Vol 66, No 5 (2022)

Настоящий номер журнала «Здравоохранение Российской Федерации» посвящён XIII Всероссийскому съезду гигиенистов, токсикологов и санитарных врачей, проходящему под девизом «Развивая вековые традиции, обеспечивая "Санитарный щит" страны». Съезд стал значительным событием в ряду памятных дат, отмечаемых в этом году. Это столетие образования государственной санитарно-эпидемиологической службы России (1922 г.) и 130 лет со дня основания Московского гигиенического общества (1892 г.), созданного по инициативе одного из выдающихся деятелей гигиенической науки профессора Фёдора Фёдоровича Эрисмана. Преодолев 130-летний рубеж, детище Ф.Ф. Эрисмана сегодня носит имя Общероссийской общественной организации «Общество гигиенистов, токсикологов и санитарных врачей». Сохраняя память о своём основателе, Общество в 2022 году отмечает ещё одну значимую для истории отечественной и мировой гигиенической науки дату — 180-летие со дня рождения Ф.Ф. Эрисмана. Можно с уверенностью сказать, что журнал «Здравоохранение Российской Федерации» является продолжателем дела знаменитого учёного и патриота отечественной профилактической медицины, говорившего: «Да, мы хотим стать не только врачами, мы стремимся быть людьми! Для этого нам необходимо непрестанно совершенствовать наше образование…».

Introduction. Analysis and generalization of the results of scientific research of the institutions of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing (Rospotrebnadzor)institutions of a hygienic profile are extremely important in the scientific substantiation of ensuring sanitary and epidemiological well-being and managing risks to the health of the Russian population.

The purpose of the study is to analyze the results, achievements and prospects of the scientific substantiation of ensuring sanitary and epidemiological well-being and managing risks to the health of the population of the Russian Federation.

Materials and methods. An expert-analytical study was carried out. The analysis materials are the main results of the activities of scientific institutions of the Rospotrebnadzor of the hygienic profile in the implementation of the industry research program of Rospotrebnadzor for 2021–2025. “Scientific substantiation of the national system for ensuring sanitary and epidemiological well-being, managing health risks and improving the quality of life of the population of Russia”, as well as of the Federal Program (FP) “Clean Air” of the National Project (NP) “Ecology”, FP “Clean Water” NP “Housing and Urban Environment”, FP “Strengthening Public Health” NP “Demography”, the State Program “Provision of chemical and biological safety of the Russian Federation for the period 2021–2024”, the Federal Target Program “Ensuring nuclear and radiation safety for 2016–2020 and for the period up to 2030”.

Results. Within the framework of the industry program, in the first year of its implementation, six SanPiNs, 668 hygienic standards were approved, 20 analytical reviews were prepared. 23 patents for inventions, 45 — for industrial designs, 34 — certificates for computer programs, 178 objects of intellectual activity were registered. Based on the materials of scientific research, 95 articles were published in the journals Web of Science, 328 — Scopus, 802 — RSCI. 40 monographs, books and manuals have been published. 11 PhD, 2 doctoral dissertations were defended.

Limitations. The research materials are limited to the results of scientific research of the Research Institute of Hygienic Profile of Rospotrebnadzor, obtained in 2021.

Conclusion. The results of the activities of the NIO Rospotrebnadzor in 2021 indicate that the set of tasks assigned to them to ensure the sanitary and epidemiological well-being of the population is being successfully implemented. Further development of interagency cooperation is required (with scientific institutions of the Russian Academy of Sciences, the Ministry of Education and Science of Russia, other ministries and departments, with medical universities); interaction with problem committees of the Scientific Council of Rospotrebnadzor, as well as further modernization and renovation of the park of laboratory and medical equipment of scientific organizations.

Compliance with ethical standards. Research does not require the submission of a biomedical ethics committee opinion or other documents.

Contribution of the authors:
Kuzmin S.V. — research concept and design, text writing, editing.
Kuchma V.R. — research concept and design, text writing, editing.
Rakitskiy V.N. — editing.
Sinitsyna O.O. — collection and processing of material, text writing, editing.
Shirokova O.V. — collection and processing of material, text writing.
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022

The relation of tasks of managing the sanitary and epidemiological situation at the regional level to the storage, transmission and analysis of large data arrays determines the relevance of their digitization for data transformation and computational operations.

Purpose: to use digital technologies for processing dynamic spatially distributed information to optimize management decisions regarding the provision of sanitary-epidemiological welfare of the population.

Methods: system and mathematical analysis, geoinformation analysis, forecasting, online consulting, computing technologies.

