Vol 97, No 11 (2018)

Introduction. The article presents scientific and organizational-methodical approaches to the formation and implementation of programs to counter the adverse effects of global climate change on the population health of Russia. According to the results of the study of the relationship between the number of exacerbations of chronic diseases of the circulatory system and the observed meteorological and geomagnetic parameters, the need to develop methods for the determination of the physiological mechanisms of meteorological factors, as well as assessing the individual risks of their influence followed by the use of corrective programs, is shown.

Material and Methods. There are presented results of the survey of 168 patients with circulatory system diseases receiving sanatorium-resort treatment.

Results. The data obtained showed in most cases (76.8%, 129 people), weather dependence to be manifested in the form of a general deterioration in the well-being of patients. During the physiological examination, the most frequent signs of meteosensitivity were: increased blood pressure — 67.8% (114 people), headache — 41.6% (70 people), sleep disturbance — 47% (79 people), joint pain and muscles — 43.4% (73 people).

Discussion. The obtained data allowed us to confirm the prospect of creating a mathematical model for the development of increased meteosensitivity in response to the impact of adverse meteorological factors with the subsequent formation of recommendations for its use in personalized programs of sanatorium-resort treatment of meteo-dependent diseases.

Conclusion. The results of the study confirm the need to develop a concept for the development of the scientific direction “environmental medicine”.

The professional standard is the basis of education and training. It should meet modern requirements to ensure the sanitary and epidemiological wellbeing of the country’s population, the labor market. The current professional standard does not fully take into account the various types of economic activity in which young professionals of the medical and preventive profile will work. The main task of a specialist in the medical and prophylactic profile is to carry out activities aimed ensuring the sanitary and epidemiological wellbeing of the population (informing the control subject concerning mandatory sanitary and epidemiological requirements, implementation, assessing the effectiveness and effectiveness of their implementation, implementing production control, expert control, sanitary-epidemiological audit). The main employers for these young professionals are organizations of the sanitary and epidemiological services; hospitals, sanatorium, spa and resort organizations; organization of disinfection and deratization, organizations of industrial equipment, testing and analysis of the composition and purity of materials and substances; testing and analysis in the field of food hygiene; testing and analysis of physical and mechanical properties of materials and substances; examination of design documentation and engineering survey results; monitoring of environmental pollution. The professional standard of the young professionals in the hygiene profile has a particular set of qualities, skills, and behaviors that ensure the success of the career. There is a set of standards for education and training of professionals in the hygiene profile. There are sanitary and epidemiological diagnostic — activities to establish compliance (inconsistency) with the requirements of the legislation of the Russian Federation in the field of public health. Also, there is the support of the sanitary and epidemiological wellbeing of the population, technical regulation, labor protection, various activities concerning and preventive measures; organization of monitoring and sanitary-epidemiological assessment of the risk of environmental factors affecting health. The education and training of students of medical-prophylactic faculties should be carried out taking into account modern approaches to the professional standard for the specialist of the hygienic profile and the educational standard developed on the basis of it.

Environmental quality management requires the compliance with a number of conditions, such as the use of criteria for the reliable assessment of the health effects of harmful environmental factors (eg., hygienic standards, risk indices) and the optimization of factors of the laboratory control, including chemicals. The A.N. Sysin Research Institute of Human Ecology and Environmental Health (now part of the Federal State Budgetary Institution “Centre for Strategic Planning and Management of Biomedical Health Risks”) of the Ministry of Health of the Russian Federation has corrected domestic hygienic standards of chemicals in the water of water bodies in accordance with international recommendations, and standards of substances in ambient air — according to time characteristics and MPC values. Unified standards in water for substances belonging to the same structural class and not differing in the mechanism of action are justified, hygienic standards for a mixture of substances in atmospheric air have been established according to the criterion “obsession of the smell”. The developing methods of predicting the toxicity of substances make it possible to improve the planning of experiments in selecting doses and indices of the state of the organism. On more than 50 territories of the Russian Federation, a health risk assessment under the influence of chemical environmental factors was implemented. At the same time, an adequate assessment and control of environmental pollution are hindered by a number of circumstances, first of all, the lack of an optimal monitoring system and imperfection of its organization. Studies have shown the number of control indices from a few units to several tens, while hundreds of components that are not provided with regulations are identified. This is due to the lack of modern equipment and analytical methods. The solution to the problem lies in the systematic application of the methodology for selecting priority indices for monitoring. At the same time, an attempt to replace the assessment of the hazard of substances’ harmful effects on the body using generalized indices, for example, a unified “interagency index”, is untenable. The developed recommendations are aimed at improving the organization and methodology of environmental quality management.

