Priority Risk Factors Research Articles

Posterior assessment of airborne non-carcinogenic health risk of the population of a large industrial center

Introduction. This article suggests an alternative solution to the task of quantifying and describing health harm under exposure to non-carcinogenic risk factors.
 Materials and methods. We have developed and tested a methodical approach that includes five subsequent steps; it is eligible for posterior quantification of non-carcinogenic health risks represented by additional diseases cases associated with poor ambient air quality. The approach relies on unified and validated methods for assessing exposure and health risks, mathematical parameterization of cause-effect relations within the "environment – public health" system, and calculation of additional incidence as well as combined assessment of all the obtained results.
 Results. According to calculated data, which were also verified by instrumental observations of ambient air quality, the existing hygienic standards are violated as per 27 chemicals in residential areas. Elevated hazard quotients are identified for 26 chemicals (up to 98.7HQac; up to 62.7HQch). Additive effects of the analyzed chemicals crated elevated hazard indices (HI) in residential areas that could be ranked as "alerting" (3<HI≤6) and "high" (HI>6) for respiratory organs, the cardiovascular and hematopoietic systems, liver, kidneys, eyes, development, the immune, reproductive, endocrine, and other systems. The identified levels of airborne exposure annually cause approximately 80.9 thousand additional diseases among the total population (71.0‰; 4.15% of the total incidence); 
 23 chemicals are considered priority risk factors (contributions vary between 0.25 and 65.0%). We have identified certain regularity for some disease classes: higher levels of additional incidence associated with ambient air quality are established in zones with higher airborne health risks. Thus, in zones where airborne risks for respiratory organs are HIch≤1, we identified no additional incidence as per such diseases; in zones with 1<HIch≤3 (with population being 800 people), additional incidence reaches 1.57‰ for the total population; 3<HIch≤6 (more than 100 thousand people), 3.25‰; HIch>6 (more than 1.09 million people), 5.0‰.
 Limitations. The suggested approaches have been obtained by calculation. Their results might differ from those obtained by targeted in-depth investigations aimed at creating an evidence base of health harm under adverse environmental conditions that do not conform to hygienic standards. The parameters of mathematical models within "the environment – public health" system have been obtained for a limited range of exposure to pollutants in ambient air and a limited list of airborne health risk factors.
 Conclusion. The suggested methodical approaches to posterior assessment of non-carcinogenic health risks allows quantifying these health risks as additional diseases associated with poor quality of the environment; they enlarge the results of health risk assessment and make them more precise, validate and support them with hygienic significance. They can be utilized within optimization of social and hygienic monitoring and assessment of effectiveness of implemented prevention activities.

Analisa Faktor Risiko Prioritas pada Proyek Konstruksi Jembatan

Construction projects in the construction sector are often faced with the issue of risk uncertainty. Risk has significant value because it has a high level of consequences if not properly managed, whether it brings opportunities or results in losses. Effective risk control plays an important role in preventing delays at the time of project implementation. A total of five (5) bridge construction projects were reviewed. Identification based on literature by determining the source of risk. The next step is to obtain answers from risk identification before doing a priority risk analysis, followed by data obtained from the survey questionnaire according to the prescription of 30 respondents. The aim of this study is to identify the priority factors that influence the construction of a bridge project as measured by the size of the presentation value on each risk indicator by the Saverity Index (SI) method by analysing the risk management on the bridge construction project. The results of the research show that there are 10 (ten) priority risk factors in the construction of bridge construction projects: (1) not using BIM technology; (2) design errors that do not match the conditions of the field; (3) late or untimely payment methods; (4) design and specifications are incomplete; (5) delays in delivery of materials and equipment; (6) rising prices for materials and equipment; (7) quality of truck contractors; (8) poor ground conditions; (9) lack of skills from the workforce; (10) there are design changes. The benefits of the results of this study can be used as an insight for stakeholders in evaluating important risks so that they may be used to anticipate or as an appropriate measure in managing risks that cannot be ignored but can be mitigated, transferred, or accepted.