Results. Using the example of the Krasnoyarsk Territory, digital technologies were used to assess, analyze and optimize the sanitary-epidemiological situation at the regional and municipal levels (55 municipalities, 2.9 million people, 40 thousand production facilities, 19 classes of diseases and causes of death, about 10 years of observations, 50.0 thousand health studies, etc, a total of 1.5 billion units of information).

The territorial distribution of the total risk of causing potential harm to the health of the population has been quantified with geoinformation binding, and a shift in priorities towards the location of the activities of economic entities has been revealed. The zones of aerotechnogenic impacts on the population were digitized, the maxima of the spread of diseases associated with the risk of harm to the health of the exposed population were estimated. There are obtained digital parameters of models of dependence of morbidity of the population on the total risk of harm to the health of the population formed by subjects of various types of activity.

With the use of digital technologies, at the regional level there is substantiated an effective model of the system of socio-hygienic monitoring, based on the combination with risk-oriented control and supervisory activities. Their optimal interaction in relation to the sanitary-epidemiological situation is ensured by a cyclical interconnected planning process that eliminates zones of excessively high or unacceptably low intensity of observations.

Limitations. The results of the conducted research on the use of digital technologies for processing dynamic spatially distributed information for the assessment, analysis and optimization of the sanitary-epidemiological situation are applicable only in the territories of federal districts, regional and municipal levels of the Russian Federation.

Conclusion. The potential for optimizing the sanitary-epidemiological situation at the regional and municipal levels is quite high. Digitalization provides efficiency, high accuracy, and selection of scenario management decisions to minimize risks to public health.

Compliance with ethical standards. The study does not require the submission of the conclusion of the Biomedical ethics committee or other documents.

Contribution of the authors:
Goryaev D.V. — research concept and design, editing, statistical processing, writing the text;
Tikhonova I.V. — material collection and processing, statistical processing, collection of literature data, compilation of the list of literature, writing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgement. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022 

Introduction. Risk management is one of the main directions of occupational health at the present stage. At the same time, the analysis of factors affecting human health is an important component of this process. Many scientific papers have been devoted to the study of the health status of industrial workers, showing priority etiological factors contributing to the development of both occupational and chronic non-infectious pathology. Much less attention is paid to the study of the causes and consequences of health disorders of social workers, who make up a significant part of the able-bodied population.

The purpose of the research is to develop modular corporate programs for industrial and social workers using scientifically based differentiated approaches.

Materials and methods. The study of working conditions, socio-demographic factors, lifestyle characteristics, morbidity of nine hundred forty seven employees of various professional groups, clinical and functional examination and neuropsychological testing of 395 employees of the studied enterprises and institutions was carried out. The assessment of working conditions was carried out using data of sanitary and hygienic characteristics and charts for special assessment of working conditions, socio-demographic status, lifestyle and self-esteem of employees were studied using questionnaires, neuropsychological questionnaires were used, morbidity was analyzed based on data from outpatient charts and a functional survey.

Results. The analysis of working conditions revealed priority production factors affecting the health of employees of the studied occupational groups: the noise vibration factor and the severity of labour in machine–building workers and miners, labour intensity in combination with other factors for social workers. The risk factors of lifestyle, risk diseases characteristic of workers of various industries and workers of the non-industrial sphere have been identified.

Limitation: the study was conducted on a representative sample of 947 employees, 395 of whom underwent an in-depth examination, the limitation of the results of the study was the subjective assessments of respondents during the questionnaire.

Conclusion. The obtained results made it possible to develop differentially directed medical and preventive effects, taking into account the peculiarities for each professional group.

Compliance with ethical standards: the design of the study was approved by the local ethics committee of the Federal Scientific Center for Hygiene named after F.F. Erisman” of Rospotrebnadzor, Protocol No. 8 of 15.01.2020.

Contribution of the authors:
Zheglova A.V. — concept and design of research, collection and processing of material, writing text.
Yatsyna I.V. — concept and design of research, editing.
Gavrilchenko D.S. — statistical data processing, writing text. 
All authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest. 

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022

Introduction. The preservation and strengthening of the health in children and adolescents is currently a problem of individual health management in connection with which there is a need to change the approach to health assessment, which consists not only in determining the disease, but also in a prenosological assessment of the level of individual health.

The purpose is to develop integral indicators of quantitative assessment of health, on the basis of which to scientifically substantiate the health management system for children and adolescents.

Materials and methods. Four thousand eight hundred children and adolescents of school age (7–17 years old) underwent computer diagnostics of the functional state of the central nervous, autonomic and cardiovascular systems using the methods of variation chronoreflexometry (Moroz MP, 2001) and variation cardiorhythmotography (Igisheva LN, 2003). Mental health is investigated by determining anxiety levels, negative emotional experiences, stress prognosis, and stress tolerance. The level of social health was assessed according to the method of E.V. Tsikalyuk (2013).

