Health Risk Analysis

4–12

Authors: A.Yu. Popova, N.V. Zaitseva, I.V. May, D.A. Kiryanov

The authors stress in the paper that at a moment when a large-scale administrative reform of control-surveillance activities in the Russian Federation took place there was an efficient tool greatly compatible with control and surveillance activities, a so called social-hygienic monitoring system. When control and surveillance activities and social and hygienic monitoring are brought together, it is a process when mutual integration of both systems takes place; results obtained in one of them give grounds for planning in another. Control and surveillance activities should give precise and targeted recommendations for the social social-hygienic monitoring system for those objects which are to be observed systematically. Both systems accumulate data on which obligatory requirement this or that surveillance object is likely to violate. The monitoring systems allows to make scientifically grounded choice on observation points and monitoring programs development taking all zones influenced by risk sources into account. Measurement results are aimed at validated and precise determination of unacceptable health risk occurrence or threats to human life or health as well as an object causing such threats. But still each systems continues to solve each own tasks attributable only to it. Both systems, social-hygienic monitoring and control and surveillance activates, are becoming dynamic. Monitoring points and observations programs are changing in accordance with surveillance authorities actions and economic entities reactions to such actions. Control and surveillance authorities get another tool which helps to further validate their efficiency over the previous time periods. System management processes are cyclic and have time gaps between specific stages during a year; it causes substantial time expenses which are necessary to obtain optimal parameters. The overall management cycle for one system is equal to 4 years, and for combined systems, 8 years

22–31

Authors: D.A. Shaposhnikov, B.A. Revich

The paper dwells on techniques applied for assessing impacts exerted by environmental factors on population health which have become conventional all over the world over recent years. The greatest attention is paid to up-to-date approaches to calculating risks of additional mortality which occurs in big population groups during cold and hot temperature waves. The authors consider basic stages in direct epidemiologic research: temperature waves definition; statistics hypotheses formulation; models specification; statistical criteria sensitivity, and statistical validity of the obtained results. As per long-term research performed by us in various Russian cities, we constructed logistic curves which show probability of obtaining significant risk assessment results for small samplings. We recommend to apply percentiles of long-term average daily temperature distributions as temperature thresholds when identifying temperature waves; in our opinion, such thresholds correspond to perceptions of extreme (for this or that region) temperatures and provide comparable results in terms of expected waves quantity in different climatic zones. Poisson's generalized linear model for daily mortality is shown to be the most widely spread technique for calculating risks caused by hazardous environmental factors. It is advisable to allow for an apparent correlation between mortality and time and air contamination in any regression model. We can allow for meteorological conditions which influence heat balance (air humidity and wind speed) either via including them apparently into a model or via bioclimatic indexes application; research in this sphere is going on. When calculating risks, it is advisable to allow for time lags between extreme temperatures waves and changes in mortality. We revealed that minimal population of a typical city for which it is possible to obtain statistically significant assessment of risks caused by heat waves ensembles is about 200,000 people.

39–46

Authors: N.Kh. Davletova, Е.А. Tafeeva

Atmospheric air contamination holds the first place among priority factors which determine environmental risks for sportsmen's health at open-air sport facilities. Training processes especially those aimed at aerobic endurance development and improvement are inefficient under ecologically unfavorable conditions. Our research goal was to assess atmospheric air quality on territories where open-air sport facilities were located in Kazan. Our initial materials were data on contaminants emissions on Kazan territory, results of instrumental research on air quality, data taken from state Reports on natural resources and environmental protection issued in Tatarstan in 2006–2016. We examined impacts exerted by meteorological conditions on dispersion and accumulation of emissions from stationary sources and automobile transport in close proximity to open-air sport facilities. We charted all the open-air sport facilities and enterprises and assessed mutual influences by various city districts on each other depending on prevailing winds which de-termined contaminants transfer from place to place. Our analysis on winds repeatability from May to September over 2006–2016 revealed that North-West wind prevailed in July, and West wind, in May, June, August, and September. Conditions which were favorable for contaminants dispersion were observed only in 30.9 % of months over the examined period; partially favorable or even unfavorable ones occurred in 69.1 % of time. So, natural-climatic conditions existing in Kazan create specific qualitative composition of city air and contaminants are present in atmospheric air above open-air sport facilities in concentrations exceeding maximum permissible ones. It causes potential risks for sportsmen' s health. The obtained data give grounds for air monitoring planning at periods when sport events take place; for organizing work at priority enterprises when meteorological conditions are unfavorable; they can also be applied when changes are made into architectural and design plans for the city territory including transport routes development; or when activities aimed at environment protection are developed and im-plemented.

59–65

Authors: I.G. Nenakhov, Yu.I. Stepkin, I.A. Yakimova

Our research was performed on 90 people working at Voronezh Center for Hygiene and Epidemiology, a certified test laboratory center. Our research goal was to assess peculiarities of sensorimotor reactions detected in personnel of hygienic and epidemiologic laboratories as per simple visual-motor reaction parameters and complex visual-motor reaction. To examine visual-motor reactions, we applied EffectonStudio software, "Jaguar. Perception. Reactions. Research on precision and speed qualities and human working capacity" package, and Maslash and Jackson procedure supplemented with a mathematical model developed in Bechterev's Saint-Petersburg Scientific Research Psychoneurological Institute to assess occupational burnout risks. The paper dwells on how fatigue develops during a working week and on contributions made by each working day into overall fatigue experienced by personnel employed at a certified test laboratory center. We examined occupational burnout peculiarities detected in laboratory center workers as per emotional exhaustion parameters, depersonalization, and reduction in professional competences; we calculated integral burnout index for them. We reveled health risks for certified test laboratory center personnel which were caused by their emotional burnout and determined cause-and effect relations between the central nervous system functional state and emotional burnout. On the basis of the obtained data we made recommendations on prevention activities aimed at working conditions optimization and occupational burnout prophylaxis. Our research supplements and enlarges this knowledge sphere in occupational hygiene in terms of examining and preventing fatigue occurring in personnel at their workplaces.

78–88

Authors: V.A. Loginova, G.G. Onishchenko

We performed comparative hygienic assessment of environmental factors and health of population living near the South-Eastern railway and railroad transport workers over 21012–2016 and revealed a trend for environmental quality improvement both at railroad objects and on territories influenced by them. This trend was confirmed by a 3.8 times decrease in specific weight of atmospheric air samples with hazardous substances concentrations exceeding MPC; a decrease in drinking water samples taken from distribution networks which deviated from standards (by 31.5 % as per sanitary-chemical parameters, and by 26.5 %, as per microbiological ones); lower share of soil samples not corresponding to standards (it went down to 0 as per sanitary-chemical parameters, and there was a 1.8 times decrease in it as per microbiological parameters); there was also a decrease in a number of workplaces not corresponding to hygienic standards in terms of physical factors (noise, by 1.6 times lower, microclimate, by 3.1 times, luminance, by 1.7 times) and in terms of MPC levels related to vapors and gases concentrations in working area air (by 4.3 times), as well as dust and aerosols (by 1.6 times). At the same time there are persistent negative trends for dynamic parameters of water reservoirs quality: a specific weight of water samples not corresponding to standards increased, by 3.4 % as per sanitary-chemical parameters, and by 29.2 %, as per microbiological ones. Occupational risks for railroad transport workers still exist. Industrial noise is considered to be a priority risk factor and it corresponds to occupational morbidity structure. 19 occupational morbidity cases were detected at South-Eastern railway over the examined period. Occupational morbidity went down from 1.3 to 0.2 cases per 10,000 workers (from 1.5 to 1.14 per 10,000 workers for the whole railways network). Sensorineural hearing loss amounts to 63.2 % in occupational pathology structure (up to 73 % for the whole railways network). Working conditions of locomotive team members remain the most unfavorable. Negative environmental factors continue to exert their influence on health. Although primary morbidity among population in general and workers employed by "Russian Railways" PLC ("RR" PLC) over 2012–2016 (by 13.1 % and 13.6 % cor-respondingly), an increase in respiratory organs diseases is detected both among population in general (by 11.2 %), and workers employed by "RR" PLC (by 18.5 %). Besides, respiratory organs diseases make the greatest contribution into primary morbidity. Their specific weight amounts to 26.5–39.8 % among population in general, and to 37.9 %, among "RR" PLC workers. As a whole, morbidity among "RR" PLC workers employed at the South-Eastern railway tends to be 34.7–43.9 % higher than among population in general (by 24.3–36.4 % for the whole railways network), and this fact proves there are additional negative influences exerted by occupational factors. It is also shown that morbidity with temporary disability among 1st category workers has a negative trend (a 5 % increase).

