Introduction: Establishing geographical features of health effects of socio-economic factors and characteristics of adaptation of certain population groups to new living conditions is important for taking appropriate preventive measures to improve the situation and for strategic planning in the sphere of health care and social development of territories. The purpose of the research was to determine priority regional risk factors for pancreatic disorders in the population of Primorsky Krai. Materials and methods: We conducted a hygienic and statistical analysis of the impact of selected socio-economic factors on the incidence rates of pancreatic diseases in children, adolescents, and adults. The database on the registered non-communicable disease incidence included the indices registered by the Primorsky Regional Medical Information and Analytical Center. The study of socio-economic factors included a quantitative assessment of data on three groups of indicators including living conditions, material well-being, and medical density over a 17-year observation period extracted from the regional yearbooks of the Department of the Federal State Statistics Service for Primorsky Krai. Results: We established an inverse relationship between pancreatic disease rates and the indices of population density, per capita income, and solvency ratio and a direct relationship with the proportion of living space in houses without utilities. Conclusion: Our findings enabled us to establish the relationship between adverse effects of socio-economic factors and pancreatic diseases in the regional population and to make a significant contribution to substantiating appropriate measures of primary prevention at the population level.

Introduction: The study of characteristics of the spread of iodine deficiency disorders among the population of the Primorsky Krai is important due to the fact that, along with iodine deficiency in the body, secondary factors indirectly related to insufficient iodine intake contribute to the occurrence and development of such diseases. Previous studies have already shown that, under the influence of factors of exogenous and endogenous nature, iodine consumed with food may not be fully assimilated by the body. Purpose of research. Assessment of the significance of the influence of social and hygienic lifestyle factors on iodine deficiency diseases in the population of Primorsky Krai. Used method. The method of social and hygienic analysis (questionnaire) was used among patients Of the center of endocrinology in 2017-2018. The study involved 200 respondents. Mathematical processing of the results of the sociological study was carried out using the Terentyev correlation Pleiades method. Results: Factors of socio-hygienic nature significant for the occurrence and development of iodine deficiency disorders in the population of the Primorsky Krai were classified by their degree of significance and divided into five groups (pleiades) including the general group of socio-hygienic factors and individual groups of factors related to the lifestyle, dietary habits, and health status. Among the identified pleiades of factors, the first group was the most extensive and consisted of the largest number of factors of the socio-hy-gienic nature and inter-factor relationships, combining the most significant factors contributing to the occurrence and development of iodine deficiency disorders in the local population. Conclusions: Our results help outline directions for further studies of effects of socio-hygienic and lifestyle factors on formation and development of iodine deficiency disorders in the population of the Primorsky Krai, develop comprehensive and targeted prevention programs.

Introduction: The article is devoted to poor ambient air quality in some cities of the Russian Federation, one the most important social and environmental issues of today. The city of Chita is a priority area in term of ambient air pollution included in the Federal Clean Air Project of the National Ecology Project. Our objective was to assess air quality in residential areas of the city for a further improvement of the ambient air quality monitoring system and air quality action planning. Materials and methods: We analyzed the results of measuring ambient air quality at the monitoring sites of the government environmental monitoring system for 2014-2018 and statistical data on the volume and composition of industrial emissions. The spatial analysis of the impact of enterprises on residential areas was carried out in accordance with the guidelines of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor). Results and discussion: We established high concentrations of benzo(a)pyrene (up to a 10.5-fold excess of the average daily maximum permissible concentration (MPC)), particulate matter (up to a 1.63-fold excess of the average daily MPC and a 11.4-fold excess of the single MPC), nitrogen dioxide (up to a 1.18-fold excess of the average daily MPC), hydrogen sulfide (up to a 11.94-fold excess of the single MPC), phenol, soot, and some other hazardous air contaminants. We determined priority sources of anthropogenic emissions and other factors contributing to poor air quality in Chita. Conclusions: Our findings indicate the necessity to enhance the existing ambient air quality monitoring network and programs, to assess spatial distribution of resulting exposure levels and population health risks, and to decide on the adequacy of the air quality action planning in the city of Chita in accordance with the comprehensive plan.

Introduction: The problem of safe recreational water use is closely related to conditions of surface water bodies (rivers, reservoirs, lakes, and ponds) experiencing a significant anthropogenic load and their water quality. The purpose of the study was to assess safety of recreational water use of the population based on the results of testing water quality in the bodies of water of the Upper Don River basin. Materials and methods: In 2015-2019, surface water samples were taken at 73 water quality checkpoints of 26 water bodies and tested for chemical, microbiological and parasitological indicators. Test results were then used to assess hazards related to recreational water use of the population. Results: It was found that in 26 of 73 surveyed recreation areas (35.6 %) water quality failed to meet recreational water quality criteria. Poor microbiological water quality indicators were established at 21 of 73 sites (26.7 %) with the proportion of water samples with high thermotolerant and total coliform counts varying from 1.5 to 75.0 %. Risks of epidemic hazard posed by recreational water use were assessed to be the highest in three recreation areas (4.1 %) and moderate - in 18 areas (24.7 %). Conclusions: The estimated significance of differences in the long-term incidence rates of infectious diseases probably related to microbiological surface water quality indicators (by Student's t-test) confirmed the hypothesized association between poor microbiological water quality parameters and high incidence rates of acute intestinal infections and bacillary (Flexner) dysentery (p < 0.05). The findings demonstrate the necessity of implementing measures to ensure health and epidemic safety of recreational water use of the population.

