Office Of Rospotrebnadzor Research Articles

Региональные аспекты оценки результативности и эффективности риск-ориентированной модели контрольно-надзорной деятельности в сфере обеспечения санитарно-эпидемиологического благополучия населения

This research is relevant since it is important to assess performance and effectiveness of activities performed by Rospotrebnadzor bodies and organizations in RF regions. The aim of this study was to assess performance and effectiveness of control and surveillance activities performed by a territorial office of Rospotrebnadzor given the current reduction in scheduled inspections. Control and surveillance activities performed by the Rospotrebnadzor Rostov Regional Office in 2023 were selected as the research object. They were aimed at improving the quality of the environment for the region population and indirectly at reducing population incidence and mortality associated with exposures to harmful risk factors represented by ambient air, water, and soil pollution etc. The study was accomplished relying on methodical instruments developed by the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies and approved by the RF Chief Sanitary Inspector. The basic methodology establishes rules for calculating economic losses associated with population mortality and incidence (children, working age population and population older than working age) caused by environmental exposures. Calculations were based on the results of instrumental measurements of the environment quality in cities in the Rostov region and the results of scheduled and off-schedule control activities performed by the Rospotrebnadzor Rostov Regional Office in 2023. It was established that control and surveillance activities performed by the Service managed to prevent approximately 1760 deaths and more than 152.4 thousand diseases, which could actually occur should the Service fail to perform its regulatory actions. The total prevented economic losses equaled approximately 2.1 billion rubles in 2023. Economic effectiveness was established relying on prevented losses of the gross regional product and equaled 7.25 rubles per 1 spent ruble in 2023 prices. There are several promising trends in the scientific and methodical support provided by practical activities performed by Rospotrebnadzor. They include development and implementation of methodical approaches to assessing effectiveness of prevention activities; searching for new approaches to assessing performance and effectiveness of other activities accomplished by the Service (licensing, registration of new and hazardous chemicals and products, etc.).

Regional aspects in assessment of performance and effectiveness of the risk-based model for control and surveillance activities in provision of sanitary-epidemiological wellbeing of the population

This research is relevant since it is important to assess performance and effectiveness of activities performed by Rospotrebnadzor bodies and organizations in RF regions. The aim of this study was to assess performance and effectiveness of control and surveillance activities performed by a territorial office of Rospotrebnadzor given the current reduction in scheduled inspections. Control and surveillance activities performed by the Rospotrebnadzor Rostov Regional Office in 2023 were selected as the research object. They were aimed at improving the quality of the environment for the region population and indirectly at reducing population incidence and mortality associated with exposures to harmful risk factors represented by ambient air, water, and soil pollution etc. The study was accomplished relying on methodical instruments developed by the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies and approved by the RF Chief Sanitary Inspector. The basic methodology establishes rules for calculating economic losses associated with population mortality and incidence (children, working age population and population older than working age) caused by environmental exposures. Calculations were based on the results of instrumental measurements of the environment quality in cities in the Rostov region and the results of scheduled and off-schedule control activities performed by the Rospotrebnadzor Rostov Regional Office in 2023. It was established that control and surveillance activities performed by the Service managed to prevent approximately 1760 deaths and more than 152.4 thousand diseases, which could actually occur should the Service fail to perform its regulatory actions. The total prevented economic losses equaled approximately 2.1 billion rubles in 2023. Economic effectiveness was established relying on prevented losses of the gross regional product and equaled 7.25 rubles per 1 spent ruble in 2023 prices. There are several promising trends in the scientific and methodical support provided by practical activities performed by Rospotrebnadzor. They include development and implementation of methodical approaches to assessing effectiveness of prevention activities; searching for new approaches to assessing performance and effectiveness of other activities accomplished by the Service (licensing, registration of new and hazardous chemicals and products, etc.).

Comparatively analyzed pattern of Delta and Omicron SARS-CoV-2 genovariant dominated COVID-19 incidence in the population of the Saratov region

