Introduction. A sufficient level of staffing for primary health care is the availability of primary health care for the population. Despite qualitative changes in the healthcare system, the shortage and imbalance of medical personnel in the provision of primary health care is a significant problem.

The purpose was to analyse the main trends in the provision of the health care system of the Russian Federation with physicians providing primary health care for the period 2018–2022.

Methods and material. Statistical, analytical, method of comparative analysis, federal statistical observation No. 30 “Information on a medical institution” for 2018–2022 were used.

Results. During the analysed period, there was a slight decrease in the provision of doctors providing primary health care on an outpatient basis. The staffing of full-time medical positions by individuals in outpatient settings in the Russian Federation increased by 2.1%, and the part-time ratio decreased by 4%, which is a favourable trend.

The level of provision with doctors of the local service differs in the federal districts. In the Russian Federation, there was noted a positive trend in terms of provision with district general practitioners and paediatricians.

The provision of general practitioners, on the contrary, is declining.

Limitations. The research materials are limited to the results of the analysis of the data of the federal statistical observation No. 30 for the federal districts and the Russian Federation as a whole.

Conclusions. There were identified main trends in the availability of doctors providing primary health care in outpatient settings. The shortage and imbalance of personnel in the system of primary health care continue to persist, which requires a comprehensive study of the problem of staffing.

Compliance with ethical standards. This study does not require a conclusion from the Local Ethics Committee.

Contribution of the authors. All authors made an equal contribution to the search and analytical work and preparation of the article, read and approved the final version before publication.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare the absence of any conflicts of interest regarding the publication of this paper.

Received: July 6, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. Regions where both ecological and sanitary-hygienic situation is unfavorable tend to have growing incidence and more frequent applications for medical aid by population in Russia and worldwide as well.

The purpose of this study was to assess population incidence in different regions in the country associated with poor quality of the environment as a factor creating additional burden on public healthcare institutions in a given region and probable economic losses in it.

Materials and methods. We applied data of state medical and sanitary-hygienic statistics over 2013–2021. Medical and demographic losses associated with exposure to harmful environmental factors were quantified using step-by-step regression analysis modified by enumeration of functions for independent variables. Economic losses were estimated for diseases and deaths among population involved in producing gross regional product.

Results. We were able to obtain more than one hundred authentic models that provided a quantitative association between population prevalence and violations of hygienic standards regulating quality of the environment. We established that between 2.9 and 5.8 million diseases associated with environmental factors were annually detected in the country over the last 10 years. Burden on regional healthcare systems grew in regions with obviously high levels of pollution in ambient air and drinking water; this gain grows up to 12.55%. In 2021, losses of gross regional products due to diseases and deaths caused by violations of hygienic standards regulating quality of the environment exceeded 170.6 billion rubles.

Limitations of the study. A set of factors included into modeling can be considered a certain limitation of the present study.

Conclusion. It seems quite relevant to coordinate efforts by different ministries and departments in the sphere of public health protection in Russia. It is also advisable to consider a peculiar sanitary-hygienic situation in a given region when calculating scopes of necessary funding for a regional healthcare system. Development of public-private partnerships seems another vital trend in health protection within efforts aimed at reducing impacts on the environment and implementing medical and prevention programs for population.

Compliance with ethical standards. The study does not require the approval of a biomedical ethics committee of other documents (the study was performed using publicly available official statistics).

Contribution of the authors:
Zaitseva N.V. — study concept and design, editing;
May I.V. — writing, statistical analysis, editing, references;
Kiryanov D.A. — data collection and analysis.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The research was not granted any sponsor support.

Competing interests. The authors declare no competing interests.

Received: August 13, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. Solving the health saving problem of middle-aged people in a risk social context is impossible without increasing the level of their medical activity, as well as forming a value attitude to health.

Material and methods. The study was conducted on the data of the Russian Longitudinal Monitoring Survey of the National Research University “Higher School of Economics” for 2018–2021. The analysis of statistical data was carried out using the methods of descriptive statistics and correlation analysis, the calculation of the odds ratio and cluster analysis were carried out.

