<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">rfhealth</journal-id><journal-title-group><journal-title xml:lang="ru">Здравоохранение Российской Федерации</journal-title><trans-title-group xml:lang="en"><trans-title>Health care of the Russian Federation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0044-197X</issn><issn pub-type="epub">2412-0723</issn><publisher><publisher-name>Federal Scientific Center of Hygiene named after F.F. Erisman</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47470/0044-197X-2025-69-4-373-379</article-id><article-id custom-type="edn" pub-id-type="custom">hrqiwm</article-id><article-id custom-type="elpub" pub-id-type="custom">rfhealth-1973</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МЕДИЦИНА ТРУДА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OCCUPATIONAL MEDICINE</subject></subj-group></article-categories><title-group><article-title>Производственный стресс и риски развития сердечно-сосудистых заболеваний у работников химических производств</article-title><trans-title-group xml:lang="en"><trans-title>Occupational stress and the risks of cardiovascular diseases development in chemical industry workers</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9859-8260</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Каримова</surname><given-names>Лилия Казымовна</given-names></name><name name-style="western" xml:lang="en"><surname>Karimova</surname><given-names>Lilia K.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор, гл. науч. сотр. отдела комплексных проблем гигиены и экологии человека ФБУН «Уфимский НИИ медицины труда и экологии человека», 450106, Уфа, Россия</p><p>e-mail: iao_karimova@rambler.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), Professor, Chief researcher, Department of complex problems of hygiene and human ecology, Ufa Research Institute of Occupational Health and Human Ecology, Ufa, 450106, Russian Federation</p><p>e-mail: iao_karimova@rambler.ru</p></bio><email xlink:type="simple">iao_karimova@rambler.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6031-5683</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Зайдуллин</surname><given-names>Искандер Ильдарович</given-names></name><name name-style="western" xml:lang="en"><surname>Zaydullin</surname><given-names>Iskander I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, науч. сотр. отдела медицины труда, ФБУН «Уфимский НИИ медицины труда и экологии человека», 450106, Уфа, Россия</p><p>e-mail: iskanderdent@yahoo.com</p></bio><bio xml:lang="en"><p>PhD (Medicine), researcher, Department of occupational medicine, Ufa Research Institute of Occupational Health and Human Ecology, Ufa, 450106, Russian Federation</p><p>e-mail: iskanderdent@yahoo.com</p></bio><email xlink:type="simple">iskanderdent@yahoo.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3518-3519</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мулдашева</surname><given-names>Надежда Алексеевна</given-names></name><name name-style="western" xml:lang="en"><surname>Muldasheva</surname><given-names>Nadezhda A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Науч. сотр. отдела комплексных проблем гигиены и экологии человека ФБУН «Уфимский НИИ медицины труда и экологии человека», 450106, Уфа, Россия</p><p>e-mail: muldasheva51@gmail.com</p></bio><bio xml:lang="en"><p>Researcher, Department of complex problems of hygiene and human ecology, Ufa Research Institute of Occupational Health and Human Ecology, Ufa, 450106, Russian Federation</p><p>e-mail: muldasheva51@gmail.com</p></bio><email xlink:type="simple">muldasheva51@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4266-9410</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Шеенкова</surname><given-names>Мария Викторовна</given-names></name><name name-style="western" xml:lang="en"><surname>Sheenkova</surname><given-names>Maria V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, зав. терапевтическим отделением Института общей и профессиональной патологии им. акад. РАМН А.И. Потапова ФБУН «ФНЦГ им. Ф.Ф. Эрисмана» Роспотребнадзора, 141014, Мытищи, Московская область, Россия</p><p>e-mail: sheenkova.mv@fncg.