Multilevel zero inflated and hurdle models for under five-child mortality in Indonesia

Introduction: Overcoming under-five mortality rate remains a great challenge for Indonesia to meet the national target despite its notable advancements and progress in reducing child mortality rate. Therefore, understanding risk factors of under-five mortality is essential to enhance the health and well-being of children. This research seeks to investigate associated factors of under-five mortality in Indonesia by using the 2017 Indonesia Demographic and Health Survey data. Methods: The multilevel zero-inflated and multilevel hurdle models are considered to handle unobserved heterogeneity that may occur at province level, and to model prevalence and risk of child death as a joint process, which are reported in terms of odds ratio (OR) and incidence ratio rate (IRR), respectively. Results: Lower number of household members (IRR = 0.803, 95% confidence interval [CI]: 0.784–0.823), older mother's age at first birth (IRR = 1.020, 95% CI: 1.007–1.032), higher number of children ever born (IRR = 1.491, 95% CI: 1.450–1.533), lower mother's education (IRR = 1.224, 95% CI: 1.013–1.479), and lower father's education (IRR = 1.232, 95% CI: 1.015–1.495) are significantly associated with higher total death numbers in children before the age of 5 years. Furthermore, the odds of no child death are significantly higher among mother who use a contraceptive method (OR = 11.088, 95% CI: 6.659–18.462) and among household in higher quantile wealth (OR = 1.133, 95% CI: 1.005–1.277). Conclusion: This evidence-based empirical highlights priority risk factors that might provide insight for policymakers, health professional, and the community in general to design appropriate intervention to help reduce the burden of under-five mortality in the country.

Risk management in humanitarian supply chain based on FMEA and grey relational analysis

The COVID-19 pandemic has disrupted the humanitarian supply chain management (HSCM) necessary for delivering emergency items during the disaster. The combined effects of climate change and the pandemic uncover the vulnerabilities of humanitarian supply chain operations and highlight the importance of risk management. This study aimed to identify priority risk factors and proposed mitigating risk strategies of a local government that is at the forefront of relief operations. It used Grey Relational Analysis (GRA) method to validate the Failure Mode and Effect Analysis (FMEA) approach in identifying priority issues relating to the supply chain risks. This paper reveals that the results of FMEA and GRA are almost similar.

Risk factors of maternal and failed maternal mortality, prediction of severe obstetric conditions

Objective. To determine the priority risk factors for maternal mortality (MM) and failed maternal mortality (FMM) on the basis of clinical and epidemiological features and to develop scientifically based patient-centered models for predicting severe obstetric conditions.
 Materials and methods. Primary documentation of successful and dysfunctional maternal outcomes that occurred at the levels I, II, III of medical organizations in Perm and the territories of Perm Krai from 2007 to 2018. Using random sampling, two observation groups were formed: women with failed maternal mortality, deceased women and the control group. Analytical epidemiological "case-control" studies were carried out, which included the determination of confidence intervals, etiological accuracy using Epi Info and Excel 2016 MSO programs, a package of applied electronic tables Stat2015 of the author ( V.S. Sheludko, 20012016), the MedCalc 15.8 Portable program.
 Results. Socio-behavioral, general somatic, obstetric-gynecological risk factors, the frequency of occurrence of which among women with failed maternal mortality was 1,44,3; 1,225,5; 1,17,6 times more often, and in the group of deceased mothers 1,99,0; 1,729,5; 2,89,0 times higher than in the group of healthy participants. The "indicators of maternal death" have been identified, which increase the risk of a failed maternal death turning into maternal death. Early clinical and laboratory signs of severe obstetric conditions are the following: high leukocyte intoxication index (LII), elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), urea and creatinine, decreased levels of fibrinogen, prothrombin index (PTI), prolongation of thrombin time (TT). Infectious-inflammatory, hypertensive complications, comorbidity, a high percentage of premature births and, accordingly, severe perinatal conditions are significantly more common in groups with unfavorable outcomes.
 Conclusions. In the course of the study, reliably significant risk factors were identified, on the basis of which scientifically based models for assessing the probability of developing critical obstetric conditions were worked out.

