Information is provided about the activities of scientists and employees of the Central Institute of occupational diseases of the people’s Commissariat of health of the USSR and other scientifi c and practical institutions during the great Patriotic war, the role of labor hygienists and occupational pathologists in the development of issues to improve health care for workers in the defense industry factories, as well as at the frontline positions.

Introduction. It is known that despite the achievements of modern science and technology and the introduction of modern safe technologies in coal mining enterprises, working in coal mines remains one of the most dangerous for health. It is established that one of the most important and signifi cant causes of occupational diseases in miners is respiratory pathology. Miners working in underground conditions are exposed to a long-term set of harmful physical and chemical factors that contribute not only to increasing the risk of various chronic occupational diseases, but also to genotoxic risk. Accounting for chromosomal aberrations is one of the most highly sensitive methods of biological indication, which allows us to assess the General patterns and specifi cs of the impact of genotoxic exposure.

The aim of the study is to conduct a chromosomal analysis of somatic cells of workers of Kuzbass coal mines who are suffering from occupational pulmonary pathologies.

Materials and methods. To assess the genotoxic impact of the production environment of coal mines, a cytogenetic analysis of chromosomal aberrations in the blood lymphocytes of 169 miners with lung diseases was performed. Of these, 93 people were diagnosed with “chronic dust bronchitis”, and 76 people — “anthracosilicosis”. For comparison, we used data from cytogenetic analysis of 376 conditionally healthy miners, without signs of lung diseases. As a control, 250 male individuals who did not work in industrial enterprises were studied. The material for the study was whole peripheral blood. Blood cells were cultured using a standard semi-micrometer method. The proportion of aberrant metaphases was determined by calculating the frequency of metaphases with chromosome aberrations (as a percentage of the studied number of cells).

Results. It was found that the frequency of chromosome aberrations in the group of miners with lung diseases (5.04±2.40%) and healthy miners (4.12±2.32%) was signifi cantly higher than in the group of individuals who did not work in production (1.78±1.26%, p<0.00001). There was a signifi cant increase in aberrant cells, single fragments, and chromatid-type aberrations in miners with pulmonary pathologies compared to healthy miners.

Conclusions. The results of the study indicate a high genotoxic hazard of working conditions in coal mines. Chronic lung diseases in miners caused by prolonged contact with production factors are accompanied by a statistically signifi cant increase in chromosomal instability in peripheral blood lymphocytes. The highest values of the frequency of chromosomal abnormalities were recorded in  miners performing basic production operations. Data were obtained on the modifying eff ect of work experience on the frequency of certain types of chromosomal aberrations in miners. It is shown that smoking miners with more than 20 years of experience registered an increase in the level of chromosomal aberrations.  

Introduction. A comprehensive study of adaptation and changes in the functional state of participants of the Arctic roundthe-world fl ight “North Your” to maintain a high level of performance of pilots remains relevant. Work in conditions of sharp change of climatic zones and transmeridional movement is the cause of the formation of unfavorable functional states of the body — bias natural circadian biological rhythm that can lead to the development of DS, hypertensive reactions, decrease in functional reserves of physiological systems, becoming a risk factor for work-related pathology.

The aim of the study is to study the adaptive responses of the participants of the Arctic round-the-world air fl ight to a sharp change in climatic conditions and trans-meridional movements.

Materials and methods. The design of the study included a comprehensive laboratory and instrumental examination at the start and fi nish, including clinical and biochemical blood analysis, determination of the degree of DNA damage in cells. Physiological studies of functional stress of the body included an assessment of the characteristics of the state of the cardiovascular system. The objects of research were 7 pilots aged from 39 to 69 years (average age 55.33 years). The research results were processed using the methods of variation statistics.

Results. It is revealed that knowledge about functional adaptation is important for understanding the state and predicting the performance and reliability of employees.

Conclusions. The results obtained indicate a high adaptive capacity of the pilots' body when working under extreme loads during a round-the-world Arctic fl ight.

Introduction. The predominant source of environmental pollution is motor transport, the release of pollutants which leads to excessive formation of free radicals. The most important metabolic part of the non-specifi c component of the syndrome of adaptation to adverse factors is the activation of free radical oxidation processes that contribute to the mobilization of protective reserves of the body. There is evidence that different groups of the population have different vulnerability to Prooxidant exposure to pollutants.

The aim of the study is to establish correlations between the indicators of the pro — and antioxidant system and the elemental status of professional drivers living in the Khanty-Mansiysk Autonomous Region.

