Introduction. Influence of incidental nanoparticles of industrial aerosols on occupational lung diseases development is not studied enough. As nanoparticles has properties to induce inflammation and fibrosis, it is hypothesized that they affect occupational chronic obstructive pulmonary disease (COPD) phenotype.

The aim was to establish monocyte subsets, airway inflammation, clinical and functional features in occupational COPD due to aerosols containing nanoparticles exposure.

Materials and methods. Study design was a single center prospective cohort observational. Subjects with occupational COPD (GOLD 2011–2021 criteria) exposed to aerosols containing nanoparticles (n=50) enrolled. Comparison group — COPD in tobacco smokers (n=50), control group — healthy people (n=50). Groups were matched by demographics and COPD duration. Nanoparticles at workplaces air were measured by inductively coupled plasma atomic emission spectrometry and by scanning electron microscopy. Of participants 26 were exposed to maximal concentrations of metal nanoparticles and 24 — of silica nanoparticles. Spirography, body pletysmography, lung diffusing capacity (DLco/Va), Doppler-ehocardiography, induced sputum cytology, COPD exacerbations assessment were done. Monocyte subsets were determined by flow cytometry. Linear regression model was used to explore relationships.

Results. COPD due to aerosols containing metal nanoparticles was characterized by most severe airflow limitation, lung hyperinflation, pulmonary hypertension, most prominent decrease in DLco/Va, frequent and severe COPD exacerbations, eosinophilic inflammation. The largest proportion of «classical» CD14+CD16– monocytes subset, 96,4% (90,3%; 97,2%), high level of CCR5 expression were seen in this group. The features of COPD due to aerosols containing silica nanoparticles were substantial decrease in DLco/Vа, the least airflow limitation, mild lung hyperinflation, rare COPD exacerbations, paucigranulocytic inflammation. The largest proportion of «non-classical» CD14^DimCD16+ monocytes with high level of CCR2 expression revealed. Mass concentration of metal nanoparticles was associated with «classical» monocytes, (В=1,5), silica nanoparticles — with «non-classical» monocytes (В=1,4). On their turn, «classical» monocytes were associated with DLco (В=–1,6), functional residual volume (В=1,2), mean pulmonary artery pressure (В=–1,4), eosinophilic inflammation. «Non-classical» monocytes were associated with DLco (В=–1,5) and paucigranulocytic inflammation (В=1,2), р<0,015.

Conclusions. Exposure of incidental nanoparticles was associated with circulated monocyte subsets, airway inflammation and occupaitonal CODP phenotype.

Introduction. To adequately protect workers from gaseous air pollution using air purifying respiratory protective devices (RPD), it is necessary to periodically replace filters.

The aim of the study was the analyze the methods of monitoring the performance of workers’ RPD.

Materials and methods. Nowadays the subjective reaction of smell to an increase in the concentration of gas in the mask is widely used. This practice is compared with the available scientific information on the subjective ability of humans to detect gases.

Results. The requirements for filter replacement in the legislation of foreign countries are analyzed. It has been established that for most hazardous substances there is no available information on the thresholds of odor (irritant) perception, and the available data show a high probability of exceeding the odor perception thresholds over the maximum permissible concentrations of hazardous substances in the working area. for getting used to it, distraction of attention, low individual sensitivity, etc. The existing approach in Russia leads to the belated replacement of part of the filters and, as a consequence, to the deterioration of the professional health of workers.

Conclusion. Recommendations are formulated on the measures, the implementation of which is necessary to improve the protection of personnel used air purifying RPD.

Relevance. Emotional burnout is dangerous due to the presence of a wide range of neurotic and psychosomatic symptoms. The article discusses the features of the structure and formation of the emotional burnout syndrome as manifestations of personal value-semantic deformations. Burnout has been found to be negatively associated with solving existential problems.

The study aims to explore the specifics of the emotional burnout syndrome as manifestations of personal value-semantic deformations in the representatives of "helping" professions.

Materials and methods. The study involved 968 respondents employed in the field of "helping" professions. Of the entire sample, 465 people (consulted persons) made up the main research group, and 503 individuals were included into the control group. The main study methods were clinical and psychological and experimental-psychological. 

Results. Psychodiagnostics made it possible to clarify the types of emotional states and self-attitudes that characterized the specificity of burnout. Psychodiagnostic examination confirmed the presence in the subjects studied the elements of existential crisis associated with both professional situations and the personality traits of the "burned out" persons.

Conclusions. Emotional burnout syndrome is a "payment" not for sympathy and love for people from the representatives of "helping" professions, but for their unfulfilled expectations, for the lack of sometimes visible result of work, for the loss of the activities meaning, for the devaluation of efforts by those around him.

