Vol 61, No 5 (2017)

In 2014, increasing of mortality is observed in the Republic of Crimea. The attempts to normalize situation using common preventive means turned out to be not enough effective. The purpose of study is to analyze causes of deterioration of demographic situation and to substantiate measures of efficacious prevention. The data of state statistics was used as a primary material. The mortality of main non-infectious diseases prevailed in the structure of human losses. However, its dependence on classical risk factors had no factual confirmation. The ecological situation ameliorated. The health care system maintained a needed stability. The deterioration of psychic condition of population was detected. The suggestion was expressed concerning its effect on somatic reserves of health. In conditions of etiological uncertainty of mortality decreasing a personalized prevention was proposed targeting management of health reserves under control of personal risks. The percentage of Crimea population with redundant lethal risk makes up to no more than 5%. The modernization of actual dispensarization system is proposed to detecting and health improving them. The working population is proposed to pass screening examination without breaking labor process on the basis of health posts (health room) of enterprises. The traveling diagnostic teams can be used. The idle population is examined in the departments of prevention in polyclinics. The low cost prognostic technologies are used. The selection of individually efficient health promoting measures requires long work with patient. to implement this approach a third stage of dispensarization is proposed using innovative health promoting technologies. The medical social workers are involved into this activity. The trade union organizations can play an important role in the prevention system functioning. The particular attention is paid to using health promoting possibilities of recreation institution of Crimea.

The article presents the analysis of trends specific for onco-urological morbidity of Moscow population on the basis of data of official statistical reports for 2006-2015. It is established that prostate cancer is the most actual onco-urological problem in Moscow. The level of morbidity of prostate cancer in the capital exceeds the corresponding average level in the Russian Federation. During 2006-2015, the morbidity of prostate cancer in Moscow increased up to 33.6% i.e. from 52.7 to 70.4 cases per 100 000 of male population. In Moscow, in 2015, morbidity of kidney cancer made up to 11.73 and bladder cancer - 9.72 cases per 100 000 of population. As compared with 2006, morbidity of prostate cancer decreased up to 3.1% and morbidity of bladder cancer increased up to 9.2%. In Moscow, for morbidity of prostate cancer and bladder cancer are specific lower levels in comparison with national average indices. It is demonstrated that efficiency of target oncologic preventive examinations, timeliness of detection of onco-urological diseases and also efficiency of their treatment in Moscow is higher than in the Russian Federation on the whole. At that, in Moscow 31.6% of cases of prostate cancer, 29,7% of cases of kidney cancer and 17.7% of bladder cancer are detected at stage III-IV of disease. The results of implemented study testify necessity of development of urological care of population, including its out-patient section that effects efficiency and timeliness of detection and effectiveness of treatment of onco-urological diseases.

The labor conditions of workers of key professions of selwynite concentrating manufacture (drying machine operative, granulation machine operative, dosing of drying-granulating room machine operative, centrifuge operative, filtration operative, transporter of drying granulating room, engineer of mill machine) are characterized by effect of physical factors of industrial environment. The noise is the most significant of them. It is established that level of noise at working places of workers of analyzed specialties attains 83-98 dBA that on 18 dBA is higher of maximum permissible level of 80 dBA. In examined workers a reliable increasing of level of homocysteine and lipoprotein (a) up to 3.8 times is established against the background of decreasing of production of nitric oxide in blood serum up to 1.2 times and increasing of level of malonic di-aldehyde up to1.3 times relatively to similar indices in workers of comparison group. The consequence of these processes can be a disorder of structure and endothelial function of vessels, increasing of permeability of endothelium, loss of its elasticity and as a consequence disorder of functional activity of vessel wall. The substantiation is given to indicator indexes (level of lipoprotein (a), homocysteine in blood serum and content of malonic di-aldehyde in blood plasma), having higher and average degree of occupational conditionality and forming biochemical profile of endothelial dysfunction as a predictor of arterial hypertension in workers of selwynite ore-dressing and processing enterprise undergoing effect of noise. The given biochemical indices are appropriate to be applied in early diagnostic and prevention of endothelial dysfunction in workers of the mentioned enterprises.