Comparative Risk Assessment Research Articles

Global, regional and national burden of disease attributable to 19 selected occupational risk factors for 183 countries, 2000-2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.

ObjectivesWe provide a brief introduction to the objectives, data, methods and results of the World Health Organization (WHO)/International Labor Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates), which estimated the burden attributable to 19 selected occupational risk factors.MethodsThe WHO/ILO Joint Estimates were produced within the global Comparative Risk Assessment framework, which attributes the burden of one specific health outcome (ie, disease/injury) to a specific occupational risk factor. For 39 established occupational risk factor-health outcome pairs, estimates are produced using population attributable fractions (PAF) from recent burden of disease estimates. For two additional pairs, PAF are calculated from new databases of exposure and risk ratios produced in WHO/ILO systematic reviews. Attributable disease burdens were estimated by applying the PAF to total disease burdens.ResultsGlobally in 2016, it is estimated that 1.88 [95% uncertainty range (UR) 1.84–1.92] million deaths and 89.72 (95% UR 88.61–90.83) million disability-adjusted life years were attributable to the 19 selected occupational risk factors and their health outcomes. A disproportionately large work-related burden of disease is observed in the WHO African Region (for disability-adjusted life years), South-East Asia Region, and Western Pacific Region (for deaths), males and older age groups.ConclusionsThe WHO/ILO Joint Estimates can be used for global monitoring of exposure to occupational risk factors and work-related burden of disease and to identify, plan, cost, implement and evaluate policies, programs and actions to prevent exposure to occupational risk factors and their associated burden.

Comparative health risk assessment of nitrate in drinking groundwater resources of urban and rural regions (Isfahan, Iran), using GIS.

Infantile methemoglobinemia, thyroid disorders, and probably some carcinogenic effects are health concerns associated with dietary nitrate. Isfahan province has a dry and semi-arid desert climate such that the main source of various applications in this province is groundwater resources. This study evaluated spatial analysis of the groundwater NO3- concentrations and its possible health risk to residents. Method 8171 Hach was used for nitrate measurement of 1319 groundwater samples from March 2018 to February 2019. Non-carcinogenic risk due to NO3- exposure through consumption of drinking water was assessed, and the associated zoning maps were presented using geographic information system (GIS). Nitrate concentrations in the rural and urban areas were within 0.4-137mg/L NO3- and 2.9-209mg/L NO3-, respectively. Also, 226 (25%) and 104 (24%) of samples in the rural and urban areas, respectively, were detected above the Iran and WHO guideline NO3- values of 50mg/L. The highest levels of NO3-, which were found in the western and central groundwater resources, occurred in the agricultural and residential areas. The NO3- concentrations were higher in urban than rural areas in the many studied counties. Also, nitrate was higher in wet seasons than in dry ones. Infants' non-carcinogenic risks were higher than the other groups. Infants (HQ > 1) were the most vulnerable group compared with the other groups in some counties. Thus, there are potential risks of methemoglobinemia, especially for infants. It is critical to adopt specific strategies to reduce the nitrate concentration in the studied groundwater.

RISK-ORIENTED APPROACH TO QUALITY MANAGEMENT ON THE EXAMPLE OF THE PROCESS “METROLOGICAL EXAMINATION OF TECHNICAL DOCUMENTATION”

The issues of quality management at the enterprise of the machine-building industry are studied on the basis of process and risk-oriented approaches. A comprehensive approach to risk assessment is proposed, the advantage of which is the application of the principle of matching the significance of risk and the costs of its elimination in a comparative risk assessment. The features of the application of the method of analyzing the causes and consequences of failures, calculating the priority number of risks based on expert and statistical data are analyzed. The method of risk assessment is shown on the example of the process “Metrological examination of technical documentation”. On the basis of statistical data on the results of metrological examination of technical documentation and the classifier of typical metrological errors, scales for calculating the priority number of risks were developed and an analysis of the causes and consequences of process failures was carried out. The approach to improving the quality of the process is justified on the basis of the principle of matching the priority number of risks and costs for eliminating the discrepancy. Based on a comparative risk assessment by constructing a map of the ratio of the priority number of risks by function and the costs of their elimination, the most significant risks that significantly affect the results of the process are identified.

