Environment&Health (Dovkillia ta zdorovia)

15-22

Authors: ОМЕЛЬЧЕНКО Е.М., ПОЛЬКА О.О., ЄЛІЗАРОВА О.Т., КАРТАШОВА С.С.

Smoking is at one of the first places among the factors of lifestyle that negatively affect human health, including indicators of the respiratory, reproductive, digestive and cardiovascular systems. A relationship between smoking and morbidity, prevalence and mortality from cardiovascular diseases (CVD), taking into account the age structure of the Ukrainian population, was a subject of the study. These diseases were selected as an indicator of the negative effects of smoking. Objective: We identified the trends in the variability of cardiovascular pathology among the population under the influence of both active and passive smoking, established the degree of relationship between these indicators and assessed «cause-effect» relationships as well. Materials and methods: The data analysis was performed on the basis of the official state statistics and own retrospective genetic monitoring data. Results: In Ukraine, since 2009, current legislation significantly restricts smoking in public places. Due to the reduction of smoking intensity, the above measures were expected to lead to a reduction in the incidence (mortality) from CVD during a long period after the enactment of legislative changes. The share of smokers in Ukraine (age 12+) for the period 2013-2016 is lower by 17.4% (t=4.6; p<0.01) than for the period 2004-2012. The share of the smokers in Ukraine (age 12+) for the period 2013-2016 is lower by 17.4% (t=4.6; p<0.01) than for the period 2004-2012. At the same time, there was a decrease in the proportion of those who smoke 1-5 or more 20 cigarettes a day. From 2009 to 2016, the incidence of CVD decreased by 23%, and the mortality rate from CVD decreased by 9%. This decrease was due both to a decrease in the number of smokers (almost by 32%) and to a decrease in cigarette sales (at least by 39%). The relationship between a decrease in the proportion of smokers in the population and a decrease in morbidity and mortality from cardiovascular disease (p<0.05) has been established. Conclusions: The enactment of the Law of Ukraine on Tobacco Control had a positive systemic effect, its impact affected the reduction of morbidity and mortality of the population of Ukraine from cardiovascular diseases, which significantly improved the demographic situation.

28-35

Authors: BANDAZHEVSKYI YU.I., DUBOVA N.F.

Objective: We compared thecontent of homocysteine, hormones and minerals of the blood in the children with different levels of physical development living in the settlements near Chornobyl exclusion zone. Methods: We used instrumental, laboratory, mathematical and statistical methods in the study. Results: 158 children (78 boys and 80 girls) from Polisskyi district, Kyiv oblast were examined within the projectsof the European Commission in Ukraine «Health and Ecological Programmes Connected with Chornobyl Exclusion Zone: Development, Training and Coordination of Health-Related Projects» and Rhône-Alpes Regional Council (France). The studied territory has remained contaminated with radioactive substances after Chornobyl accident until the present day. 137Cs incorporation was shown to affect negatively the physical development (PD) of the children. 137Cs radionuclides cause the disorders of cellular energy, affect negatively thyroid hormone genesis.A significantly high level of free triiodothyronine (T3), parathyroid hormone (PTH) and P was established in adolescents with abnormal low PD in comparison with the children with abnormal high PD. Correlations between the indices of PD, endocrine system and mineral metabolism, registered in a group of examined children, reflect the physiological response of the organism to the cell damage associated with an exposure to 137Cs radionuclides. Comparison of the values of separate metabolic indices with the reference values does not always reflect objectively the severity of metabolic disorders. To identify the metabolic disorders under conditions of constant incorporation of 137Cs radionuclides in a child’s organism, it is necessary to use the information on the associations among several metabolic indices in a group of children living in the territory suffered from the accident at Chornobyl nuclear power plant.

44-55

Authors: ЧЕРНИЧЕНКО І.О., БАЛЕНКО Н.В, ЛИТВИЧЕНКО О.М., БАБІЙ В.Ф., ГЛАВАЧЕК Д.О., КОНДРАТЕНКО О.Є.

Objective: We determined the possible effects of priority chemical environmental carcinogens on the incidence of hormone-dependent tumors and the mechanisms of their effect on the basis of the analysis of literature data and our own research. Results: The performed analysis demonstrates the scanity of the research devoted to the study of chemical carcinogens which are concerned only with the class of polycyclic aromatic hydrocarbons (PAH), benzo(a)pyrene (BP), atmospheric pollution, emissions from vehicles, the cadmium heavy metal and products of smoking containing these substances. The connection with PAH (BP) and the development of breast, ovarian cancer, cadmium with the development of breast, endometrial, ovarian cancer in women and prostate cancer in men was established. Epidemiological data, combined with experimental ones, suggest a possible contribution of carcinogens into the increase of the incidence of hormone-dependent tumors. At the same time, mechanisms of action of PAH and cadmium on the development of hormone-dependent tumors are unclear. The accumulated experimental and epidemiological data allow us to conclude that the oncological danger of these carcinogens lies in the combination of genotoxic and hormone-mimetic properties; the main mechanisms, involved in the realization of the effect of BP and cadmium, are associated with changes and disorders at different levels of the structural and functional organization of the organism, including the endocrine system, which can lead to the development of tumors. The urgency of the problem of the incidence of hormone-dependent tumors and the potential role of the studied chemical carcinogens as pollutants of the environment of human functions indicate the need to take these circumstances into account when developing and implementing preventive measures.

