Volume 97, Nº 12 (2018)

Development of social and hygienic monitoring (SHM) system as a means of ensuring sanitary-epidemiological wellbeing of the population of Russian Federation is one of the main activities of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing. The authors analyzed the current state of organization of SHM: lists of control points of human-environment factors and laboratory test findings; information collection techniques and systematization; procedural approaches to automation of data collection, processing and visualization.SHM is legally assigned to control measures, during which the interaction of state and municipal control bodies with legal entities and individual entrepreneurs is not required. The further SHM development is reported to be restrained by a number of organizational -technologic and financial- economic problems: analysis of sanitary-epidemiological wellbeing state among population has shown that according to SHM, interregional aspects are not taken into account; procedural approaches to the choice of control points and formation of environmental pollution indices lists, as well as the assessment procedure of social and economic efficiency of SHM, have not been properly worked out; the number of departments and experts specialized in SHM and responsible for it is decreasing, and etc. A model of interregional social-hygienic monitoring as a way of SHM improvement is suggested. Its aims include the quality increase of expert-and-analytical SHM data processing within the entire RF Arctic zone; consideration of factors affecting population health and having interregional character. Departments and Federal State Healthcare agencies named “Centers of Hygiene and Epidemiology” in various subjects of the Russian Arctic and the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing research institutions will participate in the interregional SHM. A concept of GIS portal of the Russian Arctic based on geo-information system and aimed to improve SHM is developed. It can be a comprehensive electronic database of human-environment factors and population health state, as well as an effective instrument with spatial analysis function for the assessment of sanitary and epidemiological wellbeing of the population.

Nowadays natural type soils are actually absent in urban and rural populated areas, and existing so-called “urban soils” are characterized by different degrees of technogenic and anthropogenic contamination which appears to be impossible to avoid. Such soils represent compound natural-and-anthropogenic objects which are a source of the secondary pollution of subsoil and surface waters, atmospheric air, and directly affect human beings. It results in the necessity of keeping soil quality at a proper level satisfying the requirements of № 52-FZ: Federal Law of 30.03.1999, entitled “On Sanitary and Epidemiological Wellbeing of Population”, item 21. Compliance/non-compliance with maximum allowable concentrations (MAC) or with tentative allowable concentrations (TAC), set by sanitary-epidemiological requirements to soil quality and by health standards, is the main criterion of soil contamination. The currently available regulatory-procedural basis is insufficient for effective monitoring of soil quality in residential areas, it has not recently been updated and expanded. There are no health standards for a number of chemical and biological indices of the soil quality, having hygienic significance for the human well-being. The requirements are dispersed in numerous regulatory-procedural documents (RPD) and are often inconsistent. The absence of clearly stated regulatory requirements, work-permit regulation, rules of setting and periodicity of updating regional background levels of soil contaminant concentrations, unified procedural approach to carrying out some types of tests cause certain difficulties in defining the scope of studies and conditions of their implementation, as well as in the assessment of findings. Major problems arising in the process of carrying out sanitary-epidemiological expert examinations of laboratory test findings of residential area soils are discussed in the article.

Introduction. Fundamental changes in the political and social infrastructure of the Russian Federation, the active development of the market economy, the assertion of legal statehood turned out The Russian legislation to have entered a qualitatively new state, a notable feature of which was the interdepartmental and intrastructural inconsistency. The sanitary rules on the sanitary protection zones of water supply sources have not passed this fate as a result of the problems of application of the norms of the document into the practice.

The purpose of the study: to study of legal acts of the Russian Federation, establishing requirements for the areas of sanitary protection of sources of drinking and domestic water supply, identification of contradictions and development of proposals for amendments and additions to the existing sanitary rules on the areas of sanitary protection of water sources and drinking water supply.

Material and methods. The article considers Federal laws and Government resolutions, sanitary rules, and norms, projects of sanitary protection zones of drinking and household water supply sources, literature sources as materials. The methodological basis of the research was the complex of General scientific methods for the study of public relations arising in the field of ensuring the hygienic safety of sources of drinking and economic-household water supply: analysis, systemic-structural, comparative.