Materials and methods. 182 male residents (32.6±6.2 years old) of the Khanty-Mansiysk Autonomous Region (KHMAR) were examined: 94 drivers of heavy trucks and fuel trucks and 88 employees. Free radical oxidation products (FRO) were determined in the blood: lipid hydroperoxides (LHP) and thiobarbituric acid active products (TBA-AP) using test kits from BCM Diagnostics (Germany) and AGAT (Russia). Total antioxidant activity (TAA) and thiol status (TS) were determined using commercial kits from Cayman Chemical and Immundiagnostik AG (Germany). The coefficient of oxidative stress (COS) was calculated using the formula: COS=LHP×TBA-AP / TAA×TS. The content of vitamin E was determined on the fl uorometer “Fluorat 02 — ABLF” of the company “Lumex” (Russia), vitamin C — using commercial kits of the company “Immundiagnostik AG” (Germany) on the analyzer of the company “Personal Lab” (Italy). The concentration of macro — and microelements (Ca, Se, Zn, Fe, Pb, Cd) was determined in the samples of AES — ISP and MS — ISP hair in TcMB (Moscow). Statistical processing was performed using the Microsoft Exsel software package and “Statistica 8.0”. For normal
distribution, M, m, min, and max values were used. For abnormal distribution, both Me, 25 and 75 PS were used. Correlation relationships were studied using Spearman’s correlation coefficient. Differences at p<0.05 were considered reliable.

Results. Drivers compared with employees have signifi cantly higher values of lipid peroxidation, Pb, Cd, Fe (p<0.001–0.046), against the background of lower indicators of AOS, Ca, Se, Cu, Zn (p<0.001–0.040). Direct relationships between TAA, vitamins E, C, Se and Zn (r=+0.312–0.802) and inverse relationships between TAA and Pb, Cd (r= –0.623–0.558) were found in drivers of KHMAR with more than 5 years of work experience, which is associated with the development of an oxidative imbalance, which is characterized by an increase in lipid peroxidation products.

Conclusions. The relationship between the indicators of the state of oxidative metabolism, the availability of bioelements and antioxidant vitamins involved in the regulation of metabolic processes (p=0.048–0.001) has been established. Direct relationships between the indicators of total antioxidant activity, the glutathione system and the concentration of vitamins E, C, selenium and zinc (r=+0.312–0.802) and inverse relationships between the level of total antioxidant activity, thiol status, and toxic elements: lead and cadmium (r= –0.513–0.604) in the male population of KHMAR were revealed. More pronounced changes in adaptive metabolic reactions in the body of employees of motor transport companies who have a work experience of more than 5 years are associated with the development of an oxidative imbalance, which is characterized by an increase in POL products. The obtained data on the state of the oxidative status of the body of residents exposed to the negative eff ects of a chemical factor can be the basis not only for the formation of risk groups, the development and implementation of a set of scientifi cally-based preventive measures, but also for subsequent evaluation of the eff ectiveness of their use.

The article considers the evolution of views on burnout in connection with the transition of society from an industrial to a service economy. The study of the phenomenon of burnout has passed many years of research by various experts. Today, the understanding of burnout as a three-component model (emotional exhaustion, depersonalization, or cynicism, reduction of personal achievements) is expanded by its positive opposite — engagement (energy, participation in work, a sense of one’s own professional effectiveness).
The concept of this phenomenon as a global phenomenon associated with the increasing role of psychosocial factors that form professional stress is presented. Models of professional stress formation based on psychosocial factors ‘ imbalances are highlighted. The analysis of the modern system understanding of burnout caused by the integration of social psychology, hygiene, occupational medicine and other fi elds of activity is given. The signifi cance of the psychosocial work environment with its new components (mobbing, cybermobbing, presenteeism, absenteeism, livism, workaholism) in the formation of professional burnout is shown.
The analysis of modern views on burnout from a psychological phenomenon to a medical diagnosis in a number of foreign countries is carried out. Information is given about the introduction of burnout in ICD–11 as a syndrome that occurs as a result of chronic stress in the workplace, characterized by a sense of exhaustion, increased mental detachment from work, and a decrease in professional efficiency. It is emphasized that burnout refers only to phenomena in the professional context. 
The results of their own research on the features of professional burnout of teachers of General education organizations are presented. The article substantiates the necessity of forming the concept of professional burnout in occupational health, based on an integrated approach to assessing working conditions, including psychosocial factors in the workplace and the health of employees.

The review of modern foreign and domestic sources confi rms the position on the problems existing in the fi eld of assessment and control of the mental health of the working population, as well as ways to prevent it. A separate group consists of mental health problems caused directly by the impact of working environment conditions.
As early as 2005, the Helsinki Declaration, published as a result of a meeting of who member countries, called for «the need to include work-related mental health issues in occupational health and safety programmes». According to a recent who-led study, it is estimated that the decline in productivity associated with depression and anxiety disorders costs the global economy $ 1 trillion annually. Adverse working conditions can lead to physical and mental health problems and reduced productivity. Many risk factors for mental health disorders can be associated with working conditions.
Some activities may have a higher risk to the employee (for example, the work of a disaster recovery worker or humanitarian worker), which may lead to negative effects on mental health and symptoms of mental disorders. The world community recognizes that individual interventions based on practice and research are needed to help maintain good mental health and well-being in the workplace. This was confi rmed in the latest International classifi cation of diseases, adopted at the 72nd Session of the World Health Assembly in May 2019, which included the code QD85 — burnout syndrome (a syndrome that occurs as a result of chronic stress in the workplace, which was not successfully overcome). Burnout refers specifi cally to phenomena in a professional context and should not be used to describe experiences in other areas of life. For the fi rst time, the ICD includes syndromes associated with occupational conditions. Thus, we can talk about the trend towards practical implementation of the task set by the OUN to integrate diagnostic criteria for diseases associated with the profession with the diagnostic criteria of ICD. By January 1, 2022, countries using ICD should be ready to implement the revised and accepted who diagnostic criteria in practice.