62-71

Authors: МАХНЮК В.М., ЧАЙКА Г.В., ЧОРНА В.В., ВОЛОЩУК О.В., МЕЛЬНИЧЕНКО С.О., ПЕЛЕХ Л.В.

Background: Health care facilities located in built-in non-residential premises of residential buildings are medical institutions of a new type. There are no sanitary-and-hygienic requirements for their placement in the Ukrainian legislation for them. The above was a basis for the conduction of the comprehensive hygienic research on this issue using the T. Saati method. Objective: We performed an expert assessment of the impact of architectural planning decisions and maintenance conditions of health care facilities built into residential buildings on the medical workers’ feel and the conditions of the stay of visitors and residents by means of the in pair comparison of hierarchies (the T. Saati method). Materials and methods: In our study we used the materials of the research on the architectural-and-planning decisions on the location and maintenance of built-in residential buildings of health care institutions which were a subject for expert assessment by the T. Saati method. Conclusions: According to the results of the research, the changes into the regulatory framework of urban planning legislation - SBSB.2.2-10-2001 «Health Care Facilities» on the standardization of the special purpose area for temporary mini-parking, built-in health care institutions for medical workers and visitors were substantiated.

14-19

Authors: ЛИПОВЕЦЬКА О.Б., ПРОКОПОВ В.О., АНТОМОНОВ М.Ю.

Objective: We developed the simplified formulas for the calculation of carcinogenic risk in case of inhalation and cutaneous entry of drinking water chloroform into the human body. Materials and methods: We calculated average daily lifetime doses for the oral, inhalation and cutaneous entry of drinking water chloroform into the human body according to the R.2.1.10.1920-04 and MU 2.2.4-122-2005. The calculation of carcinogenic risks was carried out taking into account the average daily entry of a chemical substance throughout life and the slope factor. Mathematical calculations were performed with the help of the STATISTICA 10 portable software package. Results: In the calculation of the carcinogenic risks, the formulas for the determination of the average daily dose for the inhalation and cutaneous routes of entry of carcinogen into the human body are more complex in comparison with the oral route with additional calculations, reference values, coefficients, etc. Therefore, we have developed a simplified method for its assessment. Linear regression models were chosen to describe the dependence of the carcinogenic risk in the inhalation and cutaneous routes of entry on the concentration of chloroform in water. Evaluation of the results obtained by the values of the correlation coefficients (R, RI), Fisher's criterion (F, pF), and errors of the coefficients (p) showed that both models were adequate to the initial data with a very high degree of reliability. Conclusions: As a result of the study, the solutions of the problem of the assessment of the carcinogenic health risk from the entry of chloroform with drinking water by inhalation and cutaneous routes were obtained with the help of simplified mathematical formulas of linear dependence. The advantage of the proposed solution method is a speed and ease of getting value of the individual carcinogenic risk for the population of various cities of Ukraine for each route of entry, based on the chloroform content in drinking water. This will make it possible to apply risk assessment for a comparative assessment of the impact of chloroform in drinking water at different territories, in different periods of time before and after preventive measures, to compare the effectiveness of the introduction of new technological processes and equipment, etc.

29-35

Authors: БАНДАЖЕВСЬКИЙ Ю.І., ДУБОВА Н.Ф.

The aim of this paper was to assess the prevalence of the T risk allele of the MTHFR:677 genetic polymorphism in a group of girls from Ivankovsky and Polessky districts located near the Chernobyl exclusion zone. In addition, we assessed variants of combined carriership of the T allele with risk alleles of other genetic polymorphisms regulating the folate cycle. Research methods. Immunochemical, statistical. Results. Genetic predisposition to breast cancer risk was analyzed in a group of 251 adolescent girls. Carriership of the T allele of the MTHFR:С677Т polymorphism was found in 142 children (56.6%), while the homozygous T/T variant was found in 25 girls, or in 10.0% of cases. Compound heterozygosity for the 677CT/1298AC alleles of the MTHFR gene was recorded in 60 individuals, or in 23.9% of cases. Conclusions. The revealed genetic changes in the folate cycle lead to a significant decrease in the activity of methylenetetrahydrofolate reductase, and, accordingly, to an increase in the level of homocysteine in the blood, creating conditions for the occurrence of breast cancer. Given the high level of genetic predisposition, taking into account the constant impact on the body of radioactive elements and their decay products, the occurrence, as a consequence, of serious metabolic disorders, it is necessary to identify the breast cancer risk group of children.

42-48

Authors: РУБЦОВ Р.В.