98–103

Authors: A.V. Voronkov, A.S. Lysenko, A.F. Bandura

Our research goal was to examine influences exerted by new pyrimidine derivatives coded as BL0 and BL2 on cerebral hemodynamics auto-regulation parameters and vasodilatating function of vessels endothelium as risk factors causing ischemic and hemorrhagic strokes under chronic hemic hypoxia. We performed an experiment on white Wistar rats to prove that endothelial dysfunction which evolves under chronic hemic hypoxia leads to disorders in endothelium-mediated mechanisms for cerebral circulation auto-regulation in rats. We modeled hypoxia in animals via granting them free access to 0.2 % sodium nitrite solution instead of ordinary drinking water. Endothelial dysfunction was confirmed as per disorders in vasodilatation and vasoconstriction reactions at intravenous introduction of acetyl choline (0.1 mg/kg) and methyl ether hydrochloride nitro-L-arginine (10 mg/kg). Cerebral blood flow speed was measured with MM-D-K-Minimax v.2.1. ultrasound Doppler. We assessed cerebral circulation auto-regulation as per compression test results which allowed us to calculate overshoot coefficient and auto-regulation power. Examined pyrimidine derivatives and comparison preparations were introduced orally 60 minutes prior to taking readings. Mexidol doses were calculated on the basis of interspecific recalculation of a maximum daily dose for a man. Nicergoline dose was taken as a most effective one as per literature data. When new pyrimidine derivatives BL0 and BL2 are applied under chronic hemic hypoxia, it causes overshoot coefficient to grow authentically higher than in a negative control group but it doesn't exert any positive influence on collateral reserve parameter, namely auto-regulation power. BL0 and BL2 improve endothelium vasodilatating function at intravenous acetylcholine introduction (0.1 mg/kg) and don't exert any influence on vasoconstricting function at L-NAME intravenous introduction (10 mg/kg). The examined substance BL0 has more apparent pharmacological effects thus exceeding the second substance BL2 and such comparison preparations as Mexidol and Nicergoline in some parameters.

113–125

Authors: E.V. Bragin

Examination of natural ageing processes including those caused by multiple external factors has been attracting re-searchers' attention over the last years. Senile cataract is a multi-factor disease. Expenditure on cataract surgery remain one of the greatest expenses items in public health care. Age is a basic factor which causes senile cataract. Morbidity with cataract doubles each 10 years of life. This outline considers some literature sources which describe research results on influence exerted on cataract evolvement by such risk factors as age, sex, race, smoking, alcohol intake, pancreatic diabetes, intake of certain medications, a number of environmental factors including ultraviolet and ionizing radiation. mane of these factors are shown to increase or reduce senile cataract risk; there are conflicting data on certain factors. The outline also contains quantitative characteristics of cataract risks which are given via odds relation and evolve due to age parameters impacts, alcohol intake, ionizing radiation, etc. The authors also state that still there is no answer to the question whether dose-effect relationship for cataract evolvement is a threshold or non-threshold.

4-22

Authors: N.V. Zaitseva, I.V. May, S.I. Sychik, E.V. Fedorenko, L.M. Shevchuk

The paper dwells on basic legal and sub-legislative documents issued in the EU, the USA, Canada, by the WTO and Codex Alimentarius Commission which provide control of consumer products safety on the basis of assessing risks for consumers' life and health. Risk-oriented surveillance is shown as a system which makes for lower loads on business but still provides systemic control over most hazardous products. The EU legislation fixes the right to perform supranational control over state control systems existing in the EU member states in terms of their relevance and legitimacy. This supranational control is supported by organizational structures and regulatory and methodological documents. National control systems are systematically reviewed and analyzed in order to secure their conformity to supranational regulatory acts, to detect any cases of non-compliance, and to spread the best practices. Risk analysis reviews and results are open and discussable. As a result of products hazards assessment their turnover can be limited, or they can be withdrawn from the market, or additional information on hazards or risks they may cause is to be provided for consumers. Public and constantly operating systems of informing about hazardous goods are well-developed. International experience and practices in the sphere of risk-oriented surveillance over consumer products can be and should be applied in the Eurasian Economic Union (EEU) countries. The Eurasian Economic Union countries fix orientation at observing consumer goods safety principles in their legislation. There are also legal grounds for and practices in the sphere of risk-oriented approach to products manufactures. But it is neces-sary to further develop a products classification system as per consumer health risk parameters. And this task requires working out unified approaches to classification of both eatable and non-eatable products. It seems relevant to develop a public analytical database of risk-oriented control created with the use of the control and surveillance activities results obtained in the EEU countries. All the involved parties should more actively interact and exchange information on issues of products risks assessment as it is a vital component required for further development of the system.

32-41

Authors: V.Yu. Smolensky, P.Z. Shur, D.V. Suvorov, O.I. Goleva, V.A. Safronov, E.V. Khrushcheva, I.V. Vindokurov

As we assess health risks caused by extremely dangerous infections, we can apply mathematical modeling to estimate a disease or a death case probability. This mathematical modeling describes epidemiological processes and allows to imitate their development without performing any anti-epidemic activities. Parameters which quantitatively assess morbidity and mortality cases obtained via this modeling together with actual data on losses which were not prevented even if anti-epidemic activities were in place, can be used as grounds for economic effects assessment. An economic effect of anti-epidemic activities was calculated in terms of indirect prevented losses which became possible due to decrease in mortality and morbidity; the effect was calculated in money units which were applied in the GDP calculation. The calculation is performed in full conformity with 'The Methodology for calculating economic losses caused by population mortality, morbidity, and disability" (Moscow, 2012) and envisages assessment of losses in the current year and over a period of survival (for death cases). The methodology was tested on the example of Ebola fever outbreak in Guinea in 2014-2016. The testing results revealed that if not for anti-epidemic activities which included substantial assistance rendered by other countries (the RF among them), a number of morbidity cases caused by Ebola virus would have reached 521,289, and a number of death cases, 56,345. The RF Rospotrebnadzor made a significant contribution into Ebola fever outbreak elimination in Guinea; it sent a special anti-epidemic team there in August 2014. The team participated in diagnostic procedures, staff training, and anti-epidemic activities organization. Risk prevented due to assistance rendered by other countries, including the RF, amounted to 517,485 morbidity cases, and 53,809 death cases. Economic effects for Guinea achieved due to anti-epidemic activities aimed at risk minimization with the help of other countries is estimated to be equal to 229.51 million USD; it amounts to approximately 3.5% of Guinea GDP.

46-56

Authors: M.M. Vasileva, A.A. Popel, E.S. Yurkevich, I.I. Ilyukova

Our research goal was to perform hygienic assessment of risks caused by Graminis KE and Rinkor VG herbicides for people working with them. We applied sanitary-hygienic and toxicological research techniques in our work in full conformity with valid technical regulatory documents and guidelines. We set the following research tasks: to analyze literature and information sources; to perform primary toxicological assessment of preparatory herbicides and study their acute toxicity together with sensitizing effects at intragastric introduction, cutaneous application, and inhalation exposure on laboratory animals; to examine herbicides cumulative effects and calculation their cumulation coefficient; to examine working conditions during a natural experiment when Graminis KE and Rinkor VG herbicides were applied and calculate risks for workers; to work out scientifically grounded recommendations on their safety application in agriculture. The examined herbicides, Graminis KE and Rinkor VG, are classified as substances with the 3rd hazard degree as per their toxicometric parameters (moderately hazardous substances). Calculated risks of complex (inhalant and dermal) exposure to Gramins KE and Rinkor VG herbicides for workers (operators who refills them and those who spray plants with them) when they are applied in agriculture don't exceed acceptable levels (are less than 1). Our work results allow to enrich a set of plant protectors which are applied in the country and to use such preparations in agriculture which are the least harmful for health and the environment. Application of Graminis KE and Rinkor VG herbicides will help to increase crops productivity.

