Introduction. Part of the population working at carcinogenic enterprises is exposed to double exposure to carcinogens (in industrial and domestic conditions), however, studies to assess the total inhalation exposure is practically not carried out.

The aim of the study is hygienic assessment of the contribution of working environment factors to the formation of individual carcinogenic risk (ICR) for workers in the main professions in the car repair company, including the assessment of the predicted values of occupational risks in the dynamics of work experience.

Materials and methods. There was the calculation of the levels of ICR for workers of the main professions in the wagon wheel, wagon meintenance, wagon assembly workshops. The assessment of exposure for workers is given on long-term average concentrations in the air of the working area and on average annual concentrations in the atmospheric air. When calculating the doses of toxicants in the air of the working area, «standard» parameters of pulmonary ventilation for an adult, body weight, work experience in contact with carcinogenic substances — from 1 to 30 years, the number of days in contact — 240, working time — 8 hours (in accordance with the duration of the working day) were used.

Results. Workers of major occupations carcinogenic enterprise levels ICR differ in dozens of times. Calculation of ICR at 30-year work experience showed that in all studied main and auxiliary professions the total ICR was in the 4th range (more than 1,0·10^–3). Unacceptable values for the predicted ICR for the professions of «painter», «locksmith-electrician», «impregnator», «mechanic of rolling stock» begin with a 5-year work experience, the least carcinogenic is the work of a tinker, whose risk reaches an unacceptable level after 20 years of the work experience. Among the most dangerous jobs should be attributed to the wagon assembly workshop. In contribution to the ICR the leading carcinogens are benzene, nickel, formaldehyde.

Conclusions: The problems of monitoring carcinogens in the production environment, expert assessments to prove the professional genesis of malignant neoplasms were considered; it is noted that the rank number of carcinogenic professions of wagon repair production is as follows: painter, electrician, impregnator, mechanic of rolling stock.

Introduction. Methanol and its derivatives occupy one of the leading places among the main organic synthesis intermediates in terms of their importance and scale of production. According to experts, by 2027 the global demand for methanol can reach 135 million tons, the annual growth will be about 5.5%. However, there is little information regarding the assessment of working conditions and occupational risks for workers in modern methanol production and its derivatives.

The aim of the study is hygienic assessment of working conditions and the formation of health risks in workers of modern production of methanol and methylamines.

Materials and methods. The assessment of the main adverse factors of production is given. When studying the state of health, objective indicators (the results of an in-depth medical examination) and subjective (the results of a quantitative assessment of the risks of the main pathological syndromes associated with health) are considered.

Results. According to long-term observations, the concentration of harmful substances in the air of the working area, indicators of labor severity, parameters of physical factors met hygienic requirements, with the exception of industrial noise exceeding the maximum permissible level, as well as labor intensity of 1 degree. The General assessment of working conditions corresponds to the category of harmful 2 degrees (3.2). According to the results of the medical examination and quantitative assessment of the risks of health disorders in workers, the most significant were functional disorders and diseases of the circulatory system. The levels of somatic pathology on the part of the main body systems were significantly higher in apparatchiks compared to the engineering and technical personnel (ETP).

Conclusions: In the production of methyl alcohol and methylamines, the main hygienic importance is the impact on workers of the complex of harmful substances of 1-IV hazard classes in low concentrations, increased levels of industrial noise, labor intensity of 1 degree. According to the subjective assessment of health and medical examination, the greatest prevalence of health risks in workers was observed from the circulatory system, and the levels of the revealed somatic pathology were statistically significantly higher in apparatchiks compared with the ETP.

Introduction. Professional groups of railway workers engaged in the repair of wagons are directly responsible for the safety of railway traffic. The analysis of literature testifies to insufficient attention of researchers to the hygienic problems associated with labor activity of workers of wagon-repair production.

The aim of the study is to assess the occupational risk to the health of wagon repair workers, due to the impact on them of factors of the working environment and the labor process.

Materials and methods. The study used comprehensive hygienic studies using the methodology of occupational risk to worker’s health.

Results. The leading factors of the working environment (class of working conditions 3.2–3.4), which are exposed to workers depending on the specifics of the work performed. Identified professional groups with medium (significant) high (unbearable) and very high (intolerable) category of a priori occupational risk: in wagon meintenance workshop — 17 groups (94% of jobs), in a wagon assembly workshop — 11 groups (80% jobs), in wagon wheel workshop — 3 group (100% jobs). At the same time, according to the request for medical care, employees were diagnosed with isolated cases of occupational diseases.

The levels of morbidity with temporary disability of employees of the main workshops are statistically significant (p<0.05) higher than those of the control group in 1.4–1.9 times. The influence of the complex of chemical factors of low and medium intensity on the levels of morbidity of respiratory diseases in the group of workers of the wagon wheel workshop, which were 1.7–2.0 times higher than in the control group, is confirmed by the average degree of causation of the production condition of this pathology (RR=1.7; EF=42.0%).

