Search

The main task of the military medical service in the area of work to eliminate the consequences of the Chernobyl nuclear power plant disaster was to organize and carry out sanitary and hygienic measures aimed at preventing radiation exposure to liquidators-military personnel in excess of the established dose limits and the emergence of mass infectious and non-infectious diseases. The article summarizes the experience of the participation of the employees of the S.M.Kirov Military Medical Academy in the implementation of anti-radiation and other preventive measures in the area of the accident. The entire faculty. of the Department of Naval and Radiation Hygiene and a number of employees of the Department of General and Military Hygiene, who on a rotational basis were continuously in the zone of work to eliminate the consequences of the accident, went through the mill of Chernobyl. Their personal contribution to the solution of urgent scientific and applied problems -of minimization of radiation impact and preservation of health of servicemen-liquidators of the accident were noted.

The article presents the investigational results of psychophysiological and social-and-psychological adaptation to military service in conditions of the European North of Russia in servicemen called up from different regions. During the first 6 months the positive dynamics concerning the communicative and personal adaptation potential and behavioral regulation was noted in all 239 servicemen. It was established that the representatives from northern region have lower potential possibilities of social-and-psychological adaptation to military service in the European North of Russia than the youths called up from other regions. Social-and-psychological adaptation to military service in the northern conditions was better than in the persons called up from the southern and central regions. The complete adaptation of servicemen at biological level wasn't observed.

Hemorrhagic fever with the renal syndrome (HFRS) is a typical natural-and-focal virus infection having military-and-epidemiological importance for Armed Forces of most countries. Severe forms of this infection are typical for the Far East of Russia, countries of South-East Asia and especially for the American continent. The lethality from HFRS amounts to 15-50%. The main natural carriers and keepers of HFRS stimulus are various mouse-type rodents. In Russia besides well-studied natural focuses on the Far East, Siberia, Ural, Povolge other active HFRS focuses were determined not long ago (Moscow, Orel, Lipetsk, Tula and Voronezh regions, the territory of Big Sochi). A man is infected by an aerosol, forming during drying up of rodents' urine, feces, saliva containing HFRS virus. Vaccinal prevention of HFRS in Russia hasn't yet been worked out. Ribavirin is the most effective in the treatment for HFRS. The means of prevention of population and servicemen must exclude their contact with rodents both in natural conditions and in populated areas.

In 2002 the analysis of parasitosis incidence in the servicemen of North-Caucasian military district was conducted in order to evaluate the risk of its spread and to optimize the ways of its prevention at the territory studied. One of the most important directions of prophylactic work is the training of specialists (parasitologists, laboratory physicians, epidemiologists, laboratory assistants) in the field of parasitology and early diagnosis of parasitogenic diseases in servicemen.

At the modern level of society development, on the one hand its Armed Forces are the object that requires the defense from unfavourable effect of environmental factors, on the other hand they are potential source of ecology worsening. The problem of ensuring ecological safety in the army and navy becomes urgent. In order to solve this problem first of all it is necessary to develop the conceptual bases of military ecology. Among all medical sciences the military hygiene by purpose, tasks, subject and objects is the most close to military ecology.

With local wars and armed conflicts the sanitary-epidemiological situation for the troops and local population shows a tendency to worsen. The main objects of the military medical service at the period of deployment are the preventive measures against troops infection from local sources by virus hepatitis A, bacterial dysentery, typhoid, cholera etc. As a rule, combat actions result in communal service destruction, low quality of potable water, soil contamination and worsening sanitary norms and standards. Also, there is a danger of reactivation of the natural centres of infection due to large-scale defence earthworks in the region of operations. The experience of the military medical service in Afghanistan and Chechnya proves, that a multimedia approach to preventive antiepidemic measures is necessary together with the emphasis on the most important actions against infections that represent the biggest danger for the land troops.

The article is dedicated to the outstanding figure in national medicine--colonel-general MD E.I. Smirnov (1904-1989), the Hero of Socialist Labour, member of the Academy of Medical Sciences of the USSR, who was the Head of the Main Military Sanitary Department of the Red Army during the Great Patriotic war, and the Minister of Health of the USSR in the post-war period. The main attention of the author is drawn on the contribution of E.I. Smirnov to the development of military medicine. The article makes a detailed analysis of the role of E. Smirnov in the development and practical implementation of military medical doctrine and the antiepidemic support system during the years of the Great Patriotic War, as well as his contribution for organizational arrangement of field therapy as an independent scientific discipline and as a subject of study in the system of medical education; his merits in organization of specialized medical care; formation of an institution of senior medical specialists; reforms in military medical education. The article contains many concrete examples which characterize a celebrated personality of E.I. Smirnov and his leadership qualities.

