Health Risk Analysis

4-11

Authors: V.G. Kostarev, V.А. Khoroshavin, А.V. Brazhkin

The paper outlines the first stages of sanitary activities development in Perm region. We highlight the fact that it was Perm where I.I. Molessson, the first official sanitary inspector in Russia, worked. Here one of the first sanitary inspection of a whole region was performed and "Perm sanitary bulletin" was first published. It was in Perm, where the first sanitary office was established in 1890, and in 1898 the first bacteriological laboratory was organized. Bodies and institutions of Rospotrebnadzor in Perm region are known to be founded on September 15, 1922, when a Decree by Russian People's Commissars Council "On the Republic's sanitary bodies" was issued. A sanitary-hygienic faculty of Perm Medical Institute was set up in 1931 and it gave grounds for preparing qualified sanitary inspectors for state sanitary authorities. We described basic tasks which were tackled by sanitary inspectors during the Great Patriotic War and just after it. Rospotrebnadzor activities are proved to make for substantial improvements of sanitary-epidemiologic situation in the region. Currently more than 95 % of population are provided with drinking water which fully corresponds to the sanitary legislation requirements. We note constant improvements in catering objects quality and we also see that a quantity of food samples taken at such objects which don't correspond to hygienic standards remains stably low. A share of working places deviating from hygienic standards as per noise, vibration, and illumination, has reduced. Medical examinations are now available to 97.9 % of workers functioning under hazardous (dangerous) working conditions. The lowest occupa-tional morbidity level over the last few years was registered in Perm region in 2016. The Service was among the first in the country to transfer to result-oriented budgeting and risk-oriented surveillance model. Organizational structure is constantly being developed; new legal, economic and organizational approaches are being created and implemented in the activities performed by bodies and institutions of the Federal Service for Surveillance over Consumer Rights protec-tion and Human well-being.

21-30

Authors: I.V. May, S.Yu. Balashov, S.A. Vekovshinina, M.A. Kudrya

The article dwells on issues of modeling electromagnetic fields levels (EMF with frequency equal to 300 KMHz - 300 MHz which are created by television and radio broadcasting objects, radiolocation, and mobile communication in a large regional cen-ter, in geoinformation system environment. Our task was to estimate EMF levels on areas where apartment blocks were located; to assess energy flows at various floors, to determine zones in a city as per EMF levels; to verify the obtained results with the direct factor measuring. Our calculation included data on 2,011 EMF sources located on a city territory. We allowed for bulk parameters of 31,949 buildings including 17,307 apartment blocks, 3,160 administrative buildings, 307 pre-school children facilities and 105 secondary schools. We performed our calculations in city coordinate system at 109 thousand points. Each calculation created a picture of EMF spread in a plane at a set height which allowed us to determine exposure level at a control point as per "slice" re-sults and to build up a 3D contamination model. Approximately 80% of all the calculated results had EMF parameters within 0.1-10 safety criterion range. We spotted zones with maximum calculated EMF levels at 18-25 meters. Instrumental research proved high factor levels in these zones including those where levels exceeded safety criterion 4-6 times; it makes for certain vigilance in judgments on environmental safety for people who live on the examined territory permanently. The obtained data can be used for foundation of instrumental research points within the frameworks of specific research or social-hygienic monitoring as well as for consequent exposure and health risk assessment. The materials can be used in epidemiologic research for conjugate spatial analysis of energy flows and children and adults mortality.

40-47

Authors: I.N. Yakovina, N.A. Bannova, E.V. Kashtanova, Ya.V. Polonskaia, Yu.I. Ragino

The paper focuses on tasks of creating and implementing a new technique aimed at assessing ischemic heart diseases risk. The techniques is based on a laboratory-diagnostic complex which includes oxidative, lipid-lipoprotein, inflammatory and metabolic biochemical parameters; s system of logic-mathematic models used for obtaining numeric risk assessments; and a program module which allows to calculate and analyze the results. we justified our models in the course of our re-search which included 172 patients suffering from ischemic heart diseases (IHD) combined with coronary atherosclerosis verified by coronary arteriography and 167 patients who didn't have ischemic heart diseases. Our research program in-cluded demographic and social data, questioning on tobacco and alcohol addiction, questioning about dietary habits, chronic diseases case history and medications intake, cardiologic questioning as per Rose, anthropometry, 3-times meas-ured blood pressure, spirometry, and electrocardiogram taking and recording with decoding as per Minnesota code. We detected biochemical parameters of each patient and adjusted our task of creating techniques and models for assessing ischemic heart disease risks on the basis of inflammatory, oxidative, and lipid biological markers. We created a system of logic and mathematic models which is a universal scheme for laboratory parameters processing allowing for dissimilar data specificity. The system of models is universal, but a diagnostic approach to applied biochemical parameters is spe-cific. The created program module (calculator) helps a physician to obtain a result on the basis of laboratory research data; the result characterizes numeric risks of coronary atherosclerosis and ischemic heart disease for a patient. It also allows to obtain a visual image of a system of parameters and their deviation from a conditional «standard – pathology» boundary. The complex is implemented into practice by the Scientific Research Institute for Therapy and Preventive Medicine

