Introduction. Despite the positive trends in the field of industrial and consumer waste management, issues related to the legal regulation of activities to eliminate objects of accumulated damage to the environment and its relationship with activities to eliminate unauthorized landfills remain unresolved. A separate and important problematic aspect is the assignment of waste to a certain hazard class and their subsequent accounting and neutralization.

The study aims to consider the established practice of using sanitary-epidemiological and environmental legislation in the management of industrial and consumer waste, including in assessing their toxicity.

Materials and methods. The authors conducted the study using an information and analytical method for analyzing regulatory documentation and scientific publications from the databases Elibrary, Scopus, Web of Science, PubMed, Techexpert, Consultant, etc. They also compared the topical issues of assessing the toxicity of production and consumption waste and identified the specifics of the methodology for calculating the amount of damage as a result of unauthorized waste disposal.

Results. It has been established that one of the optimal solutions in the issue of assessing the hazard class of waste may be to bring the criteria for their classification according to the degree of toxicity to uniformity, as well as the development of a single document carried out by institutions regardless of departmental subordination. Studies conducted to determine the amount of damage as a result of unauthorized disposal of production and consumption waste and to establish the hazard class of waste must comply with the requirements of uniformity of measurements and accreditation in the national system, respectively. To correctly calculate the amount of harm, you need to use the value of the mass of waste with the same hazard class. The availability of separate documents in sanitary-epidemiological and environmental legislation can significantly affect the calculation of the amount of harm due to various methods of determining the hazard class of waste, as well as the timeliness of identifying the long-term impact of waste on the environment and public health.

Limitations. The study is limited to the analysis of law enforcement practice in the field of waste management, as well as the results of research in domestic and international literature. The analysis will allow researchers to consider non-obvious and controversial issues in the planning of activities.

Conclusion. Updating documents on the establishment of the hazard class of waste should be carried out considering law enforcement practice. The absence of duality in compliance with the established requirements in both the field of environmental and sanitary-epidemiological legislation can be a guarantee of the reliability and truthfulness of research. This will allow you to make the right management decisions.

Ethics. The study does not require the submission of the conclusion of the biomedical ethics committee.

Contribution:
Vodianova M.A. — research concept and design, data collection and processing, text writing, manuscript preparation;
Ushakova O.V. — data collection and processing, text writing, manuscript preparation;
Savostikova O.N. — concept and design of the study, editing, preparation of the manuscript;
Rusakov N.V. — the editing.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 26.02.2024 / Accepted: 30.09.2024 / Published: 08.11.2024

Introduction. The increasing prevalence of cardiovascular pathology among industrial workers determines the importance of studying not only occupational diseases, but also their combination with diseases of the circulatory system. Endothelial dysfunction is a key link in the pathogenesis of atherosclerosis. Evaluation of endothelial function indicators in occupational respiratory diseases in combination with atherosclerosis in workers of the coal mining industry is an urgent task.

The study aims to consider the indicators of endothelial function in miners with occupational respiratory diseases in combination with atherosclerosis.

Materials and methods. The authors have examined 88 miners with previously diagnosed occupational respiratory diseases (chronic dust bronchitis, anthracosilicosis, chronic obstructive pulmonary disease), 45 of them showed signs of atherosclerosis. There were two comparison groups without signs of atherosclerosis: 44 miners who work long-term in harmful working conditions, without lung pathology (control group) and 42 residents of Novokuznetsk who have never worked in harmful working conditions, and without lung pathology (unexposed group).

Results. We found that miners with occupational respiratory diseases in combination with atherosclerosis had several forms of endothelial dysfunction: vasomotor (decreased synthesis of nitric oxide, increased endothelin-1 levels), hemostatic (increased levels of Willebrand factor), adhesive (increased levels of endothelial adhesion molecules sVCAM-1).

The development of respiratory insufficiency in miners with occupational respiratory diseases increases endothelial dysfunction: miners with respiratory insufficiency have lower levels of nitric oxide (NO), higher levels of endothelin-1 and endothelial adhesion molecules sVCAM-1 than miners without respiratory insufficiency. There are correlations between indicators of endothelial function and production factors: with work experience in harmful working conditions, the level of the average concentration of coal-rock dust in the workplace and the frequency of exceeding the maximum permissible concentration of coal-rock dust. Limitations. The study is limited to a sample of workers in the main professions of coal mines who were examined at the Research Institute of Complex Hygiene Problems and Occupational Diseases, aged 40 to 54 years, with more than 15 years of experience working in underground dust conditions.

