Health Risk Analysis

4-16

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

It is shown in the article that since the establishment in 1992 and until now the social and health monitoring (SHM) oper-ates as a complex open system of extended collection and processing of heterogeneous data about the parameters of the envi-ronment, socio-economic indicators of living of the population of the country’s regions, medical and demographic characteristics of society as a whole and of individual population groups. As part of the SHM system Rospotrebnadzor annually performs hundreds of thousands of instrumental measurements of objects in the environment of the Russian Federation. These federal and regional information assets have tremendous analytical capacity and allow a knowledge-based processing of information in the "health-environment" system for a variety of management tasks of sanitary and epidemiological situation. Changing of the general paradigm of control and supervisory activities of Rospotrebnadzor and giving a fundamentally new status of control measures to researches and measurements of the system of social and hygienic monitoring without interaction with legal entities and individual entrepreneurs were important bases for further improvement of the SHM. The development of SHM in conjunction with the risk-based supervision model can significantly improve analytical capabilities, effectiveness and effi-ciency of each system. This development requires the adoption of a new edition of The statements of the SHM, the development of a scientific approach to the formation of "risk profiles" of objects of sanitary and epidemiological surveillance; the development of methodological approaches to the selection of points and formation of programs of instrumental studies of air, water and soil as the control activities in the areas of influence of economic entities. Of great current interest are the development and consolidation of regulatory requirements for the registration of the results of sampling and measurement in the course of monitoring activities in the framework of the SHM; the establishment of criteria for associating violations of hygienic standards of air quality, natural and drinking water and soil with the facts of causing threat to life and health of citizens; the development of scientific and organizational approaches to the establishment, registration and proof of cases of harm to human health in violation of the mandatory requirements of the objects of sanitary and epidemiological surveillance.

23-30

Authors: S.F. Sosnina, N.R. Kabirova, M.E. Sokolnikov, P.V. Okatenko

Malignant tumors of hematopoietic and lymphoid tissues in children have polyetiologic nature, including some contribution of parents’ exposure to radiation. The causal relationships between parental chronic preconceptive external gamma-irradiation and hematological malignancies in their children have been studied. Retrospective epidemiological study based on a “nested case-control approach” using matching method was carried out in the cohort of Ozyorsk pediatric population. “Case” is defined as a child under 15 years old with diagnosed hemoblastosis. The “control” group is the one without such a diagnosis. The controls were selected from the same Ozyorsk children’s cohort by matching cases on sex, birth year and parents’ age at children’s birth. Subgroups of children who are offspring of those occupationally exposed are distinguished. Calculation odds ratio (OR) with 95 % confidence interval (CI) is performed. There were 51 children under 15 years age diagnosed with hemoblastosis in Ozyorsk within 1949–2009. The control group included 197 health children. 29.4 % (15 children) in the study group were offspring of people who had accumulated doses of preconceptive exposure, whereas in the control group the indicator is 43.1 % (85 children). The total doses of external gamma radiation on the parent’s gonad varied widely (2.1–3397.3 mGy in the study group and 0.5–2899.3 mGy in the control group). The average age of leukemia contraction was 6 years without regard to sex. Acute leukemia was a major contributor to the hemoblastosis structure (66.7 % of all cases). Analysis of the data showed no statistical relationship between preconceptional prolonged external gamma-radiation exposure in parents and oncohematological pathology in their offspring. OR indicator amounted 0.55 (0.28–1.07), among boys – 0.48 (0.19–1.22), among girls – 0.64 (0.25–1.65).

38-45

Authors: T.S. Ulanova, M.V. Antipieva, M.V. Volkova, M.I. Gileva

This paper presents the results of the experimental determination of particulate matter PM2,5, PM10 mass concentration and total suspended particles up to 15 microns (TSP), which are the priority components of air pollutants near the highways. The measurements were made during the year 2016 using a laser analyzer of aerosol DustTrak 8533. The study shows the dependence of the particulate matter concentration from the time of day and the traffic congestion. The sampling (N = 67) was performed due to brief program on the basis of the route monitoring station, which is located on the road junction with heavy traffic – up to1,200 vehicles per hour on the test sites. The single concentrations of the suspended substances reached the levels of the Maximum permissible concentration (MPC) of 1.5. During the study period, the exceeding of the established average daily MPC for fine particles PM2.5 and PM10 fractions near the highways have not been identified. The significant linear relationship between the number of diesel vehicles on stops and the concentrations of particulate matter PM2.5, PM10, TSP (correlation coefficient from 0.62 to 0.65; Fisher's criterion of 14.2 to 38.0; p <0.05) has been estab-lished and parameterized, what allows to predict the level of air pollution by diesel vehicles when braking and accelerating. It is recommended to fulfill continuous monitoring of the average daily and single MPC of the fine suspended particles near the roads with traffic load of 769 – 1270 or more the diesel vehicles per every 20 minutes. The obtained data may be used in evaluation of the risk to public health induced by the transport emissions as well as in the estimation of the fine particles PM2.5, PM10 concentrations on the sites close to the highways of the large industrial center.

