The analysis of the medical and social aspects of occupational noise-induced hearing loss (NIHL) on the basis of its phenomenology is presented. The ear as an information receiver and frequency range of voice communication are considered. The NIHL classifications in Russia, starting with GOST 12.4.062-78 are described, and an overview of international (WHO, 2011; ILO, 2013; UKOOA, 2003) and national (Belgium, France, USA) NIHL criteria are outlined. As example a civil aviation pilot audiogram was compared to different criteria; it is shown that in 5 of 14 models used criteria were stricter than GOST 12.4.062-78. It is noted that for the medical fitness to work examination it is necessary to use criteria that differ from those for population.

The modification of GOST 12.4.062-78 classification is proposed by subdivision of signs of the noise influence on the hearing into 2 groups: early and expressed signs with NIHL values at 4 kHz less than 20 dB and 20-40 dB, respectively, that is useful for monitoring and prevention. The use of PPE with a view to ensuring safety is considered.

The proposal to improve NIHL evaluation criteria are proposed in connection with the adoption of SanPiN 2.2.4.335916 onphysical factors with PEL of noise and GOST R ISO 1999-2017 on assessment of noise-inducedhearing loss, taking into account the role of hearing health for safe and effective work.

The article presents parameters and structure of primary and repeated disablement due to occupational diseases in Russian Federation over 2012-2016. Findings are lower number of first diagnosed as disabled due to occupational diseases over 5 years by 44,4% and of overall quantity of repeatedly diagnosed as disabled by 49,7%. Results also demonstrate 2 times lower level of primary disablement due to the stated diseases, and middle-aged and III group disabled individuals prevalent in structure of first diagnosed as disabled. The authors revealed that overall amount of repeatedly diagnosed as disabled is considerably higher than that of first diagnosed as disabled; level of repeated disablement over 5 years tended to decrease, but was 4 times higher than that of primary disablement. Middle-aged and III group disabled individuals appeared to prevail in structure of repeatedly diagnosed as disabled.

The article describes the current state of the problem of the impact of lead exposure on the health of workers, identifies promising areas for further research. On the basis of in-depth examination of workers of lead recycling plant results stages of adaptation to lead exposure have been emphasized, necessity of establishment of new reference range of biomarkers of effect for workers exposed to lead has been proved. The importance of the correct use of personal protective equipment, personal hygiene measures, as well as the effectiveness of the use of pectin in the complex of preventive measures has been proved. Taking into account the combined effect of lead with other metals in the conditions of modern industry, the importance of assessing microelement homeostasis has been shown. The importance of expanding the range of the determined biomarkers of effect in the biological monitoring and assessment of the genetically determined sensitivity to lead exposure has been confirmed.

The authors revealed specific work conditions for potassium mine workers in Verkhnekamsky field. Microclimate of main workplaces is characterized by subnormal air temperature throughout a year, low temperature and high thermal conductivity of surrounding rocks. Findings are overcooling of miners, intensity of which is determined by physical activity character or repose state. Signs are lower skin temperature (especially of arms and legs), rare pulse, with unpleasant sensations of temperature - proving stress of thermoregulation system. One among the factors causing workers' cooling is insufficient heat-proof properties of present miners' working clothes.

To evaluate influence of night shift work on psycho-emotional state of anesthesiologist resuscitator doctors, the authors conducted diagnostic testing of 28 anesthesiologist resuscitator doctors of various age before and after night or round-the-clock shift, using Shulte test. Results proved that psychoemotional stress felt by anesthesiologist resuscitator doctors during night (round-the-clock) shift influences considerably on the work efficiency and warming-up degree - quantitative parameters of which reliably decreased by 16.1% and 5.1%, resulting in psychoemotional fatigue.

The authors presented social-hygienic characteristics of regular doctor personnel, age-related, length of service, occupational and nosologic structure of morbidity with transitory disablement, management of medical care to hospital staffers according to implemented program of management optimization technologies of prevention and sanitation for doctors in major medical institution. Efficiency evaluation was presented for the specified and implemented program.

The study covered bioelemental state of firemen living and working in North-West region of Russian Federation. The study was aimed to evaluate bioelemental state of firemen in dependence on residence area and on their work features. Regional features of firemen's bioelemental state were revealed. Findings are deficiency of some vitally important bioelements (iodine, selenium, cobalt) and accumulation of toxic microelements (nickel, silver, cadmium, arsenic, aluminium, lead). The authors demonstrated differences in contents of toxic microelements in dependence on length of service and degree of participation in fire-fighting.

The authors described contemporary theory of rotatory cuff affection, with consideration of clinical anatomy and biomechanics of shoulder joint, under exposure to excessive static and dynamic load applied to shoulder girdle and wide range movements. New data are presented, specifying pain syndrome mechanisms. The authors' materials helped to justify criteria of altered relationships between shoulder rotators and work conditions.

Histo-physiologic changes were revealed in thymus of Wistar rats taking dichlordiphenyltrichlorethane in various low doses during 6 and 10 weeks. Studies covered histo-physiologic characteristics of thymus, that proved long intake of low doses of dichlordiphenyltrichlorethane to increase thymus involution due to intense death of thymocytes and their lower proliferative activity. Findings are that mechanisms underlying thymocytes death under exposure to dichlordiphenyltrichlorethane are mostly of p53-dependent apoptosis.

Experimental study covered protective properties of succinate-containing ant-hypoxant reamberine in acute exposure to cold, vibration and immobilization in rats.

Rats of reference group and group receiving 50 mg/kg of reamberine were subjected to cold (-15C during 60 min) and immobilization after session of general vibration with amplitude 0.5 mm and frequency 44 Hz during 90 min. Parameters assessed were rectal temperature and succinate dehydrogenase activity of peripheral WBC by quantitative cytochemical test based on reduction of paranitroviolet tetrasolium to formazan.

The review presents literature data on gonado- and embryotoxic effects of xenobiotics included into additional list of stable organic pollutants. Maximally interesting are polybromated, polychlorinated and polyfluorinated compounds widely used in industry, agriculture and household sphere. The review also covers problems of relationship of environmental distribution of this eco-pollutants class and state of male and female reproductive functions, possible pathogenetic mechanisms of infertility development, ways to reduce risk of reproductive disorders.

The authors assessed group and individual occupational risk of health loss in workers of ferroalloy industry. Findings are that main occupations of melting workshop are connected with formation of average group occupational risk and high individual risk.

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