RISK-ORIENTED TRANSFORMATION OF THERAPEUTIC AND PREVENTIVE NUTRITION FOR WORKERS

Relevance. Milk provision to employees exposed to hazardous working conditions remains a large-scale social guarantee in Kazakhstan. However, a universal food product does not account for differences in toxicant properties, exposure intensity, occupational risk, nutritional status, or individual contraindications.

Objective. To formulate a two-component framework for risk-oriented occupational nutrition that preserves workers’ statutory and contractual guarantees, and to specify its implementation and evaluation requirements.

Materials and Methods. This was a critical secondary documentary analysis and conceptual policy study, not a systematic review. The documentary corpus comprised statistical, regulatory, organizational, economic and biomedical materials available to the authors, together with accessible public primary sources used to verify legal and statistical claims. No comprehensive bibliographic search, formal study-selection flow or risk-of-bias assessment was undertaken. Narrative synthesis distinguished externally reported observations, authors’ arithmetic calculations and conceptual proposals.

Results. The analysis produced a two-component framework linking preservation of existing guarantees with exposure-specific nutritional assessment and product evaluation. It specified a staged decision process covering exposure characterization, individual suitability, product documentation, worker participation and controlled evaluation. Official statistics record 325,429 recipients of milk or equivalent products in the surveyed enterprise population in 2025. Organizational material identifies implementation issues, while the economic analysis specifies the inputs required for a reproducible future full-cost comparison. Incomplete enterprise documentation limits assessment of implementation outcomes. Historical biomonitoring values attributed to the Kola Mining and Metallurgical Company were excluded from quantitative analysis because the original report and essential methodological information were unavailable.

Conclusions. The framework provides a structured basis for developing and testing differentiated occupational nutrition while maintaining mandatory provision. It links legal guarantees with requirements for product selection and evaluation. Preventive efficacy, safety, acceptability and cost-effectiveness require prospective assessment.

1. Ministerstvo zdravookhraneniya i sotsialnogo razvitiya Respubliki Kazakhstan. (2015). Ob utverzhdenii norm vydachi rabotnikam moloka ili ravnotsennykh pishchevykh produktov, i (ili) pishchevoy produktsii dieticheskogo lechebnogo i dieticheskogo profilakticheskogo pitaniya (Prikaz ot 28 dekabrya 2015 g. № 1056; registratsionnyy № 12709; prilozheniya 1, 2, s izmeneniyami i dopolneniyami). Retrieved August 1, 2026, from https://old.adilet.zan.kz/rus/docs/V1500012709

2. Respublika Kazakhstan. (2015). Trudovoy kodeks Respubliki Kazakhstan (Ot 23 noyabrya 2015 g. № 414-V; st. 182, p. 2, podp. 4). Retrieved August 1, 2026, from https://old.adilet.zan.kz/rus/docs/K1500000414

3. Byuro natsionalnoy statistiki Respubliki Kazakhstan. (2026, April 16). Chislennost rabotnikov, zanyatykh vo vrednykh i drugikh neblagopriyatnykh usloviyakh truda v Respublike Kazakhstan, za 2025 god [Statistical tables]. Retrieved April 30, 2026, from https://stat.gov.kz/api/iblock/element/341178/file/ru/. Accompanying publication: Osnovnye pokazateli po trudu v Respublike Kazakhstan za 2025 god. Retrieved March 10, 2026, from 4Octobehttps://stat.gov.kz/ru/industries/labor-and-income/stat-wags/publications/509385/

4. Pravitelstvo Respubliki Kazakhstan. (2023). Ob utverzhdenii Kontseptsii bezopasnogo truda Respubliki Kazakhstan na 2024–2030 gody (Postanovlenie ot 28 dekabrya 2023 g. № 1182). Retrieved March 10, 2026, from https://old.adilet.zan.kz/rus/docs/P2300001182