Results. Middle-aged Russians are characterized by a low level of medical activity, which is due to their health status. Gender has an impact on the indicators of medical activity: men demonstrate a lower level of medical activity, despite low health indicators. In modern conditions, models of medical activity are varied: from passive practices without prevention to highly active practices combined with preventive examinations. An “inconsistent” model of medical activity with a predominance of self-treatment practices without preventive motives for visiting a doctor is the most common pattern during the COVID-19 pandemic.

Limitations. When studying the medical activity of middle-aged Russians in the “pre-pandemic” and “pandemic” periods, 17,631 questionnaires were evaluated during 2018–2021, which is sufficient to achieve the set goal. This study has limitations related to the survey period: data is not available after 2021, but the COVID-19 pandemic has officially ended in May 2023.

Conclusion. Insufficient medical activity of the middle age group of the population, especially during crises (including during the pandemic), presents itself as a risk factor for health loss, reduces the ability of institutional medicine to diagnose diseases at an early stage. The predominance of attitudes towards maintaining employment and income among middle-aged people, as well as an independent search for information on the Internet to resolve health issues, increases commitment to self-treatment practices.

Compliance with ethical standards. The study does not require the submission of a biomedical ethics committee or other documents.

Contribution of the authors:
Gordeeva S.S. — research concept and design, writing the text, editing;
Sharypova S.Yu. — writing the text, statistical data processing, compilation of the list of literature, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study was carried out for Russian Science Foundation grant account No. 23-18-00480 «Self-protective strategies of people in Russia in the new normality».

Conflict of interests. The authors declare absence of conflict of interests.

Received: August 13, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. Genetic testing has become the part of the practice of providing specialized cancer care. This allows not only detecting the further tactics for patient management, but also identifying a risk group for the occurrence of malignant neoplasms (MNP). However, there are still no algorithms for dispensary monitoring of healthy carriers of mutations, which determined the relevance of our study.

The purpose of the study was to propose an organizational model for the work of the office of hereditary tumor pathology (HTP) based on the analysis of our own experience in identifying patients with hereditary oncological syndromes and their relatives as potent carriers of mutations associated with an increased risk of occurring MNP.

Materials and methods. Genetic testing was carried out in two thousand two hundred seventy six patients (residents of Moscow) with breast, gastrointestinal tract, and ovarian cancer.

Results. 714 patients out of 2276 MNP patients had mutations associated with an increased risk of developing cancer. Further, 277 relatives of these patients were invited, and mutations were detected in 143 (51.7%). Based on these data, an management model of the HTP office was proposed as part of the Outpatient Oncology Center (OOC), and the need for specialists to work in the HTP office per 100 thousand people was determined — 0.06 oncologist’s rate, 0.03 doctor’s rate-genetics and 0.03 psychologist rates.

Limitations. This study did not include patients who did not meet the selection criteria, as well as persons under 18 years of age or who isn’t resident of Moscow.

Conclusion. The introduction of genetic testing of patients’ relatives into practice will allow forming risk groups for subsequent dispensary observation, early detection of tumor and precancerous pathology.

Compliance with ethical standards. The study program was approved by the Moscow City Independent Ethical Committee (protocol No. 69 dated 10/13/2020).

Contribution of the authors:
Byakhova M.M. — research concept and design, writing the text, compilation of the list of literature;
Parts S.A. — research concept and design, writing the text, statistical data processing, editing, compilation of the list of literature;
Semenova A.B. — collection and processing of material;
Kuzmina E.S. — collection and processing of material, compilation of the list of literature, editing;
Didenko V.V. — collection and processing of material;
Galkin V.N. — collection and processing of material, editing;
Gadzhieva S.M. — statistical data processing, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgments. The study was conducted at the expense of a grant from the Department of Health of the City of Moscow (agreement on the provision of a grant in the form of a subsidy from the budget of the city of Moscow GKOB No. 1 1022/2 dated 12/24/2020).

Conflict of interest. The authors declare no conflict of interest.

Received: August 7, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Analysis of indicators of primary and general morbidity of the population plays a decisive role in the management strategy in the healthcare system. It is necessary for developing management decisions at all levels of government. Evaluation of the results of this study allows optimal planning and forecasting of the development of various health care indicators, including the staffing level of medical personnel.