The combined effect of vibration and severity of the labor process forms a high level of temporary disability of employees of the main workshops in connection with diseases of the musculoskeletal system, which was 2.7–4.4 times higher than in the control group, and also determines the prevalence of this pathology in the structure of diseases detected on medical examinations (23.2%). Diseases of the musculoskeletal system are caused by the production of employees of the wagon meintenance workshop (RR=3,9; EF=74,9%), as the most unfavorable in terms of hygiene on these factors.

The stressful influence of the complex of harmful production factors on the health of wagon repair workers is manifested by the high risk of diseases of the cardiovascular system, gastrointestinal tract, neurological disorders, violation of adaptation of the cardiovascular system in 97% of the examined, as well as the predominance of diseases of the digestive system and circulatory system detected on periodic medical examinations.

Conclusions. Harmful working conditions (class 3.1–3.4) cause the suspected occupational risk from small (moderate) to very high (intolerable) to 100% of the jobs of wagon repair workers. The results of the study of morbidity and risk of pathology indicate a significant risk of damage to the health of workers.

Introduction. Vibration disease (VD) occupies a leading place in the overall structure of chronic occupational pathology. High sensitivity to environmental influences, instability of emotional state, hypochondriac features, rigid stereotype of behavior, propensity to depressive states, dissatisfaction with the state which is often considered by patients as disability are revealed in patients with VD. However, there is almost no information about the psychoemotional state of patients in the post-exposure period.

The aim of the study was to study the psychological status of patients with VD in the post-exposure period.

Materials and methods. The studies were performed in patients with VD from exposure to local vibration in a connected sample (n=20), including the post-exposure period. For the evaluation of psychological status were used: «Scale of assessment of the level of reactive and personal anxiety», an adapted version of the Minnesota multi-factor personal questionnaire (MMPQ), «Lifestyle index «, the variants of coping behavior was investigated using the methodology of E. Heim.

Results. Moderate level of reactive and high level of personal anxiety was revealed in patients with post-exposure period. The MMPQ profile throughout the study period is characterized by a neurotic slope. Patients with VD in the post-exposure period more often use relatively adaptive forms of cognitive strategies, the constructiveness of which depends on the significance and severity of the overcoming situation. Among the options for emotional coping is dominated by adaptive forms. A wide range of behavioral strategies, both constructive and non — constructive, was revealed in patients with post-exposure period; there is a relatively narrow range of intense mechanisms of psychological protection, which are represented by their protective forms — «denial», «displacement», «intellectualization» and «reactive formations».

Conclusions: The studies show the persistence in the post-exposure period, previously identified in patients with VD of psychological problems that fi t into the framework developed the theory of sensory conflict of Siberian Institute of Medical and Ecological Research, when developing long-term adaptive and non-adaptive reaction is complete the formation of the maladaptive psychological states. In the system of prevention of occupational pathology from the effects of vibration, it is necessary to provide measures of psycho-hygienic and psycho- prevention orientation for psychological adaptation of patients.

Introduction. Vibration disease continues to occupy one of the leading places in the structure of professional pathology. In workers after the termination of contact with vibration generalization and progression of violations in an organism is noted. The pathogenetic mechanisms of the progredient course of disturbances in the nervous system in the post-contact period of vibration exposure remain insufficiently studied.

The aim of the study was to test an experimental model of vibration exposure to assess the neurophysiological and morphological effects of vibration in rats in the dynamics of the post-contact period.

Materials and methods. The work was performed on 168 white male outbred rats aged 3 months weighing 180–260 g. The vibration effect was carried out on a 40 Hz vibrating table for 60 days 5 times a week for 4 hours a day. Examination of animals was performed after the end of the physical factor, on the 30th, 60th and 120th day of the post-contact period. To assess the long-term neurophysiological and morphofunctional effects of vibration in rats, we used indicators of behavioral reactions, bioelectric activity of the somatosensory zone of the cerebral cortex, somatosensory and visual evoked potentials, parameters of muscle response, morphological parameters of nervous tissue.

Results. In the dynamics of the post-contact period observed the preservation of violations of tentatively research, motor and emotional components of behavior. In the Central nervous system instability of activity of rhythms of an electroencephalogram, decrease in amplitude of visual evoked potentials, lengthening of latency of somatosensory evoked potentials, decrease in total number of normal neurons and astroglia is established. In the peripheral nervous system remained changes in indicators: increasing duration and latency, reducing the amplitude of the neuromuscular response.

