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Introduction. Occupational asthma has long been considered as a separate, independent disease, but in recent years, more and more attention is paid to its heterogeneity. Molecular genotyping opens up new possibilities in the search for a more targeted and personalized approach to the treatment of occupational asthma, and in the development of an individual strategy for its prevention. The aim of the study was to determine genetic markers of the risk of developing occupational bronchial asthma under exposure to sensitizing substances by assessing polymorphic variants rs2069812 of the IL-5 gene and polymorphic variants rs1837253 of the TSLP gene. Materials and methods. The study was conducted in one hundred seventy patients with various phenotypes of occupational bronchial asthma and 50 people in the control group. Genotyping was performed by real-time polymerase chain reaction using primers and probes developed using the PrimerQuest program (Intergrated DNA Technologies, Inc.). Results. For the first time, genetic markers of the risk for occupational bronchial asthma under exposure to sensitizing substances were identified to include polymorphic variants rs2069812 of the IL-5 gene and polymorphic variants rs1837253 of the TSLP gene. It makes it possible to recommend the determination of these genetic markers during in-depth periodic medical examinations in people working under conditions of exposure to sensitizing and irritating substances in the presence of clinical and functional, immunological changes. Limitations. The study has regional (Samara region) and occupational (detailed working conditions in the studied comparison groups) limitations. Conclusion. The identified marker profiles of occupational asthma genotypes can optimize the approach to diagnosis, treatment, and prevention of this pathology, and expand the range of criteria for predicting the course of the disease.

Diseases arising from exposure to industrial aerosols remain an urgent problem and occupy a leading position among all occupational diseases. Scientists present clinical observations demonstrating the development of pneumoconiosis with a relatively short work experience in contact with fibrogenic dust slightly exceeding the maximum permissible concentrations. The rapidly progressing course is characterized by the development of the disease by the type of complicated pneumoconiosis with the formation of nodular fibrosis or an increase in profusion (severity) by more than one subcategory for five years. As a rule, it develops after ten or less years of work experience in contact with high concentrations of quartz dust. Researchers have considered the features of the occurrence and course of silicosis in persons in contact with industrial aerosols with a high mass fraction of silicon dioxide in production conditions.We have analyzed the situations demonstrating the development of pneumoconiosis with a professional experience of less than five years in persons who come into contact with industrial aerosol in low excess of the maximum permissible concentration of quartz dust, but with a very high mass fraction of silicon dioxide. An important condition in the prevention of pneumoconiosis should be mandatory periodic medical examinations with digital radiography of the lungs in two projections. The authors recommend performing computed tomography (CT) of the chest to persons working in contact with fibrogenic dust with a frequency of once every five years due to the fact that CT has a higher sensitivity and specificity for detecting reticular and focal seals in the lungs, as well as initial changes in the pleura. Ethics. The study was conducted in compliance with ethical principles and with the voluntary informed consent of the participants.

The new SARS-CoV-2 coronavirus and the COVID-19 disease caused by it in medical workers can be considered as an occupational disease if the infection occurred while they were performing their official duties. Along with damage to the respiratory system, SARS-CoV-2 can lead to hematological disorders, disorders of the nervous system, the development of autoimmune and rheumatic diseases. The presented clinical case describes possible serious multisystem pathological manifestations associated with a new coronavirus infection - pulmonary fibrosis, polyneuropathy. We have described the reinvention of SARS-CoV-2 with subsequent hematological disorders, complications from the musculoskeletal system in the form of aseptic osteonecrosis of the femoral heads. The scientists have presented the principles and results of the medical examination conducted in order to establish a causal relationship of the disease with the professional activity of a medical worker. We emphasize the need for a multidisciplinary approach to the diagnosis of manifestations, treatment of COVID-19 and its complications with the mandatory participation of a neurologist and rheumatologist.