Manage the environmental risks of perovskites

Manage the environmental risks of perovskites

Comparative hygienic assessment of working conditions and potential risks for workers' health when applying pesticides in different technics

In the structure of regional and planetary pollutants, pesticides are in the top ten, and among food contaminants along with heavy metals – they occupy first place in the world. It is known that pesticides and agrochemicals, which belong to the group of biologically active compounds, are one of the important factors affecting the human body.
 The aim: comparative hygienic assessment of working conditions and occupational risk when using pesticides by different methods of application (knapsack, rod, ventilator, unmanned and aviation) on the example of the fungicide Amistar Extra 280 SC.
 Materials and methods. Field studies were conducted in 2018–2021. When applying the formulation knapsack sprayer SOLO-10, trailed boom sprayer AMAZON 1201 UF combined with a tractor MTZ 82.1 Belarus, unmanned aerial vehicle (UAV) for spraying fields Agras T16, AN-2 aircraft combined with OZh-2 were used.
 Results. As a result of field researches of working conditions of employees during the performance of production operations on the pesticides application, it was found that in the air treatment areas and in areas of possible drift the levels of studied active ingredients were below the limit of quantification of the method. The difference between azoxystrobin (0,04±0,003) and cyproconazole (12,4±0,5) for the tank refueler and the UAV external pilot in the field studies is significant according to Student's criterion (p >0,05). For the operator who applied the pesticide with a knapsack sprayer, the values of inhalation risks were significantly higher than for the tankers of the sprayer tank at p >0,05. The values of the combined risk when using a fan sprayer (0,46±0,02) significantly exceeded the data obtained when using a rod sprayer (0,14±0,006)
 Conclusions. Analysis of the obtained results showed that the values of the combined risk are significantly higher for the operator / tractor driver, signalman than for their refuelers (at p <0,05). The values of the combined risk of the external pilot were significantly lower than those of the tanker when using a pesticide using a UAV.

RISK OF AIR POLLUTION FROM INDUSTRIALIZATION TOWARDS HEALTH: A COMPARATIVE RISK ASSESSMENT

ABSTRACT Palm oil mills generate large quantities of waste and by-products which consequently cause air pollution. Previous studies had investigated about the exposures of different types of air pollution toward certain age groups such as children, as well as targeting specific diseases. In this article, the assessment on the posed risk of air pollution in Sepang, Malaysia palm oil mills toward health are being investigated. In particular, we study the particulate matter of PM2.5 and PM10, in which exposures toward these fine particles may cause toxic effects in blood and other illnesses such as cancer that may lead to mortality. Our aim is to estimate the number of premature deaths in Malaysia due to all causes of ambient air pollutants and avoidable mortality rate using the comparative risk assessment framework. We also quantified the relative risk and attributable fraction by adopting the framework of air pollution health-risk assessment. Our findings estimated that there would be around 5692 for PM10 and 9287 for PM2.5 premature deaths in Malaysia due to all causes of ambient air pollutants. However, with the decrease in 20% of the pollutant’s concentration, there would be an avoidable mortality of 18.75% or 1067 and 17.98% or 1670 due to PM10 and PM2.5, respectively. This model can be extended into more detail assessment of each contributing particles for air pollution, as well as to water pollution.

The global and regional costs of healthy and sustainable dietary patterns: a modelling study

