Health Risk Analysis

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 As a result of products hazards assessment their turnover can be limited, or they can be withdrawn from the market, or additional information on hazards or risks they may cause is to be provided for consumers.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.