Introduction: The realities of today demonstrate high importance of the ability of healthcare professionals to raise awareness of health knowledge in the population. Skills of health promotion develop already in the course of training in medical educational establishments. Our objective was to assess the dynamics of building health knowledge in medical students in the process of studying. Materials and methods: We conducted a targeted questionnaire-based survey of 264 medical students including 167 students of the Faculty of Public Health of the Pacific State Medical University (hereinafter referred to as University) specializing in preventive medicine, clinical psychology, and medical biochemistry and 97 students of medical and nursing departments of the Vladivostok Medical College (hereinafter referred to as College) in the first and final year of study. A specially developed questionnaire included 25 questions on basic knowledge of clinical medicine, health, and health maintenance behavior. Data analysis was conducted using methods of descriptive statistics (cross-tabulation analysis and Student's t-test). Conclusions: Our findings helped improve the curriculum of hygienic disciplines by including optional classes aimed at consolidating theoretical knowledge gained in the study of hygienic and epidemiological disciplines and at acquiring practical skills in accordance with professional competencies.

Introduction: Research data on the prevalence and consequences of occupational noise exposures of industrial workers and miners are presented. Arterial hypertension is considered as an occupational disease. Scarcity of available literary sources describing health status of occupational cases of sensorineural hearing loss (SNHL) is generally noted. Our objective was to analyze the prevalence of non-occupational diseases in cases of occupational SNHL. Materials and methods: Due to a very small number of female SNHL cases (n = 3), health assessment was conducted for male cases (n = 105; average age: 66.0 ± 1.3 years) using the prevalence rate of non-occupational diseases per 1,000 cases of occupational SNHL with an error of intensive indicator and the share of the pathology in the structure of non-occupational diseases. Results: We established that non-occupational diseases of the circulatory system prevailed in men with a diagnosis of work-related sensorineural hearing loss (32.2 % or 457.1 ± 48.6), with arterial hypertension and ischemic heart disease being the most prevalent (123.8 ± 32.1 and 101.9 ± 29.1, respectively). Musculoskeletal disorders ranked second (29.5 % or 419.1 ± 48.2) with prevailing dorsopathies (361.9 ± 46.9), and dis! eases of the respiratory system ranked third (13.4 % or 190.5 ± 38.3) dominated by acute infections of the upper respira! tory tract (111.1 ± 30.2). Conclusion: The established high prevalence of non-occupational circulatory, musculoskeletal, and respiratory diseases in SNHL cases requires their early diagnosis by primary healthcare providers based on the results of dispensary examination and development of appropriate measures for primary and secondary prevention.

Background: As of today, there is no unified health information system that registers and systematizes the results of periodic medical examinations of workers exposed to occupational hazards in the Russian Federation. Our objective was to study the results of periodic medical examinations in the Sverdlovsk Region over a five-year period. Materials and methods: We reviewed medical reports and conclusions issued by regional health facilities in 2015-2019 and submitted to the Regional Occupational Health Center of the Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, and analyzed completeness and timeliness of their submission. Results: We established that occupational health assessment based on the results of periodic medical examinations is complicated by late and incomplete data reporting by healthcare facilities of the Sverdlovsk Region. Conclusions: Our findings prove the importance of creating a “Periodic Medical Examination” subsystem of the unified health information management system. Providing access to standardised results of periodic medical examinations based on a single digital platform to all professional participants of the national occupational health system will enable data recording, analysis and assessment at the interregional and intersectoral levels, as well as at the level of business entities, and facilitate their use for the purposes of workers' health risk management. Timeliness of reporting and completeness of date entry in the “Periodic Medical Examination” subsystem (or a Federal Registry of Periodic Medical Examinations) may be monitored and verified by local Rospotrebnadzor bodies to be connected to the unified state health information systems of constituent entities of the Russian Federation.