Introduction. The novel coronavirus pandemic has a serious impact on the psychological health of healthcare workers. The purpose of the study is to investigate the syndrome of emotional burnout among medical workers. Materials and methods. Groups of medical workers in COVID hospitals (n=201), groups of medical workers in multidisciplinary hospitals (n=195), groups of outpatient medical workers (n=186), as well as a control group (n=190) were studied. Results. According to the Maslach Burnout test, group of medical workers of COVID-hospitals; a group of medical workers of the outpatient level a group of medical workers of multidisciplinary hospitals who provide medical care in their main profile have a significant increase in the indicators of “exhaustion” and “depersonalization” and a significant decrease in the indicator “reduction of personal achievements” compared with the control group. Medical workers of COVID-hospitals have significantly higher indicators of “emotional exhaustion” and “depersonalization” compared to medical workers of multidisciplinary hospitals (p≤0.001) and medical workers of outpatient clinics (p≤0.001). Medical workers in COVID hospitals have a significantly lower indicator of “reduction in personal achievements” compared to medical workers in general hospitals and outpatient clinics (p≤0.001). Limitations. As limitations, the following were identified: assessment of the dynamics of the burnout syndrome in future employees of COVID-hospitals, outpatient clinics and inpatients in the course of increasing seniority rises; assessment of the dynamics of the burnout syndrome in future specialists of COVID hospitals, outpatient clinics and hospitals, depending on the ongoing psychological and pharmacological correction. Conclusions. A comparative assessment revealed medical workers in COVID hospitals to have significantly higher rates of “emotional exhaustion”, “depersonalization” and lower values of the indicator “reduction of personal achievements”, compared with medical workers of multidisciplinary hospitals and outpatient clinics.

Introduction. The professional activity of medical workers (MW) is in close contact with daily contact with various factors of the production environment: physical, chemical, biological, and labor processes. Until 2020, tuberculosis and viral hepatitis prevailed in the structure of occupational diseases (OD) of the medical workers in the Russian Federation. According to the State report "On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020," the first ranking the second place in the structure of occupational diseases, depending on the impact of harmful production factor took the illnesses associated with the action of biological factors - 20,19%, while the main reason for the growth in the incidence of healthcare workers in coronavirus infection COVID-19 (further COVID-19). The study aims were to identify problematic aspects in the establishment of the COVID-19 work from MW. Materials and methods. We have given descriptions of clinical cases, as well as a retrospective analysis of issues of OD according to the patient registers of the following medical institutions: the Center of Occupational Pathology of Sechenov University, the Republican Center of Occupational Pathology of the Ministry of Health, Republic of Tatarstan, the Regional Center of Occupational Pathology of the Samara Region. Results. In 2020, COVID-19 was the most common OD with fatal outcomes and complications in healthcare workers. Today, difficulties in determining the connection of COVID-19 with the profession arise when assessing the epidemiological history, the consequences after a coronavirus infection, and the formulation of the diagnosis. Conclusions. For a qualitative examination of the connection of COVID-19 with the profession, it is necessary to develop a list of clinical conditions with the definition of the timing of complications.

At present, the preservation and strengthening of the health of the working population is one of the priority tasks of health care in the Russian Federation, including in the Samara region. Up to 39.7 % of the country's working-age population work in conditions that do not meet sanitary and hygienic requirements. Unsatisfactory working conditions are the main reason for the development of occupational diseases among the working population in the Samara region. 42 acute occupational diseases with permanent disability, including 13 acute occupational diseases with fatal outcomes from the biological factor «novel coronavirus infection caused by the COVID-19 virus», are registered in the workers of medical institutions. In the Samara region, there is a low detection rate of occupational diseases revealed in the course of preventive medical examinations — 43.08 %, this figure remains below the national average — 59.31 %.

Currently, work in any medical organization carries a risk of coronavirus infection, and, first of all, this applies to medical organizations dealing with the treatment of patients infected with coronavirus. Medical workers are a group at increased risk of infection with the SARS-CoV-2 virus in the provision of medical care in modern conditions, which determines their incidence of COVID-19 [1–3]. The aim of the study is to explore the prevalence of cases of COVID-19 infection in medical workers providing medical care on an outpatient basis. The analysis of the incidence of COVID-19 medical workers in one of the large medical organizations of the Samara region during the period of the pandemic was carried out. The medical staff of the medical organization includes 207 doctors. There are 11 subdivisions in the structure of the medical and prophylactic institution. Research methods: content analysis of the modern regulatory framework (2020-2021), statistical, expert. For the period from May 2020 to March 2021 71 cases of infection of medical workers on an outpatient basis with SARS-CoV-2 were identified, of which 32 doctors (45%) and 39 people (55%) nurses. Based on the results of the expert assessment, the insurance nature of the infection case was established in 50 people (70%). Among the medical and nursing categories of medical workers, the largest number of cases was made by doctors and nurses of primary contact — specialists of the district service: general practitioners (40%), pediatricians (32%), doctors — obstetricians-gynecologists (12%), nurses adults (76%) and children (20%) polyclinic departments. A third of health workers received inpatient treatment for severe COVID-19, an average of 60 days. Medical workers are a risk group of COVID-19 who need support measures, since the possibility of occupational infection has been sufficiently proven, and the risk probably depends on the work performed and the conditions of direct contact of medical personnel, which requires further study in the current persisting epidemic conditions. © 2021, Izmerov Research Institute of Occupational Medicine. All rights reserved.

