Introduction. One of the basic principles of quality management is customer orientation. The most convenient method of monitoring and measuring customer satisfaction is a customer survey. Literature review showed a lack of information on the analysis of consumer assessment of the quality of services in the field of ensuring sanitary and epidemiological well-being of the population. The purpose of the study was to substantiate measures for optimization of the quality management system (QMS) based on the analysis of consumer (customer) satisfaction with the quality of services for the conduct of sanitary and epidemiological expert examinations (hereinafter referred to as examinations) rendered by the Inspection Body of the Moscow Center for Hygiene and Epidemiology, Federal Budgetary Health Institution, with the exception of its branch offices in administrative districts, including those rendered for provision of government services by Moscow Rospotreb-nadzor Office. Materials and methods: A special questionnaire was developed to study customer satisfaction with the quality of services rendered by the Inspection Body and the total of 510 questionnaires was analyzed in 2019 using statistical, sociological, and logical methods of research. The results of the survey showed that the customers were generally satisfied with the quality of services provided by the body. The data on priority factors determining the customer's choice of an institution for conducting expert examinations were collected. The need to optimize the information component of the official website about the services was identified. The importance of developing remote interaction with customers, including that through the official website, was established. Introduction of a systematic monitoring of customer satisfaction including electronic questionnaire-based surveys was proposed. The expediency of optimizing the procedure for preparing expert opinions based on the results of laboratory tests, which would improve the quality and shorten the time for conducting examinations, was established. Conclusions: The survey of customer satisfaction with the quality of expert services rendered by the Inspection Body of the Moscow Center for Hygiene and Epidemiology revealed the determinants for choosing the institution, the necessity to develop information technologies for interaction with customers, and the factors showing the importance of improving the QMS procedure for conducting expert examinations of laboratory test results.

Introduction: Human health and lifestyle are influenced by many risk factors and living conditions. The purpose of the study was to analyze lifestyle and health characteristics of students during traditional and compelled distance learning. Materials and methods: We conducted a questionnaire-based survey of 300 students (years 2, 4, and 6) of the Voronezh State Medical University named after N.N. Burdenko. The questionnaire was specially developed by the authors and included questions about physical activity of medical students, their compliance with Coronavirus lockdown rules, sleep and rest, daily routine, diet, addiction to bad habits, and self-rated health during traditional (of-line) and distance learning. Results and discussion: The study was conducted stepwise. We observed better self-discipline in following a stay-at-home order among junior students compared to their senior fellows. The period of compelled distance learning caused a decrease in physical activity of students, regardless of the year, with the exception of persons regularly engaged in physical exercises. The average daily walking distance of the respondents dropped from 5.35 km to 1.36 km in those observing the lockdown rules and to 3.15 km in those violating them. We established the relationship between distance learning and changes in sleep patterns, nutrition, and daily routine. We also revealed nutrition disorders leading to a weight gain and ranked bad habits related to transition to an unusual e-learning. A statistically significant worsening of self-rated health of the respondents was demonstrated. Conclusion: Distance learning during the spring semester of 2020 raised a number of novel questions regarding a wide variety of aspects of the educational process, lifestyle, nutrition, sleep, and rest.

Introduction: Health of the working population is a prerequisite for successful general economic development and improvement of labor productivity and the quality of life of workers. According to the World Health Organization, most countries lose 4 to 6 % of their gross national product due to health problems related to poor working conditions. Our objective was to analyze the relationship between subjective characteristics of health of the working population (self-rated health status, the presence of chronic diseases, frequency and severity of diseases, and days lost due to sickness) and conditions and nature of their work (occupation, physical activity at work). Materials and methods: The study was based on data of a regular stage of sociological monitoring of physical health of the population in the Vologda Region carried out by the Vologda Research Center of the Russian Academy of Sciences in 2018. The statistical significance of the relationships was estimated using descriptive statistics (a method of multivariate analysis) using tools of the SPSS software package. Results: We found that the best self-rated health status was reported by the respondents satisfied with their working conditions, having little physical activity or walking in the workplace. The worst self-rated health status was reported by those dissatisfied with their working conditions, engaged in unskilled physical labor or sedentary work. It is extremely important to introduce the system of monitoring employee assessments of working conditions and health status using questionnaire-based surveys, to apply and disseminate the most effective health-saving techniques in the workplace taking into account the importance of psychological comfort.

