The article presents an analysis of the formation of general disability among persons older than working age due to diseases of the nervous system in Moscow. Introduction. Disability among the population - one of the most important medical and social problems - is an integral indicator. The purpose of the study is to study the patterns of the formation of general disability. Materials and methods. The study is solid for 2012-2018, using statistical forms of observation: form 7-sobes, statistical collections of THE Federal Security Service of the Russian Ministry of Labour. Research methods - excavation of information, descriptive statistics (absolute, extensive, intense indicators, series of dynamics, reliability assessment (average error). The results of the study. There has been an increase in the overall number of disabled people with a more pronounced growth rate in Moscow compared to the Central Federal District and the Russian Federation. The structure of general disability due to diseases of the nervous system was dominated by re-recognized persons with disabilities, but their share is lower than in the Central Federal District and the Russian Federation. The structure was dominated by disabled people in the third group with a tendency to increase their specific weight and disability, and there was a decrease in the proportion of disabled people in the I-II group and their levels. Conclusions. The total number of disabled persons among persons of older working age due to diseases of the nervous system in the dynamics of 2012-2018 has steadily increased, the growth rate was 18.6%, which is significantly higher than in the Central Federal District (4.1%) and the Russian Federation (8.2%). The structure was dominated by persons re-recognized as disabled, their share in the dynamics tended to increase, but the figure was lower than in the Central Federal District and the Russian Federation. The general population of persons with disabilities remained at 6,5 ± 0.11 cases per 10,000 of population of the appropriate age. The structure of general disability in severity was dominated by group III persons with disabilities, with a tendency to increase their specific weight and disability level. The proportion of persons with group I-II disabilities and their level tended to decrease

Introduction. The article presents the results of a comprehensive assessment of disease incidence among male workers of shipbuilding and ship repair industries in the Astrakhan Region for creation of an organizational and management model of a comprehensive assessment of their disease incidence at workplaces in order to develop adequate preventive measures that exclude adverse health effects of occupational hazards in male shipbuilders. Materials and methods. Data for analysis were extracted from medical histories of inpatients and medical records of outpatients of the Russian Southern District Medical Center for the period 2015-2017. We applied methods of an opinion poll, expert examinations, correlation and regression analysis, mathematical modeling, as well as software products. Results. We built analytical models to assess health effects of determinants in shipbuilders. We also established the main occupational dangers, risks of occupational diseases, and the correlation between the number of patients and adverse industrial factors. We found that the risk of occupational diseases (0.8) was the highest in men over 45 (31.9 %) exposed to occupational hazards for more than 8.5 years. The lowest risk (0.2) was estimated for men aged 27-39 (68.1 %) with up to 6.6 years of occupational exposure. Conclusion. The organizational and management model was developed for the comprehensive assessment of causal relationships between the duration of exposure of shipbuilders to occupational hazards, the age of the employee, the risk of developing an occupational disease, and adequate preventive measures eliminating health risks and reducing effects of adverse industrial determinants.

Introduction. Maintaining health of the younger generation is one of the priority activities of Rospotrebnadzor bodies and governmental policy. Environmental factors, including chemical contamination of food, play an important role in health preservation. A constant intake of contaminants, even in small concentrations, causes malfunctioning of body organs and systems. Our objective was a comparative analysis of relationship between baby food contamination and disease incidence in children. Materials and methods. We analyzed data of the Federal information Fund of Social and Hygienic Monitoring of the Russian Federation. Results. The analysis of chemical contamination of baby food established that the main food toxicants included lead, cadmium, arsenic, and mercury. The contamination data in the areas were compared with disease incidence rates in the child population. We did a comparative analysis of contamination of food products intended for children aged 0 to 14 and changes in disease incidence rates in children of the same age in the Russian Federation in 2012-2017. The highest concentrations of heavy metals were measured in fruit and vegetable products used as first baby food by most mothers. We found a relationship between toxic elements in baby food and cancer incidence rates in children aged 0 to 14 (r = 0.27; p < 0.05). Conclusion. Measures taken to reduce baby food contamination with chemicals will contribute to prevention and a decrease in disease incidence rates in children.