Conclusions: The experimental model allows us to study the long-term neurophysiological and morphological effects of vibration on the body. The formation and preservation of changes in behavioral activity, neurophysiological and morphological effects of vibration from the 30th to the 120th day of the post-contact period were confirmed.

Introduction. The issues of studying the central nervous system (CNS) damage under the influence of mercury remain relevant at the present time.

The aim of the study was to identify the relationship of dissomnic and psychological disorders in patients in the remote post-exposure period of chronic mercury intoxication (ChMI) and to substantiate the effectiveness of the proposed scheme of their therapy.

Materials and methods. The study involved 30 patients in the long-term period with occupational chronic mercury intoxication (CHMI) and 30 patients in the control group (CG), with complaints of sleep disorders without chronic expressed diseases, not in contact with toxic production factors in professional activity, 84 men — residents of the Irkutsk region from the comparison group to assess the health-related quality of life comparable with patients in social and living conditions and not in contact with harmful production factors. A set of clinical, neurophysiological, psychological and statistical methods was used in study.

Results. Based on the data of polysomnographic examination revealed differences in the nature and severity of insomnia in patients of these groups. Confirmed the mixed nature of insomniatic disorders in patients with chronic mercury intoxication. Patients CG revealed changes in the structure of night sleep has focused on intracomesa violations. It was found that patients with CHMI suffer from a more severe form of insomnia compared to patients with CG, which is confirmed by the data of medical and psychological testing. High rates of reactive and personal anxiety, moderate levels of depression and asthenic state, as well as low values of estimates on all scales of health-related quality of life (HRQL), including the total physical and mental components, were revealed in patients with CRMI. Research’s scales HRQL in patients CG with sleep disorders did not reveal any significant differences compared with those in the comparison group, indicating medium and high levels of overall quality of life.

Conclusions. The adequacy of the use of a complex of therapeutic and preventive measures, including two main methods of treatment of insomnia disorders, is proved by improving the quality and quantity of sleep structure and emotional and personal sphere.

Introduction. Unfavorable tendencies in the health of the working population, especially those with high neuro-emotional stress in professional activities, the scarcity of information about the impact of professional factors on the health and performance of police officers, which is characterized by nervous and hard work, determine the relevance of this study.

The aim of the study is to study the biological age with an assessment of the rate of aging of individual body systems and the level of somatic health of police officers.

Materials and methods. We examined 110 men — police officers. Biological age was determined by an automated expert system of diagnostics of aging by the method of A.A. Podkolzin, V.N. Crutko. To quantify the level of somatic health the method of G.L. Apanasenko was used. We used clinical, physiological and computational methods to study the state of the cardiovascular and respiratory systems, static balancing, interviewing methods and mathematical statistics.

Results. The accelerated rate of aging was revealed in 65.4% of the examined patients. Accelerated aging of the neuropsychic, respiratory and cardiovascular systems was the most common (97.3%, 94.6% and 75.5%, respectively). A decrease in functional activity of blood circulation was revealed in 70.9%. The coefficients of endurance of cardiac activity and efficiency of blood circulation exceeded the norm, which indicates a possible weakening of the activity and the state of fatigue of the cardiovascular system, myocardial weakness. The ratio of pulse wave velocity in the vessels of muscular and elastic types below the norm was determined in 40.9% of the surveyed, which may indicate the presence of transitional and late-stage hypertension, 62.2% of such persons have an accelerated type of aging of the cardiovascular system. The proportion of persons with accelerated type of aging of the respiratory system significantly (p<0.05) exceeded the proportion of persons with normal and delayed type of aging. The proportion of persons with an accelerated rate of aging was significantly higher in persons with a duration of static balancing below the standard (79.1% [71.5–86.7] versus 20.9% [13.3–28.5], p=0.009).

Conclusions. Accelerated rates of aging of cardiovascular, respiratory and neuropsychic systems, low functionality of the body can be regarded as a manifestation of occupational stress. The discrepancy between the subjective assessment of their health and objective indicators of the rate of aging, the level of somatic health can be caused by the socio-psychological characteristics of the service and the tightening of medical requirements for police officers.

Introduction. Occupational chronic obstructive pulmonary disease (COPD) is one of the leading nosological forms of occupational respiratory disease. Numerous studies have shown high effectiveness of the combination of indacaterol/glycopyrronium (Ultibro®breezhaler®) on the impact on clinical and functional indicators in the treatment of COPD in General practice.

The aim of the investigation the case of occupational COPD with the analysis of the dynamics of functional indicators, tolerance to physical load and evaluation of the quality of life of workers engaged in aluminum production by using combination of indacaterol/glycopyrronium.

Materials and methods. The random sampling method included 20 men, workers of aluminum production, with the established diagnosis of professional COPD at the age of 40 to 60 years. The survey was conducted (Borg scale, medical Research Council scale (mMRC) and COPD Assessment Test (CAT). Functional methods of studies were conducted: spirometry, body plethysmography, electrocardiography (ECG) and the six-minute stepper test (6-MST).