60-65

Authors: L.B. Masnavieva, I.V. Kudaeva, V.S. Rukavishnikov

Nowadays each forth person suffers from allergic diseases and allergic pathology prevalence is constantly growing. There are compounds in air which are generally toxic, or have sensitizing or allergenic effects on a body. For example, we can name formaldehyde and nitrogen dioxide. Our research goal was to reveal a correlation between reaction of leucocytes migration inhibition to formaldehyde and level of inhalation exposure to the examined chemicals. We examined 410 teenag-ers who permanently lived in industrial cities in Irkutsk region. We studied individual load as per formaldehyde and nitrogen dioxide. We estimated eosinophils content in nasal mucus and determined indexes of leucocytes migration inhibition to for-maldehyde. Index of formaldehyde effects danger was detected to exceed 1 in 54% teenagers. The greatest value of danger coefficient in terms of exposure to this substance was equal to 1.76. anger index in terms of exposure to nitrogen dioxide didn't exceed 0.7 in the examined teenagers. The obtained results prove that inhalation formaldehyde load influences teenag-ers from industrial centers as sensitization to this substance evolves in them. We found out that true inhibition reaction of leucocytes migration in a reaction with formaldehyde more frequently occurred in people with danger index in terms of ex-posure to this substance being lower than 1. We obtained models which described correlation between level of sensitization to formaldehyde and a number of eosinophils in nasal mucus and it allowed us to detect that sensitization depended on the examined contaminants content in the air. The sensitization to chemical air contaminants which we revealed in teenagers calls for necessary activities aimed at reducing risks of allergenic pathology evolvement in them.

76-82

Authors: A.N. Chigisova, M.Yu. Ogarkov, S.A. Maksimov

We analyzed risks of arterial hypertension development in occupational groups employed at coal-mining enterprises in Kemerovo region (1,915 workers). We used data on arterial hypertension development in Kemerovo region as our reference group; these data were obtained within the framework of ESSE-RF epidemiologic research (700 people aged 25–64 were exam-ined). We noted that work at coal-mining enterprises involved several factors which could have negative influence on workers' health. Working conditions for those workers who had to stay in a mine during the whole working shift meant that workers were under negative impacts caused by unfavorable microclimate and heavy dust loads. To eliminate age discrepancies between workers employed at coal-mining enterprises and the reference group, we performed standardization as per age (data on the reference group were taken as our standard). We calculated arterial hypertension frequencies in the chosen occupational groups and determined relative risks of arterial hypertension via creation of contingency tables. To exclude any influence that might be exerted on relative risks of arterial hypertension by occupational selection, we corrected the obtained results as per "health recruitment effect". Miners had lower arterial hypertension prevalence among them than unorganized sampling made of ordinary Kemerovo region population, 28.46 % and 53.29 % (p<0.001). We showed that statistically significant low risks of arterial hypertension among workers were due to occupational selection they had to undergo when being recruited. As we per-formed this correction as per "healthy recruitment effect" arterial hypertension risks for miners and drifters changed from sta-tistically significant low to statistically significant high, from 0.55 (95 % CI 0.48–0.64) to 1.14 (95 % CI 1.04–1.26). So, if we want to assess arterial hypertension prevalence and risks in occupational groups where occupational selection can't be excluded we should perform this additional correction to remove "healthy recruitment effect"

