Introduction. Employees of locomotive crews are one of the categorized professional groups, the stable performance of which largely depends on the state of working capacity, which determines the safety of movement and the efficiency of production activities of railway transport.The study aims to conduct a comparative assessment of the functional state and operability of locomotive crews of railway transport of full and reduced composition, taking into account the specifics of the production load.Materials and methods. The authors have conducted a comparative analysis of the results of comprehensive production studies to assess the functional condition of 70 freight train drivers in the operational locomotive depots of JSC Russian Railways when working in full complement (with an assistant) and reduced staff (without an assistant — "one person"). Physiological and hygienic methods were used: continuous timekeeping during various shift periods with recording of work operations and determination of the total number of work operations per shift and the proportion of complex (combined) work operations; physiological — continuous recording of heart rate in automatic mode throughout the entire work shift using heart rate variability indicators (variation range, mode, mode amplitude, number of cardio intervals, stress index of regulatory systems, stress index, index of vegetative equilibrium).Results. The results obtained indicate the presence of both general patterns in the dynamics of working capacity and specific differences due to the peculiarities of the production process.Limitations. The study was conducted with the participation of employees of locomotive crews who had no medical contraindications for their profession and were allowed to work based on the results of a pre-shift medical examination in accordance with orders from the Ministry of Health and the Ministry of Transport of Russia.Conclusion. The production load of the locomotive crews of the reduced composition is fundamentally different from that of the locomotive crews of the full composition. In conditions of reduced physical activity of machinists working without an assistant, the level of nervous and emotional tension increases, primarily due to the high workload of the analyzer systems, which is confirmed by an increase in the central circuit of regulation and an increase in sympathetic activity (HR, respectively: 83,0–89,3/78,8–83,0). Despite the absence of factors of tension in the labor process due to the possibility of intra-team conflicts and responsibility for the result of collective labor, the work of machinists without an assistant is intellectually stressful, as evidenced by a higher proportion of complex operations — an average of 61.2%. The dynamics of the working capacity of machinists and locomotive crews of reduced composition, in comparison with full-time machinists, is characterized by a longer period of service life, a shorter period of sustained working capacity and a faster development of fatigue. These features of the work load of machinists working without an assistant necessitate the development of sound working conditions using physiological and hygienic criteria and updating the system of medical and preventive traffic safety, primarily in the organization and conduct of regulated medical examinations and dynamic monitoring throughout their professional activities.Ethics. The study was conducted in accordance with the generally accepted scientific principles of the Helsinki Declaration of the World Medical Association (ed. 2013) and in accordance with the Program-methodology developed by FSUE VNIIZHG and coordinated with the structural unit of the employer, which is responsible for employees of locomotive crews. The employees of the locomotive crews were informed about the procedure for conducting production research in terms of a list of methods and principles of voluntariness and anonymity. Due to the absence of personal data in the research materials, informed voluntary consent of the staff is not required.Contributions:Wilk M.F. — the concept and design of the study, discussion of the results, conclusions;Tulushev V.N. — collection of material, analysis of results, writing of text, formulation of conclusions;Pankova V.B. — research concept and design, discussion of results, writing and editing of text, conclusions.Funding. The study had no funding.Conflict of interest. The authors declare no conflict of interest.Received: 27.11.2025 / Accepted: 25.12.2025 / Published: 15.02.2026