Modifying impact of environmental factors on the course of an epidemic process

Introduction. It is necessary to establish peculiarities and regularities of COVID-19 infection; this task requires further research on how to formalize and build spatial-temporal models of the infection spread. This article focuses on determining non-infectious factors that can modify the epidemic process caused by the COVID-19 coronavirus for further substantiation of integrated solutions that are necessary to ensure sanitary-epidemiological welfare of the RF population. Materials and methods. Our study involved analyzing regularities of regional differentiation in parameters introduced into mathematical models. These models described how the epidemic process developed in RF regions depending on modifying non-infectious factors identified by modelling the dynamics of spread of SARS-CoV-2 delta strain. These modifying factors included anti-epidemic activities; sanitary-epidemiological, sociodemographic, and economic conditions in a region; weather and climate; public healthcare systems and people’s lifestyles in RF regions over 2020-2021. The dynamics of the epidemic process was modelled by using the conventional SIR-model. Relationships between parameters introduced into the model of the epidemic process and modifying regional conditions were examined by using correlation-regression analysis. Results. The modelling made it possible to identify priority risk factors that modified COVID-19 spread authentically (p<0.05) and explained regional differences in intensity of contagion, recovery and lethality. We established that population coverage with vaccination, especially among people aged 31-40 years, had the greatest authentic positive influence on the decline of reproduction index (R0) of the virus (r=-0.37). An increase in monthly average temperatures in autumn and winter as well as over a year made for people moving faster from the susceptible to infected category (r=0.21-0.22). Growing sun insolation over a year, especially in summer, resulted in slower movement of susceptible people into the infected category (r=-0.02-(-0.23)). Next, several sanitary-epidemiological indicators authentically made the infection spread faster; they were improper working conditions (not conforming to the safety standards as per physical indicators) and ambient air quality in settlement not corresponding to the hygienic standards as per chemical indicators and noise (r=0.29-0.24). Recovery took longer in regions where alcohol consumption was comparatively higher (r=-0.32). Limitations. The limitations of the study include modelling the epidemic process using the standard SIR model; limited set of indicators and period of analysis. Conclusions. The existing regional differentiation in development of specific stages in the epidemic process related to the COVID-19 delta strain occurs due to complex interactions and influence exerted by modifying factors that create a certain multi-level and multi-component system. This system is able to transform the epidemic process either potentiating it or slowing it down.

Traffic Noise as a Factor of Health Risks and Restrictions on the Use of Land Plots of Urban and Rural Settlements

Introduction: Noise is one of the priority risk factors for human health and the environment. Urban noise exposure demonstrates a steady increase. New instruments of government regulation are necessary to prevent sanitary and epidemiological ill-being of the population. The existing regulatory framework and methodological approaches facilitate management of the current situation while maintaining health of citizens. Objective: To zone the territory of a large city by noise levels for the tasks of urban planning and assessment of health risks posed by road traffic noise. Materials and methods: Data on 4,200 sections of the road network as sources of urban noise with the average daily traffic of ca. 300,000 vehicles were used for acoustic modeling. Complex acoustic calculations were performed using the “Ecolog-Noise” software incorporating current regulations and guidelines on spatial distribution of noise for the entire area of the city within the boundaries of the computational rectangle sized 50 × 35 km and a grid step of 200 meters. The mapping of zoning results was made using geographic information systems. Potential risks of health disorders were assessed in accordance with the current methodology for assessing human health risk posed by traffic noise. Results: Based on simulation and situational acoustic modeling of spatial distribution, we zoned the territory of the city by noise levels for the tasks of urban development and assessed potential health risks for its citizens. We established zones of acoustic discomfort with the noise levels above 55 dBA and 45 dBA, taken as safety criteria for daytime and nighttime, respectively. Three major zones with different levels of noise exposure were identified: zone 1 (< 45 dBA) with the area of 255.44 km2 ; zone 2 (45–55 dBA), 263.72 km2 ; and zone 3 (> 55 dBA), 289.88 km2 . We estimated that most city inhabitants (893,306 people) lived in the third zone and were at risk of noise-related health disorders. The results of health risk assessment showed that long-term exposure to urban noise generated moderate risks by 14 years of age and high and very high risks by 45 and 55 years of age, respectively. Conclusion: Under current circumstances, the use of certain land plots in the city is limited. Such areas require effective noise protection and minimal residential development to eliminate human exposure to harmful noise levels. Our findings have substantiated managerial decisions on the spatial development of urban territories.

Современные внешнесредовые угрозы и вызовы здоровью населения арктических и субарктических регионов

The paper concentrates on reviewing results of studies that address the influence exerted by climate change in the Arctic and sub-Arctic regions on local population health, ecological situation and ongoing sanitary-epidemiological processes. The systemic review includes research articles available in PubMed (maintained by The United States National Library of Medicine at the National Institutes of Health), Scopus (the largest abstract and citation database of peer-reviewed literature), WoS (the abstract and citation database of peer-reviewed literature) and BVS (Virtual Health Library) that were published over the period from 1960 to 2021. The review covers pressing environmental, sanitary-hygienic and social issues and identifies priority risk factors for public health and wildlife. Global pollution and communicable diseases are shown to pose threats for indigenous people living in the Arctic. These threats are likely to be greater than those faced by populations living elsewhere in the world. We suggest certain solutions to the existing issues. Our conclusion is that climate is changing faster in the Arctic than anywhere else on the planet. Global pollution and communicable diseases pose threats for public health, including the health of indigenous people living in the Arctic and sub-Arctic regions. It is necessary to intensify cooperation among different states to reduce external influences on the Arctic environment and to maintain public health.