Despite the stable decline in SARS-CoV-2 virus-caused COVID-19 incidence in most countries worldwide by the end of 2023, spreading of this infection on a global scale remains relevant. Among all known SARS-CoV-2 genovariants, within the last about two years Omicron remains dominant. The distinctive properties of this genovariant are presented by short incubation period (1–5 days), high contagiousness, and a relatively mild disease course due to largest number of genomic mutations among all SARS-CoV-2 genovariants. The first case of Omicron genovariant-caused infection in Russia was recorded in early December 2021. Over many month-monitoring after active spread of the genovariant in Russia, it is obvious that in a number of key characteristics it differs profoundly from previous SARS-CoV-2 genovariants. Analyzing major patterns inherent in COVID-19 epidemic process particularly uncovering geographic features is one of the most crucial activities in COVID-19 surveillance. Here, we provide a comparatively analyzed pattern of Delta and Omicron SARS-CoV-2 genovariant dominated COVID-19 incidence in the population of the Saratov region. For this, there was used statistical reporting from the Office of Rospotrebnadzor for the Saratov Region. The main research method is based on epidemiological analysis. The study data showed that upon Omicron genovariant dominance, an increased percentage in COVID-19 cases among children of varying age, increased rate of infected subjects with unknown source of infection as well as improved clinical disease course were recorded. Regardless of the circulating genovariant, elderly people remain to be in risk group. Thus, after three years of the COVID-19 pandemic, the mutual adaptation for SARS-CoV-2 and human population can be observed, which is accompanied by altered biological properties of the former and the accumulation of herd immunity. Alleviated disease symptoms and decreased mortality rate among Omicron genovariant-infected individuals evidence in favor of further COVID-19 transformation into a seasonal infection.

Analysis of Potential Economic Damage to Consumers and Business Entities Posed by Circulation of Non-Conforming Food Products and Ways to Reduce It

Introduction: Failure to comply with sanitary and epidemiological requirements poses risks of harm to consumer health and damage to business entities, which reduction necessitates the search for effective preventive measures. Objective: To analyze the potential economic damage to consumers and business entities related to circulation of food products and to consider ways to reduce it. Materials and methods: We have analyzed data collected by the Sverdlovsk Regional Rospotrebnadzor Office on violations of mandatory legal requirements by business entities and administrative fines imposed within inspections; the Center for Hygiene and Epidemiology in the Sverdlovsk Region on laboratory test results and customer complaints; the Federal State Statistics Service (Rosstat) on the prices of food products by groups; the Regional Operator for Municipal Solid Waste Management on the cost of disposal of a ton of withdrawn non-conforming products, and the Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers on the results of audits and questionnaire-based surveys of food enterprises for the years 2015–2019 and 2022 using Microsoft Excel tools and the Statistica 10 software. Results: The annual economic damage from the circulation of non-conforming products for food retailers averaged 73,893.5 thousand rubles. We observed a 1.5-fold increase in the number of customers’ product quality complaints. The structure of damages shows an increase in disposal costs and those related to customer complaints. At the same time, decreasing administrative fines undermine motivation of businesses to comply with mandatory sanitary and epidemiological regulations. Large and small retailers lose on average 2,630.2 and 16.2 thousand rubles per enterprise per year, respectively. An integrated approach to carrying out preventive measures using theoretical and practical knowledge and skills in managing the quality and safety of products has been shown to reduce the number of violations of sanitary and epidemiological requirements in more than 40 % of enterprises, that of complaints – in 20 % of the companies, and general expenditures on withdrawal and disposal of non-conforming and dangerous products. Conclusions: After supervisory activities have been cut down, the total potential damage to business entities is largely attributed to customer complaints and disposal of non-conforming products. Large retailers selling dairy, meet, and fish products, fruit and vegetables are at higher risk of economic damages. Raising awareness of the total economic damage among business entities when carrying out preventive measures can be considered as an incentive to comply with mandatory quality requirements.

Epidemic manifestations of coronavirus infection caused by «omicron» genovariant in the Volgograd region

The article is devoted to an urgent problem the study of the epidemic manifestations of the new coronavirus infection COVID-19 during the fourth wave of the rise in the incidence, which began in January 2022 in the Volgograd region.
 Materials and methods: We used the official statistical data of the Office of Rospotrebnadzor for the Volgograd Region on the incidence of COVID-19 and the results of SARS-CoV-2 genomic RNA sequencing. The main research method is epidemiological analysis. We analyzed the period from the beginning of the next increase in the incidence, coinciding with the almost complete replacement of other variants of SARS-CoV-2 by omicron (since January 16, 2022), until the decrease and stabilization of the incidence rates on March 30, 2022. Comparison of the epidemiological process indicators was carried out with the period before the appearance of the omicron genovariant (as of December 30, 2021).
 Results and discussion: Since mid-January 2022, there has been a sharp rise in the incidence of COVID-19 in the region up to 2,222 cases per day by mid-February and a subsequent decrease in incidence rates by the end of March. It has been established that the next wave of coronavirus infection is associated both with an increase in interpersonal contacts on holidays and the subsequent introduction of the infection into work and educational teams, and with the change of the SARS-CoV-2 genovariant to omicron. During 2.5 months of the fourth wave, 76,717 people fell ill with coronavirus, which is 36.6 % of the total number of cases registered over the entire observation period. Moreover, the proportion of cases in the age category up to 18 years has significantly increased (by 13.1 %). During the analyzed period, the proportion of cases with a mild course increased by 18.3 % (up to 88.6 %), and the percentage of cases of moderate severity decreased by 10.1% (up to 10.5 %), a severe course decreased by 4.1% (to 0.7 %), asymptomatic also decreased by 4.06 % and accounted for 0.14 % of the total number of detected cases of COVID-19. The share of pneumonia in the total morbidity for 2.5 months decreased by 16.8 % (to 1.6 %). In most cases, the treatment took place on an outpatient basis. The percentage of patients requiring hospitalization decreased to 18.5 %. There is a downward trend in the mortality rate from 4.3 % before the rise in incidence to 3.2 % as of March 30, 2022.
 Conclusions: In the Volgograd region, from January 14, 2022, another rise in the incidence of COVID-19 was registered with the maximum indicators for the entire observation period in February. The omicron genovariant, which has become dominant, has a higher contagiousness and is actively spreading in childrens groups. The disease is characterized by a milder clinical course in the form of acute respiratory viral infections, bronchitis, and a decrease in the proportion of deaths.