54-63

Authors: D.V. Goryaev, I.V. Tikhonova

The analysis of the primary morbidity dynamics in the population of the Krasnoyarsk region is performed for the period 2005–2015. The incidence forecast by classes of ICD diseases, X revision is calculated. It was found that the figures of the first time revealed incidence in the Krasnoyarsk region exceeded the average for the Russian Federation during the years 2011–2014 on neoplasms, nervous system diseases, diseases of the circulatory and the digestive systems, diseases of the musculoskeletal system and connective tissue, endocrine diseases and a number of other systems. The values of the integral health risk indicators are calculated by the methodology of State Sanitary and Epidemiological Surveillance Agency of the year 1995. For risk characteristics the following criteria are used: integral index of health less than <0.312 – minimal risk; 0.313–0.500 – moderate risk; 0.501–0.688 – increased risk of more than 0.689 – the highest risk. It was found that the increased health risk is typical of 21 municipal territories of the region, which is home to 66.1 % of the population. Among the areas with “high” public health risk in different years were Sharypovo, Birilyussy and Evenk districts. In most areas the priorities relate to a group of non-communicable diseases associated with the negative impact of various factors of habitat population (disease of the respiratory system, circulatory system, neoplasms, including malignant, etc.). According to the forecasts in 2016 we expect the decrease in the proportion of inhabitants in the region from the group with the “moderate” and “elevated” risk, and an increase in the number of people with “high” and “minimal” risk to public health. It is shown that a number of regional municipalities have a necessity in the planning and implementation of measures to improve the population health.

72-79

Authors: Andreeva E.E.

The article describes the results of the sanitary-epidemiological evaluation of Moscow soil quality as a possible risk factor for injury to citizens’ life and health. It presents a comparative analysis of the dynamic non-standard soil samples on the sanitary-chemical, parasitological and microbiological indicators in the Russian Federation and in Moscow. The data for the soil quality analysis in the administrative districts of Moscow are summarized. It has been demonstrated, that in the metropolis territory there is a tendency of soil quality improvement in comparison with the year 2012 (according to the sanitary-chemical parameters - by 5.64 %, microbiological – by 4.52 % and parasitological – by 0.4 %). Levels of soil chemical and microbiological contamination in Moscow for the years 2012–2014 were higher than levels in the Russian Federation by 2.43–2.71 and 1.49–2.23 times respectively. The highest proportion of soil samples, that do not meet hygienic standards for chemical indicators in 2014, both in the Russian Federation and in Moscow, was recorded in the zones of influence of the industrial enterprises, highways (RF – 10.64 % Moscow – 17.65 %) and in the residential areas (RF – 6.53 %, Moscow – 17.63 %). More than 50 % of soil samples which do not meet hygienic standards for chemical indicators in 2014, was observed in 4 of the 10 administrative districts of Moscow Central Administrative District (CAD) – 83.3 ± 36.5 %, West AD – 94.4 ± 31.7 %, North AD – 50.0 ± 25.3 %, South AD – 88.9 ± 30.8 %. By the year 2014 the priority pollutants of urban soils in Moscow were lead, zinc, chromium, cadmium, cobalt. In two districts of Moscow the proportion of poor soil samples for bacteriological parameters exceeded 50 % in 2014: South-Eastern Administrative District (54.2 ± 29.4 %) and Eastern Administrative District (75.0 ± 30.0 %). Due to the microbiological parameters the unsatisfactory samples of soil in Moscow demonstrated the excessive indicators of coliforms and enterococci indices. The proportion of soil samples exceeding hygienic standards for parasitological indices ranged from 3.3 ± 6.5 % to 5.6 ± 7.7 % in the North AD, South AD and Central AD (non-viable helminthic eggs identified).

95-106

Authors: S.A. Maksimov, G.V. Artamonova

In scientific terms, the protection of workers' health is based on evidence of causal links between occupational factors and the onset of illness (or fatal case). The review considers the factors that modify the causal relations between occupational exposures and pathology of the cardiovascular system of workers in epidemiologic studies. Analysis of published data shows strong role of modifying impact of traditional risk factors, and healthy worker effect in shaping of the levels of cardiovascular disease in the working population. This modifying effect needs to be identified and eliminated at the moment of the analysis of the causal relations between occupational exposure and the development of diseases. Some of the most common methodological mistakes are presented on the example of the concrete case studies: ignoring the traditional risk factors for cardiovascular diseases, considering of correlations of occupational experience with the prevalence of diseases as causal, not as associative (due to age), lack of analysis of the possible occupational selection (artificial or spontaneous) of more healthy workers in poor working conditions. The main directions of methodological approaches of formation of the test samples, the results of analytical and statistical processing techniques eliminating the modifying effect were presented. The author's methodical methods that allow identifying and correction of the modifying effect of the healthy worker effect (healthy hire effect and healthy worker survivor effect) on the relative risk and etiologic fraction of disease in occupational groups on the basis of epidemiological data were highlighted in details. It is noted that a broader and more complete use of the modern developed methodological approaches to the formation of the test samples as well as to the results of analytical and statistical processing techniques, can significantly improve the adequacy and reliability of national epidemiological studies.