66-75

Authors: N.Kh. Gafiatulina, L.V. Tarasenko, S.I. Samygin, S.Yu. Eliseeva

We chose young students as our research object as they represent a social-demographic group with a specific social health, lifestyle, social activity, and social well-being. Our research goal was to assess students' social health and to determine how they perceived risks for it. Analysis of social health risks perception by young students was performed within socio-centric and sociogenic approaches as well as risk-examining paradigm. We considered social activity, social networks involvement, and social well-being as key aspects of social health. It is shown that young students mostly have average social health as per its integral index. But here we detected low social activity, high social networks involvement, and average social well-being. We singled out 3 typical groups of young students: "socially active integrated optimists", "socially passive moderately integrated pessimists", and "socially passive integrated optimists". All three students groups mentioned difficulties related to employment as important social health risk factors; however, it were respondents with low social health who were most preoccupied with "future uncertainty". Young students with low social health are to a greater extent preoccupied with risk factors causing personal danger for themselves than for a society as a whole. It is necessary to create complex activities in a contemporary education space; these activates are to aimed at minimizing and preventing risks for Russian students' social health. We should make for higher social activity as it will inevitably lead to higher social well-being and improve overall students' social health.

83-90

Authors: E.Ya. Titova, S.A. Golub'

We examined data provided by a healthcare facility at a large industrial enterprise focusing on occupational morbidity dynamics over 2013-2016 and periodical medical examinations results obtained in 2015 and 2016. We created a specialized program and applied it to conduct sociological research on health of workers who has a periodical medical examination. We detected that most questioned workers (50.48 %) whose occupations were associated with dangerous and hazardous occupa-tional factors were poorly aware of occupational diseases prevention and needed relevant knowledge. It is shown that over 2013–2016 occupational morbidity decreased from 9.38 cases per 10,000 workers to 3.55 cases. However, it remained higher that in Russian and Perm region on average . All occupational diseases were detected in workers older than 40 with their working record being longer than 15 years. A share of people able to work with certain limitations grew in 2016 in comparison with 2015 (from 7.35 to 9.31 %); a number of people who needed sanatorium-resort therapy also grew from 19.96 to 32.12 %; a number of people with general somatic diseases increased from 31.23 to 70.17 %); health index reduced from 38.77 to 29.82 %. Musculoskeletal system diseases, con-nective tissue diseases, circulatory system diseases, eye and its accessory apparatus diseases, respiratory organs diseases, and digestive organs diseases prevailed in general somatic morbidity structure. We registered a substantial growth in hearing organs diseases (mostly hearing loss, from 49.47 to 99.06 cases per 100 examined); skin and subcutaneous tissue diseases (from 7.73 to 36.3 cases per 100 examined); urinary system diseases (from 68.42 to 100.62 cases per 100 examined). We detected that most examined workers pursued unhealthy lifestyle. For example, 29.9 % often consumed strong spirits (equally men and women), and 72.8 % smoked. All the respondents tended to have low physical activity. We also revealed some drawbacks in periodical medical examinations procedure: 26.3% respondents mentioned medical staff were indifferent and even rude to them; 40.8 % complained on having to wait for a long time to get to a specialist; 26.2 % said they had to wait for a reception in rather unfavorable conditions; all the respondents mentioned untimely receipt of their "health passport". The data we collected can be applied in assessing risks of health disorders occurrence in workers employed at industrial enterprises and in the process of creating prevention activities aimed at health risks minimization.

97-107

Authors: M.F. Vil'k, O.S. Yudaeva, V.A. Aksenov, V.M. Ponomarev, V.I. Apattsev, E.A. Sorokina, V.B. Prostomolotova, A.S. Kozlov, E.O. Latynin

The paper dwells on generalized analysis of morbidity which is characteristic for conductors working in passenger carriages of locomotive-driven trains. Working conditions train conductors had to work in were examined as per results of sanitary-hygienic research on intra-carriage environment, specific working conditions assessment, and questioning. Hazards caused by working environment factors for train conductors to a certain extent depend on a carriage type, its technical and hygienic state, as well as on a route a train goes by. Our research revealed that impacts exerted by various working environment factors, namely physical, chemical, biological, and psychophysical ones, caused respiratory diseases, increased allergic reactivity, changes in hearing sensitivity, and overall morbidity growth among people from this occupational group. Unordered regime resulting from constant trips and unfavorable living conditions in a carriage lead to the following diseases: varix dilatation in legs, ischemic heart disease together with primary hypertension, and chronic rheumatic heart diseases. More precise classification of conductors' working conditions can be obtained via a mathematical model creation as it enables precise estimation of occupational diseases probability. Such models should be based on a relationship between diseases frequency (or probability) and working conditions as per specific hygienic factors. We worked out methodical guidelines on providing safe working conditions at conductors' working places which include efficient activities aimed at prevention of hazardous impacts exerted by working environment factors. It will help to improve working conditions substantially, to preserve workers' health, and to ensure safe passengers traffic. Safe working conditions for conductors can be secured due to a set of activities aimed at equipping new carriages and those after capital repair with air-conditioning, disinfection systems, heating, ecologically clean toilets, modern furnishing materials, as well as at improving sanitary and living conditions, providing comfortable uniforms, and better regulation of work and rest re-gimes.

117-128

Authors: P.V. Trusov, N.V. Zaitseva, V.M. Chigvintsev, 2, D.V. Lanin

Our task was to create a mathematical model which could describe anti-virus immune response regulation allowing for disorders in the adaptation (neuroendocrine and immune) systems caused by chemical factors of various genesis. We analyzed immune response allowing for immunity types (inborn and acquired one) with certain quantitative parameters chosen in order to characterize them, notably: interferon and NK-cells for inborn immunity, and virus-specific cytotoxic T-cells and antibodies-forming B-lymphocytes for acquired immunity. Regulatory mechanisms incorporated in the model comprise influences exerted by hypothalamus-hypophysis-adrenals system hormones (corticoliberin, adrenocorticotropic hormone, and hydrocortisone), and cytokines (interleukin-1 and interleukin-2) produced by various regulatory cells of the immune system. The suggested model also takes spatial organization of infection and immune processes in different organs and tissues into account as we introduced a time lag for components interaction into it. The model includes a system of 18 ordinary differential equations with a retarded argument; its parameters characterize how fast various processes influencing an infection dynamics evolve in a body. The parameters are identified on the basis of published experimental data which describe a process of a body being infected with a virus. We calculated dynamics in the immune and neuroendocrine system parameters under a virus infection allowing for disorders in the marrow synthetic function. The model is developed within the framework of a concept viewing a human body as a multi-level model allowing for interactions between its systems and functional state of examined organs under influences exerted on them by hazardous factors of different genesis. The performed research gives a qualitative idea on biological factors which explain an infectious agent kinetics under a virus infection and impacts exerted by factors of various genesis. The results can be applied for adjusting parameters of existing population models, spread and clinical course of various infections, and for making long-term forecasts on an epidemiologic situation which is necessary when we analyze infectious diseases risks, including those which occur under impacts exerted on a human body by hazardous environmental factors.

147-160

Authors: N.A. Lebedeva-Nesevrya, I.G. Zhdanova-Zaplesvichko, V.I. Rerke, A.O. Barg

Our review comprises medical and sociological research conducted over the last 20 years and dedicated to examining reasons and consequences of alcohol consumption in the Russian Federation. We detected that this research covered a wide range of issues starting from analyzing social contexts of alcohol consumption, microsocial, psychological, and biological factors causing alcohol-associated behavior in specific population groups, and then moving on to examining prevalence and gravity of medical and economic consequences which alcohol consumption usually leads to. We dwell on research results which explain reasons for alcohol consumption in various social and age population groups. We also describe different approaches to risk assessment procedure, assessment techniques and criteria applied for characterizing risks. We give concrete data on this bad habit prevalence in a number of the RF regions as well as data on medical-demographic losses caused by alcohol consumption. It is shown that the issue is recognized at the federal level and a number of political and administrative steps are taken to minimize it. We stress the necessity of closer cooperation between experts, authorities, and population in the process of solving tasks aimed at making our society healthier. We also reveal that risk-communication as a dialogue model is replaced with an information model; and the absence of "feedback" from risk recipients doesn't allow to adequately adjust information flows or to assess their efficiency. In our opinion, the most important task is to build up relevant risk-communications in the society as they will provide searching for most efficient dialogue techniques in the risk-communication system on alcohol addiction reasons and consequences. New risk-communication technologies should make for better risk awareness among population, above all among young people, as well as for creation of persistent attitude towards giving up alcohol as self-preserving behavior.

