COMORBID INTERNAL DISEASES IN MILITARY SERVANTS WHO HAVE SENSED THE EXPOSURE OF EXTREME FACTORS OF MILITARY SERVICE
Authors:   Ukrainian Military Medical Academy, 45/1, building 33, Moskovskaya Str., Kyiv, 01015, Ukraine, Voronko A. , Seliuk O. ,   Ukrainian Military Medical Academy, 45/1, building 33, Moskovskaya Str., Kyiv, 01015, Ukraine, Bohomolets O. ,   Ukrainian Military Medical Academy, 45/1, building 33, Moskovskaya Str., Kyiv, 01015, Ukraine
Published: December 2021

Objective: to analyze comorbid pathology by methods of its quantitative assessment in servicemen exposed to extreme factors of military service (a set of factors of radiation accidents, the influence of modern armed conflicts and modern combat trauma without blood loss). Materials and methods. Studies of comorbid pathology were performed in 613 servicemen who were treated at the clinical base of the Ukrainian Military Medical Academy (UMMA) in National Military Medical Clinical Center «Main Military Clinical Hospital» NMMCC «MMCH» during 1989–2018 years. Soldiers who suffered from acute radiation sickness (ARS) in 1961 (n = 34), participants in the liquidation of the consequences of the Chornobyl catastrophe (PLCChC) 15 years after participating in the elimination of its consequences and in a later period (respectively PLCChC 1st group (n = 59) and the 2nd group (n = 337)). Soldiers are participants in the anti-terrorist operation (ATO)/Combined Forces (CFO) operation who did not receive modern combat injuries with blood loss (participants in the ATO/CFO, n = 183). All servicemen did not have any diseases limiting their fitness capabilities for military service before being exposed to extreme factors of military service. A cumulative CIRS scale was used to comprehensively assess comorbidity. Results. With increasing time after participation in the elimination of the consequences of radiation accidents, the course of arterial hypertension (AH) is aggravated, but the dose-dependence of the severity of AH on the received radiation dose has not been established. The easier course of hypertension in ATO/CFO servicemen compared to ARS remote servicemen and group 2 PLCChC servicemen can be explained by their younger age at the time of the survey and less time after exposure to extreme military service factors. In the military in the remote period after exposure to a complex of factors of radiation accidents, the frequency of diagnosing diseases by individual organs and body system increases comparing to non-irradiated servicemen. The total number of disease severity scores on the cumulative scale of CIRS diseases is also higher. However, a dose-dependent effect of the severity of comorbid pathology was also not found. These data indicate a higher prevalence of comorbid pathology in servicemen affected by a complex of factors of radiation accf5idents, compared with participants in the anti-terrorist operation / environmental protection. However, the lower severity of comorbid pathology in ATO/CFO participants can also be explained by their younger age at the time of the survey and less time after exposure to extreme factors of military service. Conclusions. For servicemen, with increasing time after participation in the elimination of the consequences of radiation accidents, the course of hypertension without its dose dependence becomes more difficult. The total number of disease severity scores on the cumulative scale of CIRS diseases in servicemen in the remote period after participation in the elimination of the consequences of radiation accidents is higher than in non-irradiated servicemen. However, a dose-dependent effect of the severity of comorbid pathology was also not found. Key words: servicemen, participants of liquidation of consequences of the Chornobyl catastrophe, participants of anti-terrorist operation / operation of the Joint Forces, radiation accidents, acute radiation sickness, ionizing radiation, comorbid pathology, chronic diseases.