卷 99, 编号 8 (2020)

Introduction. Norilsk is annually both included into the Priority list of RF cities with the highest ambient air contamination and considered also among 12 large industrial centers where “Pure air” Federal project, an integral part of “Ecology” National project, is implemented. It is possible to assess whether targets fixed in a Federal project have been achieved only provided that there is a relevant system for assessing changes in ambient air quality parameters. To achieve that, experts created an information system for analyzing ambient air quality; among other data, the system used those obtained via social hygienic monitoring activities. Determining a list of chemicals that are priority factors causing inhalation risks is an integral part in finding solutions to this task.

Material and methods. To solve tasks formulated in the research, we calculated comparative hazard indices for contaminants emitted by industrial enterprises in Norilsk; we also assessed sufficiency of programs for monitoring over ambient air quality taking into account results of dispersion calculations, results obtained via field observations performed by Federal Service for Hydrometeorology and Environmental Monitoring (Rosgidromet) and Federal Service for Oversight of Consumer Protection and Welfare (Rospotrebnadzor), and health risk assessments.

Results. The assessment comparative hazard indices allowed creating a preliminary list of priority contaminants that included 18 substances. The list was specified and there were supplemented results obtained by analyzing data on aggregated dispersion calculations. Hygienic analysis of results obtained by field observations revealed substances that were priority ones as per their concentrations exceeding MPC and acceptable health risk levels. The final list included 19 chemicals that were recommended for monitoring over ambient air quality in Norilsk, including particulate matter PM₁₀ and PM_2.5.

Conclusion. Further development of programs for monitoring the ambient air quality is among the most significant activities aimed at solving project tasks within “Pure air” Federal project and assessing achievements of project targets. Application of the methodology of health risk assessment allowed spotting out priority chemicals that were the most hazardous for people living in Norilsk; those chemicals were subject to obligatory control. The list included nitrogen oxide, nitrogen dioxide, benzene, particulate matter, PM₁₀, PM_2.5, phenol, hydrogen sulfide, cobalt oxide, copper (II) oxide (recalculated as per copper), nickel oxide (recalculated as per nickel), sulfur dioxide, and formaldehyde.

Introduction. The issue of presence/absence of the consequences of technogenic space and rocket activity over the long period is on the agenda of the professional, social, and political communities, especially in regions were the certain territories have been appointed as the fall areas for the separated rocket vehicles parts, including the Republic of Altai.

Aim of study. Identification of the chemical composition of snow samples, drinking water, and blood in the population residing in the fall areas of the separated rocket vehicle parts in the Republic of Altai.

Material and methods. Identification of the chemical composition has been performed along with the quantitative determination of the content of N-nitrosamines in blood samples (n=50) in n the population who constantly live near to the fall areas of the separated rocket vehicles, as well snow samples (n=7), and drinking water (n=9). The samples were examined by a hybrid method using an Agilent gas chromatograph with a quadrupole mass spectrometric detector. In order to decrypt the results of the mass spectrometric analysis, we used the NIST Mass Spectrometry Data Library 08.L, WILEY275.L, PMW_TOX2.L., libraries of the United States Environmental Protection Agency, narcotic, herbal, toxic and contaminated substances. The quantitative determination of N-nitrosamines in the blood samples was performed by the method of chromatography-mass spectrometry.

Results. During the library search, 94% of the studied blood samples in the population registered substances that can be identified as unsymmetric dimethylhydrazine and 6% of the samples contain its decomposition product N-nitrosodimethylamine. However, the probability of categorizing these impurities to the desired substances was of 4-26%. In the blood samples of residents in whom there were identified asymmetric dimethylhydrazine and N-NDMA by quantitative chromatography-mass spectrometric analysis, the tag (Alt+2) N-nitrosodimethylamine and N-nitrosodiethylamine was found in the concentration range of 0.00095-0.346 mg/dm³. In 100% of the studied drinking water samples, residual amounts of asymmetric dimethylhydrazine were identified with a low probability of matching the library mass spectrum of 12-33%.

Conclusion. The conducted chromatography-mass spectrometry studies of snow samples, samples of the water, and blood of the population living near to the fall area of the separated rocket vehicle parts in the Republic of Altai allowed establishing the signs of residual quantities of dimethylhydrazine and N-nitrozodimethylamine.

Introduction. Brucellosis belongs to zooantroponoses, the relevance of which is connected with widespread in several regions of the Russian Federation and the unfavorable employment outlook for cases of persons.

Material and methods. Based on updated data, the modern trends of the sanitary-epidemiological situation on the incidence of occupational brucellosis in the Federal districts of Russia, including occupational cohorts, conditions, diagnosis, and occupational prognosis were analyzed.

