Introduction: Within the framework of the Federal Clean Air Project, it is envisaged to implement comprehensive action plans aimed at reducing air pollution and increasing the level of public satisfaction with the environmental situation in a number of industrial centers of the Russian Federation with high and extremely high levels of ambient air pollution. Decree No. 1792 of the Russian Government of December 24, 2019 approved the requirements for compensatory measures aimed at improving ambient air quality, preventing and eliminating adverse health effects of environmental factors. To increase the validity and adequacy of the measures taken, it is necessary to elaborate method approaches for Rospotrebnadzor bodies to designing and conducting studies on establishing the association between air pollution and adverse health outcomes in the population living in industrially contaminated areas. The purpose of our work was to substantiate an algorithm of actions and to demonstrate its efficiency within epidemiological studies focused on establishing and proving the causal relationship between airborne chemicals and observed health consequences in the population. Materials and methods included a set of modern hygienic and epidemiological research methods, assessment of risk and its health damage, in-depth research, and modeling of cause and effect relationships. Results: We proposed approaches and conducted studies to establish the link between industrial air pollution and the diseases diagnosed in the exposed population. Conclusions: The suggested algorithm of actions tested in the city of Bratsk proved to be effective and helped identify risk-attributed health disorders; specify the pollutants requiring development or adjustment of measures to reduce their ambient emissions; clarify and expand the list of target organs and systems for prediction and monitoring; substantiate and fulfil managerial decisions and adequate targeted preventive measures based on health damage criteria.

Introduction: Comprehensive risk management considering behavioral risk factors is a possible way to minimize adverse health effects of occupational factors. The purpose of the study was assess behavioral risk factors and to develop appropriate measures for preventing occupational diseases in oil refinery operators. Materials and methods: The observation groups included crude oil treatment operators of Ritek LLC in the Volgograd Region located in the subarid climatic zone. The first group consisted of 100 workers under the age of 35 while the second group consisted of 106 workers aged 36-60. Previously published studies were used to substantiate priority occupational risk factors for the operators. To assess lifestyle habits, we conducted a questionnaire-based survey and analyzed data in terms of their statistical significance and real controllability using a multidimensional confirmatory factor analysis. Results: We established that the priority occupational health risks of operators in the climatic conditions of the Volgograd Region included labor severity and intensity (3.1) and hot environment (3.2) posing a high occupational risk of disrupting the thermal state (overheating) of workers. We also identified typical behavioral risk factors, the prevalence and quantitative burden of which was age-specific. In the younger age group, bad habits and poor healthcare activity (reluctance to seek medical advice) generated the highest burdens (943 conditional units each) while in the older age group, major burdens were generated by bad habits and malnutrition (849 and 501 units, respectively). The developed mathematical model proved that a comprehensive health risk management for workers exposed to occupational hazards is feasible by correcting certain behavioral risk factors: a 10 % and 50 % decrease in the burden of bad habits and poor healthcare activity led to a 1.1 and 1.5-fold decrease in the extent of health risk, respectively. Conclusion: The study revealed the most significant behavioral risk factors affecting health of oil refinery operators and substantiated options of the most optimal interaction between the elements of the system reducing the overall risk to human health. Comprehensive health risk management based on optimal interaction of system elements (both occupational and behavioral risk factors) reduces health risks for oil refinery operators.

Introduction: Professional populations have significant differences related not only to the specifics of working conditions, but also to numerous socioeconomic circumstances of their formation (education, income, lifestyle, etc.). This fact impedes selection of adequate occupational groups for comparison and identification of workers requiring priority therapeutic and preventive measures. Materials and methods: We compared three different cohorts of workers exposed to occupational hazards by indicators of cardiovascular performance, body weight, anthropometric parameters, results of a questionnaire-based survey and clinical examination. According to a developed method of visualization of individual parameters, we established the employees with the most significant deviations from the average group values, especially those of blood pressure, heart rate, and whole-body fat percentage. Results: The comparison of three groups of workers demonstrated a possible dependence of health status not only on occupational but also on social and household factors. Examples of identifying individuals with the most altered health indicators using radar charts are presented. Conclusions: The proposed method of individual health risk assessment in industrial cohorts based on comparing personal parameters with the group averages contributes to elaboration and better choice of preventive programs. The use of visual presentation of individual indicators against group averages in radar charts helps identify risk subgroups requiring special attention.