119-127

Authors: I.O. Taenkova, О.Е. Trotsenko, L.A. Balakhontseva, A. A.Taenkova

To prevent the social diseases, including HIV infection – is one of the high-priority tasks of the public health. To assess the awareness level among the students of the Khabarovsk Krai in the age of 17–20 years about the risk factors and the HIV transmission ways, the special investigation has been held in 2016. The method of selection of respondents was random. The sampling included the first-year students of two universities and one college in the city of Komsomolsk-on-Amur (120 pers.) and two high schools and college in Khabarovsk (100 pers.). The average age of respondents was 19.2 ± 1.04 years. The distribution by sex: men – 33 ± 3.17 %, women – 67 ± 3.17 %. The comparison of the data of the previous years (2008, 2012) and the study in 2016 confirmed that the majority (92 ± 1.5 %) of the surveyed young adults in general are well-informed about HIV, sexual and parenteral routes of transmission. However, in recent years, the share of those who consider the possibility of HIV transmission through kisses, bites of blood-sucking or by sharing a meal. The performed studies have confirmed the tendency of the younger generation to the risky behavior. Their search for novelty and the thrills can be traditionally considered to be a contributing factor to the experiments with psychoactive substances and early initiation of sexual relations. The conducted analysis has showed the possibility of using the various forms and methods of youth behavior research. The study has revealed a certain potential for preventive planning of primary prevention of HIV infection. The obtained results have demonstrated that for the effective containment of the HIV epidemic it is necessary to carry out continuous risk monitoring system and preventive work among all young people, not only among the vulnerable groups.

135-143

Authors: I.V. May, E.V. Sedusova, T.M. Lebedeva

The shaping the system of control and surveillance activities in the Russian Federation, which affects the bodies of the sanitary-epidemiological surveillance, requires the development of new forms of cooperation between authorities and legal entities, individual entrepreneurs and population. Such a form may be represented by the sanitary and epidemiological audit as an independent objective assessment of reputable third parties. The audit is intended to check the compliance with the mandatory requirements of the economic entities, performing economic or other activities. The sanitary-epidemiological audit may be associated with a system of certification for compliance with sanitary requirements and may assume the documented confirmation of the compliance issued by the authorized persons. The sanitary-epidemiological audit and the compliance certification to mandatory sanitary requirements can make an alternative to the planned supervision activities on facilities attributed to the category of low and moderate risk of harm to human health. The Russian sanitary legislation does not recognize the sanitary-epidemiological audit as a form of conformity assessment. The analysis of the international experience shows that it is necessary to consolidate the general rules and regulations of the sanitary-epidemiological audit at the legislative level and to develop a set of sublegislative documents in order to implement these norms. The crucial is a creation of the national system capable to regulate the registration and functioning of the organization having a right to conduct the audit activities in the field of hygienic safety. It is reasonable to develop the regulation on the list-register of auditors and to create a special training system for the auditors, who possess the methodology for health risk assessment. The key aspect of the successful introduction of the audit is a granting of presences to the economic entities having compliance certificates as a result of voluntary sanitary-epidemiological audit. The authorities for the accreditation and monitoring of the audit firms in the field of sanitary and epidemiological safety can be given to a federal executive body competent in this field.

4-12

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

The hygienic aspects of the transport illumination and the risks of the negative impact of LED lighting on the health of op-erators, drivers and passengers have been investigated. The transport illumination is a subject of the longitudinal research of the light effect of the beam and signal lights on driver’s reaction and dazzle. The study of the vehicles’ light effect on passengers’ health was not carried out because for the illuminating of the passenger compartments the incandescent bulbs were used, the characteristics of which are well known. Increasing of the duration of trips, their intensity and the replacement of incandescent lamps to LED lamps makes these studies more urgent. Particular attention is drawn on the fact that the transport system transports millions of passengers and children who are regularly exposed to excessive doses of blue light. The blue light time exposure is more than an hour per trip within the city and more than 5 hours during travel between the cities. The specialists of N.M. Emanuel Institute of Biochemical Physics RAS have indicated that modern white LEDs have expressed emission band in blue spectrum 440-460 nm that is entirely attributable to the spectrum of action of retinal photochemical damage and its pigment epithelium. Such extensive emission poses a hazard to the eyes of children and adolescents, because their crystalline lenses are almost twice as transparent in the dark-blue and blue spectrum area than those in adults. Retinal photochemical damage develops in distant time and can cause gradual, irreversible visual impairment. The risks of negative impact especially increase in the application of blue LED for interior lighting passenger vehicles. It was demonstrated that at the retinal cells’ affection by the excessive dose of the blue light the consequences have delayed character. The results of the accelerated assessment of the retina damage in Japanese quils (Сoturnix japonica). The eyes of these birds are a complete analog of human eyes. It has been shown that moderate daily blue LED lighting of the young animals induces 1.5 times overload of the cellular metabolism of the retina, resulting to its accelerated aging and functional activity suppression of the blood-retinal barrier structures.

23-34

Authors: Andreeva E.E., Onishсhenko G.G., Kleyn S.V.

The article describes the results of work on the dual hygienic assessment of priority risk factors of the environment and the health condition of the population of Moscow. It is shown that in the territory of the metropolis the impact of conditions of negative factors on human health is retained. These trends are confirmed by the excess of the hygienic standards of pollutants in ambient air (up to 6.6 TLVc.e.), by the substantial increase (up to 65.8 %) of share of the centralized sources of water supply, water quality does not meet the hygienic standards due to the high level of non-standard samples of soil (more than 50 % on a number of sanitary-chemical and microbiological parameters in the territories of certain administrative districts). At the same time there is a tendency to a decrease in non-standard drinking water samples taken from the distribution network of centralized drinking water supply (from 4.36 % to 2.45 %). It was established that the primary morbidity have a number of positive trends to decrease, but exceeds the average indicators for individual classes and nosology, including the classes of "Respiratory diseases", "Diseases of the skin and subcutaneous tissue", "Neoplasms" and etc. by 4.1–68.3 %. Analysis of causality (about 50 significant biologically-based mathematical models were received) on the system of "quality of habitat (a risk factor) – health status (morbidity, mortality) " showed that the impact of negative environmental factors probably shape up to 29.2 ‰ of additional cases and up to 0.056 ‰ of the additional deaths per year. The largest contribution to the formation of the probability of additional cases is made by the excess of morbidity by hygienic standards of air quality and soil, mortality and air quality. Risk factors are phenol, benzo a pyrene, nitrogen dioxide, suspended solids, ammonia, chlorine and its compounds, and sulfur dioxide, etc., coming from the atmospheric air, and cadmium, microbiological agents, radioactive substances contained in the soil.