Conclusion. Miners with occupational respiratory diseases in combination with atherosclerosis develop several forms of endothelial dysfunction: vasomotor, hemostatic, adhesive. The development of respiratory failure increases endothelial dysfunction.

Ethics. This medical study involving a human as a subject was carried out in compliance with the Ethical principles presented in the latest version of the Helsinki Declaration, developed by the World Medical Association.

Contribution:
Panev N.I. — research concept and design, data collection and processing, text writing, editing;
Filimonov S.N. — the concept of research, editing;
Korotenko O.Yu. — data collection;
Rumple O.A. — data collection, text writing.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 30.09.2024 / Accepted: 10.10.2024 / Published: 08.11.2024

Introduction. The high prevalence of diseases of the circulatory system necessitates their detection and prevention at an early stage, especially in regions with high industrial potential. The occurrence of subclinical heart failure depends on a cascade of processes that are already occurring in the body and may eventually manifest themselves in clinically pronounced diseases. One of the possible mechanisms of its development is a violation of the balance of the autonomic nervous system with a violation of adaptive capabilities to the labour process, characterized by severe physical overloads among miners.

The study aims to evaluate changes in heart rate variability in workers of the main professions at the coal industry with signs of heart failure with a preserved left ventricular ejection fraction.

Materials and methods. The study included 78 employees of the main professions at the coal industry. Specialists performed ultrasound examination of the heart according to generally accepted methods with the study of longitudinal deformation of the myocardium. The concentration of NT-proBNP in the blood serum was determined by solid-phase enzyme immunoassay. The authors also conducted an analysis of heart rate variability, determined temporal, spectral and linear parameters.

Results. Specialists revealed a decrease in longitudinal myocardial deformation in 38.5% of the examined patients, signs of diastolic dysfunction in 41%; in these groups, a tendency to increase the concentration of NT-proBNP was revealed. In the examined miners with heart failure with preserved ejection fraction, they revealed a significant decrease in the SDNN index and an increase in IC values. The increase in DFA and LF/HF indicators reflects a vegetative imbalance towards sympathetic activation observed in all surveyed miners.

Limitations. This study is limited to a sample of employees of the main professions of the coal industry undergoing periodic medical examination at the Research Institute of Complex Problems of Hygiene and Occupational Diseases.

Conclusion. The revealed relationship between indicators of heart failure and heart rate variability (SDNN, LF/HF, DFA and IC) in miners allows us to identify a group of people at greatest risk of adverse outcomes.

Ethics. The study was conducted in compliance with the standards of the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, established in accordance with the Helsinki Declaration of the World Medical Association «Ethical Principles of Conducting medical Research with human participation as a subject» as amended in 2013 and the «Rules of Good Clinical Practice» approved by Order No. 200n of the Ministry of Health of the Russian Federation dated 04/01/2016. The subjects signed an informed consent to participate in the study.

Contribution:
Martynov I.D. — concept and design of the study, writing the text;
Korotenko O.Yu. — concept and design of research, data collection and processing, collection of literary data, writing text;
Filimonov E.S. — data collection and processing, editing;
Rumple O.A. — data collection.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 16.09.2024 / Accepted: 29.09.2024 / Published: 08.11.2024

Introduction. In the National Healthcare Project, one of the key areas is the federal project «Fight against oncological diseases for 2019-2024». The influence of the nature of work activities of workers in contact with industrial carcinogens — polycyclic aromatic hydrocarbons (PAHs) significantly increases the risk of skin neoplasms, as evidenced by differences in the frequency of their occurrence among representatives of different labor categories. The leading factor in the development of skin neoplasms is ultraviolet radiation (UV) of the A and B spectrum. There is literature evidence of a possible mutual enhancement of the combined effects of PAHs and UV in the occurrence of skin neoplasms and their malignancy.

The study aims to evaluate the role of the combined effects of polycyclic aromatic hydrocarbons (PAHs) and ultraviolet radiation (UV) in the occurrence of pigmented skin tumors in workers engaged in the construction of highways and highways and in housing and communal services.

Materials and methods. During periodic medical examinations (PMEs) in 2022–2024, specialists have examined 140 people who formed 4 study groups. The researchers have conducted a physical examination of skin tumors; examination in the rays of a Wood lamp; dermatoscopy of skin tumors using a Heine Delta 20 dermatoscope. Hyperpigmentation was assessed according to the hyperpigmentation area and severity index (NASI).

