卷 99, 编号 4 (2020)

Introduction. The work is devoted to evaluating the results of our own research of sanitary-microbiological monitoring of environmental objects in diversified treatment-and-prophylactic institutions of stationary type and of the analysis both of domestic and foreign data in order justify of the list of priority controlled sanitary-microbiological indices of air and surfaces to ensure the safety of hospital environment, medical organizations stationary type, regardless of their functional purpose.

Material and methods. The survey was conducted in various premises in the medical-prophylactic institutions of stationary type for two years. Studies included determination of microbial contamination of the air environment, working surfaces, hands of personnel with the detection of bacteriological, virological, and mycological parameters, followed by macroscopic and microscopic identification of microorganisms and identification using automated systems with the method of time-of-flight matrix-assisted laser mass spectrometry platform MALDI-TOF, based on the study of the mass spectra of ribosomal proteins in the range of 1000-10000 Daltons and bioinformatic comparison of the obtained spectrum with database reference spectra and PCR.

Results. As a result, the research of surface washings in the premises of a multidisciplinary clinic revealed microbial contamination with conditionally pathogenic gram-positive cocci, including S.aureus, gram-positive and gram-negative bacteria posing a serious epidemiological danger to patients in these wards regardless of the MOST profile and requires mandatory monitoring taking into account of the used disinfectants.

Conclusion. Our own research and analysis of domestic and foreign literature showed that it is not enough to monitor the air in the MOST premises only in terms of total microbiological contamination. In the operating, procedural and dressing blocks, as well as in the wards, physiotherapeutic, diagnostic, laboratory rooms and auxiliary units, it is also necessary to take into account other sanitary and microbiological indices: total microbes count, gram-positive rods and cocci, including S.aureus, fungi, adeno-, entero-, astroviruses, coliphages.

In recent years, in the Russian Federation there has been an increase in the levels of radiofrequency electromagnetic fields in residential areas, including due to an increase in the number of base stations (BS). The purpose of sanitary and epidemiological surveillance at the stages of placement and commissioning of base stations (BS) is to prevent their adverse effects on public health. The increase in the number of base stations, together with the advent of new electronic equipment and antennas, provide opportunities for improving the processes of their accounting at the stage of placement and monitoring of the levels of radiofrequency electromagnetic fields at the operation stage. This automation tool can be a geo-information portal for providing sanitary and epidemiological surveillance of cellular base stations. The prototype of the geo-information portal allows both calculating the size of sanitary protection zones (SPZ) and building restriction zones (RZ) from the BS in online mode, displaying the results of calculations in graphical form and issuing sanitary and epidemiological conclusions for the placement and operation of base stations. The geo-information portal has the ability to synchronize with the data of the radio frequency center. Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing will be able to receive up-to-date analytical data. There will be completely automated processes of collecting, processing and storing information on BS.

Purpose of the study. Based on the official statistics for 1999-2014, we carried out a comparative analysis of the incidence of congenital brain malformations in children resided in the radiation-contaminated areas of the Bryansk region after the Chernobyl disaster with different densities of Cesium-137 and Strontium-90.

Material and Methods. Student’s t-test, Pearson chi-square test, Pearson correlation test, linear regression.

Results. As a result of the study, no statistically significant excess in the frequency of anencephaly, hydrocephalus and encephalocele in children in more radiation-contaminated south-western territories (SWT) was found compared to the average regional data. However, in the SWT, the prevalence of microcephaly is statistically significant (p<0,05) above the average regional values (5.8 times). While the maximum values are recorded in the most radioactively polluted areas of the region when high statistically significant correlations are detected with the density of radioactive contamination with Cesium-137 (r=0.69; p=0.040) and Strontium 90 (r=0.70; p=0.037), while there are no significant dependencies for other brain defects of the brain. A statistically significant decrease in the long-term trend in the prevalence of microcephaly throughout the region without SWT in the period 1999-2014, and an increase in the radiation-contaminated SWT, was found.

Conclusions. The results obtained presumably indicate to the influence of the radiation factor on the increased incidence of microcephaly in SWT relative to the average regional values without SWT for a sixteen-year period (1999-2014). The further studies are needed to analyze the incidence of various types of congenital malformations in order to determine a strategy for preventing birth of children with congenital anomalies.

Introduction. The development of different ways of identifying hazard of substances, polluting the environment, that are alternative to routine methods for assessing health of different professional groups of people, as well as to tests on laboratory animals, has been assessed and summarized in a number of papers, and there is a growing volume of actual data on this issue. The analyzing pathogenic properties of microflora, isolated from polluted habitats or changed under the effect of pollutants, allows both assessing the risk of diseases with microbial etiology and identifying the influence of modifying factors on this process.

Materials and methods. The research was performed on 150 cultures of Klebsiella pneumoniae, exposed to diethanolamine, phenol, sulfuric and nitric acids, taken at the level of their threshold limit value. The same cultures incubated without pollutants were used as a control group. Pathogenic factors were determined with the use of traditional methods, our modified methods (RNAase activity) and standard agents, kits and media.