44-52

Authors: Pivovarova E.A., Shibanova N.Yu.

During the observation period for 2011–2015 in the Republic of Khakassia it has been revealed that 63.2 % of samples of drinking water contain the excess of А due to natural radionuclides 234U, 238U. Within the limits of MPC the carcinogenic hazardous substances: cadmium, lead, arsenic, beryllium, chromium have been detected. Individual risks of occurrence of stochastic effects in the form of malignant tumors, caused by natural radionuclides in drinking water in different administrative territories of the Republic, vary in the range of 3.14–7.81•10–6 cases/year; collective risks 0.013–0.288 cases/year on the corresponding amount of population. Individual cancer risks are determined by the content of carcinogenic chemicals in drinking water, in different administrative territories of the Republic it varies in the range between 5.29•10–5 – 1.04•10–4 cases/year; collective risks of 0.88–2.704 event/year on the corresponding amount of population. The total population carcinogenic risks caused by content of carcinogenic chemicals and PRN in drinking water, for the period of observation were as follows: Altaisky (2.903 at 26.000 of population), Beysky (1.123 at 18.500 of population), Bogradsky (0,98 at 15,000 of population), Shirinsky (2.63 at 27100 of population), Ordzhonikidzevsky (1.178 at 11900 of population), and Ust-Abakansky (2.79 at 41100 of population). The contribution of drinking water into primary ontological morbidity of population in administrative territories of the Republic was equaled to 0.5–1 %. Therefore, currently, the events aimed at reducing the carcinogenic risks caused by drinking water are not required. At the same time, due to the high seismic activity in the Republic for the last five years, the laboratory monitoring of drinking water on indicators of radiation safety and the evaluation of the carcinogenic risks continues in the prescribed amount.

61-69

Authors: Gigolaeva L.V., Tibilov A.G.

Cobalt administration in the human body is a risk factor for developing pulmonary and cardiovascular health problems. In this paper we report the results of functional studies and biochemical mechanisms of endothelial dysfunction and pathology of internal organs in cobalt intoxication in experiment. System-organ nature of the activation of oxidative processes is identified according to the increase of MDA secondary prod-uct in erythrocytes and homogenates of internal organs as well as the participation of AOC imbalance in the development of lipid peroxidation, the peculiarities of the violations of NO release endothelial function and participation in this process of L-arginine and an analogue of endogenous inhibitor of expression eNOS -L–NC - arginine methyl ester (L-NAME or L-nitro-arginine-methil-ester) with cobalt intoxication in conditions of activation of oxidative processes. Chronic cobalt intoxication in rats leads to the activation of oxidative processes, thus there is inhibition of superoxide dismutase activity and the concentration of catalase and ceruloplasmin increased. Cholesterol metabolism is disturbed, as well as impaired nitric oxide production and its bioavailability, which is accompanied by the change of the microcirculatory hemodynamics of the visceral organs. The evaluation of the internal organs’ functional state according to the activity of the Na+,K+-ATPase in homogenates is performed, as well as due to the activity of organ-specific and excretory enzymes in blood serum on the background of cobalt toxicity. The role of changes of cholesterol metabolism is established – as a risk factor of atherogenesis in violation of the bioavailability of nitric oxide. For the pathogenetic correction of violations we applied the method using the endogenous antioxidant coenzyme Q10 and regulators of the expression eNOS L-arginine, L-NAME and their combination with coenzyme Q10.

80-87

Authors: Muhammadieva G.F., Karimova L.K., Bakirov A.B., Kaptsov V.A., Beygul N.A., Gimaeva Z.F., Mav¬rina L.N.

In the process of producing of continuous glass fiber workers are exposed to complex impact of carcinogenic chemicals released into the air of the working area (including formaldehyde, epichlorohydrin, ethane acids, aerosol of mineral oil). The penetrating effect of harmful substances through the skin is enhanced by the fine glass dust, which has a traumatic and irritating effect. Aggravating factors of the impact of lubricants on the body of the operators is the increased temperature and the excess of heat radiation. A risk factor is also the unfavorable climate of the workplace. Among the professional patients (71 person of 170 examined employees) most of persons aged 50–59 years. The average age of the patients at the time of detection of hyperkeratosis was 51,9 ± 0,9 years, skin cancer – 57,3 ± 1,7 years. Professional skin neoplasms were diagnosed mainly in workers who have been working for more than 10 years (average period of 12.6 ± 2.4 years). The period of transformation of limited hyperkeratosis to the skin cancer was on average 5–8 years. It was found that the molecular-genetic factors predisposing to the development of professional skin lesions are polymorphic variants of the gene suppressor of tumor growth TP53 (Ex4 + 119G>C, IVS3 16 bp Del/Ins and IVS6+62A>G). It has been shown that the development of preventive measures aimed at reducing the risk of occupational diseases is relevant and should include the interaction of administration, engineering and technical staff of the enterprise, labor protection service, Rospotrebnadzor specialists, doctors specialized in occupational diseases and the workers themselves. The complex of measures of primary and secondary prevention of health problems is suggested. The necessity of including the continuous glass fiber production to the list of carcinogen production processes, presented in national normative documents

98-109

Authors: Rakitskiy V.N., Ustinova O.Ju., Valina S.L.