SummaryBackgroundAdoption of healthy and sustainable diets could be essential for safe-guarding the Earth's natural resources and reducing diet-related mortality, but their adoption could be hampered if such diets proved to be more expensive and unaffordable for some populations. Therefore, we aimed to estimate the costs of healthy and sustainable diets around the world.MethodsIn this modelling study, we used regionally comparable food prices from the International Comparison Program for 150 countries. We paired those prices with estimates of food demand for different dietary patterns that, in modelling studies, have been associated with reductions in premature mortality and environmental resource demand, including nutritionally balanced flexitarian, pescatarian, vegetarian, and vegan diets. We used estimates of food waste and projections of food demand and prices to specify food system and socioeconomic change scenarios up to 2050. In the full cost accounting, we estimated diet-related health-care costs by pairing a comparative risk assessment of dietary risks with cost-of-illness estimates, and we estimated climate change costs by pairing the diet scenarios with greenhouse gas emission footprints and estimates of the social cost of carbon.FindingsCompared with the cost of current diets, the healthy and sustainable dietary patterns were, depending on the pattern, up to 22–34% lower in cost in upper-middle-income to high-income countries on average (when considering statistical means), but at least 18–29% more expensive in lower-middle-income to low-income countries. Reductions in food waste, a favourable socioeconomic development scenario, and a fuller cost accounting that included the diet-related costs of climate change and health care in the cost of diets increased the affordability of the dietary patterns in our future projections. When these measures were combined, the healthy and sustainable dietary patterns were up to 25–29% lower in cost in low-income to lower-middle-income countries, and up to 37% lower in cost on average, for the year 2050. Variants of vegetarian and vegan dietary patterns were generally most affordable, and pescatarian diets were least affordable.InterpretationIn high-income and upper-middle-income countries, dietary change interventions that incentivise adoption of healthy and sustainable diets can help consumers in those countries reduce costs while, at the same time, contribute to fulfilling national climate change commitments and reduce public health spending. In low-income and lower-middle-income countries, healthy and sustainable diets are substantially less costly than western diets and can also be cost-competitive in the medium-to-long term, subject to beneficial socioeconomic development and reductions in food waste. A fuller accounting of the costs of diets would make healthy and sustainable diets the least costly option in most countries in the future.FundingGlobal Panel on Agriculture and Food Systems for Nutrition and Wellcome Trust.

High body-mass index and mortality from cardiometabolic diseases in Peru: a comparative risk assessment analysis

Background: High body-mass index (BMI) is a major contributor to the global burden of cardiometabolic diseases (CMD) like type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). We aimed to quantify the mortality burden associated with high BMI in Peru to inform policies and set priorities. Methods: We computed population attributable fractions (PAF) combining BMI prevalence estimates from the Peruvian Demographic and Health Survey and relative risks between high BMI and CMD mortality from the GBD 2019 Study. PAFs were multiplied by the CMD deaths recorded in the national death registry to obtain the absolute number of CMD deaths attributable to high BMI in each region, sex and five-year age group. Results: In 2018, the absolute number of T2DM deaths attributable to high BMI in Peru was 1,376 (50.3%) in men and 1,663 (56.0%) in women; the absolute number of CVD deaths related to high BMI was 1,665 in men (23.6%) and 1,551 (24.7%) in women. Most CMD deaths related to high BMI were attributable to obesity class 1 and overweight. Regions with the highest proportions of CMD deaths related to high BMI were in the Amazon (Madre de Dios, Ucayali) and the Coast (Tacna, Moquegua); conversely, regions with the lowest proportions were in the Highlands (Huancavelica, Apurimac). Conclusions: High BMI is a major contributor to the CMD mortality burden in Peru, with high variability across regions. Health policies need to be strengthened to reduce BMI at the population level, which may have a subsequent reduction in the associated CMD mortality.

The estimated health impact of sodium reduction through food reformulation in Australia: A modeling study.