Introduction: In the Russian Federation, much attention is traditionally paid to military education and training. A special place in its structure is occupied by the system of cadet classes and corps. A distinctive feature of the learning mode in such institutions is a combined effect of standard and specific factors of indoor school environment and intensive physical activity owing to sports, applied military and drill training. No evidence-based methods of establishing nutrient requirements of children in modern conditions of cadet corps have been developed so far, which predetermines the potential of transforming nutrition from a health-saving factor into a health risk factor. Our objective was to provide a scientific substantiation of the model of healthy nutrition for students of cadet-type educational establishments. Methods: The statistical significance of the correlation was evaluated using the Student's t-test. Correlation and regression analyses were used to assess cause-and-effect relationships. The Pearson correlation coefficient (r_xy) was used as an indicator of the strength of the relationship between quantitative indicators x and y, both having a normal distribution. Correlation coefficient (r_xy) values were interpreted in accordance with the Chaddock scale. For the purpose of statistical modeling, the method of multiple linear regressions was used. Conclusions: We substantiated the innovative model of organizing healthy nutrition for students of cadet-type schools based on the correlation and regression analyses with determination of statistical significance of the studied characteristics. Its efficiency indicators include an increase in average functional capabilities of students by more than 10 % and a reduction in the probability of developmental disorders by more than 25 %.

Relevance: Parameters of learning environment and organization of the educational process can have adverse health effects in schoolchildren. Our objective was to conduct a hygienic assessment of factors of learning environment and organization of the educational process at schools of the city of Smolensk. Materials and methods: We studied indicators of indoor learning environment and the level of organization of the educational process in ten urban comprehensive schools. A hygienic assessment of the microclimate, illuminance, indoor air quality, and organization of the educational process for third and fourth graders (aged 9-11) was given. The assessment of learning conditions and organization of the educational process was carried out according to the method generally accepted in hygienic research (Suharev AG, Kanevskaya LY, 2002). Results: We found that elementary school pupils of Smolensk were exposed to multiple adverse factors such as poor microclimate parameters and insufficient natural illumination in some school rooms, excessive daily study load and irrational distribution of the academic load during the school week. The analysis of the timetable revealed an irrational distribution of the academic load in 37.3% of school days. We established that conditions of education in the surveyed urban schools were moderately dangerous to children's health (750-806 points). Conclusion: The results enabled us to give a hygienic assessment of the factors of learning environment and organization of the educational process at schools in Smolensk and to outline a set of appropriate preventive measures.

Introduction: In solving the problem of preserving and strengthening health of gifted schoolchildren representing the country's main intellectual potential, the main component is the observance of hygienic requirements for conditions and organization of learning activities in educational establishments for gifted children and adolescents. The purpose of the study was to conduct a prenosological assessment of the health status of gifted adolescents influenced by various educational process factors. Materials and methods:Using hardware and software complexes, we assessed the level of physical development, functional status of the central nervous, respiratory, and cardiovascular systems in 300 gifted adolescents in grades 9-11 (1517 years of age). Results: We established that under the conditions of a boarding school (lyceum), gifted schoolchildren were exposed to such health risk factors as increased study loads, their irrational distribution during the school day and week, and a high level of tension in the educational process (class 3.1). It was proved that the educational process factors affected the functioning of the major body systems of gifted schoolchildren. High study loads of a pronounced degree of tension ensured an improvement of the functional status of the central nervous system of gifted school-age adolescents by stabilizing the nervous reaction, increasing the functional level of the nervous system and the ability of the central nervous system to form the body's adaptive system when adapting to the factors of the educational process in the dynamics of learning. Maintaining a high level of functioning of the central nervous system in gifted school-age adolescents was ensured by the multiparameter interaction of the main body systems, which was characterized by an increase in the functional parameters of the respiratory system, a change in vegetative regulation, and a decrease in the level of biological adaptation. Conclusions: Our findings determine the need for systematic screening of gifted children in educational institutions to identify the level of their prenosological health in order to maintain and increase the adaptive potential of gifted adolescents.

