Vol 96, No 1 (2017)

The changes in socio-economic conditions of the modern world require the public authorities to improve the methods of management. The index of the effectiveness of this management is the achievement objectives of public interest. Based on historical data, taking into account recommendations of international organizations for the assessment of the performance and efficiency of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing it is proposed to use infectious morbidity rate indices of the population controlled by means of vaccination; the level ofparasitic diseases; the percent ofprevented cases as a result of the activities of agencies and organizations of Federal Service For Surveillance On Consumer Rights Protection And Human Wellbeing, mortality rate due to the impact of environmental factors, percent ofprevented cases as a result of the activities of bodies and organizations of Federal Service For Surveillance On Consumer Rights Protection And Human Welbeing, the prevalence rate of diseases associated with neoplasms in the population, diseases of the circulatory system, asthma, liver disease, congenital abnormalities (newly diagnosed malformations, deformations and chromosomal abnormalities) and the value of economic loss, generated by medical and demographic losses and underproduction of Gross Domestic Product prevented by measures of Federal Service For Surveillance On Consumer Rights Protection And Human Wellbeing. Methodological approaches for monitoring and analysis of these indices have been developed. There are determined ways of the improvement of the system of collecting and processing information for the correct assessment of the performance and efficiency of service activities.

In the article there is considered the problem of optimization of the control and supervision activities of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing on the criterion “prevention of the economic damage”. In the process of the solution of the multi-objectives optimization the task was reduced to one-criterion, to be solved by the methods of mathematical programming. The results were obtained by the use of main criterion methods and successive concessions. The problems were solved with the help of MS Excel means, by using “Search solution” tool. Testing of the solution of the problem was performed on the statistical data at the federal level. The optimal performance indices of the activity of agencies and organizations of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing were acquired for the script, which preserves the existing level offunding. The use of an optimal model of action allows to predict an increase by 38% of prevention of economic losses from underproduction of Gross Domestic Product due to the loss of health of economically active population of the country at the same cost to the supervisory activities of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing. The solution of problems of optimization by the criterion offinancial costs of activities of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing has shown that the reduction in funding of control and supervisory activities of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing even in case of the system of measures ’ optimization could have the effect of lowering the total avoided economic loss. The latter indicates to the relevance of the maintenance of the level of providing health surveillance when improving its structure and organization.

There are given results of generalization of designing materials for sanitary protective areas of objects of the oil production, preparation and primary oil refining. It is shown that as a result of manufacturing technology enhancement, renewal of the hardware park and implementation of air-security actions aiming at exhaust fumes reduction and the reasonable use of passing oil gas, considerable changes happened over the last decade as regarding the impact of objects on the atmospheric air and population health. The accumulated expertise of designing and concordance of the projects of sanitary protective areas for the oil production, preparation and primary oil refining objects confirms that for the majority of objects of approximate sizes of sanitary protective areas determined by the actual sanitary norms and regulations are excessive. Single and average daily maximum concentration limits as well as allowed levels of cancerogenic and non-cancerogenic risks for the health of the population are provided at the distances from the borders of construction sites which are considerably less than the ones determined by the sanitary classification. Calculation data is confirmed by results of the systematic instrumental research. There are given guidelines to introduce changes in the sanitary norms and regulations. For a number of objects it is suggested to keep the existing classification.

The article analyses and demonstrates methodical approaches to the practical implementation of the one of key stages in the formation of the evidential base of hazard to health caused by the negative impact of environmental factors. The stage comprises the establishment of the causal dependence (proven relation) of the chemicals’ content in biological media of exposed population on the personalized loading dose. The experiment included the local population (224 cases) living in the area of the exposure of the Dzhidinsky tungsten-molybdenum combine waste (Republic of Buryatia). The cartographic association of the residential areas of the population has been made as well as the approximation of the field study data of environmental factors due to 7 heavy metals has been performed. The total personalized loading dose caused by exposure to lead, cadmium, nickel, chromium, zinc, copper, manganese (the wastes of the metallurgical plant) was calculated. It is evident that the poor quality of the environment leads to the contamination of biological media (blood) by chemicals. More than 90 significant biologically-based mathematical models of the system “exposure - exposure marker” have been received. On the example of cadmium there was established the total dose of 0.0003 mg /(kg*d) for the child population, the excess of which significantly increases chances of both exceeding the concentration of a substance in blood over the control level and leading to the formation of a stable causal relationship with exposure markers of the multimedia load.

