Introduction. Th e aluminum industry belongs to the industry with a high status of occupational pathology. The study of metabolic bases and hygienic aspects of fl uorosis is a priority section of modern occupational health. Organ failure occurs in a separate group of workers, despite the equivalent conditions of production and may be due to biochemical polymorphism.

The aim of the study was to explore the associative relationship of molecular genetic, biochemical markers with the nature of chronic fl uoride intoxication in workers of the aluminum industry.

Materials and methods. Th e complex of clinical and genetic parameters of workers of Novokuznetsk aluminum plant with the determination of the content of harmful impurities in the air of the working areas was evaluated. Statistical analysis was carried out using IBM SPSS Statistics 22.

Results. Over 25 years of observation, the maximum risk of intoxication was observed in the workplaces of electrolyzers, anodes against the background of metabolic disorders. Th e associative relationship of CYP, GST, SOD genes with the nature of fl uoride intoxication was determined.

Conclusions. Th e development of fl uorosis is predetermined by the hereditary component. Markers associated with the dynamics of metabolic maladaptation allow to predict the course of the disease.

Introduction. Th e system of formation of a healthy lifestyle is recognized as the most important area of prevention. Studies of motivation for health and healthy lifestyles in workers engaged in harmful working conditions are few and indicate the negative impact of occupational disease on the psychosocial status of patients, a signifi cant impact of adherence to a healthy lifestyle on the prevalence and course of somatic diseases and the need to develop health-saving behavior.

The aim of the study was to study the prevalence of diff erent levels of motivation for maintaining health and a healthy lifestyle among workers in the metallurgical and coal industries.

Materials and methods. 72 workers of mines and sections of the South of Kuzbass with the established diagnosis of occupational disease were surveyed; 372 workers of the aluminum plant and 54 people who do not work in harmful working conditions (engineering and technical workers). The surveys were conducted by the method of «Motivation index for health and healthy lifestyle», alexithymia was evaluated by the method of «Toronto scale of alexithymia (TAS)» with the informed consent of the subjects.

Results. Th e high level of motivation for health and a healthy lifestyle among employees of the aluminum industry corresponds to the population. Th e group of coal industry workers with occupational diseases surveyed is dominated by a low level of motivation to maintain health and a healthy lifestyle. In the group of workers who are not employed in harmful working conditions, a high degree of motivation for health and a healthy lifestyle is determined. Th e predominance of motivation on emotional and cognitive scales among workers not employed in harmful working conditions was revealed. In the group of coal industry workers with occupational diseases, the number of persons with a high level of motivation on an emotional scale has been reduced. Among persons with alexithymia signifi cantly reduced the level of motivation on an emotional scale. Among the workers of the coal industry with occupational diseases revealed signifi cantly higher prevalence of alexithymia.

Conclusions. It is assumed that the link of reduced motivation for health in persons with occupational diseases with the presence of alexithymia. 

Introduction. Unfavorable working conditions of miners are a risk factor for cardiovascular diseases. In the literature there is information about the formation of functional and morphological disorders of the cardiovascular system in miners, at the same time, the mechanisms of their development are poorly covered. Fibrous changes in the myocardium of miners are most oft en associated with coronary heart disease, hypertension and diabetes. In recent years, the att ention of researchers is drawn to the study of the role of dysfunction and transformation of vascular endothelium in the pathogenesis of many diseases.

Th e aim of the study is a morphological study of the walls of the heart vessels of miners with diff erent experience in the dusty atmosphere.

Materials and methods. Histological and morphometric study of the vascular wall of the heart muscle in miners of diff erent age groups (in the range from 5 to 30 years) and in the control group was carried out. Autopsy material was obtained during 24 forensic examinations of miners of the Kemerovo region. The control group was formed from 8 forensic examinations of men killed in a road accident in Novokuznetsk at the age of not older than 30 years, who did not have the results of autopsies of visible organ pathology. In vessels of diff erent diameters were evaluated: thickness of walls, size of the cells of the endothelial layer, the thickness of the perivascular fi brosis.