Many authors point to the low incidence of occupational diseases in our country. The reasons  are  poor-quality preventive examinations, the lack of interest of employers in identifying these diseases, and others. However, there are no works in the literature devoted to errors in the statistical coding of diagnoses of occupational pathology and their accounting.

The study aims to improve the accounting of occupational diseases in Russia.

We conducted the study using the information base of the Industry Register of Persons with Occupational Diseases, developed by Burnazyan State Medical Center of the FMBA, Russia, which operating in the industry since 2011. As of  31.12.2020, the register contains information on 2,056 patients with occupational diseases, from among the employees of enterprises and organizations served by healthcare institutions of the FMBA, Russia.

Errors of incorrect coding of diagnoses for occupational diseases with violation of the classification principles in the used directive materials played a negative role.

The development of plans for medical and social rehabilitation measures to reduce the incidence of occupational diseases among the people working in harmful  conditions. It requires correct knowledge of morbidity indicators of this nosology. In order to improve the accounting of occupational diseases in Russia, it is necessary to switch to the system of coding diagnoses of this nosology, adopted in medical statistics, and make appropriate changes to the directive documents.

One of the duties of an employee as a subject of labor legal relations is the obligation to undergo established pre-trip, pre-shift, and post-trip, post-shift medical examinations. The digitalization of all spheres of public life, the erasure of spatial boundaries, the development of artificial intelligence naturally change the procedure for conducting these types of medical examinations. The purpose of this article is to identify the main proposals for changing the procedure for carrying out these types of medical examinations, as well as to analyze their legality from the point of view of the current legislation. In the course of the study, the current legislation was analyzed, collisions, gaps and difficulties in its application by business entities were identified when organizing and conducting pre-shift, pre-trip and post-shift, post-trip medical examinations. The results of pilot studies and analysis of judicial practice on these issues are presented. The objects of research were the official websites of manufacturers of software and hardware systems used for conducting pre-shift, pre-trip and post-shift, post-trip medical examinations remotely. It is concluded that the remote method of conducting pre-trip, pre-shift, and post-trip, post-shift medical examinations does not comply with the law, as well as the need for administrative control over the quality of pre-trip, pre-shift, and post-trip, post-shift medical examinations.

The results of the use of electrostatic massage in the miners with vibration disease and with shoulder joint diseases are presented. In the all patients the rehabilitation program included electrostatic massage on the ELGOS device using a lead-out electrode according to the local-segmental method. Patients of the comparison group underwent manual massage of similar areas. Before and after the treatment, the clinical manifestations of vibration disease were evaluated by vibration sensitivity test using a Rydel-Seiffer vibrotone C 64 Hz / C 128 Hz. The dynamics of functional activity indices in the patients with shoulder joint diseases was assessed using a visual analog scale questionnaire. The work showed that the electrostatic massage contributes to a faster restoration of vibration sensitivity, the volume of movements in large joints and a reduction in the clinical manifestations of vibration disease (pain in the fingers, paresthesia, numbness, etc.), which has an advantage in the conditions of the COVID-19 pandemic, since the direct impact of the masseur’s hands on the patient’s body is excluded.

The article examines the socio-demographic indicators of professional groups of medical workers, some factors of job satisfaction. Purpose of the study — socio-demographic characteristics of medical personnel in obstetric institutions for the further development of scientifically based recommendations on the formation of health-preserving behavior. The research was carried out by means of anonymous questionnaires on the basis of obstetric institutions of the second and third levels. Ryazan, Kolomna, Lipetsk, Smolensk. The study involved doctors (obstetricians-gynecologists, neonatologists) and nurses (midwives, anesthetics nurses, ward nurses).

The study showed that about half of the respondents in medical professions, one tenth in the professional groups of nursing staff belong to the age category under 30 years old. The age group of 30–39 years is represented by doctors and mid-level medical personnel in almost equal proportions. In the age group 40 years and older, representatives of the nursing professions prevail. A significant part of the respondents are medical professions, have work experience in their specialty from 5 to 9 years; representatives of nursing professions, mainly, have work experience of 10-14 years and more than 15 years. In the families of nursing staff (nurse anesthetists and ward nurses), one can note dissatisfaction and incomplete satisfaction with the level of wages and lack of confidence in the future. The revealed dissatisfaction with work can lead to a decrease in motivation to perform professional duties.

Socio-demographic characteristics are basic and serve as the basis for further hygienic and statistical studies, identifying correlations between unfavorable hygienic factors (physical inactivity, prolonged static load, local overstrain of certain muscle groups, exposure to physical, chemical and biological factors, psychoemotional and informational stress).

Healthcare workers are at risk of contracting new coronavirus infections (COVID-19) due to their job responsibilities.

The study aims to explore the incidence of a new coronavirus infection of medical workers of private healthcare organization (PHO) of JSC "Russian Railways".