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), Head, Therapy Department, Institute of General and Occupational Pathology named after Academician of the Russian Academy of Medical Sciences A.I. Potapov</p><p>e-mail: sheenkova.mv@fncg.ru</p></bio><email xlink:type="simple">sheenkova.mv@fncg.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6668-2196</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гимаева</surname><given-names>Зульфия Фидаиевна</given-names></name><name name-style="western" xml:lang="en"><surname>Gimaeva</surname><given-names>Zulfia F.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, ст. науч. сотр. отдела медицины труда ФБУН «Уфимский НИИ медицины труда и экологии человека», 450106, Уфа, Россия</p><p>e-mail: gzf-33@mail.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), senior researcher, Department of occupational medicine, Ufa Research Institute of Occupational Health and Human Ecology, Ufa, 450106, Russian Federation</p><p>e-mail: gzf-33@mail.ru</p></bio><email xlink:type="simple">gzf-33@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2677-0479</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рябова</surname><given-names>Юлия Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Ryabova</surname><given-names>Julia V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, зав. лабораторией токсикологии отдела токсикологии и генетики с экспериментальной клиникой лабораторных животных ФБУН «Уфимский НИИ медицины труда и экологии человека», 450106, Уфа, Россия</p><p>e-mail: ryabovayuvl@yandex.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), Head, Toxicology Laboratory, Department of toxicology and genetics with an experimental clinic of laboratory animals, Ufa Research Institute of Occupational Health and Human Ecology, Ufa, 450106, Russian Federation</p><p>e-mail: ryabovayuvl@yandex.ru</p></bio><email xlink:type="simple">ryabovayuvl@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">ФБУН «Уфимский научно-исследовательский институт медицины труда и экологии человека»<country>Россия</country></aff><aff xml:lang="en">Ufa Scientific Research Institute of Occupational Medicine and Human Ecology<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Институт общей и профессиональной патологии имени академика РАМН А.И. Потапова ФБУН «Федеральный научный центр гигиены имени Ф.Ф. Эрисмана» Федеральной службы по надзору в сфере защиты прав потребителей и благополучия человека<country>Россия</country></aff><aff xml:lang="en">Institute of General and Occupational Pathology named after Academician of the Russian Academy of Medical Sciences A.I. Potapov, Federal Scientific Center of Hygiene named after F.F. Erisman<country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>12</day><month>09</month><year>2025</year></pub-date><volume>69</volume><issue>4</issue><fpage>373</fpage><lpage>379</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Каримова Л.К., Зайдуллин И.И., Мулдашева Н.А., Шеенкова М.В., Гимаева З.Ф., Рябова Ю.В., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Каримова Л.К., Зайдуллин И.И., Мулдашева Н.А., Шеенкова М.В., Гимаева З.Ф., Рябова Ю.В.</copyright-holder><copyright-holder xml:lang="en">Karimova L.K., Zaydullin I.I., Muldasheva N.A., Sheenkova M.V., Gimaeva Z.F., Ryabova J.V.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rfhealth.ru/jour/article/view/1973">https://www.rfhealth.ru/jour/article/view/1973</self-uri><abstract><sec><title>Введение</title><p>Введение. Хронический стресс оказывает негативное воздействие на организм, включая нарушение работы иммунной и пищеварительной систем, психические расстройства, заболевания сердечно-сосудистой системы (ССЗ) и метаболические нарушения. Работники химических предприятий подвергаются значительному стрессу в силу высокой взрыво- и пожароопасности производственных процессов, а также воздействию комплекса производственных стресс-факторов.</p><p>Цель исследования — изучить влияние профессионального стресса на развитие ССЗ у работников отдельных химических производств и разработать комплекс профилактических мероприятий, направленных на снижение кардиоваскулярного риска.