Introduction: A biological factor is the leading occupational hazard for healthcare professionals. Identification of risk factors for novel coronavirus disease 2019 (COVID-19) in ambulance employees and substantiation of measures to prevent the spread of this infection is a modern-day challenge. The purpose of our study was to examine COVID-19 incidence rates in emergency medical services (EMS) workers and to identify occupational risk factors for this infection. Materials and methods: We studied COVID-19 cases among Ryazan ambulance employees in terms of their age, sex, position, and specialty taking into account disease severity and duration for the period from May 1, 2020 to September 1, 2020. Results: We established higher relative risk values and incidence rates of the novel coronavirus infection in EMS workers compared to the population of the city of Ryazan (p < 0.05). In May-August 2020, COVID-19 cases among the ambulance employees and the population of Ryazan, as well as the number of EMS-attended patients with acute respiratory infection followed a similar pattern. The number of COVID-19 cases among the staff of resuscitation crews was significantly higher than that in the general practice and other specialized crews (p < 0.05). We estimated a statistically significant high relative risk of a longer and severer course of the disease among physicians compared with paramedics (RR = 1.333; p < 0.05) and among EMS workers aged 61 or older (RR = 1.286; p < 0.05). Conclusions: Emergency medical services workers have a high occupational risk of COVID-19 in the pandemic. Among them, employees aged 31-35 and resuscitation crewmembers face a higher risk of infection. Elderly employees aged 61-64, medical doctors, and general profile EMS workers are most at risk for a more severe and durable disease course.

Introduction: The formation of highly pathogenic strains of Vibrio cholerae resistant to antibiotics determines the pathogenesis, clinical picture, epidemiology, and laboratory diagnosis of cholera. It is necessary to study the structure of the genome of V. cholerae of any serological groups isolated during routine monitoring of environmental objects or patients with acute intestinal infections in order to detect toxigenic genes inherent to epidemic strains of V. cholerae O1. Our objective was to study changes in phenotypic properties and molecular genetic bases of persistence, epidemic and pathogenetic potential of El Tor variant of Vibrio cholerae O1 isolated from patients and environmental objects in the Caucasus in 1970-1998. Materials and methods: We studied phenotypic and molecular genetic characteristics of 32 V. cholerae O1 strains isolated from patients and environmental objects in the Caucasus (1970-1998) using a microbiological assay and PCR test, respectively. Results: We established that the following biotypes of V. cholerae O1 were found in the Caucasus: a) El Tor, ctxA-, and Hly+ nontoxigenic strains of V. cholerae O1, typical in their phenotypic and molecular genetic properties. Their toxigenic potential is represented by exo- and endotoxins different from the enterotoxin of toxigenic V. cholerae; b) toxigenic El Tor, ctxAB^EL+, rtxC+, and Hly- variant biotypes of V. cholerae O1, typical in their phenotypic, molecular and genetic properties during outbreaks of invasive cholera, producing a CT-2 enterotoxin and containing genes responsible for persistent, pathogenic and pandemic potential, and c) typical in terms of their main phenotypic characteristics but molecularly genetically altered variants (hybrids) of El Tor variant of Vibrio cholerae O1 including El Tor ctxAB^CL+, rtxC+, Hly-. Conclusions: The main manifestation of evolutionary changes in a typical toxigenic vibrio of the El Tor variant biotype was the replacement of the ctxB^El gene in its genome with the ctxB^CL gene encoding the classical type of enterotoxin (CT-1), which significantly increased the persistent, toxic, epidemic, and pandemic potential of genetically modified variants of El Tor biotype Vibrio cholerae. The genome of these strains contains an integrative and conjugative element SXT with genes for antibiotic multiresistance.

Introduction: Identification of hygienic determinants of the epidemic process and their inducing factors is an urgent regional problem that ensures a decrease in infectious disease rates in modern conditions. One of the priority tasks of the Russian economy is the development of beach tourism in coastal areas. Medical tourism is gaining more and more popularity in Russia: this direction is one of the most promising and demanded. According to the Ministry of Economic Development, 45 % of Russian tourists prefer beach holidays. Development of a competitive, highly efficient tourist and recreational complex is impossible without a modern approach to assessing safety of recreational water facilities for the population and minimizing risks of adverse health effects of recreational water use in holidaymakers. The anthropogenic factor influences reliability of assessments of the local hygienic and epidemic situation. The establishment of cause-effect relationships between the environment and the disease is the basis for elaborating preventive actions. The objective of our study was to analyze the incidence of acute intestinal infections in the local population of the Black Sea coast of the Tuapsinsky district, Krasnodar Krai, and visitors from other regions of the Russian Federation. Materials and methods: We applied epidemiological and statistical methods of analyzing disease incidence taking into account terrain features, age of patients, and seasons of the year. Laboratory test results were used to confirm the etiology of diseases registered in the district. Results: We established season- and age-specific increase in the incidence of acute intestinal infections among groups of the local population having excluded cases among the visitors. The incidence was noted for a high rate of acute intestinal infections caused by potentially pathogenic bacteria and viruses in coastal areas with a developed resort and spa infrastructure as compared to the mountainous areas. We also observed a recent rising trend in the incidence of viral gastrointestinal infections with rotaviruses accounting for 89.8 % of all cases of acute intestinal infections in 2018. Discussion: Our findings were used to develop appropriate preventive measures and to make managerial decisions on surveillance of the recreational facilities in order to prevent the risk of gastrointestinal infections in the area and to create a safe environment for tourists. Conclusions: In the summer months, acute intestinal infections in the area were induced by potentially pathogenic bacteria and viruses. The majority of cases were registered among holidaymakers while children aged 1-6 years were most at risk for gastrointestinal infections.