Introduction. The structure and prevalence of occupational and occupational-related pathology largely depends on the level of non-compliance with sanitary and hygienic standards of the harmful factors of the working environment at industrial facilities, as well as the completeness and quality of mandatory preliminary and periodic medical examinations of employees. Occupational health is actively studying the relationship between the hygienic parameters of production and the clinical and physiological parameters of the body to assess the occupational risk of pathological changes in the health status of workers, and therefore an interdisciplinary approach to the study of this issue is extremely relevant.The study aims to provide scientific substantiation of methodological approaches to assessing the occupational risk of upper respiratory tract pathology in workers of caustic soda production.Materials and methods. The authors have studied the peculiarities of the health status of 292 employees of a caustic soda production company. The work uses a set of hygienic, clinical, laboratory, morphological, instrumental, and statistical research methods.Results. The risk of upper respiratory tract pathology among employees of a caustic soda production plant is determined by a chemical factor due to the predominant content of chlorine gas and metallic mercury in the air of the working area. Researchers have established the peculiarities of the formation of pathological processes in the mucous membrane of the upper respiratory tract and bronchopulmonary system in workers of caustic soda production, depending on the variants and combinations of the influencing chemicals.The study identified key indicators characterizing the effect of chemicals on the state of the respiratory tract. These include: a shift in the pH of nasal secretions to the alkaline side, a violation of the functional integrity of the epithelial layer of the upper respiratory tract, expressed in a decrease in its transport activity, as well as morphometric changes manifested in an increase in the index of alteration of ciliated and multilayered squamous epithelium, indicating a violation of the regulation of physiological processes in the respiratory system, which can have negative consequences for her general condition. Further research in this area may contribute to the development of effective strategies for the prevention and correction of the negative effects of exposure to industrial aerosols on the health of workers.Limitations. The study is limited to a sample of individuals from certain professional groups.Conclusion. The risk of developing upper respiratory tract pathology in employees of caustic soda enterprises is due to a chemical factor with a predominant content of chlorine gas and metallic mercury in the air of the work area. Based on the results of the study of functional and morphometric shifts in the upper respiratory tract, the authors identified approaches to early diagnosis, prediction of the development of respiratory pathology and minimization of negative consequences for the health of workers in professional contact with caustic soda chemicals.Ethics. The survey of employees was conducted in accordance with the Ethical standard of the Helsinki Declaration of the World Medical Association "Ethical principles of conducting scientific medical research with human participation". All the surveyed signed an informed consent to participate in the study. There is a conclusion of the Local Ethics Committee of theNational Medical Research Center for Otorhinolaryngology (Protocol No. 04/2016 dated 09/07/2016).Contributions:Fedina I.N. — concept and design of research, text editing;Uchurov A.G. — collection and processing of material, statistical data processing, writing text;Serebryakov P.V. — research design, statistical data processing, text editing;Bolshakov A.V. — material processing, statistical data processing, text writing;Fayzova Yu.M. — research concept, material processing;Pankova V.B. — research concept, text editing.Funding. The study had no funding.Conflict of interest. The authors declare no conflict of interest.Received: 21.10.2025 / Accepted: 12.11.2025 / Published: 10.12.2025

Introduction. New technologies are being actively introduced in Russian railway transport – high-speed and high-speed traffic, automated control of technological processes using artificial intelligence. In this regard, the role of mental labour and the intensity of the labour process increases, which creates additional risks of health disorders. The purpose of the work is to determine the nature of changes in the functional state in the body of transport workers using modern production process technologies – automatic train guidance systems and remote train tracking. Materials and methods. Comparative hygienic and physiological studies of more thirty locomotive crews were carried out in production conditions when working in normal mode and using automated train management systems; 15 operator drivers and train drivers-instructors of the center for dispatching control and traffic control of electric trains. Results. A qualitative change in the occupation load of employees in locomotive crews has been established when using automated train management systems. An improvement in most indices of the production load of assistant drivers has been revealed, stipulating a possible transition to work without an assistant when using automated train driving. The analysis of individual components of the occupation load in employees in locomotive crews working in modern conditions of labour management designate its qualitative change due to the gain in the information component, which requires improvement of the system for assessing the readiness of employees associated with train movement for production activities. Limitations. The research was conducted with the participation of employees in locomotive crews without medical contraindications for work in the occupation and are allowed training work in accordance with the procedure provided by orders of the Ministry of Health and the Ministry of Transport of the Russian Federation. Conclusion. The gain in the information component causes a qualitative change in the occupation load in employees in locomotive crews working in advanced forms of labour management, which determines the requirements for assessing the readiness of locomotive crews for train work based on improved methods and criteria for evaluating performance for occupational selection and prevention of health disorders.

