Methodological aspects of using allostatic load analysis in assessing health of working population exposed to adverse occupational factors (Analytical review)

UDC: 
616.092.12
DOI: 
10.21668/health.risk/2024.3.16.eng
Authors: 

G.A. Bezrukova1, A.N. Mikerov1,2, T.A. Novikova1

Organization: 

1Saratov Hygiene Medical Research Center, 1a Zarechnaya St., Saratov, 410022, Russian Federation
2Saratov State Medical University named after V.I. Razumovsky, 112 Bol’shaya Kazachaya St., Saratov, 410012, Russian Federation

Abstract: 

Preventive medicine of pathogenetically based technologies for prenosological diagnostics of health risks at the stage of reversible physiological dysregulation is being introduced into practice as a relevant strategy for preserving population. It provides suitable conditions for timely prevention of chronic diseases and reducing risks of premature mortality among working age population. Using resources of the scientific information systems CyberLeninka, eLibrary, PubMed and Google scholar, the authors analyzed and summarized scientific literature data on methodological aspects and problems related to practical appli-cation of the concept of allostasis and allostatic load (AL) in assessing and predicting health risks for working population.

The review focuses on the main causes of physiological dysregulation leading to AL formation under environmental exposures, including occupational ones; presents the most popular biomarkers of the functional state of the neuroendocrine, immune-inflammatory, cardiovascular and metabolic systems included in the sets of variables for determining the AL index. The review also provides the description of the most common algorithms for calculating the AL index used in preventive examinations of workers and highlights methodological approaches to the correction of AL values with regular intake of medicines. The sex-specific age dynamics of AL is presented; attention is drawn to the aggravating effect produced on AL by negative behavioral factors.

The review shows that it is still difficult to introduce this methodology into routine practices of preventive medical examinations of working population despite the proven diagnostic and prognostic significance of the prenosological diagnosis of health disorders based on AL. This is mostly due to lack of consensus on standardized approaches to creating sets of biomarker scales and a method for calculating the AL index, as well as considering the sex factor and contribution of therapeutic effects to cumulative assessment of risks of developing physiological dysfunctions.

Keywords: 
homeostasis, allostasis, allostatic load, allostasis biomarkers, allostatic load index, prenosological diagnostics, working population, working conditions, adaptation, occupational stress
Bezrukova G.A., Mikerov A.N., Novikova T.A. Methodological aspects of using allostatic load analysis in assessing health of working population exposed to adverse occupational factors (analytical review). Health Risk Analysis, 2024, no. 3, pp. 155–166. DOI: 10.21668/health.risk/2024.3.16.eng
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Received: 
12.08.2024
Approved: 
19.09.2024
Accepted for publication: 
23.09.2024

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