</p></sec><sec><title>Материал и методы</title><p>Материал и методы. Исследование включало анализ условий труда, психофизиологического состояния работников предприятий химической отрасли с различной степенью автоматизации технологического процесса — производства этилбензола-стирола (ЭБС) и этилена-пропилена (ЭП). Применяли стандартизированные опросники («ДОРС», HADS, Reeder), изучали результаты периодического медицинского осмотра.</p></sec><sec><title>Результаты</title><p>Результаты. Аппаратчики производства ЭП, работающие в условиях более выраженного воздействия вредных производственных факторов (класс условий труда 3.2), имеют более высокий уровень тревожности, стресса и утомления, по сравнению с аппаратчиками ЭБС (класс условий труда 3.1).</p><p>У аппаратчиков производства ЭП выявлена более высокая распространённость артериальной гипертензии (34,3% против 27,2% у работников центра автоматизации, работающих в условиях допустимого класса условий труда), а также значительная распространённость субклинической тревоги (37,9% против 21,7% у работников центра автоматизации). Анализ факторов риска по шкале SCORE показал более высокий кардиоваскулярный риск у работников данного производства.</p><p>Ограничения исследования связаны с неучётом индивидуальных факторов риска работников и субъективностью методов оценки стресса.</p></sec><sec><title>Заключение</title><p>Заключение. На основании результатов исследования разработан комплекс профилактических мероприятий, направленных на снижение негативного влияния на работников производственного стресса. Предлагаемые меры должны быть включены в корпоративную программу и направлены на оптимизацию условий труда, обучение методам управления стрессом, мониторинг за состоянием здоровья.</p><p>Соблюдение этических стандартов. Исследование одобрено локальным этическим комитетом ФБУН «Уфимский научно-исследовательский институт медицины труда и экологии человека» (протокол № 01-1 от 22.01.2025), проведено согласно общепринятым научным принципам Хельсинкской декларации Всемирной медицинской ассоциации. Все участники дали информированное добровольное письменное согласие на участие в исследовании.</p></sec><sec><title>Участие авторов</title><p>Участие авторов: Каримова Л.К. — концепция и дизайн исследования, написание текста; Зайдуллин И.И. — написание текста, статистическая обработка материала; Мулдашева Н.А. — написание текста; Шеенкова М.В. — редактирование; Гимаева З.Ф. — сбор и обработка материала; Рябова Ю.В. — составление списка литературы. Все соавторы — утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.</p></sec><sec><title>Финансирование</title><p>Финансирование. Исследование не имело спонсорской поддержки.</p></sec><sec><title>Конфликт интересов</title><p>Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.</p></sec><sec><title>Поступила</title><p>Поступила: 10.03.2025 / Принята к печати: 24.06.2025 / Опубликована: 12.09.2025</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. The article examines the impact of occupational stress on the risk of developing cardiovascular diseases (CVD) among workers in chemical production. The study covers two groups of employees from chemical industry enterprises with different levels of process automation — ethylbenzene-styrene (EBS) and ethylene-propylene (EP) production.</p><p>The purpose — to investigate the effect of occupational stress on the development of cardiovascular diseases among workers in specific chemical industries and to develop a set of preventive measures aimed at reducing cardiovascular risk.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. The study included an analysis of working conditions, the psychophysiological state of employees using standardized questionnaires (“DORS,” HADS, Reeder), as well as results from periodic medical examinations.