Introduction. Search solutions to strategic tasks aimed at preservation of population health in the Russian Federation requires an increase in the productivity and efficiency of public administration, including that performed by control and surveillance organizations. Material and methods. The article focuses on an algorithm for assessing the efficiency of control and surveillance activities performed by Federal Service for Surveillance over Consumer Rights Protection and Human Well-being organizations and authorities. The authors calculated population morbidity and mortality rate associated with adverse effects produced by the environment and prevented due to control and surveillance activities by Federal Service for Surveillance over Consumer Rights Protection and Human Well-being. The calculation was based on certain regularities related to the interaction between compartments in a tripartite system “ Federal Service for Surveillance over Consumer Rights Protection and Human Well-being activities - environmental objects quality - population health”. The authors also suggest indices that can help to estimate the productivity of activities performed by Federal Service for Surveillance over Consumer Rights Protection and Human Well-being and its managerial resources. Spatial classification and typologization of the RF regions was performed as per a set of parameters with k-means cluster analysis. Results. The suggested approaches were tested in research on the productivity of control and surveillance activities aimed at a decrease in a population mortality and morbidity rate in the RF regions caused by neoplasms and circulatory system diseases and associated with the environment quality. The authors estimated a contribution made by Federal Service for Surveillance over Consumer Rights Protection and Human Well-being activities on providing sanitary-epidemiologic well-being in the achievement of target figures on population mortality caused by neoplasms and circulatory system diseases. Discussion. There are vital tasks that need to be solved if we wish to increase the productivity of Federal Service for Surveillance over Consumer Rights Protection and Human Well-being activities as per criteria that reflect prevented population health losses caused by the sanitary-epidemiologic situation. Finding solutions to these tasks requires creating a system of additional managerial actions aimed at improving the quality of environmental objects; it can be done due to the redistribution of resources spent on the performance of Federal Service for Surveillance over Consumer Rights Protection and Human Well-being activities. The task is an optimization one and is an object for further research and publications by the authors. Conclusion. Analytical techniques described in the article are universal and are not confined to a specific social-economic system or a public administration system. It makes wide implementation of the suggested approaches quite possible; they can be applied to estimate contributions made by various public authorities in achievement of target figures.
Methodical approaches to the integrated evaluation of the exposure and length of service in occupational risk assessment have been proposed. There are: the identification of hazards with a specific assessment of working conditions; the establishment of the occupational dependence of the health disorders in workers on the base of the results of epidemiological studies; quantitative risk assessment, taking into account the work experience factor on the basis of a mathematical model “exposure - work experience - response probability”; the establishment of quantitative risk characteristics, taking into account the dynamics of changes in health status over time, as well as the assessment of an integral risk of accumulation of the body functional disorders on the basis of the risk evolution modeling. When testing an integrated risk assessment approach for the workers occupied in underground mining, there was revealed the occupational dependence both for respiratory diseases (RR = 1.75) and disorders of the circulatory system (RR = up to 1.69). The work experience determination of the occupationally chronic rhinitis and rhinopharyngitis (J30- J31) has been established as well as the predictable probability of the development of hypertension after 5 working years as 0,094, after 10 years -0,179 has been detected. The risk of health problems under exposure to occupational factors becomes unacceptable (R) by 45 years. In this the risk for the occurrence of the circulatory disorders is critical.
The research focuses on classifying Russian regions as per their sanitary-hygienic and social-economic welfare, as well as on assessing (for certain nosologies) correlations between heterogeneous risk factors and morbidity with temporary disability among working population. The RF regions were classified (with k-average cluster analysis) as per their sanitaryhygienic and social-economic welfare in order to spot out territories with similar "background" for formation of working population health.We used data provided by the Federal Statistic Service (as per the RF regions) collected in 2016 as our empiric base. As per cluster analysis results, we assigned the RF regions into four specific categories, namely "ill-being", "moderately ill-being", "moderately well-being", and "well-being" (the obtained data are visualized on the map of the country).The performed correlation-regression analysis allowed us to obtain more than twenty authentic models that described correlations between various factors and morbidity with temporary disability among working population.We calculated determination coefficient R 2 for each model that characterized a share of explained variation in a health parameter caused by a factor that was considered in a model.We paid special attention to the 1st cluster that had the least favorable background for health formation (here we detected most apparent influence exerted by social and economic factors on analyzed health parameters of working population). The 2 nd clyster was also examined thoroughly as it was characterized with the highest morbidity among working population (we revealed that social-hygienic welfare on territories belonging to this cluster had greater influence on health parameters than social and economic one).Our data can be appliedto create federal and regional programs aimed at preserving and improving working population health.
In a priori assessment, the professional risk for workers in the production of phthalic anhydride is characterized by an average (class of labor conditions - 3.2), the main harmful chemical production factors: phthalic anhydride, fumaric acid, maleic aldehyde, dimethylbenzene (MPC for single dose (MPCsd) - up to 5.9). These factors are identified as priority ones in the development of adverse effects from the side of the hepatobiliary system. The impact of chemicals is intermittent in character during the shift, which requires control of the content of chemicals in the air in the working area in the form of average shift concentrations. In workers of the complex for the production of phthalic anhydride and fumaric acid, there is an accumulation of o-xylene, phthalic and fumaric acid, whose concentrations are significantly higher (p = 0.0001 - 0.03) if compared with the reference parameters of the comparison group (the excess multiplicity up to 7 times). Among the workers of the phthalic anhydride and fumaric acid production complex, there were no established statistically significant differences in the blood content of o-xylene, phthalic acid and fumaric acids when performing work under conditions of thermal loading of the environment and under conditions with acceptable microclimate parameters. The development of disorders of the hepatobiliary system was shown to begin with the intensification of free radical damage to cell membranes (manifested by an increase in the MDA content of blood relative to the age physiological norm and relative to the index of workers in the comparison group). With a work experience of up to 5 years, the accumulation of secondary products of lipid peroxidation (LPO) in workers is hampered by the activation of antioxidant protection processes. At the experience of more than 5 years, the development of adverse effects from the side of the liver has been established: significantly higher levels of aspartate aminotransferase (AST) (p = 0.027), in cases with an experience of more than 10 years - the level of total and direct bilirubin in blood serum is elevated by 1.4-1.5 times, p = 0.0001 - 0.002). There was found the statistically significant cause-and-effect relationship of the elevated total blood bilirubin content with labor conditions (RR = 2.86, 95% CI = 1.03-7.98, etiological proportion 65.08%)
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