4-11

Authors: V.G. Kostarev, V.А. Khoroshavin, А.V. Brazhkin

The paper outlines the first stages of sanitary activities development in Perm region. We highlight the fact that it was Perm where I.I. Molessson, the first official sanitary inspector in Russia, worked. Here one of the first sanitary inspection of a whole region was performed and "Perm sanitary bulletin" was first published. It was in Perm, where the first sanitary office was established in 1890, and in 1898 the first bacteriological laboratory was organized. Bodies and institutions of Rospotrebnadzor in Perm region are known to be founded on September 15, 1922, when a Decree by Russian People's Commissars Council "On the Republic's sanitary bodies" was issued. A sanitary-hygienic faculty of Perm Medical Institute was set up in 1931 and it gave grounds for preparing qualified sanitary inspectors for state sanitary authorities. We described basic tasks which were tackled by sanitary inspectors during the Great Patriotic War and just after it. Rospotrebnadzor activities are proved to make for substantial improvements of sanitary-epidemiologic situation in the region. Currently more than 95 % of population are provided with drinking water which fully corresponds to the sanitary legislation requirements. We note constant improvements in catering objects quality and we also see that a quantity of food samples taken at such objects which don't correspond to hygienic standards remains stably low. A share of working places deviating from hygienic standards as per noise, vibration, and illumination, has reduced. Medical examinations are now available to 97.9 % of workers functioning under hazardous (dangerous) working conditions. The lowest occupa-tional morbidity level over the last few years was registered in Perm region in 2016. The Service was among the first in the country to transfer to result-oriented budgeting and risk-oriented surveillance model. Organizational structure is constantly being developed; new legal, economic and organizational approaches are being created and implemented in the activities performed by bodies and institutions of the Federal Service for Surveillance over Consumer Rights protec-tion and Human well-being.

21-30

Authors: I.V. May, S.Yu. Balashov, S.A. Vekovshinina, M.A. Kudrya

The article dwells on issues of modeling electromagnetic fields levels (EMF with frequency equal to 300 KMHz - 300 MHz which are created by television and radio broadcasting objects, radiolocation, and mobile communication in a large regional cen-ter, in geoinformation system environment. Our task was to estimate EMF levels on areas where apartment blocks were located; to assess energy flows at various floors, to determine zones in a city as per EMF levels; to verify the obtained results with the direct factor measuring. Our calculation included data on 2,011 EMF sources located on a city territory. We allowed for bulk parameters of 31,949 buildings including 17,307 apartment blocks, 3,160 administrative buildings, 307 pre-school children facilities and 105 secondary schools. We performed our calculations in city coordinate system at 109 thousand points. Each calculation created a picture of EMF spread in a plane at a set height which allowed us to determine exposure level at a control point as per "slice" re-sults and to build up a 3D contamination model. Approximately 80% of all the calculated results had EMF parameters within 0.1-10 safety criterion range. We spotted zones with maximum calculated EMF levels at 18-25 meters. Instrumental research proved high factor levels in these zones including those where levels exceeded safety criterion 4-6 times; it makes for certain vigilance in judgments on environmental safety for people who live on the examined territory permanently. The obtained data can be used for foundation of instrumental research points within the frameworks of specific research or social-hygienic monitoring as well as for consequent exposure and health risk assessment. The materials can be used in epidemiologic research for conjugate spatial analysis of energy flows and children and adults mortality.

40-47

Authors: I.N. Yakovina, N.A. Bannova, E.V. Kashtanova, Ya.V. Polonskaia, Yu.I. Ragino

The paper focuses on tasks of creating and implementing a new technique aimed at assessing ischemic heart diseases risk. The techniques is based on a laboratory-diagnostic complex which includes oxidative, lipid-lipoprotein, inflammatory and metabolic biochemical parameters; s system of logic-mathematic models used for obtaining numeric risk assessments; and a program module which allows to calculate and analyze the results. we justified our models in the course of our re-search which included 172 patients suffering from ischemic heart diseases (IHD) combined with coronary atherosclerosis verified by coronary arteriography and 167 patients who didn't have ischemic heart diseases. Our research program in-cluded demographic and social data, questioning on tobacco and alcohol addiction, questioning about dietary habits, chronic diseases case history and medications intake, cardiologic questioning as per Rose, anthropometry, 3-times meas-ured blood pressure, spirometry, and electrocardiogram taking and recording with decoding as per Minnesota code. We detected biochemical parameters of each patient and adjusted our task of creating techniques and models for assessing ischemic heart disease risks on the basis of inflammatory, oxidative, and lipid biological markers. We created a system of logic and mathematic models which is a universal scheme for laboratory parameters processing allowing for dissimilar data specificity. The system of models is universal, but a diagnostic approach to applied biochemical parameters is spe-cific. The created program module (calculator) helps a physician to obtain a result on the basis of laboratory research data; the result characterizes numeric risks of coronary atherosclerosis and ischemic heart disease for a patient. It also allows to obtain a visual image of a system of parameters and their deviation from a conditional «standard – pathology» boundary. The complex is implemented into practice by the Scientific Research Institute for Therapy and Preventive Medicine

60-65

Authors: L.B. Masnavieva, I.V. Kudaeva, V.S. Rukavishnikov

Nowadays each forth person suffers from allergic diseases and allergic pathology prevalence is constantly growing. There are compounds in air which are generally toxic, or have sensitizing or allergenic effects on a body. For example, we can name formaldehyde and nitrogen dioxide. Our research goal was to reveal a correlation between reaction of leucocytes migration inhibition to formaldehyde and level of inhalation exposure to the examined chemicals. We examined 410 teenag-ers who permanently lived in industrial cities in Irkutsk region. We studied individual load as per formaldehyde and nitrogen dioxide. We estimated eosinophils content in nasal mucus and determined indexes of leucocytes migration inhibition to for-maldehyde. Index of formaldehyde effects danger was detected to exceed 1 in 54% teenagers. The greatest value of danger coefficient in terms of exposure to this substance was equal to 1.76. anger index in terms of exposure to nitrogen dioxide didn't exceed 0.7 in the examined teenagers. The obtained results prove that inhalation formaldehyde load influences teenag-ers from industrial centers as sensitization to this substance evolves in them. We found out that true inhibition reaction of leucocytes migration in a reaction with formaldehyde more frequently occurred in people with danger index in terms of ex-posure to this substance being lower than 1. We obtained models which described correlation between level of sensitization to formaldehyde and a number of eosinophils in nasal mucus and it allowed us to detect that sensitization depended on the examined contaminants content in the air. The sensitization to chemical air contaminants which we revealed in teenagers calls for necessary activities aimed at reducing risks of allergenic pathology evolvement in them.