Results. During the clinical examination, the authors assessed the presence of pigmentation and skin neoplasms (lentigo, ephelides, seborrheic keratomas). The most frequent localizations of pigmentation and skin neoplasms were open areas of the body: face, hands, upper third of the back. At the same time, in asphalt concrete workers — group I, working under the influence of PAHs and solar insolation (spectrum A and B, in the range of 320–400 nm and 280–320 nm), specialists revealed pigmented neoplasms in a larger number of individuals compared with the population control for all skin localizations. The HASI index (in the surveyed groups) showed that the highest rates (24–48) of HASI were observed in a larger number of individuals — 57.1% — from group I (UV+PAHs), compared with groups of individuals (II, III, IV) who do not work under conditions of exposure to solar insolation (spectra A and B, in the range of 320–400 nm and 280–320 nm). The authors noted that the intensity of pigmentation is higher and the lesion area is larger when assessing the foci of hyperpigmentation in the rays of the Wood lamp compared with the clinical examination in all the examined groups.

Limitations. The study is limited by the number of subjects examined, corresponding to the design of the study and the time interval of the study.

Conclusion. To obtain objective results of the study of the role of the combined effects of polycyclic aromatic hydrocarbons (PAHs) and ultraviolet irradiation (UV) in the occurrence of pigmented skin tumors, scientists used a method for determining the hyperpigmentation area index and severity index (HASI) in the rays of a Wood’s lamp. When comparing the results obtained, experts revealed an increase in the area of hyperpigmentation and its intensity with localization in open areas of the body in workers engaged in the construction of highways and housing and communal services, in contact with the combined effects of carcinogens (PAHs) and ultraviolet irradiation (UV A and B).

Further in-depth studies are needed to study the etiopathogenesis of photogenotoxicity depending on the dose-effect ratio.

Ethics. The work was performed in accordance with the ethical standard set out in the Helsinki Declaration of the World Medical Association of 1964 (as amended and supplemented in 2013). The authors conducted all the studies after receiving informed consent and a decision of the Local Ethics Committee (extract from Protocol No. 7 dated 10/21/2020).

Contribution:
Izmerova N.I. — concept and design, data collection and processing, text writing, editing;
Kuzmina L.P. — concept and design, text writing, editing;
Chistova I.Ya. — data collection and processing, text writing.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 26.09.2024 / Accepted: 07.10.2024 / Published: 08.11.2024

Reducing the risks of occupational stress requires improving the methods of psychological support for employees of locomotive crews. Virtual reality technology offers restorative measures comparable to traditional techniques.

The study aims to analyze the effectiveness of the impact of virtual reality technology on the basis of the analysis of the psycho-emotional state of employees of locomotive crews before and after rehabilitation measures; to evaluate the ratio of stress biomarkers before and after exposure to classical and technical techniques; to compare the effectiveness of psychological influence carried out by various methods.

The scientists conducted a survey and diagnosis of the functional state of locomotive crew workers, followed by rehabilitation measures using various methods. The specialists performed a saliva analysis based on the concentration levels of cortisol and dehydroepiandrosterone. 120 people took part in the study, of which: 60 people according to the classical program and 60 people according to the virtual reality program, of which 15 people are at risk according to psychophysiological indicators. The session lasted 21 minutes. The average age of employees of locomotive crews participating in the study was 35.4 years.

88% of the subjects underwent functional state diagnostics and a full course of relaxation sessions in virtual reality. Of these, 73% have improved psychophysiological indicators: response accuracy, increased neuropsychiatric stability, and decreased anxiety levels. The authors noted calmness, improved mood and relief of muscle tension. 60% of the employees have completed a full course of rehabilitation measures using classical techniques. Of these, 70% have an improvement in their functional state according to certain parameters. There is a decrease in cortisol levels (unit of measurement — nanograms per milliliter) from 6.75 ng/ml to 6.28 ng/ml with a simultaneous increase in dehydroepiadrosterone levels (unit of measurement — micrograms per milliliter) from 0.53 mcg/100 ml to 1.77 mcg/100 ml, which corresponds to a decrease in the overall stress level. The analysis of the obtained results showed sufficient effectiveness of virtual methods comparable to classical approaches to relaxation.

Immersive technologies more effectively activate natural compensatory mechanisms by expanding the individual regulatory capabilities of the nervous system. Scientists have identified areas for improving the latest methods of rehabilitation measures in order to correct the functional condition of locomotive crews.

Limitations. The representativeness of the sample was ensured by the participation of 120 employees of locomotive crews in the study. The limitations are related to the gender homogeneity of the sample: only men are included, due to their professional status.