The purpose of the study is to assess the relationship between morbidity among the adult population of the Sverdlovsk region and the level of medical staffing.

Materials and methods. Statistical materials from the annual collection “Health of the population of the Sverdlovsk region and the activities of medical organizations” were used: statistical reporting data on the morbidity of the population, staffing with medical personnel.

Results. In the Sverdlovsk region, over 2017–2021 a gain in primary morbidity among the adult population accounted for 33.1% and an increase in overall incidence — 9.4%. The medical staffing level for 2021 (61%) was by 6.1% lower than during 2017 (65%). When assessing the impact of medical staffing on the morbidity rate using correlation analysis, a strong inverse relationship between these indicators was revealed.

Limitations. When studying the morbidity rate of the adult population of the Sverdlovsk region, an analysis of data from FFSN No. 12 and No. 30 for 2017–2021 was carried out.

Conclusions. The identified problems can negatively affect the availability and quality of medical care provided to the population, lead to an increase in primary and general morbidity rates, as well as a decrease in their labour potential. The results we obtained require appropriate attention and subsequent management decisions in matters of training and attracting medical personnel, which should be based on systemic measures aimed at eliminating personnel shortages.

Compliance with ethical standards. To conduct this study, the conclusion of a biomedical ethics committee was not required (the study was performed on publicly available official statistics).

Contribution of the authors:
Akulin I.M. — concept and design of the study, editing;
Ionkina I.V. — text writing, editing, collection and processing of material, text writing, statistical data processing, compiling a list of references.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare that there are no obvious or potential conflicts of interest in connection with the publication of this article.

Received: September 4, 2023
Accepted: October 11, 2023
Published: December 23, 2023

The problem of assessing the impact of disorders of lipid metabolism on cardiovascular risk remains relevant.

Purpose of the study: to study the relationship between the thickness of abdominal adipose tissue and the parameters of the blood lipid profile and cardiovascular risk in young women.

Materials and methods. Two hundred four young women (36.4 ± 5.4 years) were examined. Body mass index (BMI), waist circumference (WC), as well as ultrasonic criteria for adipose tissue thickness (subcutaneous and preperitoneal adipose tissue thickness, preperitoneal circumference), lipid spectrum parameters were assessed, and cardiovascular risk was calculated.

Results. All criteria for assessing adipose tissue demonstrated a relationship with lipid metabolism parameters. The coefficient of determination for bonds with triglycerides ranged from 0.116 (for the thickness of preperitoneal adipose tissue) to 0.207 (for OT); for links with HDL cholesterol — from 0.030 (for BMI) to 0.052 (for OT); for links with non-HDL cholesterol — from 0.057 (for the thickness of preperitoneal adipose tissue) to 0.112 (for BMI). An assessment of the relationship between the criteria for assessing adipose tissue and lifelong cardiovascular risk showed statistical significance for all criteria with a determination coefficient from 0.122 (for the thickness of preperitoneal adipose tissue) to 0.266 (for BMI). Evaluation of the relationship in linear multivariate regression models of criteria for assessing adipose tissue, systolic blood pressure (SBP), non-HDL cholesterol and lifetime cardiovascular risk showed the statistical significance of all predictors included in the model.

Limitations. The study include neither men nor women over 50 and under 19 years.

Conclusion. All studied anthropometric and ultrasonographic characteristics of adipose tissue in young women have a comparable effect on the parameters of the lipid spectrum of blood plasma and the calculated lifetime cardiovascular risk, while the significance of their contribution to cardiovascular risk is lower than blood pressure and atherogenic lipid fraction.

Compliance with ethical standards. The study was approved by the ethics committee of the FBCI «Federal Scientific Center for Medical and Preventive Health Risk Management Technologies». Protocol No. 2 of 01.02.2021. Patients were informed about the purpose of the study, and voluntary informed consent was obtained.