Introduction: in recent years, much attention has been paid to conditions of forming high schoolers' health. Characteristics of the high school age largely determine the future of a person, his physical and mental health, the success of inclusion in adulthood, and realization of the reproductive potential. Health disorders in this period are largely determined Dy the influence of behavioral risk factors. Our objective was to assess the prevalence of behavioral health risk factors among Moscow high schoolers and to study their gender characteristics in order to determine up-to-date priorities of adolescent hygiene and school medicine. Materials and methods: in October 2018, a survey of 2,254 Moscow adolescents in grades 10-11 (15-18 years of age) was conducted using a questionnaire based on that of the World Health Organization collaborative cross-national survey “Health Behaviour in School-Aged Children”. Resuits: The most common risk factors in high schoolers included intensification of learning (90.5 ± 0.6 %) and high levels of screen time (92.0 ± 0.6%) that significantly increased daily visual workload of adolescents and might induce vision disorders (49.9 ± 1.1% of respondents), frequent headaches (56.2 ± 1.1%), and back pain (43.5 ± 1.0%). The majority of respondents also noted mood swings (71.8 ± 0.9%) and weakness after school (69.6 ± 1.0%). Almost half of the students (45.3 ± 1.1%) rated their health as satisfactory or poor. Conclusions: The irrational use of electronic devices in the educational process and at leisure can negatively affect the daily routine of schoolers causing reduction in the time spent on physical activities and outdoors and a decrease in night sleep duration. For most high schoolers malnutrition is yet another adverse factor characterized by imbalance and irregularity. Our findings help identify priority strategies of health promotion among high schoolers and appropriate preventive measures in view of the identified behavioral risk factors having a negative impact on adolescents' health.

The objective of the study was to investigate the risks, structure and prevalence of occupational diseases in workers engaged in extraction of oil and gas, coal, and ore raw materials in the Russian Arctic. Materials and methods: I analyzed the results of socio-hygienic monitoring "Working Conditions and Occupational Health" conducted in the Arctic zone of the Russian Federation in 2007-2018. Results: Significant differences in working conditions in the extraction of various types of minerals were established, the most favorable being in the oil and gas industry as opposed to the coal mining. The risk of occupational diseases in coal mining was higher than that in oil and gas production (OR = 366.7; CI 275.8-487.6) and ore mining (OR = 1.66; CI 1.58-1.73). Among oil and gas industry workers, the structure of occud pational diseases was dominated by sensorineural hearing loss (50.0 %), radiculopathy (20.8 %) and vibration disease (18.9 %). In coal miners, the most prevalent diseases included radiculopathy (32.8 %), chronic bronchitis (26.9 %) and mono-and polyneuropathy (15.5 %), and in ore miners - vibration disease (44.8 %) and radiculopathy (16.3 %). In 2018, compared to 2007, the number of occupational diseases in ore and coal miners increased by 2.16 and 1.42 times, respectively. In 2007-2018, the proportion of occupational diseases diagnosed in miners of the Russian Arctic rose from 57.9 % to 75.6 %. Conclusions: In the mining industry of the Russian Arctic, the maximum health risk is observed in coal mining, and the minimum - in gas and oil industry. The number of occupational diseases in miners tends to increase, which requires improvement of preventive measures adapted to Arctic conditions.

Introduction: Amorphous silicon dioxide nanoparticles of (SiNPs) are among the most common nanomaterials today. Besides, industrial aerosols formed by condensation and containing a significant proportion of SiNPs are spontaneously produced by a number of pyrometallurgical and welding processes. A significant number of individuals are therefore exposed to SiNPs in the occupational setting or polluted ambient air and while using this nanomaterial. The purpose of our experimental study was to develop a preventive method promoting the resistance of the organism to adverse cytotoxic effects of amorphous silicon dioxide nanoparticles. Materials and methods: White laboratory rats received a monthly course of a specially developed bioprophylactic complex (BPC) before a single intratracheal instillation of a SiNPs suspension at a concentration of 0.5 mg/mL. The suspension was obtained by laser ablation of thin sheet targets of the appropriate material of 99.99 % purity in sterile deionized water. The average diameter of SiNPs was 43 ± 11 nm. Cytological (the number of bronchoalveolar macrophages and neutrophils and their ratio) and cytochemical indices of the bronchoalveolar lavage (BAL) fluid (alkaline phosphatase, alanine aminotransferase, gamma-glutamyl transpeptidase, amylase, and lactate dehydrogenase) were evaluated at 24 hours after the injection. The bioprophylactic complex was administered to the animals with feed and drink and included monosodium glutamate, fish oil rich in omega-3 polyunsaturated fatty acids (PUFAs), iodine, and an antioxidant complex of selenium, quercetin (rutoside), and vitamins A, E, and C. Conclusions: Our findings show that changes in both cytological and biochemical BAL parameters proved a positive health effect of premedication that helped reduce cytotoxicity of SiNPs exposure.

