Relevance. Fire and other emergencies expose firefighters to harmful and hazardous factors associated with greater stress impact on their health and functional reserves, as well as augmented risk of diseases and injuries

The objective is to analyze the morbidity among the workforce employed by the Federal Fire Service (FFS) of the EMERCOM of Russia who were declared unfit for service and to calculate dismissal rates for health reasons.

Methods. We studied morbidity rates among the FFS employees of the EMERCOM of Russia who hold special ranks and were declared unfit for service; the data was obtained from annual reports issued 2008 through 2024 by the military medical commissions of the Ministry of Internal Affairs of Russia. The average annual morbidity rate was calculated based on the total number of cases over 17 years and represented as the mean annual level (M ± m) per 1,000 firefighters. The dismissal rate was calculated per 10,000 firefighters (10^–4). The analysis focused on disease categories according to the International Classification of Diseases, 10th Revision (ICD-10), with disease significance ranging from rank 1 to 5. The Mann–Whitney U-test was utilized to obtain results to be further compared with the data for contract servicemen (officers, warrant officers, rank-and-file, sergeants, petty officers) of the Russian Ministry of Defense, with female personnel excluded. Dynamic regression analysis with a second-order polynomial trend model was performed; the Pearson correlation coefficient was calculated to study the congruence of trends.

Results and analysis. Over 17 years, some 5,000 FFS employees of the EMERCOM of Russia were declared unfit for service for health reasons. The level of morbidity for major disease categories (ICD-10, Chapters II, IV, IX, XIII, XIX) was statistically significantly higher (p < 0.001) than in contract servicemen, while the discharge rate was lower (p < 0.001). The average annual discharge rate among firefighters was 27.38 • 10^–4, including due to Circulatory system diseases (Chapter IX) 9.23 • 10^–4 (33.7%); Neoplasms (Chapter II) 4.91 • 10^–4 (17.9 %); Injury, poisoning and certain other consequences of external causes (Chapter XIX) 3.20 • 10^–4 (11.7 %); Endocrine, nutritional and metabolic diseases (Chapter IV) 2.40 • 10^–4 (8.8 %); and Diseases of the musculoskeletal system and connective tissue (Chapter XIII) 2.16 • 10^–4 (7.9 %). Overall, these categories accounted for 79.8 % of the total morbidity.

Conclusion. Prevention, early diagnosis, treatment, and rehabilitation of major diseases can help reduce morbidity and dismissals among firefighters due to health reasons.

Relevance. The wounded and injured veterans of the special military operation require rehabilitation to bring back their functionality and well-being lost in combat. In combat veterans undergoing rehabilitation, digital augmented reality (AR) can efficiently provide a motivating and immersive environment allowing to practice motor skills, overcome psychological barriers, and accelerate functional recovery.

The objective is to assess the efficiency of digital AR-based technologies and adaptive sports in the outpatient and medical rehabilitation resort setting by way of comparative analysis of health-related quality of life indicators in the special military operation veterans.

Methods. Health-related quality of life indicators were selectively studied in the two groups of the wounded and injured special military operation veterans who had undergone medical rehabilitation at an outpatient clinic (for 2 to 3 week) or medical rehabilitation resort (for 3 week). Group 1 was exposed to conventional therapeutic and general physical training (TPT and GPT), whereas Group 2 received rehabilitation using adaptive sports techniques. Group 1 (n = 78) represented combat veterans who received conventional rehabilitation (TPT, GPT, and adaptive sports), that did not include augmented reality technologies. Group 2 (n = 31) included combat veterans who received identical rehabilitation, though combined with digital augmented reality technologies. The study subjects were interviewed using the Russian version of the World Health Organization Quality of Life Brief Questionnaire (WHOQOL-BREF/WHOQOL-26). The non-parametric Mann-Whitney U test was used to compare the results between the groups was. Based on the numerical data set, the median, lower and upper quartiles were calculated (Me [Q₁; Q₃]). At p < 0.05 the differences were considered statistically significant.

Results and discussion. In Group 2, the wounded and injured combat veterans reported significantly higher overall WHOQOL-26 quality of life scores both in the total sampling and within the subgroup aged under 30, as opposite to Group 1. Physical and psychological well-being, self-perception, self-assessed health quality, and overall quality of life were characterized by statistically significant differences in the median scores for both the total sampling and in the subgroup of the veterans aged under 30. Group1 and 2 showed no significant differences with regard to social well-being and microsocial environment. Age-related characteristics and the absence of notable differences for social parameters should be considered in the development of new AR applications and simulators for rehabilitation purposes.

