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Public Health and Life Environment – PH&LE

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No 10 (2022)
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COMMUNAL HYGIENE

7-15 728
Abstract

Introduction: The article dwells on major legislative and methodical aspects related to the latest update of the system for air quality management in the country.

Objective: To summarize the experience in applying the health risk assessment procedure to the system of new mechanisms for ambient air quality monitoring and management.

Materials and methods: The study relied on the results obtained by summary estimates of dispersion of emissions from 1.5 to 6.5 thousand sources per city and health risk assessment in twelve cities included in the Federal Clean Air Project. We also analyzed the results of biomedical studies (about two thousand chemical, immunological, and clinical tests done in 2020–2022) in and outside the zones of influence of mining and chemical industries.

Results: Health risks were estimated as unacceptable in the cities included in the experiment on introducing new emission control technologies. In some cases, risks were rated as “very high” for diseases of the respiratory system, blood and blood-forming organs, musculoskeletal system, etc. We substantiated the lists of priority pollutants for emission monitoring and quoting and the lists of priority objects generating unacceptable risks. We demonstrate that the evaluation of health damage as an indicator of realized risks under certain circumstances can serve as yet another evidence of adverse health effects of environmental pollution. We suggest a fundamental algorithm for including the assessment of human health risks and damages into the system of air quality management for elaboration of the existing regulatory and methodological framework of monitoring and standardization.

Conclusions: The procedures of assessing health risks and damages are a significant component of air quality management. Their results ensure adequacy of the monitoring programs to the current situation, make managerial actions more targeted and precise, and guarantee optimal achievement of the major goal to preserve public health through safe and comfortable environment. 

16-24 1725
Abstract

Introduction: The epidemic situation in the territory of the Russian Federation is noted for an increase in waterborne diseases and registration of up to 70 % of cases of acute intestinal infections of unknown etiology on certain territories. Numerous cases of gastrointestinal diseases of bacterial and viral etiology associated with the use of water that complies with regulatory requirements validate the importance of improving criteria for pathogen control in water bodies.

Objective: To substantiate the expediency to expand the list of key microbiological indicators and standards for an objective assessment of safety of various water bodies.

Material and methods: We summarized the results of microbiological testing of water quality and safety in water bodies (potable water, reservoirs, waste water) and substantiated water safety standards proposed by research institutes and centers for hygiene and epidemiology of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) for 2010–2020. Sanitary and microbiological indicators of potable water and water bodies in places of water use of the population were analyzed based on data of Annual Report Form No. 18 for 2017–2021.

Results: Introduction of new indicators and standards for all coliform bacteria, Escherichia coli, and enterococci to control water safety will ensure the absence of waterborne pathogenic and potentially pathogenic bacteria causing gastrointestinal infections. Noncompliance with regulatory requirements for Escherichia coli and enterococci is a strong evidence of recent fecal pollution and the potential epidemic danger of the aquatic environment. Introduction of the Legionella pneumophila indicator to control safety of hot water of centralized water supply, swimming pools and water parks is aimed at preventing Legionella infections in the population.

Discussion: Harmonization of key indicators for all types of water enables determination of the epidemiological significance of a particular water body in transmission of pathogens of intestinal infectious diseases and prediction of the epidemic situation.

Conclusions: The adequacy of the detected key indicators of water safety determines health outcomes. Their excess indicates the extent of contamination and related risks for population health and necessitates prompt managerial decisions and appropriate preventive measures to eliminate adverse health effects of microbiological agents. 

25-32 690
Abstract

Introduction: Noise is one of the priority risk factors for human health and the environment. Urban noise exposure demonstrates a steady increase. New instruments of government regulation are necessary to prevent sanitary and epidemiological ill-being of the population. The existing regulatory framework and methodological approaches facilitate management of the current situation while maintaining health of citizens.

Objective: To zone the territory of a large city by noise levels for the tasks of urban planning and assessment of health risks posed by road traffic noise.

Materials and methods: Data on 4,200 sections of the road network as sources of urban noise with the average daily traffic of ca. 300,000 vehicles were used for acoustic modeling. Complex acoustic calculations were performed using the “Ecolog-Noise” software incorporating current regulations and guidelines on spatial distribution of noise for the entire area of the city within the boundaries of the computational rectangle sized 50 × 35 km and a grid step of 200 meters. The mapping of zoning results was made using geographic information systems. Potential risks of health disorders were assessed in accordance with the current methodology for assessing human health risk posed by traffic noise.