Pressing issues of environmental health and medical challenges in Arctic and sub-Arctic regions

The paper concentrates on reviewing results of studies that address the influence exerted by climate change in the Arctic and sub-Arctic regions on local population health, ecological situation and ongoing sanitary-epidemiological processes. The systemic review includes research articles available in PubMed (maintained by The United States National Library of Medicine at the National Institutes of Health), Scopus (the largest abstract and citation database of peer-reviewed literature), WoS (the abstract and citation database of peer-reviewed literature) and BVS (Virtual Health Library) that were published over the period from 1960 to 2021. The review covers pressing environmental, sanitary-hygienic and social issues and identifies priority risk factors for public health and wildlife. Global pollution and communicable diseases are shown to pose threats for indigenous people living in the Arctic. These threats are likely to be greater than those faced by populations living elsewhere in the world. We suggest certain solutions to the existing issues. Our conclusion is that climate is changing faster in the Arctic than anywhere else on the planet. Global pollution and communicable diseases pose threats for public health, including the health of indigenous people living in the Arctic and sub-Arctic regions. It is necessary to intensify cooperation among different states to reduce external influences on the Arctic environment and to maintain public health.

ON ASSESSING THE MORBIDITY OF THE POPULATION ASSOCIATED WITH THE ATMOSPHERIC AIR QUALITY ON THE EXAMPLE OF A RUSSIAN CONSTITUENT ENTITY

According to the World Health Organization (WHO), 24% of the global burden of diseases and 23% of all deaths associate with environmental factors. The presence of chemical impurities in the air can have an adverse effect on the health of the population. A connection has been established between the increased content of chemical impurities in the air and the development of such pathologies as diseases of the respiratory system, circulatory system, the formation of malformations, etc. Many countries implement projects to improve air quality. For the purpose of targeted development of management decisions aimed at minimizing the adverse impact of atmospheric air on the health of the population, the study of the morbidity of the population associated with the impact of priority atmospheric air hazard factors is relevant. The research goal is to characterize the morbidity of the population associated with air quality (on the example of Krasnoyarsk Krai) to identify the priority factors of atmospheric air that form the greatest contribution to the associated morbidity. The qualitative characteristics of the atmosphere and the level of morbidity of the population in Krasnoyarsk Krai are estimated on the basis of official data of federal and industry statistics. The analysis of the primary morbidity of the population, designated by the WHO as an indication of the effect of environmental factors, has been carried out. The authors calculate the number of third-party cases of diseases associated with the quality of the atmosphere and determine the priority risk factors. High proportions of air samples that do not meet the standards for the content of heavy metals, benz(a)pyrene, xylenes (59% of samples) have been registered over the territory of Krasnoyarsk Krai. Since 2012, there has been an increase of 0.2%–6.4% in the indicators of primary morbidity, indicated by the WHO as an indicator of the effect of environmental factors and a significant increase in congenital anomalies (the growth rate is 93.2%). Up to 231 thousand third-party cases of diseases of the general population with diseases affecting the respiratory organs, circulatory system, hematopoietic organs, nervous system, eyes and their appendages determine the presence of aromatic hydrocarbons, nitrogen dioxide, hydroxybenzene (as well as its derivatives), benz(a)pyrene, nitrogen oxide, ammonia, dihydrosulfide and carbon disulfide, sulfur dioxide in the air in concentrations exceeding the standards. The most substantial number of diseases associated with air quality forms in the class of respiratory diseases (2020 – 587.4 cases per 100 thousand population, 64.5% of the total air-associated morbidity).