76-82

Authors: A.N. Chigisova, M.Yu. Ogarkov, S.A. Maksimov

We analyzed risks of arterial hypertension development in occupational groups employed at coal-mining enterprises in Kemerovo region (1,915 workers). We used data on arterial hypertension development in Kemerovo region as our reference group; these data were obtained within the framework of ESSE-RF epidemiologic research (700 people aged 25–64 were exam-ined). We noted that work at coal-mining enterprises involved several factors which could have negative influence on workers' health. Working conditions for those workers who had to stay in a mine during the whole working shift meant that workers were under negative impacts caused by unfavorable microclimate and heavy dust loads. To eliminate age discrepancies between workers employed at coal-mining enterprises and the reference group, we performed standardization as per age (data on the reference group were taken as our standard). We calculated arterial hypertension frequencies in the chosen occupational groups and determined relative risks of arterial hypertension via creation of contingency tables. To exclude any influence that might be exerted on relative risks of arterial hypertension by occupational selection, we corrected the obtained results as per "health recruitment effect". Miners had lower arterial hypertension prevalence among them than unorganized sampling made of ordinary Kemerovo region population, 28.46 % and 53.29 % (p<0.001). We showed that statistically significant low risks of arterial hypertension among workers were due to occupational selection they had to undergo when being recruited. As we per-formed this correction as per "healthy recruitment effect" arterial hypertension risks for miners and drifters changed from sta-tistically significant low to statistically significant high, from 0.55 (95 % CI 0.48–0.64) to 1.14 (95 % CI 1.04–1.26). So, if we want to assess arterial hypertension prevalence and risks in occupational groups where occupational selection can't be excluded we should perform this additional correction to remove "healthy recruitment effect"

92-100

Authors: M.A. Fesenko, O.V. Sivochalova, E.V. Fedorova

The paper outlines the data obtained in the course of long-term research dedicated to studying the extent to which re-productive system pathologies in workers with high-risk occupations are occupationally induced. Their peculiarity is joint impacts of various occupational factors (for example, impacts exerted by chemicals together with physical and biological factors, and labor hardness and intensity as well) on a female body. Our research goal was to examine the extent to which reproductive system pathologies in workers with high-risk occupations were occupationally induced. To achieve it, we applied statistical estimate of correlation between health disorders and work. Our occupational group included a number of occupations with harmful or hazardous working conditions in civil en-gineering, metallurgy, chemical industry, polymer-processing industry, and health care as well. As a rule, working condi-tions class of workers from the examined groups varied from 3.1 to 3.3; and occupation with permissible working conditions were used as a comparative group. The research results revealed that there are certain occupations with high risk of reproductive health disorders evolvement and infants development pathologies evolvement. They are: – model makers and checkers in civil engineering and crane operators at a metallurgic plant; – analysts at chemical analysis laboratories, chemical engineers in chemical industry (including petrochemical plants, polymer-processing plants, and organic synthesis plants); – surgeons, obstetrician-gynecologists, midwives, surgical nurses working in in-patient departments. Estimate of correlation and occupational dependence of reproductive system diseases on working conditions revealed that women with harmful working conditions (3.1–3.3 hazard class) had defective pregnancies or labor pathologies which had strong and average correlation with working conditions. Health disorders in newborns were estimated as per very strong corre-lation with mother's work. Thus, we can state that a mother occupational risk induction for a child health is fundamentally proved. On the basis of the obtained results we rank female workers with 3 class 2 harm degree working conditions as having an occupation with high risks of reproductive health disorders. We worked out an algorithm aimed at managing these risks; it should be applied in order to lower occupational risks for reproduction in female workers.

109-117

Authors: M. Khodzhiev, N.F. Izmerov , I.V. Bukhtiyarov

We examined significance which social and psychological factors had in occupational stress evolvement in labor migrants who came to Moscow and Moscow region from Central Asia republics. A separate issue was sexual harassment occurrence which female migrants and Moscow region females faced. Psychological tension, i.e. occupational stress, is a contemporary danger in non-conventional working process (labor migration) and it attracts attention of occupational medicine experts. We determined that there were some social and psychological reasons for occupational stress, such as dissatisfaction with work, low level of integration in working teams, poor living conditions. As per questioning results we revealed single harassment cases (3-5%) and their number was the same both for female migrants and for females from Moscow region. Neuro-emotional labor intensity category amounted to 3.3-3.2 for millwrights, subways builders, steelmen, and road construction workers; it amounted to 3.1 for other workers; as for female migrants employed in social sphere, their work category was 3.2. The follow-ing physiological and psychological peculiarities characterize people with low working adaptation as per criteria of great occu-pational stress evolvement probability: low attention level, slow visual signals perception, prevalence of high systolic and dia-stolic blood pressure as a sign of arterial hypertension evolvement. Functional state of labor migrants mostly corresponds to "working strain of 1st and 2nd degree" and "overstrain". Staging in occupational stress evolvement in labor migrants is deter-mined by level of labor neuro-emotional intensity. It seems vital to provide social and psychological support for labor migrants which can include improvements in occupa-tional training, informing workers on health risks occurring at their working places, training on safe working practices, devel-opment of occupational selection culture, organization of rational work and rest regime, providing social support for workers.

127-134

Authors: N.V. Dudchik, V.A. Filonyuk, V.V. Shevlyakov, S.I. Sychik, O.E. Nezhvinskaya

Scientific foundation and practices in the sphere of hygienic and ecological standardization concerning biological factors of the environment have a number of peculiarities and are methodically less developed than chemical factors standardization. Efficient industrial control over maximum permissible concentrations of standardized microorganisms-producers in working area air is based on validated instrumental techniques of quantitative assessment. Our goal was to create experimental models for microorganisms-producers' aerosols of a multi-component microbe specimen in working area air as a risk factor causing impacts on health of workers employed at biotechnological production; another task was to work out a procedure for measuring Pseudomonas aurantiaca B-162/255.17concentration and cells and spores of Bacillus sp. BB58-3 strain in working area air. We gave grounds for a technology aimed at quantitative determination of microorganisms-producers in working area air in a modeling experiment; it was based on conventional stages and tech-niques accepted in microbiological practices, namely air samples taking via aspiration technique allowing for a volume taken; cultivation under conditions which are optimal for examined microorganisms-producers in a nutrient medium with reduced composition; calculation of evolved colonies with specific morphological features; morphologic identification of microorganisms and colonies; calculation of microorganisms' quantity on dishes with recalculation per 1 m3 of air. Bas-ing on the detected regular concentration dependences of microbe contamination dynamics in air we worked out a proce-dure for quantitative determination of microorganisms-producers; we also performed metrological estimate of opera-tional properties for assessing microorganisms-producers of a multi-component microbe specimen as a risk factor caus-ing hazardous impacts on health of workers employed at biotechnological production. We validated our measuring procedure in conformity with the requirements set forth by ISO.

4-15

Authors: N.V. Zaitseva, I.V. May, D.A. Kiryanov

We present scientific-methodological approaches to defining risk categories of economic entities which are subject to surveillance in the sphere of consumer rights protection. Risk is suggested to be assessed as a product of violations frequency comprising violations of separate provisions of the law on consumer rights protection detected in the course of scheduled and unscheduled inspections; a number of claims per one detected violation which were satisfied by courts in favor of consumers; each separate case of harm accepted by court in money terms (as a sum of physical and moral damage to health and damage to property); and coefficient of a potential impact scope which differentiates risks for economic entities belonging to micro-, small, medium-sized and large business. Our information sources are official statistic data obtained due to realization of state control in the sphere of consumer rights protection and court practice collected in all the RF regions over 2012–2016. It is shown that a share of economic entities with extremely high risk potential which can cause total material damage to consumers in sums greater than 10 million rubles per year amounts to about 0.15 % of the total number of economic entities (both juridical persons and private entrepreneurs); economic entities with high risk potential account for about 2 %. Such groups are made of companies involved in financial markets, share construction services, insurance and tourism. About 23 % of juridical persons and private entrepreneurs can be classified as having low risk potential and they can be excluded from scheduled inspections. Economic entities structure in general corresponds to world practices. It is shown that risk-oriented surveillance model development requires improvements in keeping registers of juridical persons and private entrepreneurs as such registers should contain comprehensive information; it is necessary for correct risk category (or hazard category) determination. It is also vital to work out a regulation on registering cases of moral and property damage to citizens caused by violations of obligatory requirements in the sphere of consumer rights protection. Other ways of protecting consumer rights are becoming especially important; here we first of all mean preventive and procedural ones. Such ways are to be developed and implemented especially widely for spheres of activities which are "risky".