BackgroundThe Australian Government recently established sodium targets for packaged foods to encourage voluntary reformulation to reduce population sodium consumption and related diseases. We modeled the health impact of Australia’s sodium reformulation targets and additional likely health gains if more ambitious, yet feasible sodium targets had been adopted instead.Methods and findingsUsing comparative risk assessment models, we estimated the averted deaths, incidence, and disability-adjusted life years (DALYs) from cardiovascular disease (CVD), chronic kidney disease (CKD) and stomach cancer after implementation of (a) Australia’s sodium targets (overall and by individual companies); (b) United Kingdom’s targets (that covers more product categories); and (c) an optimistic scenario (sales-weighted 25th percentile sodium content for each food category included in the UK program). We used nationally representative data to estimate pre- and post-intervention sodium intake, and other key data sources from the Global Burden of Disease study. Full compliance with the Australian government’s sodium targets could prevent approximately 510 deaths/year (95% UI, 335 to 757), corresponding to about 1% of CVD, CKD, and stomach cancer deaths, and prevent some 1,920 (1,274 to 2,600) new cases and 7,240 (5,138 to 10,008) DALYs/year attributable to these diseases. Over half (59%) of deaths prevented is attributed to reformulation by 5 market-dominant companies. Compliance with the UK and optimistic scenario could avert approximately an additional 660 (207 to 1,227) and 1,070 (511 to 1,856) deaths/year, respectively, compared to Australia’s targets. The main limitation of this study (like other modeling studies) is that it does not prove that sodium reformulation programs will prevent deaths and disease events; rather, it provides the best quantitative estimates and the corresponding uncertainty of the potential effect of the different programs to guide the design of policies.ConclusionsThere is significant potential to strengthen Australia’s sodium reformulation targets to improve its health impact. Promoting compliance by market-dominant food companies will be critical to achieving the potential health gains.

Global burden and attributable risk factors of acute lymphoblastic leukemia in 204 countries and territories in 1990-2019: Estimation based on Global Burden of Disease Study 2019.

To provide a foundational guideline for policy-makers to efficiently allocate medical resources in the context of population aging and growth, the latest spatial distribution and temporal trend of acute lymphoblastic leukemia (ALL) along with attributable risk factors by sex and age were mapped. Based on the Global Burden of Disease Study 2019, estimated annual percentage change (EAPC) was calculated according to the relativity between age-standardized rate and calendar year, to quantify temporal trends in morbidity and mortality of ALL. We used applied Spearman rank correlation to estimate the relationship between the EAPC and potential influence factors. The population attributable fraction of potential risk factors for ALL-related disability-adjusted life years were estimated by the comparative risk assessment framework. As a result, we found that new ALL cases increased significantly by 1.29% worldwide, and the age-standardized incidence rate increased by 1.61% annually. The proportion of elder patients sharply increased, especially within the higher socio-demographic index (SDI) region. Smoking and high body mass index remained the predominant risk factors for ALL-related mortality. Notably, the contribution of high body mass index presented an increasing trend. In conclusion, the global burden of ALL has steadily increased, especially in Middle SDI region. Health measures and new drugs should be taken into consideration to improve the management and treatment of elders with ALL due to an increasing proportion in the higher SDI region. For Low SDI areas, attention should be paid to the environmental problems caused by industrial development.

A systematic literature review of studies estimating the risk factor attributable burden in Europe

Abstract Along with the computation of disability-adjusted life years (DALY), the Global Burden of Disease (GBD) study uses the comparative risk assessment method to estimate the burden attributable to risk factors (RF). The methodology used for GBD studies has undergone continuous improvements through the years and across many independent studies. The European burden of disease network launched a series of systematic literature reviews (SLR) to explore key assumptions used in the European burden of disease (BoD) assessments. The SLR will give an overview of existing studies, including those estimating the BoD attributable to RF and focus on the different computational approaches. The SLR will also help to identify ways to harmonize computational procedures to enhance the comparability of RF attributable burden. The SLR involved four parallel reviews: non-communicable diseases, communicable diseases, injuries and RF. For the latter, we used a search strategy with terms describing the population (GBD area “European region”) and terms specifically used in comparative risk assessments (comparative risk assessment [CRA], attributable mortality/burden/risk). Studies published between January 1990 and April 2020 were included, without language restrictions. The search strategy was run in PubMed, Web of Science, Cochrane, and Embase. OpenGrey, OAIster, CABDirect, WHO, and targeted public health agency websites were screened for indexed grey literature. In addition, burden-eu members were asked to supplement the list of publications with any material available in their national public health institutes. The title, abstract, and full-text screening resulted in the final inclusion of 114 publications. The list of publications includes peer-reviewed articles and reports showing a variability in CRA analysis (e.g. use of exposure-response function, relative risks) and other methodological choices. Further data extraction and analysis is in process and will be presented during the workshop.