Introduction: Pathology of the musculoskeletal system remains a complex medical and social problem due to a high prevalence of injuries and the severity of social consequences including incapacity for work and disability. Our purpose was to study the structure and dynamics of recurrent disability of the adult population in Moscow resulting from musculoskeletal injury outcomes in comparison with the indicators for the Central Federal District and the Russian Federation as a whole in 2012-2017, in order to develop appropriate measures for medical and social rehabilitation. Materials and methods: We studied cases of recurrent disability resulting from musculoskeletal injury outcomes in people aged 18 and older in Moscow (9,787), the Central Federal District (55,363) and the Russian Federation (246,376) using the electronic database of the unified information and analytical system of medical and social expertise, statistical observation forms No. 7, Social Security (“Sobes”), and digests of the Federal Bureau of Medical and Social Expert Examination of the Ministry of Labor and Social Protection of the Russian Federation. We applied methods of data copying, comparative analysis, and descriptive statistics (extensive and intensive indicators, significance tests (p)). Results: We established a decrease in the number of cases of recurrent disability both in Moscow and in the Central Federal District and the Russian Federation in 2012-2017. The proportion of such cases in Moscow was higher than in the Russian Federation, but lower than in the Central Federal District while the rate of recurrent disability of the adult population resulting from musculoskeletal injury outcomes in Moscow was lower than that in the district and the country as a whole. Most cases of recurrent disability were persons of working age (18-44 years of age): the extensive indicators were higher in Moscow while the intensive indicators in Moscow were lower than in the Central Federal District and the Russian Federation. As for the severity of disability, then persons with grade III disabilities predominated; their percentage was higher in Moscow but the disability rate there was still lower than in the Central Federal District and the Russian Federation. Conclusions: The study of recurrent disability resulting from musculoskeletal injury outcomes in Moscow in 2012-2017 revealed that novel approaches to carrying out expert rehabilitation diagnostics contribute to a more accurate assessment of severity of impairments and selection of appropriate age and sex-specific rehabilitation measures promoting effective rehabilitation and social integration of people with disabilities.

Introduction: The problem of human interaction with the environment acquires special importance nowadays. Significant migration processes observed in the last decade have become global, thus necessitating studies of the mechanisms of human adaptation to new environmental conditions. Our objective was to study age-related changes in functional indices of the cardiovascular system in adolescents between 11 and 17 years of age, born in Magadan in the first to third generation of Caucasians who had migrated to this city. Material and methods: In all, 1,442 school-age adolescents were examined including 809 boys and 633 girls. The main anthropometric parameters (body weight, kg, and height, cm) were measured and cardiac hemodynamics was determined at rest in the sitting position by volumetric compression oscillometry using a non-invasive hard- and software unit for central hemodynamic study. Results: Significantly higher values of cardiac output and stroke volume prevailed in boys of all age groups. The boys aged 14-17 years also demonstrated higher values of systolic blood pressure and left ventricular power output compared to girls. At the same time, the girls had higher age-specific indices of the heart rate, diastolic blood pressure, and total peripheral resistance. Conclusion: We established that the highest rates of cardiovascular functional development occur during puberty in 11 to 16-year-old boys and 11 to 13-year-old girls. Our findings showed that only 70.2 % to 77.2 % of the boys and 75.1 % to 80.2 % of the girls had blood pressure and heart rate readings within the age norm. Prehypertension was registered in 11.3 % and 10.3 % while hypertension was observed in 11.5 % and 9.5 % of the examined boys and girls, respectively. Tachycardia at rest was noted in 18 % of the boys and 20.2 % of the girls.

Introduction: At present, training of highly qualified military personnel including cadet corps students acquires special importance. Educational programs in cadet corps provide for high daily physical activity of students. At the same time, daily food rationing regulated by current sanitary norms and rules does not comply with higher energy expenditures of such students. The purpose of our study was to substantiate a healthy diet of students of boarding schools taking into account their total daily energy expenditures, calorie needs and requirements for micro- and macronutrients ensuring a high level of functional state of the body, high mental and physical performance. Materials and methods: We studied indicators of health status and physical development of cadets based on the results of medical examinations, results of assessing daily physical activity, and school meals. Daily timekeeping and pulse measurements were used to estimate daily energy expenditures and activity levels. Evaluation of nutrition was based on the analysis of a cyclic menu, process charts, menu layouts, and catering hours. Conclusions : The regulated daily norms of food products adopted in cadet corps subordinate to the Ministry of Education of the Russian Federation are significantly lower than actual energy expenditures of their students. This reality determines the necessity of revising food rationing. Draft guidelines for hygienic justification of the recommended diet for students with a higher level of physical activity have been developed. The proposals for improvement of boarding school meals were included in the appropriate sanitary rules and regulations within the framework of the regulatory guillotine.