26-36

Authors: I.V. May, N.V. Nikiforova, V.A. Khoroshavin

The article deals with an issue related to risk assessment as a criterion of durable consumer goods safety for population health; construction materials and finishing materials are a very relevant example of such goods. We showed that legislative and methodological grounds for assessing such risks were not sufficient. So we developed approaches to risk assessment on the basis of evolution models which allowed to examine risks growth under chronic exposure. We revealed that even if certain goods con-formed to sanitary standards set forth by technical regulations they could still cause unacceptable health risks for consumers. And the risks tended to grow dramatically when several goods with similar or identical hazardous effects were consumed together. We performed epidemiologic and profound medical-biological examinations and obtained authentic mathematical de-pendencies of correlation between exposure and consumer health disorders; these models are adequate to the data taken from relevant scientific literature. We tested methodological approaches to application of the detected "dose - effect" dependencies for evolution modeling. These approaches were tried out in real-life situations when certain construction and finishing materials were used in precast frame low-rise housing construction. We proved that long living in houses which were built with the use of 7–8 and more polymer-containing materials formed unacceptable risks for citizens' health after 10-12 years. The results we obtained helped to justify a decision that people should moved houses as it was unacceptable to live in them any longer; it was also considered inadvisable to use newly-built and still uninhabited houses of the studied lines for constant living. Basically, these methodical approaches can be applied in assessing risks caused by a wide range of durable consumer goods.

47-56

Authors: K.P. Luzhetskiy

It is vital to develop systems of preventing risk-associated pathology due to constantly high levels of endocrine diseases in children exposed to chemicals with trophic effects on endocrine system (lead, cadmium, manganese, chromium, nickel, benzene, phenol, formaldehyde, benzpyrene, chlorine-organic compounds, and nitrates). Applying risk management techniques is one of the most promising trends in prevention of diseases related to environmental impacts. We offer methodical approaches based on system combination of activities at various management levels aimed at improving risk-oriented model of surveillance and control. These approaches enable allowing for detected thropic risk factors in regional social-hygienic monitoring programs, implementing algorithms of case monitoring over exposed children population, and applying contemporary prevention technologies. Social-hygienic monitoring improvement at territorial level implies stricter control and more comprehensive lists of monitored components. This can be achieved by studying compounds which form risks for endocrine system, by working out scientific-methodological grounds for accounting chemical compounds which are trophic for endocrine system, as well as by refining volumes and contents of scheduled inspections performed at high risks objects together with laboratory examination of chemical compounds including those thropic for endocrine system. Local level includes algorithms and schemes of prevention activities aimed at early detection of endocrine disorders related to chemicals impacts. When we give grounds for personified technologies of endocrine diseases prevention (alimentary disorders, physical retardation and obesity related to impacts exerted by chemicals which are trophic for endocrine system) we should remember that individual programs choice is based not only on their capacity to eliminate priority compounds determining total chemical load on a person faster but also on possibility to correct basic pathophysiological and pathomorphological disorders.

65-72

Authors: V.V. Suchkov, S.A. Khotimchenko, O.V. Sazonova, D.O. Gorbachev, T.K. Ryazanova, E.A. Semaeva

The article deals with the problem of soil contamination with benzpyrene within sanitary-hygienic zone of an oil refinery plant. We proved that benzpyrene penetrated into soils due to oil-containing wastes and sedimentation of polycyclic aromatic hydrocarbons from powder-gas discharges on soil surface. Benzpyrene concentration detection at the boundary of a sanitary-hygienic zone provides guidelines for determining discharges spread into the atmosphere from stationary sources; it also serves as an indirect parameter characterizing soil self-purification intensity. We treated benzpyrene content in soils as an informative indicator showing soil horizon contamination with polycyclic aromatic hydrocarbons and heavy oil fractions. Over 2015–2016 66 soil samples were taken and analyzed. We detected benzpyrene concentration with Agilent Technologies 7820A GC System «Maestro» gas chromatograph with mass-selective detector Agilent Technologies 5975 Series MSD in full conformity with ISO 18287: 2006. We compared actual benzpyrene concentrations with maximum permissible concentration (MPC = 0.02 mg/kg), confirmed by Hygienic Standard 2.1.7.2041-06. The results of analyzing the samples as per benzpyrene content revealed that it was higher than maximum permissible concentration (MPC) in all of them. Share of samples with benzpyrene content higher than 1.5 MPC varied from 54.5 % to 90.9 % in different seasons. Some places within sanitary-hygienic zone had high benzpyrene concentration in soils reaching 9.85 MPC. High benzpyrene content in soils proves there is persistent soil horizon contamination with polycyclic aromatic hydrocarbons and soil self-purification slows down. And this, in its turn, causes carcinogenic health risk occurrence (1.0810–3 – 6.5510–3).

88-95

Authors: T.N. Govyazina, Yu.A. Utochkin

1–3 year students attending medical and preventive faculty of a medical university were our research object. Our research had many stages, and at the first one our goal was to examine and to assess basic behavioral risks for reproductive health of students attending medical and preventive faculty of a medical university. We conducted a sociological examination via questioning. 428 students were questioned as per materials collecting program which included 74 parameters; they accounted for 91.6 % out of the overall official number of students, 45.0 % male students and 40.0 % female students combined work and studies. We detected that, as per questioning results, the specific weight of students who took care of their health amounted to 79.2 % boys and 95.2 % girls. However, the students tended to have bad habits, i.e. constant alcohol intake or smoking. And although information on diseases prevention and on how to pursue healthy lifestyle was perfectly available to them, students didn't try to use it and preserve their health. All the respondents said they were against abortion. Girls were likely to adopt a complex approach when choosing a contraceptive, they resorted to hormonal agents, and, with their partners' consent, to condoms. But they often took hormonal agents without any consultations with a gynecologist or an endocrinologist. Contraceptives were rather rarely applied, and students appeared to have no knowledge on risk factors causing reproductive health deterioration. They also tended to be negligent and too self-confident when it came to reproductive health protection. A risk of abortions was very high for girls who didn't use contraceptives, and also all students ran rather high risk of catching sexual diseases. Sexual education is needed to correct contraceptive behavior; medical workers are a main source of information on reproductive health of young people in 7–10 % cases only. We need to create interactive educational programs on health protection at university level and to involve specialists from health centers and antenatal clinics to participate in them.

102-112

Authors: S.I. Ereniev, O.V. Plotnikova, V.G. Demchenko, N.V. Rudakov

We have studied sanitary-hygienic characteristics of working conditions, charts with results of sanitary-epidemiologic examination performed in a zoogenous nidus, outpatient clinic cards and questionnaires filled in by 202 patients living in Omsk region and suffering from occupational brucellosis. The disease usually prevails among stock-breeders, veterinaries and workers employed at meat-processing enterprises. Our goal was to detect risks of occupational, production-induced and general pathology evolvement. Working conditions which all the examined people had to work in corresponded to hazardous (3.3) or even dangerous (4) category as per occurrence of contacts with infectious agents and parasites (biological risk). Apart from biological factor, a number of workers were under complex exposure to ammonia concentrations (higher than MPC), noise higher than MPL, vibration, cooling microclimate, uncomfortable lighting environment, labor process hardness and intensity. There were several factors causing epidemiologic risks as well. Disinfectants were absent or their quantity was not sufficient; industrial and amenity rooms were not well-organized; there was no central hot water supply or shower rooms, separate rooms for meals, specialized implements for removing abortus and stillborn fetuses and afterbirths, correctly organized burial grounds, or first aid kits. Hygienic health risks were caused by insufficient cleaning agents supply, absence of centralized protecting clothing laundering, and insufficient provision with personal protection means. Occupational health risks resulted from absence of preliminary medical examinations in standard recruitment procedures, irregularity and low quality of periodical medical examinations. Our qualitative assessment of behavioral health risks revealed that a lot of workers tended to have irresponsible medical and hygienic behavior, there were disorders in their work and rest regime (shift work with shifts rotation), nutrition, sleeping and waking. We also found out that the examined workers didn't pursue self-preserving lifestyle as they drank alcohol, smoked, underestimated the importance of being vaccinated against brucellosis and of having medical examinations, and didn't apply for medical aid in due time. We detected the third type of risk-genous behavior, "high risk-genous level, passive" in 28.22 % of our respondents