Results. In the period from 2011 to 2017, 412 cases of occupational brucellosis (OB) were shown to be registered in rural regions. OB was proved to rank third in the nosological structure of accumulated occupational pathology (14.6%). Despite the downward linear trend in the frequency of detection of OB, its prevalence in the nosological structure of the primary occupational morbidity of the working rural population did not undergo statistically significant changes and was within the range of 10.28 - 17.16%. Most often, the disease was detected in workers in occupations as follows: animal breeder, veterinarian, milker/operator of machine milking, and veterinary paramedic, infected during industrial contact with cattle. The North-Caucasus, Siberian, and Southern Federal districts were the most disadvantaged regions of the Russian Federation in terms of the OB incidence. In 96.6% of cases, OB was represented by a residual form, diagnosed in 88.5% of cases with self-treatment. The late diagnosis of OB and the high percentage of workers with primary established loss of performance (59.5%) could be related to both the virulence of Brucella abortus and the low quality of periodic medical examinations and limited availability of primary occupational pathology care in rural regions.

Conclusion. Reducing the level of the OB incidence is not possible without strictly controlling the timeliness, completeness of coverage and regulated volume of periodic medical examinations, increasing the level of awareness and awareness of occupational risks, compliance with sanitary and veterinary rules for the prevention and control of infectious diseases common to humans and animals.

Introduction. In recent years the nature of the developing professional pathology of the respiratory system and the features of clinical manifestations have been proved to be determined not only by harmful factors of the working environment but also by individual characteristics of the body, such as age, state of the immune system, etc. In some cases, the differential diagnosis of various forms of bronchopulmonary pathology to date causes certain difficulties.

Aim. To establish the criteria for differential diagnosis of the nosological form of the pathology of the bronchopulmonary system from the effects of occupational airborne pollutants using fluorine compounds as an example at different times of diagnosis.

Material and methods. 130 patients with an established diagnosis of occupational pathology of the broncho-pulmonary system were examined. All patients were divided into 2 groups: 1 - patients with professional bronchopulmonary pathology, in whom the disease was associated with the occupation during initial hospitalization, during the continuation of work in aluminum production or no later than a year after termination of work); Group 2 - persons with occupational bronchopulmonary pathology, who were diagnosed with respiratory pathology during the period of work, and the connection of the disease with the occupation more than 1 year after termination of work. Patients underwent spirometry, body plethysmography, a 6-minute walk test, questionnaires using the COPD Assessment Test (CAT) questionnaire, and respiratory symptoms were assessed using a 4-point mMRS scale. Statistical analysis methods were performed using the STATISTICA software package - version 6 of Stat Soft Inc. (USA). Intergroup comparison of quantitative indices was carried out using the nonparametric Mann-Whitney test. Values are presented as mean and mean error. To establish the criteria for differential diagnosis, a discriminant analysis was performed.

Results. The CAT score (strong COPD influence on the patient’s life) was statistically significantly worse (25.91 points) in group 2 (versus 21.85 points in group 1), as well as spirometry indices: FVC, 68.30% of due values against 79.90% and FEV₁ - 62.15% against 70.88%. (p <0.05). As a result of discriminant analyzes, informative criteria for the differential diagnosis of occupational bronchopulmonary pathology were established: the severity of shortness of breath on the CAT questionnaire, the total score on the CAT questionnaire; the ratio of the forced vital capacity of the lungs to the forced expiratory volume in 1 minute (FVC /FEV₁), the instantaneous volumetric rate after expiration is 25% FVC (MOS₂₅), the instantaneous volumetric rate after expiration is 50% FVC (MOS₅₀, forced expiratory volume per 1 minute (FEV₁); total bronchial resistance according to body plethysmography (sRtotal), residual lung volume according to body plethysmography (RLV). The results indicate the progression of clinical manifestations of bronchopulmonary pathology even after stopping work in aluminum new production.
Conclusion. The criteria for differential diagnosis of bronchopulmonary pathology from the effects of occupational airborne pollutants taking into account the individual characteristics of the body are established.

Introduction. According to WHO experts, the lack of proper physical activity is one of the leading health risk factors for students.

The purpose of this assessment was to study the physical activity of students of Sechenov University.

Material and methods. Quantitative indices of the physical activity were assessed on the base of the step counts data obtained from smartphones. Analysis of the subjective assessment of the physical activity sufficiency and the awareness of students about its age-matched normal level was performed on the survey data. Data included 167 4th year students of the Sechenov University.