Introduction. The relevance of the research is attributed to the increased incidence of autoimmune thyroiditis in children, especially those dwelling in contaminated areas. Our objective was to study effects of environmental exposures to industrial chemicals on the course of autoimmune thyroiditis. Materials and methods. In order to establish the relationship between specific features of the course of autoimmune thyroiditis and adverse environmental exposures, we conducted a comparative study of incidence rates of thyroid diseases including thyroiditis, cytotoxicity testing, thyroid status assessment, antioxidant activity assays, and thyroid ultrasound. The observation group consisted of 98 children living the area with the developed metallurgical industry while the comparison group included 23 children living in a recreation area. The groups were matched by age and socio-economic characteristics. Results. We established that thyroiditis incidence rates in the industrially polluted area were almost thrice as high as those in the relatively clean area. The observation group was characterized by smoothed sexual differentiation, earlier development of the autoimmune thyroiditis, higher (up to 1.6 times) frequency of typical diffuse structural changes, and increased thyroid gland. Blood levels of metals having a direct cytotoxic effect on the thyroid gland were 2.0 to 6.7 times higher than normal in the cases compared to their matched controls. The correlation and regression analysis established contribution of chemicals to the increased incidence of autoimmune thyroiditis in children (zinc), antibodies to thyroid gland tissue (lead), thyroid-stimulating hormone (nickel), and decreased resistive indices (lead). Conclusion. High blood levels of lead, nickel and zinc were among the factors having an adverse effect on the course of AIT and thyroid function.

Introduction. Prevention of cardiovascular diseases in young people is a key factor of adults' health care and increase of their life. The purpose of the current investigation was to use indicators of variability of heart rate as a marker of prognosis of risks of cardiovascular pathology in practically healthy young people. Materials and methods of investigation. 63 students (21 young males and 41 young females) at the age of 18-23 years (median age: 20.0 ± 0.15 years) were involved in the investigation by means of cardiorhythmography, registration of blood pressure, calculation of striking power and minute volume, and peripheral vascular resistance. Complex evaluation of the cardiovascular system of medical students of higher medical schools was performed. Results and discussion. Differences in the structure of heart rates as well as rates in correlative connections of heart rhythm between separate rhythms as well as connections of indicators of heart rates with integral indicators of hemodynemics are thought to be connected with the primary type of vegetative regulation. Conclusions. Evaluation of vegetative regulation of heart rhythm in combination with vegetative of hemodynemics allows to determine predisposition to development of cardiovascular diseases in the above mentioned people.

NTRODUCTION. IN ACCORDANCE WITH VALID REGULATORY DOCUMENTS, ADVERSE HEALTH EFFECTS OF OCCUPATIONAL EXPOSURES ARE PREVENTED AMONG RUSSIAN WORKERS BY MEANS OF HEALTHY NUTRITION BUT THE IMPORTANCE OF ITS EFFICIENCY EVALUATION IS OFTEN UNDERESTIMATED. THE OBJECTIVE OF THE STUDY WAS TO ASSESS THE NEED OF CORRECTING MEASURES FOR NUTRITION-BASED PREVENTION OF OCCUPATIONAL DISEASES BASED ON THE RESULT OF BIOLOGICAL MONITORING OF HEAVY METALS. MATERIALS AND METHODS. WE USED ATOMIC ABSORPTION SPECTROMETRY METHODS TO TEST LEAD AND COPPER IN 4,995 BLOOD AND URINE SAMPLES OF NON-FERROUS METALLURGY WORKERS. RESULTS. THE BLOOD LEAD ANALYSIS SHOWED THAT THE MEDIAN BLOOD LEVEL WAS 53.7 ΜG/L WHILE THE LEVEL OF CONCERN (> 100 ΜG/L) WAS DETECTED IN 25.4 % OF WORKERS. URINE LEAD LEVELS EXCEEDED THE BIOLOGICAL MAXIMUM PERMISSIBLE VALUE IN 15.6 % OF WORKERS. THE AVERAGE BLOOD COPPER LEVM EL WAS 979.9 ± 4.1 ΜG/L WHILE THE CRITERIA VALUES WERE EXCEEDED IN 0.1-7.6 % OF WORKERS. HIGH LEAD LEVELS WERE PREVALENT AMONG WORKERS OF MAIN OCCUPATIONS BUT HIGH COPPER LEVELS, ON THE OPPOSITE, WERE MORE PREVALENT IN WORKERS OF AUXILIARY OCCUPATIONS. CONCLUSIONS. THE RESULTS MAY INDICATE THE PRESENCE OF CERTAIN CATEGORIES OF WORKERS HEAVILY EXPOSED TO HEAVY METALS, WHICH IS A DIAGNOSTIC CRITERION FOR TOXIC LOAD AND AN INDICATOR OF INEFFICIENT NUTRITION-BASED DISEASE PREVENTION.

