Introduction: Population health strongly depends on accessibility and timeliness of primary health care. It is common knowledge that access to health care services in the region of residence is related to the perceived comfort of living conditions, disease rates, and life expectancy in the population. Elimination of territorial disparities in access has been defined as a relevant area of development of the health care system for the population of remote areas.

Objective: To determine the main directions for improving primary health care for the population to increase the comfort of living conditions in hard-to-reach areas of the Russian Federation.

Materials and methods: We analyzed the results of providing health care services during the 86-day operation of the Saint Panteleimon mobile medical center, a railway train consisting of cars specially designed and built by the Tver Carriage Works and equipped for rendering medical services and performing instrumental and laboratory tests.

Results: The train traveled along the East Siberian and Transbaikal railways in the Far Eastern and Siberian Federal Districts and stopped at 59 railway stations. The length of the routes was over 7 thousand km.

Discussion: A total of 7,263 people applied for medical assistance, in whom 9,493 diseases were diagnosed during the examination; 25 % of the diseases were diagnosed for the first time in life. Cardiovascular, endocrine, musculoskeletal, and eye diseases prevailed; 2.2 % of those examined were referred to hospitals. Measures related to the operation of the railway consultative and diagnostic center help raise the healthcare system in hard-to-reach areas to a higher level.

Conclusion: Health services provided by mobile consultative and diagnostic centers will significantly reduce the risk of loss of health in the population, increase life expectancy, maintain active longevity, and have a positive impact on the quality of life and comfort of living conditions in the East Siberian and Far Eastern regions. The accumulated experience can be used in other remote, sparsely populated areas.

Introduction: Geographic information systems (GIS) are widely used in assessing sanitary and epidemiological well-being, planning control and supervisory activities, and organizing monitoring owing to a set of spatial analysis tools that allows prediction of the magnitude and distribution of values of a factor within the study area based on limited initial data. GIS development has led to the emergence of many variations of such tools while the variety of methods at their core complicates the choice, potentially leading to erroneous results.

Objective: To analyze tools of spatial data analysis implemented in geographic information systems from the standpoint of their applicability to the tasks of assessing and forecasting environmental conditions.

Materials and methods: We used the results of ambient air quality monitoring in St. Petersburg in 2022–2023; drinking water and ambient air quality and morbidity data collected in the Arkhangelsk, Murmansk, and Vologda regions in 2018–2023, and the results of summary calculations of ambient air pollution in the city of Petrovsk-Zabaikalsky as of 2023. Methods of visualization of distribution of spatially referenced data using spatial analysis and data grouping tools were analyzed using the ArcMap 9.3 geographic information system as an example.

Results: Our findings showed the importance of taking into account characteristics of the samples of analyzed data, the type and nature of the data themselves when choosing certain tools for grouping (classifying) data or performing geostatistical analysis. Practical examples illustrate the significance of choosing a certain spatial analysis method for the result of forecasting value distribution of an indicator.

Discussion: Traditional GIS remain relevant in the analysis of environmental factors, incidence and prevalence rates, and the results of public health monitoring, which require the use of specialized tools for data grouping and geostatistics. To obtain objective results, it is essential to take into account properties of the data array when choosing an analysis tool.

Conclusion: Recommendations for selecting the optimal spatial analysis tools for the tasks of assessing and forecasting the sanitary and epidemiological situation given the type of data, their sample characteristics, and the goals set are suggested.

Introduction: The uniqueness of the problem of establishing the comfort of an urban environment is related to its multifactorial nature owing to the fact that physicochemical factors having a potential combined effect on the human body are involved in creating a comfortable urban environment in addition to social ones. Comfort assessment questionnaires traditionally include social questions on satisfaction with the living environment.

Objective: To evaluate comprehensive perception of the comfort of living by urban population. Materials and methods: The online population survey was conducted from July to September 2024 at https://rusarctic.com. The answers of 254 respondents from 38 settlements of 15 constituent entities of the Russian Federation were then analyzed in Microsoft Excel and visualized using ESRI ArcGIS 9.3.

Results: We established that 43.3 % and 51.2 % of the respondents considered climate and environmental conditions comfortable for living, respectively. Less than 9.0 % of them lived near industrial enterprises and major sources of traffic noise. The reasons for living in the current settlement included it being the place of birth, followed by housing, work, relatives and friends. In the opinion of 81.9 % of the respondents, air and water pollution, high levels of exposure to road traffic noise, and lack of public services and social amenities reduced the overall comfort level. The measures suggested to enhance comfort included improvement of the quality of environmental factors and landscaping.

Discussion: The respondents noted poor climate conditions, lack of landscaping, drinking water pollution, and traffic noise as the reasons for reduced comfort. Those who found it difficult to appraise the comfort of living reported high-quality modern conveniences in populated areas, low noise levels, clean ambient air and drinking water.