Introduction. The main tasks of the occupational pathology service are early diagnosis of occupational diseases, prevention of their formation, and in case of development, slowing down the progression. Due to the timely start of rehabilitation measures, it is possible to preserve employees' ability to work, and the employer — the labor potential of qualified personnel. In modern enterprises, it is necessary to create programs to provide workers with medical care at the early stages of the formation of diseases, to prevent their progression, the development of complications and the preservation of professional ability to work. The study aims are the scientific substantiation of methodological approaches to optimizing rehabilitation and preventive programs for employees of "dust−hazardous" professions. Materials and methods. The scientists have examined 254 employees of KAMAZ PJSC: 164 employees of the Foundry and 90 employees of other divisions of the enterprise. The work uses a complex of hygienic, clinical and laboratory, instrumental, statistical research methods. Results. The authors have established the features of the a priori and a posteriori risk of the formation of occupational pathology of the respiratory organs in the departments of a large machine-building enterprise. There is specificity of the development of respiratory pathology depending on the exposure characteristics and characteristics of the physico-chemical properties of industrial aerosols in workers of a machine-building enterprise. The researchers have developed and scientifically substantiated a methodological approach to the application of a set of measures aimed at reducing risk and preventing occupational pathology of the respiratory system in employees of a machine-building enterprise, based on a personalized assessment of harmful factors of the production environment, a differentiated approach to correcting modifiable risk factors. Conclusions. The authors justified the use of various rehabilitation and preventive programs for interned employees of the enterprise who have a high risk of developing occupational pathology of the respiratory system, developed a differentiated approach to the use of various rehabilitation and preventive programs based on the analysis of the dynamics of clinical and functional indicators reflecting the course of respiratory pathology under the influence of industrial aerosols of various compositions (formation of obstructive-restrictive disorders, changes in exercise tolerance, the dynamics of morbidity with temporary disability).

The article discusses the main, modern provisions of the programs of medical and social rehabilitation of patients with occupational diseases of the ENT organs. The criteria of the degree of loss of professional ability to work in hearing loss and malignant neoplasms of the upper respiratory tract are presented. Rehabilitation programs and forms are developed taking into account the needs of the victim in medical, social and vocational rehabilitation, taking into account the potential capabilities and abilities of the victim to carry out professional, domestic and social activities.

Introduction. In Russian railway transport, flaw detection is one of the reliable methods for assessing the quality of trackbed condition and the most important component of traffic safety. The working conditions of defectogram interpreters in railway transport refer to a complex form of work organization, because professional activities are carried out year-round in various climatic regions, under conditions of exposure to industrial noise and vibration, magnetic fields, etc., contact ultrasound, etc., as well as a number of factors of an unavoidable nature — work in conditions of moving vehicles. The study aims to carry out a comparative assessment of the production load of specialists in decoding flaw patterns of removable and mobile flaw detection equipment in railway transport, depending on intra-group differences in working conditions. Materials and methods. The authors conducted industrial physiological and hygienic studies with the participation of operators of flaw detectors with different working conditions - decoders of the stationary Center, flaw inspection vehicles and flaw detection wagons. The study was of a complex nature and was carried out at the workplaces of employees, including in the direct performance of official duties. We used timekeeping, professional, and physiological indicators and recorded indicators of functional systems both remotely and through short-term three inspections during the shift. Results. Using the example of decoding engineers, scientists have shown a high production load throughout the entire work shift, characteristic of representatives of all three studied objects, with its greatest severity among employees of the stationary defect decoding center. We noted the greatest deviations in accommodation indicators by the end of the work shift, which indicates fatigue of the visual analyzer, requiring the use of rehabilitation measures. Conclusion. There is a high production load and the lack of formation of a stable dynamic stereotype of work, which is associated with a high degree of tension in the work process of employees of all groups of flaw detectors in railway transport. The load is most pronounced among the decoding engineers of the flaw detection centers, which requires the organization of a monitoring system for their professional reliability, optimization of work and rest modes. Ethics. We have conducted the study in compliance with Ethical principles and the voluntary consent of the participants.