Conclusion. In outpatient and medical resort rehabilitation, the combination of digital augmented reality technologies, TPT and GPT methods, as well as adaptive sports-based rehabilitation effectively improves quality of life of the wounded and injured combat veterans of the special military operation. The results justify the need to establish in Russia a comprehensive, evidence-based framework for combat veterans, incorporating high-tech digital solutions across various stages and types of rehabilitation.

Introduction. Occupational safety set-up pursues safety of the EMERCOM of Russia personnel, as well as compliance with legislative and other regulatory legal acts of Russia regarding occupational safety and advanced occupational injury prevention.

The aim is to develop a model allowing to predict occupational body injuries among the firefighters of the Federal Fire Service (FFS) of the EMERCOM of Russia, based on specific regional factors related to the performance of official duties.

Methods. We analyzed the reports on occupational injuries of the FFS of the EMERCOM of Russia for 2014–2023 by Russian regions. The injuries were matched with the injury groups under Chapter XIX ‘Injury, poisoning and certain other consequences of external causes’ according to the International Classification of Diseases and Behavioral Disorders (ICD-10). The risks of damage to body parts and areas among firefighters was calculated using the correction factors for unidentified (no diagnoses provided in the injury records) and poorly identified (general diagnoses provided only) injuries.

Results and analysis. The predicted occupational injury rates among the FFS personnel of the EMERCOM of Russia was calculated using a discriminant formula, that accounts for the number of occupational injuries or damages to body parts and areas, the number of firefighters, their average age, and professional experience. The results were registered in Rospatent № 2024611607 dated January 23, 2024 through a specialized computer program. A correction factor should be included into the present formula, as well as the regional peculiarities of Russian constituents: yi = yRi/R, where yi is the predicted injury number among the FFS personnel of the EMERCOM of Russia in the i-constituent, Ri is the risk of injury among the FFS personnel of the EMERCOM of Russia in the i-constituent, and R is the overall risk of injury among the FFS personnel of the EMERCOM of Russia.

Conclusion. The proposed method allows to predict the total number of occupational injuries among firefighters, including lesions of particular body areas, thereby estimate the resources and capacities required for treatment and rehabilitation in every region of Russia.

Relevance. The existence of a well-developed regulatory and legal framework is a prerequisite for a functionally integral public healthcare system and disaster medicine in particular. Territorial disaster medicine services across Russian regions have witnessed a comprehensive multi-stage advancement, associated with the establishment and further improvement of the dedicated rules and regulations. The amended rules and regulations, aimed at establishing improved disaster medicine services, consider various medical and geographic parameters of every region, as well as its hazardous industrial facilities.

The study aim is to examine the dynamics and advancements of the disaster medicine in a historical perspective based on the retrospective analysis of regulatory documents issued by Moscow healthcare authority from 1990 to 2025, governing the territorial disaster medicine service of the region.

Materials and methods. We performed a retrospective analysis of nine major decrees issued by the Moscow healthcare authority characterizing the disaster medicine service and its activities from 1990 to 2025. The study utilized the historical and comparative methods, as well as systems analysis, correlation, and scientific generalization.

Results and analysis. The analysis of regulatory documents issued by the Russian regional healthcare authority under consideration revealed a strong dependence between the territorial disaster medicine service development and the quality of the regulations regarding its functionality. The improvements relied on the adoption of new regulations governing the service activities and its functional units, that were developed based on scientific findings and insights accumulated by medical organizations and territorial disaster medicine formations throughout the years of expertise in eliminating medical and sanitary consequences of emergencies.

Conclusion. Our retrospective analysis of regulatory documents issued by the Moscow healthcare authority allowed to split the development of the territorial disaster medicine service into three stages: establishing the emergency medical service (1990–1995); stagnated development of the emergency medical service (1996–2015); and establishing the territorial disaster medicine service (2016–2025).

Relevance. The militarization of a number of countries and the number of armed conflicts in the world are not decreasing, which necessitates the development of programs to curb armed violence and improve the safety of the population in a number of countries.

The aim is to study the risks of deaths in armed conflicts in the regions of the world, which can be extrapolated to sanitary losses and optimize the elimination of consequences.

Methods. We have studied 6 scientific projects that index the consequences of armed conflicts in the world. Deaths by category (combatants, civilians, unidentified persons) were obtained from the UCDP/PRIO database on armed conflicts [https://ucdp.uu.se/]. The number and types of armed conflicts (state, non-state and «unilateral violence») were specified on the electronic resource War and Peace [https://ourworldindata.org/war-and-peace]. Knowing the number of the world’s population and regions that you have received on the site [https://countrymeters.info /] calculated the individual risks of death in armed conflicts per 1 million people of the population (10^-6). Acceptable (conditionally acceptable risk) is data that differs by ¹/₃ from the global average, optimal – less than ¹/₃ of the average value, high (unacceptable) – more than ¹/₃. The dynamics of the indicators were presented in the form of polynomial trends of the 2nd order with the calculation of the coefficient of determination, the threshold of significance of which was 0.5.