Contribution of the authors:
Nosov A.E. — collection of material, statistical processing, text writing;
Ivashova Yu.A. — collection of material, text writing;
Ustinova O.Yu. — concept, editing;
Luzhetskiy K.P. — concept, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: September 4, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. Within the theory on self-regulation of parasitic systems, natural and social factors are considered not only the necessary condition for interaction between an infectious agent and susceptible organisms but they are also seen as regulators of phase transformations over the epidemic process. The COVID-19 epidemic process, if it conforms to postulates outlined in this theory, should be determined by influence of certain combination of environmental factors.

The purpose of the study. To establish priority social and hygienic environmental factors potent of modifying COVID-19 epidemic process on the RF territory.

Materials and methods. We applied correlation-regression and factor analysis to establish cause-effect relations between environmental factors and parameters of the COVID-19 epidemic process. Parameters of the COVID-19 epidemic process were identified based on the SIR+L compartment model and used as dependent variables. Overall, 263 factors were examined; they were conditionally divided into seven groups (anti-epidemic activities, environment, etc.).

Results. The study findings revealed several priority statistically significant factors. They include anti-epidemic activities (“population covered by vaccination” especially in older age groups (r = –0.67–(–)0.69)), levels of economic development on a given territory (gross regional product (r = –0.22)), socioeconomic wellbeing of population (households’ expenditures on food (r = 0.27)), lifestyle indicators (retail alcohol sales as per specific products (r = 0.21–0.38)), quality of the environment, workplace included (r = 0.11–0.22), urbanization (motorway density (r = 0.18)), weather and climatic factors (average monthly temperatures (r = 0.22), average monthly insolation (r = –0.25)) and others.

Limitations. The set of the examined priority factors and a period of their analysis can be considered limitations of the present study.

Conclusion. The obtained estimates as regards the priority environmental factors determining the COVID-19 epidemic process can be used when developing systemic strategic decisions on public health protection and securing its safety both in specific regions and the country as a whole.

Compliance with ethical standards. The study does not require the approval of a biomedical ethics committee of other documents (the study was performed using publicly available official statistics).

Contribution of the authors:
Zaitseva N.V. — research concept and design, editing, approval of the final version of the article;
Kleyn S.V. — editing, writing the text, approval of the final version of the article;
Alekseev V.B. — research concept and design, editing, approval of the final version of the article;
Kiryanov D.A. — editing, writing the text, approval of the final version of the article;
Glukhikh M.V. — statistical data processing, collection and processing material, writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 13, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. The impact of unfavourable environmental chemical factors on the human immune system predetermines the conditions for the formation of pathological conditions associated with allergies.

The purpose of the study. To study the features of immunological indicator parameters in children with allergies modified by contamination of biological media with nickel and polymorphism of the detoxification CPOX rs1131857 gene.

Materials and methods. A study was conducted one hundred eighty children suffering from various forms of allergies, permanently residing in the zone of the Far North (121 of them — under conditions of aerogenic exposure to nickel aerosols, and 59 children — in a “conditionally clean” territory). The subject of the study was biological media (blood). The change in the content of specific IgE to nickel was determined by an allergosorbent test with an enzyme label. The study of cell differentiation clusters included the use of flow cytometry (CD3⁺, CD19⁺, CD3⁺CD4⁺, CD3⁺CD8⁺, CD16⁺CD56⁺). Polymorphism of the CPOX (rs1131857) gene was studied by real-time polymerase chain reaction (PCR).

Results. The analysis of the immune and genetic status of children with various manifestations of allergic pathology revealed cellular immunodeficiency (CD3⁺CD4⁺, a decrease in the immunoregulatory index), the development of processes of hypersensitivity to chemical technogenic haptens (IgE to nickel), as well as an increased frequency of occurrence of heterozygous AC polymorphism of the second detoxification gene. phase CPOX rs1131857, verified by significant parameters of inheritance models (OR = 2.83; 95% CI: 1.14–7.01; p < 0.05).

Limitations. The present study is not exposed to the adult population, does not consume the population, and does not consume, except in the Far North.

Conclusion. A feature of the course of allergic pathology in the children’s population of the Arctic, modified by contamination of biomedia with nickel and polymorphism of the detoxification CPOX rs1131857 gene, will be an increased frequency and duration of recurrence of allergopathology due to the addition of viral (decrease in cellular immunity) and hapten (nickel) components.