Results. The paper presents proposals to bring up to date the terms, names, and powers of the parties to the relationship, as well as clarifying the requirements for the composition of the project, its text, and cartographic part. 

Conclusion. Submitted proposals will create a consistent structure of the constituent elements of the regulated relations, to ensure the symmetry of the standards document with standards that determine the safety of drinking and economic — household water supply of the population in other normative acts. In addition, the proposed changes will form a system of rights and obligations, resulting in the liability for the violation of sanitary norms in the establishment of the boundaries of sanitary protection zones.

Introduction. The list of ecological problems has recently enlarged by another one: environment pollution, and first of all, of surface water basins, by so-called «emerging contaminants». Based on the findings of research centers in RF, European countries and in the USA an independent class of human-environment pollutants of anthropogenic origin named «Pharmpollutants», was identified.

Discussion. It can be related to the growing scale of world pharmaceutical production output (average annual growth about 4.6 %), to the development of up-to-date technologies in animal and poultry breeding, as well as to increased use of pharmaceuticals among the population. Systematization and analysis of data on the effect of unsanctioned and uncontrolled medical product disposal on quality of surface sources of drinking water supply, development of recommendations for health risk minimization among population exposed to potential intake of pharmaceutical traces contained in surface water basins and drinking water, based on available findings, and defining priority areas for the development of statutory-regulatory and procedural documents, - were the objectives of our study. Development of the recommendations can improve regulatory and procedural base and will contribute to the development of specific measures to prevent the transfer of medicinal products into the environment.

Conclusion. National and foreign research findings on the topic of interest are reviewed, and potential routes of pharmaceuticals transfer into environmental objects are described. The scope of problems is outlined, ways of coping with problems of water reservoir pollution by pharmpollutants and health risk minimization for population exposed to pharmaceuticals present in drinking water, are suggested; recommendations for minimization of population health risks caused by environmental pharmaceuticals have been prepared.

This work is devoted to the problems of hygiene and epidemiology of the Helicobacter pylori infection. In recent years among the causative agents of infectious diseases, Helicobacter pylori (lat. Helicobacter pylori, HP.) takes a special place. Analysis of domestic and foreign literature had shown that at this time there is a high prevalence of Helicobacter infection (HI). It has been diagnosed in almost half of the world’s population. Published data of the Russian researchers point out its high occurrence among the population of Russia (56-88%). Analysis of the annual report of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing of the Russian Federation for 2017 showed an effective system of epidemiological and social and hygienic control of HI to have not been developed yet. Considering multiple mechanisms, ways and factors of transmission of the causative agent of HI, directions of scientific researches on the prevention of its distribution are planned. The solution of the hygienic and epidemiological problems of preventing helicobacteriosis can be carried out only by the consolidated participation of specialists of all directions of hygiene and laboratory science, as well as epidemiologists, microbiologists, and public health specialists. Clinical observations and laboratory results suggest a significant role of HP in human pathology: it is an etiological factor of more than half of all gastritis; it is found in more than 95% of patients suffering from duodenal ulcer, in 70-80% of persons with gastric ulcer, and in 60-70% of cases with gastric cancer. Accumulated over last 3 decades data indicates that up to 60-90% of all cases of stomach cancer may be associated with this infection. Against the background of such high numbers of the detection of this pathogen, questions arise why measures of hygienic prevention of Helicobacter pylori have not yet been developed, and scientific institutions of the epidemiological and hygienic profile are not sufficiently puzzled by their development.

Introduction. Macromycetes include mercury compounds in their metabolism processes. The method for assessing the contamination of the soil layer (topsoil) by mercury by estimating the mercury content in the mushrooms is accessible and sufficiently informative. Mercury is a persistent inorganic ecotoxicant, it enters the human body from the environment. This process requires constant monitoring of the content of this hazardous metal in the environment and the in biomaterials of the human organism.

