No 4 (2020)
ISSUES OF MANAGEMENT AND SOCIAL HYGIENE
5-12 1342
Abstract
Introduction: Spatial zoning of an urban area by the level of anthropogenic burden using land-based research methods is very time-consuming. Since the end of the 20th century, the usage of the Earth remote sensing (ERS) techniques has served as their more efficient alternative. The study objectives included geoinformation zoning and evaluation of the level of technogenic changes in the areas according to NDVI (Normalized Difference Vegetation Index) values. Materials and methods: The cities of the Voronezh Region and their suburban ten-kilometer territories were chosen as the study objects. For the spatial analysis of the area of anthropogenically modified territories based on the example of the cities of the Voronezh Region we created an archive of multichannel satellite images taken by the Landsat-7 and Landsat-8 satellites. The data were borrowed from the Website of the US Geological Survey. Space images were grouped by two periods (the years of 2001 and 2016). Depending on NDVI values, territories with high and low anthropogenic burden, natural framework zones, and water bodies were distinguished. Results: We established that the smallest percentage of areas of the natural framework and their poor location was observed in the city of Voronezh. The largest area occupied by the natural framework was identified within the town of Borisoglebsk. This fact is attributed to the sensible policy of ensuring environmental and hygienic safety of the population implemented by the regional and municipal authorities. Discussion: At present, it is still impossible to fully use space monitoring data to assess health risks of technogenic factors; they can only be used simultaneously with ground monitoring that includes instrumental and laboratory monitoring of environmental quality indicators within the framework of the socio-hygienic monitoring. Conclusions: The analysis of changes in the proportion of areas with a high anthropogenic burden relative to the natural framework performed using satellite images taken in 2001 and 2016 showed an increase in the technogenic burden on the urban environment.
PEDIATRIC HYGIENE
13-17 676
Abstract
Background: Over the past decades, the relation between children's health risks of medical and social factors has changed. In order to determine health effects of some medicosocial factors among primary school children we conducted a questionnaire-based survey of parents in different years. Materials and methods: The studies were conducted in schools of the city of Ufa in the years 2005 and 2017 and included 456 and 465 parents of primary school children, respectively. Results: We established statistically significant relationships between the analyzed medicoso-cial factors and children's health. We noticed a decrease in the number of children with the least risk of developing a disease and an increase in the number of children at risk. We also observed some differences between the years of research in adverse health effects of occupational factors in mothers, alcohol consumption by mothers during the perinatal period, and living conditions. Along with the already known risk factors, we found that chronic diseases and tobacco smoking of the father of the unborn child played an important role in the health of schoolchildren. The survey demonstrated that in the year 2017 primary school children spent less time watching television but much more time on the computer than in 2005. Conclusions: A systematic study of medical and social factors is essential for establishing children's health risk factors and developing appropriate preventive measures. Most risk factors associated with the lifestyle and living conditions are manageable and this fact emphasizes the importance of creating a healthy lifestyle of children and their parents.
18-23 478
Abstract
Background: The innovative form of organizing schooling in the mode of dynamic postures providing for alternation of standing and sitting postures at each lesson is implemented in order to prevent detrimental health effects of the long-term stationary sitting posture, reduce static and educational fatigue, preserve and strengthen health in educational institutions. Our objective was to assess the health status of primary school children studying in dynamic postures. Materials and methods: We assessed the health status of 174 pupils aged 7-10 in the first to third grades of primary school studying in the mode of dynamic postures. The health data was obtained from their personal medical records. The assessment was carried out in accordance with the comprehensive methodology for assessing health of children and adolescents based on the 10th revision of the International Statistical Classification of Diseases and Related Health Problems. Physical development was measured using regression scales. Results: We established that visual impairment (137.9%) and musculoskeletal disorders (109.2%) ranked highest in the structure of functional disorders (FD) among the first to third graders. The prevalence of functional disorders of the circulatory and respiratory system was 86.2% and 80.5%, respectively. Musculoskeletal conditions dominated in the structure of chronic diseases (63.0%), the prevalence being 293.1%. These were followed by diseases of the skin and subcutaneous tissue and gastrointestinal diseases with the prevalence rate of 46.0% each. The total prevalence of functional abnormalities among the primary school first to third graders was 500.0% while the prevalence rate of chronic diseases was 465.5%. Normal physical development was observed in 82.9% of the subjects. Overweight and obesity were detected in 11% and 0.6% of the children, respectively, while underweight, small and big height were measured in 3.1%, 1.8%, and 0.6% of the children, respectively. Conclusions: The comparative data analysis helped establish lower disease prevalence rates among the children studying in dynamic postures compared to those studying in the seated position. Our findings may serve as a scientific substantiation of efficiency of using the dynamic posture regime in order to maintain and improve health of schoolchildren.