Development of the epidemic process of HIV infection in the penitentiary system

The purpose statement is to identify and assess the risk factors determined by the development of the epidemic process of HIV infection in the area of high concentration of the risk group.Object of study. 365 deceased HIV-infected were identified, of which: the study group — 222 prisoners who died HIV-infected on the basis of the Regional Hospital of the Federal Penitentiary Service of the city of Tyumen for the period 2008–2018; control group — 143 civilian (law-abiding) patients who died HIVinfected on the basis of the Regional Infectious Diseases Hospital for the period 2011–2018.Research methods. The work used the methods of epidemiological research, mathematical modeling and forecasting, logistic regression of stepwise inclusion with ROC analysis.Results. To assess the epidemiological situation in relation to the incidence of HIV infection in places of detention, the longterm dynamics of the development of the epidemic process was studied with an assessment of priority risk factors, forecasting the development of the epidemic process of HIV infection with the establishment of social significance and risk for the civilian population over a long period. The probability of developing a fatal outcome in HIV-positive men serving sentences is 4.7 times higher than among civilian men, while 14.6 times higher when infected with HIV by parenteral (narcotic) infection, 4.8 times higher with concomitant viral hepatitis and 20 times higher in the presence of a respiratory disease, 99.2% higher in the clinical stages of HIV infection 3, 4A, 4B than in civilians.Conclusion. Prisoners have an unfavorable situation for HIV infection with high mortality. A set of organizational and preventive measures to prevent the spread of HIV among prisoners at the present stage should be strengthened with an emphasis on groups at increased risk and progression of infection.

Priority risk factors for population health in large industrial cities

Introduction. In large cities an assessment of the impact of environmental risk factors in addition to the levels of air pollution on the morbidity of the population and the medical and demographic situation should take into account the influence of the socio-economic living conditions of the population, both availability and quality of medical care. The purpose of the work is to conduct a comparative analysis, assess the informativeness of indicators of air quality, socio-economic living conditions of the population, the availability of medical care, and identify the priority of these factors in large industrial cities of different regions of Russia. Materials and methods. A comparative analysis of indicators of the ecological situation, socio-economic conditions of living and the availability of medical care to the population in large industrial cities for the period 2008-2018 was carried out according to official statistics. Results. The criterion for choosing cities for the analysis was the population size. Large industrial cities of four Federal districts were selected as objects of research: Central (Central Federal District), Volga (Volga Federal District), Ural (Ural Federal District) and Siberian (Siberian Federal District). The main source of anthropogenic load in the Central Federal District in 50.0% of cities included in the analysis is motor transport, in 25.0% - stationary, in 25.0% the contributions of sources are comparable; in the Volga Federal District in 100.0% of cities - mobile sources; in the Ural Federal District, 50% of cities have stationary sources and 50% have mobile sources. In the Siberian Federal District, in 62.5% of the cities included in the analysis, stationary sources make the main contribution to the anthropogenic load. In cities with a population of 0.5-1 million people, the ratio of monetary income to the subsistence level and the number of doctors per 10,000 population is higher than in cities with population of 250-500 thousand. Limitations. Limited access to quantitative data and time periods. Conclusions. The indicator of anthropogenic load per inhabitant is an informative indicator of the direct impact of atmospheric air pollution on the health of the population in large cities. The ratio of the average per capita income to the subsistence minimum most objectively characterizes the level of material well-being of the population in regions with different levels of economic development. The number of doctors per 10,000 people is an indicator of the inequality of the constituent entities of the Russian Federation in terms of the level of medical provision and the availability of medical care.

Hygienic assessment of the situation and analysis of the health risk of the population as an information basis for the management of monitoring and the formation of complex plans for air protection measures of the federal project "Clean Air"

Introduction. The quality of the environment and the health of the population are the main factors in the socio-economic development of society. To reduce the volume of emissions of pollutants into the atmosphere and improve the living conditions of residents of contaminated cities, a federal project, “Clean Air” has been developed. Analysis of the efficiency and effectiveness of air protection measures according to public health risk criteria is a priority task for achieving the project conditions and ensuring a safe living environment. Materials and methods. The initial information for the hygienic assessment and health risks of the city of Bratsk was the data of in-situ measurements of the quality of atmospheric air within the framework of environmental and socio-hygienic monitoring and summary calculations of the dispersion of emissions from stationary and mobile sources. Results. According to the hygienic assessment and health risk assessment, 13 priority impurities were identified for inclusion in the systematic monitoring program. Conclusion. Analysis of measures to reduce emissions of pollutants into the air by health risk criteria made it possible to establish that, in general, the directions of efforts are adequate to the list of priority risk factors for the health of citizens. For the correct assessment of the effectiveness and efficiency, it is advisable to supplement with materials containing data on specific emission sources on which it is planned to implement measures; supplying the assessment of health risks with data on the actual morbidity of the population in the city; as well as to assess and discuss with business entities the results of health risk assessment, all identified discrepancies between declared emissions, calculated levels of pollution and the real sanitary and hygienic situation in the city.