Based on the existing concept of COPD pathogenesis, treatment and rehabilitation measures should be aimed at normalizing the functioning of the mucociliary system and forming an energy-saving stereotype of breathing. In this regard, the inclusion of flutters as breathing simulators in the complex of treatment and rehabilitation programs is scientifically justified.
43 patients with moderate-severity PCOS were examined without exacerbation. The subjects were divided into 2 groups: 1 (main) — 22 patients receiving FT, and 2 (comparison) — 21 patients without FT. To assess the effectiveness, we used data from functional indicators, the results of the 6-minute walking test (6MWD) and standard questionnaires CAT, mMRC, SGRQ. The state of the respiratory muscles was assessed by the size of the chest area and indicators of endurance to static loads of the back and abdominal muscles. Studies were conducted before the start of therapy and 3 months after its end.
Use of FT leads to a signifi cant regression of clinical symptoms, a signifi cant increase in OFB1, positive shifts in the CAT, mMRC and 6MWD test results, increased strength and endurance of respiratory muscles and improved quality of life. This proves the feasibility of including FT in the complex of treatment and rehabilitation measures for PHOBL.

The object of the study was 108 workers of metallurgical production, of which 61 people (observation group) were exposed to industrial noise in the course of their work. The comparison group consisted of 47 people from the number of engineering and technical workers, without exposure to harmful production factors.
The aim of the study was to determine the contribution of industrial noise to the development of arterial hypertension in workers exposed to industrial noise.
The average length of service of the observation group was 11.4±5.7 years, and the average age was 39.8±2.9 years. The average length of service in the comparison group was 13.1±5.9 years (p>0.05), and the average age was 41.8±3.2 years (p>0.05), respectively. To determine the working conditions, the results of a special assessment of working conditions were analyzed. We used data from clinical examination and ultrasound examination of endothelial dependent vasodilation of the brachial artery.
The results of the survey of employees showed that the percentage of people diagnosed with arterial hypertension in the observation and comparison groups was 6.7% and 4%, respectively (p>0.05). With 15 years or more of experience in the follow-up group, the proportion of people with arterial hypertension in the follow-up group was 24.1% compared to 8.3% in the comparison group, p=0.25).
Analysis of the communication of arterial hypertension with production factors revealed a high degree of industrial conditionality for the development of the disease in employees with more than 15 years of experience (EF 65.5%). Production noise (R2=0.52; p<0.05) makes the main contribution to the development of AH in metallurgical production workers.

During professional activities of fl ying personnel of the air forces exposed to the combined effect of harmful factors. Noise is one of the leading harmful factors in the workplace of aviation professionals, as it has a wide range of adverse effects on humans. High acoustic load creates the risk of occupational diseases.
Purpose of the study was to assess the importance of aircraft noise in the risk of professional and professionally caused pathology on the basis of the study of working conditions and morbidity of the fl ight-lifting composition of the Air force.
To solve this goal, an assessment of the working conditions of the fl ight and lifting equipment, its morbidity according to accounting documentation and sanitary-hygienic method of risk assessment was carried out. The class of working conditions corresponds to harmful noise (class 3.3) and infrasound permissible (class 2). The analysis of morbidity showed that the structure of diseases is dominated by diseases of the musculoskeletal system, the organ of hearing and vision, which according to generally accepted criteria correspond to occupational diseases.
Based on the results of hygienic assessment of labour conditions, materials of periodic medical examinations and epidemiological data category of evidence of risk in fl ying personnel composition in accordance with the criteria for assessment of professional risk according to the degree of evidence necessary to be classifi ed as proved.
Aviation noise plays an important role in the formation of professional pathology of the fl ight-lifting structure and determines the professional risk of diseases, which requires measures to improve working conditions and optimize the acoustic load.

The monitoring of the situation on temporary disability of employees revealed a low quality of medical examinations (surveys) of employees engaged in harmful working conditions, and an annual increase in the cost of mandatory social insurance for temporary disability from general diseases. Monitoring the health of employees, their satisfaction with the availability of preventive measures in the workplace to reduce the incidence of disease is the basis for making managerial decisions on the formation of employee responsibility for their health.