Environment&Health (Dovkillia ta zdorovia)

4-13

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

Objective: We studied the dynamics and causes of acute occupational morbidity on COVID-19 in medical staff, changes in labour conditions and safety of medical workers, their protection with adequate and effective personal protective equipment in particular. Materials and methods: We applied bibliographic, hygienic, questionnaire and mathematical methods in the study. As a material for the study, we used the results of our own observations, questionnaires for a survey of medical staff, data of the WHO, the Ministry of Healthcare of Ukraine, the Center for Public Health of the Ministry of Healthcare of Ukraine, the State Labour Service of Ukraine, the State Statistics Service of Ukraine and thematic scientific sources of information. Results: The work of the doctors involved in COVID-19 pandemic overcoming is classified as dangerous (extreme). An increase in the degree of neuro-emotional stress and accumulation of fatigue was revealed in comparison with the data of the first report. A significant number of ergonomic and physiological and hygienic deficiencies in personal protective equipment were recorded. Nurses (38.43%), assistant nurses (22.69%) paramedics (3.72%), practicians of family medicine (2.91 %), therapists (2.86%) and anesthesiologists (2.52%) predominate among medical staff diagnosed with COVID-19 acute occupational disease. An extremely low number of commission investigations of the accidents (COVID-19 diseases in medical workers), completed as of June 22, 2020, was revealed. Conclusions: The incidence rates of medical workers for COVID-19 and a significant number of the deaths in medical staff as a result of the infection with SARS-CoV-2 coronavirus indicate the insufficient attention of the state to the issues of labour protection in medical industry.

21-26

Authors: BANDAZHEVSKY Yu.I., DUBOVA N.F.

Objective: We determined a role of folate metabolism genotypes in the occurrence of hyperhomocysteinemia in children after a forest fire in the Chоrnobyl exclusion zone (ChEZ). Material and methods: In the study, we applied immunochemical, Real-time PCR, mathematical and statistical methods. Results: A survey of 84 adolescents from the Poliske district, Kiev region revealed changes in their metabolic processes in the form of increased homocysteine production in connection with a forest fire in the ChEZ which was recorded during April 26-29, 2015. A comparative analysis of the specific gravity of the folate cycle genotypes in the subgroups of the children with hyperhomocysteinemia before and after a forest fire showed that an endogenous factor in the form of a genetic apparatus, controling synthesis of folate cycle enzymes, was not involved in this phenomenon. Сonclusions: Forest and peat fires in the Chernobyl exclusion zone are one of the main causes for the elevation in blood homocysteine levels in children from the adjacent districts, regardless of the state of folate metabolism genetic system. Monitoring of the blood homocysteine levels in children and adults living under conditions of the exposure to wood combustion gases, containing radioactive elements, is a key component of the programmer for the prevention of cancer and cardiovascular diseases.

35-45

Authors: ОЧЕРЕТЯНА Г.В., МАХНЮК В.М., ЧОРНА В.В., ГОРВАЛЬ А.К., КЛИМЕНКО Г.В.

Objective: We analysed the regulatory framework on the design of healthcare facilities built in the residential buildings, studied the conditions of their location and developed sanitary-and-antiepidemic requirements for them. Materials and methods: In the work, we used bibliosemantic (for the analysis of the use of legal regulation), theoretical (retrospective use of research data) and analytical methods. Results: According to the reform of the healthcare sector of Ukraine, at the primary level of medical care, the number of healthcare institutions is growing, in particular outpatient ones (outpatient clinics, family doctors’ offices, etc.), which are located in built-in (attached) non-residential premises of ground, first, and basement floors of multistory residential buildings. The authors of the article propose sanitary-and-hygienic and antiepidemic requirements for the location of built-in healthcare institutions at the hybrid type of the construction of residential and public part of the building, using parametric and target (object-by-object) methods. Conclusions: Taking into account that the outpatient healthcare institutions are the primary link in healthcare and make up the bulk of the entire healthcare institutions network, as well as the shortage of land for the construction of outpatient clinics in a separate building, the built-in healthcare institutions have become widespread and are located mainly in non-residential premises and residential buildings (ground, first, and basement floors), which is the element of hybrid construction. Developed sanitary-and-hygienic and antiepidemic measures for built-in healthcare institutionswill help to increase their epidemic safety, to prevent occupational diseases of medical staff.

