Preserving the working population's health is a priority direction of state policy in labor relations, labor protection, and the provision of healthy and safe working conditions by the employer and the state, prevention of occupational diseases. The state's economic growth in a competitive era is mainly due to the level of health and working capacity of the population.

This issue has acquired relevance in the COVID-19 pandemic for medical workers. Among these workers, the incidence of the new coronavirus infection COVID-19 is associated with professional duties and entails a high risk of morbidity and mortality.

The paper presents the results of a special assessment of working conditions. The author studied the data on the presence of occupational diseases among medical workers in 2019 (according to the data of the Social Insurance Fund of the Russian Federation). On the example of 15 medical organizations of the Russian Federation, an analysis of the working environment factors was carried out. The distribution of occupational diseases was analyzed depending on the harmful factors of the working environment in 2019.

Information is provided on the implementation in 2020 by the Social Insurance Fund of the Russian Federation of the Decree of the President of the Russian Federation dated 06.05.2020 No. 313 "On providing additional insurance guarantees to certain categories of medical workers" (as of 07.12.2020).

Clinic of the Izmerov Research Institute of Occupational Health and the centers of occupational pathology of the constituent entities of the Russian Federation provided preliminary information on the examinations of professional suitability, studies of the connection of the disease with the profession (including among medical workers) in the Russian Federation in 2020.

Introduction. Infectious diseases occupy a leading place in the structure of occupational diseases (OD) of health care workers (HCW). If until 2020, the main OD from exposure to a biological factor were tuberculosis and viral hepatitis (VH), then in 2020 the world faced another infectious disease of professional etiology – infection of health workers with a new coronavirus infection (COVID-19).

The aim of the study is to identify problematic issues in establishing the connection of an infectious disease with a profession in health care workers.

Materials and methods. A retrospective analysis of cases of occupational diseases was applied according to the data of the Department of Rospotrebnadzor for the Republic of Tatarstan (RT) and the register of patients of the Republican Center of Occupational Pathology.

Results. Among the health care workers of the Republic of Tatarstan, mainly occupational infectious diseases are diagnosed (88.9%). Tuberculosis is the most common occupational disease among health care workers of the Republic of Tatarstan, accounting for 68.4%, and viral hepatitis accounts for 20.5%. In 2020, the most common OD from biological factors in the health care workers of RT was infection COVID-19.

Conclusions. Currently, the most common disease of infectious genesis in health care workers is a new coronavirus infection. For a high-quality examination of the connection of an infectious disease with a profession, the list of documents must include a card of epidemiological examination, which must be filled in by an epidemiologist not after establishing the connection of the disease with the profession, but in parallel with the preparation of a sanitary and hygienic characteristic (SGC) of working conditions.

Introduction. Health care workers are at risk of infection with the SARS-CoV-2 virus. However, many aspects of the professionally conditioned COVID-19 are still poorly understood.

The aim of study is to conduct a brief review and analysis of scientific data on the prevalence, features of clinical and laboratory COVID-19 syndromes in medical professionals. To evaluate the structure of post-COVID syndrome in health care workers who are observed in a large multidisciplinary medical organization that has a center for occupational pathology. To present the current state of the problem of examination of the connection of COVID-19 with the profession and admission to work in conditions of high risk of SARS-CoV-2 infection.

Materials and methods. At the first stage, a brief review of the literature on the problem of COVID-19 in health care workers was performed, at the second — a single-center observational prospective study of COVID-19 convalescents. The main group consisted of health care workers (n=203), the comparison group — people who do not have occupational health risks (n=156). The groups were comparable in demographic characteristics. The work experience of the medical staff was 15 (5; 21) years. Of the participants in the main group, 20.2% worked in hospitals, and 79.8% in outpatient institutions. Three of the participants (1.5%) were employees of specialized COVID hospitals. Doctors were 25.6%, secondary medical personnel — 51.7%, junior medical and technical personnel — 22.7%. A severe form of COVID-19 was suffered by 25 (12.3%) people, after the artificial ventilation of the lungs (AVL) — two participants. The observation time is 60 days. Statistical analysis included standard methods of descriptive statistics, determination of relationships by the method of logistic regression. The significance level is p<0.05.

