ISSUES OF MANAGEMENT AND SOCIAL HYGIENE
Introduction: The dynamics of socio-economic development of the society and emergence of unpredictable large-scale events determine the necessity of creating a classifier of public health challenges.
The purpose of the study is to develop a methodological approach to compiling a public health challenge classifier.
Materials and methods: We elaborate on our methodological approach to creating a classifier of public health challenges developed through systematization of provisions of GOST R ISO 31000-2019 and “The urban health index: A handbook for its calculation and use” by the World Health Organization. The use of these documents as a basis is justified by the fact that public health challenges entail risks of not achieving strategic targets for maintaining and improving public health. We reviewed 36 scientific papers published in 2002–2023 and found in PubMed, SCOPUS, and eLibrary.ru using the following keywords: risk, public health challenges, and disasters. The method of expert assessments was applied to select indicators of challenge differentiation. Experts were chosen from among public health professionals given established criteria and their opinions were then evaluated for consistency using the coefficient of concordance. The examples of public health challenges were considered based on the reports of the Russian Ministry of Emergency Situations.
Results: The classifier of public health challenges implies assignment of challenges to a certain category depending on the level of implementation (occurrence), as well as the expected graveness of consequences. Classification by the level of implementation includes federal, regional, and municipal levels while that by the severity of consequences – high, moderate, and low categories of expected negative consequences. Such classification takes into account the division of powers between the authorities of different levels to ensure feasibility and effectiveness of subsequent application of response tools.
Conclusion: The methodological approach considering key characteristics of public health challenges, correct classification of the latter, and timely use of emergency response tools will ensure public health maintenance in the Russian Federation on the federal, regional, and local levels.
MEDICAL SOCIOLOGY
Introduction: The COVID-19 pandemic has changed usual behavior and habits, including dietary practices, of Russian people, which has implications for public health.
Objective: To identify specifics of transformation of dietary practices of Russians before, during and after the COVID-19 pandemic in order to establish the impact of conditions and context of this infectious disease spread on eating behavior and habits.
Materials and methods: We used the method of content analysis of unique Russian-language messages from the VKontakte and Odnoklassniki social networks (145 thousand messages). Data were collected using the IQBuzz social media monitoring service during three time spans: before (January 1, 2018 to February 28, 2020), during (March 1, 2020 to June 30, 2022), and after the COVID-19 pandemic (July 1, 2022 to August 31, 2023).
Results: We found that, regardless of the time span under study, Russians consider fruits and vegetables (26.9 %), dairy and fermented milk products (12.6 %), water (9.0 %), tea (10.0 %), and meat (8.3 %) as key components of a healthy diet. Attempts to cope with stress caused by the pandemic were manifested by a 2.6-fold and double increase in the number of festive feasts during and after the pandemic, respectively; cooking for relaxation; higher consumption rates of sweets (before – 3.9 %, during – 6.2 %, and after – 5.1 %) and alcohol (3.6 %, 3.2 %, and 4.3 %, respectively). The persistence of high social tension deepened the practices of emotional eating of sweets and drinking alcohol. We observed a shift from traditional offline shopping to a widespread use of online services, which became a sustainable norm of consumption after the pandemic.
Conclusion: Health maintenance is closely related with food choices and eating behavior, so healthy eating has become a more frequent topic of discussion after the pandemic. Our findings suggest that the majority of Russians are stable in their dietary practices in the context of preserving health.
Introduction: People of many countries have become more susceptible to health risk behavior during the COVID-19 pandemic. Modern experts have studied psychological, but not psychosomatic outcomes of this susceptibility.
Objective: To examine somatic symptoms and health risk behavior, their prevalence and associations among Russian youth during the COVID-19 pandemic.
Materials and methods: In 2021–2022, 1,050 young Russians aged 18 to 25 years were surveyed. They filled out the Patient Health Questionnaire-15 and a form containing questions about behavioral patterns in relation to sleep, diet, smoking, alcohol consumption, and physical activity during the COVID-19 pandemic.
Results: Among the respondents, 32 % were somatized, 79 % slept less than 7 hours a day, 89 % ate junk food, 40 % smoked regular or electronic cigarettes, 46 % often consumed alcohol, and 81 % had low physical activity. Somatization was more frequent in women, while health risk behavior was more common in men and the respondents with somatic symptoms.
Conclusion: It is important to develop and implement programs of psychological education and prevention of somatization and health risk behavior.
COMMUNAL HYGIENE
Introduction: The use of antibiotics in medicine and veterinary medicine has led to their accumulation in the natural environment, including source water, and antimicrobial resistance of certain types of bacteria. The development of methods for analyzing antibiotics in aquatic environments is relevant for ensuring tap water quality control at the level of hygienic standards, as well as for studying the process of development and spread of antibiotic resistance.