Assessment of the state of the ecosystem of the Lipetsk region

The characteristics of the state of the ecosystem of the Lipetsk Region are presented on the basis of official statistical reporting by the Office of Rospotrebnadzor for the Lipetsk Region, the Lipetsk Center for Hydrometeorology and Environmental Monitoring - a branch of the Central Chernozem UGMS, the Department of Ecology and Natural Resources of the Lipetsk Region. Environmental problems of the Lipetsk region are associated with pollution of atmospheric air,drinking water, soil, and food products by toxic substances. Sources of environmental pollution are ferrous metallurgy, chemical industry, motor vehicles, agricultural production, including livestock. Anthropogenic anomalies of the habitat are becoming one of the main causes of veterinary problems in modern animal husbandry. The purpose of the study: to assess the state of the ecosystem of the territory of the Lipetsk region, including monitoring of surface watercourses in the area of the city of Lipetsk: the rivers Matyra, Voronezh, Lipovka and the Matyr reservoir. For the analysis of water sources for heavy metal contamination with an atomic absorption spectrometer with electrothermal authorization "MGA-1000". Sampling of natural water was carried out according to GOST 17.1.5.05-85. The volume of the sample taken was 250 ml, the filtrate was preserved with nitric acid. Statistical processing of analytical data was carried out by conventional methods.Up to 90% of emissions of harmful substances from stationary and mobile sources of pollution are accumulated by soil, from where toxins migrate into water and plants. The content of zinc slightly exceeded the maximum permissible level in 35% of the selected samples, %, manganese - in 32% and aluminum - in 34% of the selected samples. So the highest content of iron and lead was recorded in the river. Voronezh and in the region of Lipetsk, exceeding the MPC by 1.5 times. To a lesser extent, increases in MPC r. Matyr and Matyr-sky reservoir.

The Impact of Vaccination on Disease Course and Outcome in Intensive Care Patients With COVID-19