</p></sec><sec><title>Results</title><p>Results. Operators of ethylene-propylene (EP) production, working in conditions of more pronounced exposure to harmful production factors (class of working conditions 3.2), have a higher level of anxiety, stress and fatigue, compared to operators of ethylbenzene-styrene (EBS) (class of working conditions 3.1). The operators of the EP production showed a higher prevalence of arterial hypertension (34.3% versus 27.2% among the automation center workers working under the acceptable class of working conditions), as well as a significant prevalence of subclinical anxiety (37.9% versus 21.7% among the automation center workers). The analysis of risk factors according to the SCORE scale showed a higher cardiovascular risk among the workers of this production.</p><p>Limitations include the lack of consideration of individual risk factors among workers and the subjectivity of stress assessment methods.</p></sec><sec><title>Conclusion</title><p>Conclusion. Based on the study results, a set of preventive measures was developed to reduce the negative impact of occupational stress on workers. The proposed measures should be incorporated into the corporate program and focus on optimizing working conditions, training in stress management techniques, and health monitoring.</p><p>Compliance with ethical standards. The study was approved by the local ethical committee of the Ufa Scientific Research Institute of Occupational Medicine and Human Ecology (meeting protocol No. 01-1 dated January 22, 2025), and the Helsinki Declaration of the World Medical Association was carried out.</p><p>Contribution of the authors: Karimova L.K. — the concept and design of the study, writing text; Zaydullin I.I. — writing text, statistical processing; Muldasheva N.A. — writing text; Sheenkova M.V. — editing; Gimaeva Z.F. — collection and processing of material; Ryabova J.V. — compiling a bibliography. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.</p></sec><sec><title>Funding</title><p>Funding. The study had no sponsorship.</p></sec><sec><title>Conflict of interest</title><p>Conflict of interest. The authors declare no conflict of interest.</p></sec><sec><title>Received</title><p>Received: March 10, 2025 / Accepted: June 24, 2025 / Published: September 12, 2025</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>химическое производство</kwd><kwd>условия труда</kwd><kwd>производственный стресс</kwd><kwd>артериальная гипертензия</kwd><kwd>анкетирование</kwd></kwd-group><kwd-group xml:lang="en"><kwd>chemical production</kwd><kwd>working conditions</kwd><kwd>occupational stress</kwd><kwd>arterial hypertension</kwd><kwd>survey</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">WHO. Stress; 2023. Available at: https://who.int/news-room/questions-and-answers/item/stress</mixed-citation><mixed-citation xml:lang="en">WHO. Stress; 2023. Available at: https://who.int/news-room/questions-and-answers/item/stress</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Баймаков Е.А., Мишкич И.А., Еременко С.А., Юшкова О.И., Капустина А.В., Зайцева А.В. и др. Профессиональный стресс у педагогических и медицинских работников и его профилактика. Медицина труда и промышленная экология. 2023; 63(2): 122–8. https://doi.org/10.31089/1026-9428-2023-63-2-122-128 https://elibrary.ru/twngbp</mixed-citation><mixed-citation xml:lang="en">Baimakov E.A., Mishkich I.A., Eremenko S.A., Yushkova O.I., Kapustina A.V., Zaitseva A.V., et al. Occupational stress in teaching and medical workers and its prevention. Meditsina truda i promyshlennaya ekologiya. 2023; 63(2): 122–8. https://doi.org/10.31089/1026-9428-2023-63-2-122-128 https://elibrary.ru/twngbp (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Гимаева З.Ф., Каримова Л.К., Бакиров А.Б., Капцов В.А., Калимуллина Д.Х. Риски развития сердечно-сосудистых заболеваний и профессиональный стресс. Анализ риска здоровью. 2017; (1): 106–15. https://doi.org/10.21668/health.risk/2017.1.12 https://elibrary.ru/yhphlz</mixed-citation><mixed-citation xml:lang="en">Gimaeva Z.F., Karimova L.K., Bakirov A.B., Kaptsov V.A., Kalimullina D.Kh. Risks of cardiovascular diseases evolvement and occupational stress. Health Risk Analysis. 2017; (1): 102–11. https://doi.org/10.21668/health.risk/2017.1.12.eng https://elibrary.ru/eruecs</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Cannizzaro E., Ramaci T., Cirrincione L., Plescia F. Work-related stress, physio-pathological mechanisms, and the influence of environmental genetic factors. Int. J. Environ. Res. Public Health. 