Environment&Health (Dovkillia ta zdorovia)

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.