Conclusion: The questionnaire-based survey allowed us to make a comprehensive evaluation of the comfort of living for the population. A more detailed analysis of satisfaction with living conditions that takes into account the combined effect of environmental factors will be feasible after modifying the questionnaire and surveying a larger number of respondents to improve representativeness.

Introduction: High incidence of occupational diseases in workers is one of the reasons for the introduction of novel, safer technologies for nickel production.

Objective: To study workers’ health risks posed by electrolytic refining and electrowinning of nickel. Materials and methods: We studied industrial control data at a nickel industry enterprise and the Murmansk regional register of occupational diseases for 2004–2023.

Results: In 2004–2013, nickel was produced using electrolysis, while in 2014–2023, this technique was substituted by electrowinning. Such a transition was accompanied by a 2.5 to 3.5-fold decrease in time-weighted average concentrations of nickel water aerosols in the electrolysis departments and a 4.4-fold increase in chlorine concentration in the hydrometallurgy departments. Over 20 years, 311 occupational diseases were registered in workers of this refinery, particularly electrolysis bath operators (31.7 %), among which respiratory diseases predominated (60.1 %). Compared to 2004–2013, we observed a decrease in the incidence rate by 14.1 % (from 86.67 to 75.88 cases per 10,000 workers) and a lower risk of developing a disease (OR = 1.45; 95 % CI: 1.04–2.02) in the years 2014 to 2023. Both techniques pose high, very high, and extremely high workplace health risks and an unacceptable cancer risk (≥ 1.0×10–3). Only one case of acute chlorine poisoning was registered in 2019.

Conclusion: Switching from electrolytic refining to electrowinning of nickel does not increase health risks at the workplace. However, the previously existing and persisting high, very high, and extremely high occupational risks, as well as the unacceptable carcinogenic risk for most jobs indicate the priority of introducing new health-maintaining technologies for workers in the nickel industry after technological upgrade (personal protective equipment, working time reduction, etc.).

Introduction: The negative impact of excessive use and measures to prevent the adverse effects of information and communication technologies (ICT) on health, performance and risk of occupational burnout syndrome in general practitioners have not been sufficiently established so far. The article presents the results of our own study of effectiveness of recommendations for the safe use of ICT tools on the performance of general practitioners.

Objective: To identify the main indicators of changes in performance parameters and to assess the risks of job burnout in therapists actively using information technology at work.

Materials and methods: In August 2021 to August 2024, we surveyed 140 general practitioners (94 women and 46 men aged 27 to 75 years) working at hospitals of Moscow and the Moscow Region. Their performance and burnout risks were assessed using the Fatigue Severity Scale questionnaire, the scale of diagnostics of emotional burnout of personality by V.V. Boyko, and the Maslach Burnout Inventory. Preventive recommendations included organization of the workplace and work schedule at the computer, prevention of musculoskeletal disorders, and a safe use of gadgets.

Results: The comparative analysis of the Maslach Burnout Inventory scores for general practitioners, before and 12 months after the implementation of recommendations for the safe use of ICT tools, demonstrated a significant decrease in the severity of signs of occupational burnout syndrome according to the Maslach emotional exhaustion scale and reduced sense of personal accomplishment (p < 0.05), a significant decrease in the severity of signs of professional burnout syndrome by all three phases (tension, resistance, and exhaustion) according to the Boyko scale (p < 0.05), and a significant decrease in the chronic fatigue index based on the Fatigue Severity Scale questionnaire responses (p < 0.05).

Conclusions: Following recommendations for the safe use of information and communication technologies for hospital physicians significantly reduces the risk of burnout and signs of fatigue.

Background: Despite the growing body of knowledge about ocular effects of light, data on the impact of visible laser radiation on the organ of vision is insufficient. This radiation can penetrate the eye, reach the retina, and cause damage. The issue of assessing eye effects of laser radiation has become very important due to the growing number of events accompanied by laser shows and registered complaints of their attendees.

Objective: To evaluate changes in the functional state of the eye following laser radiation exposure using light sensitivity and color vision tests.

Material and methods: Scattered radiation from a semiconductor laser in the red, green, and blue spectral regions with a wavelength of 0.63, 0.53, and 0.44 microns, respectively, with illumination power of 1×10–4 W/cm2 and 1×10–5 W/cm2 , was directed to the eyes of healthy volunteers aged 20 to 40 years divided into two groups of 96 people each. The functional state of the eyes was established using the anomaloscope and dark adaptometry tests in 2022–2023.

Results: The results of testing were significantly different from the initial values following the exposure to laser radiation with illumination power of 1×10–5 W/cm2 (group 1) and 1×10–4 W/cm2 (group 2) at all wavelengths, with the exception of subjects from group 1 (440 nm), who had significant deviations only in terms of green and blue colors. It is worth noting that blue light sensitivity decreases the most, regardless of the wavelength of the source, while the blue laser light itself has the least effect on the light sensitivity and color vision.