There are given results of instrumental studies of the air of 77 living rooms of precast framed houses of the microdistrict Usolsky, the Perm region, Russia. There were used materials emitting formaldehyde, phenol and other chemical impurities into the environment. In 90% of rooms levels offormaldehyde were shown to be systematically registered as by 1.5-10 times exceeding the hygienic average daily standard (0.01 mg/m³). Revealed concentrations create health risks to residents, which can be evaluated as unacceptable: lifelong cancerogenic risk made up about 2.8*10^-4, non-cancerogenic risk for respiratory organs disorders accounted of 8.7HI. Profound studies of residents ’ health showed the increased level of respiratory diseases in adults living for 1.5-3.0 years in observed houses. The group of the exposed people of the micro-district Usolsky was characterized by significantly higher consistent blood level of formaldehyde (3-7 times higher than in the comparison e group), and the presence of negative prenosological changes of several laboratory indices, including some of indices which testify both to general and specific sensitization to formaldehyde and the risk of the development ofproliferative processes. There are given suggestions concerning the guidelines to arrange primary and secondary preventive measures against potential health disorders of the residents of the micro-district.

In the article there are presented results of a study of the functional state of the cardiovascular system in 614 adolescents living in the various conditions of ambient air pollution in the territory of the Irkutsk region. The risk for non-carcinogenic effects for adolescents from the 1^st district was established to be high, for adolescents residing in (2^nd and 3^rd districts - acceptable), for adolescents from the 4^th district - minimal. Accordingly to results of the evaluation of the dynamics of the danger index in the 1^st and 2^nd districts in 2003-2014 there was noted the absence of significant trend towards to the increase in ambient air pollution.It is noted that in adolescents industrial centers (1^st and 2^nd districts) during the functional test there were established signs of the pronounced functional exertion of the cardiovascular system: severe tachycardia; a significant increase in systolic blood pressure and diastolic blood pressure; delay from the age norm pumping function of the heart. In adolescents from the “relatively clean” village (4^th district) responses of the cardiovascular system to load testify to sufficient adaptive and accommodational capabilities.

There was executed a clinical laboratory study of 183 children residing in the conditions of constant low-level impact of a complex of such consumed from atmospheric air and drinking water metals as lead, manganese, nickel, chrome, cadmium) and 46 children residing in the conditions of sanitary-hygienically wellbeing of the habitat. The evaluation of Total Hazard Indices (THI) for conditions of chemical substances entering with atmospheric air and drinking water have revealed the excess of accepted values (THI>1) regarding to disorders of the central nervous system in children (THI amounted for up to 4.93) and disorders ofendocrine system (up to THI of 1.13). The results of chemical-analytical researches showed the blood content of lead, manganese, nickel, chrome, cadmium in children living in conditions of low-dose complex load to exceed the reference level by 1.3-2.2 times. In persistent multi-medium polymetallic load the number of children having physical development disorders was found to increase up to 1.2-1.6 times (body weight deficiency - up to 16.5%). There is determined a verified direct probabilistic relationship of cause and effect ofphysical development disorders in children with high blood content of manganese, nickel, and chrome. Exceeding content of lead, manganese, nickel, and chrome (1.3-9.4 times higher than the reference level and the comparative group) in bio-media of children makes a negative impact on the central and autonomous nervous system, creates disorders in protein-synthetic processes in liver, form early shifts of hypothalamo-hypophyseal regulation with further deterioration of physical development indices.