Results. The contact with all the pollutants resulted in a fair increase in adhesive, anti-Ig, lysozyme, anti-lysozyme and RNAase activities of microorganisms, their resistance to antibacterial action of blood serum, as well as to damaging action of lactoferrin. The bacteria increased their ability to synthesize a substance, immunologically similar to human lactoferrin. At the same time, there was a decrease in lipase activity, primarily referred to factors determining the bacterial ability to survive in the environment.

Discussion. Therefore, the paper results can be presented as follows: being an independent and holistic section of modern microbiology, bacterial biochemistry unites the issues appeared to be far from each other – changes in factors of pathogenicity and persistence of microorganisms and technogenic changeability of the environment. Being quite urgent today, this problem may become aggravated in the course of further technological progress.

Introduction. Over the past decade, in Russia and abroad, there has been a clear trend towards an increase in cases of sudden death in the workplace from the disease of the circulatory system.

Material and methods. During the study, there were studied the databases of the State Labor Inspectorate in the Republic of Bashkortostan in 2014-2018, including accident investigation reports, information on a special assessment of working conditions, medical examinations, forensic medical examinations and other materials.

Results. Diseases of the circulatory system (DSC) were the main cause of sudden death in the workplace in more than 90% of cases. The maximum number of cases of sudden due to DSC was recorded in the age group of 56-60 years. The overwhelming majority of the deceased cases were represented by working occupations - 82.8%, drivers of transport were in 13.7% of cases. The vast majority of deaths occurred in the morning (from 6 to 12) and daytime (from 12 to 18) hours. The working conditions of deceased DCS workers in most cases (59.8%) corresponded to the permissible class (class 2); under harmful conditions (subclass 3.1 - 3.3) 24.9% cases worked. Most often, some form of acute coronary heart disease (CHD) was mentioned as the immediate cause of death (64.0%). Among acute forms of coronary heart disease in medical documents in more than 50% of cases the code I 24.8 “Other forms of acute coronary heart disease” was established. “Acute myocardial infarction” was verified in 11.1% of cases and was the main cause of death in men. In the group “Cerebrovascular Diseases”, “Intracerebral hemorrhage” was most often diagnosed.

Conclusion. The obtained results substantiate the need to develop measures to prevent sudden death in the workplace, aimed primarily at preventing the development, progression and early diagnosis of DSC.

Introduction. The article is devoted to assessing the effectiveness of drug and non-drug treatment of tobacco dependence in health care workers.

Material and methods. The study included 621 medical workers (237 men and 384 women) working in hospitals in Moscow, at the average age of 48.3 ± 5.6 years, including 207 doctors and 414 nurses. The medical workers were divided into 2 groups depending on the anti-smoking program used. The first group consisted of 316 medical workers who received non-drug methods of treatment: psychosocial support, using cognitive aspects; psychotherapy; breathing exercises; acupuncture; increase physical activity. The second group consisted of 305 medical workers who, in addition to non-drug methods (described above), received Varenicline treatment (Champix® - tablets) and, if necessary, nicotine replacement therapy.

Results. In medical workers from the 2^nd group, besides non-pharmacological therapy, received the drug Varenicline, 195 out of 305 (64%) persons completely stopped smoking; In the 1^st group of Medical workers receiving non-drug therapy, 177 out of 316 (56% ) cases completely quit smoking (OR= 1.40; 95% CI: 1.01-1.93; р=0.0423). 6 months after the end of the treatment program, in the first group 84 (26.7%) medical workers) in the 2nd group - 31 medical workers (10.2%) restarted smoking, (OR=3.02, 95% CI: 2.05-5.02; р<0.00001).

Conclusion. Thus, the antismoking program, including drug Varenicline and, if necessary, nicotine-replacement therapy, as well as non-drug effects, including psycho-social support; psychotherapy; breathing exercises; acupuncture; an increase in physical activity showed higher
efficacy compared with the antismoking program without Varenicline, moreover, high efficacy remained even after the treatment carried out for 6 months.

Introduction. In children and adolescents myopia in some countries already reached epidemic levels due to the growing prevalence is an urgent need for new approaches to management and search for screening indics of its development risk and key points in its stabilization. Taking into account the development and progression of myopia may be associated with autonomous influences of the nervous system, it becomes relevant to study the features of the autonomous status formation in children, depending on the presence and degree of myopia.

Material and methods. The functional state of the autonomic nervous system in 380 5-10 grades students with low degree myopia (group 1), moderate myopia (group 2), and without myopia (group 3) was assessed by heart rate and central nervous system variability and mental performance using variation chronoreflexometry.

Results. The maximum number (40%) was recorded in eighth grade of myopia students, 39.4% cases - in fifth grade students. An imbalance in the autonomic nervous system in schoolchildren was established to increase with growing myopic refraction. Thus, vagotonia occurred in 42.8% of students with low degree myopia, eutonia - in 42%, and sympathicotonia only in 15.2%. While in students with moderate myopia in 75% of cases the constraint of regulation systems was revealed due to excessive tone of the sympathetic part of the autonomic nervous system, which leads to uneconomic work of the cardiovascular system and a sharp decrease in the functional reserves of the body in 50% -70% of students.