Introduction. The mining and metallurgical industries form the basis of the economy of the Murmansk Region. Working conditions at industrial enterprises, combined with extreme climatic conditions of the Arctic, pose an increased risk of occupational diseases. The purpose of the study was to investigate working conditions and occupational disease rates among industrial workers of the Murmansk Region in 2007-2017. Materials and methods. We studies socio-hygienic monitoring data on working conditions and occupational diseases in the population of the Murmansk Region in 20072017 provided by the Federal Center for Hygiene and Epidemiology of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, Moscow. Results. In 2008-2017, the most common occupational risk factors in the Murmansk Region included noise (25.8%), job strain (17.8%), and chemical factor (12.6%) while 39.2% of workers were exposed to a combination of occupational hazards. Over 10 years, the absolute number of workers exposed to dangerous and hazardous industrial factors decreased by 1.8 times. In the Murmansk Region, 84.3% of occupational disease cases were registered among workers of mining and metallurgical enterprises. In 2007-2017, the region experienced a significant decrease in occupational disease incidence mainly related to job cuts. The role of other factors (improvement ofworking conditions, health promotion) needs to be clarified; yet, it is possible to predict their positive influence on occupational morbidity in the next few years. Conclusion. To achieve a substantial decrease in occupational disease incidence rates, it is essential to keep improving comprehensive measures aimed at preserving workers' health in the Murmansk Region.

Introduction. It has been demonstrated that the use of 2,4-D herbicide contaminates the environment with polychlorinated compounds, including dioxins. Additional risk factors for population health and the environment include climatic conditions of Siberia, processes of translocation of compounds from soil to plants, their ability to reach the human body along trophic chains and to have a toxic effect. The objective of this study was to analyze the behavior of the 2,4-D herbicide and dioxins in the environment and to justify health risk factors. Materials and methods. We used the method of gas chromatography-mass spectrometry that combines high efficiency of separation of impurities, the possibility of determining their molecular composition, selectivity of recording, and high sensitivity. We used a chromatographic method to determine residual amounts of the 2,4-dichlorophenoxyacetic acid amine salt (2,4-D) in soil, feed, and food of plant and animal origin. The calculation of average and statistical errors of indicators was performed using t-test in MS Excel. Results. Contamination of water of open reservoirs of the Irkutsk Region with the 2,4-D herbicide amine salt was found in concentrations as high as 7.7 μg/L with a positive sample count of 49%. In spring and summer, the water of open reservoirs is also polluted. In soils, the 2,4-D amine salt is immobile, concentrated in the surface layer at the level of 0.42-0.37 mg/kg. The maximum total soil concentration of dioxins reached 1,479 ng/kg exceeding the maximum permissible soil concentration of dioxins by 306 times. The maximum concentration of dioxins in feed was found at the end of the growing season (317-322 ng/kg). Dioxins accumulate in fat-containing food; thus, measured dioxin concentrations in butter averaged 680.6 ng/kg demonstrating a 10-fold excess of the permissible level. The estimated daily intake of dioxins with food can be as high as 26.2 pg/kg, which is 2.6 times higher than the permissible daily dose. We conducted the environmental and medico-hygienic analysis of outcomes of using the effective herbicide that poses a serious danger to human health due to the possibility of dioxin formation. We identified risk factors and substantiated the daily dose of dioxins for humans as a temporary value.

The objective of the study was to analyze the results of fulfilling the Action Plan for Implementing the Strategy for Prevention of HIV Transmission in the Volga Federal District in the specified period. Materials and methods. We analyzed data of the state statistical monitoring forms “Information about measures for prevention of HIV infection, hepatitis B and C, diagnosis and treatment of HIV-positive patients” and “Information about the results of blood tests for HIV antibodies” for 2017-2018 submitted by regional AIDS Prevention and Control Centers. Results. We established that, even though the number of HIV-positive persons had increased over the past three years, the percentage of cases receiving medical care remained stable (92.1% in 2018, 92.6% in 2017, and 92.3% in 2016). ART coverage was increasing: the number of patients on therapy significantly exceeded the number of patients in urgent need. We revealed a descending trend in the percentage of patients who discontinued therapy. The coverage by chemoprophylaxis of mother-to-child HIV transmission demonstrated an increasing trend but only 91.3% of pairs received a complete course in 2018. In 2018, 25.1% of VFD citizens were tested for HIV. For the first time, the results of work in the regions of the Volga Federal District were assessed by comparing achieved indicators not only with the district averages but also with the regional target indices. Conclusions. Most targeted indicators of the Strategy were achieved (HIV testing coverage, percentage of HIV positive women in labor who received chemoprophylaxis). We revealed the necessity of continuing efforts to increase ART coverage of HIV-infected persons and to provide its high efficiency.