Anti-icing reagents (AIR) are one of the main soil pollutions of large cities of countries with the cold climate. The salinization adversely affects the environment and urban health. The data on the content of readily soluble salts, the response of the medium, and a number of other indices of soils of Moscow’s different functional areas are presented. Stocks of ion-pollutants in the root zone soil layers have been identified. The expansion of anomalies of salt reserves and enhancement of the salt process within individual functional areas was noted. The maximum pollution was observed in the soils of the transport zone (dissolved solids reached 0.19%), which corresponds to the average degree of salinity. According to the prevailing ionic composition, most of the soils was found to belong to the sodium chloride class. Revealed growth of fine silt fraction (fine dust) during soil salinization was detected.

The most abundant protozoan Blastocystis spp. from human and animal intestines is one of the poor-studied pathogens causing the occurrence of a protozoal infection of the human gastrointestinal tract. In Russia, no Blastocyst invasion is recorded and neither included in the forms of state statistical reporting. The manifestations of the epidemic process of blastocyst can be judged based on a small number of studies. Analysis of clinical observations and literature data indicates a variety of forms, localization, and nature of the infection manifestation. This article is devoted to substantiating the need to detect blastocysts in environmental objects (water, soil, surfaces) as potential risk factors for the occurrence of a protozoal infection. At the same time, the studies both of the survival duration in the external environment and influence of various factors the Blastocystis survival have both the theoretical and practical importance. This information can be used in problems of epidemiology and epizootiology, for developing new methods for Blastocystis elimination, and identifying ways of spreading these parasites. Infection risk factors are sanitary and hygienic problems of environmental objects (geographical, environmental and social factors), profession features, contact with animals, use of contaminated water and food, immigration and travel to tropical countries, as well as people with weakened immune status.

Introduction. Means for working with information — communication devices (personal computers, laptops, tablet computers, and smartphones) are leaders in the dynamics of modification and updating of the technical base. This is accompanied by a dynamic change in the electromagnetic characteristics of computer equipment. The amount of information faced by young people receiving education in the modern world is growing. In students, this is accompanied by long-time work with personal computers (PCs) not only in the classrooms but also at home, in the process of preparing for classes. It is important to study the effect of PCs’ electromagnetic factors on the user’s body, taking into account the exposure. 

Material and methods. The was studied memory, attention, non-specific adaptation reactions, the adaptation potential of the cardiovascular system (CVS), the vagosympathetic interaction index (VII), skin temperatures, and biological age in students - PC users. The PC determined the strength of the electrostatic, electric and magnetic fields of monitors, system units, laptops and tablet computers of various types and manufacturers. There was calculated the individual electromagnetic exposure (EMEi). 

Results. Measured values ​​of electromagnetic fields (EMF) of the studied PCs were revealed to be below the maximum permissible levels. The determination of the number of indices for students — PC users showed that they were within physiological norms. 

Discussion. There is an impact of individual electromagnetic exposure on the studied indices among students — PC users. 

Conclusion. Correlation analysis by Pearson allowed identifying the most important relationships of electromagnetic exposure with investigation of memory (R=-0.383; p<0.001) and attention (R=0.326; p<0.001) and nonspecific adaptive responses (R=-0.325; p<0.01), VII (R=0.618, p<0.001), the adaptive capacity of the cardiovascular system (R=0,267; p<0.01) and amplitude difference of the skin temperatures ( R= -0,284; p < 0,01). Biological age was associated with a weak positive dependence (R = 0,231; p < 0,05).

Introduction. A review of the literature on nanotechnology shows the advanced development of hygienic research in the field of nanotoxicology to be of fundamental importance, as it allows creating a basis for the introduction of safe production at the design stage of technological processes. The effects of carbon nanotubes (CNT) on the body are evaluated for the use in many different technical applications, including the alleged possibility of their use as a sorbing material in the water treatment process. 

Material and Methods. Two-weeks intragastric effect of single-walled carbon nanotubes (oUNT) at doses of 0.05 and 0.5 mg/kg and a complex of vitamins A and E (AE) at a dose of 25.3 mg/kg (vitamin E — 25.2 mg/kg and vitamin A — 0.1 mg/kg) on the liver of male Wistar rats, as well as in the same batch of animals three months after a two-week experiment and a single exposure to oUNT at a dose of 5 mg/kg were studied in fifteen groups of animals. oUNT was dissolved in sunflower oil at the rate of 0.5 ml of oil per 100 g of body weight. 