Estimated economic burden of cancer associated with suboptimal diet in the United States.

Suboptimal diet is a preventable cause of cancer. We aimed to estimate the economic burden of diet-associated cancer among US adults. We used a Comparative Risk Assessment model to quantify the number of new cancer cases attributable to seven dietary factors among US adults ages 20 + years. A Markov cohort model estimated the 5-year medical costs for 15 diet-associated cancers diagnosed in 2015. We obtained dietary intake from 2013 to 2016 National Health and Nutrition Examination Survey, cancer incidence, and survival from 2008 to 2014 Surveillance, Epidemiology, and End Results (SEER) program, and medical costs from 2007 to 2013 linked SEER-Medicare data. The estimated 5-year medical costs of new diet-associated cancer cases diagnosed in 2015 were $7.44 (2018 US$). Colorectal cancer had the largest diet-related 5-year medical costs of $5.32B. Suboptimal consumption of whole grains ($2.76B), dairy ($1.82B), and high consumption of processed meats ($1.5B) accounted for the highest medical costs. Per-person medical costs attributable to suboptimal diet vary by gender, race, and age group. Suboptimal diet contributes substantially to the economic burden of diet-associated cancers among US adults. This study highlights the need to implement population-based strategies to improve diet and reduce cancer burden in the US.

Exposure study on susceptible people - SPES: An integrative biomonitoring approach

BackgroundThe evaluation of environmental exposure risk requires a global analysis of pollution phenomena, including biological effects and potentially correlated clinical outcomes in susceptible populations. Although human biomonitoring plays a fundamental role in assessing the degree of contamination, it is not effective alone in identifying a direct link between exposure, biomolecular effects and outcomes on target organisms. While toxicogenomics and epidemiology are mainly focused on the investigation of molecular reactions and clinical outcomes, the monitoring of environmental matrices works independently to characterize the territorial distribution of toxic compounds, without proving any correlated health risk for residents. ObjectivesWe propose a new biomonitoring model based on a whole systemic analytical evaluation of environmental context. The paradigm of the method consists of identifying the sources of pollution, the migration pathways of those pollutants and their effects on target organisms. By means of this innovative, holistic epidemiological approach, we included healthy human subjects in a cohort to identify potential risks of exposure and predict possible correlated clinical outcomes. 4205 residents of the Campania region were enrolled in the “SPES” biomonitoring study, which especially focused on the areas dubbed “Land of Fires” in the recent decades. DiscussionThe analysis of environmental exposure risk suffers the lack of data integration from various science fields, and this comes down to a limited point of view and a limited knowledge of phenomena.In implementing our model, we first constructed an analytical picture of the Real-world situation. We next conducted a comparative risk assessment, in order to identify possible correlations between pollution and health within a holistic view. ConclusionThis type of research activities aims to support the implementation of public health interventions and to become a reference model in the evaluation of the risk of exposure to environmental pollutants.

Critical incidents in acute pain management-A risk analysis of CIRS reports

HintergrundTätigkeitsgebiete mit vielen Schnittstellen, wie die Akutschmerztherapie, gelten per se als Bereiche, in denen ein erhöhtes Risiko für Fehler und Zwischenfälle besteht.Ziel der ArbeitZiele waren die Risikoidentifikation und Graduierung des Risikos von gemeldeten Zwischenfällen im Kontext der Akutschmerztherapie.Material und MethodenAus 5365 Fällen des bundesweiten Meldesystems CIRSmedical Anästhesiologie wurden 508 Berichte mit dem Selektionskriterium „Schmerz“ identifiziert und 281 Berichte (55 %) analysiert und anhand einer Risikomatrix graduiert.ErgebnisseDiese eingeschlossenen Fälle standen im Kontext parenteraler Analgetikaapplikationen (40 %) und rückenmarknaher (40 %) bzw. peripherer Regionalanästhesieverfahren (23 %) sowie der patientenkontrollierten Analgesie in 13 % der Meldungen (Mehrfachnennung möglich). Die meisten Ereignisse waren anhand der Schilderungen auf fachliche Fehler, Kommunikationsdefizite und ein Abweichen von der Routine zurückzuführen. Sie basierten meist auf Zugangs‑, Dosis- oder Wirkstoffverwechslungen. Etwa ein Drittel der Fehlerquellen war organisatorischer Art. Ein mögliches vitales Risiko war anhand der Berichte in 59 % der Fälle anzunehmen; 16 % der Fälle gingen mit tatsächlichen vitalen Komplikationen einher. Die Risikograduierung ergab zusammengefasst in Risikoklassen in 7 % ein „extrem hohes“, in 62 % ein „hohes“, in 25 % ein „moderates“ und in 6 % ein „niedriges“ Risiko.DiskussionInsgesamt stellte sich ein relevantes Risikopotenzial für die Patienten dar. Gerade Zwischenfälle mit menschlichen Fehlern, Abweichen von der Routine und organisatorischen Aspekten gehen mit hohem Risiko einher.