24-29 587
Abstract
Introduction: Balanced diet is one of the principal factors of maintaining health; thus, actual nutrition monitoring is an important stage of disease prevention. The objective of the study W8s to аssess the diet, macronutrient and micronutrient composition, and caloric balance of food. Materials and methods: Actual nutrition was studied in the autumn and winter periods by analyzing meal frequency among the high school pupils (Grades 10-11; the average age: 15.9±0.7 years). Results: The eating frequency of the schoolchildren ranged 2 to 6 without any marked differences between sexes. The analysis of distribution of the daily diet energy value showed that the majority of pupils received the maximum of food calories in the evening. Evaluation of the macronutrient composition of food demonstrated high protein and fat consumption accompanied by low consumption of complex carbohydrates in both sex groups against the background of the sufficient energy value of the diet. The contents of simple carbohydrates in the diet of both boys and girls were twice as much as the permissible values. The imbalanced diet led to changes in the micronutrient status of the schoolchildren with a more pronounced deficit of calcium, magnesium, phosphorus and iron in girls. The deficit of vitamins B1, PP, and A was observed in all pupils. Undernutrition was more common in the young men while overnutrition prevailed among the girls. The risk group included 22.4% of the pupils with extreme values of the body mass index indicating pronounced changes in nutritional status. Normal BMI values were observed only in 40% of boys and in 38.3% of girls. Conclusions: We established that nutrition of the high school pupils was imbalanced and required correction.
30-36 743
Abstract
The objective of the study was to analyze disease incidence and prevalence rates among university students in the city of Kaliningrad. Materials and methods. We analyzed morbidity among first to fifth year students of a civil (No. 1) and two military universities (Nos. 2 and 3) including its structure per 1,000, trends, annual incidence and prevalence rates among local and nonresident students. Results and discussion: The overall prevalence rates were higher in the military universities (1,474.9 ± 14.5 % and 930.4 ± 5.2 % in Nos. 2 and 3, respectively) than in the civil one (802.1 ± 10.3 %). In universities Nos. 1 and 3, the prevalence rates of diseases of the skin and subcutaneous tissue were similar while the rates of diseases of the genitourinary system were higher than those in university No. 2. We observed a higher disease prevalence rate among unacclimated students: the smaller was their percentage, the lower was the overall rate. In the universities 1-3 the prevalence rates in local and nonresident students were 779.1 ± 11.8 % and 918.9 ± 17.0 % (p = 0.000), 921.5 ± 13.5 % and 1,548.1 ± 16.9 % (p = 0.000), and 719.5 ± 12.7 % and 906.2 ± 9.6 % (p = 0.000), respectively. The nonresident students of the civil university were healthier: their prevalence rates of diseases of the eye and adnexa, mental and behavioral disorders, and diseases of the musculoskeletal system and connective tissue were, respectively, 2.8, 1.9 and 4.2 times lower than those in non-local students of the military establishments. Conclusions. Respiratory diseases and diseases of the skin and subcutaneous tissue generally prevailed among the students. The excess of the upper limit of the annual incidence rate in the same seasons and months of the year proves the role of body resistance in disease pathogenesis. The observed disease rates were higher in the military universities than in the civil one due to the specific features of nutrition, accommodation, and the educational process (curricula, indoor and outdoor classes at the training ground). The analysis of morbidity rates among students of each year is essential for the development of efficient preventive measures. General measures shall include ways and means of boosting the immune system as well as proper sanitary and hygienic conditions of students' accommodation and learning facilities.
