Environmental contamination with metals as a risk factor causing developing autoimmune thyroiditis in children in zones influenced by emissions from metallurgic enterprises

Chemical environmental factors trophic for the endocrine system and its organs produce negative influence on it that becomes apparent through growing incidence and pathomorphism of endocrine diseases. Our test group was made up of 102 children with diagnosed autoimmune thyroiditis (AIT) who were chronically exposed to metals (lead, manganese, nickel, chromium, and zinc) being components in emissions from metallurgic enterprises in Perm region. Our reference group included 46 children with AIT who lived beyond zones influenced by the aforementioned enterprises in areas with the sanitary-hygienic situation being relatively favorable. We comparatively analyzed the results of clinical and ultrasound examinations that focused on evaluating children’s thyroidal and immune state. A growth in incidence with thyroiditis amounted to 63.6 % on the test territory over 10 years and it was 1.6 times higher than on average in the region (40.8 %); there was no growth in the indicator detected on the reference territory. Concentrations of chromium, nickel, lead, zinc, and manganese higher than regional background level were 1.7–5.5 times more frequently detected in blood of children from the test group against the reference one. A number of AIT cases was higher among exposed boys (by 2.0 times, p = 0.070); exposed children also had higher Ig A, M, and G contents in blood serum (by up to 2.9 times, p = 0.015–0.056), higher TSH levels (by 2.0 times, p = 0.096), and lower free T4 contents (by 5.4 times, p = 0.057). Diffuse damage to the thyroid gland was by 1.3 times more frequent under exposure to adverse factors created by metallurgic production; AIT combined with other diseases was also more frequent (p = 0.041). Rates and growth in incidence of thyroid gland diseases and thyroiditis are by 1.3–2.3 times higher among children and teenagers living on territories where metallurgic enterprises are located against the same indicators on territories where sanitary-hygienic situation is relatively favorable. We detected less apparent gender-related differences in AIT frequency, a greater number of improper thyroidal state, elevated risks of diffuse changes in the thyroid gland and activation of humoral immune response that was by 2.2–3.4 times more frequent together with concomitant damage to other systems under elevated contents of metals in blood.

On revealing risk groups regarding emotional burn-out syndrome among medical workers during the covid-19 pandemic

Medical workers have become a most affected population group during the pandemic of the new coronavirus infection (COVID-19). They were the first to start fighting against an unknown infection and at that stage their psychoemotional state determined not only correct evaluations of a situation but also relevant planning regarding control over it. Our research aim was to reveal risk groups among medical workers regarding developing emotional burnout syndrome and peculiarities of reacting to stress in an emergency epidemic situation. We applied our own author’s anonymous online poll available at Google platform to examine psychoemotional state of medical workers. The poll had a built-in “Scale of perceived stress-10” that included two sub-scales; one of them measured a subjectively perceived level of the situation strain and the other, the amounts of efforts made by medical workers to overcome it. The poll was performed in November–December 2020; overall, 638 medical workers took part in it. They were of different age and sex and had different positions and working experience. We established great variability in individual levels of overstrain as per the stress perception sub-scale (Ех < 0; Ех = –0.59) with more “low” than “high” values as per this sub-scale (Аs > 0; Аs = 5.66). Having analyzed variability of values as per the stress overcoming sub-scale, we revealed that they were homogenous (Ех > 0; Ех = 3.98) with prevailing “high” values (Аs < 0; Аs = –6.97). Medical workers with their working experience being shorter than 5 years turned out to be a risk group with the most destructive reactions to long-term affecting stress factors at work and at home during the COVID-19 pandemic. Apart from them, high mental risks were also detected for workers who treated patients with COVID-19 as well as those who had previously had the coronavirus infection. The research allowed obtaining actual data on psychoemotional state of medical workers during the COVID-19 pandemic and determining potential risk groups regarding developing emotional burnout syndrome. We substantiated the necessity to constantly provide psychological trainings for medical workers with their focus on peculiarities of their reacting during the first meeting with destabilizing factors and with further adjustment of educational programs provided for potential risk groups.