BACKGROUND Our study provides a unique opportunity to compare the course of the disease with a new coronavirus infection in seriously ill patients in the groups of vaccinated and unvaccinated patients hospitalized in the infectious intensive care units of N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department since the start of the vaccination campaign.AIM OF STUDY The study of the composition of hospitalized patients with COVID-19 in the N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department in serious condition, requiring resuscitation, in groups of vaccinated and unvaccinated patients in terms of their age and gender characteristics, the severity of the condition and duration of treatment, the presence of concomitant (chronic) diseases, as well as the outcome of hospitalization.MATERIAL AND METHODS The initial analyzed material was data from the Unified Medical Information and Analytical System (EMIAS) of the Institute and statistical cards of patients who left the hospital. The formation of the main group of vaccinated patients was carried out in accordance with the instructions of the Moscow Department of Health and in pursuance of the letter of the Office of Rospotrebnadzor for the city of Moscow No. I-17-17/1 dated January 26, 2021 “On monitoring COVID-19 cases in those vaccinated against a new coronavirus infection “. The Institute has created a registry of hospitalized patients diagnosed with Coronavirus infection caused by the COVID-19 virus, who have a certificate of vaccination with registration in EMIAS. Also, to determine vaccinated patients, we used information from the Headquarters for measures to prevent the importation and spread of infection caused by the 2019-nCoV coronavirus in the city of Moscow. The comparison group included patients with coronavirus infection caused by the SARS-CoV-2 virus, hospitalized in the infectious diseases intensive care units of the Institute and not having information about the certificate in EMIAS. The analyzed period was counted from the moment the register was created and amounted to 6 months: from May 1 to October 31, 2021. Discrete numerical accounting characteristics of each unit of observation (hospitalized patient) were age, duration of stay in the hospital (including in intensive care). Categorical data were gender, diagnosis, source of admission, severity, presence of pneumonia upon admission, history of chronic diseases, outcomes of hospitalization. After the anonymization of the personal data of patients and the distribution of patients into comparison groups, the obtained information was processed by standard means of mathematical statistics using the R-free software computing environment. The calculation of additional absolute and relative values, average errors of indicators was made. Statistical significance of differences in numerical values was determined using the Student’s t-test, categorical values were calculated using the ӽ2 test. In both cases, the p-value was chosen to be less than 0.05.RESULTS When comparing the course of coronavirus infection, concomitant diseases, the duration and nature of inpatient treatment, the frequency of external and internal transfers between different departments, as well as disease outcomes in vaccinated and unvaccinated patients hospitalized at N.V. Sklifosovsky Research Institute for Emergency Medicine of the Moscow Health Department revealed:the average duration of stay both in clinical units and in intensive care units in vaccinated patients is significantly less than in unvaccinated patients;all patients were admitted to the hospital in a serious or extremely serious condition caused by severe clinical manifestations of coronavirus infection in unvaccinated patients and comorbid diseases in most of the vaccinated patients;the mortality among vaccinated patients is significantly lower, and the immediate cause of death was almost always complications of a severe course of competing (non-infectious)CONCLUSION The study showed that in vaccinated patients with intense post-vaccination immunity, the risk of developing a severe course of coronavirus infection (requiring resuscitation) is much lower. Along with this, the duration of treatment is also significantly reduced, especially in intensive care units, and the likelihood of an unfavorable outcome of the disease is reduced to a minimum.

Multiple problems of school medicine: state of health and organization of nutrition for schoolchildren

Introduction. In recent years, there has been an increase in the number of schoolchildren with chronic diseases. Employees of the Astrakhan State Medical University, together with colleagues from Children’s City Polyclinic №4, worked to study the impact of nutrition on the growth of disease cases in educational institutions.Aim. Study of the impact of nutrition in educational institutions on the state of health of modern schoolchildren in the city of Astrakhan, as well as the understanding of children and their parents of the principles of healthy nutrition of children.Materials and methods. The health status of 9063 schoolchildren was monitored in general education institutions located in the service area of Children’s City Polyclinic No. 4. Data from preventive examinations 2018–2020 were used. Schoolchildren (579 people) in grades 8–11 and parents (591 people) were surveyed for the state of the child’s health and attitude to healthy nutrition in schools.Results. According to the results of monitoring by the Office of Rospotrebnadzor in the Astrakhan region in the region, no educational institution has a balanced diet. Preventive examinations of schoolchildren showed that only 7% of children with health group I entered the first grades. In a significant part of schoolchildren, various functional violations were noted (57%). In the structure of such disorders, the first place is diseases of the musculoskeletal system, the second place is the pathology of the digestive organs, and the third place is the violation of neuropsychiatric health. There was a high level of allergopathology, eye diseases. 3% of children showed hearing loss. When examining the cardiovascular system (ECG screening), only 63% of schoolchildren had no significant abnormalities.Conclusion. Unsustainable nutrition of schoolchildren is one of the reasons for the high level of incidence of schoolchildren, the prevalence of chronic diseases, and physical disorders. It is necessary to introduce healthy-saving technologies in schools and control the organization of nutrition for schoolchildren.

Interdepartmental Cooperation of the Rospotrebnadzor Office in the Republic of Tatarstan in Carrying out the Order to Provide Free Hot School Meals to Pupils in Grades 1-4

Introduction: Proper, healthy and safe school nutrition is an important factor in maintaining health and physical growth of a child from a medical point of view, which, in the long run, determines health of the future generations. High-quality food raw materials, a modern material and technical base, qualified personnel, and promotion of healthy eating among schoolchildren and their parents are crucial for successful school feeding. Objective: To analyze the experience and effectiveness of cooperation between the Office of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in the Republic of Tatarstan, executive authorities and parents to improve school nutrition in the 2020/21 academic year. Materials and methods: The analytical method was used to assess the effectiveness of interdepartmental interaction when carrying out the order to ensure provision of free hot school meals to pupils in grades 1–4 (aged 7–11 years) in the Republic of Tatarstan. Results: Well-coordinated effective actions were implemented in the republic in 2020–2021 to organize free hot meals for elementary school children. They consisted of planned improvement of school catering units, elaboration and introduction of unified menus, including those for children with special dietary needs. Regular inspections of school catering helped improve its quality and enhance responsibility of officials in charge. The experience gained can be applied in other constituent entities of the Russian Federation. Conclusion: Thanks to the close cooperation of executive authorities of the Republic of Tatarstan, the Rospotrebnadzor Office in the Republic of Tatarstan, and the parental community, effective work has been carried out to organize provision of free hot school meals to first to fourth graders since September 1, 2020. All the improvements shall contribute to prevention of diet-related diseases in schoolchildren.

