Vol 97, No 1 (2018)

The article presents main stages of the accommodation of the Federal Service for Supervision in the field of consumer rights protection and human well-being for a risk-oriented model of control and supervision activities. The main methodological approaches to the classification of the activities of legal entities and individual entrepreneurs on the potential risk of harm to human health in the case of non-compliance with mandatory sanitary and epidemiological requirements are described. When assessing the risk, the probable frequency of violations of legislative requirements, the associated indices of potential harm to human health and the population under the influence of the surveillance facility activity were shown to be taken into account. For the tasks of the risk-oriented model, there was formed a federal register of supervisory objects, supplemented by data from all 85 regions of the country. The results of categorization of more than 630 thousand objects of supervision, data on which are included in the federal register, indicate to the share of objects of extremely high and high risk of harm to amount about 7.5% of the total mass. About 40% of the facilities do not form significant risks for citizens and can be excluded from the planned supervision, which does not exclude unscheduled inspections of their activities on the grounds established by law. The classification system is dynamic, allows lowering or raising the category of the object of supervision, depending on the results and history of inspections. The ways of the development of the risk-oriented model of supervision are determined.

The article deals with hygienic problems related to effects of the results of the previous economic activities of the ore mining and processing enterprise located in Zakamensk (Republic of Buryatia) on the health of the population. The storage of the plant’s waste in close proximity to residential buildings was established to generate an abnormal quality of the habitat (up to 2 MPC for single dose (MPCsd) of the investigated metals in the atmospheric air, up to 4 MPC in drinking water, up to 85 MPCsd in the soil), and unacceptable levels of a carcinogenic risk to the health of the population (total individual carcinogenic risk is up to 2.11 ∙ 10^-3). The main factors of carcinogenic risk are metals (cadmium, nickel, chromium, cobalt, beryllium, arsenic, lead, etc.) presenting the components of the waste of the ore mining and processing enterprise, among which the greatest contribution is made by chromium [contribution to total cancerogenic risk (TCR) up to 80.9%] and arsenic (contribution up to 53.2%). Priority objects of risk factors from the habitat are atmospheric air and food products (contribution to the TCR value up to 71.0 and 43.1%, respectively).

A total of 366 children aged from 4 to 10 years living in the territory with the presence of vanadium at atmospheric air at a level of up to 1.2 MPC average daily dose (MPC add) and manganese — up to 2.2 MPCadd were examined. In conditions of the chronic aerogenic exposure to vanadium and manganese, unacceptable levels of chronic non-carcinogenic risk to respiratory health (HI up to 72.3) and central nervous system (HI up to 41.3) are formed. The comparison group included 358 children of similar age who were not exposed to vanadium and manganese. In exposed children, the average content of vanadium and manganese in the blood appeared by 1.1–3.5 times higher than the reference levels and by 4.2 times than in the comparison group. During the clinical-functional and laboratory examination every second child with a high blood content of vanadium and manganese was established to show chronic respiratory diseases and pathology of the nervous system. It was noted that in the observation group chronic lymphoproliferative diseases of the nasopharynx are diagnosed by 2.3 times, chronic allergic rhinitis — by 8.5 times more frequently. Every third child of the observation group was revealed to have a restrictive disorder of breathing. The syndrome of autonomus dysfunction occurred in 12% of exposed children and manifested as sinus bradyarrhythmia or sinus tachycardia. Exposed children with a high blood content of vanadium and manganese develop oxidative stress (1.3 times increase in the content of lipid hydroperoxide, a 1.3-fold decrease in the level of total antioxidant status, superoxide dismutase in the blood serum), and a violation of the mechanisms of biological regulation at the molecular level (an increase in the level of nitric oxide, cyclic guanosine monophosphate, a decrease in the content of cyclic adenosine monophosphate).