COMMUNAL HYGIENE
37-42 493
Abstract
The object of the study was the centralized drinking water supply system of the Voronezh Region. The purpose of the study was to assess health risks for the population of the Voronezh Region associated with drinking water quality. Materials and methods: The data of the regional drinking water quality monitoring system, which included monthly sampling and testing of water samples at 553 sites in 32 administrative districts and the city of Voronezh for 8 priority sanitary and chemical indicators (total hardness, concentrations of iron, manganese, nitrates, nitrites, boron, fluorine, and ammonium ions) for the years 2010-2019 were used. To achieve the objective based on monitoring studies of drinking water quality in the water distribution system, four generally accepted stages of risk assessment were implemented including hazard identification, evaluation of dose-response relationship, exposure assessment, risk quantification and characterization. When evaluating the exposure, four calculation scenarios were considered and probable body burdens for children and adults were calculated using the average long-term concentration and 95 percentile of concentration in a separate administrative territory. Results: Regional non-carcinogenic risks estimated on the basis of the average regional concentrations of priority pollutants did not exceed acceptable values (HQ < 1) for 6 of 7 ingredients. Unacceptable risk levels were observed in two of 33 administrative districts due to the presence of nitrates in drinking water (HQ ranged 1.34 to 2.95 for children and equaled 1.26 for adults). Detailed information for separate settlements (control points) using an aggravated scenario helped identify 4 rural settlements in 2 administrative districts with unacceptable risks for the child population of iron in drinking water (HQ up to 2.31), 230 settlements in 27 districts - of nitrates (HQ up to 9.51), one settlement - of boron (HQ = 1.17), and 35 settlements in 13 districts - of fluorine (HQ up to 4.17). Discussion: Summarizing the results of the regional studies of health risks for the population associated with the quality of drinking water, one can testify the shift of the problem to rural settlements where water treatment is practically null. The use of average concentrations of chemicals in drinking water in administrative districts proved to be insufficiently objective and having significant uncertainties. The reduction of uncertainties was achieved by a detailed review of the information for each monitoring site and the use of the 95th percentile concentration of the chemical to assess the health risks for children and adults. Conclusions: With a sufficient degree of certainty, the priority regional indicators determining the unacceptable level of non-carcinogenic risk (HQ > 1) associated with the quality of drinking water include elevated levels of nitrates, fluorine, boron, and iron.
MEDICAL SOCIOLOGY
43-47 544
Abstract
Background: The Russian Federation is among the countries with the highest road traffic fatality rates in the WHO European Region. One of the main reasons for that is the personal attitude of traffic participants to safety that includes medical illiteracy and unpreparedness to render first aid to the injured. Our objective was to study failure to give quick and competent first aid as one of the possible causes of road traffic deaths in the Russian Federation and to identify potential ways of improving the situation. Materials and methods: In May-September 2018, in January and June 2019, we conducted a survey of 403 Russian citizens (284 men and 119 women) having a driver's license and driving experience in different Russian regions including the Volgograd Region, the Krasnodar Krai, the Rostov Region, Moscow, etc. The respondents were asked to answer the questions about first aid training courses in driving schools, prior involvement in road traffic accidents, and first aid techniques. Results: Most of the respondents (63%) reported having had first aid training courses at driving schools given by driving instructors and almost a quarter of the respondents (23%) reported having never had such courses at all. Approximately 68% of the survey participants had no first aid training using dummies. About 17% witnessed traffic collisions and provided at least some level of first aid while almost 14% could not give any help due to the stressful situation or fear to do harm to the injured. We then calculated the number of correct and complete answers rated 1 and 2 points according to the estimation scale and drew a control chart of the average value. The analysis of the control chart showed that 331 of 403 participants (82%) passed our test. Conclusions: Although the results were not as bad as might have been expected, significant gaps in basic first aid knowledge did exist: some respondents failed to answer the questions correctly. Given that in addition to theoretical knowledge the person should be able to use this knowledge decisively and calmly, without panic and the fear of blood, the percentage of those who can really help is even lower. First aid training courses in driving schools shall be mandatory and must be given by medical professionals. Governmental regulatory authorities should pay special attention to this issue when licensing. At the same time, more emphasis should be placed on first aid training in educational institutions (kindergartens, schools, colleges, and universities). In addition, we recommend compulsory first aid training of professional drivers of commercial vehicles.
48-51 459
Abstract
Introduction: The excessive use of electronic devices may induce visual impairment. Our objective was to get and analyze a subjective evaluation of effects of digital devices on vision with account for hygienic principles of protecting the eyesight based on the results of an online survey of 568 students from Russia and Belarus. Material and methods: We conducted an online questionnaire survey of 498 university students from the Russian Federation and 70 students from the Republic of Belarus to analyze their subjective evaluation of the impact of behavioral risk factors on health and vision. Results: More than half (53.9%) of the respondents rated their health as "good" and 28.3% as "satisfactory". Vision was considered "excellent" by 25.9% of the respondents while 22.5%, 26.8%, and 24.8% of the students assessed their vision as "good", "satisfactory", and "bad", respectively. The average subjective vision risk values ranged from 6 to 8 points. The majority of the respondents reported that the main sources of information about eyesight protection included the Internet (80%) and the opinion of teachers (70%) and medical workers (67%). Conclusions: The students adequately assessed both health and vision risks of behavioral factors. Yet, good awareness of the damaging effect of digital devices on eyes did not influence the temptation of their use in adverse conditions for the eyesight. We identified a risk group including almost 30% of the respondents characterized by a careless attitude to health and neglect of hygienic principles of eyesight protection. University teachers should take into account the fact that students consider their opinion to be significant for the development of health-saving competencies of young people.
