The functional state of the cardiovascular system of children aged 8-12 years who underwent COVID-19 was studied. It has been shown that one of the mechanisms of functional disorders in the cardiovascular system in the period from 3 to 6 months after suffering COVID-19 is considered a syndrome of autonomic dysfunction. The manifestations of autonomic dysfunction in children are hypertensive changes in the cardiovascular system in the absence of pronounced clinical manifestations, the presence of functional tension of regulatory systems, unsatisfactory functional status, decreased rates of increase in heart rate power in response to load, low values of sympathetic regulation mechanisms and centralization of the cardiovascular system regulation circuit, a large proportion of the influence of the peripheral regulation circuit. Conclusion. One of the pathogenetic mechanisms for reducing the functional parameters of the cardiovascular system in children who have had a coronavirus infection is endothelial dysfunction syndrome.

The aim of the study was to assess the professional risk of developing diseases in workers of the railway car repair enterprise. The Voronezh Car Repair Plant, a branch of Vagonremmash Joint-Stock Company, was chosen as the object of study. Methods: «The methodology for calculating individual occupational risk depending on the working conditions and the health status of the employee», developed by the Klin Institute for Protection and Working Conditions in conjunction with the Research Institute of Occupational Medicine (2013), the main professions; cohort study with the calculation of the relative risk of morbidity with temporary disability, the odds ratio, the etiological share of factors in the formation of morbidity (group size: 250 people, experimental group — workers of the main specialties, 95 people — comparison group). Results. According to the research results, the priority factors of occupational health risk include: chemical, noise, heating microclimate, low light level. For certain professions, the share of the contribution of priority factors to the risk profile (PV) reaches 40 %. The indicator of individual occupational risk is 0.12 to 0.26 units. The high level of professional risk (0.22 ÷ 0.26) is characterized by the working conditions of the mechanics for the repair of rolling stock, machine tools (woodworking), casters (metal), thermists, plastic casters. In professional groups with medium and high risk, the indicator of the relative risk of morbidity with temporary disability is higher than 1 (RR = 1.75 and 1.39, respectively), and the etiological share of production factors in the formation of diseases is from 27.95 (subgroup with secondary professional risk) up to 42.88 % (a subgroup with high professional risk), which indicates the professional condition of the disease. Discussion. In general, our data are consistent with the results of similar studies conducted earlier at the car building and car repair enterprises. In order to ensure hygienically safe working conditions and preserve the health of workers, it is necessary to reduce the level of exposure to production factors, including through the introduction of modern equipment and improvement of technological processes.

Introduction. Professional groups of railway workers engaged in the repair of wagons are directly responsible for the safety of railway traffic. The analysis of literature testifies to insufficient attention of researchers to the hygienic problems associated with labor activity of workers of wagon-repair production.The aim of the study is to assess the occupational risk to the health of wagon repair workers, due to the impact on them of factors of the working environment and the labor process.Materials and methods. The study used comprehensive hygienic studies using the methodology of occupational risk to worker’s health.Results. The leading factors of the working environment (class of working conditions 3.2–3.4), which are exposed to workers depending on the specifics of the work performed. Identified professional groups with medium (significant) high (unbearable) and very high (intolerable) category of a priori occupational risk: in wagon meintenance workshop — 17 groups (94% of jobs), in a wagon assembly workshop — 11 groups (80% jobs), in wagon wheel workshop — 3 group (100% jobs). At the same time, according to the request for medical care, employees were diagnosed with isolated cases of occupational diseases.The levels of morbidity with temporary disability of employees of the main workshops are statistically significant (p<0.05) higher than those of the control group in 1.4–1.9 times. The influence of the complex of chemical factors of low and medium intensity on the levels of morbidity of respiratory diseases in the group of workers of the wagon wheel workshop, which were 1.7–2.0 times higher than in the control group, is confirmed by the average degree of causation of the production condition of this pathology (RR=1.7; EF=42.0%).The combined effect of vibration and severity of the labor process forms a high level of temporary disability of employees of the main workshops in connection with diseases of the musculoskeletal system, which was 2.7–4.4 times higher than in the control group, and also determines the prevalence of this pathology in the structure of diseases detected on medical examinations (23.2%). Diseases of the musculoskeletal system are caused by the production of employees of the wagon meintenance workshop (RR=3,9; EF=74,9%), as the most unfavorable in terms of hygiene on these factors.The stressful influence of the complex of harmful production factors on the health of wagon repair workers is manifested by the high risk of diseases of the cardiovascular system, gastrointestinal tract, neurological disorders, violation of adaptation of the cardiovascular system in 97% of the examined, as well as the predominance of diseases of the digestive system and circulatory system detected on periodic medical examinations.Conclusions. Harmful working conditions (class 3.1–3.4) cause the suspected occupational risk from small (moderate) to very high (intolerable) to 100% of the jobs of wagon repair workers. The results of the study of morbidity and risk of pathology indicate a significant risk of damage to the health of workers.