Results: Based on simulation and situational acoustic modeling of spatial distribution, we zoned the territory of the city by noise levels for the tasks of urban development and assessed potential health risks for its citizens. We established zones of acoustic discomfort with the noise levels above 55 dBA and 45 dBA, taken as safety criteria for daytime and nighttime, respectively. Three major zones with different levels of noise exposure were identified: zone 1 (< 45 dBA) with the area of 255.44 km2; zone 2 (45–55 dBA), 263.72 km2; and zone 3 (> 55 dBA), 289.88 km2. We estimated that most city inhabitants (893,306 people) lived in the third zone and were at risk of noise-related health disorders. The results of health risk assessment showed that long-term exposure to urban noise generated moderate risks by 14 years of age and high and very high risks by 45 and 55 years of age, respectively.

Conclusion: Under current circumstances, the use of certain land plots in the city is limited. Such areas require effective noise protection and minimal residential development to eliminate human exposure to harmful noise levels. Our findings have substantiated managerial decisions on the spatial development of urban territories. 

33-39 429
Abstract

Introduction: An urgent problem of aquatic ecotoxicology is the global pollution of the aquatic environment with hazardous persistent organic pollutants (POPs). They persist in the environment despite the ban on their production and use in most industrialized countries. The danger of POPs for humans and animals depends on duration of their stay in the environment (short- or long-term) and pathways into the water body (from local point or diffuse atmospheric sources).

Objective: To determine the quantitative and qualitative composition of different groups of POPs (PCBs, DDT, HCCH) in bottom sediments of some freshwater bodies of the Russian Federation and propose a methodological approach to determining pollutant sources and pathways.

Materials and methods: The study was conducted in 2006–2018 at 13 water bodies of four morphological and hydrological types: large circulating water reservoirs, large lakes, small marsh lakes, and river estuaries. 86 samples of bottom sediments were taken from the surface horizon of 0 to 5 cm. POP concentrations were measured in the air-dried samples by high resolution gas chromatography/mass spectrometry.

Results: The analysis showed that, in most cases, POPs entered the studied freshwater bodies with precipitation. That was evidenced by the spectra of their qualitative composition transformed towards dechlorination compared to the initial commercial products, even spatial distribution, and a low content. We found, however, that POPs still get into some water bodies from industrial sources, as shown by the unchanged spectrum of their qualitative composition relative to the initial commercial products, gradient spatial distribution, and high concentrations.

Conclusions: To establish the main pathways for POPs to get into water bodies, it is necessary to analyze the upper layer of silty bottom sediments, evaluate the total content of each pollutant and its individual components (homologous groups, metabolites, isomers), and determine spatial distribution of compounds in the water area. 

OCCUPATIONAL MEDICINE

40-47 549
Abstract

Introduction: Health maintenance in workers implies assessment of occupational risks and development of techniques of their elimination in order to increase labor efficiency and working life expectancy.

Objective: To develop the system for maintaining health of social workers based on occupational risk assessment and management.

Materials and methods: In 2019–2022, studies of working conditions, socio-demographic status, and psychological wellbeing of social workers were conducted in the clinic of F.F. Erisman Federal Research Center for Hygiene.

Results: We established groups of social workers at risk of health disorders, such as common diseases and various manifestations of occupational burnout, including groups with null, early, and severe signs of job burnout, and elaborated programs for disease prevention incorporating targeted techiques of health maintenance.

Conclusion: We provide a rationale for the system of preserving physical and mental health of social workers that contains various modules aimed at optimizing working conditions, mitigating risk factors, preventing health disorders, including occupational burnout, and promoting a healthy lifestyle. 

48-57 509
Abstract

Introduction: Metallurgical workers are heavily exposed to a combination of occupational stress factors.

Objective: To assess the adaptive risk for metallurgists depending on duration of work under hazardous working conditions, to identify markers of impaired neurohumoral regulation of the heart rate indicating an increased risk of cardiovascular diseases in workers with little work experience.

Materials and methods: The study included 222 male metallurgists with the mean age of 38.8 ± 0.39 years and the mean duration of work of 12.9 ± 0.43 years. Parameters of the functional state were assessed by general clinical and biochemical methods. The adaptive risk was estimated using heart rate variability indices according to the method by R.M. Baevsky. We then analyzed the relationship between the adaptive risk and the functional state parameters, including blood levels of copper, zinc, selenium, and formaldehyde.