The increase in the number of children in groups of preschool educational institutions (PEI) of more than 22 people is accompanied by a deterioration of sanitary and hygienic state of the premises of group cells by chemical, biological and physical indicators. In the densely populated groups the content of phenol and formaldehyde in the air of playing and sleeping rooms reaches 2.2–4.6 MAC daily average, for 30 % increases the air contamination by the conditionally pathogenic flora (St. aureus), the level of noise impact during gaming sessions is up to 80 dBA. Direct dependence between the increase of morbidity of children by the allergic diseases of the respiratory organs and the skin, functional gastrointestinal disorders, acute viral and bacterial diseases and urinary tract infections with the index of fill rate of PEI groups (R2 = 0,32–0,89; r≤0,035–0,0001) has been correlated. The risk of violations of physical development and development delay of biological maturation of children is increased by more than 1.5–2.0 times (OR = 1,51–2,17; DI = 1,1–3,01; p = 0.01–0.03 and reduce of the adaptive reserve of the cardiovascular, respiratory and autonomic nervous system and the development of functional disorders, including cognitive, increases in 1,2–10,0 times (OR = 1,2–10,11; DI = 1,11–18,81; p = 0.01–0.04). Longtime combined effects of chemical, biological and physical factors determine the formation of chronic physiological distress syndrome in children, manifesting by a change in metabolism, haematopoiesis, decreased cellular activity and humoral immune response, a violation of the intracellular mechanisms of antioxidant protection (p = 0,0001–0,017). The results of sanitary-hygienic, clinical laboratory and mathematical methods of research have established that the optimum fill rate of groups of standard PEIs of general developmental orientation should not exceed 14–16 children and the standard of playing or sleeping areas shall be not less than 4 m2 for 1 child. When the fill rate of the group cells of PEI does not exceed 14–16 people and with the compliance of floor space, the indices of physical, cognitive development, functional state of children's life-support systems are minimally determined by hygienic conditions of the internal environment of premises of PEI.

4-9

Authors: Shigan E.E.

The main stages of the introduction and development of preventive medicine and the term HEALTH RISK are described. The “risk” definition is related to the works by Max Fasmer and Frank Knight. The development of preventive medicine was also influenced by the works of scientists and physicians of the ancient world and the Middle Ages. Particular attention is paid to the appearance, formation and development of the medical school of Salerno, and the impact of its work and the activities of scientists and teachers on further development of prevention and treatment. The relationship of these two concepts and their history is shown. The author dwells on the prevention development in Russia, paying particular attention to domestic researchers, especially after the victory of the Great October Revolution. Works by N.A. Semashko, Z.P. Soloviev, G.V. Khlopin, A.N. Sysin and F.G. Krotkov played a huge role in the development of preventive medicine in Russia and in the world. The article also represents the prevention medicine development facts in the post-war years – the creation of large schools of medicine, aimed at the prevention of diseases and epidemiological studies of the risk incurred. The article also pays attention to the foundation of International Institute for Applied Systems Analysis (IIASA), some areas of its work, especially in relation to research on the health risks. The itegration at mathematical modeling and forecasting with medicine in general and health in particular, as well as the study of the health concepts of risks at individual nosological examples are written.

19-27

Authors: Lyuboshenko T.M., Flyanku I.P.

The purpose of this study was to develop and implement the risk assessment method for detection of health deterioration in sports high school students. To evaluate the health status of the students, the questionnaires and the method for express physical health evaluation by G.L. Apanasenko was used. Sampling size comprised 250 young males students from 2–3 courses of various faculties. To identify the correlation between the physical health level and the indicators of psychosomatic syndromes, the correla-tion analysis has been used. It was established, that the safety level of the somatic health belonged to more than a halve of the stu-dents engaged in sport and to a third part of the students, that are not engaged in sport. The critical level of the physical status was registered with equal frequency in both groups. The low physical health level was detected 3.7 times frequently in the students who were not engaged in sports activities in comparison to the sportsmen. Basing on the data, obtained by the "decision tree" method, the models of health deteriorations’ risk in young males, engaged and not engaged in sport, have been built. The application of these models allow performing preclinical diagnosis and health monitoring without special equipment. The advantage of the offered method is its speed and the possibility to survey large numbers of contingents of various ages.

36-44

Authors: Gimranova G.G., Bakirov A.B., Karimova L.K., Gimaeva Z.F., Beigul N.A.

A complex social-hygienic investigation for the assessment of health-related life quality and living standards among 1200 male workers occupied in mining and primary processing of hydrocarbon raw materials has been performed. The study included the method of the anonymous survey for the employee with using a questionnaire developed by WHO experts for the realization of Health, environment and social capital management in enterprises (HESME). The health risk factors’ prevalence associated with alcohol, smoking, low physical activity, poor nutrition, stress in the workplace has been established. The feeling of stress and nervousness is generated by the fear of dismissal (18 % of employees), conflicts with administration (4%) and by financial problems. About 47% of persons are anxious about social and economic instability. Not more than 4% of employees consider that the health deterioration is directly related to harmful working conditions. The survey has revealed an inflated self-esteem regarding the health. Thus 59.00 % of employee considers their health status to be excellent or normal, while an objective assessment revealed only 29.7 % of healthy employee. Due to the employee’s opinion, the saving of health is conditioned by healthy lifestyle, but the practice of self-preservation behavior is poorly spread. Not more than 37 % of respondents follow the doctors’ recommendations. Among the positive process there are changes in dietary habits in everyday life, namely 60 % of the respondents have chosen the balanced diet. The obtained data regarding the quality and way of life of the employee, occupied in mining and processing of hydrocarbon raw materials, should be taken into consideration when developing complex social development programs on an enterprise.