Results. Two-weeks study of oUNT at doses of 0.05 and 0.5 mg/kg and three months after a single exposure at a dose of 5mg/kg revealed no damage to the nucleus of hepatocytes, but three months after a two-week experiment, when exposed to both doses of oUNT, showed a significant increase in this index, as well as indices of fatty degeneration, only in relation to groups of the two-week exposure. Thus, with two-weeks exposure of oUNT, three months after it, as well as three months after a single exposure at a dose of 5 mg/kg the fatty degeneration develops. The effect of the complex of vitamins AE in the two-weeks experiment and three months after it significantly worsens all the studied parameters in the rat liver, and with its complex effect with oUNT indices remain at the same changed level. 

Discussion. Probably UNT, getting into the digestive tract, cause pathological changes both in the place of direct contact — in the small intestine and in the remote body — the liver, which is consistent with both our data and previous studies. 

Conclusion. oUNT in different studied periods of exposure causes the development of fatty degeneration in the liver, and the use of vitamins A and E does not reduce the response of the liver damage.

Introduction. The toxicity of carbon nanotubes (CNT), which are chemically inert particles, is thought to be connected with responses of aseptic inflammation and oxidative stress. This study was conducted to determine how far antioxidants may reduce CNT toxicity in laboratory animals.

Material and methods. Male Wistar rats were administered by oral gavage with 0.05 or 0.5 mg/kg/day of Tuball© single-walled CNT in vegetable oil for 2 weeks, without a modifier or in combination with Aevit© (mixture of retinol and α-tocopherol given in doses 25,000 IU/kg/day and 25 mg/kg/day correspondingly). Control animals received oil or Aevit without CNT. 10 markers of oxidative stress and 12 clinical chemistry markers were determined in the rat blood samples.

Results. Aevit didn’t influence the above biochemical markers, but combination “Aevit + CNT” increased the prooxidant action of CNT and arose biochemical signs of malabsorption, presumably as a result of retinol inhibitory action onto repair of intestinal epithelial cells, damaged by CNT.

Discussion. The lack of tocopherol protective action, which usually removes prooxidant effects of high retinol concentrations, can be explained by superposition of two mechanisms: 1) two components of Aevit, in the presence of CNT, may be separated in space, since only retinol has isoprenoid side chain needed for the formation of donor-acceptor complexes with CNT surface; 2) the effects of retinol on cell reproduction, differentiation and wound healing is not related to its anti - or pro-oxidant properties but takes place at the level of target genes transcription after binding of retinoic acid with nuclear receptors RARs and RXRs. The data obtained allowed supposing the mechanism of lung cancer increases in ATBC and CARET trials was not prooxidant action of retinol and its precursor β-carotene, but regulatory inhibition of lung epitheliocytes reparation during its continued damage by cigarette smoke and asbestos fibers by retinoic acid.

Conclusion. Aevit (and, probably, other retinoid-containing preparations) can’t be recommended to ensure the safety of humans and animals during oral CNT intake. The results obtained explanation needs both functional activities of retinol, which is simultaneously antioxidant and one of the nuclear regulators; this, in turn, leads to the new assumption about the mechanisms of unsuccessful outcomes in ATBC and CARET trials.

Introduction. Adverse weather conditions are one of the reasons for the development of exacerbations of circulatory system diseases. The consequences of extreme atmospheric conditions clearly demonstrate the summer of 2010 in the central part of Russia, when prolonged high temperatures and a sharp deterioration in the quality of the air environment had a strong impact on the life and health of the population, and also led to huge human and economic losses.

Material and methods. The article presents an analysis of data on the calls of the ambulance to patients with diseases of the circulatory system in the city of Yaroslavl in 2014-2017 in relation to observed values ​​of meteorological and geomagnetic parameters. The results of the processing of archival data at the Clinic of Scientific Medicine in Milan (Italy) are also summarized.

Results. A correlation was found between the growth in the number of requests for emergency medical care on the occasion of exacerbation of circulatory system diseases (rhythm disorder, arterial hypertension, heart failure) and the temperature of the environment in July. Ruptures of a cerebral aneurysm were also shown to be seasonal: 42% of the ruptures occurred in the spring, 38% of the ruptures in the autumn and 20% in the rest of the year (p <0.05 by the criterion χ², if compared to the “spring” and “autumn” indices).

Discussion. The results obtained indicate to the dependence of the number of exacerbations on weather conditions.

Conclusion. The presented data allowed us to confirm the prospect of creating a mathematical model for the development of complications of circulatory system diseases in response to adverse meteorological factors, as well as the subsequent formation of recommendations for its use in personalized programs of sanatorium-resort treatment of meteo-dependent diseases.