Introduction. Diseases of cardiovascular system are the leading causes of morbidity and mortality among the able-bodied population. There have been no studies of the impact of the COVID-19 epidemic on cardiovascular mortality in Russian Railways. The study aims to analyze the mortality of Russian Railways employees from diseases of the circulatory system during the COVID-19 pandemic with the working-age population of the Russian Federation. Materials and methods. The study was carried out on the basis of data obtained during the COVID-19 pandemic (2019-2021). Information on the mortality of employees of JSC "Russian Railways" is formed on the basis of the data of the CHUZ of JSC "Russian Railways". Information about the natural movement of the working-age population was formed on the basis of data from the Unified State Register of Civil Status Records. Results. During the pandemic, the mortality rate in JSC "Russian Railways" was 2.2 times lower compared to the working-age population of the country. Excess mortality by road polygons was different. The maximum mortality rate (3.4 per 1000 employees) was among employees of enterprises of central subordination, the minimum (2.1) was on the Northern Railway. 82.5% of deaths occurred in men, while the mortality rate among men is 2 times higher compared to women. The main cause of death of workers were diseases of the circulatory system (BSC) - 28.7%. The mortality rate from BSK in JSC "Russian Railways" was 0.656, which is 2.9 times lower than for the working-age population of Russia. Conclusion. The study showed that under the conditions of a new coronavirus infection, the mortality rate from circulatory system diseases in Russian Railways employees is lower than in working-age population of Russia. Ethics. We have carried out this study in accordance with the rules of good clinical practice and the Helsinki Declaration. The study did not require the conclusion of the Ethics committee.

Occupational hearing loss in the civilian flight crew members prevails in the structure of occupational hearing loss. The study was aimed to assess errors made in forensic evaluation of flight personnel with hearing loss. A total of 213 definitive diagnoses of occupational hearing loss established in 2015–2021 were assessed. Expert errors were found in 73% of cases. The most common, typical errors were reported that were evident in 12 cases submitted for forensic evaluation. The main errors were as follows: incorrect assessment of the parameters of noise inside the aircraft cabin, lack of knowledge about the clinical and audiological features of noise-induced hearing loss, incorrect assessment of audiological indicators, underestimation of the role of comorbidities, etc. The findings showed that high proportion of occupational hearing loss in the civilian flight crew members was in large part due to imperfection of expert solutions resulting from the lack of knowledge about the basic criteria of the diagnosis and the relationship between the noise-induced hearing loss and profession. The major requirements for evaluation of the relationship between the noise-induced hearing loss and profession and the issues related to professional suitability set out in the current regulatory documents issued by the Ministry of Health of the Russian Federation and seminal publications were not taken into account. The cornerstones of expert work on the issues of the relationship between the hearing organ disorder and profession in the civilian flight crew members were underestimated. This resulted in unsubstantiated professional unsuitability, disability among working-age people, and economic losses.