Objective:We studied the efficiency of the comprehensive treatment of ore mining and iron and steel industry workers having the pneumoconiosis combined with chronic obstructive pulmonary disease in terms of intoxication indicators as an assessment of measures aimed at treatment and prevention of this occupational pulmonary pathology. Results: It was established that conducted treatment in the patients, ore mining and iron and steel industry workers with the use of bronchodilator, mucoregulator, anti-inflammatory agent of a complex vitamin medication, as well as sessions of hyperbaric oxygenation at 1.3 atm led to a decrease in the activity of inflammation processes with regard to the content in the peripheral blood of the total number of leukocytes, their stab and segmented subpopulations, and a decrease in most intoxication indices: the leukocytic index of intoxication, the granulocytic-agranulocytic index, the general index of intoxication, the sinistroposition index, the index of the ratio of leukocytes to erythrocyte sedimentation rate, which indicates a decrease in the systemic inflammation activity with the simultaneous suppression of intoxication phenomena. In comparison with the patients with other occupational lung pathology, the comprehensive treatment led to a more significant decrease in the content of segmented and stab leukocytes, as well as the main integral intoxication indices: the leukocytic index of intoxication, the granulocytic-agranulocytic index, and the general index. Thus, the comprehensive treatment of ore mining and iron and steel industry workers having the pneumoconiosis combined with the chronic obstructive pulmonary disease is an important link in the system of measures aimed at treatment and prevention ofthis occupational pulmonary pathology. Conclusions: In the ore mining and iron and steel industry workers having the pneumoconiosis combined with the chronic obstructive pulmonary disease,the comprehensive treatment with the use of bronchodilator, mucoregulator, nebulizer-administered anti-inflammatory agent, a complex vitamin B medication administered intramuscularly, as well as sessions of hyperbaric oxygenation led to an improvement in some inflammation indicators and intoxication indices which is a predictor of a positive course of the disease. The assessment of the results of the conducted comprehensive treatment of the workers indicates a significant positive dynamics of intoxication processes and makes it possible to regard this treatment as an important link in the system of measures aimed at treatment and preventionofthisoccupational pulmonary disease.

60-65

Authors: ГОЛІЧЕНКОВ О.М., ДОМАРАЦЬКА Ю.С., ГРИГОРЕНКО Л.Є., СТЕПАНЧУК С.В. ЛЯШЕНКО В.І., МАЙСТРЕНКО З.Ю.

Objective: We evaluated the sensitizing effect of various detergents intended for the care of dishes and other products for children. Materials and methods: The study was carried out in guinea pigs. The sensitization of the animal’s organism was studied in the reaction of degranulation of peripheral blood basophils (after Shelley). Forthestudy, we selected 10% solutions of domestic and foreign products for washing children's dishes ("Alionka", "Karapuz", "Ushastyi Nian", "Frosch Baby") purchased in the supermarkets of Kyiv. Results: In 21 days, the performed study made it possible to establish the development of sensitization of the organism of the animals in the experimental groups exposed to the solutions of the detergents "Alionka", "Karapuz", "Ushasty Nian” for washing children's dishes, although the degree of its manifestation was different. The solution of the detergent "Ushastyi Nian" was shown to possess more pronounced sensitizing properties, as evidenced by the development of weak positive autosensitization and positive sensitization of the organism of the experimental animals. The impact of the detergents for cleaning children's products "Alionka" and "Karapuz"on the animals’ organism leads to the development of mild sensitization, and when using the solution of "Alionka" detergent, a development of the weakly expressed autosensitization of the organism is also observed in the animals. There was no increase in the degranulation of basophilic granulocytes in the presence of both tissue antigen and hapten in the group of animals where the solution of detergent "Frosh Baby" was used, which indicated the absence of auto- and sensitization of the organism of the animals of this group.

71-79

Authors: КУЗМІНОВ Б. П., САГАЙДАКОВСЬКИЙ М. М., СМОЛЬНИЦЬКА В. Л.

On the basis of the analysis of the scientific works and archival and documentary materials, the authors studied the history of the scientific legacy of G.S. Mosing, the outstanding epidemiologist of the twentieth century. The study of aetiology, pathogenesis, clinical picture and treatment of epidemic typhus is presented in the scientist’s works. Dr. G. Mosing developed the effective system of antiepidemic measures aimed at the complete elimination of this disease.

14-20

Authors: ЄЛІЗАРОВА О.Т., ПОЛЬКА Н.С., ГОЗАК С.В., ПАРАЦ А.М., ЛИНЧАК О.В., СТАНКЕВИЧ Т.В.