Results. A comparative analysis of the obtained values in the groups of miners and the control group showed that harmful working conditions of miners already at 5–9 years of experience lead to the development of morphological changes in the wall of the heart vessels in the form of endothelial cell hypertrophy, thickening of the muscle fi bers of media and the formation of fi broplastic changes in the perivascular zones. However, no statistically signifi cant diff erences were found in the studied characteristics with the control group. Th e internship was accompanied by the growth of the above-mentioned morphological changes. Signifi cant diff erences in wall thickness with the indicators of the control group were revealed in most structures. Th e increase in the duration of work in harmful conditions up to 20–30 years led to the development of pronounced changes in the morphostructure of the heart vessels in the form of endothelium, hypertrophy of media and perivascular fi brosis. At the same time, the measured parameters of the heart vessels were signifi cantly higher than the control values in almost all studied groups of vessels.

Conclusion. Unfavorable working conditions of miners are a risk factor for the development of changes in the vessels of the heart muscle in the form of their morphostructural transformation. 

Introduction. Th e actual problem of modern occupational health is the study of the role of exogenous and endogenous factors in the development of occupational pathology of the bronchopulmonary system. То identify groups at increased risk of developing a dusty pathology of the bronchopulmonary system, it is necessary to conduct a comprehensive study of clinical and genetic factors, as well as to determine the most signifi cant diagnostic markers of the development of this pathology.

The aim of the study was to study the genetic status of a set of biochemical and molecular genetic markers, as well as biochemical parameters of blood and respiratory function in coal industry workers with chronic dust bronchitis and persons of the control group.

Materials and methods. 115 workers of coal mines from the South of Kuzbass aged from 39 to 58 years were examined in the Clinic of the Institute. Among them — 71 people with a previously established diagnosis of chronic dust bronchitis (the main group) and 44 people of the control group of persons working in the same sanitary conditions, but not having this pathology. A complex of clinical, biochemical and genetic methods of research was used in the study, and functional parameters of the bronchopulmonary system were evaluated. Statistical processing of the results was carried out using IBM SPSS Statistics 22 soft ware.

Results. Statistically signifi cant diff erences between biochemical (increase in the concentration of ceruloplasmin and α–1antitrypsin) and immunological parameters (increase in the total number of leukocytes and ESR, increase in the concentration of IgG) in miners with chronic dust bronchitis and coal industry workers without this pathology were revealed. The dependence of the functional changes of the respiratory system with the development of professional pathology is determined. Th e persons of the main group showed a statistically signifi cant decrease in functional parameters (forced exhalation per second and lung capacity), increased respiratory failure. A predisposition to the development of dust bronchitis in the owners of the HP 1–1 genotype and resistance to the formation of this pathology in persons with the HP 2–2 genotype were found. Th e study of GSTT 1 deletion polymorphism revealed that carriers of the GSTT 1 «+» variant are most susceptible to the development of chronic dust bronchitis, and owners of the GSTT 1 variant are» resistant to its formation. Th ere was a positive аssociation with the development of dust bronchitis of the holders of the MM phenotype (MN).

Conclusions. When working in similar conditions, some workers have a deviation of biochemical and immunological parameters fr om the norm, as well as a violation of the respiratory system, while others have no changes. Th e response of the body to the impact of certain external adverse factors may be due to genetic predisposition or resistance to the development of the disease. 

Introduction. Th e study of the infl uence of air pollution on the health of the population of industrial cities is an urgent task of preventive medicine.

The purpose of the study — assessment of risk for population health of the city of Novokuznetsk, associated with the receipt in atmospheric air of polluting substances from SC «Kuznetsk TPP».

Materials and methods. The paper presents the results of risk assessment for the health of the population of Novokuznetsk from the impact of atmospheric emissions of coal thermal power plant. Risks were calculated in accordance with the «Guidelines for the assessment of public health risks from exposure to chemicals that pollute the environment».