92-100

Authors: M.A. Fesenko, O.V. Sivochalova, E.V. Fedorova

The paper outlines the data obtained in the course of long-term research dedicated to studying the extent to which re-productive system pathologies in workers with high-risk occupations are occupationally induced. Their peculiarity is joint impacts of various occupational factors (for example, impacts exerted by chemicals together with physical and biological factors, and labor hardness and intensity as well) on a female body. Our research goal was to examine the extent to which reproductive system pathologies in workers with high-risk occupations were occupationally induced. To achieve it, we applied statistical estimate of correlation between health disorders and work. Our occupational group included a number of occupations with harmful or hazardous working conditions in civil en-gineering, metallurgy, chemical industry, polymer-processing industry, and health care as well. As a rule, working condi-tions class of workers from the examined groups varied from 3.1 to 3.3; and occupation with permissible working conditions were used as a comparative group. The research results revealed that there are certain occupations with high risk of reproductive health disorders evolvement and infants development pathologies evolvement. They are: – model makers and checkers in civil engineering and crane operators at a metallurgic plant; – analysts at chemical analysis laboratories, chemical engineers in chemical industry (including petrochemical plants, polymer-processing plants, and organic synthesis plants); – surgeons, obstetrician-gynecologists, midwives, surgical nurses working in in-patient departments. Estimate of correlation and occupational dependence of reproductive system diseases on working conditions revealed that women with harmful working conditions (3.1–3.3 hazard class) had defective pregnancies or labor pathologies which had strong and average correlation with working conditions. Health disorders in newborns were estimated as per very strong corre-lation with mother's work. Thus, we can state that a mother occupational risk induction for a child health is fundamentally proved. On the basis of the obtained results we rank female workers with 3 class 2 harm degree working conditions as having an occupation with high risks of reproductive health disorders. We worked out an algorithm aimed at managing these risks; it should be applied in order to lower occupational risks for reproduction in female workers.

109-117

Authors: M. Khodzhiev, N.F. Izmerov , I.V. Bukhtiyarov

We examined significance which social and psychological factors had in occupational stress evolvement in labor migrants who came to Moscow and Moscow region from Central Asia republics. A separate issue was sexual harassment occurrence which female migrants and Moscow region females faced. Psychological tension, i.e. occupational stress, is a contemporary danger in non-conventional working process (labor migration) and it attracts attention of occupational medicine experts. We determined that there were some social and psychological reasons for occupational stress, such as dissatisfaction with work, low level of integration in working teams, poor living conditions. As per questioning results we revealed single harassment cases (3-5%) and their number was the same both for female migrants and for females from Moscow region. Neuro-emotional labor intensity category amounted to 3.3-3.2 for millwrights, subways builders, steelmen, and road construction workers; it amounted to 3.1 for other workers; as for female migrants employed in social sphere, their work category was 3.2. The follow-ing physiological and psychological peculiarities characterize people with low working adaptation as per criteria of great occu-pational stress evolvement probability: low attention level, slow visual signals perception, prevalence of high systolic and dia-stolic blood pressure as a sign of arterial hypertension evolvement. Functional state of labor migrants mostly corresponds to "working strain of 1st and 2nd degree" and "overstrain". Staging in occupational stress evolvement in labor migrants is deter-mined by level of labor neuro-emotional intensity. It seems vital to provide social and psychological support for labor migrants which can include improvements in occupa-tional training, informing workers on health risks occurring at their working places, training on safe working practices, devel-opment of occupational selection culture, organization of rational work and rest regime, providing social support for workers.

127-134

Authors: N.V. Dudchik, V.A. Filonyuk, V.V. Shevlyakov, S.I. Sychik, O.E. Nezhvinskaya

Scientific foundation and practices in the sphere of hygienic and ecological standardization concerning biological factors of the environment have a number of peculiarities and are methodically less developed than chemical factors standardization. Efficient industrial control over maximum permissible concentrations of standardized microorganisms-producers in working area air is based on validated instrumental techniques of quantitative assessment. Our goal was to create experimental models for microorganisms-producers' aerosols of a multi-component microbe specimen in working area air as a risk factor causing impacts on health of workers employed at biotechnological production; another task was to work out a procedure for measuring Pseudomonas aurantiaca B-162/255.17concentration and cells and spores of Bacillus sp. BB58-3 strain in working area air. We gave grounds for a technology aimed at quantitative determination of microorganisms-producers in working area air in a modeling experiment; it was based on conventional stages and tech-niques accepted in microbiological practices, namely air samples taking via aspiration technique allowing for a volume taken; cultivation under conditions which are optimal for examined microorganisms-producers in a nutrient medium with reduced composition; calculation of evolved colonies with specific morphological features; morphologic identification of microorganisms and colonies; calculation of microorganisms' quantity on dishes with recalculation per 1 m3 of air. Bas-ing on the detected regular concentration dependences of microbe contamination dynamics in air we worked out a proce-dure for quantitative determination of microorganisms-producers; we also performed metrological estimate of opera-tional properties for assessing microorganisms-producers of a multi-component microbe specimen as a risk factor caus-ing hazardous impacts on health of workers employed at biotechnological production. We validated our measuring procedure in conformity with the requirements set forth by ISO.