For the effective and safe implementation of quarantine measures for the prevention of infectious diseases, it is necessary to a create the conditions for the maintenance of physical and mental health of the population, especially of the children and adolescents, the most vulnerable part of it. The monitoring of quarantine conditions, as well as a lifestyle of children with the identification of possible negative factors affecting the health of schoolchildren, is a prerequisite of it. Objective: We assessed the living conditions of school-age children during the COVID-19 pandemic lockdown. Materials and methods: We analyzed the results of the online survey of the parents of 920 children and adolescents from all regions of Ukraine (497 boys and 432 girls). All respondents signed informed consent. Data were collected from April 17 to June 5, 2020. We applied STATISTICA 8.0 for statistical analysis. Results: Only (59.4±1.7)% of urban and (33.1±4.3)% of rural families with school-age children adhered to quarantine rules (p<0.001). The probability of the deviation from the quarantine rules is 1.7 times higher in rural regions than in urban ones (RR=1.65; CI 1.42-1.92; p<0.001), and 1.4 times higher in the parents with secondary education than in the parents with higher education (RR = 1.41; CI 1.22-1.62; p<0.001). (25.0±1.4)% of school-age children were determined not to leave their homes during the lockdown. About 60% of school-age children went for a walk 1-7 times a week (10-60 min/day). Proportion of children and adolescents with walk duration of more than 60 min/day with a frequency of 5-7 times a week during quarantine made up only (10.3±1.0)%, while before quarantine - 48.5%. Conclusions: Revealed trends demonstrate a need for the development and promotion of the measures for the rise of the population awareness on the importance of compliance with quarantine rules, taking into account demographic and social characteristics. It is necessary to develop ways to achieve optimal duration of outdoor walk for children.

27-34

Authors: МИХАЙЛОВА Л.Л., БУЗИННИЙ М.Г.

The analysis of the documents of the authoritative international organizations and scientific works was carried out from the point of view of the development of the strategy for ensuring the radiation quality of drinking water. The radiation parameters of the quality of drinking water, the interpretation of monitoring results by screening and recommended levels, the value of the individual dose criterion, as well as algorithms for establishing the frequency of monitoring of the radiation parameters of drinking water were considered. Objective: We analyzed the documents of reputable international organizations and scientific works in terms of the development of the strategy for ensuring radiation quality of drinking water and the features of the practical application of the parameters of water radiation quality in the world and Ukraine. Methods: bibliographic, analytical. Materials: We performed the analysis of the documents of international organizations (WHO, IAEA, ICRP, UNSCEAR), as well as scientific publications on the radiation quality of drinking water in the light of the experience in measuring the content of drinking water radionuclides at the territory of Ukraine. Results: Materials of the international documents and scientific publications demonstrate that the assessment of radiation quality of drinking water requires a balanced analysis. In some cases, based on the results of only one determination of the total alpha and total beta activity, it is impossible to draw an unambiguous conclusion about the suitability or unsuitability of drinking water for consumption. Taking into account the geological heterogeneity of the territory of Ukraine, in order to obtain sufficient data on the radioactivity of groundwater, it is necessary to conduct extensive screening studies of the radiation quality of water in the regions of the country with the involvement of geological and monitoring services, local authorities.

46-52

Authors: СТИРТА З.В., МАХНЮК В.М.

Objective: We performed sanitary-and-epidemiological and ecological-and- hygienic substantiation of the conditions for the location of low-capacity enterprises for the manufacture of asphalt concrete, developed the hygienic criteria for their location taking into account the newest home sanitary, ecological and town-planning legislations and requirements of the European Union directives. Materials and methods: In the article we used results of sanitary-and-epidemiological examination of the project materials and applied bibliosemantic, analytical methods. Results: Тhe sanitary legislation of Ukraine of 1971 and 1996 in the normalization of sanitary-and-protection zone for the above mentioned enterprises was analyzed and compared with the analogous standards in the European countries. According to the results of the scientific sanitary-and-epidemiological examination of the project materials on the substantiation of the sanitary-and-protection zone for home low-capacity enterprises for the manufacture of asphalt concrete (80% of them were put into operation before 1996), the following was established. All investigated enterprises work with the prepared bitumen with the implementation of nature protection measures by means of the use of high-efficiency dust and gas cleaning systems, that shortened the gross emissions of the pollutants in ambient air to a large extent and decreased influence on the environment and adjoining settlement territory, that complies with the requirements of the Directive of 2010/75/EС of European Parliament and Council on the industrial emissions (integrated prevention and control of contamination), November 24, 2010. Implementation of nature protection measures with the use of the high-efficiency dust and gas cleaning systems at the existent low-capacity enterprises for the manufacture of asphalt concrete provided the absence of the exceed of MPC of the specific pollutants at the distances that were 1.5-3.0 times less than standard sanitary-protective zone that was a cause for the substantiation of the use of new approach at the establishment of sanitary-and-protection zone by the calculation method at building of the new or reconstruction of the existent low-capacity enterprises for the manufacture of asphalt concrete.

63-70

Authors: РЯБОВОЛ В.М.

