Introduction: In accordance with the main objectives of the National Demography Project, all citizens, regardless of their social, economic and physical status, shall have access to high-quality food products sufficient to meet human physiological needs in basic nutrients and energy for health preservation and" active ageing. The objective of our study was to assess the results of pilot monitoring of food quality and availability of domestic food products contributing to elimination of macro- and micronutrient deficiencies within the framework of the National Demography Project implemented in the Sverdlovsk Region. Results: We identified problems related to planning, sampling and testing of food products including those associated with purchases, laboratory equipment, and methods of testing. According to the results of laboratory testing carried out in compliance with the developed method recommendations, 47 % of all food samples failed to meet the established quality requirements. We identified a high percentage of poor quality samples of meat, dairy, confectionery, bakery, and fish products. Conclusions: The results of our pilot project can be used to correct and develop methodologies of food sampling and testing and to regulate quality characteristics. They will contribute to enhancement of the methodological basis for monitoring of food quality and availability of local foodstuffs rich in macro- and micronutrients to the population.

Introduction: Implementation of the Federal Public Health Promotion Project should raise awareness and develop skills of healthy nutrition in children, thus contributing to disease prevention. Our objective was to evaluate the results of pilot nutrition monitoring in school-aged children of the Sverdlovsk Region as part of the Federal Public Health Promotion Project and the National Demography Project. Results: We established that school meals were generally satisfactory: the rations complied with physiological needs of children in terms of their nutritional value, basic nutrients, energy, and distribution of calories by main meals. We noted differences in the cost and nutritional value of meals and the variety of dishes and foodstuffs used between urban and rural areas. As a rule, pupils have one or two school meals a day. Outside of school, their consumption of dairy products and fruit is limited. Conclusions: Our findings may promote the elaboration of municipal programs aimed, inter alia, at changing the amount of sugar and salt used in the manufacture of public catering products, the cost of dishes with a high content of sugar, saturated fats, and salt, and subsidies on healthy nutrition.

Introduction: Many countries develop approaches to understanding nutritional balance in order to estimate adequate intakes for each type of food and nutrient required to preserve health of individuals and the population as a whole. The objective of the study was to analyze changes in food preferences and diet-related diseases (conditions) in the population of the Russian Federation over a five-year period. Methods: A retrospective comparative analysis of data of questionnaire-based surveys of the population of the Russian Federation conducted in 2013 and 5 years later in 2018 by the Federal State Statistics Service in accordance with Decree No. 946 of the Russian Government of November 27, 2010 was conducted. Results: Both positive and negative changes were observed in the diet and health status of Russian people over the study period. The positive ones included an increase in the number of people consuming healthy foods on a daily basis and rejecting products with low biological value, especially in big cities, and a decrease in the number of people with diabetes or hyperglycemia. The observed negative changes included an increase in the proportion of people with excessive dietary fat intake, insufficient consumption of complex carbohydrates, and nutrition-related high blood cholesterol levels.

Introduction: Physical development is one of the important health criteria of children and adolescents. The objective of our study was to evaluate anthropometric status indicators of school-aged children and their parents using the results of a questionnaire-based survey conducted in the Sverdlovsk Region. Materials and methods: The survey was carried out in accordance with method recommendations and practical guidelines developed by the Federal Research Center for Nutrition and Biotechnology and involved 3,369 schoolchildren and 5,303 parents. When parents specified body height and weight of their children in questionnaires, we also made use of the results of regular medical checkups provided by medical workers. Results: We established that the majority children had normal height and weight, a third of them were overweight, which was more typical for children living in rural areas, and every fifth child was underweight. Overweight was more prevalent among primary and secondary school boys whereas underweight was more common among high school girls. The average body mass index of parents was slightly above the healthy weight range and equaled 25.6 kg/m², overweight being more frequent in men. We noticed that most overweight parents of both genders lived in rural areas. The odds of overweight in children of mothers and fathers with a body mass excess were 1.9 and 1.4 times higher, respectively. Relative risk values indicate an immediate relationship between overweight in parents, especially mothers, and their children. Conclusions: The risk of childhood overweight and obesity is higher in children of overweight parents.