Results. 37.7% of the examined children were found to have a satisfactory level; 28.2% stress, 23% – unsatisfactory and 11.1% showed disadaptation. A high level of anxiety in everyday life was experienced by 36.7% of the subjects and 61.3% in the classroom; 12.3% of children had a high level of negative emotional experiences. 28.1% of children had a high level of social health; 51.6% had an average; 12.3% had a low level; 6.5% had a social “unhealthiness”.

Limitations of the study. When developing a modern model for assessing and managing physical, psychological and social health, data from a psychophysiological examination of 4,800 school-age children were used.

Conclusion. The developed integral measures of univariate assessment of children’s physical, mental and social health provided the basis for justifying the model of screening and health management of the child population.

Compliance with ethical standards. The study was approved by the Local Ethics Committee of the Orenburg State Medical University, dated 03/24/2022.

Patient consent. Each participant of the study (or his/her legal representative) gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form in the journal "Health Care of the Russian Federation".

Contribution of the authors:
Setko A.G. — research design, material processing, writing a text, compiling a list of references.
Setko N.P. — concept and design of research, text writing, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022

Introduction. Acute cerebrovascular accidents are among the leading causes of death and disability in the population. The study of regional features of the incidence of acute disorders of cerebral circulation in the context of a pandemic of a new coronavirus infection COVID-19 is an urgent task.

Purpose — to conduct a comparative analysis of the primary incidence of acute disorders of cerebral circulation, including transient ischemic attacks, in the adult population of Russia, the Urals Federal District and the constituent entities of the Russian Federation as part of the Urals Federal District.

Materials and methods. A comparative analysis of the primary incidence of acute cerebrovascular accidents in the adult population in the Urals Federal District and in individual subjects of the district during the 2020 pandemic was carried out relative to the average long-term indicators for 2015–2019. Transient transient cerebral ischemic attacks, intracerebral and other intracranial hemorrhages, cerebral infarctions and strokes not specified as hemorrhage or infarction were taken into account. Average long-term levels of primary morbidity, standard deviation, coefficient of variation were calculated. Statistical data analysis was carried out using Microsoft Excel software products.

Results. During the COVID-19 pandemic, the levels of primary incidence of certain acute cerebrovascular accidents in the Russian Federation and the Urals Federal District as a whole decreased compared to the long-term averages of 2015–2019.

Conclusions. Indicators of primary morbidity of the adult population of the Ural Federal District with certain acute cerebrovascular accidents, including transient ischemic attacks, in different subjects of the district have pronounced regional features. Regional peculiarities of morbidity should be taken into account when planning the volume and financial parameters of territorial programs for the provision of free medical care to citizens. Significant differences in morbidity rates should be in the focus of attention of the chief neurologists of the Ministry of Health of the Russian Federation and the constituent entities of the Russian Federation.

Compliance with ethical standards. This type of study does not require the submission of a biomedical ethics committee or other documents, since the main material is based on statistical reporting.

Contribution of the authors:
Shirokov V.A. — research concept and design, material collection and processing, editing.
Shastin A.S. — research concept and design, material collection and processing, statistical processing, text writing, editing.
Gazimova V.G. — material collection and processing, text writing.
Mityukova M.N. — statistical processing, editing. 
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors claim no conflict of interest.

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022

Introduction. One of the main tasks of the improvement of federal sanitary and epidemiological surveillance is the development of its staff potential. The level of professional competence of young specialists is assessed during their accreditation.

Materials and methods. The results of primary and primary specialized accreditation in an enlarged group of specialties and areas from 30 educational institutions of higher education providing of training 32.00.00 Health Sciences and Preventive Medicine in 2021 were analyzed. 

Results. Graduates in the specialty 32.05.01 Preventive medicine care undergo primary accreditation starting from 2017. Since 2021, primary specialized accreditation has been carried out in specialties classified as enlarged groups of specialties and areas of training 32.00.00 Health Sciences and Preventive Medicine. In 2021, primary accreditation was carried out in 30 educational organizations of higher education that train of preventive specialists. 96.8% of specialists successfully passed primary accreditation. Primary specialized accreditation was carried out in 22 educational institutions in 11 specialties. The share of accredited specialists was 95.5%.

Study limitations. Limited time.

Conclusion. Generally, primary and primary specialized accreditation were successfully carried out. Within the primary accreditation, 1437 specialists were accredited, within primary specialized accreditation — 443 specialists in 11 fields of training. 

Compliance with ethical standards. The study does not require the submission of the opinion of the biomedical ethics committee or other documents.