Compliance with ethical standards. The study program was approved by the ethics committee of the «Federal Scientific Center for Medical and Preventive Health Risk Management Technologies» (Protocol No. 3 of 01/24/2022). All patients were informed about the purpose of the study, the parents of the examined cases signed a voluntary informed consent for the child’s participation in the study.

Contribution of the authors:
Shirinkina A.S. — the collection and processing of the material, writing a text, editing;
Dolgikh O.V. — the concept and design of the study, writing a text, editing.
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study was not sponsored.

Conflict of interest. The authors declare that there is no conflict of interests.

Received: May 4, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. Trends in of schoolchildren’s health highlights the importance of performing complex estimates aimed at identifying what influence of the contemporary education process and environmental factors have on prevalence among children and adolescents.

Materials and methods. The research involved examining data obtained by a profound medical examination of three hundred thirty nine schoolchildren attending municipal secondary schools with different educational programs. In this research, the test group (146 schoolchildren who attended a gymnasium) and the reference group (193 schoolchildren who attended an ordinary secondary school) were divided into several sub-groups based on their age group. We analyzed data of medical and social questioning, ‘Weekly Rations of a school student’ and school schedules covering classes and breaks between them. All the data were analyzed using conventional statistical procedures and logistic modelling together with calculation of relative risks.

Results. We established different ratios of harmful components related to the educational process, lifestyle, diets, and the environment in schools with different educational programs. This fact indicates the examined exposure to be multi-factorial and determines some peculiarities of incidence and unfavourable age periods in clinical courses of diseases among schoolchildren attending a gymnasium or an ordinary secondary school. Causation of negative health outcomes in schoolchildren by lifestyle factors equaled R² = 0.11–0.86; the educational process, R² = 0.10–0.84; environmental factors, R² = 0.13–0.58.

Limitations: a rather small sample.

Conclusion. Schoolchildren in gymnasium have 3.1–4.8 higher risks of diseases of the endocrine and musculoskeletal system in primary school; diseases of the nervous system, in senior school; ophthalmic pathologies, during the whole school period. Likelihood of digestive diseases and diseases of the musculoskeletal system grows by 4.6–41.0 times in middle and senior school. Greater effectiveness of medical check-ups and timely identification of risk factors are the most important tools for creating an integral preventive environment.

Compliance with ethical standards. The research program was approved by the local ethics committee (protocol No. 7 of March 11, 2020). Voluntary informed consent of the children’s legal representatives was formalized.

Contribution of the authors:
Valina S.L. — study concept and design, data collection and processing, writing the text;
Shtina I.Е. — data collection and processing, statistical analysis;
Ustinova О.Yu. — study concept and design, writing the text;
Maklakova О.А. — data processing.
All the authors have approved on the final version of the manuscript and bear full responsibility for the integrity of the whole article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 2, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. In the the industrialized regions of the Russian Federation one of the hygienic problems is the formation of additional morbidity among the population associated with intense air pollution.

The purpose of the work is to study the health disorders in children under conditions of aerogenic chemical exposure in terms of primary morbidity.

Materials and methods. Analysis of the primary morbidity of the children population (data from state statistical reporting and actual seeking medical care in 2017–2021); the content of the main chemical pollutants in the atmospheric air in residential buildings (data from social and hygienic monitoring and the regular observation network of Roshydromet for 2016–2020 according to the content of twenty two impurities); chronic non-carcinogenic risk; connection of diseases with aerogenic chemical exposure according to epidemiological indicators; economic assessment of predicted losses.

Results. Comparing to the reference area, the level of primary morbidity in children with diseases of the respiratory system, digestion, kidneys, nervous system, osteoarticular apparatus, associated with aerogenic exposure to chemical pollutants, was established to be an increased by up to 3.4 times. In the atmospheric air of residential buildings, the content of a number of chemicals (metals, aromatic and fluorine-containing inorganic compounds) was found to be increased by 6.9 times and 4.0 times relative to the average daily and maximum one-time maximum permissible concentrations, respectively, and within the hygienic standards. The formed exposure causes an unacceptable risk of developing non-carcinogenic effects (HI up to 18.7 times) in relation to target organs. Additional morbidity in the children population (about 1.5 thousand cases per year) has been identified in the event of which the projected economic losses will amount to about 10 million rubles over year.