Results. On average, students took 9703 ± 3006.2 steps per day, which is lower than the average activity level for young people. Less than half of the students (43%) were classified as show medium and high physical activity. There were no gender differences in the level of physical activity. In the weekly dynamics, a tendency to a decrease in activity on weekends was revealed. Physical activity for everyday life exceeded 10,000 steps per day and was regarded as medium and high. On weekends, activity decreased to 8,236.9 ± 4,556.1, which corresponded to “below average” activity. A relationship between the level of the physical activity and body mass index in this age group was not found. Subjective assessment of the physical activity did not correspond to the results of the pedometer. The level of awareness of medical students in matters of motor activity standards was generally quite high - 70.1%, but among young men, it was only 26.3%.

Conclusions. Issues of a healthy lifestyle in general, and physical activity in particular, should be included in the curriculum for training doctors in higher education institutions either as a separate discipline or as part of a special discipline, such as hygiene.

Introduction. International research works have revealed that Russian children and teenagers tend to have one of the highest anxiety levels in the world. Anxiety at school can be a risk factor causing certain diseases.

Purpose. To assess the relation between anxiety at school and morbidity among boys attending 5-11 grades at secondary schools in the Perm region.

Material and methods. We conducted our research in spring 2019 in two secondary schools in the Perm region (in Perm and Kungur). Anxiety at school was estimated with F. Taylor questionnaire modified by N.M. Peisakhov (there were 30 statements in it that characterized various anxiety parameters; children filled it themselves). Morbidity was assessed by analyzing children’s medical profiles kept at schools (0.26/u-2000 form) and clinical examinations performed by medical experts. To establish a relation between certain anxiety parameters and morbidity, we applied non-parametric Spearman’s correlation test. To assess the risks of diseases for children with different anxiety levels, we applied the odds ratio (OR).

Results and discussion. We revealed the greatest number of relations between anxiety and endocrine diseases, nutritional disorders, and metabolic disorders. Children who were anxious about controlling their knowledge were nervous, stress-filled, and had no self-confidence, authentically more frequently suffered from overweight, obesity, and protein-energy deficiency as well. This relation can be mediated with emotion-induced nutrition behavior which is especially typical for teenagers. Children who were anxious about controlling their knowledge and had no self-confidence (assessed as per three parameters) ran higher risks of functional dyspepsia than those who didn’t have anxiety. The same relations were detected regarding disorders in the immune mechanism and nervous system diseases. These relations can be explained by looking into psychosomatic mechanisms of disease occurrence. Established relations between anxiety and diseases of the eyes, respiratory organs, and musculoskeletal system more likely indicate that children and teenagers with somatic pathologies run higher risks of anxiety at school.

Conclusion. It is necessary to perform complex activities aimed at reducing anxiety at school among schoolchildren attending secondary schools; their activities should involve the participation of medical experts with a wide range of specialties as well as parents.

Introduction. Obesity in children makes for the earlier occurrence of cardiovascular, musculoskeletal, and endocrine system diseases.

Data and methods. We examined 130 children who were distributed into two groups according to their body fat mass (BFM). Our test group included children with excess BFM fraction and our reference group was made up of children with normal body fat mass. All children were examined with bioimpedance analysis techniques. We comparatively assessed basic impedance analysis indices: fat, protein, carbohydrates, and mineral metabolism; as well as children’s vegetative status.

Results. We revealed 20% of children to have overweight as their BMI while impedance analysis indicated that 40% of children had it. Children with BFM excess had a smaller phase angle and less active cellular and musculoskeletal mass combined with lower metabolic rates detected in 50% of them. Changes in body composition in the test group were accompanied by elevated contents of dextrose, sodium, total cholesterol, and hydrocortisone and prevailing influences exerted by sympathetic vegetative regulation against the reference group. Correlation analysis allowed revealing direct correlations between a BFM fraction, cholesterol, and vegetative regulation parameters. We also revealed direct correlations between hydrocortisone, atherogenic lipids and body composition that characterized fat metabolism; reserve correlations between hydrocortisone and a faction of musculoskeletal mass; between lipids in blood serum and fat-free body mass and phase angle; between a fraction of body fat mass and metabolic rate, and a fraction of musculoskeletal mass.

Conclusions. Excess BFM fraction is a predictor of metabolic syndrome. Impedance analysis allows creating prevention programs aimed at correcting pathogenetic mechanisms that make for overweight occurrence.

Introduction. Nitrosamines that are introduced with food produce both general toxic effects on a body and specific and remote ones (allergic, mutagenic, teratogenic, or carcinogenic effects). Nitrosamines that occurred in food products aimed for infants nutrition are priority contaminants for working out standard as per health risk criteria.

