One of the leading problems of modern health care is nosocomial infection of health care workers with bloodborne infections viruses, including parenteral viral hepatitis B and C. The aim of the study was to assess the frequency of detection of markers of hepatitis B and C based on the results of screening studies and the incidence of viral hepatitis B and C among medical workers and the general population of the Voronezh region, to analyze the structure of emergency situations in medical organizations. A retrospective descriptive study was conducted, the materials of which were data on the frequency of occurrence of markers of parenteral hepatitis, the incidence of viral hepatitis B and C among medical workers, and the frequency of registration of emergency situations. Analysis of the incidence and results of screening examinations for markers of viral hepatitis B and C among medical workers in the Voronezh region for the period 2011–2018 revealed a pronounced trend towards a decrease in the prevalence of this pathology. However, the indicators remain at a consistently high level among the staff of the hemodialysis, hematology, and surgery departments. The annual frequency of registering emergencies for the specified period was from 1.7 to 3.1 per 1000 workers. It has been established that most often medical accidents occur among middle medical personnel and auxiliary health care workers. More than half of the respondents (53.0 %) answered in the affirmative to the question about the emergency situation in their professional activities, only a fourth (26.0 %) carried out emergency postexposure prophylaxis of viral hepatitis B. Insufficient adherence of medical workers to timely accounting of injuries, low level of knowledge of algorithms of behavior in an emergency situation, a significant underestimation of emergency situations in medical organizations require close attention.

A retrospective analysis of clinical and immunological manifestations of COVID-19 was performed in 419 patients (women n=167 (39.8 %) men n= 252 (60.2 %)) aged 20 to 80 years. Mild stage I (early infection) in patients was mainly manifested by symptoms characteristic of other acute respiratory infections. Distinctive features were the loss (distortion) of smell and taste. The clinical manifestations of stage II (pulmonary) were determined by lung damage in the form of pneumonitis. Stage III (hyperinflammatory response) it was characterized by severe lung damage, involvement of other organs in the pathological process as a consequence of a hyperimmune reaction. The determination of cellular and humoral immunity indicators reflected the severity of damage to the body's immune system, and, accordingly, the severity of the course of coronavirus infection. The variety of clinical manifestations and examination results confirms that COVID-19 is a systemic disease with a multi-organ lesion that requires in-depth study of its clinical and immunological features.

The pandemic of the new COVID-19 infection has had an impact on the epidemic process of most known infectious diseases. Given the high pandemic potential and the economic damage caused by influenza and SARS, the assessment of the prevalence of these infections in modern realities seems relevant. Aim: to assess the current manifestations of the epidemic process of SARS and influenza during the COVID-19 pandemic. Official statistics data were used to study the manifestations of epidemic processes of influenza and SARS. For serological examination, blood serum samples from conditionally healthy adults (N=270) collected in February 2022 were used. The titer of IgG antibodies to strains of influenza virus H1N1 pnm09, influenza H3N2, influenza B (Phuket), influenza B (Washington) was determined using a hemagglutination inhibition reaction. The samples were examined by enzyme immunoassay for the presence of IgG antibodies to adenovirus, respiratory syncytial (RS) virus, metapneumovirus, rhinovirus and parainfluenza viruses of types 1 and 3. Against the background of the development of the COVID-19 pandemic, an increase in the incidence of influenza has been established to a maximum value in 2021 (65.99 per 100 thousand population). The prevalence of influenza in the capital was 4.6 times higher than the average in Russia (14.96 per 100 thousand population). A significant proportion of persons immune to the influenza virus (more than 60 %) with a maximum value for the influenza B virus was identified, which is consistent with the data on the prevalence of this variant of the pathogen in the etiological interpretation of the incidence in 2021. Among the pathogens of ARVI, the maximum proportion of seropositive was detected to rhinovirus (77.8 %), which corresponds to the data on the greatest prevalence of this pathogen in the etiological structure of this group of infections. The active circulation of the influenza virus and the vaccination of the population became the basis for the formation of a high level of population immunity to the corresponding virus, which was shown by the results of the assessment of the prevalence of specific IgG antibodies.

Based on the study of the materials of the state reports of the Federal Service and territorial departments of Rospotrebnadzor (the Russian consumers’ supervisor) of the Russian Federation «About the condition of sanitary and epidemiological welfare of the population» within the period of 2011–2020, the results of the analysis of incidence indicators and epizootological monitoring of ixode tick-borne borreliosis (ITB) in two clusters of natural zones of the Central Federal District (CFD) of Russia are presented — northern (zones of taiga, mixed and broad-leaved forests) and southern (zones of forest-steppes and steppes). Over the last ten — year period, the average incidence rates of ITB in the Russian Federation and in the Central Federal District are statistically indistinguishable — 4.78 and 4.79 per 100 thousand of population. The incidence of ITB in Russia has a moderate downward trend (average increase tendency-aver.incr.T = –4.0 %), in the Central Federal District it is characterized by stable dynamics (aver.incr.T = –0.3 %).The incidence of ITB in the Central Federal District is statistically significantly correlated with the proportion of people bitten by ticks (341.5 per 100 thousand people, Rh/y = 0.6). The incidence rate and the proportion of people bitten by ticks are characterized by higher values in the northern cluster of the Central Federal District (5.5 and 394.6 per 100 thousand people. respectively). In the southern cluster, they are 3.6 and 281.8 per 100 thousand people. respectively). There is a statistically significant correlation between these indicators in the northern cluster, as well as in the Central Federal District (Rh/y = 0.7). The tick infection rate in the Central Federal District has been 16.1 %, in the northern cluster — 14.4 %, in the southern — 17.8 %. There is no correlation between these indicators and the corresponding levels of incidence.