Limitations. The study includes the children population under the age of 14 years.

Conclusion. The primary morbidity of children in regions with developed industrial infrastructure is characterized by special random events associated with aerogenic exposure to risk factors. Projected additional losses require priority regulatory action.

Compliance with ethical standards. This study did not require the opinion of the Biomedical Ethics Committee (the study was performed on publicly available official statistics).

Contribution of the authors:
Koldibekova Yu.V. — writing the text, statistical processing of the material, editing, complitation of the list of literature;
Zemlyanova M.A. — research concept and design, editing;
Goryaev D.V. — collection and processing of material;
Chetverkina K.V. — statistical processing of the material.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study was not sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: April 27, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. The issues of studying the causes and development mechanism of chronic prostatitis as the most important factor in the formation of male infertility are extremely relevant nowadays. Confirmed reprotoxicants including aromatic hydrocarbons inhibit spermatogenesis and lead to androgen deficiency.

Purpose: to identify the features of spermatozoa apoptosis in vitro in middle-aged and older men with chronic prostatitis under exposure to reprotoxicants (using benzene as an example).

Material and methods. A study of the ejaculate in thirty men with chronic prostatitis was conducted. 19 men were under 36 years old, 11 men were over 44 years old. Intracellular and membrane cell death markers (AnnexinV-FITC⁺PI^–, AnnexinV-FITC⁺PI⁺, Bax, caspase-3) in semen samples were identified by flow cytometry. Seminal fluid samples without benzene were control; samples with the addition of 0.001 µ/ml of benzene were experimental. Spontaneous and benzene-induced samples were incubated for 72 hours at 37 °C.

Results. The in vitro system revealed that the addition of 0.001 µg/ml benzene to the ejaculate of men under 36 years of age reduces the content of AnnexinV-FITC⁺PI^–-spermatozoa (p < 0.05). The content of CD95⁺- and AnnexinV-FITC⁺PI^–-spermatozoa in the sperm of men over 44 years of age was significantly reduced against the background of an increase in Bax compared with the results of patients under 36 years of age (p < 0.05).

Limitations. The study limitations are the use of specific cellular material — gametes, as well as indicators of cell differentiation clusters reflecting the cell death.

Conclusion. In vitro experiment verification features of sperm lethal program in men with chronic prostatitis revealed the signs of apoptosis inhibition associated with age and a chemical modifier — benzene. We revealed the signs of the violations in mitochondrial regulation and phosphatidylserine realization of programmed germ cell death in older men relative to young men were revealed. It is recommended to use the content of Bax, CD95⁺- and AnnexinV-FITC⁺PI^–-spermatozoa in an ejaculate as the diagnostic predictors of sperm fertility disorders in men = with chronic prostatitis under benzene exposure.

Compliance with ethical standards. The study was carried out in accordance with the norms of the Helsinki Declaration of the WMA “Ethical principles of medical research with human participation as a subject” (1964, 2013). The study was approved by the LEC of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies (protocol No. 1 of 22.01.2020). All participants signed a voluntary consent to participate in the study.

Contribution of the authors:
Dolgikh O.V. — concept and design of the study, editing;
Alekseev V.B. — concept and design of the study, editing;
Dianova D.G. — concept and design of the study, writing the text;
Alikina I.N. — collection and processing of material;
Nikonoshina N.A. — writing the text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: July 28, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Ambient air pollution is a significant risk factor for cardiovascular diseases.

Purpose of the work: to study the structural and functional characteristics of the carotid arteries in women living in the Far North under conditions of exposure to metals and particulate matter.

Materials and methods. Observation group consisted of seventy eight women living in the Far North in the zone of impact of metallurgical enterprises; comparison group included 20 women living in similar climatic conditions. Duplex scanning of the brachiocephalic arteries was used to evaluate the intima-media thickness (IMT), Peterson’s (Ep) and Young’s (Ym) elastic modules. The cause-and-effect relationships of vascular disorders with blood concentrations of nickel, copper, and chromium were studied.