Results. It was found that sulfur dioxide, coal ash, nitrogen dioxide had the largest share in the index of non-carcinogenic hazard of emissions. Th e maximum hazard index of carcinogenic substances was detected in hexavalent chromium. Th e greatest risk of immediate action, manifested in the development of refl ex reactions, was detected at two points of exposure to concentrations; it was determined by the infl uence of coal ash. In the formation of the risk of chronic intoxication, coal ash, sulfur dioxide, nitrogen dioxide, nitrogen oxide had the greatest impact; the greatest risk was detected at three points. Th e hazard coeffi  cients of the concentrations ranged from 2.04×10–4 to 6.723. The maximum index of danger equal to 29.31, corresponded to the residential district of Lenin square. Th e highest levels of carcinogenic risk identifi ed at three points were determined by exposure to hexavalent chromium.

Conclusion. Th e work identifi ed environmentally disadvantaged neighborhoods of the city. It is shown that the main contribution to the formation of non-carcinogenic risk of health disorders of the city’s population is made by nitric oxide and nitrogen dioxide, coal ash, sulfur dioxide. Th e main carcinogen is hexavalent chromium. Th e total values of risks expressed in the multiplicities of excess of acceptable risk, for most points exceed 1, indicating a signifi cant impact of emissions on the health of the population. A set of atmospheric protection measures aimed at reducing risks to public health is recommended. 

Introduction. On the territory of the Altai territory there are four areas of falling of separating parts of space launch vehicles. For many years, these territories have been exposed to negative factors of rocket and space activities. In order to assess the possible impact of rocket and space activities on the health of the inhabitants of the Altai territory, living near the areas of falling of the separating parts of the launch vehicles, their medical examination is regularly carried out.

The aim of the study is to assess the possible impact of rocket and space activities on public health.

Materials and methods. Th e results of dynamic analysis of the prevalence of circulatory disease among the residents of Novoaleysky and Ploskovsky village councils of the Tretyakov District of the Altai territory. In 1999, 1929 people were examined, in 2005–1213 people, in 2010–1016 people and in 2015–843 people. Extensive and intensive indicators of prevalence of diseases of the circulatory system were obtained.

Results. Basing to results of the dynamic analysis, the peculiarities of the signifi cance and prevalence of the circulatory system diseases, as well as of separate nosologies of this class, were identifi ed. Th e most common circulatory system diseases were determined for the studied contingent. Th e prevalence of this pathology diff ers in men and women. Comparison of the results of the medical examination in 2015 with the data on the general morbidity of the population of the Altai territory showed that the level of detection of diseases of the circulatory system among the inhabitants of the studied areas is signifi cantly higher than the level of the general morbidity of this pathology. Th e obtained results of the analysis of the prevalence of the circulatory system diseases allow overtime monitoring the residents’ health of the territories boarding to the areas of rocket and space activities. Th is allows to evaluate the eff ectiveness of measures to optimize their health and provides sound information for management decisions.

Conclusions. Th e overall prevalence of diseases in the study areas in 2015 was signifi cantly lower than in 1999, but the prevalence of diseases of the circulatory system in 2015 was signifi cantly higher than in 1999. In the study areas, the most signifi cant diseases of the circulatory system are hypertension, myocardiodystrophy, angina pectoris and atherosclerosis of the aorta. In all the years studied, the prevalence of circulatory diseases among women was signifi cantly higher than among men. Among women, the prevalence of myocardiodystrophy of various etiologies and hypertension is signifi cantly higher. Th e prevalence of angina in men and women was the same. Th e prevalence of aortic atherosclerosis is much higher in men.