Risk factors influencing the expansion of the epidemic process of hiv infection in the penitentiary system of the region with a high level of HIV prevalence

The Tyumen Region, being the largest one in the Ural Federal District in terms of territory, has a high level of HIV prevalence, particularly among those taken into custody. This group of people involves the maximum number of injecting drug users, men having sexual encounters with other men and sex workers. All acquired diseases including the diseases aggravated during the service of sentence become the problem of the expirees as well as the entire civil society. From an epidemiological perspective it is important to search for the risk factors which are active among the prisoner population serving their sentence in the region and which cause HIV progression with fatal outcome, taking into account their unequal significance among the prisoner population and the civilians.Object of research. 365 HIV-infected, deaths were identified, including: the study group — 222 prisoners, HlV-infected and died at the regional hospital of the Federal penitentiary service of Tyumen for the period 2008-2018; the control group - 143 civil (law-abiding) patients, HIV-infected and died at the Regional infectious diseases hospital for the period 2011-2018.Purpose of research. Identification and assessment of priority risk factors for the expansion of the epidemic process of HIV infection with a fatal outcome in the zone of high concentration of the risk group.Methods of research. The following methods have been used in this work: methods of epidemiological research, methods of mathematical modeling and forecasting, as well as the method, of logistic regression, of step-by-step inclusion with ROC analysis.Results. To assess the epidemiological situation in terms of the HIV infection prevalence in the prison area a long-term and intra-annual dynamics of the epidemic process expansion in the region have been studied along with assessment of the priority risk factors, trends, forecasting of the HIV infection expansion in the penitentiary system specifying the social significance and risks to the civilian population over a long period.

Geographic disparities in heart transplantation persist under the new allocation policy.

This study evaluated the impact of the 2018 heart allocation policy change on geographic disparities in United States orthotopic heart transplantation (OHT). The United Network for Organ Sharing registry was queried to measure geographic disparity in OHT rates between pre-policy and post-policy change eras. We performed multilevel Poisson regression to measure region-level OHT rates. We derived an allocation priority-adjusted median incidence rate ratio (MIRR) for each policy era, a measure of median change in OHT rates between regions. 5958.78 waitlist person-years were analyzed, comprising 6596 OHT procedures (3890 pre-policy and 2706 post-policy). Median region-level OHT rate was .94 transplants/person-years before and 1.51 transplants/person-years after the policy change (P<.001). The unadjusted OHT MIRR across regions was 1.29 (95% CI 1.00-1.50) pre-policy change and 1.17 (95% CI 1.00-1.43) post-policy change, suggesting that the region-related variance in OHT rates decreased under the new allocation. After adjustment for allocation priority risk factors, the MIRR pre-policy change was 1.13 (95% CI 1.01-1.32) and post-policy change was 1.15 (95% CI 1.00-1.35). Geography accounts for ∼10% of the disparity among United States OHT rates. Despite broader heart sharing, the updated allocation policy did not substantially alter the existing geographic disparities among OHT recipients.

Health risk to the population in Norilsk under exposure of substances polluting ambient air

Introduction. The city of Norilsk is included in the list of cities participating in the federal project “Clean Air.” The comprehensive action plan for protecting atmospheric air of substances provides a 75% reduction in emissions and a decrease in the level of pollution from “very high” to “high.” The aim of the study was to assess human health risk from chemicals that pollute the atmospheric air of the city of Norilsk before the implementation of a complex of air protection measures. Also, we planned to identify priority factors and sources of risk. Material and methods. The assessment of carcinogenic, acute, and chronic non-carcinogenic health risks was carried out at 1105 points of location of residential buildings in the city based on summary calculations of dispersion. The database of parameters of 2145 sources of pollutant emissions into the atmospheric air of the city was used. Results. Unacceptable, including high levels of risk to the health of citizens, have been established to be registered throughout the city. More than 181.8 thousand people live in high-risk zones. Risks occur both during short-term and long-term exposure to atmospheric pollution. The risk indicators for respiratory disorders diseases of the immune system and the blood system are ten or more times higher than the acceptable levels. There have been eleven priority pollutants contributing up to 90% to unacceptable risks (nitrogen oxides, sulfur dioxide, copper, nickel, lead oxides, the sum of various types of industrial dust, etc.). Conclusion. In general, aerogenic health risks require urgent measures to reduce them. The planned measures to suppress sulfur dioxide emissions, nitrogen oxides, and dust in Norilsk are generally large-scale and adequate to the priority risk factors. At the same time, it is necessary to develop and implement measures to reduce emissions of heavy metal compounds. Until the levels of acceptable health risk are reached, measures of a medical and prophylactic nature are relevant as compensation measures provided for by current legislation.