Ethics. The study was performed in accordance with the rules of good clinical practice and the Helsinki Declaration of the World Medical Association, the conclusion of the ethics committee was not required.

Contribution:
Kostenko N.A. — fundamental elements of the article, such as concept, design, methodology;
Bukhtiyarov I.V. — concept and design of the study;
Borisova E.V. — data processing, analysis, interpretation, editing and other technical work.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 03.09.2024 / Accepted: 29.09.2024 / Published: 08.11.2024

Currently, there is sufficient evidence of the importance and clinical effectiveness of non-drug therapy. The scientific discussion on the priority of the clinical application of pharmacological and non-pharmacological methods of rehabilitation of patients with mononeuropathies has acquired particular importance against the background of neurological post-COVID complications in patients with COVID-19.

The study aims to compare the effectiveness of drug therapy and non–drug technology of post-covid rehabilitation of workers with intensive computer workload based on the study of clinical and laboratory parameters.

Scientists have conducted a survey of two groups of workers with intensive computer workload who underwent rehabilitation after COVID-19 with the use of drug therapy and non-drug technologies, including balneotherapy, drinking narcotherapy, aerosol inhalations, low-frequency magnetic therapy. The authors have evaluated the effectiveness of therapy based on the results of studies of asthenization, degree of fatigue, latent coronary insufficiency, the state of the blood microcirculation system, immune status, the state of the POL-AOSIS system and endogenous intoxication of patients.

Asthenization, the degree of fatigue, and latent coronary insufficiency decreased in the majority of the examined patients after post-COVID non-drug measures. Whereas in patients of the drug group, a decrease in these indicators was noted in a small number of examined patients. The indicators of the immune status of patients after non-drug therapy returned to normal, after drug therapy they only approached the limits of the norm, but did not reach it. After the treatment, the indicators of lipid peroxidation in the group of patients undergoing post-COVID rehabilitation using non-drug technologies decreased more significantly than in the group receiving drug treatment. The content of the antioxidant enzymes catalase and ceruloplasmin and the fat-soluble antioxidant α-tocopherol after treatment increases in both groups, but in the group of drug treatment they do not reach the lower limit of the reference intervals. The decrease in the content of medium-molecular peptides is more pronounced when using non-drug technologies.

The application of the proposed non-drug technology for the rehabilitation of patients with post-COVID syndrome who are subjected to intense computer loads during work showed a significantly more pronounced normalization of asthenization, fatigue, latent coronary insufficiency and the state of the blood microcirculation system, immune status, the state of the POL-AOSIS system and endogenous intoxication of patients. The data obtained indicate a high therapeutic effect of the use of non-drug technology.

Limitations. The surveyed groups included only persons permanently registered in Kislovodsk.

Ethics. The research was conducted in accordance with the principles of biomedical ethics and approved by the local Ethics Committee of the Izmerov Research Institute of Occupation Health, Moscow (Protocol No. 4 dated 04/14/2021). Each participant of the study submitted a voluntary written informed consent signed by him after explaining to him the potential risks and benefits.

Contribution:
Kuzmina L.P. — concept, editing; approval of the final version of the article;
Afanasyeva Yu.F. — collection of material, data processing, compilation of tables and graph;
Bezrukavnikova L.M. — collection of literature data, statistical processing of results, editing.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 24.09.2024 / Accepted: 16.10.2024 / Published: 08.11.2024

The authors studied the physiological characteristics of drivers of heavy-duty coal mine vehicles based on spectral analysis of EEG-ECG and stress tests, which have prognostic value in professional activity.

The study aims to assess the functional condition of heavy-duty truck drivers of different age groups based on a comprehensive spectral analysis of EEG-ECG under occupational examinations.

During the survey, the authors have studied the spectral parameters of the EEG‒ECG in 300 male drivers aged 25 to 66 years. Specialists have performed EEG registration when placing electrodes in the 10–20 system. The EEG analysis was performed with a preliminary visual analysis followed by the removal of artifacts. The scientists assessed the level of representation of the main alpha rhythm and its spatial distribution. The ECG registration was in the first lead. The duration of EEG-ECG registration is about 15 minutes in a typical sequence of stress tests: baseline, rhythmic photostimulation, hyperventilation with recovery periods. The spectral analysis of the EEG‒ECG was performed automatically on a Neurotravel device (Italy).

The authors found lower alpha and delta activity in the initial EEG spectra in older drivers aged 45–66 years, which contributed to the cumulative effect of stress load. Light stress stimulation significantly reduced alpha and delta activity and increased beta EEG activity in both groups, while in the older group the high-frequency range significantly exceeded the low-frequency range. Simultaneously with the changes in the EEG, stress photostimulation increased the energy of the ECG spectra in all frequency ranges.