Results. In the observation group the IMT thickness was greater than in the comparison group (0.55 (0.49;0.62) mm versus 0.46 (0.45;0.5) mm, p < 0.0001). In the observation group, Ep was 1.84 times and Ym was 1.52 times higher than the indicators in the comparison group. The relative risk of increasing IMT reached 2.1 (95% CI 1.1–4.3). An increase in the probability of IMT thickening was revealed with an increase in the blood chromium concentration (R² = 0.10; p = 0.003), an increase in the values of Ep — copper (R² = 0.15; p = 0.002) and chromium (R² = 0.19; p = 0.0002), and Ym values — copper (R² = 0.39; p < 0.0001).

Limitations of the study. This study did not include middle-aged and elderly women, men, and did not include the population of territories other than the Far North.

Conclusions. Young women living in conditions of inhalation exposure to nickel, chromium, copper, and particulate matter experience an intensification of atherosclerotic and arteriosclerotic processes, manifested by an increase in IMT, atherosclerotic plaques, and an increase in the stiffness of the common carotid artery (CCA). A cause-and-effect relationship between the copper and chromium blood concentration and the probability of an increase in IMT, Ep and Ym has been established. The identified changes in the CCA make it possible to classify young women living in environmentally unfavourable areas as a higher category of cardiovascular risk.

Compliance with ethical standards. The study program was approved by the ethics committee of the FBSI «Federal scientific center for medical and preventive health risk management technologies» (protocol No. 3 dated January 26, 2022). All patients were informed about the purpose of the study, and voluntary informed consent was obtained.

Contribution of the authors:
Nosov A.E. — collection of material, statistical processing, text writing;
Ustinova O.Yu. — concept, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 22, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Currently, the oil refining industry, as an integral part of the oil industry, makes a significant contribution to the economy of the Russian Federation and includes a significant contingent of workers exposed to a complex of harmful chemicals present in the air of the working area during the oil refining process. In this regard, the study of the prevalence of bronchopulmonary pathology in oil refinery workers is quite urgent task. The database of eLIBRARY.RU, Google Academy, CyberLeninka, Web of Science, Scopus and PubMed were used for the preparation of the literature review. It has been established that in the available modern scientific literature of the data devoted to the influence of oil hydrocarbons and oil products polluting the air of the working zone on functional disorders of the respiratory system in oil refinery workers could not be found. The most relevant studies on the effects of the chemical factor on the respiratory system in refinery workers have a significant statute of limitations and do not reflect current working conditions. The few data on the prevalence of respiratory diseases in workers in modern refineries are characterized by ambiguous results obtained by various authors. Thus, the issues of the influence of working conditions on the development of bronchopulmonary pathology among workers of modern oil refineries are extremely insufficiently covered. The results of the review indicate the relevance of both an in-depth study of the causes of the pathogenetic mechanism of bronchopulmonary diseases and prenosological diagnosis of respiratory pathology. So far, the main stage in the development of sound medical and preventive measures contributes to the preservation of health and prolongation of occupational longevity in workers employed in the oil refining industry.

Contribution of the authors:
Raikova S.V. — the concept and design of the study, collection and processing of material, writing a text;
Novikova T.A. — collection and processing of material, writing a text;
Komleva N.E. — editing;
Trubetskov A.D. — writing a text.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 13, 2023
Accepted: October 11, 2023
Published: December 23, 2023

Introduction. Prevention of chronic non-communicable diseases, maintaining health and prolonging the occupational longevity of the working population is the most important strategic direction of the state policy of the Russian Federation in the field of public health

The purpose. Stratification of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings for the subsequent development of specialized targeted programs for the prevention of health disorders.

Material and methods. An assessment of the occupational risk of developing chronic non-communicable diseases among workers in the production of bearings is given on the basis of complex studies of production factors, primary and general chronic morbidity using the methodology for assessing occupational health risk.