Introduction. Up to now, it has not been established whether Helicobacter pylori, the most common bacterial pathogen of human, is involved in cholelithiasis. 

Material and Methods. Based on the analysis of prophylactic medical examination of working people in the Moscow region, the determination the pyloric Helicobacter infection and assessment of the virulence of bacteria there were studied the associations of H. pylori infection and gallstones. The infection was detected by the presence of serum specific antibodies of IgG class, the virulence of the strain H. pylori — by the presence of total antibodies to the protein associated with the cytotoxic gene CagA. There was used enzyme-linked immunosorbent assay. The study included 1,487 people, 931 men and 556 women aged 21-77 years. 

Results. The H. pylori infection was detected in 1348 (90,6%), CagA protein in — 392 (56.2 %) cases. Gallstones were diagnosed in 72 patients, 21 men (2.3%) and 51 women (9.2%), 67 were seropositive (5% of all infected) and 5 — seronegative (3.6% uninfected). In cholelithiasis cases, the presence of CagA positive strain of H. pylori was investigated in 35 patients. A virulent strain of bacteria was detected in 26 cases (74%), much more often than in the rest examined persons. 

Conclusion. There were no statistically significant differences in the incidence of cholelithiasis in infected H. pylori and non-infected individuals. A significantly higher prevalence of infection with pathogenic strains of H. pylori in patients with gallstones was found in comparison with the whole group of examined patients, that indicates to the favor of possible involvement of H. pylori infection in this pathology. Confirmation of the role of H. pylori infection as a cumulative risk factor for the gallstones cholecystitis, as well as for other extragastral pathologies, may have an epidemiological, prophylactic, clinical application, due to its widespread prevalence. Further research is needed.

Introduction. The nitrate entry into the body with drinking water might lead to endogenous nitrotyrosine and N–nitrosamine formation. The study aims to prove quantitative measurement of N-nitrosodimethylamine in blood and nitrates in urine as markers of the exposure to nitrates entering the body with drinking water. 

Material and methods. Analysis of blood samples for N-nitrosodimethylamine was carried out using Agilent gas chromatograph with quadrupole mass spectrometric detector. When preparing blood samples, an automatic system for solid extraction Sepaths was used. Studies of urine samples for nitrates were carried out using the system of capillary electrophoresis “Kapel”. The target audience includes two groups. Children consuming drinking water with nitrate level exceeding hygienic norm by 1.2 times and N-nitrosodimethylamine level exceeding by 1.6 times. The second group included children consuming drinking water of satisfactory quality. The establishment of cause-effect relationships is carried out using the package of applied programs Statistica 6.0.

Results. The nitrate level in drinking water of target area was 51.7 mg/dm³, what is by 4.7 times higher than in comparison area of 10.9 mg/dm³. The N-nitrosodimethylamine level was at the level of 0.016 mg/dm³, which is by 2.5 higher than in the comparison area of 0.0065 mg/dm³.

Discussion. The long-term exposure to nitrate and N-nitrosodimethylamine in the drinking water was found out to form in the children’s blood of first group the N-nitrosodimethylamine accounted of 0.0045±0.0014 mg/dm³ i.e. by 1.5 times higher in comparison with the second group (0.003±0.0009 mg/dm³). In the urine of children from the first group, the nitrates were by 1.5 times more than in the urine of children in the second group. Experimental studies proved that the concentration of nitrates in the urine and N-nitrosodimethylamine in the blood might be considered as markers of the oral exposure and correspond to the permitted level for nitrates in the urine of 43.7 mg/dm³ and N-nitrosodimethylamine in the blood of 0.003 mg/dm³ when nitrate concentration in drinking water is from of 45-51.7 mg/dm³ and N-nitrosodimethylamine from of 0.01-0.016 mg/dm³.

There was performed a study of the diagnostic activity of sera with antibodies to Toxocara spp. and Echinococcus spp. in conditions of long storage at different temperature regimes. The use of cryoprotectants makes it possible to increase the safety of diagnostic sera by two times during prolonged storage at low temperatures.

Международный форум Научного совета РФ по экологии человека и гигиене окружающей среды (далее — Форум), посвящённый методологическим проблемам профилактического здравоохранения (профилактической медицины), состоялся 14-15 декабря 2017 года на базе ФГБУ «Центр стратегического планирования и управления медико-биологическими рисками здоровью» Минздрава России (Москва), в состав которого вошёл НИИ экологии человека и гигиены окружающей среды им. А.Н. Сысина. На повестке дня Форума особо подчёркивалось, что 2017 год был объявлен Президентом страны В.В. Путиным «Годом экологии».