Results. Against the background of 8 weeks of therapy, the volume of forced exhalation for 1 minute (FEV₁) increased by 14.7% and amounted to 67.90% of the due values, the forced vital capacity of the lungs (FVC) increased by 11.3% and amounted to 76.95% of the due. According to the body plethysmography (BPG) is set to decrease in residual lung volume on average by 13.4% and static hyperinflation, confirmed by the decrease in functional residual volume (FRV) of 18.8%. During the study period increased physical activity of patients. The average difference between the distance traveled in the six-minute step test before and after treatment was 58.8 m. The analysis of personal data showed that the quality of life of patients improved, the total score in the questionnaire CAT at the beginning of the study was 16.9 points, and after 8 weeks decreased by 63% and amounted to 10.7 points.

Conclusions: The Results indicate a positive effect of combination therapy with indacaterol/glycopyrronium on the course and progression of occupational COPD.

Introduction. The study of the elemental status of the population of individual regions of the Russian Federation with the purpose of scientific development and implementation of measures for elimination of revealed elementosis is a promising direction for preventive medicine.

The aim of the study is to study the elemental status of the adult able-bodied population of the Republic of Buryatia, which was part of the Siberian Federal district (SFD) until 2018.

Materials and methods. The analysis was performed by inductively coupled plasma mass spectrometry (ICP-MS) on the basis of the accredited laboratory of “Center of biotic medicine”. (Moscow; ISO 9001: 2008 certificate 54Q10077 from 21.05.2010). The content of chemical elements in the hair of 130 adults (102 women and 28 men) aged 25–50 years was studied. This indicator serves as an indicator in assessing the impact of the environment on the human body. Methods of nonparametric statistics were used for mathematical processing of the data.

Results. For women living in the Republic of Buryatia, the maximum values of Zn, increased levels of Cu, Li, Si were revealed; for men — the maximum values of Mg, Cr, Si, increased levels of P, Li, Se, V, Pb. Minimum values were found for P, Fe, V. Elemental status indicates a significant degree of prevalence of essential trace element deficiencies and electrolyte imbalance. The obtained data can be used as reference values for the content of chemical elements in the hair of adults living in the Republic of Buryatia.

Conclusions: Elemental analysis of the population of the Republic of Buryatia indicates imbalances among the adult working-age population.

Introduction. Vibration disease (VD) is one of the leading occupational diseases. One of the manifestations of this disease when exposed to general vibration may be a violation of balance.

The aim of the study is to identify the imbalance and the causes of their occurrence in patients with vibration disease.

Materials and methods. 3 groups of patients were examined. The first group consisted of 50 patients diagnosed with VD associated with combined exposure to local and general vibration (age 48.7±3.1 years); the second group consisted of 50 patients diagnosed with VD associated with exposure to local vibration (age 48.9+2.8 years); the control group consisted of 50 relatively healthy men not in contact with vibration (age 49.1+2.5 years). Survey on electronic stabilometer ST–150 (Biomera, Russia). Patients performed the Romberg test standing barefoot vertically on a stabilometric platform with a “European” stop position. Statistical processing of the results was carried out using the software package “Statistica 10.0” (StatSof, USA, 2011). Methods of descriptive statistics included estimation of median, lower and upper quartiles. The statistical significance of the differences was determined using the nonparametric Wilkinson method. Differences were considered statistically significant at p<0.05.

Results. In the analysis of the obtained stabilometric parameters found that in the first group of patients marked imbalance.

Moreover, in comparison with the second group and the control group in the phase with eyes closed, patients are more difficult to maintain a given posture, which increases the length of statokinesigram (p=0.02 and p=0.005), increasing the speed of movement of the center of pressure (p=0.03 and p=0.004) and the square of the deviation of the center of pressure (p=0.03 and p=0.004). When closing the eyes, patients put more effort to maintain balance, which affects the rate of mechanical work (p=0.001 and p=0.001). When comparing the second group with the control group, no statistically significant difference was found in the main stabilometric indicators.

Conclusions: In the group of patients with VD associated with the combined effects of local and general vibration, marked (64%) and moderate (36%) postural disorders, especially in the phase of closed eyes. In the group of patients with VS associated with local vibration exposure and in the control group, imbalance was detected in 10% and 6%, respectively. The leading role in the occurrence of postural disorders in patients with VD, associated with the combined effects of local and general vibration, plays the formation of a focus of stagnant excitation in the centers of vibration sensitivity. In the future, the pulse can spread to nearby centers of pain, temperature sensitivity and proprioception, which contributes to the emergence of lower limb polyneuropathy and impaired stability in patients with vibration disease.