Prevention and management of physical health conditions in adults with severe mental disorders: WHO recommendations

BackgroundPeople with severe mental disorders (SMD) experience premature mortality mostly from preventable physical causes. The World Health Organization (WHO) have recently produced guidelines on the prevention and management of physical health conditions in SMD. This paper presents the evidence which led to the recommendations presented in the guidelines.MethodsThe work followed the methodological principles for WHO guideline development. Systematic reviews in relation to the treatment of seven key priority physical health conditions and associated risk factors in persons with SMD were systematically sourced. The quality of this evidence was assessed, and compiled into evidence profiles. Existing guidelines and treatment recommendations were also considered. Based on this information, specific recommendations were developed on the prevention and management of physical health conditions and their risk factors amongst people with SMD.ResultsNineteen recommendations were made in relation to the seven key priority physical health conditions and risk factors, alongside best practice statements for each condition. A mixture of conditional and strong recommendations were made, the quality of evidence underpinning these was generally low or very low. This is owing to the dearth of direct evidence relating to people living with SMD and comorbidities.ConclusionsThis paper presents evidence-based recommendations to prevent and manage physical health conditions in people with SMD. The recommendations are designed to inform policy makers, healthcare providers as well as other stakeholders about what they can do to improve the management of physical health conditions in adults with SMD and support the promotion of individual health behaviors to reduce the risk factors for these conditions. If implemented, these recommendations can improve the care that people with SMD receive for their physical health conditions in an equitable and person-centered manner, so that in future in relation to premature mortality ‘no-one is left behind’.

Теоретическое обоснование оценки факторов риска здоровью в условиях самоизоляции

Billions of people had to face self-isolation for several months due to COVID-19 pandemic; given that, it seems quite vital to provide theoretical grounds for sanitary-hygienic health risk assessment. Our research objects were people who had to self-isolate during CIVID-19 pandemic. In our research we provided theoretical substantiation for priority health risk factors determined by hypodynamia, hypoxia, improper nutrition, distorted work and leisure regime, and psychoemotional strain. These factors can result in growing morbidity with non-communicable diseases among population. Our research goal was to give theoretical grounds for sanitary-hygienic assessment of health risk factors caused by self-isolation, to reveal priority health risk factors causing morbidity with non-communicable diseases, and to give recommendations on how to prevent it. We applied analytical, information, and statistical procedures in our research. Data were obtained from regulatory and legal documents on sanitary-hygienic standardization in the Russian Federation, specifically, data on nutrition hygiene, occupational hygiene, children and teenagers hygiene, etc.; we also revised scientific works published by Russian and foreign authors and analyzed documents issued by the World Health Organization as well as by public healthcare authorities in different countries during COVID-19 pandemic. When developing theoretical grounds for sanitary-hygienic assessment of health risk factors causing morbidity with non-communicable diseases due to self-isolation, we determined priority risk factors and suggested certain hygienic criteria for assessing self-isolation. We provided theoretical substantiation for a suggested hygienic self-isolation index and its score estimate. The existing system for sanitary-hygienic standardization in the RF fixes requirements for nutrition, work, and leisure regime as well as people’s physical activity; it was applied for performing hygienic assessment of self-isolation and self-isolation index score estimates. We suggested certain activities aimed at minimizing health risks under self-isolation; these activities were based on sanitary-hygienic standards. Since hypodynamia and hypoxia are primary sanitary-hygienic health risk factors, we suggest sticking to adequate nutrition with optimal energy capacity, proper physical activity, as well as proper work and leisure regimes.