To analyze the incidence of COVID-19 among medical workers of PHO of JSC "Russian Railways", we used the data of weekly monitoring conducted by the company from 5.04.2020 to 28.03.2021. The χ² method was used for statistical processing. The epidemiological data were also smoothed by linear filtering using 2 points.

A feature of the medical service of PHO of JSC "Russian Railways" is the continuous nature of its activities. 5 hospitals were converted to COVID hospitals. 12.9% of cases of COVID-19 were recorded among employees of PHO of JSC Russian Railways. The minimum number of cases was registered on the Far Eastern and East Siberian Railways. The maximum number of cases was noted on the South-Eastern and Northern railways. 94% of the sick were on outpatient treatment. Half of the sick are nurses. The testing of medical workers of PHO of JSC "Russian Railways" revealed a higher percentage of people with IgG to the SARS-CoV-2 virus than the number of cases registered. This may indicate an asymptomatic course of the disease in medical workers.

The data obtained indicate the effectiveness of preventive measures to protect medical workers of PHO of JSC "Russian Railways" from a new coronavirus infection. The conducted research will increase the effectiveness of preventive measures in the other PHO.

Currently, work in any medical organization carries a risk of coronavirus infection, and, first of all, this applies to medical organizations dealing with the treatment of patients infected with coronavirus. Medical workers are a group at increased risk of infection with the SARS-CoV-2 virus in the provision of medical care in modern conditions, which determines their incidence of COVID-19 [1–3].

The aim of the study is to explore the prevalence of cases of COVID-19 infection in medical workers providing medical care on an outpatient basis.

The analysis of the incidence of COVID-19 medical workers in one of the large medical organizations of the Samara region during the period of the pandemic was carried out. The medical staff of the medical organization includes 207 doctors. There are 11 subdivisions in the structure of the medical and prophylactic institution. Research methods: content analysis of the modern regulatory framework (2020-2021), statistical, expert.

For the period from May 2020 to March 2021 71 cases of infection of medical workers on an outpatient basis with SARS-CoV-2 were identified, of which 32 doctors (45%) and 39 people (55%) nurses. Based on the results of the expert assessment, the insurance nature of the infection case was established in 50 people (70%).

Among the medical and nursing categories of medical workers, the largest number of cases was made by doctors and nurses of primary contact — specialists of the district service: general practitioners (40%), pediatricians (32%), doctors — obstetricians-gynecologists (12%), nurses adults (76%) and children (20%) polyclinic departments. A third of health workers received inpatient treatment for severe COVID-19, an average of 60 days.

Medical workers are a risk group of COVID-19 who need support measures, since the possibility of occupational infection has been sufficiently proven, and the risk probably depends on the work performed and the conditions of direct contact of medical personnel, which requires further study in the current persisting epidemic conditions.

Professional training of cadets of lyceums in the process of mastering working specialties is accompanied by the influence on the adolescents' organism of ecological and hygienic territorial environmental factors, as well as specific factors of the educational and production environment.

The study aims to explore the influence of factors of the environment and educational-production environment of river transport lyceums on the adaptation of adolescents' bodies in the process of teaching working specialties.

A survey of 400 cadets studying at the Saratov and Balakovo lyceums of river transport (200 boys each) at the age of 15–18 years was carried out. The hygienic assessment of the organization and conditions of vocational training of adolescents mastering working specialties was carried out in accordance with SanPiN 2.4.3.1186-03, assessment of the conditions and nature of cadets' work in accordance with R 2.2.2006-05 "Guidelines for the hygienic assessment of the factors of the working environment and the labor process. Criteria and classification of working conditions". The processes of adaptation of the body of young men were studied in terms of psychophysiological status on a computer complex KPFK-99 — "Psychomat". To assess the adaptation of the cardiovascular system to physical activity, the Rufier index and the Martinet-Kushelevsky test were used. Statistical processing of materials was carried out using the program "Statistica for Windows 10.0".

It is shown that vocational training of students in the process of passing educational practice in the shops of a ship repair enterprise, as well as swimming practice is accompanied by the impact on cadets of unfavorable production factors: microclimatic, increased sound pressure and vibration levels, exceeding the permissible content of chemicals in the air of the working area. The nature of the factors of educational and production activity of cadets during the periods of technological, swimming practice leads to a decrease in the adaptation processes of the body of young men, which is manifested by changes in the indicators of the psychophysiological status and functional activity of the cardiovascular system during stress tests.

Negative factors of atmospheric air pollution of the environment, regardless of the territorial affiliation of the settlement, contribute to an increase in the overall incidence of cadets with a predominance of respiratory diseases. Among students with a deficit or excess body weight, in the process of passing professional practice, the number of people with low indicators of the body's adaptive ability to workloads is increasing.