Согласно литературным данным, у спасателей чаще всего диагностируются заболевания органов пищеварения, дыхания, костно-мышечной системы и соединительной ткани, системы кровообращения. Показано, что уровень забо-леваемости среди лиц опасных профессий выше, чем в популяции. Выявлено, что заболевания системы кровообраще-ния являются наиболее частыми причинами, приводящими к инвалидности пожарных. Установлено, что каждый пя-тый случай патологии эндокринной системы у спасателей -ожирение, и у спасателей, страдающих ожирением, в 100% случаев были диагностированы заболевания органов пищеварения и эндокринной системы, в 76% -болезни костно-мышечной системы. Отмечено увеличение частоты онкологических заболеваний у пожарных.Ключевые слова: лица опасных профессий, заболеваемость, сердечно-сосудистые заболевания, ожирение. 5 Department of Adaptive Physical Culture and Sports Medicine of Moscow State Academy of Physical Education, Moscow Region According to the literature data, rescuers are often diagnosed digestive, respiratory, musculoskeletal circulatory and connective tissue disorders. It is shown that the incidence rate among persons of hazardous occupations is higher than in general population. It was found that diseases of the circulatory system are the most frequent causes of disability among firefighters. It was found that each fifth case of the endocrine pathology in rescuers is obesity and 100% rescuers with obesty suffer from digestive and endocrine diseases, and 76% -musculoskeletal diseases. It was revealed the significant increase in the incidence of cancer among firefighters. SOME FEATURES OF MORBIDITY IN PERSONS OF HAZARDOUS OCCUPATIONS

INTRODUCTION. Preserving the health of the working population is a priority task of modern medicine; in this case, special attention should be paid to specialists working under the influence of harmful production factors, such as noise, vibration and other physical and chemical factors. Such professional groups include employees of railway transport, in particular, employees of locomotive crews. The most common occupational disease in this occupational group is sensorineural hearing loss. The review presented the main areas of work on the treatment and rehabilitation of locomotive crews workers, depending on the degree of hearing loss. The effectiveness of early diagnosis, the need to form risk groups for dynamic observation and in-depth examination, the use of various medicinal and physical methods to restore auditory function in the initial manifestations of hearing loss, which will keep qualified personnel able to work in their profession, were analyzed. Non-specific changes associated with noise exposure and methods for their correction were also considered. AIM. To summarize literature data on the organization of rehabilitation programs for employees of locomotive crews with occupational sensorineural hearing loss. CONCLUSION. The development of rehabilitation programs for the correction of auditory function in employees of locomotive crews requires an integrated approach, with the earliest possible start of rehabilitation measures, the use of medical and physical methods of medical rehabilitation.

Due to the progressive increase in the incidence of endocrine pathology in the world, the issues of prevention and treatment of this group of diseases become topical. Diseases of the endocrine system are often accompanied by the development of comorbidities and complications, which negatively affects the quality of life and survival of patients. Currently, the features of the trace element status in patients with various diseases are actively studied. Numerous modern studies are devoted to the question of the influence of the balance of trace elements on the etiology and pathogenesis of diabetes mellitus, obesity and some thyroid diseases, including autoimmune ones. The role of iodine, selenium, iron, zinc and copper in the development and progression of these diseases has been established, but the results of these studies are sometimes contradictory. This review presents the data obtained by national and foreign researchers on the role of trace elements in the development of endocrine pathology, gives a brief description of the most significant mineral substances, as well as the effect of their imbalance on the structure and function of the organs of the endocrine system. The need for further study of this issue is discussed, taking into account concomitant diseases, as well as the mutual influences of mineral substances on each other, which can lead to a change in the concentration of trace elements in the body.

Comorbidity is an important problem of modern medicine, the study of which is a priority for public health. According to  the literature, the prevalence of comorbidity reaches a third of the population in some countries, while there is a tendency for an increase in the number of such patients in all age groups. In the context of the COVID-19 pandemic, the presence of   comorbidity in patients is a significant risk factor affecting the course and prognosis of a new coronavirus infection; at the same time, it is comorbid patients who belong to the most vulnerable group. The review presents data indicating a significant impact of comorbid pathologies on an increase in the number of complications and mortality; the most common combinations of diseases in patients with a new coronavirus infection were analyzed. There is an increase in the prevalence of comorbidity in all age groups, which dictates the need to develop an integrated interdisciplinary approach for such patients. The vast majority of clinical guidelines for the  treatment of comorbidities in COVID-19 are mainly focused on individual diseases, which limits the use of these algorithms in comorbid patients. Due to the high risk of contracting a viral infection, as  well as the frequent development of   complications and mortality in comorbid patients, preventive measures should be  focused simultaneously on two tasks: measures aimed at preventing infection with COVID-19 and compensating for  comorbid pathology. In the case of SARS-CoV-2 infection, careful monitoring of such patients, most often in a hospital setting, is necessary in order to prevent complications and adverse outcomes.

Introduction. Factors affecting the severity of the course of a new coronavirus infection remain unexplored to the endAim. To study the factors associated with the transition of COVID-19 from moderate to severe form of the disease in patients undergoing inpatient treatmentMaterials and methods. The diagnosis of COVID-19-associated pneumonia was made by a clinician on the basis of PCR test data and an up-to-date chest CT scan. A total of 195 consecutively recruited patients were examined. The average age of the surveyed was 54 (12.1) years.Results. Significantly more patients with severe coronavirus infection at the time of hospitalization were active tobacco smokers (33 (29.73%) vs 67 (79.6%); p < 0.002) and had a BMI consistent with pre-obesity/obesity (42 (37.84%) vs 44 (52.38%); p = 0.027). In patients with severe COVID-19, a significantly higher content of leukocytes was noted in the complete blood count (6.054 (2.813) vs 7.307 (4.707); p = 0.021). The groups also differed significantly in the content of micro- and macroelements. The imbalance of minerals revealed in our study is published for the first time, because. The study of the content of Al, B, Li, Co, Sr and Si in patients with COVID-19 was not carried out.Conclusion. The revealed changes in the microelement status require further study to confirm their significance in the development of a severe form of a new coronavirus infection in patients.