Regional Practice of Organizing Parental Control over School Nutrition in the Republic of Mordovia: Experience, Results, and Expected Effectiveness

Introduction: Increasing attention has been paid recently to the issues of school nutrition due to the observed rising trends in the rates of diet-related diseases in children. Today, along with the interdepartmental interaction of government institutions, parents can also be involved in monitoring and resolving problems of school feeding by exercising public control. Objective: To assess organization of interdepartmental interaction between the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) and regional executive authorities, public organizations, government agencies, and the parent community on issues of school meals. Materials and methods: We analyzed the results of monitoring and inspections of the Republican Office of Rospotrebnadzor, complaints and appeals on school meals, reports of parental control commissions, and surveys of parents and children on satisfaction with school nutrition (the total of 898 episodes in the 2020/21 academic year and 420 – in September–December, 2021). Results: We established that all elementary schoolchildren (grades 1–4) received hot school meals while the total coverage was 96.2 % for all students. We also observed a decrease in the number of complaints about school catering in October to December 2020; in December 2020 to March 2021, the republican rating of school meals launched by the Russian Movement of Schoolchildren rose from “Top 10 Bad Taste” to “Top 10 Good Taste” owing to a significant improvement of the menu of school breakfast and lunch that, inter alia, included gradual replacement of confectionery with fruit and sausages with meat dishes. Conclusion: The combined interdepartmental and parental monitoring of school nutrition has proved its effectiveness in problem detection and its prompt solving.

ОЦЕНКА КАНЦЕРОГЕННОГО ПОТЕНЦИАЛА OPISTHORCHIS FELINEUS КАК ФАКТОРА РАЗВИТИЯ ХОЛАНГИОЦЕЛЛЮЛЯРНОЙ КАРЦИНОМЫ

According to the latest official materials of the territorial departments of the Office of Rospotrebnadzor for the Khanty-Mansiysk Autonomous Okrug-Yugra, opisthorchiasis remains the most relevant and socially significant parasitic pathology of the population of the okrug. The mechanisms of O. felineus carcinogenesis are not fully understood. However, recent advances in Siberian science have made a significant contribution to understanding the developmental model of O. felineus-associated cholangiocellular carcinoma and can be used to reassess the carcinogenic potential of this parasite.

Population health as a basis for sustainable development of a region

A healthy life in harmony with the environment is one of the principles of sustainable development. We consider the incidence of the population as an indicator of the health of the environment. On the example of Samara region, we analyzed the infectious morbidity associated with natural conditions and diseases that depend on social interaction within the human population. The study was carried out on the basis of data on infectious morbidity in 35 administrative and municipal divisions of Samara region (8 cities and 27 municipal districts) provided by the Office of Rospotrebnadzor of the Russian Federation. On the basis of data on natural focal morbidity, we carried out zoning of the territory: 1) by the level of natural focal morbidity; 2) by the incidence of natural focal diseases. The authors, based on the data on the incidence of chronic viral hepatitis B and C, assess the age structure of the incidence. The authors analyze the relationship between the incidence rate of chronic hepatitis B and C with the level of socio-economic development in the region. The calculation of the socio-economic damage from the incidence of chronic hepatitis C was carried out. The statistical analysis of the influence of socio-economic indicators in the region on the incidence of tuberculosis was carried out. The research was carried out by methods of comparative and statistical analysis. Some formulas for calculating socio-economic damage are given.