Introduction. In the period from 2013 to 2021, industrial enterprises saw a reduction in jobs that did not meet sanitary and hygienic requirements for the level of exposure to noise, vibration, illumination, microclimate parameters and electromagnetic fields on the workers' bodies. However, the proportion of unfavorable workplaces that do not meet the standards for noise levels remains the largest, which determines the peculiarities of the structure of the occupational pathology of workers in the Russian Federation: professional pathology of the hearing organ - professional sensorineural hearing loss - remains in the first place. The transport industry is among the sectors of the economy with the most significant indicators of occupational diseases exceeding the average Russian indicator. The study aims to analyze additional causes of pathogenetic significance in the development of professional hearing loss using the example of employees of the driving professions of railway transport and flight professions of civil aviation aircraft. Materials and methods. We have analyzed the state of the auditory function in members of locomotive crews of JSC Russian Railways for 2017-2021 according to the Territorial Administration of Rospotrebnadzor for Railway Transport and persons of flight professions of civil aviation aircraft of the Russian Federation for 2010-2020 according to the data of the Federal Center for Hygiene and Epidemiology. Results. Professional sensorineural hearing loss prevails in the structure of occupational morbidity of railway and aviation transport workers. Despite the absence of excess in-cabin noise levels, the leading professional group for hearing loss in railway transport are locomotive drivers and assistants, in civil aviation - aircraft commanders and co-pilots. The complexity of the professional activities of persons of these professions, a high degree of responsibility for the safety of transportation of passengers and cargo, readiness to act in non-standard conditions, loads on visual and auditory analyzers, create a high degree of labor intensity that causes chronic stress. The factor of chronic stress causes a violation of adaptive mechanisms and causes a number of complex neuro-reflex and neurohumoral shifts in the body, as a result of which labor intensity need to consider as a pathogenetically significant factor in the development of professional sensorineural hearing loss. Conclusions. Chronic sensorineural hearing loss is a priority occupational disease in persons of driving and flying professions, it is registered even in persons working in conditions of regulatory levels of industrial noise and a high degree of labor intensity. It is necessary to discuss the possibility of including labor intensity indicators as an additional etiological, pathogenetically significant factor in the expert criteria for establishing the connection of hearing loss with professional activity.

If a worker uses filtering respirators to protect against toxic gases, the cartridges must be replaced promptly, as they have a limited service life. If the service life exceeds the length of the job, the cartridges can be reused in some cases. However, toxic substances can desorb and migrate during storage; and then be released into the inhaled air. So, the cartridges can become a source of hazard themselves. The risk depends on the properties of gases, cartridges, and the conditions in the workplace and during storage. The sensory response to inhaled gas has proven to be an unreliable indicator of the end of service life, and its use has been prohibited. We prepared this article using the results of a search for relevant information in Journal of the ISRP; publications of National Institute for Occupational Safety and Health, U.S. Occupational Health and Safety Administration (OSHA), Taylor & Francis, Springer, Oxford University Press; western law requirements for respiratory protection, and textbooks. The article describes the results of studies of gas desorption during cartridge storage. Researchers have found that hazards can occur when protecting against organic compounds with different boiling points and some inorganic substances. A significant difference is shown between the amount of available information and the possible reuses of the cartridges. There are different ways to protect workers: prohibit the reuse of cartridges when protecting against most hazardous substances; prohibit reuse without the permission of the cartridges manufacturers; limit the duration of their use. If the service life is long enough, the cartridges may be used within their limits (including breaks for storage). Mathematical modelling for risk assessment is described, and recommendations for improved training and workers protection are provided. If a worker uses filtering respirators to protect against toxic gases, the cartridges must be replaced promptly, as they have a limited service life. If the service life exceeds the length of the job, the cartridges can be reused in some cases. Nevertheless, toxic substances can desorb and migrate during storage; and then be released into the inhaled air. So, the cartridges can become a source of hazard themselves. The risk depends on the properties of gases, cartridges, and the conditions in the workplace and during storage. The sensory response to inhaled gas has proven to be an unreliable indicator of the end of service life, and its use has been prohibited. The article describes the results of studies of gas desorption during cartridge storage. Researchers have found that hazards can occur when protecting against organic compounds with different boiling points and some inorganic substances. A significant difference is shown between the amount of available information and the possible reuses of the cartridges. There are different ways to protect workers: prohibit the reuse of cartridges when protecting against most hazardous substances; prohibit reuse without the permission of the cartridges manufacturers; limit the duration of their use. If the service life is enough long, the cartridges may be used within its limits (including breaks for storage). Mathematical modeling for risk assessment is described. Conclusion. Recommendations on improving the protection of workers have been given. They include: improvement of respiratory approval requirements, development of the law requirements for their use, training of occupational health and safety specialists and workers.