On the basis of the system review, the relevance of the problem of the chloroform content in the drinking water of centralized drinking-water supply systems in the Perm Territory is confirmed. The comparative characteristic with the average Russian indices is presented. Insufficient volume of information containing data on the impact of the oral intake of chloroform on the blood system was established. There are presented results of the research content of chloroform in water samples from centralized drinking water supply in the cities of Perm region, as well as in the blood of the child population aged from 3 to 13 years living in these areas and consuming water under investigation in the period from 2011 to 2015. A long-term dynamics of the content of chloroform, contained in samples of drinking water and in bio-environments is described. A mathematical simulation of the dependence of the chloroform content in the blood as an exposure marker on the concentration of chloroform in water was carried out. As a result of the analysis of the prevalence rate of diseases of the blood system, hematopoietic organs and certain disorders involving the immune mechanism in the child population, there was established the relevance of differences between the territories of Permsky Krai with surface and underground water supply. The dynamics of the chloroform content in water and morbidity according to the class of blood diseases, hematopoietic organs and certain disorders involving the immune mechanism is presented and described. The association between the exposure to the oral intake of chloroform with drinking water with a morbidity on the class of diseases of the blood system was established on the basis of constructing a mathematical model. The conclusion about the legitimacy of information on the effect of the oral intake of chloroform on the blood system, hematopoietic organs and certain disorders involving the immune mechanism is presented.

The article deals with the chemical safety of polymer-containing materials, including furniture and raw materials for its production. The focus of the study is on the current issue of the adequacy of established standards for the emission of formaldehyde from furniture products and polymer-containing wood products. The article presents data on the levels of formaldehyde migration from a number of constructing and finishing materials used in the prefabricated-frame construction of residential buildings. The migration of formaldehyde from all the materials studied was found to not exceed the permissible level of 0.01 mg/m³. There are presented calculated data on the levels of air pollution in conditions of the combined use of construction and finishing materials, which can reach 1.3 MPC for average daily dose (MPC_add). There are reported results of instrumental studies of the content of formaldehyde in the air of precast frame houses. The average daily concentrations of formaldehyde were found to be in the range from 0.002 to 0.083 mg/m³ (0.2-8.3 MPC_add). The article presents a comparative analysis of the results of in-depth medical and biological research on the health status of the population living in prefabricated frame houses and the population living in brick houses on conditionally clean territories. Based on the results of in-depth medical and biological research on the health status of the population, the mathematical dependencies of formaldehyde exposure with public health impairments, adequate to the scientific literature, were obtained; a model for the evolution of the risk of respiratory diseases has been constructed. The additional risk of forming respiratory diseases with lifetime daily average exposure to formaldehyde was estimated, for example, an average annual exposure of 0.032 mg/m3 was found to form an unacceptable risk for the population after 9 years of exposure (R = 1.10 ∙ 10^-04).

In a priori assessment, the professional risk for workers in the production of phthalic anhydride is characterized by an average (class of labor conditions — 3.2), the main harmful chemical production factors: phthalic anhydride, fumaric acid, maleic aldehyde, dimethylbenzene (MPC for single dose (MPC_sd) — up to 5.9). These factors are identified as priority ones in the development of adverse effects from the side of the hepatobiliary system. The impact of chemicals is intermittent in character during the shift, which requires control of the content of chemicals in the air in the working area in the form of average shift concentrations. In workers of the complex for the production of phthalic anhydride and fumaric acid, there is an accumulation of o-xylene, phthalic and fumaric acid, whose concentrations are significantly higher (p = 0.0001–0.03) if compared with the reference parameters of the comparison group (the excess multiplicity up to 7 times). Among the workers of the phthalic anhydride and fumaric acid production complex, there were no established statistically significant differences in the blood content of o-xylene, phthalic acid and fumaric acids when performing work under conditions of thermal loading of the environment and under conditions with acceptable microclimate parameters. The development of disorders of the hepatobiliary system was shown to begin with the intensification of free radical damage to cell membranes (manifested by an increase in the MDA content of blood relative to the age physiological norm and relative to the index of workers in the comparison group). With a work experience of up to 5 years, the accumulation of secondary products of lipid peroxidation (LPO) in workers is hampered by the activation of antioxidant protection processes. At the experience of more than 5 years, the development of adverse effects from the side of the liver has been established: significantly higher levels of aspartate aminotransferase (AST) (p = 0.027), in cases with an experience of more than 10 years - the level of total and direct bilirubin in blood serum is elevated by 1.4–1.5 times, p = 0.0001–0.002). There was found the statistically significant cause-and-effect relationship of the elevated total blood bilirubin content with labor conditions (RR = 2.86, 95% CI = 1.03–7.98, etiological proportion 65.08%)

