Electronic medical examination systems for assessing seasonal fluctuations in blood pressure

Introduction. Cardiovascular diseases (CVD), in particular, arterial hypertension (AH), remain the leading cause of demographic losses in society due to the risk of complications such as coronary heart disease and myocardial infarction, being not only a medical but also a socio-economic problem affecting the professional fitness and loss of health of employees. In the conditions of production teams, high blood pressure can serve as a selection criterion. Despite a significant amount of research on hypertension, its dynamics among workers in various industries has not been sufficiently studied from the perspective of seasonal fluctuations. The study aims to evaluate the prevalence of high blood pressure among workers in the transport industry, taking into account seasonal fluctuations, based on the results of pre-shift medical examinations to improve the effectiveness of preventive measures. Materials and methods. The authors have analyzed the records of the database of the electronic medical examination system (KAP ESMO), manufactured by LLC "KVAZAR" (Russia), which conducted a pre-shift medical examination for 8 years (2016–2023) at one of the enterprises of the transport industry. They also analyzed seasonal fluctuations in the number of detected cases of systolic blood pressure exceeding 140 mmHg and/or diastolic blood pressure exceeding 90 mmHg at a pre-shift medical examination (PSME). Experts calculated the coefficients of arterial hypertension (CAH) using the formula: CAH=(Number of employees with BP≥140/90 mmHg. Total number of employees who passed the PSME in a month)×100. Data processing was performed using MS Excel 2013. The analysis of the normality of the distribution of the studied variables was carried out using the Kolmogorov–Smirnov criterion. The seasonal differences were analyzed using the Kruskal–Wallis criterion for independent samples. The researchers applied the t-test for independent samples of detailed comparison of paired differences between months. The information value of the feature was assessed using the p-level. The critical significance level (p) was assumed to be 0.05 when testing statistical hypotheses. Results. An analysis of the data showed that more workers with hypertension are identified in the autumn-winter period than in the spring-summer period. Statistically significant differences by month were confirmed by the Kruskal-Wallis criterion (p<0.001). The AH coefficient is higher in the cold months than in the summer, which indicates the need for increased monitoring of the condition of employees during this period and timely preventive measures. The introduction of CAH made it possible to take into account the influence of the sample and objectively assess the dynamics of AH in the team. The detected fluctuations in hypertension may influence the decision of a medical professional on admission to work. If the number of detected cases of hypertension increases, but the number of suspensions from work remains stable, this may indicate the formal nature of medical examinations. Thus, it is necessary to introduce automated health assessment systems and increase responsible attitude to the results of the pre-shift medical examinations. Limitations. The analysis was carried out solely on the basis of data from the automated system of pre-shift medical examinations (CAP ESMO), which excludes the possibility of comparison with data from traditional medical examinations. The sample under study is dominated by men, which reflects the specifics of the industry under study, but limits the possibility of extending the results to enterprises with a gender-balanced team. Conclusion. The revealed patterns of seasonal fluctuations in hypertension must be taken into account when developing corporate health programs and planning preventive measures. The introduction of automated medical systems increases the objectivity of medical monitoring and minimizes the influence of subjective factors on the part of medical staff, which is essential for maintaining professional health and reducing the risk of complications of cardiovascular diseases. Ethics. The study was conducted in compliance with the ethical principles of medical and scientific research. All data was obtained from the database of the electronic medical examination system in compliance with the principles of anonymity and confidentiality. The study did not require additional intervention and did not involve any changes to the standard procedures of the PSME.