Objective: The intent of the work reported here was to analyze the literary data on the production methods, structure and toxic effects of titanium dioxide nanoparticles. Based on the data of the developer, the structure and physico-chemical characteristics were analysed, the acute toxicity and local action of titanium dioxide nanoparticles were investigated. Methods: Hygienic, toxicological, bibliographic, analytical methods were applied in the work. Results: Titanium dioxide nanopowder with photocatalytic effect is practically monodisperse, the average size of the particles is 10 nm, it has a mesoporous structure, contains soft conglomerates from 50 nm to 500 nm, its specific surface area is 57.3 m2/g. Titanium nanodioxide, obtained by thermal decomposition, refers to low-toxic and low-hazard substances, DL50 is more than 5000 mg/kg at intraperitoneal administration to mice. This nanopowder does not irritate the skin and the eye mucous membrane of the rabbits. According to the literature, it has been determined that under chronic exposure to TiO2 nanoparticles in the laboratory animals, the nanoparticles accumulate and contribute to tissue damage in the liver, kidneys, lungs, spleen. In particular, they affect lipid peroxidation and significantly alter the expression of the genes that are responsible for circadian rhythms, metabolic processes and apoptosis.

10-18

Authors: ЯВОРОВСЬКИЙ О.П., ШКУРБА А.В., СКАЛЕЦЬКИЙ Ю.М., БРУХНО Р.П., ХАРЧУК Л.В., БУГРО В.І., РИГАН М.М.

Objective: We assessed the conditions of the work of medical personnel under conditions of the coronavirus COVID-19 pandemic and determined the risks associated with them. Materials and methods: We used bibliographic, hygienic, questionnaire and mathematical methods in the study. The results of our own observations, questionnaires for a survey of medical workers, data of the WHO, Ministry of Health of Ukraine, Center for Public Health of the Ministry of Health of Ukraine, the State Labour Service of Ukraine, data of the State Statistics Service of Ukraine and thematic scientific sources of information were used as a material for the study. Results: The work of medical workers, involved inthe COVID-19 pandemic overcoming, is classified as dangerous (extremal). The risk of infection of medical personnel with the SARS-CoV-2 virus is increased with a deficiency of personal protective equipment for medical workers and its wrong application. The work under dangerous conditions of work at the healthcare institutions leads to a high incidence of COVID-19 in medical workers. Nursing personnel (38.43%), junior nursing staff (22.69%), anaesthetists (5.87%) predominate among medical workers with acute occupational disease COVID-19. Conclusions: The analysis of the results of performed studies allowed to make a conclusion that measures for the prevention of the incidence of COVID-19 in medical workers and measures for the improvement of the safety of the hospital environment should be aimed at more stringent compliance with national legislation and regulatory-and-methodological requirements for the protection of the conditions of workin medical personnel and infection control at the healthcare institutions

25-32

Authors: КУЗНЕЦОВА О.М., ОСТАНІНА Н.В.

Objective: We evaluated and analyzed the level of dietary supplement (DS) consumption in Ukraine and detected the risks arising with their consumption. Materials and methods: We conducted a questionnaire-based survey on the issue of DS consumption among the residents of the cities of Kyiv, Poltava, Kharkiv and Vyshneve (Kyiv oblast). We analyzed the statistical data on the number of the Ukrainian population, availability of the pharmaceutical facilities in the regions of Ukraine, DS sale volumes and laboratory data, concerning correspondence of DS to the claimed composition of active ingredients. Statistical analysis was carried out with the help of the standard software Microsoft Excel 2007 and STATISTICA 8.0. Results and discussion: The survey allowed us to evaluate the health state of the respondents taking DS, to find out the information concerning recommendations for the application of DS, to detect the ways of the purchase of the product, to identify the risk of poor-quality DS taking. According to the survey results, about 72% of the respondents are taking DS. The survey results indicate that 39% of the respondents, taking DS, are healthy, almost a half of the respondents have insignificant health problems and about 12% of the respondents have serious health problems.79% of the respondents buy DS at the pharmacies, it allow us to conclude that about 59.7 million packagings of DS were consumed in Ukraine in 2019. It has been proved that the provision of the population of Ukraine with pharmacy institutions is even for all regions of Ukraine and, accordingly, the population has the opportunity to purchase necessary DS at the pharmacies. Taking into account the results of the laboratory tests of DS quality, the risks of the consumption of poor-quality DS may be about 9.5% in Ukraine in 2019. The results of the investigations of the control procurement show that given risk may be increased significantly. Conclusions: The level of the consumption of dietary supplements by the Ukrainian population was established. It was found that the most widespread way of DS purchase is a network of pharmacies, but nearly 20% of all respondents, taking DS, purchase them at the web-stores, through network marketing, etc. The similar ways of the purchase cannot be easily tracked and are not under serious control, which creates significant risks of DS falsification, therefore, much attention should be paid to these indicated ways of distribution. It was established that in Ukraine, the probability of the consumption of non-compliant DS might be up to 9.5% (among those who used DS) in 2019. For the safe use of DS by the citizens of Ukraine, it is necessary to have a confirmation of the qualitative and quantitative composition of the active components of DS while conducting their quality and safety control.