Establishing indicators for assessing non-carcinogenic risks under chronic inhalation expo-sure to benzene and average annual mpc for benzene as per health risk criteria

Recently multiple new toxicological and epidemiologic data on negative effects produced by chemicals have become available; given that, it is necessary to improve quantitative criteria applied in health risk assessment. It is advisable to revise previously established reference concentrations and to make more precise lists of organs and systems affected by a chemical in concentrations which are either equal to reference one or exceed it. Our research aim was to establish a reference concentration for benzene and additional quantitative indicators of its effects (additional reference concentrations) on specific organs and systems under chronic inhalation exposure; another aim was to determine average annual MPC verified as per permissible lifetime carcinogenic risk using evolution models. The research allowed recommending 0.005 mg/m3 to be used as a reference concentration under chronic inhalation exposure to benzene; a decrease in quantity of B-lymphocytes was recommended as a critical effect since this decrease might produce negative effects on the blood and immune system. Additional reference concen-trations for benzene were fixed at 0.007 mg/m3 for the liver as a critical organ and 0.012 mg/mg3 for violated process of organism development as a critical effect. They can be used as additional indicators for assessing non-carcinogenic health risks under chronic inhalation exposure to benzene in its elevated concentrations. Our research results were used to substantiate average annual MPC for benzene in ambient air; its recommended value was 0.005 mg/m3 since it provided safety (absence of impermis-sible (unacceptable) lifetime health risk), probable carcinogenic effects taken into account.

Fuel and energy enterprises as objects of risk-oriented sanitary-epidemiologic surveillance

The present research aims to provide analytical support for the risk-oriented model of sanitary-epidemiologic control over fuel and energy enterprises. The research task were to reveal the most common violations of sanitary-epidemiologic requirements by fuel and energy enterprises; to determine priority environmental indicators that should be included into a program of laboratory support for control and surveillance activities; to estimate actual impacts exerted by fuel and energy enterprises. We established that in 2020 there were totally more than 6 thousand economic entities that performed their activity in the sphere of “Electric energy, gas and steam supply; air conditioning”. Since fuel and energy enterprises tend to be located close to residential areas, violations in the sphere of ambient air protection (Clause 20) involve negative influence on a considerable number of people. In 2020 the greatest number of revealed violation regarding requirements to ambient air quality was registered for heat and power engineering enterprises in the Far East Federal District (FEFD), Siberian FD (SFD), Central FD (CFD), and Ural FD (UFD) and varied from 10.6 to 42.9 %. Average potential health risk (Rlav) per one economic entity amounted to 5.44∙10-4 for heat and power engineering. A share of economic entities dealing with this economic activity and assigned into extremely high and high (the 1st and 2nd accordingly) risk categories as per potential health risk amounts to 21.7 %. A scale of exposure (Mli) for economic entities operating in heat and power engineering can reach 930 thousand people. The greatest share of economic entities belonging to the 1st and 2nd risk categories as per potential health risk is registered in the SFD, Volga FD, CFD, UFD, and FEFD and amounts to 78.5 %. The greatest average potential health risk per one economic entity (Rlav) in the sphere of “Electric energy, gas and steam supply; air conditioning” was registered in the Siberian Federal District and amounted to 9.88∙10-4. The greatest numbers of economic entities operating in the sphere of “Electric energy, gas and steam supply; air conditioning” that belonged to the 1st and 2nd risk categories as per potential health risk are located in the Krasnoyarsk region (37.9 %), Kemerovo region (32.6 %), Tomsk and Omsk regions (29.7 % each).

Analyzing risks of occupational injuries in basic industries

Our research aim was to analyze occupational injuries in basic industries in Irkutsk region. Materials and methods. Occupational injuries (OI) in basic industries were analyzed using data from statistical reports issued in 2010–2019. To analyze OI in dynamics, we calculated relative values of OI and applied linear regression and Shewhart charts. Normalized intensity indicators method was used to reveal different probability of injuries in various industries as well as to predict OI risks. Results. Analysis of OI in dynamics indicates that there is a stable descending trend in a number of injuries. However, in spite of this apparent descending trend, OI values are stably by 1.3–3.0 times higher in some industries than on average in the region. The highest frequency coefficient (FC) for occupational injuries was detected in wood processing where it was equal to 5.35 [2.90–7.71] per 1,000 workers; the indicator varied within 1.00–2.93 per 1,000 workers in other industries. Shewhart chart for FC indicates that systems of occupational health and safety management are not efficient enough in all the analyzed industries since FC exceeds the upper limit in some years. We established that severity of occupational injuries tended to grow in wood processing (Cs = +3.23; 5.33 %), metallurgy (Cs = +0.94; 1.26 %), land transport (Cs = +2.42; 4.39 %), and aircraft production (Cs = +0.59; 1.68 %). The greatest number of fatal OI was detected in mining, construction, and agriculture as a share of fatal OI in the overall structure of occupational injuries amounted to 22.0 %, 19.2 %, and 11.7 % in these brunches accordingly. A probability that an injury becomes fatal is also the highest in them, 11.7, 9.0, and 6.0 accordingly. “Wood processing and production of wood articles”, “Aircraft production”, and “Construction” are among industries where risks of occupational injuries are the most probable.

