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Assessment of working conditions of employees in key occupations in Thermal Power plants (TP) was carried out. Working environment factors (noise, general vibration, harmful chemicals, microclimatic and lighting conditions) were measured and evaluated at workplaces. The analysis of occupational and general morbidity and assessment of occupational risks was performed in the study. At workplaces there were high noises levels exceeding the maximum permissible level in some cases by 12-16 dBA; the levels of occupational co-factors - general vibration, microclimate and lighting conditions, and chemical substance concentrations - match hygiene standards. The work process severity matches the third (harmful) class of the first and second degree, and the intensity of workload - the second (permissible) class. In terms of the hazard rate, severity and intensity of work process working conditions of employees in key occupations of the PT were established to fit the harmful class, and the noise is the leading affecting factor. Exceeding the permissible levels of occupational factors promotes the development of occupational diseases. An analysis of the dynamics of occupational morbidity in the production, transmission, and distribution of energy has shown a trend to have been towards its growth in the last decade. It has been established an extension of disease of the musculoskeletal, endocrine, and circulatory systems, the eye and adnexa, digestive organs, and respiratory organs among the employees in key occupations of TP. Calculations of relative risk indicate an almost complete production conditionality of the diseases of the musculoskeletal, nervous and endocrine systems in workers engaged in TP. Prevention of occupational and work-related morbidity should include, among other things, the assessment of occupational risks with the creation and implementation of a monitoring system for the dynamics of working conditions and the health status of workers.

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