60-67

Authors: Dubel E.V., Unguryanu Т.N.

The prevalence of behavioural risk factors among health professionals at the multidisciplinary hospital was the aim of the present research. The study included a questionnaire of the WHO International Programme of Integrated Prevention of Noncommunicable Diseases “Countrywide Integrated Noncommunicable Disease Intervention Programme” (CINDI). The survey involved 333 health professionals: doctors – 14.1 %, mid-level and junior medical personnel – 62.2 % and 23.7 %, respectively. The average age of the respondents was 42.5 years. The proportion of males and females was 8.4 % and 91.6 %, respectively. It was found that a significant proportion of respondents has overweight (34.4 %) and obesity (17.5 %), hypertension (31.1 %). The prevailing part of the hospital medical staff has an average and a high level of physical activity. The eating behaviour of 80 % of health workers is characterized by low consumption of fruit and vegetables. Doctors tend to drink alcohol more frequently than the mid-level and junior medical personnel, at that the consumption of alcohol for the vast majority of persons who participated in the study is moderate. Tobacco consumption is typical for a significant proportion of the respondents (32 %), more common among nurses than among doctors and mid-level medical staff. Health workers of 40–60 years have a high individual risk of coronary heart disease associated with smoking (1.3•10–4 – 1.6•10–3). Persons older than 50 years revealed an unacceptable risk of lung cancer pathology (4.7•10–4), stomach (1.4•10–4), bladder (1.5•10–4), cerebrovascular disease (2.5•10–4) at the effects of smoking.

76-83

Authors: Goryaev D.V., Tikhonova I.V.

This study fulfills the hygienic assessment of ambient air quality in the populated areas of the Krasnoyarsk Region. It is shown that the total number of emission sources in the region is more than 23 600 units, what is higher than in previous years. Around 90.7 % out of them correspond to the set standards of permissible emissions. Air monitoring was carried by the establishments of Roshydromet, Rospotrebnadzor and by other organizations at 94 observation posts in eight urban districts and 2 municipal districts of the region. The status of the ambient air in a sequence of the populated areas of Krasnoyarsk region, namely in the cities Achinsk, Kansk, Krasnoyarsk, Lesosibirsk, Minusinsk, Norilsk, is characterized by the presence of certain pollutants, the level of which exceeds the hygienic standards. Prioritized pollutants are benzo(a)pyrene, suspended solids, nitrogen, and sulfur dioxide, formaldehyde and others. In the settlements the economic entities violate the legal requirements in the field of sanitary and epidemiological welfare of the population. The probability of the population’s health deterioration grows along with the growth of risk factors. The risks of respiratory diseases, immune system, blood and blood-forming organs and the additional mortality are assessed as unacceptable. Ensuring air quality of the urban residential areas and municipal districts of the Krasnoyarsk Territory requires the introducing the complex measures to improve it. The established levels of human health risk associated with exposure to polluted air are an additional criterion for selection of the priority objects when planning the implementation of risk-based model for supervisory activities in the field of sanitary and epidemiological welfare of the population.

4-14

Authors: Onishchenko G.G., Zaitseva N.V., May I.V., Andreeva E.E.

On the base of the analysis of multidimensional data on the levels of socio-economic development of Russian regions, the conditions of life of citizens and the quality indicators of habitat for the 2013-2015 a clustering of the subjects of the federation has been made. Four types of regions were defined in terms of sanitary and epidemiological welfare of the population, in which environmental factors and socio-economic conditions dictate a different health status. 1 cluster consists of the regions of relative sanitary and epidemiological welfare (27 subjects). 4 regions and 2 federal cities are in the group of territories with severe sanitary and epidemiological issues with a high level of socio-economic indicators of the population. Cluster 3 includes regions with moderate to severe sanitary and hygienic as well as medical and demographic challenges with national average indicators of socio-economic development (21 regions). 25 regions belong to the cluster of sanitary and epidemiological distress with a low level of socio-economic development. Priority issues that shape medical and demographic population losses were described for each cluster.

26-33

Authors: Zaitseva N.V., Zemlyanova М.А.

The results of research and evaluation of the protein profile in blood plasma in children, that have been exposed to long-term effect of fine dust containing vanadium in the zone of influence of metallurgical production sources, are demonstrated. It was established that under conditions of poor air quality in the residential area due to vanadium pentoxide dust content at the level up to 1.2 mean daily MAC (34 RfC chr ), by the suspended solids – up to 0.6 mean daily MAC (1.2 RfC chr ), there is vanadium concentration in blood of the exposed 4–7 aged children, that exceeds up to 6 times the reference level. The technology of the proteomic analysis showed that children with high content of vanadium in blood have changes in proteomic profile in blood plasma in the type of increase of the relative volume of acid glycoprotein alpha-1; reduction of clusterin, apolipoprotein A-IV, alpha-2-HS-glycoprotein, that are associated with vanadium concentration in blood. In the absence of timely primary and secondary prevention and the preservation of vanadium sustained exposure the revealed cell-molecular abnormalities allow us to predict further development of functional disturbances on tissue and organ levels as the early development of osteoporosis and osteoarticular pathology, atherosclerotic vascular changes, autoimmune allergic processes on the background of disorders of immune regulation, oncology diseases.