Stroke and stroke risk factors as disease burden

Stroke is the most common cause of disability and death in the world. Cardiovascular disease rates increase with age (10.9 % for people aged 20–30 years and 85.3 % for people older than 80 years). Coronary heart diseases is the leading cause of deaths attributable to cardiovascular diseases in the United States, followed by stroke, high BP, HF, diseases of the arteries, and other cardiovascular diseases. The report on the global burden of neurological disorders has shown that hemorrhagic stroke accounted for 35.7 % in it, and ischemic stroke, 22.4 %. Seven indicators are important and strategic to prevent cardiovascular disorders; they include healthy diet, sufficient physical activity, smokingstatius, BMI, cholesterol level, blood pressure, and glucose in blood on a fasting stomach. These indicators are associated with healthy behavior (diet quality, PA, smoking, BMI) which are as important as health factors (blood cholesterol, BP, blood glucose). There is a strong protective association between ideal cardiovascular health indicators and many clinical and preclinical conditions including premature all-cause mortality, stroke, CVD mortality, ischemic heart disease mortality, HF, deep venous thromboembolism, and pulmonary embolism. Atrial fibrillation, metabolic syndrome, renal failure, and sleep apnea are important risk factors which are modifiable and treatable. Air pollution has been reported as an increasing and very important risk factor for stroke. COVID-19 has been reported as another new stroke risk factor during the pandemic. Future targets must include each cardiovascular health indicator to decrease stroke risk burden and stroke risk.

Hygienic assessment of population health risk under exposure to chemicals that penetrate drinking water from household water mixers

At present a truly vital task is to evaluate possible changes in the structure and properties of drinking water occurring in the process of delivering it to end customers. Our research aim was to perform hygienic assessment of health risks caused by consumption of drinking water with changed chemical structure influenced by domestic faucets made from zinc alloys. Hygienic assessment of drinking water was performed to test its conformity with the requirements fixed in the Sanitary Rules and Standards SanPiN 1.2.3685-21 “Hygienic standards and requirements to providing safety and (or) harmlessness of environmental factors for people”. Water samples were aged in new household water mixers with their cases made from ZAM zinc alloy (a zinc alloy doped with aluminum, magnesium, and copper) at pH6 and pH9 in accordance with the State Standard GOST 34771-2021 “Sanitary-technical water mixing and distributing accessories. Testing procedures”. Health risks for children and adults and population risks were assessed for situations involving oral and cutaneous introduction according to the Guide R 2.1.10.1920-04 Human Health Risk Assessment from Environmental Chemicals. We established that water samples aged in household water mixers contained authentically elevated concentrations of metals included into ZAM alloy, namely copper, nickel, lead, and zinc, both at pH = 6 and pH = 9. We also detected enhanced organoleptic properties: color grew by 2–2.3 times and turbidity by 2.3–5 times. Carcinogenic risks caused by consuming water with changed properties turned out to be unacceptable both for children and adults. We also established that calculated hazard index for the blood system didn’t conform to hygienic requirements; calculated hazard indices for the central nervous system, liver, hormonal and reproductive systems were statistically significantly higher when people consumed drinking water with changed properties. We also calculated population carcinogenic risks for the whole population in the Russian Federation based on the maximum possible exposure to drinking water with changes in its chemical properties due to household water mixers. The total population risks amounted to approximately 131 thousand cases. Our research indicates it is necessary to develop preven-tion activities with a carefully planned monitoring system and control over quality and use of domestic faucets.

Aanalyzing risks of incidence of tick-borne encephalitis in areas with different climatic and geographical conditions