New regulations of professional selection and professional suitability for the state of auditory function for persons entering for the first time and already working under the influence of harmful and (or) hazardous production factors are discussed.

Introduction. Drivers and assistant drivers directly manage rail transport. The number of employees of locomotive brigades in 2018 amounted to about 140 thousand people. A significant number of driver jobs and their assistants are characterized by third class working conditions. Purpose of the study. Study of medical and social characteristics and production risk factors of locomotive crew employees. Material and methods. In 2018, 7.6% of locomotive teams employees were interviewed from their full-time number using STEPS tool and questionnaire on production risk factors. The study was carried out on all railways of the Russian Federation. 10476 questionnaires are collected. Results. 55.5% of the respondents indicated their work schedule to be abnormal; 60% of workers reported about extra-working time. More than 50% of workers told earlier start of work, 43% said about later ends. 86% of respondents believed that work hurt their health. 96% of drivers complained about the low air temperature in the cabin during the winter period, 83% reported about the need to carry out repair works during the flight, 69% say about overheating in the house in the summer, 61% wrote about the need to make a lot of movements in the place during operation, 51% reported about noise, and 52% told about vibration. Conclusion. The working schedule of at least 50% of respondents is not optimal. More than 60% of workers note not good hygienic working conditions. The ongoing work of Russian Railways JSC on the modernization of the locomotive fleet partly eliminates some of the above-mentioned occupational risk factors, which adversely affect employees’ psychoemotional and physical condition of locomotive teams.

OBJECTIVE:Analysis and comparison of clinical guidelines (CG) on malignant neoplasms of the respiratory system, placed in the CG rubricator of the Ministry of Health of Russia, for the information they contain on the role of factors and working conditions of the working environment in the etiology of respiratory diseases, including the upper respiratory tract, and comparison this information with published and regularly updated data from the International Agency for Research on Cancer (IARC).MATERIAL AND METHODS:Clinical recommendations from the heading of the Ministry of Health of Russia "Cancer of the laryngopharynx", "Cancer of the nasopharynx", "Cancer of the oropharynx", "Cancer of the nasal cavity and paranasal sinuses", "Cancer of the larynx", "Cancer of the trachea", "Cancer of the lung", and IARC data according to the List of Classifications by cancer sites with sufficient or limited evidence in humans dated 11/29/2019.RESULTS:The low level of registration of occupational cancer of the upper respiratory tract in Russia is due to an inadequate system of criteria for detecting this form of occupational pathology, a long latency period of diseases, and insufficient assessment of the history of information on the potential role of occupational carcinogens. The CGs developed to optimize the diagnosis and treatment of malignant neoplasms of the respiratory system do not contain up-to-date information on the role of professional potential carcinogens in the genesis of malignant neoplasms.CONCLUSION:Recognition of the professional nature of malignant neoplasms of the respiratory system implies, firstly, strengthening the role of otorhinolaryngologists in early diagnosis and rehabilitation of patients, and secondly, it has a pronounced preventive focus in the form of tasks facing the employer to reduce the carcinogenic load and develop preventive measures aimed to reduce and prevent the development of malignant tumors in workers, including the respiratory system.

Occupational diseases of the upper respiratory tract (URT) represent a significant section of occupational pathology of the respiratory system, since the mucous membrane of the nasal cavity and paranasal sinuses is the outpost that first comes into contact with inhaled agents (pollutants), including professional aerosols. The pathogenesis of occupational diseases of URT is based on long-term contact of pollutants with cells of the scintillating epithelium and violation of the function of the mucociliary system of URT. Occupational diseases of URT include: chronic catarrhal, subatrophic, atrophic, hypertrophic rhinitis, rhinopharyngolaryngitis; all forms of laryngitis, laryngotracheobronchitis, allergic diseases. Treatment and prevention of these diseases should be comprehensive with the use of personal respiratory protection equipment, mandatory preventive examinations and various local effects (inhalation, instillation, lavage, herbal medicine, etc.).