Results: When assessing heart rate variability parameters depending on the length of service, a significant reduction in the total power of the spectrum (r = –0.28, p = 0.000037) and the share of parasympathetic regulation (pNN50: r = –0.295, p = 0.000012) against an increase in the share humoral-metabolic influences (VLF %: r = 0.16, p = 0.02) were established. The registered adaptive risk correlated with an increase in blood pressure (r = 0.3, p = 0.0000; r = 0.25, p = 0.0003), glucose (r = 0.23, p = 0.001), total cholesterol (r = 0.21, p = 0.002), and serum copper (r = 0.22, p = 0.001). One of the signs of unsatisfactory adaptation in workers with little experience was an increase in the adaptive risk by more than 2 CU and in the electrical instability of the heart.

Conclusion: The adaptive risk in metallurgists correlates with the length of service and is associated with adverse health changes in workers. Among the metallurgists with less than 10 years of experience, signs of poor adaptation to industrial stress are registered, which is the basis for forming groups at risk of health disorders among such workers. 

58-66 627
Abstract

Introduction: The professional use of personal protective equipment (PPE) eliminates occupational exposure of personnel to pathogens that cause infectious diseases, including COVID-19. Apart from the risk of exposure to biological hazards, healthcare workers are at risk of impaired work performance and work-related diseases posed by adverse health effects of PPE itself.

Objective: To make a physiological and hygienic assessment of personal protective equipment against biological hazards used by healthcare professionals.

Materials and methods: We evaluated the thermal state of the body in 13 volunteers under simulated conditions of the Tabai temperature and humidity chamber (Japan). The study design included a physiological and hygienic assessment of four variants of protective suits, all compliant with recommendations of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) for use when working with microorganisms of risk groups I and II. We studied the physiological response of the thermoregulatory system to heat exposures in terms of indicators characterizing the temperature of the “core”, the temperature of the “shell”, and their integral indicators (weighted mean skin and body temperatures). Changes in the fluid and electrolyte metabolism and the functional state of the cardiorespiratory system were assessed based on objective (sweat and heart rates) and subjective (heat sensation) indicators.

Results: At the air temperatures of 25 and 30 °C, the maximum thermal exposure was registered in the volunteers wearing coveralls made of nonwoven material of the Tyvek type (China). A suit made of polyester fabric with a polyurethane membrane coating (Russia) had a less pronounced effect on the thermal state of the body. The minimum core and shell temperatures were noted for the suits made of polymer-viscose dustproof, water-repellent twill weave fabric (Russia) and Barrier 2X fabric (Russia).

Conclusion: The excess of established values of the thermal state of the body during medium work was observed for all types of the studied suits both in permissible (25 °C) and harmful (30 °C) microclimate conditions. To prevent ill-being of medical personnel, it is necessary to schedule work taking into account the type of PPE used, the intensity of physical activity, and indoor microclimate parameters. 

67-74 1420
Abstract

Introduction: Under current conditions of work intensification and introduction of information and communication technologies, there arise risks of developing the syndrome of emotional burnout, anxiety and depressive disorders among workers in various occupational cohorts.

Objective: To analyze scientific publications and to establish the prevalence of psychological and emotional problems among people working under conditions of increased work intensity in order to identify predisposing factors, determine occupational cohorts at risk, and prevent burnout, anxiety and depressive disorders.

Materials and methods: A scientific review of studies published in 2005–2022 in the Russian and English languages was carried out using such information platforms and databases as eLIBRARY.ru, Web of Science, PubMed, and Scopus. The search terms included work intensity, burnout syndrome, anxiety disorders, and depression. We chose prospective studies, in which neuropsychic stress at the workplace was assessed as an occupational health risk. Of 282 search results, 51 publications on psychological and emotional ill-being posed by neuropsychic overstrain were found eligible for inclusion in this review.

Results: We established a high prevalence of psychological and emotional problems among workers in various occupational cohorts, including nurses, medical doctors of various specialties, teachers, psychologists, journalists, athletes, policemen and penitentiary police officers, emergency service members. Features of clinical manifestations of burnout symptoms, anxiety and depressive disorders in workers experiencing increased tension were discussed. Our findings showed that psychosocial risk factors for burnout, anxiety and depressive disorders were role uncertainty, role conflict, role stress, stressful events, workload, and pressure at work, and that burnout was associated with various non-occupational diseases.

Conclusion: We highlight the necessity of assessing psychosocial factors at workplaces and screening for psychological and emotional disorders of employees for early diagnosis of burnout and related conditions and elimination of their negative outcomes at the individual and societal levels. We propose introduction of the international COPSOQ tool (the Copenhagen Psychosocial Questionnaire) into domestic healthcare practice to conduct a comprehensive individual assessment of psychosocial factors and to facilitate timely and appropriate preventive measures at work. 