Introduction: In order to assess the relevance of sanitary regulations in relation to food retailing we analyzed data on inspections of 12,001 enterprises and expert actions taken by the Sverdlovsk Regional Rospotrebnadzor Office and the Center for Hygiene and Epidemiology in the Sverdlovsk Region in 2016-2018. Results: We found a low proportion of violations of the requirements of sanitary regulations SP 2.3.6.1066-01, Sanitary and epidemiological requirements for trade organizations and the turnover of food raw materials and food products in them, ranging from 5.9 % to 6.3 % and its significant difference in some cases ranging from 0 % to 36 %. During inspection, compliance with 42 out of 131 paragraphs (32.6 %) was not checked or violations were not detected due to the impossibility to exercise control, recommendatory nature of some clauses, the failure to comply with which cannot be considered a violation, or irrelevance of certain items, the requirements of which are outdated. The proportion of prevalent violations related to the requirements for equipment, packaging facilities, storage and sale of food products was quite high and amounted to 27.9 % in 2016, 25.1 % in 2017, and 23.1 % in 2018, thus posing the risk of nonconforming products. Laboratory testing of samples taken within supervisory activities demonstrated noncompliance with chemical, microbiological, and parasitological requirements for food, the rates of which decreased in 2016-2018 with a simultaneous increase by 2.5 % in terms of counterfeiting. Respondents (33.3 %) from 481 surveyed food retailers proposed a long list of amendments to sanitary regulations to ensure safety of food products sold. We conclude that the current sanitary regulations need to be updated, especially in terms of management and control measures, taking into account risk-based surveillance and food quality and safety management systems.

Introduction: One of the key socially significant results of implementing the Federal Clean Air Project is the maximum possible mitigation of inhalation health risks by achieving the target rate of reducing emissions (by 20 % against the level of 2017) in a number of cities included in the federal project as priority areas. Materials and methods: Ambient air pollution monitoring as a measure of this accomplishment is indispensable both for verification of applying the model to estimating surface concentrations of pollutants, assessing health risks, and evaluating changes in ambient air quality. For the objectivity of such assessments, it is fundamental to determine the list of priority health-threatening air pollutants, to select monitoring sites that best characterize population exposure to these chemicals, and to plan air quality monitoring programs setting sampling frequency and volume. Results: The article presents the results of implementing methodological approaches adopted by the Russian Federal Service for Surveillance in the Sphere of Consumer Rights and Human Wellbeing (Rospotrebnadzor) to optimize ambient air quality monitoring within the framework of solving the tasks of the Federal Clean Air Project in the city of Nizhny Tagil, Sverdlovsk Region, in 2019. The Nizhny Tagil air quality monitoring program for 2020 has been developed and tested. This program, in conjunction with similar programs carried out by the Russian Federal Hydrometeorology and Environmental Monitoring Service (Roshydromet) and the Ministry of Natural Resources and Environment of the Sverdlovsk Region and taking into account their implementation over the past five years, helps provide implementers of the federal project with air pollution data to address its key challenges. Conclusions: The adopted ambient air quality monitoring program implemented in Nizhny Tagil in 2020 by the Center for Hygiene and Epidemiology in the Sverdlovsk Region meets terms and requirements of the Federal Clean Air Project.

Introduction: Key issues of assessing effectiveness and economic efficiency of implementing the Federal Clean Air Project by public health criteria are considered based on the example of the Comprehensive Emission Reduction Action Plan realized in the city of Nizhny Tagil, Sverdlovsk Region. Materials and methods: We elaborated method approaches and reviewed practical aspects of evaluating measures taken in 2018-2019 at key urban industrial enterprises accounting for 95 % of stationary source emissions. Results: Summary calculations of ambient air pollution and carcinogenic and non-carcinogenic inhalation health risks including residual risks, evaluation of the impact of air quality on urban mortality and morbidity rates, economic assessment of prevented morbidity and premature mortality cases have enabled us not only to estimate health effects but also to develop guidelines for development and implementation of actions aimed at enhancing effectiveness and efficiency of industrial emission reduction in terms of health promotion of the local population. Conclusions: We substantiate proposals for the necessity and sufficiency of taking remedial actions ensuring achievement of acceptable health risk levels as targets of the Comprehensive Emission Reduction Action Plan in Nizhny Tagil until 2024 and beyond.