119-127

Authors: N.F. Izmerov , N.I. Izmerova, I.V. Bukhtiyarov, M. Khodzhiev

The article gives the results of determining peculiarities which are characteristic for adaptation in female migrants de-pending on a period of their staying in Moscow region. Adaptation was assessed as per variants of functional stress status and functional abilities of circulatory system. We detected that female migrants during their adaptation to impacts exerted by neuro-emotional factors, social-psychological factors, and physical (muscular) loads which varied in their intensity and length, had signs of stress syndrome. This syndrome was apparent through physiological parameters, namely increase in index of functional changes in circulatory system, and changes in heart rate variability as per regulatory systems activity parameter (PARS). If female migrants stayed in Moscow region for less than 3 years than the most specific weight of migrants with unsatisfactory adaptation was detected among Russians and it was equal to 36.04%; adaptation mechanisms were strained among Tadjiks women (62.08 %). If they stayed for longer than 3 years, then unsatisfactory adaptation parameter grew among Tadjiks women by 12.4 % and it indicated that the body's functional reserves were mobilized and it could lead to adaptation failure. When ad-aptation was satisfactory, β-adrenoactivity of erythrocytes membranes was within the physiological changes standards regardless of a period of staying. When adaptation mechanisms were strained and adaptation itself was unsatisfactory, the greatest growth in this parameter was detected among Tadjiks women in any period of staying. Preservation of female labor migrants health and prolongation of their working capacity period requires a system of med-ical and social support. Activities aimed at primary prevention of health disorders should include general physical training, tempering, autogenous training, and elimination of hazardous communal and occupational risk factors. Secondary prevention activities are systematic medical surveillance over migrants' health, including preliminary and periodic medical examinations.

136-141

Authors: L.A. Chesnokova, I.V. Mikhailova, S.I. Krasikov, V.M. Boev

Our research goal was to study influence exerted by Fe2+ and Cr6+ cations on oxidative stress signs during an experiment on Wistar rats. We detected that when these metals were introduced into animals it caused free radical oxidation activation which became apparent through changes in chemiluminescense intensity in blood serum, in increased malonic dialdehyde and diene conjugants concentrations in blood serum and tissues (liver and pancreas), and in depression of antioxidant enzymes of superoxide dismutase and catalase erythrocytes. We showed that Fe2+ introduction with drinking water in a dose equal to maximum permissible concentration (MPC) could cause moderate activation of free radical oxidation as iron was a key element in active particles generation in biological media, including superoxide-anion-radical and most reactive hydroxyl radical. As we studied possible influence exerted by another redox-active metal, namely Cr6+, in concentration equal to 1 MPC we also detected enhanced free radical processes in blood serum which became more intense as exposure duration grew. Luminescence sum representing total antioxidant blood serum activity was almost 2.5 times higher as per two experimental periods when Cr6+ was introduced in comparison with intact animals. Processes activation under chromium cations effects is determined by its direct influence on free-radical mechanisms. Cr6+ ions recover to Cr3+in biological media; one-electron recovery process with intermediates forming at intermediate oxidation levels involves occurrence of active oxygen forms; it results in free radical processes enhancement.

4-12

Authors: D.V. Efremenko, I.V. Kuznetsova, V.G. Orobey, А.А. Efremenkо, V.M. Dubyanskiy, E.A. Manin, D.A. Prislegina, O.V. Semenko

Mass events tend to become more and more dangerous for population health, as they cause various health risks, including infectious pathologies risks. Our research goal was to work out scientifically grounded approaches to assessing and managing epidemiologic risks as well as analyze their application practices implemented during preparation to the Olympics-2014, the Games themselves, as well as other mass events which took place in 2014–2016. We assessed epidemiologic complications risks with the use of diagnostic test-systems and applying a new technique which allowed for mass events peculiarities. The technique is based on infections ranking as per 3 potential danger categories in accordance with created criteria which represented quan-titative and qualitative predictive parameters (predictors). Application of risk-oriented approach and multi-factor analysis allowed us to detect exact possible maximum requirements for providing sanitary-epidemiologic welfare in terms of each separate nosologic form. As we enhanced our laboratory base with test-systems to provide specific indication as per accomplished calcu-lations, it enabled us, on one hand, to secure the required preparations, and, on the other hand, to avoid unnecessary expendi-tures. To facilitate decision-making process during the Olympics-2014 we used an innovative product, namely, a computer pro-gram based on geoinformation system (GIS). It helped us to simplify and to accelerate information exchange within the frame-works of intra- and interdepartmental interaction. "Dynamic epidemiologic threshold" was daily calculated for measles, chickenpox, acute enteric infections and acute respiratory viral infections of various etiology. And if it was exceeded or possibility of "epidemiologic spot" for one or several nosologies occurred, an automatic warning appeared in GIS. Planning prevention activities regarding feral herd infections and zoogenous extremely dangerous infections which were endemic for Sochi was accomplished taking the completed assessment into account. The positive experience obtained through risk-oriented organization of certain activities aimed at providing anti-epidemic safety of mass international events on the Russian Federation territory allows us to be optimistic about prospects of wider im-plementation of the approach described above and other similar approaches based on health risk analysis principles.

21-28

Authors: А.V. Matveichev, М.V. Talaeva, V.Yu. Talaev, N.V. Neumoina, K.M. Perfilova, D.G. Lapaev, E.V. Mokhonova, M.I. Tsyganova, V.N. Koptelova, Z.I. Nikitina, V.A. Lapin, D.A. Melent'ev

Estimating risks of infections induced by gram-negative Helicobacter pylori, is a vital problem for healthcare due to wide spread of the agent and wide range of induced pathologies which include malignant neoplasms in gastrointestinal tract. The agent is prone to long-term chronic persistence despite its "fragility" and its being greatly demanding to culturing conditions. The persistence issue is of special interest here as it is related to data on Helicobacter pylori capability to change immune response in infected people inducing suppressive regulatory immune reactions which are more favorable for the agent, both in stomach and in a whole body. Our research goal was to estimate Helicobacter pylori capability to induce differentiation of regulatory CD4+CD25+FoxP3+ human T-cells as basic mediators of immune response regulation under direct contact between bacteria and T-cells without any participation of most professional antigen-presenting cells. Our research objects were clinical isolates of Helicobacter pylori and T-lymphocytes samples taken from people who didn't have Helicobacter pylori-infection in their case history; isolates and samples were jointly cultivated in vitro. We applied cytofluorometry to estimate changes in regulatory T-cells content. We detected that if T-lymphocytes and Helicobacter pylori were jointly cultivated during 18 hours in ratios from 1:10 to 1:50, regulatory T-cells content in cultures increased 2.12 times on average. This effects doesn't require any dendritic cells in a culture and obviously affects T-lymphocytes which are originally committed to regulatory T-cells in their development. Also, in our opinion, influence exerted on regulatory T-cells differentiation is a specific feature of Helicobacter pylori.

38-46

Authors: M.R. Kamaltdinov, N.V. Zaitseva, P.Z. Shur

The article focuses on describing mathematical model of a multi-phase flow in antroduodenum and its application for predicting digestive process features, including pH level detection. The suggested sub-model representing antroduodenal area of gastrointestinal tract is being developed within the frameworks of mathematical multilevel model depicting evolution of damage to critical organs and systems under exposure to risk factors. We introduced damages as per three functions (motor, secretory and absorbing one) to several gastrointestinal tract zones (body of stomach, antrum, and duodenum) and to pancreas and liver, into the sub-model. Mathematical problem statement includes records of mass and impulse conservation equations for mixture of liquid incompressible phases; ratios for mass flow intensity vector due to diffusion processes; ratios for mass sources due to reactions, secretion and components absorption, food dissolution, initial and terminal conditions. We obtained numeric experiment results when drinks with various pH level (2.3; 3.5; 7) were consumed; they revealed that anomalous considerable increase in acidity occurred in pyloric opening zone and duodenal cap zone when a drink with pH level equal to 2.3 was consumed. The results presented in this work make a considerable contribution into mathematical modeling development used to describe multiphase flows in biological channels with variable form. We showed that obtained acidity levels in various antro-duodenum zones correspond to experimental data given in the works of other researchers. In future the model can be applied to predict risks of duodenum damages evolvement together with detecting areas of their localization under exposure to negative factors.