The results and discussion. In 10 years (2015-2024), 1.754 armed conflicts were registered in the world, in which 1 million 489.3 thousand people died, of which 53 conflicts occurred in Europe, 284 in Asia, 305 in the Middle East, 998 in Africa, 320 conflicts in America with the deaths of 258 thousand, 211, 364, 529 and 127 thousand people, respectively. The average annual individual risk of death in all armed conflicts in the world was 19.27 ∙ 10^-6 deaths/(person ∙ year), in state conflicts – 15.32 ∙ 10^-6, in non–state conflicts – 2.76 ∙ 10^-6 deaths/(person ∙ year). There is a tendency of increasing risks in the dynamics. The high risk of death in all conflicts was 78.94 ∙ 10^-6 deaths/(person ∙ year) in the Middle East, 40.33 ∙ 10^-6 in Africa and 34.41 ∙ 10^-6 in Europe, 4.53 ∙ 10^-6 in Asia and 12.54 ∙ 10^-6 deaths/(person ∙ year) in America. A similar qualitative gradation was observed with the risks of death of combatants, for example, the risk in the Middle East was 46.92 ∙ 10^-6, in Africa – 30.64 ∙ 10^-6, in Europe – 28.53 ∙ 10^-6, in Asia – 3.91 ∙ 10^-6 and in America – 0.36 ∙ 10^-6 deaths/(person ∙ year). The risks of civilian deaths in the regions of the world correlated with the acceptable gradation, with the exception of the Middle East, where risk indicators approached the upper limit of the conditionally acceptable – 23.36 ∙ 10^-6 deaths/(person ∙ year). There is a multidirectional trend of risks in the regions. The reasons for the expressed risks in the regions have been clarified.

Conclusion. The death of the population can be extrapolated to sanitary losses and, thus, to refine the forces and means of disaster medicine in regions (countries) to eliminate the consequences of armed conflicts.

Relevance. Injury rates denote the occurrence of trauma and its consequences in a cohort within a specific time period and serve as a critical indicator of occupational safety.

The objective is to analyze long-term injury statistics at peacetime among various military personnel categories of the Russian Ministry of Defense as a promising parameter to estimate the demand for injury prevention, treatment, and rehabilitation.

Methods. We examined the morbidity database for Russian Armed Forces personnel containing medical records (Form 3/MED) from 2003 to 2021. Additionally, we investigated open access publications by staff from the Main Military Medical Directorate of the Ministry of Defense Russia. Injury rates were calculated per 1,000 military personnel (‰), whereas mortality was calculated per 100,000 (10^–5). Average long-term levels are based on cumulative absolute figures over 19 years of observation, while annual average levels rely on arithmetic means and their standard errors (M ± m) obtained from annual levels. Injury dynamics was analyzed using dynamic time series and second-order polynomial trend calculations.

Results and discussion. Over 19 years (2003–2021), servicemen of the Ministry of Defense of Russia showed the average annual injury rate (primary morbidity) for the diseases contained in ChapterXIX «Injury, poisoning, and certain other consequences of external causes (S00–T98)» (ICD-10) of 17.1 ‰, including 31.5 % among officers and warrant officers, 22.8 % among contracted military personnel and sergeants, 3.7 % among female military personnel, 42.0 % among conscripts; hospital admissions due to injuries accounted for 12.7 ‰, represented by 26.0 %, 21.8, 2.9, and 49.3 % respectively for the above four cohorts; days off from work – 322.4 ‰ represented by 33.0 %, 21.3, 4.0, 41.7 % respectively; discharges – 0.45 ‰ including 27.2 %, 12.7, 1.7, and 58.9 % respectively; mortality – 80,4 • 10^–5 with 37.9 %, 31.8, 1.5, and 28.8 % respectively. A downward trend in injury levels and shares was observed across all personnel categories, except among contracted personnel and sergeants, where an upward trend was noted. Morbidity in all military personnel categories included injuries accounting for 6–8 %, whereas injury-related mortality ranged from 24 % to 85 %, underscoring the high epidemiological significance of trauma among the military. The most pronounced consequences were observed among conscripts, as well as in officers and warrant officers. In terms of significance rank, the five most significant types of injuries ranked from most to least significant included head injuries (S00–S09) 3.30 ± 0.43 ‰ (20 %), followed by wrist and hand injuries (S60–S69) 2.74 ± 0.26 ‰ (16.6 %); ankle and foot injuries (S90–S99) 2.61 ± 0.24 ‰ (15.8 %); injures of the knee and lower extremities (S80–S89) 2.42 ± 0.11 ‰ (14.7 %); elbow and forearm injuries (S50–S59) 1.21 ± 0.12 ‰ (7.3 %). Jointly, the five groups accounted for 74.4 % of all injuries in the military personnel of the Russian Ministry of Defense personnel, with minor variability across all categories.