The authors established the appearance of additional stress indicators during light stimulation in older drivers based on the correlation of EEG‒ECG spectra (alpha/delta) and the absence of such changes in the group of young drivers aged 25–35 years. Moreover, the EEG–ECG correlation coefficients and their critical values increased in groups in increments of 6 years — from 35 to 65 years.

Elderly drivers, based on neuro-cardiodynamic indicators, were in a state of chronic stress and the resulting risks to health and professional activity, and the identified physiological mechanisms of stress may be at the heart of ways to prevent it.

Limitations. The study is limited to the assessment of EEG and ECG indicators in 300 heavy truck drivers.

Ethics. The study was performed using non-invasive methods and approved by the Bioethical Committee of the Research Institute of Complex Problems of Hygiene and Occupational Diseases, Protocol No. 5, § 1 dated 12/26/2018, in accordance with the Helsinki Declaration of the World Medical Association «Ethical Principles of conducting medical research with human participation as a subject» as amended in 2013 and the «Rules of Good Clinical Practice» approved by by Order of the Ministry of Health of the Russian Federation No. 200n dated April 1, 2016. All the examined patients signed a voluntary informed consent to participate in the study.

Contribution:
Fleishman A.N. — research concept and design, data collection and analysis, literature data collection, text writing;
Yauk A.V. — statistical processing;
Petrovsky S.A. — collection and processing of literature data;
Blazhina O.N. — data collection and processing, editing;
Korablina T.V. — statistical processing.

Funding. The study had no funding.

Conflict of interests. The authors declare no conflict of interests.

Received: 12.09.2024 / Accepted: 16.10.2024 / Published: 08.11.2024

In conditions of increased workload on the medical staff of outpatient clinics, the need to preserve their physical and mental health, reduce the socially significant consequences of emotional burnout comes first, which makes it necessary to search for new directions of prevention, correction and rehabilitation using personalized medicine methods.

The study aims to assess the state of health and the syndrome of emotional burnout in medical workers of the outpatient clinic.

Specialists have examined 100 medical workers of outpatient and inpatient departments of the medical institution in equal numbers. The average age of outpatient medical staff was 49 [46;59] years, and inpatient — 43 [33;53] years. The average work experience of the examined medical personnel was the same both in outpatient settings (20 [16;28] years) and in hospital (20 [13;31] years). The authors have performed general clinical, laboratory and instrumental examinations. In addition to the standard examination scheme, the scientists assessed emotional burnout using the V.V. Boyko method and the quality of life according to the EQ-5D questionnaire in modification 3L and the hospital anxiety and depression scale HADS, and also conducted a questionnaire on a new coronavirus infection and the detection of post-COVID syndrome.

As a result of the study, the authors proved a decrease in the psychological and physical components of the quality of life of medical workers, which are associated with both work experience and a new coronavirus infection. It was confirmed that according to the results of the Boyko questionnaire, employees of the outpatient clinic, compared with their colleagues from the hospital, often have a higher unfavorable total score. According to the results of the survey, we observe an improvement in the psychological and physical components of the quality of life of medical personnel after individual rehabilitation.

This study showed the importance of assessing the state of health and emotional burnout syndrome in medical workers, high scores were revealed according to the Boyko questionnaire.

Limitations. This study is limited to a sex-and-age sample of medical staff at a medical institution.

Ethics. The study was conducted in accordance with the Helsinki Declaration «Recommendations for Doctors on Biomedical research in Humans» (2013), the World Association «Ethical Principles of Scientific Medical Research with Human Participation» as amended in 2000 and the «Rules of Clinical Practice in the Russian Federation», approved by Order of the Ministry of Health and Social Development of the Russian Federation No. 266 dated 06/19/2003, according to the developed protocol.

Contribution:
Kireeva V.V. — research concept and design, data collection and processing, text writing;
Lepekhova S.A. — concept and design of the study, editing;
Zaika A.A. — data collection and processing;
Kurgansky I.S. — writing the text;
Usoltsev Yu.K. — the editing.

Funding. The financing was carried out within the framework of the State assignment of the Ministry of Education and Science of the Russian Federation.

Conflict of interest. The authors declare no conflict of interest.

Received: 05.06.2024 /Accepted: 23.10.2024 / Published: 08.11.2024

The formation of the main scientific branches developed at the institute since its foundation, and the prospects for their further development in the field of hygiene and occupational pathology are presented.