Damage Liability Insurance as an Alternative Means of Food Quality and Safety Management

Introduction: Widespread violations of mandatory requirements entails administrative measures that cause economic damage to both consumers and economic entities. In the context of the development of integration processes and harmonization of legislation, new, more effective approaches to the governmental control (supervision) and food quality and safety management based on prevention of violations and reduction of damage risks are being introduced. The objective of our work was to substantiate the necessity of damage liability insurance for producers and retailers as an instrument of improving quality and safety of foodstuffs and reducing risks of damages to consumers and economic operators. Materials and methods: We analyzed data of the Sverdlovsk Regional Rospotrebnadzor Office, the Center for Hygiene and Epidemiology in the Sverdlovsk Region, the Federal Service of State Statistics, the Regional Solid Household Waste Management Operator, the Yekaterinburg Municipal Unitary Enterprise “Spetsavtobaza”, as well as provisions of the Code of the Russian Federation on Administrative Offenses, using comparative and time-series methods. Results: We established factors accounting for the cumulative economic damage to consumers and economic operators from circulation of substandard food products and found that they contributed differently in terms of the amount of property damage and health damages to consumers. Administrative penalties are the main reason for the property damage to economic operators. Intestinal infections cause most physical and material losses to consumers and these damages are inevitably shared with the state. Dairy and meat industries with extremely high risks incur the greatest financial losses. The use of various approaches to food safety management, including damage liability insurance, will help minimize risks, prevent their consequences, and protect consumers and economic operators. Conclusion: Violation of regulations poses significant risks of damage to consumers and economic losses to economic operators. Insurance may be considered as an alternative means of risk management motivating businesses to ensure food quality and safety, protect consumers and help maintain their health, and reduce economic losses.

EPIDEMIC MANIFESTATIONS OF COVID-19 IN THE VOLGOGRAD REGIONDURING THE 2020-2021 PERIOD

Study objective. The researching of COVID-19 epidemic process features in the Volgograd region during 2020-2021. Materials and methods. The analvsis based on statistical data from the Office of Rospotrebnadzor in the Volgograd Region on the incidence of COVID-19 was carried out. The main research method is epidemiological analysis. Results and discussion. For the period from March 24, 2020 to September 6, 2021, 83 814 cases of SARS-Cov-2 infection were registered in the Volgograd Region, the incidence rate was 3 344.76 per 100 000 population (95 % CI: 3 321,97-3 367,55), case fatality rate - 2,77 %. In the development dynamics of COVID-19 epidemic process in the Volgograd region, three seasonal incidence increases are identified: April - June 2020 (relatively low), September 2020 - February 2021 (high), June 2021 - present (the highest). It is shown that the third rise in the incidence rate is caused by the combined effect of a number of factors - the intensification of seasonal migration, the spread of a new genetic variant of the pathogen ("delta" genovariant, B.1.617.2) and low vaccination coverage of the population. An excess of the regional average incidence rate (3 344,76) was established in 13 districts of the region, the most affected territories are Volgograd (40,3 % of the total number of cases), Volzhsky (15,7 %) and Kamyshinsky district (6,1 %). The distribution of cases by sex revealed the predominance of women (60,3 %) in all age groups, with the exception of 0-18 years old and 70 years and older. The greatest contribution to the incidence of COVID-19 over the entire observation period is made by the age groups 50-59 years (17,7 %) and 60-69 years (17,4 %). During the third wave of incidence, active involvement of the 0-18 age group in the epidemic process and a decrease in the proportion of people 60 and older were established. The clinical picture of the disease is characterized by the prevalence of the mild course of the disease (64,4 %), there is a tendency for the reduction of moderate and asymptomatic forms.

Opportunities for using telemedicine in occupational pathology

Introduction. The Russian Federation has certain socio-demographic and geographical features that make it difficult to provide qualified medical care to the population. The relevance of telemedicine in modern conditions is difficult to overestimate. Telecommunications technologies have significant potential to address the challenges of providing affordable, cost-effective and high-quality health services to the population. Telemedicine uses information and communication technologies to overcome geographical barriers and increase public access to health services. On May 9, 2017, the President of the Russian Federation approved the "Strategy for the development of the information society in the Russian Federation for 2017-2030" by decree № 203. Digital healthcare is an integral part of the digital economy. The aim of study is to analyze the regulatory framework for telemedicine support of occupational pathology activities. Materials and methods. The analysis of the development of telemedicine technologies in the Russian Federation is carried out. The legal framework regulating the work of a professional pathologist using telemedicine technologies has been studied. Results. Consultation of the patient or his legal representative by the medical officer are prevention, collection, analysis of the patient's complaints and data of anamnesis, evaluation of the efficiency of diagnostic and therapeutic activities, medical monitoring of patient's condition and decision on the need for face-to-face reception (examination, consultation). The implementation of these measures using telemedicine technologies is regulated by article 36.2 of Federal Law № 323-FZ, which states that remote monitoring of the patient's health and correction of previously prescribed treatment by the attending physician can be carried out after an in-person appointment (examination, consultation). Remote surveillance is carried out on the basis of data about the patient, was with the use of medical devices intended for monitoring human body, and/or on the basis of the data entered into the unified state information system in health care, or public information system in healthcare of the Russian Federation, or medical information system or information system referred to in part 5 of article 91 of the Federal Law № 323-FZ in compliance with, established by the legislation of the Russian Federation in the field of personal data, and compliance with medical confidentiality. Conclusions. It is necessary to implement telemedicine technologies for pre-hospital consultation of patients to clarify the preliminary diagnosis, methods of examination and treatment, and advice on patient management tactics in the long-term period of the disease. The question of using technologies for patient consultation in the "patient-doctor" system remains open due to the peculiarities of diagnostic and expert work of professional pathologists, which requires the analysis of a large number of documents provided by various departments (medical organizations of different forms of ownership, the office of Rospotrebnadzor, Medical and Social Expertise (MSE), employer, etc.).