2019; 16(20): 4031. https://doi.org/10.3390/ijerph16204031</mixed-citation><mixed-citation xml:lang="en">Cannizzaro E., Ramaci T., Cirrincione L., Plescia F. Work-related stress, physio-pathological mechanisms, and the influence of environmental genetic factors. Int. J. Environ. Res. Public Health. 2019; 16(20): 4031. https://doi.org/10.3390/ijerph16204031</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">James K.A., Stromin J.I., Steenkamp N., Combrinck M.I. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Front. Endocrinol. (Lausanne). 2023; 14: 1085950. https://doi.org/10.3389/fendo.2023.1085950</mixed-citation><mixed-citation xml:lang="en">James K.A., Stromin J.I., Steenkamp N., Combrinck M.I. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Front. Endocrinol. (Lausanne). 2023; 14: 1085950. https://doi.org/10.3389/fendo.2023.1085950</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Tarani C., Eric B., Michael M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ. 2006; 332(7540): 521–5. https://doi.org/10.1136/bmj.38693.435301.80</mixed-citation><mixed-citation xml:lang="en">Tarani C., Eric B., Michael M. Chronic stress at work and the metabolic syndrome: prospective study. BMJ. 2006; 332(7540): 521–5. https://doi.org/10.1136/bmj.38693.435301.80</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Hering D., Lachowska K., Schlaich M. Role of the sympathetic nervous system in stress-mediated cardiovascular disease. Curr. Hypertens. Rep. 2015; 17(10): 80. https://doi.org/10.1007/s11906-015-0594-5</mixed-citation><mixed-citation xml:lang="en">Hering D., Lachowska K., Schlaich M. Role of the sympathetic nervous system in stress-mediated cardiovascular disease. Curr. Hypertens. Rep. 2015; 17(10): 80. https://doi.org/10.1007/s11906-015-0594-5</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Hendricks B., Quinn T.D., Price B.S., Dotson T., Claydon E.A., Miller R. Impact of stress and stress mindset on prevalence of cardiovascular disease risk factors among first responders. BMC Public Health. 2023; 23(1): 1929. https://doi.org/10.1186/s12889-023-16819-w</mixed-citation><mixed-citation xml:lang="en">Hendricks B., Quinn T.D., Price B.S., Dotson T., Claydon E.A., Miller R. Impact of stress and stress mindset on prevalence of cardiovascular disease risk factors among first responders. BMC Public Health. 2023; 23(1): 1929. https://doi.org/10.1186/s12889-023-16819-w</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Hering D., Kara T., Kucharska W., Somers V.K., Narkiewicz K. High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests. Blood Press. 2013; 22(3): 183–7. https://doi.org/10.3109/08037051.2012.759689</mixed-citation><mixed-citation xml:lang="en">Hering D., Kara T., Kucharska W., Somers V.K., Narkiewicz K. High-normal blood pressure is associated with increased resting sympathetic activity but normal responses to stress tests. Blood Press. 2013; 22(3): 183–7. https://doi.org/10.3109/08037051.2012.759689</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Kivimäki M., Kawachi I. Work stress as a risk factor for cardiovascular disease. Curr. Cardiol. Rep. 2015; 17(9): 630. https://doi.org/10.1007/s11886-015-0630-8</mixed-citation><mixed-citation xml:lang="en">Kivimäki M., Kawachi I. Work stress as a risk factor for cardiovascular disease. Curr. Cardiol. Rep. 2015; 17(9): 630. https://doi.org/10.1007/s11886-015-0630-8</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Soteriades E.S., Vogazianos P., Tozzi F., Antoniades A., Economidou E.C., Psalta L., et al. Exercise and occupational stress among firefighters. Int. J. Environ. Res. Public Health. 2022; 19(9): 4986. https://doi.org/10.3390/ijerph19094986</mixed-citation><mixed-citation xml:lang="en">Soteriades E.S., Vogazianos P., Tozzi F., Antoniades A., Economidou E.C., Psalta L., et al. Exercise and occupational stress among firefighters. Int. J. Environ. Res. Public Health. 2022; 19(9): 4986. https://doi.org/10.3390/ijerph19094986</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Masi G., Amprimo G., Ferraris C., Priano L. Stress and workload assessment in aviation – a narrative review. Sensors (Basel). 