Material and methods. The object of the study was selected bracket macromycetes growing on open soil areas: lawns, boulevards, parks, squares, etc. There were studied representatives from the fungal families as follows: Agaricacea, Boletaceae, Russu-laceae, Coprinaceae. Mushrooms were collected in the stage of sporulation, in the spring-summer-autumn period from 2002 to 2017. The determination of mercury in fungi was performed by atomic absorption method on specialized mercury analyzers of the “Julia” series (detection limit of 1 ng/g, the error of the method is not more than 15%). Mercury content in hair was determined in 1153 St. Petersburg residents aged from 0 to 80 years using atomic emission and mass spectrometry methods with inductively coupled argon plasma on devices Elan 9000 (Perkin Elmer, USA) and Optima 2000 V (Perkin Elmer, USA).

Results. The results of the analysis of mushrooms collected in 2017 on one of the green streets of the industrial district of Saint-Petersburg demonstrate a high degree of mercury contamination of the megapolis. Mushrooms (Cinereus comatus) were collected at three locations of Alameda, separated by approximately 100 m, and were analyzed for the content of mercury in them. The following values of mercury in mushrooms were got is a 0.61 mg/kg, 0.83 mg/kg and 0.35 mg/kg. The hair of 1153 inhabitants of St.-Petersburg has been analyzed for mercury content. The highest concentrations of mercury have been established to be set at working population aged 18-64 years. This fact can be explained by the professional activities associated with the contact with mercury and active way of life, particularly with greater frequency of the use in the diet of mushrooms and other products, being potential sources of mercury.

Discussion. The performed studies show the mercury concentration to be not only generalized but also stable. The pollution of the territory of St. Petersburg is little different from the pollution of the territories of other cities, where the mercury content in mushrooms is also found to be high in comparison with the permissible level.

Conclusion. The obtained data indicate a high stable contamination of the territory of St. Petersburg and its nearest suburbs with mercury. Mercury and its compounds in environmental objects (mushrooms) can present the real danger to the health of the population, therefore there is a need for non-invasive monitoring of the content of mercury in biomaterials of the human organism and environmental objects.

Introduction. Despite the improvement of technologies used in mining enterprises, most miners of the Arctic zone of Russia has harmful working conditions. However, miners’ health status is affected not only by harmful production factors, but also by severe climatic conditions of the Arctic, harmful behavioral factors (e.g. smoking), and the processes of natural aging of the organism. 

The aim of the study was to differentiate and hygienically assess the professional and non-professional fractions of the annual increase in risk (AIR) of chronic health disorders of miners and their comparison with officially approved hazard classes of working conditions. 

Material and methods. The results of a targeted periodic medical examination of 700 miners of the underground apatite-nepheline and copper-nickel mines were analyzed. 301 cases out of them, according to the developed method, were included in the studies. Two age groups and four seniority groups of workers have been formed. 

Results. The results of the study showed the possibility of using the criterion of AIR of chronic diseases for assessing the degree of harmfulness of working conditions based on health indices for miners in the Arctic zone of Russia, Miners have professional AIR of diseases of the musculoskeletal system, digestive organs, respiratory organs and nervous system exceeding the control levels by 2.3, 7.0, 5.0 7.0 times, respectively. 

Conclusion. The values of professional and non- professional factors for the risk of diseases of the musculoskeletal system and respiratory organs were drawn to almost coincide, which indicates a pronounced adverse effect of environmental factors on the health of miners in the Arctic zone of the Russian Federation.

Introduction. The article presents results of a study on the hygienic evaluation of the impact of levels of electromagnetic fields (EMF) from electrical equipment, communications and navigational aids on modern automated ice-breaking vessels to the electromagnetic safety of the crew. 

Material and methods. The instrumental measurement of EMF levels from power equipment, electronic equipment, computers, were conducted in places of a permanent and temporary stay of the crew watches in parked icebreakers in the port and during sea trials. The assessment of the levels of electromagnetic radiation from the antennas of radio relay stations (radar) was conducted using the forecasting parameters of the EMF. 

Results. Onboard computers, marine electrical, communications and radar transmitters do not create electromagnetic fields exceeding the RC in crew workplaces of ship premises. Levels of EMF SHF range generated by RADAR antennas on the open deck, also do not exceed RC. Electromagnetic fields exceeding the RC are registered at work communications transmitters VHF, MF/HF on the decks of the installation of antennas transmitting devices. 