Introduction. The search for specific molecular and genetic markers of the risk of developing infectious disease complications is a current area of research in modern medical and biological science. Materials and methods. In order to solve this issue, we developed a MiDA software that implements an integrated approach allowing for selection of potential markers on the basis of indicators of expression fold change of a number of genes in the comparison groups and the feature importance for classification, i.e. the assignment of samples to the analyzed groups. Results. Using the MiDA software, we searched for molecular and genetic markers of the risk of developing severe dengue fever and chronic brucellosis. As a result of the study, the HSPA6 gene was proposed as a risk marker for the dengue complication. HSPA6 expression was reduced in the peripheral blood samples of severe dengue cases. Markers of chronic brucellosis included a decrease in the expression of miRNA hsa-miR-198 and hsa-miR-501-3p, as well as an increase in the expression of miRNA hsa-miR-618 in CD4+ T-lymphocytes. Conclusion. We demonstrated the possibility of applying the MiDA software to the analysis of big data obtained using modern techniques (sequencing, biochips, etc.). It is possible to expand the scope of the software application in order to analyze the expression of genes, transcripts and proteins in diseases of various origins, to determine molecular mechanisms of the pathological process, to search for diagnostic and prognostic markers of the disease, as well as potential targets for the development of specific therapies.

Introduction. This article describes the issues of epidemiologic surveillance of actual infectious diseases in the Moscow Region during preparation and hosting of 2018 FIFA World Cup, as well as a set of measures taken by the Moscow Regional Rospotrebnadzor Office to minimize external and internal epidemiologic risks of infection outbreaks including sanitary and quarantine control at checkpoints across the state border of the Russian Federation at Domodedovo, Sheremetyevo, and Zhukovsky airports. The purpose of the study was to analyze the efficiency of work carried out to ensure sanitary and epidemiologic well-being of the local population, guests and participants of the mass international sports event. Materials and methods. The results of long-term observations of infectious diseases and epidemiological monitoring analyzed to identify potential risks. Results. We gained the experience in ensuring sanitary and epidemiological well-being by Rospotrebnadzor bodies during the preparation and holding of large-scale events, including those with international participation. Conclusions. During the preparation and holding of the World Cup, a systematic approach to ensuring sanitary and epidemiologic well-being was implemented. We organized epidemiologic surveillance for daily collection and analysis of epidemiologic data including the analysis of external and internal risks. The actions enabled us to prevent introduction of infections and prevent the formation of group foci of infectious diseases and emergency situations.

Introduction. A comprehensive assessment of external and internal epidemiologic risks of hosting 2018 FIFA World Cup in the Russian Federation was carried out to improve efficiency of the system of preventive measures. Materials and methods. The work was carried out on the basis of statistical data acquired from WHO, Ministries of Health of the countries, local Rospotrebnadzor offices in host cities of the Russian Federation, and available publications. Results. We analyzed current epidemiologic situation in the countries of the world and assessed risks of importation of each infectious disease by participants and guests to 11 host areas. Internal epidemiological risks were assessed. The assessment made it possible to rank external and internal epidemiologic threats by the extent of potential epidemic hazard and take measures to prevent their importation and spread. Conclusions. We established a high risk of importing cholera, malaria, and dengue fever, a moderate risk of importing measles and chikungunya fever, a low risk of Zika virus disease, and the minimal risk of polio caused by wild-type poliovirus, yellow fever, Middle East respiratory syndrome, plague, Lassa fever, Marburg fever, Ebola virus disease, and avian influenza A (H7N9) during the championship. As for the regional threats, then in the Republics of Tatarstan and Mordovia, Nizhny Novgorod and Samara Regions the most significant was hemorrhagic fever with renal syndrome while in the Sverdlovsk Region, Moscow, and St. Petersburg lime borreliosis posed the highest risk. The moderate risk of tick-borne encephalitis was determined in the Sverdlovsk Region, of Crimean hemorrhagic fever - in the Rostov Region, and that of West Nile fever - in the Volgograd Region. Differentiation and ranking of epidemiologic risks by the extent of potential epidemic hazard allowed us to substantiate the main organizational, preventive, and anti-epidemic measures during 2018 FIFA World Cup and ensure sanitary and epidemiologic well-being of the population.