The working conditions, occupational and non-occupational risk factors, prevalence rate and peculiarities of the course of respiratory diseases in smelters of titanium alloys were studied. Working conditions of smelters are estimated as harmful (class of working conditions: 3.3–3.4.) due to factors: heating microclimate, chemicals (chlorine and hydrochloride, sulfur dioxide, nitrogen oxide), industrial dust. A feature of the respirable dust fraction is the high content of titanium oxide particles of the PM₁₀ dimension. There was made an analysis of the health status of workers exposed to industrial dust, depending on the length of service. Diseases of the upper respiratory tract in smelters of titanium alloys were shown to be prevalent, simple catarrhal nasopharyngitis prevails with the subsequent formation of atrophic rhinitis, its prevalence rate among smelters of titanium alloys increases with the experience. The peculiarity of the development of diseases of the upper respiratory tract in smelters of titanium alloys are: deterioration of nasal breathing in workers with experience of from 1 year to 5 years already, in patients with experience from 10 to 15 years the prevalence of catarrhal nasopharyngitis and atrophic rhinitis as its outcome in cases with experience from 15 to 20 years. The bronchial damage in the smelters of titanium alloys develops under the experience more than 5 years. The clinical forms are dominated by the phenomena of catarrhal bronchitis followed by obstruction of the bronchi progressing with the experience, with the formation of irreversible ventilation disorders. With the depletion of antioxidant protection, as a rule, with long duration of the exposure of up to 10 years, aseptic inflammation is formed, which is pronounced clinically as catarrhal endobronchitis. This is a partially reversible pathological process. The described features of the development and course of respiratory diseases in smelters of titanium alloys should be taken into account during periodic medical examinations in order to timely prevent them

There was made a study of the blood content of vitamins A, C, D, B₆ and B₁₂ in 188 children aged 6-7 years attending pre-school educational institutions located on the territory of a large industrial center with environmental pollution of organic substances of man-made origin (atmospheric air: phenol, formaldehyde, ethylbenzene, drinking water: organochlorine compounds) in concentrations exceeding hygienic standards. It has been established that even with a balanced diet provided with vitamins at the level of physiological demands, more than 75% of children have a reduced blood level of vitamins. There has been revealed a relationship between the decline of the level of provision with vitamins and a high blood content of the studied organic compounds in children. Chronic both the aerogenic and peroral intake of phenol, formaldehyde, ethylbenzene of organochlorine compounds depletes the reserve of the antioxidant defense system, as evidenced by the established feedback of the blood content of the investigated organic compounds with the content of antioxidant profile enzymes (succinate dehydrogenase and glutathione peroxidase) and total antioxidant activity of blood serum. Under conditions of a decrease in the functional activity of the enzymes of the oxidation-antioxidant system, there is increased primarily carried out by vitamins, the role of non-enzymatic responses of the antioxidant protection, which is accompanied by an increased their consumption. The activation a mechanism for increased consumption of vitamins in conditions of chronic toxic load is the basis for the formation of a vitamin deficiency associated with the exposure to organic compounds of technogenic origin. At the same time, the progressive deficiency of vitamins creates the conditions for reducing the activity of biotransformation processes of chemical substances of technogenic origin and their accumulation in biological environments. The formation of interrelated processes (elevated levels of organic compounds in the blood of technogenic origin ↔ hypovitaminosis) as the pathogenetic basis of the progressive vitamin deficiency in children requires the development of new approaches to the prevention and treatment of hypovitaminosis in children living in conditions of sanitary and hygienic troubles associated with the presence of a complex of organic compounds of technogenic origin in objects of the environment.

In the group of children population living under conditions of aerogenic exposure to aluminum, the average concentration of aluminum in urine was found to be significantly (p <0.05), ​​by 5.5 times higher than the reference values and by 4.5 times more than the similar index in the comparison group. The estimation of the parameters of the dependence “average concentration of the substance in the ambient air — concentration of the substance in the urine” made it possible to obtain adequate (F ≥ 3.96, p ≤ 0.05) and biologically plausible models of the dependence of the concentration of aluminum in urine on its average concentration upon it entering from the atmospheric air. The significant excess of the total and specific sensitization to aluminum in the main group and comparison group was found to be 1.4 and 1.5 times correspondingly. The level of specific IgG to aluminum in 44% of the children of the examined group was significantly higher than the reference level and similar indices of the comparison group (p < 0.05). A significant decrease in the serotonin content in the observation group was established to be by 1.9 times (p < 0.05) lower than in the control group. The analysis of cause-effect relationships made it possible to verify a decrease in the blood concentration of serotonin with an increase in the urine content of aluminum  (R² = 0.20, p < 0.05). There were detected  peculiarities of immunoregulatory disorders in children living under conditions of aerogenic exposure to aluminum in terms of a significant decrease in phagocytic activity in relation to the norm, suppression of CD95⁺, Bax and activation of CD127^–, indicating to a dysregulation of the processes of the programmed cell death, which, under conditions of chronic hapten exposure lead to the formation of immune depression and further to the development of immunodeficient and autoimmune conditions. The developed system of immunological indices and the tendency in their changes are recommended for monitoring of early immunoregulatory disorders associated with exposure to aluminum.

