The concept of the triad regulatory metasystem, which includes the neuroendocrine and immune regulation systems, is currently generally accepted. Changes occurring in each of the regulatory systems in response to the impact of technogenic chemical factors are also well known. This paper presents mathematical models of the immune and neuroendocrine system functioning, using the interaction between these systems in response to bacterial invasion as an example, and changes in their performance under exposure to chemical factors, taking into account the stage of functional disorders in a producing organ, using the performance of the bone marrow as an example.

1 Федеральный научный центр медико-профилактических технологий управления рисками здоровью населения, Россия, 614045, г. Пермь, ул. Монастырская, 82, 2 Пермский национальный исследовательский политехнический университет, Россия, 614990, г. Пермь, Комсомольский просп., 29Рассматриваются методические подходы к оценке риска здоровью населения при сочетанном воз-действии факторов среды обитания. Апробация методических подходов показала, что с их помощью мо-жет быть произведен расчет показателей индивидуального и популяционного риска, прогнозируемой продолжительности жизни, классифицирован уровень риска в соответствии с предложенной шкалой. Ус-тановлено, что при экспозиции комплекса химических факторов загрязнения атмосферного воздуха, транспортного шума, негативных факторов образа жизни неприемлемый (умеренный) риск здоровью формируется к возрасту 47 лет, высокий -к 58 годам. Максимальный вклад в формирование риска вносят факторы образа жизни -употребление алкоголя, курение, недостаточная двигательная активность. Про-гнозируемая продолжительность жизни сокращается на 12,3 года.Ключевые слова: оценка риска здоровью, эволюция риска, интегральный риск, прогнозируемая продолжительность жизни, факторы среды обитания.Современная санитарно-эпидемиологическая ситуация характеризуется сочетанным воздействи-ем разнородных факторов среды обитания на здо-ровье населения. К ним относятся биологические, химические, физические, социальные и иные фак-торы среды обитания, которые оказывают или мо-гут оказывать воздействие на человека и (или) на состояние здоровья будущих поколений [1]. В этих условиях существующие способы оценки риска здоровью населения, связанного с отдельными факторами и даже группами факторов, могут при-меняться только для решения локальных задач обеспечения санитарно-эпидемиологического бла-гополучия. В этой связи проблема оценки риска разнородных факторов среды обитания при их од-новременном воздействии является актуальной. При этом оправдано применение методических подхо-дов, с одной стороны, использующих уже имеющуюся

On the basis of the system review, the relevance of the problem of the chloroform content in the drinking water of centralized drinking-water supply systems in the Perm Territory is confirmed. The comparative characteristic with the average Russian indices is presented. Insufficient volume of information containing data on the impact of the oral intake of chloroform on the blood system was established. There are presented results of the research content of chloroform in water samples from centralized drinking water supply in the cities of Perm region, as well as in the blood of the child population aged from 3 to 13 years living in these areas and consuming water under investigation in the period from 2011 to 2015. A long-term dynamics of the content of chloroform, contained in samples of drinking water and in bio-environments is described. A mathematical simulation of the dependence of the chloroform content in the blood as an exposure marker on the concentration of chloroform in water was carried out. As a result of the analysis of the prevalence rate of diseases of the blood system, hematopoietic organs and certain disorders involving the immune mechanism in the child population, there was established the relevance of differences between the territories of Permsky Krai with surface and underground water supply. The dynamics of the chloroform content in water and morbidity according to the class of blood diseases, hematopoietic organs and certain disorders involving the immune mechanism is presented and described. The association between the exposure to the oral intake of chloroform with drinking water with a morbidity on the class of diseases of the blood system was established on the basis of constructing a mathematical model. The conclusion about the legitimacy of information on the effect of the oral intake of chloroform on the blood system, hematopoietic organs and certain disorders involving the immune mechanism is presented.

To know the processes occurring in the neuroendocrine and immune system, the complex and branching regulation mechanisms should be taken into account. Most of the studies in this area are dedicated to the biological and mathematical description of individual parts of the regulatory mechanisms, and it greatly facilitates the understanding of the phenomena being studied. But there is a lack of comprehensive description of the processes and internal communications. In the present article, a mathematical model for describing the antiviral immune response is considered taking into account the interacting regulatory influences of the immune and neuroendocrine systems. To describe the innate immunity, the proposed model uses parameters reflecting quantitative measures of the interferon concentration (the inductor of resistance to the infection of target organ cells) and NK-cells (responsible for removing of the infected cells). The simulation of acquired immunity is performed using parameters characterizing the concentration of virus-specific cytotoxic T cells and antibody-forming B lymphocytes. The regulatory mechanisms considered in the model cover the influence of the hypothalamic-pituitary-adrenal axis and the populations of the T-helper cells. The model is developed within the framework of the concept of a multi-level model of the human body, taking into account the interactions between systems and the functional state of the organs included in the review. The model also takes into account the spatial organization of immune and infectious processes in various organs and tissues, for which the delay time of interaction of the components is introduced. The model includes a system of 18 ordinary differential equations with a delayed argument, the parameters of which characterize the rates of various processes that affect the dynamics of infection. The parameters are identified according to published experimental data describing the process of infection of the body with a virus. The dynamics of the immune and neuroendocrine systems under viral infection was calculated, taking into account the disturbance of the synthetic function of the bone marrow. The study provides a qualitative picture of the biological factors that can explain the kinetics of the development of a viral infection.

Introduction. Preservation and growth of the country population is the top national priority in the Russian Federation. A contemporary approach focuses on several especially urgent demographic issues that can be resolved, among other things, due to public healthcare systems becoming more efficient. The present research work is vital due to the necessity to achieve target medical and demographic parameters fixed in the national and federal projects and regional programs. These parameters include life expectancy and mortality caused by cardiovascular and oncologic diseases. The goal of this work is a development of new approaches for the complex evaluation of potential management reserves of health population indicators and the prognosis of efficiency of targeted activities performed within public healthcare systems and aimed at increasing life expectancy through reducing mortality among the population caused by cardiovascular diseases and oncologic diseases. Material and methods. The work dwells on solving a “direct” task in the “medical activities - morbidity - mortality” triple analysis system; the solution involves predicting changes in morbidity and mortality under preset, planned, or scenario changes in parameters related to the public healthcare system. We modelled cause-and-effect relations in the above system, applying mathematical statistics techniques (correlation-regression analysis and factor analysis) with the consequent medical expertise of obtained results. Results. These procedures allow assessing health losses and spot out priorities in activities performed within the public healthcare system as well as ranking managerial decisions, already taken or only planned, as per their efficiency, taking into account territories; sex and age structure of the population; diseases, their subclasses and gravity; specific activities performed within the public healthcare system (prevention, diagnostics, or treatment). We should stress that the most significant potential management reserves of reducing mortality are achieved on territories with maximum mortality levels due to reserves for the reduction in it; these reserves are manageable due to prevention and early diagnostics. Conclusion. Research techniques and results described in the present work can be used in practice to achieve target parameters fixed by national and regional priorities and to select an optimal set of activities aimed at reducing mortality among the population.