Global red and processed meat trade and non-communicable diseases

IntroductionRapid increases in the trade of global red and processed meat impede international efforts toward sustainable diets by increasing meat consumption. However, little research has examined cross-country variations in diet-related...

Impact of Elevated Systolic Blood Pressure Levels on Mortality and Life Expectancy in Southeast Chinese Residents.

Background:We aimed to analyse the impact of elevated systolic blood pressure (SBP) levels on mortality and life expectancy among ≥25 yr adults in the municipality of Ningbo, China.Methods:The death cause data were collected from the Internet-based Comprehensive Chronic Disease Surveillance System in Zhejiang Province in 2015, and SBP level data were obtained from the Ningbo Adult Chronic Disease Surveillance survey. According to the comparative risk assessment theory, the population attributable fraction (PAF) of elevated SBP levels by gender and urban-rural regions has been calculated. The deaths and life expectancy loss due to elevated SBP levels were estimated.Results:In 2015, the average SBP level among ≥25 yr adults in Ningbo was 129.01 ± 17.73 mmHg, which was higher in men (131.67 ± 16.89 mmHg) than in women (126.24 ± 18.15 mmHg) and was higher among adults in rural regions (130.55 ± 18.75 mmHg) than among adults in urban regions (127.15 ± 16.19 mmHg). A total of 6181 deaths were attributed to elevated SBP levels among adults in Ningbo. The PAF of deaths caused by elevated SBP levels among adults was 16.14%, which was higher in women (18.73%) than in men (14.31%). The overall loss of life expectancy caused by elevated SBP levels among adults was 1.76 yr, which was higher in women (1.99 yr) than in men (1.53 yr) and was higher in rural regions (1.91 yr) than in urban regions (1.49 yr).Conclusion:Elevated SBP levels had a serious impact on the death and life expectancy loss of residents in Ningbo.

Risk-Attributable Burden of Ischemic Heart Disease in 137 Low- and Middle-Income Countries From 2000 to 2019.

BackgroundIschemic heart disease (IHD) imposes the greatest disease burden globally, especially in low‐ and middle‐income countries (LMICs). We aim to examine the population‐attributable fraction and risk‐attributable death and disability‐adjusted life years (DALYs) for IHD in 137 low‐ and middle‐income countries.Methods and ResultsUsing comparative risk assessment framework from the 2019 Global Burden of Disease study, the population‐attributable fraction and IHD burden (death and DALYs) attributable to risk factors in low‐income countries, lower‐middle‐income countries (LMCs), and upper‐middle‐income countries were assessed from 2000 to 2019. In 2019, the population‐attributable fraction (%) of IHD deaths in relation to all modifiable risk factors combined was highest in lower‐middle‐income countries (94.2; 95% uncertainty interval, 91.9–96.2), followed by upper‐middle‐income countries (93.5; 90.4–95.8) and low‐income countries (92.5; 90.0–94.7). There was a >13‐fold difference between Peru and Uzbekistan in age‐standardized rates (per 100 000) of attributable death (44.3 versus 660.4) and DALYs (786.7 versus 10506.1). Dietary risks accounted for the largest proportion of IHD’s behavioral burden in low‐ and middle‐income countries, primarily attributable to diets low in whole grains. High systolic blood pressure and high low‐density lipoprotein cholesterol remained the 2 leading causes of DALYs, with the former topping the list in 116 countries, while the latter led in 21 of the 137 countries. Compared with 2000 to 2010, the increases in risk‐attributable deaths and DALYs among upper‐middle income countries were slower from 2010 to 2019, while the trends in low‐income countries and lower‐middle income countries were opposite.ConclusionsIHD’s attributable burden remains high in low‐ and middle‐income countries. Considerable heterogeneity was observed among different income‐classified regions and countries.