Data and methods. We assessed impacts exerted by chemicals contained in canned meat for babies on 120 white Wistar rats. Our examined product was canned meat with N-nitrosamines in their minimum and maximum concentrations. For an approximation of the experiment to real conditions as it was only possible, we took rats with their age being comparable to that of human babies.

Results. Laboratory animals from test groups were fed with canned meat that contained N-nitrosamines for 28 days. As a result, we detected significant discrepancies in AAT, ALT, and GGT levels in blood between an intact group and test ones. We established NOAEL to be equal to 0.00064 mg/kg a day. We also conducted an experiment aimed at determining the benchmark dose level (BDML) for N-nitrosamines introduced with canned meat for babies and applied its results to perform mathematic modeling for “dose - effect” dependence. This modeling allowed establishing authentic cause-and-effect relations between canned meat contamination with a total of N-nitrosamines and increased values of hepatotoxicity markers. We chose the lowest level out of all the control ones obtained via “dose - effect” dependence modeling; it was equal to 0.00063 mg/kg a day.

Conclusion. Obtained reference dose (0.00063 mg/kg) for a total of N-nitrosamines introduced with canned meat for babies can be a starting point for determining MDM and MPL of total N-nitrosamines in examined food products

Introduction. It is vital to study circulatory diseases as they account for the greatest share in causes of death in Russia (about 55%). Also, environmental factors contribute significantly to morbidity with circulatory diseases. It is important to reveal chemicals that exert their impacts on pathology occurrence in the circulatory system; should such impacts be eliminated or reduced, it will make for a decrease in morbidity and mortality among the population caused by the nosologies being considered in the present work.

Material and methods. We took data on chemical contamination of ambient air and data on primary morbidity as per the “diseases of the circulatory system” category among the adult population living in the Perm region over 2013-2017 as or initial data. All the data were processed with many techniques including hygienic examination, health risk assessment under chronic inhalation exposure, and mathematic modeling within the “health - environment” system.

Results. Our research results allowed establishing that there was an ascending trend in primary morbidity with circulatory diseases among the population living in the Perm region. We revealed that phenol concentrations amounted up to 6.67 MPC average daily, and benzene ones, up to 2.37 MPC average daily; simultaneously, we revealed unacceptable risk regarding circulatory diseases (harm index (HI) was up to 1.9), and the greatest contribution into it was made by phenol (up to 78.52%) and benzene (up to 75.59%). Mathematic modeling allowed establishing there was an authentic and relevant cause-and-effect relation between primary morbidity with circulatory diseases among the adult population and ambient air contamination with phenol.

Conclusions. We revealed phenol and benzene concentrations in ambient air which were significantly higher than MPC; identified and parameterized an authentic cause-and-effect relation between ambient air contamination with phenol and circulatory diseases.

Introduction. In recent decades scientific studies show the level and nature of chronic respiratory pathology in the population to be the indicator of the quality of the environment, including the quality of the atmospheric air of modern cities, is in many ways. The exposure of all age groups of the population to chronic diseases of the bronchopulmonary system reliably correlates with the level of air pollution. Many studies are devoted to studying the effect of anti-icing agents (AIA) on human and animal bodies. However, very few works devoted to the causal relationship between the use of AIA and the gain in the prevalence of bronchopulmonary diseases.

The aim of the work is to conduct a descriptive epidemiological analysis of the level and dynamics of the incidence of diseases of the respiratory organs to assess the likelihood of the consequences of using GMD for the health of children and adults.

Material and methods. A descriptive epidemiological analysis of the level and dynamics of the incidence of diseases of the respiratory organs in the population of Moscow was carried out by the main age groups: children (0-14 years), adolescents (15-17 years), adults (over 18 years) for the periods 1995-2001 and 2012-2017 The study was carried out based on medical reporting data (a form of FSN No. 12 “Information on the number of diseases registered in patients living in the area of service of a medical organization”) provided by the Moscow Department of Health.

Results. The results of the study showed diseases of the respiratory system to be the leading pathology in all age groups from 1995-2017. The rate of the increase in the incidence by 2017 has decreased significantly compared with 2000. However, in 2017 compared to 2012, among children, adolescents, and adults there was a positive increase in the incidence of neoplasms, the largest increase was in the group of adolescents - by 7.2%, as well as for many other diseases.

Conclusion. Children have been established to be more susceptible to the effects of ecopathological factors, especially during critical periods of growth and development (1 year of life, at the age of 7 years, 15-17 years). The data obtained as a result of the analysis of the increase in the incidence rate of the indicator pathology of respiratory organs and diseases of the skin and subcutaneous tissue among the population of Moscow compared to 2012 confirm the need to continue in-depth studies to assess the possible impact of AIA on the health of the population.