Ticks are natural reservoirs and vectors of a virus that is an infectious agent of tick-borne encephalitis, a communicable disease with great medical and social significance. Tick-borne encephalitis (TBE) is widely spread in Arkhangelsk region (AR) located in the Arctic zone in Russia where substantial climatic changes are taking place at the moment. Our research involved examining spatial and temporal distribution of numbers of people bitten by ticks, a number of people bitten by ticks per 100 thousand, a number of TBE cases and TBE incidence in districts and settlements in AR. We calculated relative risks of TBE incidence among people bitten by ticks in AR from 1980 to 2019. We analyzed dynamics of indicators showing numbers of people bitten by ticks per 100 thousand and TBE incidence among people living in Arkhangelsk region. The analysis revealed that a number of bitten people grew slowly in 1980–1990, then there was an exponential growth in 1990–2010, and then the trend stabilized in 2010–2019. Dynamics of TBE incidence was completely in line with changes in number of bitten people up to 2014 but there was a substantial drop in TBE incidence after that. Spatial distribution of numbers of bitten people and TBE incidence revealed that average number of bitten people amounted to 25.1 per 100 thousand in the northern districts in 1980–2019 and was statistically significantly lower than in the central and southern districts (р < 0.001). Average long-term incidence was the highest (7.9 per 100 thousand) in the southern districts in comparison with the central (3.0 per 100 thousand; р<0.001) and northern ones (0.7 per 100 thousand; р<0.001). Maximum relative risks of TBE incidence was detected in the southern districts in 1990–1999 (38.8) in comparison with the northern ones. We made an assumption about probable reasons for declining TBE incidence in Arkhangelsk region detected over the last years given the growing numbers of bitten people.

Typologization of russian regions as per environmental factors, factors related to educational process and schoolchildren’s health

The structure of children population determined as per health groups is an integral characteristic of population health in this age group; it can be used as a criterion in creating medical and preventive programs aimed at managing demographic processes and assessing their efficiency. Health disorders among children occur due to many reasons including influence by socioeconomic and sanitary-epidemiological factors, peculiarities of the educational process, eating habits, lifestyle, etc. Our research aim was to determine types of regions in Russia as per environmental factors, the educational process and schoolchildren’s health. Determining different types of regions was considered to be an information basis for developing common strategies and mechanisms for improving schoolchildren’s health. Typologization of regions as per health groups revealed that the most favorable situation was in 31 regions; the last favorable, only in 2. The most favorable situation as per the educational process was in 55 regions where schools operated in one shift; the least favorable situation was observed in two RF regions where schools had to operate in two or even three shifts. Relative sanitary-epidemiological welfare was found in 20 regions and the situation in 21 regions was the least favorable as per several markers that characterized quality of drinking water, ambient air, and soils. Socioeconomic situations in the regions were analyzed to reveal that only 3 regions could be considered the most favorable and 28 regions were the least favorable; the latter were combined into one cluster with the lower values of the relevant markers including gross regional products per capita, living standard, provision with qualified medical personnel and in-patient hospital beds. A situation in each particular region is a reflection of regularities related to influence exerted by a set of aforementioned factors on children’s health; this proves the necessity to create a road map for each region in the RF with feasible mechanisms aimed at improving the existing situation as per specific aspects.

Age-related aspects in risk of developing nervous system pathology in gymnasium students

Growing neuropsychic disorders caused by intensified educational process are a peculiar feature of schoolchildren’s health at present. Our research aim was to examine age-related peculiarities in risks of developing nervous system pathology in school-children attending a gymnasium. We performed clinical examination of 94 children in primary school (Group A) and 56 children in middle school (Group B) who attended a gymnasium. The examination included determining contents of neuromediators and neurotrophic factors in blood, neuro-psychological computer testing (reaction test and STROOP-test). Educational activities were evaluated to determine whether the educational process conformed to hygienic standards. Statistical data analysis involved determining relative risk and odds ratio as well as establishing cause–effect relations. Hygienic assessment of educational activities revealed several adverse factors that made for developing disorders of the nervous system. They included growing weekly educational loads, irrational distribution of school subjects in schedules, and too long use of interactive whiteboards during lessons. We established that nervous system pathology was already developing in 62.8 % children in primary school and 42.9 % children in middle school. We also revealed that asthenoneurotic syndrome and neurosis-like syndrome were by 2.2 times more probable among primary schoolchildren whereas vegetative dysfunction was by 1.6 times more probable among middle school children. Asthenoneurotic syndrome in primary school children was accompanied with lower NOTCH-1 levels in 41.9 % cases; lower acetylcholine content in blood, in 66.7 %; greater serotonin content in blood, in 29.2 %. The disorder became apparent through increased fatigability and weakness, as well as children being too whiny and moody. Middle school children had by 3.1–6.4 times higher risks of lower neuregulin-1β and tumor necrosis factor contents in blood; developing vegetative dysfunctions in them were accompanied with sleeping disorders, headaches, and palpitation. Primary school children were established to have slower perception of a visual and sound stimulus, developing fatigue of kinesthetic reactions as well as rigid cognitive control and poorly automated gnostic functions.