Conclusion: Given the changes observed, further research is needed to fully understand the mechanisms of effect of various spectral ranges of laser radiation on the organ of vision and to develop effective protective measures against the potential harm.

Introduction: Recirculators used for indoor air disinfection in residential and public buildings in the presence of humans must ensure the required level of germicidal efficiency and exclude the possibility of adverse health effects of non-ionizing physical factors. Objective information about the levels of physical factors created by these units is therefore of current interest.

Objective: To substantiate safe placement of recirculators within residential and public buildings.

Materials and methods: We measured UV light energy levels, sound levels, and 50 Hz electromagnetic fields at different distances from the housing of five recirculators, four of which were medical devices and one was a household appliance. All measurements were taken in an anechoic shielded chamber.

Results: We established that UV waves were emitted beyond the housing of two out of five recirculators. When the devices were wall-mounted in accordance with the instructions for use, levels of UV irradiation complied with the requirements of sanitary rules and regulations at the measurement point located at a height of 1.5 m from the support surface at a distance of 1 m from the recirculator. Levels of 50 Hz electromagnetic fields at a distance of 30 cm from the recirculator did not exceed hygienic standards. Measured noise levels at a distance of 1 m from the devices corresponded to those declared in the specifications.

Conclusion: Application of recirculators sets the task of minimizing potential detrimental effects of UV radiation and noise on humans, one of the ways to solve which is to establish a safe distance for placing the devices in rooms serving different functional purposes and to select operating modes ensuring adequate disinfection efficiency at minimum levels of human exposure to hazardous factors.

Introduction: Ore extraction and metallurgical processing are associated with high rates of occupational diseases among miners and metallurgists.

Objective: To establish causes and risks of development, the structure and prevalence of occupational diseases in miners and metallurgists of the Murmansk Region.

Materials and methods: The materials of the study included three databases: 1) the Murmansk Regional Register of occupational diseases; 2) the register of extracts from occupational disease registration cards (Order No. 176 of the Russian Ministry of Health dated May 28, 2001); and 3) the results of public health surveillance in part of working conditions and occupational diseases for 2006–2023.

Results: A total of 2,686 new cases of occupational diseases in 1,243 miners and 1,168 cases in 574 metallurgical workers were reported over the study period. Significant differences in the causes and risk of development, disease structure and prevalence were found between the two groups of workers. In miners, heavy physical work was the main cause of health disorders (57.6 %) with musculoskeletal diseases prevailing (55.6 %), while the metallurgists mainly suffered from chemical exposure (54 %) and related respiratory diseases (52.7 %). Over 18 years, a significant trend towards a decrease in the number of workers with occupational diseases was observed in metallurgists (R² = 0.546) but was absent in the miners. Both the miners and metallurgists showed a tendency towards an increase in the number of diseases per worker: from 1.90 ± 0.07 to 2.21 ± 0.08 (p = 0.061) and from 2.02 ± 0.08 to 2.21 ± 0.12 (p = 0.189) cases, respectively. The miners were at a higher risk of developing diseases (OR = 1.25; 95 % CI: 1.12–1.37) and had higher disease rates compared to the metallurgists (102.95 against 76.34 cases per 10,000 workers). An increase in the proportion of women suffering from an occupational disease from 23.0 % to 45.2 % (p = 0.005) was established among the metallurgists.

Conclusion: Effective occupational disease prevention should take into consideration the differences in causes and risks, the structure and prevalence of health disorders among workers of mining and metallurgical enterprises of the Murmansk Region.

Introduction: Heavy metals can cause disturbances in the functioning of various systems of the human body and play an important role in the development of autoimmune diseases.

Objective: To assess the relationship between heavy metals and metalloids in soil and the level of rheumatoid factor (RF) in adult patients with rheumatoid arthritis living in the Republic of Tatarstan.

Materials and methods: The study included 380 permanent residents of the Republic of Tatarstan diagnosed with rheumatoid arthritis. Soil samples were collected in residential areas of the cases and tested for heavy metal concentrations. Odds ratios were used to establish the relationship between soil concentrations of heavy metals and the levels of rheumatoid factor in the blood of subjects.

Results: Changes in soil levels of heavy metals were found to correlate with those in the levels of rheumatoid factor in the blood of adults with rheumatoid arthritis. Patients with an advanced stage of the disease living in the areas with soil levels of cadmium above 0.7 mg/kg and nickel above 50 mg/kg and having an elevated level of RF were 1.8 (OR = 1.7 CI [1.00: 2.88]) and 2 times more frequent (OR = 2.17 CI [1.06: 4.45]), respectively.

Conclusions: Increased levels of heavy metals in soil provoke changes in immunological parameters in patients with various stages of rheumatoid arthritis. In areas with the elevated geochemical background concentrations of cadmium and nickel, higher levels of rheumatoid factor are observed in patients with advanced rheumatoid arthritis.