Арктические корпорации и освоенческие риски: вызов и ответ

The realities of the Russian Arctic in recent decades make it possible to determine a special phenomenon of corporate development risks, which can be structured into resource, institutional and ecosystem risks. The resource risk reflects the contradiction between the conjuncture of the global resource markets and the specific conditions for the development of unique deposits located in the Arctic zone; institutional risk — between federal norms and rules for the development of natural resource deposits and local specific conditions for the construction and operation of resource facilities in the Arctic; ecosystem risk reflects the contradiction between large-scale economic activity and the fragility of Arctic natural systems. As a result of a comparative assessment of the development risks of three Arctic corporations in Russia, it was found that the highest risk is typical for the facilities of Norilsk Nickel, the lowest — for NovaTEK, and Gaz-promneft is in the middle. Using the OLI paradigm of John Dunning, it can be argued that Arctic corpora-tions respond to the challenge of development risks by adapting their spatial, institutional and organiza-tional structure to the conditions for the development of resources and resource territories. The spatial factor is most efficiently used by Norilsk Nickel, then NovaTEK, in the strategy of adaptation to develop-ment risks, with the receipt of benefits from localization and the creation of a regional cluster, while Gaz-promneft is the least effective. The institutional factor is most effectively used by NovaTEK and Gazprom-neft, and the least by Norilsk Nickel. The organizational and structural factor as a tool for adapting to risks is most skillfully used by Gazpromneft, weaker — by NovaTEK and Norilsk Nickel. Integrally, the best positions in the strategy of adaptation to development risks are held by Gazpromneft, and the worst positions by Norilsk Nickel, which has the most significant contrast between the size of development risks and the means of adaptation to them. Strengthening the internal competencies of the company and its corporate innovation system is the most important way to successfully cope with the high risks of corporate development of resources and spaces of the Arctic.

Alcohol Use and the Risk of Communicable Diseases.

The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date—Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia—as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended.

Comparative analysis of the potential and actual risk of noise-induced hearing loss in employees of “noise” industries

Introduction. The high incidence of noise-induced hearing loss (NIHL) makes it possible to attribute the problem of prevention and prediction of the risk of NIHL to the number of socially significant ones. The aim of the study is to conduct a comparative assessment of the potential risk of hearing loss caused by noise according to GOST R ISO 1999-2017, and the actual risk of NIHL in workers of “noise” industries according to epidemiological research. Materials and methods. The calculation of the potential risk of hearing loss according to GOST R ISO 1999-2017 included assessing age, noise and total hearing loss at noise exposure with 85, 90, 95 and 100 dBA. The actual risk of NIHL was evaluated on survey data of 600 miners and 600 workers of processing plants. Results. The calculation of the probable risk according to GOST R ISO 1999-2017 and the assessment of the actual risk according to epidemiological studies showed that the risk of NIHL depends on both noise exposure and age. As the levels of noise affecting an employee increase, the risk of an NIHL becomes more determined by the effect of noise. At noise levels 85, 90 and 95 dBA, the probable risk calculated under GOST R ISO 1999-2017 coincides with the actual risk established according to epidemiological studies. At the same time, for miners exposed to high-intensity noise 100 dBА, the real risk was not as high as could be assumed from the calculated data. Conclusion. The results obtained allow stating that the GOST ISO 1999-2017 standard with a high degree of potential risk allows predicting the group risk of hearing loss due to noise exposure, to quantify the degree of risk and can be used for the formation of risk groups for NIHL and the development of programs for the preservation of hearing.