Background: Current accumulation of organogenic elements in surface waters is mainly attributed to intensive anthropogenic activities. Waterborne organic matter may endanger human health when using surface waters for drinking and recreational purposes. Applied techniques of water treatment fail to ensure complete water purification and part of organic substances (their low molecular weight fraction) still remains. Chlorination of drinking water can generate a variety of halogenated by-products having adverse health effects in humans including carcinogenic ones. Our objective was to substantiate the reference value for total organic carbon (TOC) in water disinfected by chlorine. Materials and methods: We analyzed the results of laboratory testing of surface and treated water samples taken in Yekaterinburg in 2013-2014 and 2017, carried out health risk assessment, and built predicative models of by-products formation. Results: We established that, following chlorination, TOC concentrations became 1.5 times lower while chloroform and total trihalomethane concentrations became 24.5-80.2 and 22.9-54.5 times higher than initial values, respectively. The most significant non-carcinogenic risks were estimated for children aged 0-6 years from exposures to chloroform (HQ = 1.150). Individual carcinogenic risks from exposures to bromoform and dibromochloromethane as measured in water before its supplying to the distribution system, referred to the first value range (less than 1x10^-6) while risks from bromodichloromethane and chloroform exposures fell in the second range (from 1x10^-6 to 1x10^-4). The mathematical model of the correlation between predictors (temperature, reaction time, pH, and certain chemical compounds) and levels of by-products was built. Conclusions: Our model makes it possible to predict generation of organochlorine compounds at the design stage of water treatment technique. Total organic carbon is an important indicator that should be monitored at the stages of water treatment to ensure safety of drinking water and efficiency of its disinfection.

Background: Lead oxide nanoparticles are emitted in the workplace air of copper smelters. They are also a by-product in many other metallurgical industries. Objectives: Adverse health effects of lead oxide nanoparticles (PbO-NPs) were assessed in vivo using various routes of exposure with special attention paid to particle cardiotoxicity. Materials and methods: The subacute inhalation experiments were conducted on outbred female rats exposed to the generated aerosol of PbO-NPs in the concentration of 1.30 ± 0.10 mg/m³, 4 hours a day during five consecutive days, using the Nose-Only Inhalation Exposure System. The study of subchronic exposure to PbO-NPs was conducted on male rats using intraperitoneal injections made thrice a week during six weeks (18 injections in total). Conclusions: Following both types of exposure to PbO-NPs, we observed changes in toxicological indices including those specific for lead including a decrease in hemoglobin counts, an increase in blood reticulocyte counts and urine concentrations of δ-aminolevulenic acid. The subacute inhalation exposure to PbO-NPs affected electrocardiographic findings in animals (an increase in amplitudes of P and T waves) while the subchronic intraperitoneal injections decreased blood pressure and changed biochemical indices of the cardiovascular system (decreased activity of the angiotensin-converting enzyme and the concentration of endodelin-1).

Background: Off- and on-the job injuries are characterized by a wide range of sites, formation mechanisms, outcomes, and complications and pose a serious socio-economic problem. Early and timely rehabilitation improves occupational prognosis and is necessary at all disease phases. The objectives of this review include the analysis of gender and age-specific on- and off-the job injuries and identification of possible directions of improving the efficiency of restoring health after injuries using international standards. Methods: We searched Web of Science, PubMed, eLIBRARY and ResearchGate citation databases with the following keywords both in Russian and English: on-the-job injuries, off-the-job injuries, rehabilitation technologies, International Classification of Functioning, and rehabilitation potential, and selected 52 articles out of 70 search results. Having analyzed the selected papers, we included 35 of them in this topical review. Results: The main types of injuries in terms of localization and mechanism of traumatic injury have been established and possible post-traumatic complications leading to temporary, stable, and permanent disability are described. The importance of timely, comprehensive and step-by-step rehabilitation treatment of the consequences of injuries are highlighted in view of allocating basic and additional tasks of this process. Foreign experience of using treatment methodology from the standpoint of rehabilitation potential and rehabilitation diagnosis is demonstrated. Possible directions of increasing the efficiency of the population's health recovery have been analyzed using international standards. The main stages, tasks, and possibilities of medical and social rehabilitation using the International Classification of Functioning, Disability and Health (ICF) are considered. Conclusions: Our findings show the necessity of introducing this international classification into domestic medical practice in order to highlight individual needs in the rehabilitation process, assess the results of rehabilitation, professional suitability, quality of life and other health indicators.

