Proteomic analysis technology helped to study and assess protein profile of blood serum in residents of area influenced by metallurgic industrial releases. Findings are that poor quality of ambient air in populated area concerning concentrations of vanadium, nickel, manganese (up to 24-44 RfC_chr) and stable presence of these elements in drinkable water (up to 0,006 RfD) cause mainly aerogenous chronic exposure at 0,00025-0,0022 mg/(kg-day). The exposed individuals demonstrate higher (3,5-3,8 times vs. unexposed ones and reference level) serum level of vanadium (0,0023 to 0,003 mg/dm³), nickel (0,06-0,11 mg/dm³) and manganese (0,036-0,048 mg/dm³). The authors demonstrated changes in serum proteomic profile associated with serum levels of vanadium and nickel (share contribution of vanadium and nickel equalled 15-20%) and manifested as increase of relative volume of transtyretine, apolipoprotein A-1, lower relative volume of haptoglobin. Increased serum level of vanadium disorders transport of apoproteins incorporated into lipoproteins; increased serum level of nickel activates hemolysis of RBC, disorders speed of hemoglobin-haptoglobin complex formation and its subsequent utilization by hepatocytes. Revealed molecular and cellular disorders enable to forecast thyroid disorders, hematologic diseases, cholesterol metabolism disorders.

The authors considered systemic approaches to disclosing factors that promote metabolic syndrome formation and associated risk of ciculatory system diseases in drivers. Examination covered drivers with metabolic syndrome and without it. Findings are that metabolic disorders developing in drivers are occupationally conditioned. Length of service can determine cases numbers of cardiovascular disorders, diabetes mellitus manifestations, more frequent combination of hyperglycemia and/or hyper-, dyslipidemia with abdominal obesity. The drivers with length of service over 15 years, aged over 35, demonstrated arterial hypertension in 35% of cases, postinfarction cardiosclerosis in 43% of cases, disorders of cardiac rhythm and conductivity in 55% of cases, and the number increases with length of service and reaches 80% of total examinees number by 55 years of age. Diabetes mellitus was diagnosed in 37% of cases (in 75% of the workers first diagnosed) with over 20 years of service, average age of 50 years.

Examination covered 118 medical staffers with length of service 25,7±6,3 years. Materials included work conditons, case histories, physical and laboratory examinations, cardiointervalography. To identify emotional burnout syndrome, the authors used simultaneous testing with «Maslach Burnout Inventory» (MBI) and questionnaire «Emotional burnout syndrome». According to emotional burnout syndrome components, somatic disease manifestations, cognitive, emotional, motivational and attitudinal disorders were assessed. Findings are that vegetative nervous system in medical personnel with long length of service is overstrained, functional resources are exhausted, energetic level is under normal level - that is supported by clinical and laboratory data. 36,4% of the medical staffers were diagnosed as having vegetative dysfunction syndrome. Complaints of psycho-physical, social and psychologic and/or behavoral symptoms were seen in 7% of the examinees; hypodynamia - in 53%; excuses for sedatives or psychoactive drugs intake - in 53%. Findings are that according to periodic medical examinations risk groups should be formed and specific medical and prophylactic measures should be provided.

The study was aimed to evaluate level of morbidity with transitory disablement among workers in 11 municipal districts of Perm' area with high intensity of planned modernization processes. Findings are that industrial cities being “locomotives» of social economic modernization (Perm', Solikamsk, Berezniki) demonstrate higher level of workers' health, than the territories with weak integration into modernization processes (Kudymkar, Gremyachensk and Kizelovsk municipal districts). More marked differences were seen in values of disablement due to cardiovascular diseases, traumatism, poisoning and other external causes, locomotory diseases. Measures on preservation and improvement of workers' health were proved to be a part of strategic programs of social econimic modernization of certain territories and the region as a whole.

Myocardium revascularization in coronary heart disease patients is one of the most important treatment modalities. Considerable improvement of somatic state after surgery for IHD is seen in 82-83% of patients in average, whereas only hardly more than a half return to occupational activity without decrease in preoperative level of qualification and performance. In occupational therapy and industrial medicine clinic with FBSI «Federal Scientific Center for Medical and Preventive Health Risk Management technologies», examination covered 68 workers of Perm' area enterprises, derected for occupational fitness study after coronary artery bypass grafting and 100 workers at various terms after myocardium infarction, with verified IHD. Risk factors evaluation demonstrated that after coronary artery bypass grafting 75% of patients are motivated to maintain healthy lifestyle and compliance to treatment over 5 years; positive changes in a year according to functional study were seen in 75% of cases; level of blood pressure in office 127.8±9.4 mm Hg; dyslipidemia, hypercholesterolemia remain in 11.7% of cases. At first stage, criteria of permit-to-work are: decrease in functional class of chronic cardiac failure to 0-II degrees from initial one; absence of exertional stenocardia or exertional stenocardia less than II degree, absence of ventricular arrhythmias of high grade.

The authors evaluated negative effects of cadmium and arsenic compounds on health of population residing near storage of extraction and processing waste of ore mining and processing enterprise. Hygienic analysis covered quality of ambient air, drinkable water and foods, evaluation of risk factors of lipid metabolism disorders. Clinical and laboratory examination involved 137 children and 99 adults in chronic multi-environmental (ambient air, water, foods) exposure to metals (cadmium and arsenic, HI 1.21-1.29), diagnosed endocrine diseases including lipid metabolism disorders (excessive nutrition and obesity, E67.8-66.0) in adults 1.4 times more, and in children in 1.7-2.2 times more than in the reference group. Direct probable statistically significant cause-effect relationship was established between lipid metabolism disorders and serum levels of cadmium and arsenic (R² = 0,36-0,95; 71,07

The authors defined occupational risk level and relations of health disorders in workers engaged into processing of titanium-containing and rare-elements materials with forecasting risk changes in accordance with length of service and its realization evaluation. Work conditions are characterized by exposure to chemicals (sulphur dioxide, nitrogen oxide, chlorine and hydrochloride, vanadium compounds), noise, general vibration, heating, work hardiness - and are evaluated as hazardous, jeopardy degree 3 and 4. Results of a priori assessment of occupational risk define it as high. Modelling of health risk evolution outlines that after 15 years of service (by 35 years of age) the share of cardiovascular disease will approach 65% in total workers' health risk. Prevalence of arterial hypertension in the studied group by 15 years of service equals 44,5% (p = 0,04), in the reference group no reliable prevalence of arterial hypertension with length of service was seen. Realization of health risk due to chemicals manifested with higher prevalence of upper respiratory tract diseases that were significantly more frequent (p = 0,037) among the studied group (62,23%), than in the reference group (38,30%). The authors determined length of service criteria and health disorders, that outline priority contribution into the health risk, to specify a system of preventive measures for risk minimization.

The authors presented results of hygienic evaluation of ambient air quality in area influenced by oil extraction wells, primary oil processing devices, squeeze stations and other oil extraction objects, using criteria - adherence to hygienic requirements and allowable risk levels for public health. Findings are that due to substantial technologic, organizational changes and innovations in oil extraction industry, chamicals content of air at MAC levels and allowable levels of inhalation risk in acute and chronic exposure for majority of the objects studied are reached on considerably shorter distances from industrial area, than it is preset by actual sanitary rules and regulations. Levels of hygienic safety at the objects indicate possible revision of sanitary classification toward reducing the size of approximate sanitary protective zones.

The authors present analysis of «Method of special evaluation of work conditions» by RF Labor Ministry. Thorough consideration covers preparatory stage of special evaluation of work conditions and stage of identification of hazards. Drawbacks of the methods are revealed, improvement ways are suggested.