OCCUPATIONAL HEALTH
53-58 402
Abstract
Introduction: The number of greenhouse vegetable businesses has been increasing recently. Most tasks in the greenhouses are still done manually and associated with physical stress. Our objective was to study characteristics of the circulatory and muscular systems of female greenhouse workers in the course of their work and depending on the length of service at the enterprise. The materials included some indices of the functional state of the organism of greenhouse workers growing vegetables such as the heart rate, systolic and diastolic blood pressure, muscle strength and endurance of the right hand in the process of harvesting and removing plant debris. The statistical data processing was performed using the Microsoft Excel 2016 software. The results of the study showed that the work of greenhouse vegetable growers caused gradual changes in the functioning of the cardiovascular and neuromuscular systems of the body. The most significant increase in the heart rate and blood pressure and the decrease in muscle strength and endurance were observed among the greenhouse workers with 15 or more years of work experience. We also observed a significant decrease in muscle strength of the right hand among the workers with the shortest record of service (< 5 years). The study of the functional state of the cardiovascular and muscular systems helped establish the most potentially efficient group of greenhouse vegetable growers: the smallest fluctuations of the measured indices were observed in the women with 6-9 years of service. Conclusions: Our findings prove the necessity of systematic science-based measures of disease prevention in female greenhouse employees.
EPIDEMIOLOGY
59-63 301
Abstract
The study of the composition and antibiotic resistance of bacterial communities of water bodies requires effective processing of numerous data. Our objective was to systematize studies of sensitivity/resistance of pathogenic and opportunistic microorganisms in water reservoirs of Rostov-on-Don and the Rostov Region conducted by the Rostov-on-Don Anti-Plague Research Institute and to create databases (DB) including epidemiological information on the date and source of an isolate, results of bacterial strain identification, and evaluation of their sensitivity/ resistance to antibacterial preparations (ABP). Materials and methods: Isolation, identification and interpretation of results of determining sensitivity/resistance to antibacterial preparations were carried out for different groups of microorganisms using standard techniques. Results: The databases "Phenotypes of antibiotic resistance of Vibrio cholerae of various serogroups isolated in the Rostov Region" (2017621303 dated November 14, 2017) and "Spectrum of microflora of open reservoirs in Rostov-on-Don, sensitivity/resistance to antibacterial drugs" (2017620158 dated February 28, 2017) were registered. The article describes the experience in creating and using the databases to process and analyze research results. The databases are regularly supplemented and updated as part of annual monitoring enabling us not only to monitor and analyze large amounts of heterogeneous information, but also to quickly compare the data, analyze sensitivity/resistance of microorganisms of different groups to a wide range of ABP, and visualize the results. Conclusions: The developed databases are primarily intended for multidisciplinary studies of a large number of microorganisms. Creation and development of specialized Internet resources open up new opportunities for organizing a comprehensive effective monitoring of antibiotic resistance in the Russian Federation.
I. S. Tyumentseva,
E. N. Afanasiev,
S. A. Kurcheva,
I. V. Zharnikova,
E. V. Zhdanova,
A. A. Semircheva,
A. G. Koshkidko
64-68 261
Abstract
Introduction: Plague is endemic in a number of states around the world. Despite all public health measures taken to eradicate plague, the disease persists and even reappears in some countries. Today, traditional serological methods searching for the capsular antigen of the plague microbe are widely used to monitor the presence of Y. pestis in the environment. Yet, for the causative agent of the plague, the possibility of eliminating plasmids and maintaining of the ability to cause an infectious process by atypical strains is not excluded, which reduces the diagnostic value of preparations based on the detection of species-specific antigens of the plague microbe. Our objective was to develop biotechnology for the production of immunodiagnostic drugs for detection of the plague bacteria (capsular and capsule-free forms). Materials and methods: When performing the work, 27 strains of microorganisms of pathogenicity groups I-IV of different genera and species were used. Results: The development of immunodiagnostic preparations for the detection of Y. pestis in environmental samples is described. The presented experimental preparations allow detection of typical and antigenically modified plague microbe strains with a positive and/or negative expression of fraction 1. To evaluate the effectiveness of the designed diagnosticums, both laboratory and field testing was performed demonstrating positive results in the study of both artificially and naturally contaminated samples. The possibility of using the plague immunomagnetic sorbent providing selective concentration of material with a low pathogen content and purification of samples from possible contamination with extraneous microflora during epizootological examination was also confirmed. Conclusions: We constructed promising diagnostic preparations that help identify Y. pestis strains in the studied objects regardless of the cultivation temperature and plasmid profile.
ISSN 2219-5238 (Print)
ISSN 2619-0788 (Online)
ISSN 2619-0788 (Online)