The authors present analysis of changes in general morbidity related to age and length of service for truck drivers (chronic diseases of cardiovascular system, respiratory and digestive organs, urinary system, spine, locomotory system and connective tissue) exposed to complex combination of occupational hazards (unusual work schedule, night shifts, air pollution with automobile transport exhaust gases). Morbidity parameters were calculated according to deep medical investigation results in periodic examinations of drivers and their appealability to medical office. General hygienic evaluation of work conditions was performed according to increment in risk of diseases for length of service years (annual risk increase). Difference of disease risk increase rates related to age and length of service was applied to determine occupational and non-occupational fractions of general morbidity in drivers working in hazardous conditions.

The study covered features of work conditions, occupational risks and health state in 574 workers of automobile and railway transport, engaged into transportation of lobe rock in Kolsk Transpolar area. Findings are higher risk of occupationally conditioned (onychomycosis, obesity, arterial hypertension and peptic ulcer of duodenum/stomach) and occupational diseases (neurosensory deafness, radiculopathy, vibration disease) in rock handler drivers. Conclusion was made on necessity to improve prophylaxis and treatment of health disorders in these workers.

Serum levels of zincum, lead, nickel and mercury decrease in a row «males - females - pregnant»; average levels of manganese, cobalt, copper and arsenic are higher among females; in pregnant women serum levels of most metals are the lowest. If compared to the WHO reference, levels of metals in whole blood demonstrated no excess in cobalt and cadmium, nearly absent - in arsenic, increased percentage of excess (but insignificant values) in copper and zincum, extremely high percentage of excess (and significant values) in manganese and nickel. Maximal manganese concentrations in blood reach 300 micrograms/l, those of nickel - 100 micrograms/l. Average blood concentrations of mercury in the examinees do not reach the most severe «level of concern for all ages» (5 micrograms/l), and shares of men and women with blood concentrations of mercury over this limit are relatively small. Average blood concentrations of lead in the examinees do not reach lower allowable level (50 micrograms/l).

The authors reviewed toxicologic alternative investigation methods used in Russia for evaluation of occupational and natural environment.

The authors examined algorithm of investigations in occupational pathology centers for suspected occupational polyneuropathy due to physical overload. Suggestions included a procedure to investigate the patients, including medical specialists consultations, set of laboratory and instrumental studies divided into obligatory and by special indications.

The study covered health state of mine workers of «Apatit» enterprise according to periodic medical examination data in 2014. Medical workup covered 1360 miners of main, auxiliary occupations, with assessment of standardized intensive morbidity parameters. The analysis defined the most unfavorable health state of main occupations workers, with leading pathology of locomotory diseases, nervous system (polyneuritis) and ear disorders. These diseases could be caused by specific work conditions characterized by exposure to vibration, noise, intense physical exertion, cooling.

The article presents results proving significant advantage of ultrasound examination vs. X-ray contrast myography in diagnosis of occupational myofibrosis early stages. The authors recommend implementation of this method into medical examination practice for better diagnosis of occuptional myofibrosis to objectify decision on linking the disease with occupation.

Existing practice implementing data obtained by occupational control and special evaluation of work conditions fails to evaluate hazardous effects caused in workers' health state by wide spectrum of risk factors such as social, ecologic, climate, etc. Widening possibilities for deeper health risk analysis can be provided by integration of laboratory and instrumental data on evaluation of hazardous and dangerous occupational factors into present systems of social hygienic monitoring. According to results of joint project within disciplinary program, Leningrad regional division of Federal Agency on sanitary epidemiologic supervision specified and implemented a regional model of integrated data base in informational funds of social hygienic monitoring. Consequently, quality and validity of management decisions in health risk factors control have significantly improved.

The authors defined main transgressions of law in sanitary epidemiologic well-being of population during sanitary epidemiologic examination of project materials for sanitary protective zones for enterprises, constructions and other objects, and during determination of their final dimensions.

Recently, the studies search possibilities to visualize and objectify sensory disorders in polyneuropathy caused by vibration. Special attention is paid on studies of injuried structures responsible for temperature and pain sensitivity. Examination covered 92 patients with vibration disease, aged 34 to 73 years. Methods used are: pallesthesiometry, quantitative sensory tests, questionnaires and scales of pain (visual analog scale (VAS) of pain, Pain-Detect, MPQ DN-4, HADS). Correlation was found between temperature, pain thresholds and VAS and pallesthesiometry parameters. The obtained results analysis indicates formation distal polyneuropathy syndrome of upper limbs with concomitant pain during vibration disease.

The article characterizes sea work conditions under which crew members carry occupational activities during the sail. Negative factors influencing health of crew members are listed. Among these factors, the major influence is caused by physical (noise, vibration, mechanical impacts, ionizing radiation varying in frequency), chemical, climate and geographic, social an psychologic factors. Conclusion is that extreme work conditions of sailing staffers cause overstrain of adaptation systems, disorders of regulation fuctions, worsen health state and induce disablement. Within a system of medical care for water transport workers, necessity is to have complex accounting of occupational hazards for more qualitative and safe work conditions.