Preserving the working longevity of locomotive crew employees is one of the priority tasks of Russian Railways. The urgency of the problem is related to both the medical aspects of railway traffic safety and the importance of preserving human capital. The aim of study is to research the influence of occupational and behavioral risk factors on health disorders in drivers and their assistants. The study included the results of a survey of 9308 employees of locomotive crews on the presence of production and behavioral risk factors for health disorders, as well as on the presence of cases of temporary disability, hospitalization or unscheduled medical care in the previous year. Additionally, the results of clinical and laboratory studies were studied. Noise exposure is the main production factor affecting the unscheduled attendance of locomotive crew employees to the doctor, the number of cases of temporary disability and hospitalization. Only 13% of respondents have a high level of commitment to a healthy lifestyle. Among employees who are not exposed to industrial noise, the number of people who have a high commitment to a healthy lifestyle is 2 times higher than among those who complain about the presence of an acoustic factor. The main differences in adherence to a healthy lifestyle between people who have and do not have complaints about the negative impact of the sound factor are related to alcohol abuse (1.4 times more often used by people working in conditions of noise exposure), frequent use of semi-finished products and fatty foods (1.2 times more often). Among people exposed to industrial noise, a body mass index (BMI) exceeding 25 kg/m2 is 1.5 times more common than in people who do not have noise exposure. The frequency of occurrence of blood pressure is more than 130/80 mm Hg. and blood cholesterol more than 5 mmol/l, respectively, is 1.9 and 2.2 times higher in individuals with intra-cab acoustic load, compared with those without. An increase in the number of cases of temporary disability, hospitalization, and unscheduled visits to a doctor in people who report exposure to noise in the driver's cab may be associated with both occupational and behavioral factors: alcohol consumption, poor nutrition, and a high proportion of people with a BMI exceeding 25 kg/m2.

The article discusses the issues of adjustment, developed in 2007 and supplemented in 2009, of the methodology for evaluating the equivalent level of cabin noise of civil aviation aircraft in Russia. The relevance of the problem is due to high levels of professional hearing loss among the aircrew members of the air force, which is directly related to the lack of unified and competent approaches to assessing the acoustic load on the hearing organ of the aircrew members. The updated methodology contains full-fledged data on noise levels in modern domestic and foreign airliners, data on certification of acoustic efficiency of aircraft accessories, a direct algorithm and formulas for calculating the noise load for the selected periods of flight operation.

Covers the main expert diagnostic errors diagnostic and examination for hearing loss from exposure to noise, imperfection of normative and regulatory documentation, inadequate attention to the criteria the Association of the disease with the profession, lack of qualified health workers

The article discusses the issues of a new coronovirus infection CAVID-19, which suddenly appeared from the end of January 2020. in China and actively, widely spread around the world. The SARS-CoV virus is assigned to group II pathogenicity. The entrance gate of the pathogen is the epithelium of the VDP and epithelial cells of the stomach and intestines. The main source of infection is a sick person who transmits SARS-CoV-2 by airborne droplets and contact. There is a high risk of developing epidemic foci CAVID-19 in medical institutions in case of violation of sanitary and anti-epidemic regime and the risk of epidemic foci in groups of organizations with non-compliance with infection prevention measures. On the basis of the Decree of the President of the Russian Federation dated may 06. 2020 №313 of the Ministry of health of the Russian Federation, together with the FSS and Rospotrebnadzor, additional insurance guarantees are provided to doctors, middle and Junior medical personnel of medical organizations, drivers of ambulances who work directly with patients who have confirmed the presence of a new coronavirus infection (COVID-19). Insurance cases, when a one-time insurance payment is made, are persistent loss of working capacity by a medical worker as a result of complications after a previous illness caused by a new coronavirus infection (COVID-19), confirmed by laboratory research methods, if the disease occurred during the performance of their work duties.