Analysis of Customer Satisfaction with the Quality of Services of an Inspection Body

Introduction: One of the basic principles of quality management is customer orientation. The most convenient method of monitoring and measuring customer satisfaction is a customer survey. Literature review showed a lack of information on the analysis of consumer assessment of the quality of services in the field of ensuring sanitary and epidemiological well-being of the population. The purpose of the study was to substantiate measures for optimization of the quality management system (QMS) based on the analysis of consumer (customer) satisfaction with the quality of services for the conduct of sanitary and epidemiological expert examinations (hereinafter referred to as examinations) rendered by the Inspection Body of the Moscow Center for Hygiene and Epidemiology, Federal Budgetary Health Institution, with the exception of its branch offices in administrative districts, including those rendered for provision of government services by Moscow Rospotrebnadzor Office. Materials and methods: A special questionnaire was developed to study customer satisfaction with the quality of services rendered by the Inspection Body and the total of 510 questionnaires was analyzed in 2019 using statistical, sociological, and logical methods of research. The results of the survey showed that the customers were generally satisfied with the quality of services provided by the body. The data on priority factors determining the customer’s choice of an institution for conducting expert examinations were collected. The need to optimize the information component of the official website about the services was identified. The importance of developing remote interaction with customers, including that through the official website, was established. Introduction of a systematic monitoring of customer satisfaction including electronic questionnaire-based surveys was proposed. The expediency of optimizing the procedure for preparing expert opinions based on the results of laboratory tests, which would improve the quality and shorten the time for conducting examinations, was established. Conclusions: The survey of customer satisfaction with the quality of expert services rendered by the Inspection Body of the Moscow Center for Hygiene and Epidemiology revealed the determinants for choosing the institution, the necessity to develop information technologies for interaction with customers, and the factors showing the importance of improving the QMS procedure for conducting expert examinations of laboratory test results.

Assessment of the Relevance of Requirements of the Current Sanitary Legislation for Food Retailing

Introduction: In order to assess the relevance of sanitary regulations in relation to food retailing we analyzed data on inspections of 12,001 enterprises and expert actions taken by the Sverdlovsk Regional Rospotrebnadzor Office and the Center for Hygiene and Epidemiology in the Sverdlovsk Region in 2016-2018. Results: We found a low proportion of violations of the requirements of sanitary regulations SP 2.3.6.1066–01, Sanitary and epidemiological requirements for trade organizations and the turnover of food raw materials and food products in them, ranging from 5.9 % to 6.3 % and its significant difference in some cases ranging from 0 % to 36 %. During inspection, compliance with 42 out of 131 paragraphs (32.6 %) was not checked or violations were not detected due to the impossibility to exercise control, recommendatory nature of some clauses, the failure to comply with which cannot be considered a violation, or irrelevance of certain items, the requirements of which are outdated. The proportion of prevalent violations related to the requirements for equipment, packaging facilities, storage and sale of food products was quite high and amounted to 27.9 % in 2016, 25.1 % in 2017, and 23.1 % in 2018, thus posing the risk of nonconforming products. Laboratory testing of samples taken within supervisory activities demonstrated noncompliance with chemical, microbiological, and parasitological requirements for food, the rates of which decreased in 2016–2018 with a simultaneous increase by 2.5 % in terms of counterfeiting. Respondents (33.3 %) from 481 surveyed food retailers proposed a long list of amendments to sanitary regulations to ensure safety of food products sold. We conclude that the current sanitary regulations need to be updated, especially in terms of management and control measures, taking into account risk-based surveillance and food quality and safety management systems.