40-47

Authors: ОЗЕРОВА Ю.Ю., ПРИЛИПКО В.А.

Objective:We identified the social risks among the population of surveillance areas (SA) of the NPP and their impact on socio-psychological state. Methods: In the course of the work, we performed the comparison of the assessment of the life quality by the population in the SA of Rivne NPP (RNPP) and South-Ukrainian NPP (SUNPP) located in different physical-and-geographical regions of Ukraine. We studied seven spheres of life quality, the level of psychological stress, and the concern about the risk of the emergencies among the population. The samplingpopulation made up 232 people in the SA of RNPP and 227 ones in the SA of SUNPP, the sampling error was 5.4%. Results: Employment, democratic governance, health are the critical spheres of life for the population of satellite cities, and welfare, living conditions, employmentare the critical ones for the population ofrural areas. The assessment of the level of well-being is closely connected with the assessment of living conditions, job satisfaction is closely connected with the sphere of security, social protection and the well-being level. Reliable connections have been established between the socio-psychological state of the population and the main spheres of life quality among the population in SA of the NPP: high - among the indicators of the scales of somatization, concern and reactive anxiety and the sphere of security and protection, medium - with the spheres of employment and welfare, low - with the sphere of health care. Conclusions: The data of the sociological survey of the population of SA of the studied NPP indicate the community of interests and demands of the population. The population of SA of RNPP and of SUNPP is characterized by the territorial behavior, stipulated by the awareness of the subject of their attitude to the area, where the activity of the NPP is a leading factor. Most of obtained assessments of the spheres of quality of life are similar in values irrespective of theregion. The involvement of the population of Rivne region in the liquidation of the consequences of the Chernobyl accident affects the concern of the population in case of possible man-made emergency. The population of SA of the SUNPP has a higher level of concern about social emergencies, including possible hostility and terrorist attacks, in particular.

54-59

Authors: ПАВЛЕНКО Н.П., МАХНЮК В.М., ВОЛОЩУК О.В.

Оbjective: We improved the hygienic criteria to ensure optimal conditions, training, and preservation of the health of primary school age pupils, which are common for the assessment of architectural-and-planning decisions of urban and rural secondary schools in accord with modern town-planning and sanitary legislation. Materials and methods: We applied bibliosemantic, analytical methods, method of sanitary-and-epidemiological examination of construction projects, sociological, instrumental and medico-statistical ones using StatSoft STATISTICA (v.5.5) application packages, Excel. Results: The exceeding 1.8-2.3 times the number of the actual studies that do not meet the standards for natural light and noise in urban secondary schools in comparison with the rural secondary schools, is due to the dense town-planning situation. The results of the survey of the parents of the pupils in grades 1-4 on the impact of dense school conditions of secondary schools on the indirect parameters of architectural-and-planning decisions showed that in case of insufficient space of the school room, a poor well-being was registered in 26.3% of pupils (rS <0.78), impairment of working capacity was noted in 18.75% of schoolchildren (rS <0.88).The presence of numerous interrelations between direct parameters of architectural-and-planning decisions (the intraschool space is formed according to them) and the pathological affection of urban schools’ pupils was determined. Conclusions: The occupational diseases in primary school age pupils are caused by direct and indirect impact of the parameters of architectural-and-planning decisions and hygienic provision of optimal conditions at urban and rural educational institutions by the improvement of the design of new and reconstruction of existing schools according to the hygienic criteria. We have developed a set of preventive measures to prevent these diseases.

65-73

Authors: ПРОКОПОВ В.О., ЛИПОВЕЦЬКА О.Б., ЗОРІНА О.В., КУЛІШ Т.В., СОБОЛЬ В.А.

Objective: We analyzed the current state of the study of the problem of OCC in drinking water according to the results of research of the Ukrainian scientists. Materials and methods: We used the sources of the scientific literature on the field, experimental, toxicological and epidemiological studies of OCC in drinking water. We applied the method of theoretical analysis of the scientific information. Results: The contribution of the Ukrainian scientists into the study of the problem of organochlorine compounds in drinking water of Ukraine is shown.The spectrum and levels of volatile THM and non-volatile HAA in tap water have been established. The distictions and basic regularities of their formation at the use of different chloragents (gaseous chlorine , sodium hypochlorite, chloramine, chlorine dioxide) and removal of water pipelines at the treatment plants, influence on the process of formation of various natural and technological factors (type anddose of chloragent, concentration of organic substances, exposure, pH, temperature etc.) have been defined. The obtained findings of the research on the problem of OCC in water are new for Ukraine, they indicate a potential threat to the health of the population at the long-term consumption of drinking water contaminated with OCC in excess amount. In recent years, the first results of biomedical studies of the effects of the contaminated with OCC drinking water on the organism of the animals and human health have been obtained. Epidemiological data on the effects of long-term consumption of chlorinated drinking water with excess OCC on non-communicable morbidity are being accumulated.

9-16

Authors: ІВАХНО О.П., КОЗЯРІН І.П.

