Introduction: A comprehensive assessment of adverse human health effects of environmental pollutants found in residential areas has been carried out in the Voronezh Region. Objective: To conduct a comprehensive hygienic assessment of the anthropogenic load on the territory of the Voronezh Region. Materials and methods: We analyzed the results of ambient air, drinking water, and soil quality monitoring collected by the Center for Hygiene and Epidemiology in the Voronezh Region in 2018–2022 for compliance with the maximum permissible concentrations specified in Regulations SanPiN 1.2.3685–21. The complex load was estimated in accordance with method guidelines MR 01-19/17-17. Results: We established that pollution of ambient air in residential areas contributed the most (69.8 %) to the total anthropogenic load in the town Pavlovsk; drinking water – to that in the Semiluksky district (36.5 %), and soil – in the Rossoshansky district (10.5 %). In the city of Voronezh, the level of complex anthropogenic load exceeded both the regional and district averages. The problem of ambient air pollution dominates in all districts; it should be noted, however, that air sampling is carried out only in urban areas and urban-type settlements. In rural areas, effects of agriculture-associated nitrate pollution of drinking water is more pronounced. The impact of soil pollution is more pronounced in urban residential areas. At the same time, the excess of maximum permissible concentrations of soil pollutants were registered neither in rural nor in urban areas over the study period. Conclusion: In Voronezh, the level of complex anthropogenic load exceeds the average values estimated for the region and districts. Ambient air pollution with vehicle and industrial emissions make the greatest contributions to this load both on the territory of Voronezh and in the districts. Nitrate pollution of potable water associated with agriculture is a challenge in rural areas.
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