Introduction: The development of digital economy is impossible without a widespread use of microelectronic products. Many highly qualified specialists are employed in the production of electronic components. The objective of our study was to conduct a hygienic assessment of working conditions in electronics production. Materials and methods: We studied the conditions and nature of work in employees of the main occupations in the modern production of semiconductor resistors, capacitors, and microcircuits at all stages of the technological process. We measured noise, illuminance, and air pollution at workplaces and assessed labor severity and intensity based on work time observations. In total, over 1,250 tests of factors of occupational environment and indices of labor processes were made. Results: We established that air pollution with lead compounds, increased levels of noise, and hot microclimate mostly determined working conditions of employees engaged in preparation and processing of ceramic compositions. Occupational risk factors for those performing precision assembling operations and quality control using optical devices included severity and intensity of the labor process. Sensory load when performing these operations during 55-75 % of the work shift was assessed as Grade 3.1. Conclusions: Our findings helped identify priority adverse occupational factors for electronics workers' health risk assessment and substantiate comprehensive measures for prevention of occupational and production-related diseases.

Introduction: The ongoing adverse situation with the prevalence of chronic hepatitis C virus (HCV) infection makes it especially relevant to assess the epidemiological situation of this infection in the country as a whole and the Samara Region. Our objective was to determine characteristics of the epidemic process of chronic HCV infection in the territory of the Russian Federation and the Samara Region in 1997-2018. Results and discussion: We observed a dynamic 5.88-fold increase in the Russian rates of chronic HCV infection in 1997-2014 from 6.7⁰/₀₀₀₀ to 39.4⁰/₀₀₀₀ (p < 0.01) followed by a decrease by 16.5 % in 2015-2018 (from 39.2⁰/₀₀₀₀ to 32.7⁰/₀₀₀₀). In the Samara Region, we traced a periodic wave-like increase alternating with small drops in the prevalence rates during the whole observation period. In 1997-2016, the rates of chronic HCV infection rose from 5.2⁰/₀₀₀₀ to 58.0⁰/₀₀₀₀ (by 11.2 times; p < 0.01) and declined slightly from 58.0⁰/₀₀₀₀ to 56.2⁰/₀₀₀₀ in 2016-2018. The maximum rates of chronic HCV infection in the child population of the Samara Region were registered in 2002 and 2012 (7.1⁰/₀₀₀₀ and 7.2⁰/₀₀₀₀, respectively) with the minimum of 1.9⁰/₀₀₀₀ noted in 2017. The analysis of the epidemiological situation of chronic hepatitis is important for subsequent trend forecasting and developing appropriate preventive measures.

The purpose of the study was to conduct a retrospective analysis of the epizootiologic and epidemiological situation of anthrax in the Republic of Crimea and to improve surveillance of this infection using geographic information systems (GIS technologies). Material and methods: In the process of considering specific features of manifestations of infection in different areas of the Crimean Peninsula and outbreaks of anthrax in animals and humans in 1922-2019, we analyzed and summarized data of reporting forms of the Interregional Department of Rospotrebnadzor in the Republic of Crimea and Sevastopol. ESRI's ArcGIS 10 software was used as a GIS-platform. When zoning the administrative units of Crimea by the level of endemicity, we estimated epizootic indices for anthrax. Results: We observed a relatively safe epizootiologic and epidemiological situation of anthrax in the Republic of Crimea. In 1922-2019, 211 potentially hazardous stationary sites located in nine districts and one city council and 13 anthrax burial sites in four districts were registered in Crimea. Most sites (182 or 86.3 %) appeared in 1932-1961, the peak anthrax activity occurred in 1942-1951, and the latest outbreaks of infection among animals and humans were registered in 1995. Taking into account the ability of anthrax spores to persist in soil for years, the administrative units of the Crimean Peninsula were zoned using GIS-technologies based on the established epizootic indices. As a result, the territory of the Republic of Crimea was divided into areas with different levels of risk of exposure to anthrax. We also studied the relationship between the endemic areas and local climatic and geographical conditions and found that the majority of stationary sites (167) were within the dry-steppe, typical steppe, and northern steppe zones of the Peninsula with dominating soddy calcareous, meadow chernozem, and chernozem types of soil.