42-49

Authors: Maklakova О.А. , Ustinova О.Yu., Belyaeva Е.S. , Sherbakov А.А.

The study has involved 43 children living in areas with poor air quality due to public health indicators. In 24 % of cases during the remission the children (with bronchial asthma and recurrent bronchitis, associated with exposure to anthropogenic chemicals such as suspended solids, aromatic and oxygenated hydrocarbons, formaldehyde) demonstrated peripheral signs of obstruction and the presence of functional cardiac disorders. Being under exposure to adverse effects of environmental chemical factors, the children with chronic respiratory diseases suffer from the developing of the cardiac type of vegetative dysfunction, which was manifested in bradycardia and tachycardia, eytonic and/or sympathicotonic baseline autonomic tone, hypersympathicotonic /astimpathicotonic autonomic reactivity. In 17.9 % of the children it was manifested in transient diastolic dysfunction of right ventricle and in excessive systolic blood pressure in pulmonary artery.

59-68

Authors: Bagryantseva О.V., Shatrov G.N., Khotimchenko S.А. , Bessonov V.V., Arnautov О.V.

Aluminum is the most abundant metal in the lithosphere, constituting 8 % of the earth's crust. Aluminum enters the food from the various objects of environment such as water, food contact materials (packaging materials, cooking vessels), aluminum-containing food additives. In raw food products the content of aluminum is less than 5.7 mg/kg of the product. Normally, aluminum is not practically found in a human body. However, within the last decade various toxic effects of aluminum on human body have been revealed, and they are able to cause the risk of various diseases. The analysis of the available data has demonstrated that the excessive entry of aluminum in human body with food items is associated first of all with the content of aluminum-containing food additives, as well as with the use of materials and products made of aluminum and its alloys intended for contact with food. High level of aluminum consumption has been also detected among children of all ages. At the same time, today, theprovisional tolerable weekly intake (PTWI) of aluminum for children is not established. To reduce negative effect of aluminum on human body it is necessary to: * exclude from the list of Annex 2 of the Technical Regulations of the Customs Union "Requirements for Food Additives, Flavorings and Technological Aids” (TR TS 029/2012) the following food additives – potassium aluminum silicate (E555), bentonite (E558), sodium aluminum silicate (E554), potassium aluminum silicate (E555), calcium aluminum silicate (E556), aluminum silicate (kaolin) (E559); * to develop requirements for the aluminum content in food products intended for children nutrition; * to obtain data on aluminum content in food items sold on the domestic market and to assess health risks to consumers.

77-86

Authors: Yambulatov A.M., Ustinova O.U. , Luzhetskiy K.P.

The study of the chemical substances’ content of anthropogenic origin in children with subclinical polyhypovitaminosis was conducted. It was found that a deficiency of vitamins A, C, E, B6 and B12 increases the risk of developing of elevated concentrations of organic substances of technogenic origin in blood in 1.4–6.9 times. In children with subclinical polyhypovitaminosis and high blood phenol, formaldehyde, aromatic hydrocarbons, and organ chlorine compounds increases the tension of erythropoiesis, decreases the activity of proliferating processes of lympfomonocytic germ cell factors of nonspecific resistance. Even subclinical forms of polyhypovitaminosis on the background of high content of organic compounds in the blood of children are accompanied by a slowdown of protein and carbohydrate metabolism, depletion of antioxidant defense system of reserves and shortage of energy metabolism. Developing disorders of fat metabolism in children with subclinical polyhypovitaminosis occur against a background of strained reactions of hormonal regulation that, in case of the progressive course may pose a threat to the early development of cardiovascular disease in older age groups.

96-102

Authors: Goryaev D.V., Chernenko V.V., Tikhonov I.V., Fedoreev R.V.

In order to improve the control system of sanitary and epidemiological welfare of the population under the control of Rospotrebnadzor in the Krasnoyarsk region, a register of legal entities and individual entrepreneurs, whose activities are subject to sanitary and epidemiological supervision was established. For each of the 21 386 economic entities the number of population was defined (workers, consumers of goods and services), the potential risk of harm to the health of these populations was calculated. The computational methods and expert assessments were used. Testing of objects classification into four classes (1-extremely high, 2-high, 3-moderate, 4 class – low risk) allowed to rank to the class 1 around 0.6% of supervised legal entities and individual entrepreneurs; to object class 2 – about 14%; to class 3 – almost 48%. More than 36.7% of business entities have been referred to the fourth class; the frequency of scheduled inspections of their activity is minimal or can be ruled out at all (in the absence of violations of sanitary legislation for certain time). Using a risk-based planning model has streamlined planning towards increasing the share of inspections in respect of the subjects that are highly relevant and hygienically engaged in providing health care to the population (from 3.9% to 6.8%), education (from 32.8% to 55.6%), services and audits of local governments (from 0.9% to 15.2%).