Objective: We determined a list of the objective research methods for assessing the sanitary and epidemiological welfare of institutions for children in the context of reforming the medical and educational systems in Ukraine. Materials and methods: A range of issues and research methods in child institutions of various types, regarding their sanitary and epidemiological welfare was determined on the basis of the analysis of scientific literature, evaluation of laboratory research results on the functioning conditions of child institutions conducted by the regional laboratory centers of Ukraine, data of the State Statistics Committee of Ukraine, own research in 2018-2019. Results: Taking into account the processes of the reform of medical and educational systems in Ukraine, the issues of sanitary-chemical, sanitary-bacteriological, physical research and assessment of the risk from economic activities of child institutions: nutrition safety; anti-epidemic measures of the occurrence and spread of infectious diseases; the quality of air environment and child household items; lighting and microclimate in the main premises for children’s stay; the presence of noise and vibration factor, electromagnetic radiation (EMR); organization of training process; indicators of the health of children remain relevant. Conclusions: Nowadays, the identification of the risk factors for child health during their education should be underlined. The inconsistency of state control between different departments leads to a violation of the healthy conditions for vital activity of the large groups of children, a deterioration of the material and technical equipment of the laboratory base and a decrease in the professional competencies of the specialists of laboratory medicine.

24-29

Authors: КАПУСТИНСЬКА О.А., ПРИКАЩИКОВА К.Є., ЯРОШЕНКО Ж.С., КОСТЮК Г.В., ЛУК’ЯНЮК В.О., ОЛЕПІР О. В., СИРОВЕНКО В. І., ЛИТВИНЮК І. В., ПОЛЯНСЬКА В.М.

Objective: We carried out the epidemiological analysis of the incidence of non-tumor diseases of digestive organs in the people evacuated from the 30-kilometer zone of the Chornobyl NPP at the age of 18 years and older during the post-accident observation period. Materials and methods: In the post-accident period during1992 - 2016, we performed an epidemiologic study of the incidence of non-tumor diseases of the digestive system in 7,143 people (2,198 men and 4,945 women) aged 18 years and older evacuated from the 30-kilometer zone of the Chornobyl NPP. To assess the digestive disease incidence in the examined people, we studied a structure of the diseases according to the international statistical classification of the diseases of the tenth revision (ICD-10) by the information base of the clinical and epidemiological register of the NACRM NAMSU. Results: As a result of the study of the structure of digestive system diseases, it was found that 91.05% belonged to somatic pathology by the Digestive Diseases’ class. The health of the examined by this class persons deteriorated mainly due to the the development of the diseases of oral cavity, salivary glands and jaws, which made up the largest component (47.17%) and the diseases of esophagus, stomach, and duodenum (34.39%). But a significant loss of health was caused bythe diseases of the gall bladder, biliary tract and pancreas, chronic hepatitis and cirrhosis(8.13%), non-infectious enteritis and colitis, and other diseases of the intestine (1.36%). Only digestive pathology made up8.9% among different classes of ICD-10: "Some infectious and parasitic diseases (A00-B99)", "Tumors (C00-D48)", "Congenital abnormalities (malformations), deformities and chromosomal abnormalities (Q00-Q99)". Irrespective of gender, the morbidity structure of males and females is characterized by the identity of the diseases and the ratio of indicators in the structure of the overall cohort. But females suffered more from gall bladder disease, biliary tract and pancreas disease, oral cavity disease, the malesfrom esophageal, stomach, and 12 duodenal diseases. Conclusions: Determination of the structure of the diseases on the example of diseases of the digestive organsamong the people aged of 18 years and older, evacuated from the 30-kilometer zone of the Chornobyl NPP, enables the identification of priority nosological forms for further illustration of the determined relationship of the effect of ionizing radiation on the health status of the suffered for preventive measures.

38-40

Authors: ЄРМІШЕВ О.В.