Discussion. There is a relevant matter of the protection of the crew from the EMF generated by the antennas of modern radars. Evaluation of the EMF RADAR intensity is only possible on the basis of data on forecasting levels of the electromagnetic radiation. To protect the crew from the EMF generated by antennas means the marine radio and RADAR on open decks should implement measures to limit exposure time to install warning signs and placards. 

Conclusions. There is required the improvement of normative-methodical documents in the field of the protection of the crew from the EMF. You must create a measurement technique for recording the intensity of electromagnetic radiation from the radar. Research data can be used for the development of science-based sanitary-epidemiological requirements for electromagnetic safety of the crew.

Introduction. In Russia, as in other countries, the share of the population engaged in professions in which the leading source of the health risk of workers is organizational and psychogenic causes is continuously increasing. Among them, the leading place is occupied by the physiologically inadequate workload. 

The aim of the research was to establish the relationship patterns of acute and chronic (professional burnout) fatigue with the workload, which was characterized by a combination of the intensity and quality of the work. 

Material and methods. The index used was generalizing the time-weighted average density (N) and temp (T) employment action: I = P∙T. evaluation of the physiological intensity was carried out in the relation to the level obtained for 1, which was made value I=0.84 (a comfortable temp T=1; the share of breaks and pauses in work to 0.16, P=0.84). 

Results. Functional overvoltage in doctors occurs during the working day with the intensity of labor is 1.4-1.5 times higher than the level at which the fatigue they have absent or small. The change in labor productivity (number of admissions, number of bets, etc.) in more than the stated range is only possible due to, changes in the quality of work (saving the physical, mental, emotional effort). Increased physiological labor intensity of doctors is the most common source of the risk to their health. 

Discussion. The most common causes of stress and fatigue including “volume and intensity of work” and “working hours” characterize the level of labor intensity. The factor of “imbalance of effort and reward” is also associated with the intensity of work and health risk. In the case of physical, visual and mental labor, the acute functional overstrain of the worker occurs at a labor intensity 1.4-1.5 times higher than the level at which he has little or no fatigue. The increase in labor productivity in excess of the specified range is possible only due to behavioral adaptations - saving of physical, visual, mental and emotional efforts spent on the fulfillment of a unit of standardized labor, which is inevitably reflected as a result of the activity of the doctor. 

Conclusion. The established quantitative characteristics of the main indices of the workload-the physiological intensity of labor and the length of working time are the starting point for the analysis, prediction and primary prevention of the risk of chronic fatigue and professional burnout of medical workers due to the lack of rest that occurs under working conditions, inadequate recovery ability of the human body.

This article presents data on the leading role of the biological factor in the formation of occupational diseases among health workers for an 18-year period of the work at the North-West Scientific Center for Hygiene and Public Health. The purpose of the study is to provide an objective assessment in establishing relationships related to the effects of a biofactor on the health of health workers. A retrospective analysis was made of a sample of case histories with established occupational diseases due to the impact of a biological factor. There were observed in dynamics 67 cases including 52 women (77 %) and 15 men (23%) aged 23-67 years. All of them were examined for the establishment of the relationship between the disease and occupation during the period of 2000-2017. The infectious agent is considered to be the leading harmful production factor when analyzing working conditions. The average work experience with an infectious agent was 14 years. The class of working conditions in most cases was estimated from permissible to harmful of the 1 degree. Based on the data of sanitary and hygienic characteristics of working conditions, the excess of the maximum permissible concentrations of harmful industrial substances in the air of the working area was recorded only in 8% of cases. The detectability of occupational diseases after periodic medical examinations was 6%; by clinical examination — 8%; when contacting a local physician 20%; to the pathologist 20%; as a result of self-reversal 46%. The biological factor is the leading harmful factor in the workplace of medical workers. As the main preventive measure for occupational diseases among physicians, systematic medical examinations followed by preventive, curative and rehabilitative measures are taken. The most effective way to reduce infectious diseases is the compulsory vaccination of medical staff.