4-12

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

In order to fulfill the legal requirements for the transition to the new risk-based model of the state control (supervision) in the Federal Service for Consumer Rights Protection and Human Welfare, the methodical approaches to the classification of economic entities and activities of potential risk of injury have been developed. The risk assessment takes into account the frequency of violations of sanitary legislation, the severity of the consequences of these violations for the health and extent of negative effects, which is estimated in terms of population under the influence of the economic entity. Algorithms and methods for calculating the exposed population: workers, consumers, including consumer food products, non-food products and services; residents of settlements under the negative impact of air pollution, water and soil, have been developed. Regional and federal registries of objects for sanitary and epidemiological supervision are formed. Testing of the risk-based approaches in the regions allowed excluding the low risk harm objects when forming the audit plans for 2016, due to what the number of planned inspections all over country was reduces by more than 20 %. The basic directions of further improvement of the risk-based model of sanitary and epidemiological surveillance: its extension to the system of technical regulation and consumer protection; scientific substantiation of its volume, content and laboratory support of the scheduled inspections of objects belonging to different classes of health risk; improving procedures and methods for evaluating the effectiveness and efficiency of risk-based supervisory activities; creation of an effective system of risk communication between the sanitary and epidemiological surveillance, economic entities, public organizations and associations and civil society.

21-27

Authors: Zaitseva N.V. ,Dolgilh O.V. , Krivtsov A.V., Starkova K.G. , Luchnikova V.A., Bubnov O.A., Otavina E.A., Bezruchenko N.V., Vdovina N.A.

A sequencing of the candidate genes of the pupils, exposed to strontium by the method of targeted resequencing has been performed. It is shown, that under conditions of increased revenues of strontium in drinking water the number of polymorphonuclear altered portions of candidate genes increases. As a result of the targeted resequencing in conditions of strontium exposure, the maximum polymorph modifications of the following genes are defined: sulfotransferase 1A1 (SULT1A1) and methylenetetrahydrofolate. It was shown that the structure of the mutations in conditions of the strontium exposure was characterized by the formation of defects in the gene mapping detoxification (38.5 % of all mutations) and immunoregulation (22.5 %). Analysis of the cause-effect relationships in the system "factor - the number of mutations" revealed that candidate genes reflecting strontium exposure conditions (content of strontium in drinking water is 1.3 MAC), are genes: cytochrome P450, glutathione - transaminase (detoxification); dopamine (CNS), interleukin 17 and the major histocompatibility complex (immune system), methylene-tetra-hydro-folate-reductase (reproduction).

36-43

Authors: Zemlyanova M.A., Akafeva T.I. , Dovbysh A.A. , Smirnov S.A.

The results of the research and comparative assessment of the cumulative properties of nanodisperse and microdisperse nickel oxide in the experiment are presented. It is found that after the intragastric gavage of the nanodisperse nickel oxide for 16 days (total dose administered was 16250 mg / kg) it possesses a functional accumulation, as it is evidenced by the morphological changes in the tissues of the gastrointestinal tract, liver, spleen, and material accumulation indicator which is an increase of its concentration in the brain, liver and kidneys relative to controls (4.7, 8.1 and 23.6 times, respectively). Microdisperse analague also has a functional and material accumulation, but the degree of manifestation is different from the accumulation of nanodisperse nickel oxide. The accumulation of the substance occurs only in brain and liver, and in lower concentrations as compared to the nanodisperse nickel oxide (1.7 and 3.6 times). The morphological changes of tissues of the gastrointestinal tract and the spleen are less pronounced, any change in liver tissue is not established.

50-61

Authors: Ushakov A.A. , Turbinskiy V.V., Paschenko I.G. , Katunina A.S.

The materials on health status, socio-economic, sanitary living conditions of the population of the Altai Krai have been analyzed. The comparative analysis of the conditions of life and health outcomes in urban and rural settlements’ population has been performed. The estimation of health indicators’ correlation has been carried out in children of age group 0-1 years, children of age group 0-14 years, teens of age group 15-17 years and adults of age group over 18 years, depending on the type (urban or rural) of settlement with indicators of social and sanitary environmental factors. Regression equations for the health outcomes of different age groups on the level of hygiene and social environmental factors are set, regional critical (reference) values are justified. The hygienic assessment of unfavorable social, health and sanitation of the environment on the health of the population in the Altai Krai is provided.

73-78

Authors: Malyutina N.N., Taranenko L.A. , Tolkach A.S., Nevzorova M.S.

The article proved a stable connection between an essential hypertension (EH) development, life-threatening arrhythmias and conduction under the impact of a complex of occupational factors, first of all psycho-emotional stress, noise and electromagnetic radiation. We analyzed the initial manifestations of endothelial dysfunction of the locomotive engine drivers. We found an increase of the performance of endothelin-1 (1.59 ± 0.29 p/mole/ ml), MCP-1 (268.83 ± 23.29 pg/ml). Revealed changes are proposed as laboratory predictors and forecast criteria of initial lesion of the vascular bed.

91-96

Authors: Alekseeva Е.А.

The comparative analysis of indicators of life quality of the secondary school students and pupils of the establishments of primary professional education on the basis of questioning of 382 teenagers of Pskov (206 teenagers of 14 - 18 years which study in 9–11 forms of comprehensive schools, and 176 teenagers of the same age who study in establishments of primary professional education) is carried out. After data processing the indicators of life quality which are an integrated assessment of wellbeing of the person, the physical, psychological and social health, were received. Considerable distinctions in indicators of the life quality of the pupils and the pupils of the establishments of primary professional education that informs about lower standard of living of the last, irrespective of presence or lack of work experience, have been revealed. The PF indicator in school students is 1.19 times higher, than a similar indicator of pupils of primary professional education establishments.