Introduction. Vibration disease (VD) is one of the leaders in the structure of occupational diseases among workers in the coal mining industry. The occurrence of disorders at the systemic level (primarily in the nervous and vascular systems) leads to suppression of heart rate variability (HRV) in vibration pathology as a result of damage to vegetative fi bers, centers, ganglia. The study of metabolic disorders in relation to HRV indicators, including nonlinear ones, is of interest for understanding the mechanisms of the VD, and is also important for fi nding non-invasive and less expensive methods of dynamic control.

The aim of the study was to study the parameters of heart rate variability, total cholesterol and blood glucose levels in patients with vibration disease, to identify the relationship between them.

Materials and methods. 75 patients of the Clinic of the Research Institute for Complex Problems of Hygiene and Occupational Diseases subjected to industrial vibration for 10 years or more (the main group) and 20 people of the control group who never had contact with industrial vibration were examined. Th e age of the subjects was 40–60 years. Fasting blood glucose and total cholesterol levels were studied, heart rate variability was studied. Frequency and nonlinear phenomena of heart rate variability were analyzed. Spearman correlation coeffi  cient was determined to assess the strength of the relationship between blood and heart rate variability.

Results. Glucose and cholesterol levels were statistically higher in the group of patients with vibration disease. Spectral parameters of high — and low-frequency heart rate variability in the main group signifi cantly decreased. In patients with vibration pathology of the approximated entropy was signifi cantly lower, whereas deranty fl uctuation analysis increased. Th ese changes of heart rate variability indicate the involvement of all departments of vegetative nervous system, the development of relative sympathicotonia. Correlations of average strength between heart rate variability and levels of glycemia and cholesterol were revealed.

Conclusion. Under the infl uence of industrial vibration in workers’ blood cholesterol and glucose levels increase, heart rate variability is suppressed and correlated with an increase in metabolic disorders. 

Introduction. Despite the signifi cant reduction in the production of electrolytic aluminum, the frequency of fl uorosis is a leader in this industry. In this pathology, fi rst of all, bone tissue actively reacts to the impact of factors of the working environment.

The aim of the study was to study the eff ect of chronic fl uoride intoxication on the morphofunctional state of bone tissue.

Materials and methods. Th e analysis of bone mineral density, structural rearrangement of skeletal bones was evaluated by x-ray method using photon densitometry. Biochemical status of blood of workers with fl uorosis included determination of parameters of mineral homeostasis (level of calcium, phosphorus) and genetic markers (COL1A1, IL1β, IL6, VEGF). Histological analysis of bone tissue was carried out in an experiment on white rats.

Results. A comprehensive clinical and experimental study of bone tissue under chronic fl uoride intoxication is presented. A signifi cant correlation of GG COL1A1, TT  IL1β, GC IL6, GC VEGF genotypes with the development of osteosclerosis was revealed. Th e study showed the relationship of combined signs of fl uorosis, confi rmed by experimental data on persistent bone destruction.

Conclusions. Th e leading clinical and radiological syndrome of industrial fl uorosis is the defeat of the musculoskeletal system against the background of gross violations of the morphological and functional structure of the bones of the skeleton, due to the osteotropic mechanism of action of fl uorides and the genetic status of the body.

Introduction. Anthracosilicosis (AS) is a serious and common occupational disease of workers in the coal industry, and among somatic diseases in miners more oft en than in the General population, there is an arterial hypertension (AH). One of the complications of such diseases is the development of chronic heart failure, and diastolic heart failure precedes the reduction of contractile function.

The aim of the study was to develop a system of diagnosis of predisposition to the formation of diastolic heart failure in patients with AS and AH.

Materials and methods. 71 miners with AC in combination with AH aged 40 to 54 years with preserved systolic function of the left  ventricle (LV) were examined. Determined by: the presence of diastolic dysfunction of the ventricles, the presence and degree of respiratory failure, obesity, blood group AB0, MN and Rh, mass index left  ventricular, thickness of the interventricular septum, posterior wall of LV anterior wall of right ventricle, index of relative wall thickness of LV and the average pressure in the pulmonary artery.

