; 2 ФГБОУ ВПО «Башкирский государственный медицинский университет», Уфа Статья написана по результатам исследований, которые финансировались программой Академии Наук Республики Башкортостан «Здоровье населения Республики Башкортостан: профилактика заболеваний, медицинские технологии, здоровый образ жизни». Исследования проведены в подстанции скорой медицинской помощи крупного района мегаполиса. Изучали факторы производственной среды и трудовой деятельности (химические, физические, биологические, тяжесть и напряжённость труда) работников бригад скорой медицинской помощи. Проведён углублённый медицинский осмотр 136 врачей и фельдшеров с участием терапевта, невролога, оториноларинголога, офтальмолога, гинеколога и с применением лабораторно-инструментальных методов. Анализ клинико-гигиенических параллелей позволил выявить и обосновать три ведущих вредности в трудовой деятельности: длительное воздействие транспортной вибрации (более 8 часов), уровни которой превышали нормативы, высокую психоэмоциональную напряжённость и несбалансированное питание, обусловленное разъездным характером работы. Выявлена связь заболеваемости работников скорой медицинской помощи с ведущими вредностями. Клиническая и гигиеническая оценка указанной зависимости позволила разработать описательную и прогностическую модель профессиональных рисков. Предложены управленческие решения по оптимизации условий труда и снижения рисков здоровью медицинских работников станции скорой помощи. Ключевые слова: условия труда, здоровье, скорая медицинская помощь, профессиональные риски. Скорая медицинская помощь -это система круглосуточной экстренной помощи населению при угрожающих жизни состояниях на дому и/или в местах чрезвычайных происшествий, на путях транспортировки больных и поражённых в лечебно-профилактические учреждения [1]. CLINICAL AND HYGIENIC ESTIMATION PROFESSIONAL RISKS TO HEALTH OF MEDICAL WORKERS OF STATIONS

Introduction. Reproductive system disorders, according to many authors, are among integral indicators of sanitary hygienic ill-being of territories and reflect an environmental aggression degree. Ecologic and hygienic studies of reproductive health, conducted in some entities of Russian Federation, demonstrated that environmental substances with mutagenic and reproductivity compromising activity increase prevalence of congenital anomalies 1.4–1.8 times over the reference values. During 2000–2010, prevalence of congenital anomalies in Russia varies within 30.0–30.9‰.Objective. To reveal epidemiologic features of congenital anomalies development in ecologic situation formed by various economy branches.Materials and methods. Ecologic and hygienic evaluation covered reproductive health of women residents in ecologically unfavorable regions. Th e work contained also information on sanitary and hygienic state of environment and public health state, taken from offi cial and public materials of Rospotrebnadzor and Health Ministry of Bashkortostan Republic over 2009–2016.Results. Congenital anomalies in fetus increased. In 2015, 21.4 congenital anomalies were registered per 1,000 children aged under 1 year. High levels of congenital anomalies over 2000–2015 were seen in regions of ores mining and extraction, with high content of heavy metals affecting reproductivity (copper, chromium, zinc, cadmium, cobalt, nickel, lead, mercury, manganese, etc.) — in these regions, incidence of congenital anomalies was 3.78 times higher than general level in the Republic.Conclusions. Congenital anomalies levels obviously characterize reproductiverisk of ecologic situation, can be a criterion of sanitary epidemiologic ill-being and serve as an indicator in social hygienic monitoring.

Introduction. Phthalates are substances widely used as plasticizers for the production of various industrial, domestic, food and medical polymer materials. Possessing high volatility, solubility, a wide range of toxic effects, phthalates represent a serious danger to human health. Goal. Identify the characteristics of donosological forms of impaired health. Material and methods. A special clinical and functional examination of the aparatics for the first time started their work in the production of terephthalic acid (TPA), purified terephthalic acid (oTPA) and polyethylene terephthalate (PET) in the dynamics of 5 years of operation of the enterprise POLYEF. Hygienic, hematological, cytochemical and biochemical studies were performed for workers with a primary 5-year experience in this industry. Results. It is established that the chemical factor is represented by a complex of harmful substances of 1 to 4 hazard classes, among which there are substances of irritating, general toxic, allergenic action. The production of phthalates is characterized by an increased content of TPA from 1.5 to 2.8 MPC. Discussion. The working conditions of the apparatchiks in all industries are estimated as harmful to the third degree - 3.3. Among those who have worked for 5 years, about a third of workers are recognized with clinical and functional disorders. For 5 years of work, two of the first three come into contact with phthalates revealed changes in the blood system that go beyond physiological fluctuations. Most workers have anemia, reticulocytosis, thrombocytopenia, eosinophilia, lymphocytosis, decreased activity of enzymes. Conclusions. The introduction of a differentiated approach, taking into account the results of the clinical, hygienic and laboratory-diagnostic studies carried out, will allow monitoring of the health status of workers in the production of TFA and PET, identify early donosological signs of health disorders, and adequately form high-risk groups for conducting therapeutic and preventive measures.

Clause analyzes the reasons of professional risks for health of the personnel of exit brigades of the first help. Clinical and hygienic researches in regional substation of a megacity have shown that in labour activity of these workers it is necessary to consider as leading professional harm action of transport vibration. The given circumstance and other reasons provide professional risks of development of illnesses of cardiovascular, bone-muscular system, a gastroenteric path. The interdepartmental complex of actions on improvement of operating conditions of the exit personnel is offered.

The results of the of the study cohort of young workers, who started his career with the initial of «POLIEF». Dana hygienic assessment of working conditions as risk factors for production of terephthalic acid (TPA), purified terephthalic acid (PTA), polyethylene terephthalate (PET). Submitted comprehensive medical research enterprise major workers. Key words: chemical manufacturing, health, work-related