Introduction: The paper presents the results of a retrospective analysis of the incidence rates of community-acqduired pneumonia in chrysotile miners and millers in comparison with the adult population of a municipality. It also emonstrates findings of the study of some immune response parameters in Streptococcus pneumoniae carriers among chrysotile asbestos workers. The objective of the research was to study specifics of the development of community-acquired pneumonia and to determine immune indices in healthy workers (Streptococcus pneumoniae carriers) occupationally exposed to chrysotile asbestos. Materials and methods: First, we analyzed community-acquired pneumonia incidence rates in chrysotile asbestos workers. For the retrospective analysis, we extracted comprehensive emergency notifications about cases of infectious disease, food poisoning, acute occupational poisoning, community-acquired pneumonia, and vaccine adverse reactions (Form 058/u) from the Epidemiologic Surveillance Information System maintained by the Sverdlovsk Regional Center for Hygiene and Epidemiology and Federal Statistics Form No. 2 "Information about Infectious and Parasitic Diseases" in the Sverdlovsk Region. We defined jobs and formed three groups of workers with high incidence rates of community-acquired pneumonia: group 1 included workers involved in extraction and transportation of chrysotile asbestos, group 2 consisted of workers of the ore-dressing factory while group 3 included workers of auxiliary subdivisions (logistics, security, administration, central automated control station). In 2011, 2012, 2013, and 2019, the incidence rate of community-acquired pneumonia in workers was significantly higher. The annual increase had been observed since 2016 and reached its maximum of 1,032.97±158.88 in 2019 exceeding the long-term average rate in the industry and the town by 12.77 % and 15 %, respectively. We assessed the immune status and performed a comparative analysis of immunological indices in 143 workers of selected jobs, both carriers and noncarriers of Streptococcus pneumoniae. The carriers demonstrated a significant increase in the production immunoglobulin E indicating general sensitization and immunoglobulin G., a significantly lower relative count of mature T cells, and a higher lymphocyte count in the populations of natural killer cells.

We conducted a study of refractory workers exposed to multiple occupational hazards, the most important of which being dust aerosols of predominantly fibrogenic action. Our objective was to identify the spectrum of predictors of the occupational disease in refractory workers and to build a predictive mathematical model using multivariate analysis to assess the likelihood of developing silicosis. Materials and methods: The case reports of 172 refractory production workers were analyzed. The main group consisted of 75 silicosis patients and the control cohort consisted of 97 experienced workers without this occupational disease. The groups were comparable in gender (p = 0.052), dust exposure (p = 0.862), and the severity of the work process (p = 0.147). We assessed a wide specter of factors related to refractory workers' health and occupational conditions significantly affecting the timing of developing occupational pulmonary fibrosis. Results: In the silicosis patients, arterial hypertension (p = 0.005), left ventricular myocardial hypertrophy (p = 0.002), coronary heart disease (p = 0.010), chronic circulatory depression (p = 0.010), low hemoglobin level (p = 0.022), and low speed and volume criteria of external respiration function were significantly more prevalent. We established four important independent factors associated with the development of silicosis in refractory workers including age, time-weighted average and maximum one-time dust concentrations, and the forced expiratory volume in the first second. Conclusions: We observed a medium work-relatedness of hypertension, a strong work-relatedness of left ventricular myocardial hypertrophy, sinus node tachycardia syndrome and obesity, and a very strong work-relatedness of impaired fasting glycemia. Using a logistic regression, we built a silicosis development predictive model having high predictive ability (82.8 %), sufficient sensitivity (85.2 %) and specificity (80.0 %). The model was tested and verified on clinical examples and can be used to predict the probability of silicosis in refractory workers.