56-65

Authors: L.A. Pykhtina, O.M. Filkina, N.D. Gadzhimuradova, A.I. Malyshkina, S.B. Nazarov

Issues of health state and factors determining it in infants born due to in vitro fertilization (IVF) have been frequently dis-cussed over recent years. The question yet to be answered is whether health disorders are related to burdened pre-morbid state of a mother as per extragenital and obstetric-gynecologic pathology or they are caused by IVF. Selective transfer of only one embryo has tended to increase recently, and, given this trend, specialists all around the world, and in our country as well, face a problem of detecting risk factors which cause health disorders in children born in monocyesis after IVF. Prognostic algorithm for most frequent pathologies is being worked out and it will help to implement targeted and differentiated approach to their prevention. We have completed clinical examination of infants during the first year of their life; all these infants were born in monocyesis after IVF (n=121). We have also questioned and interviewed their parents and analyzed data taken from infants' development records over a year as well. We have applied Wald sequential mathematical analysis to determine risk factors and create prognostic tables comprising most frequent somatic health disorders such as congenital abnormalities, iron-deficiency anemia, atopic dermatitis, absence of perinatal CNS damage compensation. We have detected that factors related to a mother's and newborn's health (extragenital morbidity, obstetric-gynecologic case history, pregnancy course) exert their influence on health disorders evolvement in such children during their first year of life; we have also shown that social factors and factors associated with IVF procedure don't have any statistical significance.

84-90

Authors: T.N. Govyazina, Yu.A. Utochkin

We chose students from all the six years attending Medical and Prevention Faculty of Perm State Medical University named after academician E.A. Vagner as our research object. Our research goal was to examine and to assess basic behavioral risks which could cause health risks for students attending medical higher educational establishment. We applied a set of techniques in our work: information-bibliographic one (15 literature sources were studied, both periodicals and monographs), sociological one (467 students of Medical and Prevention Faculty were included into a one-time questioning, them all being an entire assembly), statistic one (we calculated relative values and mean values, as well as correlation coefficients). The research was performed in two steps; the first one was based on analyzing subjective evidence, namely, sociologic questioning results; in our second step we focused on examining pathologic damages as per medical examinations data as well as data on morbidity obtained from register of visits to a students' polyclinic. Students' health is a significant parameter of a society intellectual potential; specific weight of students, both males and females, who take care of their health amounts to 60.0 % and 96.5 % correspondingly. 100 % questioned girls and 58.3 % boys consider their health to be "good". There are gender-based discrepancies in estimating one's health state in all sub-groups and as per all reasons for its preservation. 45 % boys and 40 % girls with quite different self-estimation of their health combine work and study. Students tend to have bad habits as they constantly drink alcohol and smoke. Despite availability of considerable volumes of information on diseases prevention students don't try to use this information and preserve their health. Medical students' lifestyle has such peculiarities as non-rational nutrition, insufficient physical, social and medical activity.

98-105

Authors: V.I. Adrianovskiy, G.Ya. Lipatov, E.A. Kuz’mina, N.V. Zlygosteva, K.Yu. Russkikh, N.P. Sharipova, T.V. Bushueva, V.O. Ruzakov

In order to develop ideological grounds for complex assessment of industrial carcinogenic danger, we performed hygienic assessment of contribution made by working environment factors into carcinogenic risks formation for workers employed at blister copper production. The assessment included predictive values of occupational risks. We determined tumor markers levels for occupations with unacceptable levels of carcinogenic risks. We examined mortality caused by malignant neoplasms. It is shown that non-organic arsenic compounds applied in blister copper production are the main factor causing carcinogenic risks. As we calculated individual carcinogenic risks for 25-year working period we found out that total carcinogenic risks for all basic and supplementary occupations in copper-smelting workshops were within the 4th range (more than 1.0 х 10-3). Unacceptable predictive values of carcinogenic risks for 100 % examined occupations appeared already after 5 years of work. We detected excess levels of tumor markers in 73 % of examined workers with occupations characterized with unacceptable values of carcinogenic risks; 19 % of such workers had excess levels of two tumor markers at once. 9 % of examined workers had excess levels of Cyfra 21.1 tumor marker, 14,5 % of workers had high levels of СЕА tumor marker, and 59 % of workers had high levels of NSE tumor marker. Intensive mortality indices for male workers employed at copper-smelting workshops as per all localizations amounted to 153.14, whereas they amounted to only 127.25 per 100,000 people for other population groups. Workers employed at blister copper production had higher intensive mortality indices than other people in terms of such nosologies as malignant neoplasms in respiratory organs and chest (86.78 and 47.72 correspondingly), including lung cancer (71.47 and 43.48 correspondingly. The obtained results will help to work out a system for managing carcinogenic risks which will include regulating and controlling activities, managerial activities, technical and technological measures, financial and economic activities, medical and prevention activities plus rehabilitation activities, as well as information and educational activities.

116-124

Authors: A.D. Volgareva, L.K. Karimova, L.N. Mavrina, Z.F. Gimaeva, N.A. Beigul

The article summarizes the data obtained in long-term research on working conditions estimates and studying damages to hearing organs in workers employed at petrochemical plants. We chose workers employed at five basic organic synthesis productions as an object of our study; these productions include ethylene-propylene, ethylbenzene-styrene, organic alcohols production (butanol and 2-ethylhexanol), phthalic anhydride. We detected that heating furnaces, compressors, and pumps were the main noise sources at the examined productions. Our research revealed that noise levels at the examined productions varied from 60 to 99 decibel, and calculated equivalent noise levels reached the 3 hazard class with 1st and 2nd hazard degree. Audiometric research showed that signs of impacts exerted by noise on hearing organs of workers belonging to basic occupational groups (processing machine operators and pumps and compressor operators) occurred authentically more frequently than in case of control equipment mechanics and automatic equipment operators (comparison group) (<0,001). The highest risk of occupational hearing loss was detected for drivers while the same pathology evolved 1.5–2.0 times less frequently in processing machines operators. Frequency of hearing organs damage in all basic occupational groups authentically increased as working period grew. Signs of such damage increased dramatically in processing machines operators' group after 10 years of work but still the overall level was slightly lower than in drivers' group. It is shown that the most efficient measures of collective protection aimed at noise reduction are application of low-noise technological equipment, acoustic protection (sound insulation and sound absorption, etc), remote control, as well as rational labor and leisure regime. Medical care and vocational rehabilitation of people with occupational hearing loss also contribute significantly into sensory deafness prevention.

132-148

Authors: V.A. Kaptsov, V.N.Dainego

Risks of eye damage and eyesight deterioration to a great extent depend on how efficient a biomechanical eye system is under energy-saving lighting conditions. The system's efficiency is determined by its adequacy in managing pupils and ciliary muscle. We analyzed mathematical models describing changes in pupil's diameter which were determined by light-technical pa-rameters of illumination environment (luminance level and brightness). We highlighted the importance of ganglionic cells and the role they play in managing pupil's diameter (miosis) when they are exposed to blue light within 480 nm spectrum. Basing on the assessment of a pupil's constriction under exposure to various light stimuli (blue, red, and green ones) we worked out a melanopsin effect concept of a pupil's retention at miosis and showed that it could be a diagnostic sign of some diseases (age-related direct retinopathy, pancreatic diabetes) under exposure to a blue light impulse with a certain wave length. Under exposure to blue light within 480 nm spectrum ganglionic cells form a managing signal for a sphincter muscle of a pupil and ciliary muscle which provides accommodation (as per Helmholtz) and regulates aqueous humor flow in ciliary channel. All modern energy-saving light sources have a low energy level at wave length equal to 480 nm due to gap in their spectrum in comparison with sunlight spectrum with the same light temperature and luminance level. Inadequate management of pupil's diameter under artificial lighting conditions leads to melanopsin effect disorders and causes disharmony in managing aqueous humor outflow. All the above-stated factors under long-term visual load cause eye diseases risks in modern illumination environment. We detected that contemporary mathematic models describing pupil's diameter fluctuations needed to be refined allowing for new knowledge on functional peculiarities of retina cells and energy-saving light sources spectrum.