Theoretical grounds for assessing health risks factors caused by self-isolation

Billions of people had to face self-isolation for several months due to COVID-19 pandemic; given that, it seems quite vital to provide theoretical grounds for sanitary-hygienic health risk assessment. Our research objects were people who had to self-isolate during CIVID-19 pandemic. In our research we provided theoretical substantiation for priority health risk factors determined by hypodynamia, hypoxia, improper nutrition, distorted work and leisure regime, and psychoemotional strain. These factors can result in growing morbidity with non-communicable diseases among population. Our research goal was to give theoretical grounds for sanitary-hygienic assessment of health risk factors caused by self-isolation, to reveal priority health risk factors causing morbidity with non-communicable diseases, and to give recommendations on how to prevent it. We applied analytical, information, and statistical procedures in our research. Data were obtained from regulatory and legal documents on sanitary-hygienic standardization in the Russian Federation, specifically, data on nutrition hygiene, occupational hygiene, children and teenagers hygiene, etc.; we also revised scientific works published by Russian and foreign authors and analyzed documents issued by the World Health Organization as well as by public healthcare authorities in different countries during COVID-19 pandemic. When developing theoretical grounds for sanitary-hygienic assessment of health risk factors causing morbidity with non-communicable diseases due to self-isolation, we determined priority risk factors and suggested certain hygienic criteria for assessing self-isolation. We provided theoretical substantiation for a suggested hygienic self-isolation index and its score estimate. The existing system for sanitary-hygienic standardization in the RF fixes requirements for nutrition, work, and leisure regime as well as people’s physical activity; it was applied for performing hygienic assessment of self-isolation and self-isolation index score estimates. We suggested certain activities aimed at minimizing health risks under self-isolation; these activities were based on sanitary-hygienic standards. Since hypodynamia and hypoxia are primary sanitary-hygienic health risk factors, we suggest sticking to adequate nutrition with optimal energy capacity, proper physical activity, as well as proper work and leisure regimes.

Sanitary and Hygienic Aspects of the COVID-19 Self-isolation

Introduction: Self-isolation during the COVID-19 pandemic is a temporary measure to limit the spread of infection. All citizens arriving from abroad to Russia must comply with the rules of self-isolation. Since April 2, 2020, almost all citizens of the Russian Federation have followed the rules of self-isolation. Also, this month in the Russian capital, Moscow, about 6 million citizens have isolated themselves. In general, in the territory of Russia, the number of citizens on self-isolation reached 100 million. Billions of citizens around the world are staying at home due to the self-isolation regime, so a sanitary assessment must be considered. Self-isolation, characterized by physical inactivity, hypoxia, diet disturbances, lifestyle changes during work / rest, mental stress; this provides an opportunity to identify the presence of public health risk factors and contributes to an increase in the incidence of No Communicable Diseases (NCDs). Purpose of the Study: Carrying out a sanitary-hygienic assessment of COVID-19 self-isolation, determining priority risk factors causing non-infectious diseases, and proposing preventive measures. Objectives: To Identify public health risk factors during self-isolation. To conduct a comprehensive hygienic assessment of self-isolation according to the priority criteria. To develop a pointing system (hygiene index for self-isolation). To propose measures to minimize health risks during self-isolation. Materials and Methods: We used analytical, and systematization approaches. Information from the legal documents of the hygienic-sanitary laws of the Government of the Russian Federation (nutrition hygiene, hygiene of workforce, children, and teenagers). World Health Organization COVID-19 documents. Research Results: We assessed the sanitary-hygienic aspects of self-isolation to identify the leading risk factors on public health, and as a result, we proposed hygienic criteria for self-isolation. We developed a hygienic self-isolation index point score (HSIPS) that considers the Russian law-based requirements for diet, work, rest, and physical activities. Thus, the usage of those hygienic standards is beneficial to prevent public health risks in ordinary and extremely challenging conditions of self-isolation. We proposed measures to minimize risks during self-isolation, and we based them on adequate sanitary-hygienic standards. The main sanitary-hygienic risk factors of self-isolation are: sedentary lifestyle, hypoxia, nutritional deficiencies (malnutrition), and work/rest imbalance. Conclusion: We proposed a sanitary-hygienic definition of self-isolation. We identified leading risk factors for public health of the self-isolated population. We proposed sanitary-hygienic criteria for assessing self-isolation based on the regulations and standards of the Government of the Russian Federation. We developed a hygienic self-isolation index point score (HSIPS), which determines that the optimal mode is directly proportional to the coefficients of a person’s physical activity (D), indoor area (air cubic capacity) per isolated (S), time spent in fresh air (T) and inversely proportional to the calorie intake. We proposed measures to prevent noncommunicable diseases (NCD) for citizens on self-isolation.