EPIDEMIC MANIFESTATIONS OF COVID-19 IN VOLGOGRAD REGION: INTERIM RESULTS

An assessment of the manifestations of the COVID-19 epidemic process in the Volgograd region in terms of intensity, territorial distribution, structure, and clinical patterns of the disease was carried out. The study used the official data of the Rospotrebnadzor Office in the Volgograd region. From March 24 to October 18, 2020, 17 811 cases of COVID-19 were registered in the region, the incidence rate was 715 per 100 thousand of the population, the case fatality rate was 0,98 %. An uneven distribution of morbidity over the territory was established: 42,3 % of cases were detected in Volgograd, 10,1% in Volzhsky and 6 % in Kamyshinsky district. The age groups 40-49 years old (17,6 %) and 50-59 years old (19,2 %) are most involved in the epidemic process. In the cases structure, the prevalence of females was noted (58,3 %). The clinical patterns of the disease are characterized by the predominance of mild forms (46,8 %), there is a trend to reduce asymptomatic forms and an increase in moderate manifestations. In the Volgograd region, a lower frequency of severe forms and deaths registration has been established in comparison with the Russian Federation. In the social structure of the infected people, the largest share is made up of pensioners (26,3 %) and workers (16,9 %).

Epidemiological characteristics of brucellosis in the Omsk Region (2008-2019)

Aim. Analysis of the epidemiological and epi-zootological situation in the Omsk region over the past 12 years (2008-2019) and identification of factors affecting the epidemic manifestations of brucellosis in modern conditions on the territory of the Omsk region. Material and methods . The data of the official registration of infectious diseases in the Russian Federation, accounting documents of the Office of Rospotrebnadzor, Rosselkhoznadzor, the Main Veterinary Directorate of the Omsk Region for 2008-2019 are analyzed. A retrospective epidemiological analysis was carried out over a 12 year period. Graphic data was obtained using Microsoft Excel 2007. An analysis of 91 stationary maps of patients with newly diagnosed brucellosis was carried out. Results. Total for 2008-2019 95 cases of newly diagnosed brucellosis in humans were reported. In the study period, registration of chronic brucellosis with a gradual onset (44 cases) and residual brucellosis (13 cases) prevailed in people. Acute brucellosis was recorded in 22 cases, subacute in 8 cases. Examination of contacts in dysfunctional foci of brucellosis revealed 8 cases of latent brucellosis. Among the cases of brucellosis, residents of the region prevailed - 84.2% (80 cases). Brucellosis in humans was recorded in 20 of 32 rural areas of the region and in the city of Omsk. In 46.3% of all newly diagnosed cases of brucellosis (44 out of 95), the professional nature of the disease was established. Conclusion. In the Omsk region in the period 2008-2019 An unfavorable situation for brucellosis remains, for many years the incidence rates have exceeded the national ones. Cases of newly diagnosed chronic and outbreaks of acute brucellosis among people continue to be recorded. Taking into account the clinical and epidemiological features and tendencies to chronicity of brucellosis infection, an increase in the number of patients requiring health and preventive measures should be expected. An objective assessment of the epidemiological situation requires a revision of the statistical forms of registration of cases of brucellosis with an indication of the clinical variants of the disease.

Occupational pathology of respiratory organs in health care workers: issues of timely diagnosis

Introduction. In the structure of occupational diseases of medical workers, respiratory pathology occupies a leading place, accounting for 60% in the Republic of Tatarstan. The most common are diseases from exposure to infectious agents in the form of various forms of respiratory tuberculosis. Most often, an infiltrative form is diagnosed, accompanied in 48.6% of cases by bacilli discharge.The aim of the study is to explore the structure of occupational respiratory diseases in workers of the healthcare industry of the Republic of Tatarstan, to identify factors that affect their early diagnosis during medical examinations.Materials and methods. A retrospective analysis of cases of occupational respiratory diseases in health care workers according to the office of Rospotrebnadzor of the Republic of Tatarstan and the register of patients of the Republican Center of Occupational Pathology.Results. In the structure of occupational diseases of the respiratory system, the leading place is occupied by pulmonary tuberculosis, amounting to 86%, followed by bronchial asthma–8%, chronic toxic bronchitis–4% and subatrophic rhinopharyngolaryngitis–2%. Analysis of cases of occupational respiratory pathology showed that only tuberculosis was detected during periodic medical examinations. Other respiratory diseases were diagnosed by applying for medical care, when there was a pronounced negative trend and when the disease was initially associated with the profession, we had to talk about sending it to the Bureau of medical and social expertise.Conclusions. Early diagnosis of occupational respiratory diseases of allergic etiology and toxic respiratory lesions in medical workers at periodic medical examinations can be achieved by the quality of a special assessment of working conditions due to the mandatory assessment of the chemical factor-contact with allergens, antitumor drugs, hormones, enzymes of microbial origin, narcotic analgesics, regardless of the concentration of harmful substances in the air of the working area. It is also necessary to take into account the presence of substances with an acute irritant effect.