Vol 61, No 4 (2017)

The study was carried out to examine population health in large industrial center exemplified by Novokuznetsk for establishing risk zones and increasing efficiency of health care functioning and medical care quality. The efficiency is determined by increasing of reliability and integration of indices of population health and its particular categories for effective decision making, amelioration of awareness of specialists and quality of medical care. The article presents the results of analysis of health of working population of a large industrial center of Siberia as exemplified by Novokuznetsk according information data bases of the Kustovoii medical informational analytical center in relationship with environmental factors and indices of health care functioning. The indicator of "problemability" is developed and its application is presented related to establishment of risk zones for population health. The results of modeling of indices of population health and algorithms of support of decision making for the most problematic indices (health of newborns and disability) are presented. The health of schoolchildren, preschoolers and pedagogic workers is analyzed according information from sub-system "Pedagogic monitoring" sub-system. The results are presented concerning the clustering of educational organizations on main health risk factors. The results of study containing summarized analytical information about human environment, zones and categories of risk are to support timely decision making by mangers of all levels, increasing of role of healthy life style, amelioration of labor conditions, ecological and social environment, preservation and promotion of population health.

The study was carried out to establish hygienic estimate of labor employment and its effect of health of adolescents in various regions of Russia. The questionnaire survey of 1 500 individuals (senior high school students and students of professional education colleges) was implemented in four regions of the Russian Federation (Moscow, St. Petersburg, Omsk and Pskovsk regions). The quality of life related to health was estimated using standard questionnaire MOS SF-36. It is established that 41.2% of adolescents worked during time free of lessons. In Moscow, number of working adolescents is reliably lower than in other regions (32.8%). The prevalence of illegal labor activity in all oblasts is demonstrated. The regional features of of structure of labor employment according types of work and causes of labor activity is established. The study confirmed that labor activity in adolescent age is a health risk factor. The analysis of health risks demonstrated that in adolescents working all days of week during academic year are established risks of health complaints: leg pains (OR = 2.1, RR = 1.7, EF = 39.4%) in St. Petersburg, back pains (OR = 1.9, RR = 1.5, EF = 35.2%) in Omsk, heartburn (OR = 2.1, RR = 2.4, EF = 44.5%) and other disorders of digestion (OR = 2.4, RR = 1.9, EF = 48.4%) in Pskov. The increased risks are established in adolescents permanently working during academic year: occurrence of health complaints (OR = 2.6, RR = 1.6, EF = 38.8%) in Pskov, complaints on leg pains (OR = 3.2, RR = 2, EF = 49.5%) in Moscow, heartburn (OR = 4.7, RR = 3.4, EF = 70.5%) in Omsk, other disorders of digestion (OR = 4.3, RR = 2.8, EF = 64.4%) in Pskov. In these groups of working adolescents lower levels of indicator of quality of life related to health (according MOS SF-36) - BP scale (pain intensity) are established.

The article presents the results of hygienic evaluation of application of pesticides of various purpose in farms of the Dmitrovsky district of the Moskovskaya oblast. The admissible risk is established concerning effect of pesticides on workers at adherence of technological regulations and requirements of safety. The comparative characteristic is given related to pesticide load in various farms of the region and health of workers contacting with the substances.

The article presents the results of study of factors of occupational risk for health of workers of ore-dressing factories. At ore-dressing factories, despite of implementing new technological processes and modern equipment, leading role of noise factor and pollution of air of working zone with aerosols predominantly of fibrogenic effect is preserved. for workers of ore-dressing factories a high degree of industrial conditioning of diseases of blood circulation organs, respiratory organs, bone muscular system, INT organs is specific. The structure of occupational diseases is formed by dust diseases of lungs and occupational pathology of organ of hearing. The complex of preventive measures is developed and ways of their implementation are proposed targeted to supporting health of workers opf ore-dressing factories and preventing development of occupational and occupationally conditioned diseases.

The article presents analysis of mortality because of external causes in population of the Sakhalin Region in 2011-2014. It is demonstrated that about a half of all losses because of external causes were determined by injuries with uncertain intentions. The analysis of picture of mortality because of injuries with uncertain intentions was implemented demonstrating that mortality because of alcohol intoxications exceeds official indices up to 5.6 times in males and up to 3.6 times in females. It is possible to suppose with higher degree of probability that losses because of suicides in the oblast exceeded official indices more than thrice and because of suicides more than 2.5 times. The noted problems are actual not only for the Sakhalin Region but for Russia on the whole.

The article presents calculation and analysis of medical manpower support of population as exemplified by such megalopolis as Moscow during implementation of the program of development of manpower of medical organizations and according to strategy of development of health care of the region. The time span of observation made up to 2013-2015 because up to that time the structural transformations in municipal health care system were factually finalized and conditions for analysis of achieved results took shape. It is established that higher support with physicians in the beginning of transformations, untypical on other territories, during three years moderately decreased and stabilized. The directions of optimization of number of physicians depending on types of medical organizations were reflected in predominant decreasing of number of established posts, in lesser degree - employed posts and in most lesser degree - number of individuals as workers. In polyclinics the process of division of labor between physicians and paramedical personnel increased. The conditions for amelioration of effectiveness of using physicians' resources and modes of remuneration of labor were organized. The presence of particular disproportions in physicians' manpower dictates necessity of proceeding monitoring of support of application of assessment and consideration of its results with the purpose of more rational distribution and priority directions of functioning of manpower resources.

The article considers activities of the People's commissariat of health care of the Russian Soviet Federative Socialist Republic targeted to preservation of health of industrial workers in second half of 1920s - 1930s. The leading role industrial workers in implementation of plans of reconstruction of national economy determined direction to their preferential medical care. The forms and methods of medical sanitary activity were altered by its ultimate drawing near to production to resolve task of decreasing of morbidity with temporary incapacity to work, occupational traumatism that was one of the most important factors of increasing labor productivity and decreasing of cost price of produced industrial production.