Vol 28, No 12 (2021)

Introduction: Adequate supply with healthcare staff remains one of the most significant challenges for public health in Russia. Suboptimal labor conditions and low payments have led to significant outflow of medical professionals from public to private health sector resulting in insufficient number of doctors and nurses, but the impact of this lack of personnel has not been assessed. Aim: To study associations between staffing in medical organizations and population morbidity in 2009-2018 in Ryazan region. Methods: Secondary data on population morbidity and staffing of medical organizations for the period from 2009 to 2018 were used for all analyses. Results: Total morbidity in the Ryazan region decreased from 7 400.3 to 7 214.9 per 10 thousand. Significant urban-rural differences were observed. In 2018, urban morbidity exceeded rural morbidity by 80 %. Staffing of healthcare system has been decreasing over the study period which is in line with the national trend. The number of doctors has been decreasing more rapidly than the number of nurses. Conclusions: Staffing of medical organizations is associated with population morbidity. Further research should concentrate on the factors that could explain the observed associations.

Introduction: The high prevalence of behavioral risk factors in Russia has a significant impact on the health of the population being a serious threat for both current and future generations. There is substantial evidence on heath differences between and within countries. Aim: To estimate the 7-year survival rate and the association between risk factors and all-cause and cardiovascular mortality among rural residents of the Samara region of Russia. Methods: This is a prospective cohort study conducted in the framework of the "Interepid» international project. The analysis included the data from a representative sample of the 20-64 years old rural residents of the Volzhsky district of the Samara region of the Russian Federation (n=1050). A cross-sectional survey was carried out in 2011-2012. Vital status and deaths from all causes and from cardiovascular diseases were analyzed twice, after 4 years and after 7 years of the follow-up. Results: Smoking, hypertension, excess intake of meat offal, whole milk and yogurt were significantly associated with all-cause mortality among men while hypertension and obesity were the main contributors to all-cause mortality among women. CVD mortality was associated with smoking, hypertension, excess salt intake, excess intake of meat offal among men while hypertension, low physical activity and excess salt were the main risk factors among women. Conclusions: We observed significant contribution of many risk factors to all-cause and CVD mortality over a 7-year follow-up period. The importance of the risk factors significantly varied across genders. The results of the study can be used in planning, implementation and evaluation of the effectiveness of public health interventions.

Introduction: Prevention of occupation diseases and elimination of risk factors are important tasks in the field of occupational health in various industries. Aim: To provide the evidence for the need of preventive measures in dairy industry in a Russian setting. Methods: We used secondary data from regular sanitary and hygienic studies with the total sample of 3779 dairy workers and performed a new study using 77 exposed and 35 non-exposed individuals at one of the regular check-ups in Saratov. Relative risks (RR) and etiological fractions (EF) were calculated. Results: Dairy workers are exposed to a wide range of risk factors including both hot (27.5-28.8 ° C) and cold (4.4 to -18 °C) air temperature, noise exceeding the permissible exposure limit by 4.5-18 dBA, insufficient lighting and physical overload. This allows classifying the working conditions as class 3.1-3.3 according to the national classification of occupational risks. Sensorineural hearing loss (RR = 4.3; EF = 76.7 %; CI = 1.6-3.9), diseases of the nervous system (RR = 4.4; EF = 77.2 %; CI = 2.358.21) and diseases of the musculoskeletal system and connective tissue (RR = 2.2; EF = 55.1 %; CI = 1.17-3.1) were mainly attributed to occupational factors. Concluzion: Assessment of occupational risks and health needs of workers in dairy industry should be performed using a combination of sanitary-hygienic, epidemiological and clinical studies. Our findings contribute to better understanding of occupational diseases among dairy workers and can be used for identifying target groups for specific preventive measures.

Introduction: Air quality in large urban settings is a considerable public health problem in Russia. Thus, identification of the main sources of pollution and qualitative assessment of their impact on air quality is of paramount importance. Aim: To perform comprehensive assessment of the influence of the main sources of pollutant emissions on air quality of atmospheric air in one of the districts in an industrial Russian city. Methods: Secondary data from the Federal State Budgetary Institution "Privolzhskoe UGMS" and the Federal State Budgetary Institution "Center of Epidemiology and Hygiene in the Samara Region" were obtained. Geographical maps, emission source location schemes, meteorological parameters, pollutant emissions and borders of sanitary protection zones of industrial enterprises were analyzed. Chromatographic, electrochemical, and photometric analysis, laboratory determination of the concentration of pollutants in the atmospheric air in different periods of the year were performed taking into account changing meteorological conditions. Results: As many as 26 % of emissions of pollutants into the atmosphere come from industrial sources while 45 % come from other anthropogenic sources including motor vehicles . Emissions from medium, small and microenterprises account for only 13 %, 9 % and 7 % of emissions, respectively. The most common pollutants were hydrogen sulfide, phenol, hydrocarbons C12-C19, formaldehyde andam- monia. Concentrations at the level of 0.2-0.4 MPC were found in most of the studied samples. In 16.4 % of the samples concentrations of hydrogen sulfide were up to 5.6 MPC. In the summer period with western and north-western winds, the concentration of pollutants was 15 % higher in all samples. In the cold period , with south-western and western winds excessive concentrations of pollutants in the atmospheric air was recorded in 23.3 % of the samples. Conclusions: Our findings suggest an adverse effect of air pollution on health of the residents of the studied district. Preventive measures in ecologically challenged areas of Samara are needed to preserve and promote health of the population.