The ecologically dependent diseases are gaining more and more weight in the structure of the general morbidity of the population, and as a result, there is a need to develop the scientific bases of the ecological safety of Ukraine, a methodology for provision and its implementation. Objective:We developed a conception and a methodology for the functional and ecological expertise (FEE) of the regions of radiological (ecological) control in Ukraine and a fast simple method for the assessment of the functional and vegetative health of children. It will make it possible to identify the areas with a high integral ecological load for a human and provide functional and vegetative certification of the children’s population. Methods: The FEE of the radiation control regions of Ukraine is based on the survey results of the functional and vegetative health of 18,650 children that lived in 92 settlements of the Vinnytsia (moderately contaminated), the Lviv (relatively clean) and the Chernihiv (strongly contaminated) oblasts of Ukraine in1993-2010. For this purpose, we used functional and vegetative diagnosis of the vegetative health of the children’s population after the V. Makats’ method, which makes it possible to reveal the indices of the dispersion of the vegetative levels which are the integral bioindicators of internal homeostasis. The integral features of the ecological state are formed on this basis and the zones of its ecological pressure are determined as well. Results:The FEE results of the Lviv oblast (2001-2006) showed a compliance with the criteria of the official dosimetric certification of the RS and the stable preference of the sympathetic activity in the children was revealed. According to the FEE results inthe Vinnytsia oblast (IV radiation control zone), only one case (Chervona Hreblia village, Chechelnytsk area) of a discordance with the official dosimetric certification criteria of the RS (according to the FEE, it is in the "Functional safety" zone) was revealed. The FEE confirms the classification of the number of RS in the Chernihiv oblast as "relatively radiation-free" ones. At the same time, in 2000, according to the functional health of children, the Borzna area (Borzna, Velyka Zahorivka, Shapovalivka) was assigned to the zone of " the development of functional strain" and the Ichnia area (Ichnia) - to the zone of the "development of functional catastrophe" (IV zone), which does not meet the criteria of the official dosimetric certification of the RS. Conclusions: The results of the FEE of the functional health levels, obtained at the contaminated territories of Ukraine, coincide with the data of the state radiological monitoring which indicates the effectiveness and reliability of the proposed FEE method. The FEE, as a method of bioindication, based on the functional and vegetative health of children under modern conditions, is a highly sensitive method for the identification of the environmental problems of the territories and it fundamentally complements the accepted forms of dosimetric and thyroid dosimetric control.

54-58

Authors: MAKHNIUK V.M., HARKAVYI S.I., NAZARENKO V.I., MAKHNIUK V.V., SHEVCHENKO О.А., RYZHENKO N.O.

Objective: We developed the hygienic approaches to the assessment of planning decisions of the cities with different city-forming systems in terms of environmental pollution and risk to the health of the population. Methods: We used a set of general scientific and special research methods: bibliosemantic (for the analysis of regulatory and legal literature in the sphere of town-planning), theoretical (evaluation of the retrospective data of the research on the hygiene of planning of the settlements), analytical (development of the method for hygienic evaluation for various purposes), sanitary-epidemiological examination of master plans of the cities and SPZ for the objects of different hazard class, epidemiological and medico-statistical ones. We applied a risk assessment methodology to evaluate the risk of exposure of chemical pollutants of ambient air of the cities to the population. Results: The cities were studied taking into account the nature of the main sectors of the economy which form their city-forming base, as well as the features of the planning structure of the cities, which made it possible to identify the residential areas that were heavily influenced by the industrial enterprises and beyond their influence. The obtained data make possible to develop measures for environmental adjustment and to resolve reasonably the issues of general plans for urban development of the cities, taking into account the specificity of the development of main industrial complexes, to make management decisions on the ground, their implementation to create safe conditions for human vital acitvity. The processes of restructurization of the major branches of heavy industry, the consolidation and re-profiling of large industrial complexes and enterprises, and the intensive development of relatively small production facilities have become essential. In connection with the scarcity of land resources in the largest cities and megalopolises, the issues of the siting of existing filling stations and the design of prospective residential buildings near them, as well as the siting of designed filling stations under conditions of existing residential development, amid the rapid motorization of modern society are becoming increasingly important and require legislative regulation of the standardization of the SPZ for modern filling stations, taking into account not only hygienic requirements, but also the requirements of fire safety.

64-70

Authors: PIATNYTSIA-GORPYNCHENKO N.K.

Objective: We summarized the results of published research papers related to the development of the main areas of personalized medicine in health care practice, including occupational medicine and definied the prior issues that dictate the need for further study. Materials and methods: We performed the analysis of literary data on the use of personalized medicine for the prevention of the occupational diseases. Results: The personalized medicine was established to be a relatively new promising direction for the further development of medical science, its main task is to create an optimum model of the health care system in order to preserve the health of the working-age population. At the present stage of scientific and technological progress development, the crucial in the implementation of the basic principles of personalized medicine (prognostic, personalized, preventive and partner), as an integrative modeling system, is given to the development of information support and molecular genetic methods for the study of public health for the purpose of early detection, prevention and treatment of diseases. Conclusions: Despite the prospect of using the concept of personalized medicine in the health care system, the domestic information and organizational, regulatory and legal (medical in some cases) base is significantly behind the needs of modern times, which makes it difficult to implement this direction in practice. However, over many years of scientific research in domestic occupational medicine, a fundamental basis has been formed for the further development of the personalized approach to the prevention of health disorders amongworkers. Nowadays some progress is being observed in the field of the search for biomarkers for early diagnosis and prevention of the formation of chronic occupational and work-related pathology, the Register of the Occupational Diseases of Ukraine has been substantiated, the methodology for the assessment and management of occupational risks is being improved, in particular, quantitative assessment of the potential and real danger of work-related exposure which is the basis for the real prevention of occupational pathology as a part of individual approach to the patient. Taking into account the current realities, the solution of the problem of the health preservation in the working requires a comprehensive approach with the involvement of the specialists in various fields: hygienists, occupational therapists, medical geneticists, specialists in the field of information technology, health care organizers.