Results. The higher the detection rate of this complication in the combination of AS and AG in patients with respiratory failure, obesity, with an increased index of myocardial mass of left  ventricle, index of relative wall thickness of LV sphericity index, thickening of the walls of the ventricles, increased pressure in the pulmonary artery, having blood group 0 (I), B (III), MM, NN, Rh-, R+. Th e method of predicting the development of diastolic heart failure is as follows: the survey is carried out once, 10 of the above markers are determined, the data are analyzed using a prognostic table.

Conclusions. With the help of the proposed method of predicting the development of diastolic heart failure in miners with AS and AH, it is possible to quickly and with litt le material cost to identify a group of people with a high risk of developing this complication.

Introduction. High levels of occupational incidence in coal miners of the Kemerovo Region determine the need to optimize the State Committ ee for Sanitary and Epidemiological Oversight for in-depth study of risk factors and planning of medical and preventive measures.

The aim of the study is to optimize the activities of the State Committ ee for Sanitary and Epidemiological Oversight in the planning of supervisory and sanitary measures aimed at reducing the level of OD in the coal industry.

Materials and methods. On the basis of a sample of materials from the database of the Department of State Committ ee for Sanitary and Epidemiological Oversight in the Kemerovo Region on the occupational morbidity of miners for 2008–2016, the analysis of data on working conditions, age, experience, dynamics of occupational morbidity. Th e information on 7515 cases of occupational diseases in workers of coal mining enterprises is analyzed.

Results. Indicators of occupational disease in the miners of the Kemerovo Region are higher than the national level, amounting to 13.23 per 10 thousand of the employed population. Employees of the main professions of the coal industry are particularly susceptible to occupational diseases: sinkers, miners of treatment faces, machinists of mining excavation machines, underground electric locksmiths, drivers of heavy vehicles, drivers of excavators and bulldozers. The reasons for the formation of occupational diseases in miners are unfavorable working conditions: physical overload, dust and gas contamination, noise and vibration, high humidity of the working area at low temperatures. Occupational diseases are more commonly diagnosed in workers aged 41 to 50 years (28.01%) and 51 to 60 years (69.23%). Th e most at risk of occupational disease are those working in contact with the harmful production factor for 21–30 years (60.5%) and from 31 to 40 years (26.1%).

Conclusions. The results of the study are necessary for the rational planning of control measures and reasoned conclusions in the preparation of sanitary and hygienic characteristics of working conditions with suspicion of occupational diseases.

Introduction. Th e high level of professional and production-related pathology among workers of the coal industry, as well as the frequent development of their combined pathology with an unfavorable prognosis determine the relevance of studying the prevalence of somatic pathology in miners with occupational diseases of the respiratory system.

The aim of the study was to explore the prevalence of internal organs pathology in coal industry workers with occupational lung diseases (anthracosilicosis, chronic dust bronchitis, chronic obstructive pulmonary disease).

Materials and methods. 788 store miners and shaft  sinkers with previously diagnosed occupational respiratory diseases (anthracosilicosis, chronic dust bronchitis, chronic obstructive pulmonary disease) and 161 miners, working for a long time in harmful labour conditions and having no occupational pathology (the control group) were examined.

Results. It was revealed that the workers of the coal industry with occupational diseases of the respiratory system pathology of internal organs occurs more often than the workers of the control group, including: diseases of the cardiovascular system (hypertension, angina pectoris I and II functional classes), diseases of the digestive system (nonalcoholic fatty liver disease and chronic pancreatitis), kidney disease (chronic pyelonephritis), as well as a combination of several somatic diseases.

Conclusions. In miners with occupational diseases of the respiratory system more oft en than in the control group, there is a pathology of the internal organs: diseases of the cardiovascular system, digestive organs, kidneys, as well as a combination of several somatic diseases. Th e data obtained should be considered during periodic medical examinations and medical examinations for the development of timely therapeutic and preventive and rehabilitation measures.