Conclusion. To ensure efficiency of treatment, rehabilitation, and injury prevention efforts, planning of resources should take to account both elevated trauma rates during armed conflicts, as well as injuries sustained during routine military activities.

The study aim is to analyze the origins and main development stages of military psychophysiology. Methods: Our research is based on archives and open scientific sources with a focus on the main stages in the formation and development of military psychophysiology among military specialists.

Results and discussion. Our findings reveal the origins and key stages in the development of military psychophysiology, representing the stage-wise evolution of an integral framework for professional psychological assessment and support among the military since the first Russian school of medical research in military psychophysiology was launched. By identifying specific historical stages in research and education efforts, the study analyzes the experience of leading Russian research teams in such areas as adaptability to military work, mental health of various military categories, as well as professional psychological assessment and medical support in peace and wartime.

Conclusion. Our study shows that throughout its history the formation and development of military psychophysiology in Russia is was largely shaped by the challenges of the time. These challenges determined the intensity of research into the most pressing issues of military medicine relevant for a particular historical period. In the 1980s these efforts allowed to establish an integral framework for professional psychological assessment and medical psychological (or psychophysiological) support among the military throughout their professional career.

Introduction. In the modern context, the diagnosis of socially significant bloodborne viral infections (BBVI) requires continuous improvement and adaptation. This is especially relevant in treatment of the military, where high accuracy and speed of laboratory diagnostics is critical.

The aim of the study is to explore extra laboratory diagnostic capacities in military medical institutions to expand the indications for combined molecular biological and immunochromatographic express tests in socially significant bloodborne viral infections.

Methods. According to the research objective, the study relies on the data obtained from open access publications available in Russian and international databases, a s well as the authors’ own laboratory findings.

Results and analysis. The study identifies key prospects for improved laboratory diagnostics of socially significant bloodborne viral infections in military medical institutions. An advanced regulatory framework is required to enhance the examination and registration of HIV patients.

Conclusion. Taking into consideration the existing laboratory diagnostic capacities, the study has identified the demand for higher precision and clarity in legal terminology, as well as unbiased statistical management of patient records in order to ensure prompt anti-epidemic measures, prevention, and treatment. In addition, updated training programs are required for medical laboratory professionals with a special focus on diagnostic algorithms and interpretation of results.

Relevance. The impact of traumatic events, such as military action, physical, emotional, and sexual violence, on postural control is currently an emerging area of interest in posturology. This fact provided an impetus for the present pilot study, The study objective is to identify the specific characteristics of postural balance in women aged 18–29 who experienced sexual violence.

Methods. A total of 232 women aged 18–29 years, mean age (M ± SD) (21.1 ± 2.6) years, were examined. Group 1 included 116 women who experienced sexual violence between 2 weeks and 12 months prior to the examination. Group 2 included 116 women of the same age with no history of sexual violence. Postural balance characteristics were assessed using the Sensory Organization Test (SOT) and Motor Control Test (MCT) mounted on the Smart Equitest Balance Manager computer system for dynamic posturography.

Results and discussion. The comparative SOT analysis revealed that women with prior experience of sexual violence showed risks associated with impaired static balance, deteriorated dynamic postural balance, reduced adaptive capacity of equilibrium function, and diminished automatic postural control. Sensory SOT analysis demonstrated reduced somatosensory, visual, and vestibular information input to balance control, along with disrupted sensory integration processes. The MCT results showed an increased speed of coordinated motor responses in women who experienced sexual violence. Such changes are associated with hypersensitivity to environmental and safety factors, worsened social adaptation, impaired spatial and temporal responsiveness, which negatively affects body perception, sexuality, and self-esteem.

Conclusion. The obtained research results substantiate the importance of using posturographic (stabilometric) systems and complexes for the diagnosis, correction and medical and psychological rehabilitation of sexual violence survivors. Our study demonstrates the need for a new generalized analysis of contemporary research devoted to rehabilitation and treatment of sexual violence survivors.