75-80 1883
Abstract

Introduction: A cellular base station is a sophisticated object, a source of radio and industrial frequency electromagnetic fields and of noise pollution. Cell sites generate a complex, time-varying, modulated multi-frequency signal of low intensity, yet having local gradients. The World Health Organization has introduced the notion of electromagnetic pollution of environment, the main source of which is a mobile phone base station. It is the fastest-growing anthropotechnogenic environmental impact since the 1950s.

Objective: To analyze the impact of mobile phone base stations on the health of population using data of domestic and foreign literary sources.

Materials and methods: A literature search was conducted for the years 2008 to 2022 on human health effects of radiofrequency electromagnetic radiation from cellular base stations using the relevant keywords in the PubMed, Scopus, Web of Science, Medline, the Cochrane Library, EMBASE, Global Health, CyberLeninka, RSCI, and other databases. The initial sample included 50 articles, of which 15 were excluded after primary screening. Experimental studies on animals were not eligible for inclusion. Results: The review of 35 full-text publications on the topic revealed a sufficient amount of evidence of adverse health effects of radiofrequency electromagnetic fields, including the radio frequency sickness, cancer, changes in biochemical parameters, DNA damage, etc. Currently, there is an urgent need to resolve the problem of the so-called electrosmog.

Conclusion: In order to prevent the diseases associated with the use of novel technologies, it is important to apply a preventive approach by limiting the exposure of groups at risk, such as children, adolescents, patients with chronic diseases etc., to sources of radiofrequency electromagnetic fields. 

FOOD HYGIENE

81-91 570
Abstract

Introduction: Development of a socially oriented state in a modern dynamic and ever changing world necessitates improvement of control and inspection in the sphere of food security, the most important element of which is laboratory testing.

Objective: To analyze the experience of introducing advanced methods of food safety and quality testing into the current system of state sanitary and epidemiological surveillance.

Materials and methods: We analyzed 92 information materials, 1,110 test reports, 18 organizational and administrative documents, and 18 guidelines issued by the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing and the Federal Center for Hygiene and Epidemiology and its affiliates in constituent entities of the Russian Federation on laboratory testing of food products in the years 2017–2021 within execution of orders of the Russian government. We used methods of statistical observation, data grouping, and comparative analysis of absolute and relative values.

Results: In 2017–2021, efforts for improvement of food safety and quality testing were focused on detection of residual antimicrobial agents, detection and identification of undeclared and potentially hazardous unintentionally present or added substances, and food quality monitoring. Reference laboratory centers equipped with modern high-precision equipment have been established for each of the directions and new methods have been developed and introduced. We observed a 9.4-fold increase in the number of tests for undeclared substances and antimicrobials in foods (from 20,002 in 2017 to 188,698 in 2021) and a 6.4-fold increase in the total number of samples tested (from 4,014 to 25,611). The number of tests performed using HPLC-MS/MS and the enzyme-linked immunosorbent assay increased by 32 and 4.2 times, respectively. We noted a 3.2-fold increase in the number of samples found to contain undeclared and potentially hazardous unintentionally present substances.

Conclusion: Supplying reference laboratory centers with modern high-precision equipment, developing, certifying and imple- menting new methods of testing, expanding the range of reference materials in the years 2017–2021 enabled effective detection and identification of undeclared and potentially hazardous unintentionally present/added substances, residual amounts of antimicrobial drugs, and effective food quality monitoring in all regions of the Russian Federation. 

92-100 631
Abstract

Introduction: The relevance of providing healthy nutrition for school-age children, a significant coverage of students with school meals, and an increase in the proportion of children requiring correction of the diet have determined the objective of the study to evaluate school feeding and to substantiate further measures for its improvement.

Materials and methods: Twenty-six regulations on school meals adopted from the year 2000 to the present have been analyzed. The study of the eating schedule and the frequency of consumption of certain foodstuffs was carried out based on a survey of 1,975 parents and schoolchildren in grades 5 to 11. The energy value, the content of vitamins and minerals in school breakfasts and home meals of 1,168 fifth graders from the city of Minsk were estimated.

Results: The findings show that regulations on school meals have been developed in the republic; dietary nutrition is organized at schools, the material and technical base of school kitchens is constantly being improved, and children are being taught healthy eating skills. At the same time, the analysis of actual nutrition at school and at home indicates malnutrition causing an imbalance in the dietary intake of macro- and micronutrients.

Discussion: An effective model of school feeding has been created in the Republic of Belarus. Yet, the current system cannot fully ensure a balanced diet for children. It is therefore important to continue personnel training, monitoring of school meals using modern information technologies, and awareness raising on healthy eating among schoolchildren. 



ISSN 2219-5238 (Print)
ISSN 2619-0788 (Online)