Assessment of the carcinogenic risk in workers operating diesel-fueled vehicles
Authors: Kopytenkova Olga I. , Levanchuk Leonid A. , Dubrovskaya Ekaterina N. 
Published: October 2022

Introduction. The strategic goal of healthcare development based on the maximum use of all possible resources is currently the formation of a system that unites medical institutions working within the framework of a single information regulation, a single expert and hygienic control. At the end of the reporting year 2021, the number of patients under dispensary supervision amounted to 3,940,529 people. Of these, the proportion of people of working age is 33.9%. The availability of a developed system of diagnostics and oncological care for the working population should be accompanied by measures to predict the risk of developing oncological pathology. The purpose of the study. To identify the features of assessing the indicator of carcinogenic risk in workers operating vehicles on diesel fuel. Materials and methods. The object of the study is employees of locomotive crews carrying out the transportation process on diesel-fueled locomotives (diesel locomotives), with different service life. The list of pollutants entering the air of the working area is determined in accordance with the “EMEP Manual/EEA on the inventory of emissions of pollutants 1.A.3.c. Railways”. Quantitative indices of the concentration of pollutants were obtained by the calculation method (UPRZA) “Ecologist” (version 4.6.7 “Calculation of dispersion taking into account the development of MRR-2017”). The assessment of the pollution level was carried out in accordance with the SanPiN. 1.2.3685-21 “Hygienic standards and requirements for ensuring the safety and (or) harmlessness of environmental factors for humans”. Reference concentrations are determined in accordance with P 2.1.10.1920-04. The calculation of health loss risk indices was carried out in accordance with the Guidelines No. 2.2.1766-03 dated 06/24/2003 and MP 2.1.9.003-03. Results. Calculations made it possible to determine the amount of pollutants likely to enter the body of employees of locomotive crews operating diesel locomotives with different service life. To establish that the daily dose of pollutants entering the body of workers of locomotive crews operating new locomotives is 7,244 mg/kg, for workers operating diesel locomotives after major repairs 1.1368 mg/kg. Some of the analyzed substances have a carcinogenic effect. The calculation of the carcinogenic risk showed that when working on locomotives with a long service life and undergoing major repairs, the risk is 5.2∙10-3, which indicates that 52 additional cases of cancer per 10,000 employees of locomotive crews are likely to form annually in such a group. When operating new diesel locomotives, the carcinogenic risk is 3.8∙10-3, i.e. 38 additional cases of cancer per 10,000 employees of locomotive crews (1.5 times less). Limitations. Features of calculations of pollutants in the air of the working area for various types of vehicles. Conclusion. The gain in the number of people with oncological pathology, a fairly large proportion of whom are of working age, implies not only the creation of an advanced system of diagnosis and medical care for cancer patients, but also the improvement of measures for predicting the risk of developing oncological pathology. A promising direction for improving the method of assessing the indicator of carcinogenic risk in workers operating diesel-fueled vehicles (railway, automobile, marine) is to take into account the full list of pollutants entering the air of the working area with exhaust gases. Currently, only substances with a predominant mass fraction in emissions are accounted for. At the same time, a complex of heavy metal compounds and poly aromatic hydrocarbons has a carcinogenic effect, which are practically not controlled in the air of the working area due to the complexity of sampling and the high cost of analytical studies. This problem can be solved by using the calculation method, an example of which is given in this paper.