The purpose of the study is to develop a method for determining such antibiotics as macrolides, penicillins, and fluoroquinolones in water at the level of hygienic standards using HPLC/MS-MS.
Materials and methods: To elaborate the method, testing was done by HPLC/MS-MS using a liquid chromatograph with a triple quadrupole mass spectrometer. Extraction of antibiotics from various types of water samples (tap, natural) was carried out by solid-phase extraction.
Results: We have developed a selective and highly sensitive method for the determination of eight antibiotics in water samples. The extraction efficiency for analytes ranged from 72 to 100 % and measured concentrations – from 0.25 to 2.50 of hygienic standards when analyzing 10 cm3 water samples; the relative error in determining antibiotics in water samples without concentration was 20–24 %, and 24–34 % in case of concentration on Oasis® HLB sorbent.
Discussion: Approaches to developing a method for quantification of antibiotics of the penicillin, macrolide and quinolone classes in water by HPLC/MS-MS using solid-phase extraction for sample preparation are considered. The results are consistent with the data of scientific, technical and methodological literature. The advantages of this method include shorter sample preparation time, high sensitivity, and a small sample size.
Conclusion: Our method can be used in hygienic studies of residual amounts of antibiotics to assess source water quality.
PEDIATRIC HYGIENE
Introduction: One of the tasks of preventive medicine and hygiene is to study the relationship between environmental factors and human health.
The purpose of the study was to compare pediatric prevalence rates in the Astrakhan Region and in the city of Astrakhan in 2007–2020 with those for the Russian Federation in relation to per capita emissions of environmental pollutants.
Materials and methods: We used official statistics on the size of population, prevalence rates in children, and emissions of air pollutants in the Astrakhan Region for the years under study. Methods of mathematical and statistical analysis, construction of trend lines and calculation of linear regression equations using built-in Microsoft Excel software were applied. An online Spearman’s Rho Calculator was used to compute correlation coefficients.
Results: The prevalence in children showed a statistical downward trend both in Astrakhan and in the Astrakhan Region as a whole with its rates being, on average, 7.8 % and 15.6 % lower than the national ones, respectively. The Spearman’s Rho (rs) showed the presence of a high and direct statistically significant correlation between per capita emissions of air pollutants and disease prevalence in the child population in the Astrakhan Region (rs = 0.73; p = 0.003) with a moderate direct, yet insignificant, correlation for the Russian Federation as a whole (rs = 0.32; p = 0.41) and null correlation for the data computed for the of Astrakhan (rs = 0.26; p = 0.32).
Conclusion: Along with the predicted decreasing trend in prevalence in the pediatric population, we established a statistical relationship between local environmental problems and children’s health, which should be taken into account in the development of disease prevention programs.
Introduction: The impact of the novel coronavirus disease on human health and its long-term outcomes, including that in the child population, remains a pressing issue. The course of the disease in children is milder than in adults, but the incidence rate has not shown a downward trend since 2020. Respiratory symptoms such as cough and shortness of breath persist in children for a long time, regardless of the disease severity.
Objective: Тo establish characteristics of spirography indicators in unvaccinated schoolchildren with specific immunity to SARS-CoV-2.
Materials and methods: The present study included 169 schoolchildren aged 7–14 years. The observation group consisted of 90 children with specific Class G immunoglobulins to SARS-CoV-2 in their blood serum and the reference group consisted of 79 children matched by age having no IgG antibodies to the virus. All subjects underwent a pulmonary function test and the spirography results were then compared using classical methods of descriptive statistics.
Results: The median indicators of forced vital capacity and forced expiratory volume in the first second measured by spirometry were within the normal range in both groups. In the observation group, statistically lower values of the median of the modified Tiffeneau-Pinelli index (%) and that of the peak expiratory flow rate (%) (p = 0.001) were established, with the latter being 2.8 times more frequent (p = 0.021).
Conclusion: The revealed changes in spirography parameters in the schoolchildren who were not vaccinated against COVID-19 but had IgG antibodies to SARS-CoV-2 may indicate mild post-COVID obstructive respiratory dysfunction.
OCCUPATIONAL MEDICINE
Introduction: The automotive industry is characterized by a complex and combined workers’ exposure to occupational risk factors. The problem of early detection, course and development of prognostic criteria for modern forms of occupational pathology remains relevant.
Objective: To assess the main workplace hazards in the automotive industry and the risk of occupational diseases in its workers.