Results. Most of the known data on COVID-19 in health care workers is obtained in cross-sectional studies. The possibility of occupational infection has been sufficiently proven. The risk probably depends on the work performed and is higher in conditions of direct contact of medical personnel with adults, potentially infected patients, but not in a specialized hospital. It is possible that the course of COVID-19 in health care workers differs from the general population of patients there is evidence of a greater frequency of weakness and myalgia. Studies of the features of post-COVID syndrome in health care workers in available sources could not be identified.

According to the results of their own research, health care workers who had experienced COVID-19 had a higher frequency of central thermoregulation disorders, arrhythmias, heart failure, panic attacks and depression.

Conclusions. Health care workers are at risk of COVID-19. Professionally conditioned post-COVID syndrome is characterized by the frequency of violations of the central mechanisms of thermoregulation and arrhythmias. COVID-19 in health care workers meets the definition of occupational disease.

Introduction. To comply with the order of the Government of the Russian Federation and the Ministry of Education and Science, the clinic of Izmerov Research Institute of Occupational Health received the necessary conditions for the provision of medical care to patients with a new coronavirus infection.

The study aims to identify possible criteria for the positive dynamics of pneumonia caused by the SARS-CoV-2 virus and to describe the general characteristics of patients hospitalized in the COVID center of Izmerov Research Institute of Occupational Health.

Materials and methods. The article describes the clinical, laboratory, and instrumental data of 68 patients with pneumonia caused by the SARS-CoV-2 virus hospitalized to continue treatment. Statistical analysis included descriptive statistics. The significance level was less than 0.05.

Results. The COVID-center received patients with complaints of shortness of breath on exertion, an unproductive cough, general weakness, myalgias, headaches, and an impaired sense of smell and taste. The condition of the patients was moderate. O2 saturation in ambient air was 93% and higher. Computed tomography of the chest revealed lesions of the lung tissue (numerous peripheral seals of the "frosted glass" type of various shapes and lengths with areas of consolidation), mainly corresponding to bilateral polysegmental viral pneumonia CT 1-2 degrees. The most frequent changes in laboratory parameters in patients were increased values of ESR (51.16% of cases), D-dimer (50% of cases), CRP (22.06% of cases), relative values of monocytes (58.14% of cases), as well as low hemoglobin concentrations (23% of cases).

Conclusions. In patients with a new coronavirus infection hospitalized to continue treatment in the COVID center of Izmerov Research Institute of Occupational Health, lung tissue lesions were detected, mainly corresponding to the moderate-severe form of bilateral polysegmental viral pneumonia (CT of the 1-2 degree). The most frequent changes in laboratory parameters in patients with COVID-19 were increased ESR values, D-dimer, CRP, relative values of monocytes, and low hemoglobin concentrations. Monocytes, being one of the indicators of activation of the immune defense, are a laboratory criterion for the positive dynamics of the course of new coronavirus infection.

Introduction. Currently, the number of confirmed cases of COVID-19 among healthcare workers continues to increase both in Russia and in other countries. Due to their professional activities' specifics, medical workers — frequent contact with sick people are most at risk of contracting SARS-CoV-2.

The study aims to research the risk factors for infection of medical workers with SARS-CoV-2 to prevent infection and the spread of COVID-19 in medical institutions, considering the use of personal protective equipment.

Materials and methods. Specialists of the Central Research Institute of Epidemiology of Rospotrebnadzor conducted an anonymous questionnaire with the subsequent analysis of the results obtained to study and assess risk factors for infection of SARS-CoV-2 medical workers, their attitude to the use of personal protective equipment, non-specific prophylaxis.

Results. The authors present a literature review on the problem of infection and morbidity of COVID-19 medical workers, who are known to be at high risk of infection due to frequent contact with the sick. We analyzed data that exposure to higher concentrations of the virus, especially from critically ill patients, can affect the disease's severity in health care workers. The authors conducted an anonymous survey to study the risk factors for infection of health care workers with SARS-CoV-2 and their attitude to the use of personal protective equipment. Based on the obtained data, identified the main ways of infection of medical staff, options of the disease, and their severity, and revealed that providers responsible for selecting and using PPE.