5. International Labour Organization. (2023, October 18). Global strategy on occupational safety and health 2024–30 and plan of action for its implementation (Document GB.349/INS/8). Retrieved March 10, 2026, from https://www.ilo.org/resource/conference-paper/es/gb/gb349/global-strategy-occupational-safety-and-health-2024%E2%80%9330-and-plan-action-its

6. Respublikanskiy nauchno-issledovatelskiy institut po okhrane truda. (n.d.). Kratkoe opisanie nauchno-tekhnicheskoy programmy “Transformatsiya gosudarstvennogo mekhanizma sotsialnykh garantiy litsam, zanyatym vo vrednykh usloviyakh truda, v sovremennykh usloviyakh” (IRN BR22182673) [Unpublished internal project document].

7. Trofimova, N. B., Rubashanova, E. A., Danilova, N. I., & Poznyakovskiy, V. M. (2018). Naturnye ispytaniya effektivnosti spetsializirovannogo produkta s pektinom v lechebno-profilakticheskom pitanii rabochikh gornorudnoy promyshlennosti. Russian Journal of Preventive Medicine, 21(4), 52–58. DOI: https://doi.org/10.17116/profmed201821452.

8. Ministerstvo truda i sotsialnoy zashchity naseleniya Respubliki Kazakhstan. (2026). O vnesenii izmeneniy v prikaz ot 28 dekabrya 2015 g. № 1056 (Prikaz ot 15 iyunya 2026 g. № 243; p. 1, prilozhenie 2, ratsion № 3). Retrieved August 1, 2026, from https://old.adilet.zan.kz/rus/docs/G26G0000243

9. Li, J., Yang, Z. L., Ding, T., Song, Y. J., Li, H. C., Li, D. Q., Chen, S., & Xu, F. (2022). The role of surface functional groups of pectin and pectin-based materials on the adsorption of heavy metal ions and dyes. Carbohydrate Polymers, 276, 118789. DOI: https://doi.org/10.1016/j.carbpol.2021.118789.

10. National Institutes of Health, Office of Dietary Supplements. (n.d.). Vitamin C: Fact sheet for health professionals. Retrieved August 1, 2026, from https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

11. National Institutes of Health, Office of Dietary Supplements. (n.d.). Vitamin E: Fact sheet for health professionals. Retrieved March 10, 2026, from https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/

12. Hosseinabadi, M. B., Khanjani, N., Norouzi, P., Mirzaii, M., Biganeh, J., & Nazarkhani, F. (2020). Investigating the effects of vitamins E and C on oxidative stress and hematological parameters among power plant workers: A double-blind randomized controlled clinical trial. Toxicology and Industrial Health, 36(2), 99–109. DOI: https://doi.org/10.1177/0748233720908993.

13. Khan, S. A., Nurulain, S. M., Qureshi, R. N., et al. (2024). Exposure to heavy metals, antioxidant status, and the interaction of single nucleotide polymorphisms in the genes CAT rs7943316, GSTP1 rs1695, as well as GSTM1 and GSTT1 genes, among workers in occupational settings. Environmental Toxicology and Pharmacology, 108, 104452. DOI: https://doi.org/10.1016/j.etap.2024.104452.

14. National Institutes of Health, Office of Dietary Supplements. (n.d.). Thiamin: Fact sheet for health professionals. Retrieved March 10, 2026, from https://ods.od.nih.gov/factsheets/Thiamin-HealthProfessional/

15. Sovet Evraziyskoy ekonomicheskoy komissii. (2012). O prinyatii tekhnicheskogo reglamenta Tamozhennogo soyuza “O bezopasnosti otdelnykh vidov spetsializirovannoy pishchevoy produktsii, v tom chisle dieticheskogo lechebnogo i dieticheskogo profilakticheskogo pitaniya” (Reshenie ot 15 iyunya 2012 g. № 34; TR TS 027/2012). Retrieved March 10, 2026, from https://eec.eaeunion.org/comission/department/deptexreg/tr/bezopSpecProd.php