The article discusses the questions of the improvement of field water supply of troops. There is a proposal to create the Service of field water supplies as an element of the Logistic Command subordination, increase the water ration, improve the system of quality water control, create a unique system of expert control, reinforce the units of water supply in field hospitals and hospital bases, make regulations for water regimen of personnel in hot climate regions. There is a conclusion that the problem of water supply needs to be considered by the Command and Research establishments of the Ministry of Defence of Russia.

The article discusses the questions of the marines' activities during the mounting and staging of naval assault operation. The authors describe unfavourable factors of environmental conditions and limitations of manned objects of military technique. There are data concerning the health status and operational ability of the marines depending on characteristic features of various climatic zones, and stages of naval assault operation. The article emphasizes the role of sanitary-epidemiological control over water supplies, meals, and accommodation of servicemen in field conditions.

Sanitary-hygienic measures which were carried out in units during liquidation of the Chernobyl disaster consequences have assured favourable hygienic conditions and promote the accomplishing of their mission. Questions of accommodation, water supply and meals were efficiently resolved. Most complicated were the problems of territory clearing, personnel decontamination, as well as bath and laundry service in field conditions at radioactive contamination zones. Basic trends of prophylactic work were as following: hygienic normalization and regulations, sanitary-epidemiologic control and anti-epidemic measures.

On the basis of the experience in antiepidemic protection of troops several methods were worked out to make epidemiological estimation of laboratory researches which were conducted in order to disclose the risk factors that provoke infectious diseases. The main attention was focused on the problem of intestinal infections. It was stressed that the practical evaluation of fecal pollution index of water had to be done taking into account the level of infectious morbidity. In unsatisfactory indices of colimetry a threat of diseases in troops is much higher in the regions with frequent intestinal infections. In unfavourable regions with high viral intestinal infections the studies of water must be done after its purification and decontamination in order to reveal the presence of coliphages. On the basis of catering objects the article gives methods for differential estimation of the results of colon bacillus tests depending on epidemiological signification of environmental objects.

The method cited in this article gives the possibility to estimate (prognosticate) the temperature of air in the working zone at the mobile objects of the ground radio electronic complexes. This method is based on formulas which take into account the lineal dependency of the air temperature inside the manned sectors from the outside temperature, sunlight intensity, type of a mobile complex, ventilation regime, and the grade of heat diffusion made by radio electronic equipment. The proposed formulas could be used for estimation (prognostication) of temperature conditions of the mobile objects at the stages of their development or during operating periods.

The article deals with the occupational problems of pharmacies, discloses the main limitations in the organization of prophylactic measures, stresses the basic trends for the practice of physicians-hygienists. The authors propose to enhance the efficiency of the current control regarding the personnel. Besides all it is necessary to made an object classification of all military pharmacies, and estimate the hygienic and sanitary conditions of personnel. The article stands for the unique method which could estimate these conditions and proposes to make the analysis of the health state of personnel, taking into account age specific rates, sex, conditions of daily life and job performance.

As for prophylactic work, the main efforts of medical service were oriented to the reduction of non-combat medical losses. Prophylactic and current control was conducted taking into account the environmental conditions of the area. The authors make a conclusion that medical service at the initial stage of its activities was not properly ready to accomplish a variety of hygienic missions. It was especially difficult to carry out prophylactic measures aimed at the prevention of diseases and health states which were caused by specific environmental factors.

In the 40th Army the hepatitis A and typhoid morbidity in enlisted personnel of the 1st year service period was 2.5 times higher than in enlisted personnel of the 2nd year service period. The greatest number of these sick cases took place in autumn and winter periods. The seasonal up-grade of shigellosis and acute intestinal infections of non-dysenteric etiology had its beginning in April-May and ended in November-January. Some garrisons had achieved a considerable efficiency in prophylaxis of hepatitis A by 2-3 ml immunoglobulin injections 2 months before the expected up-grade (morbidity reduction by 3-4 times). The experience has shown that the struggle against intestinal anthroponoses had to be executed using a complex approach to its prophylaxis. This work must be done not only by physicians, but also by the representatives of the rear service.