Conclusion. Assessing potential risk factors for the spread of coronavirus infection among healthcare workers is essential to prevent healthcare workers' infection and the spread of COVID-19 in healthcare settings.

The paper contains a literature review on COVID-19 in health care workers and demonstrates that the disease is of occupational character; features, clinical signs, and complications are described to provide evidence for such interpretation. It also addresses important documents issued by the Government of Russia to support medical professionals, some aspects of occupational risk in COVID-19, and the role of interactions between patients and health care workers in disease propagation.

Aim of the work — review the literature and essays on working conditions, the health status of healthcare workers and their degree of occupational risk in the context of the COVID-19 pandemic.

An analysis of the documents of WHO, ILO, the European Union, etc., a review of the literature and essays on the problem of assessing the professional risk of healthcare workers in the light of the COVID-19 pandemic, as well as protection and prevention measures.

A pandemic is a problem of public health and occupational medicine since healthcare workers are at the forefront of the fight against the epidemic for the health and life of the population and are themselves at extreme risk. On issues of labor protection and the health of healthcare workers, most women, there are a lot of works; there is ILO Nursing personnel Convention No. 149: Recognize their contribution, address their needs (1977), ratified by Russia. The profession is characterized by the exposure to biological agents, stress, physical loads, etc., causing physical health problems (including reproductive and newborn health), disorders of mental health and social well-being. The weakening of immunity towards the end of the working day was observed among employees of the sanitary and epidemiological surveillance services, maternity hospitals, as well as ambulances and burn centers. In general, the working conditions of the main professions of healthcare workers in the literature are assessed as harmful (classes 3.2–3.3) according to the criteria of Guidelines R 2.2.2006-05, and in an epidemic under conditions of increased loads, stress, the use of PPE and other, their working conditions can be assessed as very harmful and extreme (classes 3.4–4). The official statistics on the morbidity and mortality of healthcare workers is absent, although the media note their elevated rates. Among the preventive measures, vaccination, a regimen of work and rest, multivitamins, and others are recommended; workplaces ought to be organized as to avoid work nearby and opposite each other. It should be borne in mind that PPE, while protecting, can simultaneously create new risks (ILO, 2001).
Strengthening the safety and health of healthcare workers in such emergencies is already recognized in Russia as a priority and provided with increased social protection.

Introduction. The problem of effectively countering the COVID-19 pandemic is particularly acute for companies with a continuous production cycle, which include metallurgical enterprises.

The plan of anti-epidemic measures developed by the operational headquarters of "Metalloinvest" includes three blocks: measures to prevent infection and prevent the spread of coronavirus infection; measures to improve the effectiveness of treatment and rehabilitation.

The medical staff of corporate medical organizations and health protection groups at the company's enterprises implement a set of anti-epidemic measures daily. There are situation centers that provide organizational and advisory assistance to patients, and contact centers that inform employees about issues related to COVID-19. We are successfully implementing the program of corporate volunteering and social partnership.

In terms of the protection of employees and their families, a large-scale program was launched to support state medical institutions in the areas of presence, providing for the retrofitting of high-tech medical equipment (computer tomographs, artificial lung ventilation devices, blood gas analyzers, oxygen concentrators, specialized vehicles), as well as the supply of personal protective equipment and disinfection for medical personnel, medicines.

Thanks to the measures taken, "Metalloinvest" managed to maintain a stable production operation, ensure prompt monitoring of the health status of employees, and reduce the incidence of COVID-19. In total, from March to December 2020, 2,934 cases of COVID-19 and pneumonia were detected in employees, 17 deaths were confirmed, 20,889 tests and 1,644 CT scans of the lungs were performed. The number of employees in "Metalloinvest" with a diagnosis of coronavirus infection and pneumonia is less than 0.3% of all employees, which is almost 4 times lower than among residents of the regions where they operate.