Introduction: The necessity to assess, prevent and correct element-dependent diseases, increase the level of safety, predict and reduce the risk of exposures to industrial contaminants in the development of dental diseases in the child population is an important and promising area of modern hygiene. The objective of our study was to establish concentrations of trace elements in dental tissues of children exposed to various levels of industrial pollution. Materials and methods: We used atomic absorption spectrophotometry to measure 13 trace elements in extracted healthy and carious primary teeth in two groups of children aged 7-11. The first group consisted of 56 children living in the area with a significantly high level of anthropogenic burden (C_{averaged total} = 1.17 units) and a high prevalence of caries (86.9 %) while the second group consisted of 68 children living in the area with a relatively high level of anthropogenic burden (C_{averaged total} = 0.68 units) and a mean prevalence of caries (77.1 %) according to WHO criteria. Results: Our findings indicate that accumulation of toxic microelements in hard dental tissues of children in the first group was higher than in children of the second group: concentrations of lead, bismuth, cadmium and strontium were 2.6, 1.8, 2.5, and 1.2 times higher, respectively. We also observed higher accumulation of environmental toxicants in carious teeth compared to healthy ones. Thus, lead, cadmium and bismuth levels in carious teeth were 3.04, 1.2 and 3.13 times higher than in healthy teeth, respectively, while the level of strontium was, on the opposite, 2.5 times lower. Conclusions: The study revealed specific features of the interaction of essential trace elements in children in the form of antagonistic effects between cadmium and zinc, copper and manganese, and synergism in the content of copper, iron, nickel, zinc, and cobalt in healthy teeth, the mechanism of which is based on competition for a bond with a carrier substance and replacement of one element with another. In addition, we established that changes in the microelement balance in the hard tissues of healthy and carious teeth are not unidirectional in nature, thus reflecting complex interactions between the child's organism and anthropogenic factors. The results proved that accumulation of toxic trace elements in hard dental tissues promotes caries development and causes a sharp decrease in the content of essential trace elements, especially chromium, manganese, iron, and copper. The study showed that hard dental tissues are a depot for lead, cadmium, bismuth, and strontium in children environmentally exposed to high levels of industrial chemicals. Features of developing an imbalance of biotic concentrations of essential elements and accumulating toxic microelements in children with pollution-related tooth pathology were also established.

Introduction: In the modern urbanized environment, there is a tendency of increasing environmental stress related to the growth of technical equipment, intensification of the use of urban areas and the development of the complex transport network, which is a source of noise and air pollution. Understanding of this problem served as an incentive to conduct a sanitary inspection of the main transport routes of Omsk, which is an industrial metropolis with an irrational distribution of traffic flows, a large number of cars, and a practical absence of roadside landscaping. Our objective was to assess the main transport routes in the city of Omsk by studying the intensity of traffic flows, measuring traffic noise level and carbon monoxide (CO) concentrations on the roadway and in adjacent residential areas. Materials and methods: All measurements were taken during off-peak hours. Vehicle traffic counting was used to establish the proportion of freight and public transport cars in the total number of passing vehicles. The study objects included traffic density (the number of vehicles per hour), the average velocity of the traffic flow, the type of roadway coverage, the presence of a dividing line, and the type of highway noise barriers used. Results: Our findings showed that road traffic noise levels and CO concentrations measured at the highways and at the border of adjacent residential areas exceeded their maximum permissible values. Measures to reduce adverse health effects of traffic noise pollution and on-road vehicle emissions of carbon monoxide are proposed.

Introduction: A human health risk assessment is the process to estimate the nature and probability of adverse health effects in humans who may be exposed to various environmental factors. The purpose of the study was to analyze climatic parameters as potential health risk factors for the population of some municipalities of the Krasnoyarsk Region. Methods: We processed meteorological data of the state monitoring network in the Krasnoyarsk Region including the average, maximum, and minimum air temperatures measured every three hours in an automatic mode in accordance with a generally accepted international protocol. Climate characteristics were identified using the method of long-term distribution of average daily temperatures. To assess the climatic features of the Krasnoyarsk Region, we considered such parameters as the average seasonal temperature, dates of air temperature stable transition through zero, temperature waves, extreme daily temperature changes, and bioclimatic indices. Results: We analyzed climate characteristics as potential health risk factors for the population of six cities of the Krasnoyarsk Region (Achinsk, Kansk, Krasnoyarsk, Lesosibirsk, Minusinsk, and Norilsk) for the period from 1919 to 2019. Conclusion: Our findings may be used to establish the relationship between a combination of climatic factors and ambient air quality indices and morbidity and mortality of the local population; they can also contribute to predicting death rates in the region.