Contribution of the authors:
Meltser A.V. — research concept and design, editing.
Briko N.I. — research concept and design, editing.
Pronina A.A. — writing the text, editing.
Erastova N.V., Mindlina A.Ya. — writing the text, compilation of the list of literature.
Aristova Т.I. — collection and processing of material, writing the text.
Kolomenskaya Т.V. — collection and processing of material, statistical data processing.
Pavlova A.N. — collection and processing of material.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022

Anthroponutriciology combines areas related to the influence of actual nutrition and genetic characteristics on nutritional status, including anthropometric indicators and biochemical data on the provision of the body with nutrients, indicators of physical development and health status.

The form of research is the implementation of a systematic review, analysis and synthesis of research papers devoted to methods for determining the human somatotype, morphological and topographic features of the body and the dynamics of physical development indicators depending on the somatotype, the search for anthroponutritiological markers of alimentary-dependent diseases published over the period 2002–2022 in domestic and foreign electronic databases.

The Federal State Budgetary Institution “Federal Research Center for Nutrition and Biotechnology” has developed methodological recommendations for conducting anthroponutrition studies using classical methods of complex anthropometry. The interrelation of anthropometric indicators and metabolic features, individual psychological characteristics was proved: significant correlations between the features of physical status, physical activity were revealed; some anatomical and topographic features of internal organs, neurovascular bundles in representatives of various somatotypes are noted. In patients of different age groups, there were identified biomarkers indicating a predisposition to alimentary obesity of varying degrees and/or anorexia. For women of the mesosomal constitution, obesity of the I degree is characteristic, for the megalosomal II–III. Belonging to the asthenic, stenoplastic, pycnic and subathletic somatotype for women indicates the risk of overweight and metabolic syndrome, for men the muscular somatotype serves as such a risk factor. Nutritional correction provides a pronounced clinical effect for mature and elderly males with an abdominal-muscular somatotype; for women with a picnic somatotype, the correction was significantly higher than in cases with a euryplastic one.

The anthroponutrition approach can serve as a tool for hygienic objectification of the state of physical development of the population and its relationship with the impact of alimentary factors, it allows to determine the predisposition to the formation and development of one or another nosological form.

Contribution of the authors:
Nikitjuk D.B. — research concept and design, editing, approval of the final version of the article.
Korosteleva M.M. — writing the text, compiling a list of references.
The co-authors approved the final version of the article and take responsibility for the integrity of all its parts. 

Acknowledgment. The study had no sponsorship.

Conflict of interests. The authors declare no conflict of interest.

Received: August 26, 2022
Accepted: September 05, 2022
Published: October 17, 2022

В 2022 г. отмечается 100-летие образования государственной санитарно-эпидемиологической службы России. 15.09.1922 Декретом Совета Народных Комиссаров РСФСР «О санитарных органах Республики» был установлен перечень задач, а также права санитарно-эпидемиологической службы как государственного санитарно-контрольного органа. Федеральная служба по надзору в сфере защиты прав потребителей и благополучия человека (Роспотребнадзор, Служба) относится к федеральным органам исполнительной власти, осуществляющим разработку государственных санитарно-эпидемиологических правил и гигиенических нормативов, а также реализующим мероприятия в сферах санитарно-эпидемиологического надзора и надзора в области защиты прав потребителей. Решение возложенных на Роспотребнадзор задач обеспечивают 85 территориальных управлений и 85 центров гигиены и эпидемиологии в субъектах РФ, 21 научно-исследовательский институт, 18 противочумных станций и организации дезинфекционного профиля.

В соответствии с Постановлением Правительства РФ от 12.11.1992 г. № 869 «О государственной регистрации потенциально опасных химических и биологических веществ» был создан Российский регистр потенциально опасных химических и биологических веществ (далее Российский регистр), задачей которого являлись, прежде всего, сбор данных о свойствах обращающихся химических веществ, их анализ, ведение Федерального регистра потенциально опасных химических и биологических веществ и предоставление этой информации органам власти, промышленности и всем заинтересованным лицам, а также осуществление процедуры государственной регистрации химических веществ, впервые введённых на территории Российской Федерации. Огромную роль в создании Российского регистра и внедрении в России системы государственной регистрации, а также в её становлении сыграли Председатель Государственного комитета санитарно-эпидемиологического надзора России Е.Н. Беляев, Первый заместитель Председателя Государственного комитета санитарно-эпидемиологического надзора России С.В. Семенов, Начальник управления Государственного комитета санитарно-эпидемиологического надзора России В.И. Чибураев, первый директор Российского регистра член-корреспондент РАН, доктор медицинских наук, профессор Б.А. Курляндский. Большую помощь и содействие Российскому регистру оказывали и оказывают руководители Роспотребнадзора Г.Г. Онищенко и А.Ю. Попова. С 2009 г. Российским регистром руководит доктор медицинских наук, почётный работник Роспотребнадзора Х.Х. Хамидулина.