The problem of preserving the health of workers engaged in the management of technological transport of a mining enterprise is relevant due to the lack of information about working conditions, the state of health of workers and the risk of their health disorders in the form of occupational (vibration disease, sciatica of the lumbosacral region, sensorineural hearing loss) and professionally caused diseases (vertobrogenic lumboishalgia, arterial hypertension), which it requires the development of targeted measures to improve working conditions and preserve the health of employees. The results of the study of working conditions and health status of employees engaged in the management of technological transport of a mining enterprise are presented. The assessment of working conditions at 60 workplaces was carried out, the state of health was studied according to periodic medical examinations of 221 employees. It has been established that harmful working conditions corresponding to class 3.2 lead to the formation of occupational pathology and an increase in the frequency of diseases of the musculoskeletal system and circulatory system, which requires the development and implementation of preventive measures.

The relevance of allergic diseases at the present stage is beyond doubt, due to the high incidence rates, the increase in cases of polysensitization, the severity of the forms of the course, the expansion of geographical boundaries and age limits. The problem of allergic rhinitis caused by plant pollen remains important as a result of climate change, an increase in the spread of allergenic plants, and a decrease in the resistance of the human body under the influence of adverse environmental factors. We analyzed the incidence of hay fever in the Voronezh region for the period from 2012 to 2021 based on statistical data from reporting forms. The incidence of the region is characterized by the annual registration of cases of allergy to pollen agents. A comparative assessment of the incidence of the Voronezh region with the indicators of the Russian Federation and the Central Federal District is possible from 2012 to 2017. The regional indicator (1.4 per 1,000 population) for this period is 1.5 times lower than the long-term average in the Russian Federation (2.11 per 1,000 population). At the same time, the analysis of the incidence of the region's territories showed that in some areas, the incidence rates among the adult population (up to 2.2 times), among adolescents (up to 1.6 times) and among children (up to 1.5 times) are higher than in the Russian Federation. Federation. Among other regions of the Central Federal District, the Voronezh region occupies a middle position in terms of incidence. Estimation of morbidity rates in the districts of the region reflects the variability of values from levels exceeding regional values to the complete absence of morbidity. The ranking of 32 districts of the region, as well as the inclusion of the urban district of Voronezh in the calculation, using the method of standard deviations from the average long-term incidence rate in the region, showed 8 areas of risk for the adult population of the region, 7 areas for the adolescent population and 7 areas of risk for the child population. In all age groups, the Ramonsky district was identified as a risk area.

The article deals with the problems of medical exposure (ME), since it is the predominant source of artificial exposure and one of the essential types of exposure of the population as a whole. In the course of the study, the dose load of ionizing radiation sources (IRS) used for medical purposes on the population of the Oryol region in 1998–2018 was analyzed based on the results of the analysis of the fleet of X-ray diagnostic equipment, data from radiation passports and official annual medical statistics. To achieve the goal of the study, statistical methods were used, methods of retrospective epidemiological analysis of data on medical exposure of the population of the Oryol region. We used data from 15 million X-ray procedures recorded by the official annual medical statistics of dynamic changes over 20 years from 1998 to 2018 (form No. 30) and data from 800 annual No. 3-DOZ — forms of federal state statistical observation in the Oryol region for the period 2001–2018 provided by medical institutions. The patient pays for information with a high risk of radiation exposure. The reason for the increase in medical exposure is the increasing use of interventional radiology in recent years. Medical exposure carries the risk of stochastic effects. The incidence of malignant neoplasms among the population of the Oryol region has increased by 14 % over the past 5 years, adolescents — 1.3 times, children under 14–1.4 times; congenital anomalies and malformations were recorded — 1.3 times more, in children under 14 years of age there was an excess of 4.5 %. The health indicators of the population of the Oryol region are considered unsatisfactory in terms of the incidence of malignant neoplasms, mortality and congenital malformations. As a result of the research, proposals were made to optimize the dose load and reduce the radiation hazard to the health of the population of the Oryol Region. Recommendations have also been developed to reduce the radiation doses to the personnel of medical and prophylactic organizations, to re-equip the health care facilities with modern low-dose devices.