2023; 23(7). 3556. https://doi.org/10.3390/s23073556</mixed-citation><mixed-citation xml:lang="en">Masi G., Amprimo G., Ferraris C., Priano L. Stress and workload assessment in aviation – a narrative review. Sensors (Basel). 2023; 23(7). 3556. https://doi.org/10.3390/s23073556</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Öztürk Eyimaya A., Tezel A. Evaluating occupational stress levels of the railway workers. Florence Nightingale J. Nurs. 2021; 29(1): 40–55. https://doi.org/10.5152/fnjn.2021.19082</mixed-citation><mixed-citation xml:lang="en">Öztürk Eyimaya A., Tezel A. Evaluating occupational stress levels of the railway workers. Florence Nightingale J. Nurs. 2021; 29(1): 40–55. https://doi.org/10.5152/fnjn.2021.19082</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Yang H., Wang M., Wang Z., Lan Y. Occupational stress effects on work ability in chemistry workers. Wei Sheng Yan Jiu. 2004; 33(2): 130–3. (in Chinese)</mixed-citation><mixed-citation xml:lang="en">Yang H., Wang M., Wang Z., Lan Y. Occupational stress effects on work ability in chemistry workers. Wei Sheng Yan Jiu. 2004; 33(2): 130–3. (in Chinese)</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Menon B.G., Praveensal C.J., Madhu G. Determinants of job stress in chemical process industry: a factor analysis approach. Work. 2015; 52(4): 855–64. https://doi.org/10.3233/WOR-152119</mixed-citation><mixed-citation xml:lang="en">Menon B.G., Praveensal C.J., Madhu G. Determinants of job stress in chemical process industry: a factor analysis approach. Work. 2015; 52(4): 855–64. https://doi.org/10.3233/WOR-152119</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Alroomi A.S., Mohamed S. Occupational stressors and safety behaviour among oil and gas workers in Kuwait: the mediating role of mental health and fatigue. Int. J. Environ. Res. Public Health. 2021; 18(21): 11700. https://doi.org/10.3390/ijerph182111700</mixed-citation><mixed-citation xml:lang="en">Alroomi A.S., Mohamed S. Occupational stressors and safety behaviour among oil and gas workers in Kuwait: the mediating role of mental health and fatigue. Int. J. Environ. Res. Public Health. 2021; 18(21): 11700. https://doi.org/10.3390/ijerph182111700</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Леонова А.Б., Величковская С.Б. Дифференциальная диагностика состояний сниженной работоспособности. В кн.: Психология психических состояний: 200-летию Казанского университета посвящается. Том 4. Казань; 2002: 326–43.</mixed-citation><mixed-citation xml:lang="en">Leonova A.B., Velichkovskaya S.B. Differential diagnosis of conditions of reduced working capacity. In: Psychology of Mental States: Dedicated to the 200th Anniversary of Kazan University. Volume 4 [Psikhologiya psikhicheskikh sostoyanii: 200-letiyu Kazanskogo universiteta posvyashchaetsya]. Kazan’; 2002: 326–43. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Морозова М.А., Потанин С.С., Бениашвили А.Г., Бурминский Д.С., Лепилкина Т.А., Рупчев Г.Е. и др. Валидация русскоязычной версии Госпитальной шкалы тревоги и депрессии в общей популяции. Профилактическая медицина. 2023; 26(4): 7–14. https://doi.org/10.17116/profmed2023260417 https://elibrary.ru/rekrge</mixed-citation><mixed-citation xml:lang="en">Morozova M.A., Potanin S.S., Beniashvili A.G., Burminsky D.S., Lepilkina T.A., Rupchev G.E., et al. Validation of the hospital anxiety and depression scale Russian-language version in the general population. Profilakticheskaya meditsina. 2023; 26(4): 7–14. https://doi.org/10.17116/profmed2023260417 https://elibrary.ru/rekrge (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Reeder L.G., Chapman J.M., Coulson A.H Socioenvironmental stress, tranquilizers and cardiovascular disease. Proc. Excerpta Medica Int. Congr. Ser. 1968; 182: 226–38.</mixed-citation><mixed-citation xml:lang="en">Reeder L.G., Chapman J.M., Coulson A.H Socioenvironmental stress, tranquilizers and cardiovascular disease. Proc. Excerpta Medica Int. Congr. Ser. 1968; 182: 226–38.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