The methodical methods used in the practice of the development and application of methods for the determination of chemical compounds in food products for practical instrumental studies used in conducting laboratory studies of food safety are considered. An algorithm for the development of a chromatography-mass spectrometric technique for the determination of one of the group of highly toxic, carcinogenic N-nitrosamines (N-nitrosodimethylamine, N-nitrosomethylethylamine, N-nitrosodiethylamine, N-nitrosopyrrolidineamin, N-nitrosomorpholinamine, N-nitrosodipropylamine, N- nitrosopiperidinamine N-nitrosoperidineamine and N-nitrosodiphenylamine in homogenized canned meat and meat products (canned meat) is supposed. The algorithm included experimental development of chromium parameters of chromatography-mass spectrometric determination of an analyte, the selection of optimum conditions of sample preparation of samples of canned meat to minimize the influence of the matrix: the transesterification reaction of fatty acids, organic solvent extraction, solid phase extraction, study of extraction completeness by means of the method “introduced – found”, establishment of metrological characteristics of the process of the measurement. The high sensitivity and selectivity of the chromatography-mass spectrometric determination of N-nitrosodiphenylamine in canned meat samples with a lower limit of 0.0002 mg/kg and a maximum error of not more than 23% was achieved owing to the use of a set of methodical techniques — the selection of optimal chromatographic analysis conditions: capillary column series HP-FFAP 50m • 0,320 mm • 0,50 μm, temperature programming of the column: initial temperature of 50ºС, the temperature rise up to 120ºС at a speed of 8 °C/min; from 120° to 185 °C at a rate of 12 °C min and from 185 ° to 240 °C at a rate of 25 °C/min with exposition at a final temperature of 5 minutes; mode of operation of the mass spectrometric detector: selective ion monitoring (SIM) for three characteristic ions of the analyzed compound of 167, 168, 169 m/z. Using the reaction of transesterification of fatty acids contained in canned meat, potassium methylate, removal of the formed esters from samples of canned meat with an organic solvent (hexane), concentration of N-nitrosodiphenylamine in the aqueous layer on cartridges of an automatic solid-phase extraction system provides the extraction of N-nitrosodiphenylamine from the test samples by 99.94%. In the process of approbation of the chromatography-mass spectrometric method, the content of N-nitrosodiphenylamine in the concentration range 0.030 ± 0.011 ÷ 3.89 ± 0.83 mg/kg was found in samples of homogenized canned food meat and meat products (canned meat) from various manufacturers. The highest concentration of N-nitrosodiphenylamine C = 3.89 ± 0.83 mg/kg was found in the sample of canned meat «beef + chicken».

The article considers the legal and organizational aspects of the establishment of a national system of sanitary and epidemiological audit in the Russian Federation. There is described the experience of the functioning of sanitary audit in the republics of Belarus and Kazakhstan, examples of using audit in other spheres of supervision are given. It is shown that in the context of the administrative reform of the control and surveillance activities, the sanitary and epidemiological audit can partially replace the state planned control of low and moderate risks to human health, releasing the resources of the state authorities for overseeing high-risk objects. The creation of the system requires the normative consolidation of the registration procedure and the functioning of organizations with the right to implement activities in the field of sanitary and epidemiological audit, the development of rules for external control of audit services. It seems that the quality assurance in this area should be ensured by the Federal Service for Supervision of Consumer Rights Protection and Human Well-being in the Russian Federation, under whose auspices the national system can function. An important stage in the creation of a new tool for managing sanitary and epidemiological well-being is the development of a database structure and appropriate software to maintain auditor registers and audit reports. A separate task is to provide methodological and organizational support for the training of qualified personnel.

Знаменательные и юбилейные даты истории гигиены и санитарии 2018 г.

31 марта 2018 года исполнилось бы 90 лет со дня рождения Геннадия Ивановича Румянцева, заслуженного деятеля науки РФ, академика РАМН, доктора медицинских наук, профессора.