Introduction. The sanitary and hygienic characteristics of the patient’s working conditions made in accordance with the current regulatory documents do not contain an unambiguous conclusion about the adequacy of the occupational risk’s degree for an unambiguous justification of the relation of the disease with the occupation. In this situation a search for new methods which could help to recognize the risk degree is urgent.

Material and methods. As an example of a solution of this problem, two expert examinations are given: two patients, diagnosed adenocarcinoma of the lung and exogenous allergic alveolitis were observed in the Clinic of Occupational Pathology of North-West Public Health Research Center. The key aspect of this work was a refinement of the professional risk based on data specified in sanitary and hygienic characteristics of working conditions. The methods from the R 2.2.2006 - 05. “Guidance on hygienic assessment of working environment factors and working process. Criteria and classification of working conditions” were used. 

Discussion. The use of the described methodology was suggested in cases when it’s necessary to estimate the effect of the combination of unidirectional substances and carcinogens in low-dose rates by the long-term exposure. 

The participation of the occupational hygiene’s specialists in the expertise of the connection of the disease with the profession seems to be promisingly.

To identify the mutagenic danger of various factors for humans often use two micronuclear tests - in peripheral blood lymphocytes cultivated with Cytochalasin B and in buccal mucosa epithelial cells. The last test is non-invasive and it is incomparably easier for collection and fixation an epithelial cells. Apparently, therefore, there is a sufficient number of publications of the results of meta-analysis of comparisons of these tests, which prove the possibility of their substitution. The aim of our work is to verify the hypothesis of interchangeability of micronuclei tests (MT) on lymphocytes and epithelium mucosa cells by comparing their effectiveness (presence/absence of effect). We selected publications from an array of data on the assessment of any factors — from diseases to industrial and household hazards, but only those in which the same volunteers were taken both tissues —blood for lymphocytes cultivation and scraping of buccal epithelium. Studies with negative response in both tissues compared to the control population were excluded from consideration. Our analysis showed that in the evaluation of 30 different factors affecting humans, a positive result in both tissues was obtained for 17 factors, only in human blood lymphocytes — for 7 factors, and only in buccal epithelium cells- for 6 factors. In addition to these comparisons, the cited articles show the features of each method and the problems associated with the interpretation of the results obtained in each of them. We concluded that for greater reliability of detection of mutagenic factors in genetic and hygienic studies it is advisable to use both tests.

Introduction. The article presents data on cases of tick-borne dermatitis in medical workers caused by rat mites Ornithonyssus bacoti in unfavorable sanitary conditions. The goal is to consider the cause-effect relationship in the formation of tick-borne dermatitis as an industrial-conditioned disease. 

Material and methods. The clinical examination of 23 employees - female medical workers (doctors, nurses) aged from 28 to 56 years was carried out. 

Results. As a result of clinical examination, medical employees working in the department of a medical hospital on the first floor of the building were found to have complaints of severe itching, not associated with the time of day and the appearance of rashes in the form of roseola, small nodules in areas with thin and delicate skin, with serous or bloody crust on the top, mainly in the places of close contact with the laundry, where it fits snugly (especially the straps, collar, belt). On weekends, the improvement was noted, the itch subsided, and on returning to work the manifestations of the disease resumed. The medical staff at the workplace had contact with rat mites, triggered by the spontaneous mass infiltration of Ornithonyssus bacoti shortly after in the basement of the hospital located under this deratization department, when the main feeder-rat was destroyed and the mites were forced to look for the food, motor activity, leave the nest of rodents and crawl into the premise on the ground floor, preferring insulated places, concentrating in the crevices of the floor, walls, furniture, and there was an attack of ticks on a human. At the same time, employees working in the department did not depend on the profession, it was also noted among doctors and nurses. 

Conclusions. Given that the nature of the work in the performance of their duties at the workplace, medical personnel should not have direct contact with animals and substrate that can be infected with rat mites, as well as the occurrence of the disease soon after the deratization in the hospital, the mass and uniformity of the appearance of rashes allow to consider rat tick-borne dermatitis as an industrial-conditioned disease.