Materials and methods: We conducted our own occupational health studies, examined production control data (348 units) and results of special evaluation of working conditions (97 units) at an automobile manufacturing enterprise of the Republic of Bashkortostan in 2020–2023. In total, we took 554 measurements of noise, 554 – of hand-arm vibration, 448 – of chemicals, and 554 – of work heaviness. To assess occupational risk, we used an integral indicator of the frequency and severity of occupational diseases, the index of occupational diseases (IOD), as the inverse value of the categories of risk (Cr) and severity (Cs), a single-digit indicator (IOD), combining Cr and Cs. Calculations were done in Microsoft Excel.
Results: In the course of work, employees are exposed to a combination of physical factors, such as noise (Class 3.2) and hand-arm vibration (Class 3.1); chemical factors, including fibrogenic aerosols, metal dusts, toxicants from welding fumes, paints and varnishes (Class 3.1), and physical overload (Class 3.1). The overall working conditions correspond to Hazard Class 3, degrees 1–2. We assessed risks of developing the following occupational diseases (IOD = 0.16, total IOD = 0.32): vibration disease from exposure to hand-arm vibration and sensorineural hearing loss from noise exposure; chronic poisoning with manifestations of disorders of the pulmonary system (toxic bronchitis and chronic obstructive pulmonary disease) related to chemical exposures. Occupational diseases had a mild course with minor functional grade 1 manifestations and no progression of the pathological process.
Conclusions: The complex and combined exposure to industrial safety hazards in the automotive industry determines the moderate risk of developing occupational diseases in its workers.
Introduction: Miners are at increased risk of developing pneumoconiosis that poses a serious threat to their health. Progressive pneumosclerosis and bronchial mucosa atrophy are typical pathological changes in this disease. At the same time, there is evidence of systemic manifestations of pneumoconiosis. In this regard, a deeper understanding of how long-term exposure to coal dust affects pathophysiological processes not only in the target organ, but also in the whole body is required.
Objective: To generalize and systematize ideas about the pathogenetic foundations of systemic morphological manifestations of black lung disease.
Materials and methods: To obtain information, we have carried out a search for relevant studies published in 1995–2022 in Scopus, PubMed, and RISC databases using the following keywords: pneumoconiosis, miners, morphological changes, pathogenesis, free radical oxidation, inflammation, immune response, cytokines, growth factors, and endothelial dysfunction. We selected 59 full-text publications presenting the results of completed studies on the mechanisms of development of systemic morphological changes in coal miner’s pneumoconiosis. The systematic review was made according to PRISMA guidelines and using certain PICO(S) criteria.
Results: It has been shown that long-term exposure to coal dust causes activation of macrophage-related inflammation in the respiratory system, free radical oxidation, modulation of intracellular signaling pathways, and programmed cell death. Numerous studies have demonstrated the role of inflammation as the main pathogenetic factor of pneumoconiosis, which is closely related to oxidative stress and immune response. Inflammatory mediators ensure the immune response, regeneration and sclerosis of damaged tissues. In case of high cumulative doses of coal dust, these processes begin to have a destructive and tissue-damaging effect in both the lungs and other organs due to the systemic action of the above mediators. The key role of the endothelium in the development, course and outcome of inflammation is noted.
Our findings help improve understanding of the pathogenetic bases of coal worker’s pneumoconiosis necessary to substantiate a systemic, integrated approach to its treatment and prevention.
OCCUPATIONAL HEALTH
Introduction: Both environmental and occupational exposure to hazardous chemicals is a public health challenge since it can induce oxidative stress, lipid peroxidation, and protein modifications. Creation of a database linking work-related risk factors and adverse human health outcomes based on protein biomarkers will contribute to the development of effective preventive and therapeutic approaches.
Objective: To conduct a systematic review of literature to identify databases containing information about human protein biomarkers of exposure to environmental risk factors.
Materials and methods: We examined Russian and English-language publications containing information about existing protein biomarker databases issued in 2003–2023 and found in Elibary.ru, PubMed, Google Scholar, Scopus, and Research Gate using the following keywords: database, adverse effect, biomarkers, proteins, and occupational environment. Forty of 300 papers initially selected contained systematized data of research aimed at identifying biomarkers of occupational exposures and were therefore chosen for the review.
Results: Eight information sources have been found to match our search criteria. We have established that the databases are divided into two types by availability and accessibility of the information of interest. Type I databases contain research findings related to the impact of occupational exposures on the content of biomarkers (proteins) but have limited access. Type II databases are open to access, but they do not contain direct information about protein biomarkers associated with occupational exposures.
Conclusion: The existing databases either contain unsystematized data on protein biomarkers of adverse human health effects or are closed to access. Thus, the task of creating such publicly available information sources deems relevant.
ISSN 2619-0788 (Online)