Today, the "healthy worker effect" is understood as organized (on the part of the employer) and/or unorganized (self-selection on the part of the worker, due to the functional capabilities and the state of workers’ health) professional selection of healthier workers in unfavorable working conditions, who remain in the profession. It represents one of the most important problems in epidemiological research in occupational medicine. The “healthy worker effect” and its intensity in various industries (in various professions) can indirectly characterize the harmful and unfavorable conditions. The “healthy worker effect” and its intensity determine the need for medical and social security, as well as rehabilitation measures, not only for people who remain in this production (in this profession), but also for people who left this production or specialty, to prevent the phenomenon of increased mortality among workers who left a given production or profession due to suspension from work based on the results of periodic medical examinations and self-selection, or due to intolerance to working conditions because of the state of health.

The COVID-19 pandemic for healthcare workers is a situation of pronounced emotional stress in connection with professional activities. Healthcare professionals face new challenges in treating COVID-19 and, at the same time, they must also continue to successfully treat non-COVID-19 patients and fulfill personal responsibilities, including caring for their families and themselves. It is imperative to tackle the burnout problem affecting the wide range of healthcare professionals currently battling the COVID-19 pandemic.

The article is devoted to the study of spirographic indicators FEV1, FEV1/FVC, PEF, MEF75, MEF50, MEF25 as the most informative indicators reflecting the state of bronchial patency at the level of the proximal and distal parts of the bronchial tree in various phenotypes of professional bronchial asthma. Signs of respiratory distress are most pronounced in patients with the phenotype «PBA-occupational chronic obstructive pulmonary disease». Significantly,the» most favorable «spirographic picture in terms of FVC, FEV1, PEF, and MEF25VC is observed in the «PBA allergic» phenotype. Dynamic determination of speed indicators of forced expiration in various phenotypes of professional bronchial asthma can improve the diagnosis of obstructive disorders in this pathology, optimize the choice of treatment and prevention tactics, and predict the course of this pathology.

The article describes the features of behavior in difficult life situations of VB patients of various shapes and severity. Testing was carried out using the Lazarius copying test on the basis of the occupational pathology department of the Samara Health Unit No. 5 of the Kirov District State Health Institution SB. Non-adaptive coping strategies were identified for patients with WB: «confrontation», «acceptance of responsibility», «flight — avoidance», «planning».

Objectives - to study the severity of androgen deficiency and erectile dysfunction in patients with vibration disease and in its combination with arterial hypertension. Material and methods. 145 male patients with various forms of vibration disease were thoroughly examined. The following groups were defined - I stage and II stage vibration disease induced by local vibration; II stage, induced by local vibration with concurrent arterial hypertension; I and II stage vibration disease induced by whole body vibration; II stage vibration disease induced by whole body vibration with concurrent arterial hypertension. The control group included 30 patients. Evaluation of erectile function in men with vibration disease and its combination with arterial hypertension was carried out using the scale of severity of erectile dysfunction (International Index of Erectile Function, IIEF-5). The questionnaire for detection of androgen deficiency (Dedov II, Kalinchenko SYu, 2006) and the AMS (aging males' symptoms) questionnaire assisted in revealing the symptoms of aging in men. Results. According to the IIEF-5 questionnaire results the erectile dysfunction was defined in patients with vibration disease, most pronounced in II stage of vibration disease induced by whole body vibration and in vibration disease of any etiology with concurrent arterial hypertension. AMS-questionnaire presented the most expressed signs of androgen deficiency in patients with II stage of vibration disease induced by whole body vibration and in vibration disease of any etiology with concurrent arterial hypertension (p

Aim. To study epidemiology and risk of chronic obstructive pulmonary disease (COPD) in environmental and climatic conditions of a large industrial center of the Middle Volga Region (the city of Samara). Material and methods. The questionnaire survey was made in 2063 participants (903 males and 1160 females, the response rate 73.68%) divided into four age groups: 30-39, 40-49, 50-59, 60 years and older. The epidemiological study employed the standard questionnaire based of European coal and Steel Association questionnaire (1993). All the patients with identified respiratory problems were examined clinically and functionally to verify COPD diagnosis. Results. High COPD rate was detected in Samara - 14.49% of 2063 males and females examined (18.72% in males and 11.21% in females, p < 0.001). Leading COPD risk factors include old age, male gender, tobacco smoking, prior respiratory infections, chronic diseases of the upper respiratory tract, polluted environment, unmarried status, low education, alcoholism. Conclusion. Prevalence of COPD in population of Samara is close to that in other large industrial centers of Russia but lower than in larger cities of Europe and in populations of industrial workers. It depends on the age and has special characteristics in males and females.