In order to scientifically prove and the evaluation of the effectiveness of system of preservation of students’ health, at the 1^st stage there was executed the examination of 1797 students from high schools in Novokuznetsk. Changes in psychophysiological indices of students’ health during their training in high school (from 1^st to 4^th years) formed the basis for the development of the system. The structure included measures of the preventive, technological and organizational-administrative clusters. The evaluation of the effectiveness of a system ofmeasures (Stage 2), including the correction of body weight, the prevention of depression and inactivity, improving of the cognitive function and the level of stress resistance, was implemented 9 months after their introduction on the basis of the diagnosis of health indices in 230 1^st year students. In the main group there was noted the health improvement (64.3%), advancement in academic performance increased from 3.5 ± 0.39 to 3.98 ± 0.53; optimization of the level of situational (28.2%) and personal anxiety (12.5 %); the decline in the frequency of errors (43.3%), the increase both in stress resistance levels (46.7%) and adaptation (29.6%), functional reserves of the respiratory (11.1 - 26.,9%), cardiovascular (43.3%) and nervous (36%) systems; urine excretion indices of iodine are normalized (12.2%) and selenium (11.5%); immunoglobulin A (46%) of cortisol in saliva (18%). Effectiveness of measures of preventive, technological and organizational-administrative clusters included into the system of preservation of health, 1 year after the introduction (Stage 3), allowed to improve the students ’motivation to maintain health and a healthy lifestyle (40.8%), improve diet ration ( 60.1%), increase motor activity (38.9%), rationalize the curriculum. The implementation of the system in the educational process of the university allowed to evaluate and prove the effectiveness of its measures, which provides the possibility of its use in the country’s educational institutions.

The article demonstrates the methodical approach to the justification of biomarkers of adverse effects (for example, endothelial dysfunction) in workers of sylvinite ore-dressing production occupied in conditions of the long-term noise exposure at the level of 85-95 dBA. The methodology testing revealed that the professional risk in workers of basic specialties is estimated from mild to unbearable by the criterion class of working conditions (3.1.-3.3.). Hypertensive heart disease is a most often occupationally conditioned disorder (RR = 8.69, DI = 2.53-29.83; etiological fraction (EF) = 88.49%). Endothelial dysfunction, pathogenetically related to the development of hypertension, has a high degree of occupational conditionality in terms of a reduced level of K-brachial artery sensitivity to stress and a reduced level of the relative increase in the brachial artery diameter. Biomarkers of endothelial dysfunction (in terms of reducing the relative increase in the brachial artery diameter) are elevated serum levels of TSH, MDA, IL-10, lipoprotein (a) in respect to the physiological norms. The reasonable biomarkers of negative effect allow to expand the evidence base of industrial conditioning of disease process in workers at individual and group level at the determined noise exposure.

For workers of the enterprise

There are given results of experimental research on the development of the high-sensitive and selective chromato-mass-spectrometric methodfor the detection of the N-nitrosamines (N-nitrosodimethylamine andN-nitrosodiethylamine) in blood with the use of distillation and automated system of solid-phase extraction Sepaths (Italy) on the cartridges Coconut 6 cm³ at the stage of sample preparation. Chromato-mass-spectrometric analysis of the extract allowed the detection of the completeness of extraction of N-nitrosodimethylamine from blood equal to 98.5% and for N-nitrosodiethylamine - to 100%.The developed chromato-mass-spectrometric method for the detection of N-nitrosamines in biological media (blood) allows the execution of the control of contents of N-nitrosodimethylamine and N-nitrosodiethylamine in the concentration range of 0.002 - 0.1 mg/dm³ at error not more than 27%. The usage of the developed method for the detection of blood N-nitrosamines levels in groups of the observed child population consuming drink water with different content of nitrates allowed to determine a verified difference and excess of N-nitrosamines content by 2.8 times in the group with higher nitrates content in the drinking water as compared to the group of observed cases who drink water with standard content of nitrates. In order to confirm the presence of the defined N-nitrosamines in the blood samples of the people under research there was executed chromato-mass-spectrometric identification in the SCAN mode. Mass spectrums of N-nitrosodimethylamine and N-nitrosodiethylamine discovered in blood samples of observed cases were compared to mass spectrums of NIST 08.L library. The results of identification of N-nitrosodimethylamine and N-nitrosodiethylamine in the blood samples showed that determined compounds have the same structure as the ones given in the library. The method can be used for biomonitoring, sanitary-epidemiological examinations, and researches in evidentiary medicine in order to determine the impact of the unfavourable anthropogenic factors.