - 3 positive answers (3 points).

Table 3 - Calculation of the integral indicator of the state of health in patient B from the control group

Indicator Primary examination Follow-up examination value point value point Body mass index 32 2 31.8 1.9 Waist circumference 2 1.9 Fat percentage 35% 2 33% 1.9 Plasma glucose 6.2 mmol / l one 5.9 mmol / L 0 Cholesterol 5.9 mmol / L 2 5.8 mmol / L 1.9 Triglycerides 2.2 mmol / l 2 1.9 mmol / L 1.9 HDL 0.95 mmol / L 2 0.93 mmol / L 2.1 ALA in the urine 45 μmol / L 2 35 μmol / l 0 Maximum breath holding at rest 50 seconds 0 47 seconds 0 Maximum breath holding after exercise 15 seconds 2 15 seconds 2 The average result of three samples of peak expiratory flow 510 l / min 2 545 l / min 0 Six minute walk test 0 0 Health Self-Assessment Testing by V.P. Voitenko 7 positive answers 7 3 positive answers 3 Copper content
in blood
in urine
Blood lead
in urine mcg / dmі,
mcg / dmі
mcg / dmі
mcg / dmі Total 26 16.6

IIPSS = X (26) - Y (16.6) = 9.4

During the observation period, positive dynamics of the state of health was obtained; the integral indicator of the state of health improved by 9.4 points.

Example 3. The main group of subjects for evaluating the effectiveness of the BOB included workers in the main professions of the smelting shop of a metallurgical enterprise, which consisted of 50 males, their average age was 42.0 years, and their average length of service was 5.2 years. The control group of subjects for evaluating the efficiency of the BOB included workers at the smelting shop of the metallurgical enterprise, which consisted of 50 males, their average age was 43.0 years, and their average length of service was 5.3 years.

The average integral indicator of the state of health of the main group of subjects at the beginning of the research was 21 points (X = 21), the subsequent study - 9 points (Y = 9).

Calculation of changes in the integral indicator of health status

IIPSZ = X21– Y9 = 12

The integral indicator of the health status of the main group improved by 12 points.

The average integral indicator of the state of health of the control group of subjects at the beginning of the study was 18 points (X = 18), with a subsequent study - 10 points (Y = 10).

Calculation of changes in the integral indicator of health status

IIPSZ = X18– Y10 = 8

The integral indicator of the health status of the control group improved by 8 points.

When comparing the dynamics of changes in the integral indicator of health, it was revealed that in the main group it changed for the better

ELLP of the _{main / control} = IIPSS of the _{main group /} DIPSS of the _{control group}

EBPD = 12/8 = 1.5

In the main group of workers, the integral indicator of the state of health decreased 2 times more than in the control group.

Claims (26)

A method for evaluating the effectiveness of diets of therapeutic and preventive nutrition for working priority professions of copper metallurgy by measuring health indicators, consisting in the fact that they carry out a scoring obtained when measuring health indicators, while taking X1 - body mass index (BMI), BMI ≥30 is taken as 2, BMI 25-29.9 is taken as 1, BMI <25 is taken as 0; X2 - waist circumference, the indicator for men ≥102 cm, for women ≥88 cm they take for 2, the indicator for men 92-101 cm, for women 80-88 cm they take for 1, the indicator for men <92 cm, for women <80 cm for 0; X3 - the percentage of fat mass is taken as 2, the percentage of fat mass is 20-29% in men and 25-29% in women is taken as 1, the absence of a sign is 0; X4 - the percentage of active cellular body mass <53% in men and <50% in women take 2, the absence of a sign for 0; X5 - plasma glucose ≥7.8 mmol / L is taken as 2, the indicator 6-7.7 is taken as 1, the absence of a sign is taken as 0; X6 - blood cholesterol ≥5.6 mmol / L is taken as 2, blood cholesterol 5.2-5.5 mmol / L is taken as 1, the absence of evidence for 0; X7 - triglycerides> 1.81 mmol / L in men and> 1.53 mmol / L in women are taken for 2, the absence of a sign for 0; X8 - high density lipoproteins (HDL) <1 mmol / L is taken as 2, the indicator 1-1.4 mmol / L is taken as 1, the indicator is more than 1.4 mmol / L as 0; X9 - delta-aminolevulinic acid (ALA) in urine <43 μmol / L is taken as 0, indicator ≥43 μmol / L for 2; X10 - resistance to hypoxia, Serkin's test, the maximum breath holding on inspiration at rest <40 seconds is taken as 2, the absence of a sign as 0; X11 - resistance to hypoxia, Serkin's test, the maximum breath holding on inspiration after exercise of 20 squats in 30 seconds <15 seconds is taken as 2, the absence of a sign as 0; X12 - the average result of three samples of the peak expiratory flow rate below the average age norm is taken as 2, the absence of a sign as 0; X13 - the result of a six-minute walk test <550 m is taken for 2, the absence of a sign for 0; X14 - health self-assessment questionnaire by V.P. Voitenko, each positive answer to the question is taken as 1; X15 - the amount of metals in the blood or in the urine within the reference or group average values is taken as 0 for each indicator: for copper in the blood μg / dm³, for lead in the blood μg / dm³, for copper in the urine μg / dm³, for lead in the urine mcg / dm³, the presence of sign 1 point for each indicator, by the sum of the points, the first integral indicator of the state of health X is calculated, at the end of the period of stay in the clinic, the above studies to assess the state of health are repeated, the scores are calculated as follows: if the changes occurred in the normal range, then 0 points; if the indicator is outside the normal range, then take into account the number of points adopted for deviations of this level of values; if during the initial research the indicator was outside the range of the norm, then when it changes, 0.1 points are added to or subtracted from the previous study, depending on the direction of the dynamics, the second integral indicator of the state of health Y is calculated by the sum of points analyze the changes in the integral indicator of the state of health: if the second integral indicator Y decreased in relation to the first integral indicator X, then make a conclusion about the effectiveness of the diet of therapeutic and preventive nutrition, if the second integral indicator Y has increased in relation to the first integral indicator X, then make a conclusion about the inefficiency of the diet of therapeutic and prophylactic nutrition and make a decision on the correction of therapeutic and prophylactic nutrition and additionally give individual recommendations on nutrition.