Introduction.Part of the population working at carcinogenic enterprises is exposed to double exposure to carcinogens (in industrial and domestic conditions), however, studies to assess the total inhalation exposure is practically not carried out.The aim of the studyis hygienic assessment of the contribution of working environment factors to the formation of individual carcinogenic risk (ICR) for workers in the main professions in the car repair company, including the assessment of the predicted values of occupational risks in the dynamics of work experience.Materials and methods. There was the calculation of the levels of ICR for workers of the main professions in the wagon wheel, wagon meintenance, wagon assembly workshops. The assessment of exposure for workers is given on long-term average concentrations in the air of the working area and on average annual concentrations in the atmospheric air. When calculating the doses of toxicants in the air of the working area, «standard» parameters of pulmonary ventilation for an adult, body weight, work experience in contact with carcinogenic substances — from 1 to 30 years, the number of days in contact — 240, working time — 8 hours (in accordance with the duration of the working day) were used.Results.Workers of major occupations carcinogenic enterprise levels ICR differ in dozens of times. Calculation of ICR at 30-year work experience showed that in all studied main and auxiliary professions the total ICR was in the 4th range (more than 1,0·10–3). Unacceptable values for the predicted ICR for the professions of «painter», «locksmith-electrician», «impregnator», «mechanic of rolling stock» begin with a 5-year work experience, the least carcinogenic is the work of a tinker, whose risk reaches an unacceptable level after 20 years of the work experience. Among the most dangerous jobs should be attributed to the wagon assembly workshop. In contribution to the ICR the leading carcinogens are benzene, nickel, formaldehyde.Conclusions:The problems of monitoring carcinogens in the production environment, expert assessments to prove the professional genesis of malignant neoplasms were considered; it is noted that the rank number of carcinogenic professions of wagon repair production is as follows: painter, electrician, impregnator, mechanic of rolling stock.

The rail transport is the one of the leading sectors of the national economy. More than 50% of the employees of the enterprises of the railway complex work under the unfavourable impact of hazardous and dangerous substances and occupational factors. In the literature issues of working conditions and health of employees of railway carrepairing plant are hardly highlighted. The aim of the study is the evaluation of the morbidity rate shaped under the influence of harmful occupational factors for the elaboration of preventive measures. In the work there were used generally accepted methods of hygienic studies, analysis of morbidity rate with temporary disability (TD), according to records of periodic medical examinations, occupational prevalence. The railway car-repairing plant was established to be characterized by the complex of harmful factors of the working environment and labor process: noise, local vibration, industrial aerosols of complex composition, chemicals, low light, hardness of the labor process. The levels of incidence with temporal disability in the studied groups, depending on the work seniority in the harmful labor conditions, significantly decrease with the experience from 5 to 9 years and increase with the experience more than 10 years. Executed in-depth analysis as of the both morbidity rate and TD, as well results of periodic medical examinations of workers of main shops shows that overall indices of the morbidity rate and TD are significantly higher than in the comparison group; levels of the morbidity rate and TD in the observed groups significantly decline depending on the length of service in hazardous working conditions with a length of the experience offrom 5 to 9 years and increase with the increase in the length of experience of 10 years or more. In the structure of morbidity and TD leading positions are occupied by diseases of the respiratory system, musculoskeletal system and connective tissue, circulatory system and digestive system, diseases of the eye and its appendages. The health damage risk coefficients in the studied groups of workers and the average losses of working time due to the morbidity with TD per 1 employee in all shops are higher than those in the comparison group. The level of the occupational morbidity rate is very low. Harmful working conditions contribute to the development of general and occupationally related diseases.

Tunnels are an integral part of the ways and artificial constructions of the railway. Objective assessment of working conditions is important, because current regulations fail to allow to give a definite hygienic assessment of some factors of the production environment of the tunnels. Objective: to reveal the peculiarities of the formation of working conditions in railway tunnels with the subsequent hygienic assessment for the development of preventive measures. Measurement of the factors of working process and working environment is carried out with the use of the certified equipment for the approved the hygienic and sanitary-chemical methods in workplaces in tunnels of the East-Siberian railway. Specific conditions were shown to be formed due to constructive solutions, climate and geographical location, the length of railway tunnels, the composition of the rocks through which the tunnel, the nature of the maintenance tunnels, ventilation system, repetition rate and type of passing rolling stock. All employees from occupational groups from examined tunnels were established to be exposed to high concentrations of aerosols with predominantly fibrogenic action, noise levels, adverse climate (low positive and negative temperatures, high relative humidity and mobility of air), the lack of natural lighting, low levels of artificial light, hard exertion of labor (dynamic physical load, working position, the slopes of the body, movement in space). Additionally, high levels of the vibration, nonionizing and ionizing radiation were typical for jobs of the Baikal and the North-Muya tunnel. There is proposed the algorithm of hygienic assessment of the microclimate, light environment at the working places depending on the time of the works in the underground conditions and constructional features of tunnels, methods of accounting personnel dose rates from natural sources.