53-62

Authors: ЧОРНА В.В.

Objective: We defined the internal and external motivation features, performed a differential assessment of the states of reduced working capacity in medical workers of the Vinnytsia O.I. Yushchenko Regional Clinical Psychoneurological Hospital, Vinnytsia Regional Council (Communal Non-Profit Enterprise) and developed the preventive measures. Materials and methods: 224 medical workers (15.2% of males and 84.8% of females) of the Clinical Psychoneurologic Hospital (Communal Non-Profit Enterprise) took part in the study. 38.8% of the doctors, 61.2% of the nurses took part in the survey. The length of service in the professional activity was (19.7+12.3) years among doctors and (15.5+11.1) years among nurses. The average age of the doctors made up (44.6+12.2) years, nurses – (37.2+11.4) years. We carried out a survey on the motivation of the professional activity of doctors and nurses by the methodology of K. Zamfir in the modification of A. Rean and a study based on the technique of A. Leonov, S. Velichkovskaya regarding the differential assessment of the states of reduced working capacity (DOSR) of workers of health care institutions. To calculate the arithmetic mean, standard arithmetic mean error, we processed the results with the help of the Statistica 6.1 for Windows licensed standardized package. In the study, we used the analysis of the work of domestic and foreign scientific sources, biblio-semantic, analytical, and statistical research methods. Results: The data of the survey of the psychoneurologic hospital medical workers regarding doctors' internal and external motivation and nurses' professional activity are presented in the article. Three types of motivation and the motivation complexes in healthcare workers were determined, the following classification of motivational factors were used: «motivators» and «context factors», or «hygienic factors», which provoke negative stress affecting the quality of medical care. Analysis of the survey data shows that the external negative motivation exceeds the external positive one in male doctors and female nurses – (3.2+0.8) and (3.0+1.2) points, respectively. That’s why these medical workers have a decrease in their interest in work, lack of striving for career growth, lack of self-perception, and an indifference to work, to patients, which can negatively affect the quality of medical care and interpersonal relationships the team and at home. The questionnaire results regarding the differential assessment of the states of the reduced working capacity of the psychoneurologic hospital workers have been analyzed. The results demonstrate a high level of oversaturation index in female doctors - 3.2% and female nurses - 1.6% and a high degree of fatigue - 4.8% and 3.9%, respectively, which can be assessed as a pre-disease state in women. The preventive measures to overcome these states and to improve the psychosocial environment for the quality performance of the professional duties and satisfaction with the work are proposed.

71-79

Authors: АНДРУСИШИНА І.М., ГОЛУБ І.О., ДЕМЧЕНКО В.Ф., ЛАМПЕКА О.Г.

Objective: We studied the regional characteristics of soil pollution with heavy metals and other chemical elements, presented their comparative ecological and hygienic assessment. Materials and methods: We detected the content of 12 elements in the soils of urban agglomerations of the city of Kyiv (park, residential and transport zones), Donetsk oblast (Mariupol, Pisky etc.) and in the vicinity of the city of Halych (Ivano-Frankivsk oblast) with the help of the method of optical emission spectrometry. We studied the gross content of heavy metals in soils, determined their mobile forms, calculated the concentration coefficients and the indicator of the total soil cover pollution of urban agglomerations, established characteristic relationships between metals and their technogenic geochemical associations. Results and discussion: Among the analyzed chemical elements in soils of urban areas, the high content of Al, Mn and Crattracts a special attention. In the number of cases, it was higher than the MAC and the background level. The characteristic technogenic geochemical associations of heavy metals for studied territories were established: Cu > Cr > Pb > Zn > Ni > Mn. The mobility of heavy metals in technologically polluted soils increases in comparison with the background levels. Conclusion: A comparative assessment of soil pollution in the surveyed regions of Kyiv, Ivano-Frankivsk and Donetsk showed that they are under complex environmental pressure because of anthropogenic and technogenic environmental pollution with heavy metals.