Introduction: In the Sverdlovsk Region, the risks posed by cadmium, arsenic and lead exposures account for higher disease rates in the most sensitive groups of population. Recent studies have shown that these toxicants have an effect on mineral metabolism, damage to liver cells, kidneys, immunity indicators, and the nervous system. Objective: To assess the levels of cadmium, lead and arsenic in biological fluids of preschool children aged 3–6 years, living in towns with developed non-ferrous metallurgy, and possible changes in the health status at the detected level of toxicity. Materials and methods: The study was conducted in six towns of the Sverdlovsk Region with developed non-ferrous metallurgy. Environmental pollution in the study areas was assessed based on data of socio-hygienic monitoring. Biological monitoring was carried out to establish the levels of toxicants in blood and urine of children. A descriptive analysis of chronic morbidity in preschool children was performed, and the results of a special health examination of children (including that by a pediatrician and a neurologist) were presented. Mathematical modeling using decision trees was carried out. Results: Health monitoring data indicate an excess of the average regional prevalence rates in the studied preschoolers in nine disease categories. According to the results of an in-depth examination of the preschool children, diseases of the skin and subcutaneous tissue, diseases of the respiratory system, blood diseases and individual disorders involving the immune mechanism, and digestive diseases prevailed. Among concomitant diseases, the most prevalent were diseases of the digestive, nervous, and respiratory systems. Assessment of the neurological status showed that the largest percentage of children had residual cerebral insufficiency, attention deficit hyperactivity disorder, and cerebrastenic syndrome. Biomonitoring results indicated a higher level of lead, arsenic and cadmium in the biological fluids of those children. Mathematical modeling demonstrated statistically significant correlations between lead, cadmium, and arsenic concentrations in environmental objects, biomonitoring results, and clinical and laboratory examination data of children (the blood levels of alanine aminotransferase, zinc, total protein, phagocytic index, and the carrier of the marker of apoptosis CD95+). Conclusions: The results of biological monitoring were consistent with data on chronic morbidity in preschool children. Modeling data provided the body burden of toxicants, above which deviations of clinical and laboratory parameters from the reference values may occur. The findings can be used in implementation of targeted measures for disease prevention.

High levels of industrial development of the region’s areas caused long-term and continuous of habitat objects pollution. Based on socio-hygienic monitoring data, over 70 per cent of the Sverdlovsk Region population is exposed to a set of various chemicals, and children constitute the most sensitive risk group. Lead, cadmium and arsenic are priority contaminants of the habitat in industrial cities and towns of the region. According to the integral estimates, chemical contamination of the habitat by these toxicants forms non-carcinogenic risks to public health. The established non-carcinogenic health risks are confirmed by social and hygienic monitoring indicators of the children chronic morbidity level in organized groups and indicate a statistically significant excess compared with the average regional indicators. According to the mathematical modeling data, statistically significant interrelations were found between the content of lead, cadmium, arsenic in environmental objects and the biomonitoring results.

Introduction. SARS-CoV-2 can be transmitted by infected people without or with mild symptoms of acute respira-tory infection (ARI). Monitoring based on nucleic acid amplification techniques is used to measure the prevalence of ARI pathogens and to assess the effectiveness of preventive measures.The aim is to measure the prevalence of pathogens causing ARIs of viral etiology, influenza, and COVID-19 among individuals without ARI symptoms throughout age groups, to trace changes in the epidemic situation by weekly monitoring pathogens during the inter-epidemic period and at the beginning of a typical ARI epidemic season, to assess the effectiveness of medical masks for prevention of the above infections.Materials and methods. A total of 14,119 people (including 4,582 children) without ARI symptoms went through examination, including questionnaire surveys, in 26 regions of Russia from August to October 2020. Nasopharyn-geal and oropharyngeal swabs were tested by using AmpliSens ARVI-screen-FL, AmpliSens Influenza virus A/B-FL, and AmpliSens Cov-Bat-FL reagent kits (The Central Research Institute of Epidemiology of Rospotrebnadzor, Moscow).Results. 11.1% of the tested samples showed positive results; the rhinovirus prevailed (7.32%), while SARS-CoV-2 was detected in 1.66%. In autumn, the proportion of SARS-CoV-2 infected cases increased from 0.49% to 4.02% (p < 0.001). The SARS-CoV-2 RNA concentration was up to 1010 copies/mL.Conclusions. Differences in the prevalence of SARS-CoV-2 and rhinovirus among the age groups and over time were found and analyzed. Using of medical masks reduced the risk of infection with respiratory viruses and with SARS-CoV-2 by 51% and 34%, respectively. In case of prolonged exposure to a COVID-19 patient, healthy people must use a respirator for more effective protection. The individuals whose work was associated with a high level of social contacts were infected more rarely than other individuals in the same age group (p = 0.001); this fact supports the importance of anti-epidemic measures and commitment to their adherence by people whose profession entails frequent social contacts.

The article describes the organizational structure and results of the implementation of a unique interdepartmental system of targeted health care and disease prevention in risk groups of the most vulnerable categories of the population (children and pregnant women) resided in industry-affected areas, which is an integral part of the regional system of the management chemical risks for population health. The system is represented by a modular stepwise principle of taking a set of science-based hygienic, health care and disease prevention measures and includes hygienic diagnostics and multimedia health risk assessment; environmental epidemiology studies; biological monitoring of toxicants; evaluation of the personal multimedia toxic burden in the most vulnerable population groups; biological disease prevention, clinical and laboratory diagnostics and rehabilitation treatment of diseases, informing population about health risks posed by chemical contamination of the environment and measures of risk elimination and prevention; performance evaluation including a cost-benefit analysis. The system health management has been implemented since 2001 in 17 municipalities of the Sverdlovsk Region with the mean annual coverage of 11,000 preschool children, pregnants and women of childbearing age. In 75-80% of enrolled children, clinical and diagnostic indices improved, thus indicates to the health promotion: morbidity rate in these children decreased by 30-40%, disease frequency and duration became 2-4 times lower, and over 80 additional incident cases per 1,000 children were prevented. In 2005-2016, the prevented economic damage to public health exceeded two billion rubles. Since 2009, the system has been applied in the Republic of North Ossetia-Alania (the town of Vladikavkaz), the Orenburg Region (the towns of Mednogorsk and Gay), and the Krasnoyarsk Krai (the city of Krasnoyarsk).