The comprehensive hygienic assessment of working environment for main occupational groups Railway Car Repair Plant in factory conditions shows that workers are exposed to the impact of factors of chemical nature in concentrations exceeding maximum allowable (lead, manganese, alkali caustic, sulphuric and nitric acids, chromium trioxide, silicon-containing dust, white corundum, diiron trioxide, silicate-organic dust, wood and carbon dusts), the high level of noise, the local vibration, insufficient levels of artificial lighting. The manual work is used, that determines the high severity of the labor process in the most of workers. There was identified the inconsistency of quality and quantitative estimation of the work conditions on chemical factor at implementation of various types of control: certification of workplaces on work conditions, productions and state control. There was given an a priori evaluation of the occupational risk in the three main workshops, there were detected 13 occupations with mild (moderate) risk, 9 occupations with average (significant) risk, 6 professions with high (intolerable) risk category and 1 occupation--with very high (intolerable) risk category. Low indices of occupational diseases according to official statistics were establishedfail to be consistent with a high probability of their occurrence in the production.

The proposed conceptual approach takes into account the specific character of the formation of the radon situation in the East Siberian railway tunnels and is an effective tool in monitoring of individual doses of ionizing radiation of workers by uncontrolled natural sources in underground conditions.

The hygienic investigations of the working conditions in Severomuysk tunnel of Eastern-Siberian Railway allowed to reveal the complex of unfavorable industrial factors aff ecting the organism of underground workers. Th ey are: high concentration of Radium and powder, containing Silicon (SiO2 from 2 to 10 %), unsatisfactory microclimate conditions, absence of natural lighting, increased levels of noise, and harmful labor conditions according to the index of working process severity. Carried out hygienic investigations served as the basis for developing health care programs for workers, caring out the exploitation of the Severomuysk tunnel in the underground conditions.

Morbidity associated with temporary disability and risks for major syndromes have been studied in aircraft designers who work under the conditions regarded as hazardous (the third degree of Class 2). The risks for major syndromes have been analyzed in relation to sociopsychological characteristics. The manifestations of the emotional exhaustion syndrome have been examined in the workers exposed to industrial stresses.

Summary. Th e hygienic investigations of the working conditions in Severomuysk tunnel of Eastern-Siberian Railway allowed to reveal the complex of unfavorable industrial factors aff ecting the organism of underground workers. Th ey are: high concentration of Radium and powder, containing Silicon (SiO2 from 2 to 10 %), unsatisfactory microclimate conditions, absence of natural lighting, increased levels of noise, and harmful labor conditions according to the index of working process severity. Carried out hygienic investigations served as the basis for developing health care programs for workers, caring out the exploitation of the Severomuysk tunnel in the underground conditions. Key words: industrial factors, Radium, railway tunnel.В настоящее время интенсивно увеличивается по-ток грузов по сети железных дорог, в том числе на вос-точных направлениях. С 1995 по 2002 годы суммарный грузопоток по БАМу и Транссибу возрос на 35% (до 61,7 млн. тонн в год), а до 2010 года дальнейший рост грузопотока на двух магистралях ожидается еще почти на 30%. С завершением строительства Северомуйского тоннеля Россия получила второй выход к Тихому океа-ну, а Российские железные дороги — надежную инфра-структуру. Вывод БАМа на проектную мощность обе-спечивает освоение природных ресурсов на прилегаю-щих к магистрали территориях, доступ к которым до настоящего времени был затруднен.При проведении поисковых исследований было установлено, что условия труда работающих в под-земных условиях Северомуйского тоннеля Восточно-Сибирской железной дороги (ВСЖД) имеют ряд от-личий в связи с наличием комплекса неблагоприятных производственных факторов, ведущими из которых являются повышенные концентрации радона в зоне ды-хания, охлаждающий микроклимат, шум, физические нагрузки, пылевой фактор.Вместе с тем, в литературе практически отсутствуют работы по комплексной гигиенической оценке условий труда работающих в подземных условиях при эксплуа-тации железнодорожных тоннелей. В настоящее время актуальным вопросом остается научное обоснование подхода к управлению здоровьем населения и факторов его формирующих. При невозможности изменения технологических процессов, необходима разработка средств и методов, направленных на снижение воздействия профессио-нальных вредностей с целью регуляции течения патоло-гических процессов в организме, возникших под влия-нием специфической производственной среды.Целью настоящей работы явилось выявление осо-бенностей формирования условий труда рабочих в под-земных условиях железнодорожного тоннеля.