Introduction: As of today, acute viral upper respiratory tract infections (URTIs) remain the most common diseases in the world and the Russian Federation and one of the most important problems of national health care. The objective of our work was to study the dynamics and intensity of the epidemic process of influenza and other URTIs in the Russian Federation and Rostov Region over a thirty-year period and to establish the main features of the disease incidence in the Rostov Region. Materials and methods: We analyzed data of annual State Reports on Sanitary and Epidemiological Wellbeing of the Population in the Russian Federation and Statistical Form No. 2 on information about infectious and parasitic diseases for the period 1990-2019 and data on the size of population using StatSoft STATISTICA 6.1.478 Russian, Microsoft Excel, and Next-GIS QGIS software. Results: We found that in 1990-1999, 2000-2009, and 2010-2019, regional URTI rates tended to decrease in each subsequent decade compared to the previous one. The long-term incidence rate of URTIs in the Rostov Region was 16,099.2 ± (2.045 x 384.2) %ооо, lower than the Russian average rate of 19,710.3 ± (2.045 x 326.4) (p = 0.05). The amplitude of fluctuations in the incidence was 8,015.4 %ооо and 7,619.6 %ооо in the Rostov Region and the Russian Federation, respectively. Until 1997, regional incidence rates were comparable to the national averages but demonstrated an upward trend since the year 2000. We revealed unevenness of the course of the epidemic process related to cyclicity, with an increase in the duration of cycles since 1998. It was determined that the regional incidence of influenza was significantly lower than the national average and had a tendency to decrease. The long-term influenza rate in the Rostov Region was 412.4 ± (2.045 x 131.3) (p = 0.05) or almost three times lower than that in the country 1,553.0 ± (2.045 x 301.2) (p = 0.05). The dynamics of influenza incidence in the Rostov Region also had a cyclical course with a smaller amplitude of fluctuations (3,215.1 %оо) than in the Russian Federation (5,164.8 %оо). The duration of epidemic cycles in 1990-1998 and 2002-2012 was two years but we noted a three-year cycle in 1999-2001. We established a correlation between influenza and URTI rates and population density in regional cities and various age groups: the highest URTI rates (74.9 %) were registered in children between two to 17 years of age while 52.5 % of influenza cases were adults (aged 18+). Conclusion: The established characteristics of the development of the epidemic process of influenza and URTIs in the Rostov Region prove the necessity of a differentiated approach to organizing and implementing comprehensive preventive measures within optimization of epidemiological surveillance of these diseases, and can also serve as basic criteria for disease prediction.

Introduction: The urgency of the problem of trichinosis in the Ural Federal District is determined by diversity of animal species, both intermediate and final hosts of Trichinella, and adverse effects of anthropogenic factors on the epizootic situation. The purpose of the study was to generalize and analyze long-term monitoring data on the species structure of Trichinella hosts, the level of infestation, and the intensity of invasion in wild and domestic mammals in various invasion reservoirs. We analyzed information about complex ecological interactions in the foci, environmental and geographical features and their role in the pathogen circulation. Our findings can serve as the basis for epizootiological monitoring in constituent entities of the Ural Federal District and elaboration of preventive measures. Materials and methods: We reviewed literary sources on the topic published since the late 1960s, analyzed information bulletins of the Federal Center for State Sanitary and Epidemiological Surveillance and the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) reporting trichinellosis rates and preventive actions as well as publications of the same body on epizootiological characteristics of trichinosis, and information issued by regional offices of veterinary medicine and the Federal Service for Veterinary and Phytosanitary Surveillance (Rosselkhoznadzor). The analytical method and the comparative historical research method were applied. Results: We established the relevance of the problem of trichinosis in the Ural Federal District. The natural reservoir of Trichinella in the area is provided by a detachment of carnivorous mammals (Carnivora) of the bear (Ursidae), canine (Canidae), mustel (Mustelidae), and feline (Felidae) families. Natural reservoirs with varying degrees of extensiveness and intensity of invasion in wild animals determine danger of transition of invasion into the synanthropic environment with the formation of local foci. The presence of foci at risk of infection depends on the frequency of contact with the invasive onset. In view of local synanthropic and natural diffuse foci found in different parts of the Ural Federal District, adverse anthropogenic impacts, and complicated socio-economic problems, the need for epidemiological monitoring (both epidemiological and epizootiological observations) of biocenotic components of the territories acquires special importance and requires constant attention of responsible governmental services to the epizootic and epidemiological situation.