Results. It has been established that the development of chronic non-infectious diseases in bearing production workers is determined by a complex of harmful (classes 3.2–3.4) factors of the working environment of various nature, which form an occupational health risk in categories from medium to very high. In the structure of the general chronic non-infectious morbidity of workers, diseases of the eye and its adnexa (24.4%), diseases of the musculoskeletal system and connective tissue (20.7%), diseases of the circulatory system (19.32%) and diseases of the endocrine system had the highest prevalence in systems of eating disorders and metabolic disorders — 15.1%. A causal relationship of varying severity with the work of the most common nosological forms of chronic was revealed as arterial hypertension (RR = 1.425; EF = 29.837%; C = 1.044–1.945), obesity (RR = 1.731; EF = 42.24%; CI = 1.219–2.459), presbyopia (RR = 2.443; EF = 59.071%; CI = 1.549–3.855), indicating their occupational conditioning.

Limitations. The limitation of the study was the assessment of the occupational risk of developing chronic non-communicable diseases in one occupational cohort of workers.

Conclusion. The development of specialized programs for the prevention of chronic non-communicable diseases among workers should include the study of causal aspects of health disorders and the rationale for measures to minimize the impact of occupational risk factors for occupationally determined pathology.

Compliance with ethical standards. The study was approved by the local ethical committee of the Saratov Scientific Research Center for Hygiene, Saratov, Protocol No 3 dated 16.01.2023. All examined and signed an informed consent to participate in the study.

Contribution of the authors:
Novikova T.A. — research concept and design, writing the text;
Bezrukova G.A. — writing the text, editing;
Kochetova N.A. — statistical data processing;
Migacheva A.G. — the collection and processing of the material;
Aleshina Yu.A. — the collection and processing of the material;
Raikova S.V. — the collection and processing of the material.
All coauthors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: July 3, 2023
Accepted: October 11, 2023
Published: December 23, 2023

For most modern industries, there is characteristic the simultaneous impact of noise with other factors aggravating its effect.

The purpose of the study is to determine the features of occupational hearing loss in the combined effects of noise and vibration.

Materials and methods. A comparative assessment of the level of occupational risk and audiometric indicators was carried out in three groups of employees: 1^st group (210 people) — is exposed to noise, 2^nd group (170 people) — to noise and local vibration, 3^rd group (200 people) — to noise and general vibration.

Results. In group 1 workers exposed to isolated noise, occupational hearing loss was diagnosed significantly less frequently compared to group 2 and 3 including workers exposed to combined noise and vibration (7% vs. 14 and 13%, respectively, p < 0.05). Combined exposure to noise and vibration increases the risk of occupational hearing loss by 1.82–1.85 times (RR = 1.82–1.85; EF = 45–46%). Audiological features of the lesion of the auditory analyzer have been revealed depending on the presence and nature of the affecting vibration, manifested by changes in hearing thresholds in certain frequency spectra and their combination. According to the data of speech audiometry, a violation of speech intelligibility with the presence of speech-tonal dissociation was revealed in workers of groups 2 and 3, indicating violations in the central department of the auditory analyzer.

Limitations of the study. The study is limited to the study of the features of occupational hearing loss in the combined effects of noise and vibration in mining workers according to audiometric indicators.

Conclusion. The conducted studies have shown the need to develop individual programs for the preservation of hearing, taking into account the degree of risk and the identified features of the formation of occupational hearing loss. The topic of research on the effects of noise and vibration on hearing loss requires in-depth research, taking into account the intensity and duration of vibration exposure, the type of vibration generating equipment.

Compliance with ethical standards. The studies were conducted in compliance with the requirements of confidentiality of personal data, ethical standards and principles of conducting medical research with human participation, set out in the Helsinki Declaration of the World Medical Association (ed. 2013). Written consent of the surveyed employees was obtained to participate in the study. The research program was approved by the Committee on Biomedical Ethics of the Federal Scientific Center of Hygiene named after F.F. Erisman” of Rospotrebnadzor (Protocol No. 16 of February 18, 2021).

Contribution of the authors:
Sukhova A.V. — research concept, writing text, working with literary sources, editing;
Preobrazhenskaya E.A. — the concept of research, collection and processing of material, writing text, editing.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgment. The study had no sponsorship.

Received: September 10, 2023
Accepted: October 11, 2023
Published: December 23, 2023