Conclusion. Consideration of the relationship of myopia with the autonomous status and functional state of the сentral nervous system offers new directions to the existing concepts of myopia management in children and adolescents of school age, which can be a starting point for solving the problem of prevention of myopia and its progression.

Introduction. The important factors affecting health and performance of young people are the conditions of education, in particular,
a comfortable microclimate in the classrooms of higher educational institutions.

Materials and methods. In view of the urgency of this problem, an analysis was made of the microclimate parameters of educational organizations of different profiles (Ufa city, the Republic of Bashkortostan). 294 classrooms were studied in 22 buildings of 4 leading universities in Ufa. A total of 3,822 measurements were taken to determine the parameters of the microclimate.

The analysis of ionizing radiation in the aerial environment of classrooms. There was performed determination of radon and its affiliated products content. In order to assess the conditions and lifestyle of students of 4 higher educational institutions of the city of Ufa, we conducted an anonymous survey of 1,820 students of I and IV years of education.

Results. The average temperature in the classrooms of all universities studied was 23.9±0.09 C. The average relative humidity in all
classrooms was 34.2 ± 0.42%.

Analysis of ionizing radiation (radon and its daughter products decay) in the aerial environment of the classrooms and sports halls
located in the basement determined that the average annual equivalent equilibrium volumetric activity of the radon daughter products
(EROA ± Δ²²²Rn) ranged from 28 ± 14 to 69 ± 34.5 meter, which meets the requirements established by SanPiN.

Conclusion. The hygienic assessment of the microclimate parameters of educational institutions of various profile revealed a number of deviations from the regulated norms. The results indicate the need to control the parameters of the microclimate, both from the administration of universities, and from the professors. According to the results of the study, recommendations were prepared for the management of higher educational institutions in Ufa.

Iron is an essential element indispensable for the growth, division, differentiation and functioning of any living cell in the body. for humans iron is vitally important and dangerous at the same time, because with excessive accumulation it causes oxidative stress with the formation of highly active oxygen radicals and reactive forms of nitrogen that can destroy cell membranes, proteins, nucleic acids, reduce cell viability, which, according to modern concepts, can contribute to the development of many diseases (cardiovascular, rheumatic, gastrointestinal, neurodegenerative, oncological, metabolic and others), and also accelerate the aging process. This review discusses the issues of iron metabolism in humans, including its regulation at the cellular and systemic levels, the intake, transport, use, accumulation and export of iron in cells, the role of the labile iron pool in the cytoplasm of cells and plasma non-transferrin bound iron. There are provided data on the causes, prevalence iron overload in the formation of free radicals, the development of oxidative stress and related common diseases, as well as information on ferroptosis, a new type of iron-dependent regulated cell death. Attention is paid to the works of domestic authors, where it was found that prolonged use of drinking water with a high iron content is unfavorable for the population and leads to an increase in the overall incidence, the development of diseases of the blood, skin and subcutaneous tissue, musculoskeletal system, digestive system, urogenital system, and allergic diseases. There are cited separate publications on the possibility of a negative effect of iron at concentrations in water at a level of 0.3 mg/l and lower. The materials of the review emphasize the preventive value of a cautious attitude to regulating iron in the water of the Russian Federation, where 1/3 of the population uses iron-containing water for drinking, and substantiate the feasibility of establishing a hygienic standard for iron in water not higher than 0.3 mg/l, without inclusion in regulatory documents level of 1 mg/l as permissible.

Introduction. Evaluation of genotoxicity of the pesticide technical products is one of the mandatory requirements for their toxicological and hygienic assessment. The data about mutagenic property is ambiguous for some pesticides. This may be due to the use of various active ingredients of technical products of the pesticide for testing, as they may have different profiles of relevant impurities, some of which may be potentially genotoxic.

Material and methods. A technical product of N-(1-ethylpropyl)-2,6-dinitro-3,4-xylidine was tested using the bacterial reverse mutation method with Salmonella typhimurium (Ames test) and the in vivo mammalian micronucleus analysis in mouse bone marrow erythrocytes.

Results. Statistically significant dose-dependent mutagenic effects of the technical product of N-(1-ethylpropyl)-2,6-dinitro-3,4-xylidine were revealed for TA97 (+S9 / -S9); TA100 (+S9 / -S9); TA102 (+S9 / -S9) and TA98 (+S9 / -S9) strains. In all cases, the fold increase of the revertant numbers mediated by the tested substance compared with the concurrent negative control was > 2 except TA98 in the presence of S9. In the micronucleus test, the technical product did not induce a statistically significant increase in the frequency of the micronucleated polychromatophilic erythrocytes in CD-1 mouse bone marrow up to 2000 mg/kg bw.

Conclusion. The data suggest all technical products of pesticides entering the market should be tested for the potential genotoxicity. In such a case it is necessary to use at least two methods on different test systems for obtaining reliable results.