Relevance. An analysis of the saturation of potentially dangerous objects in the technogenic sphere shows constant increase in the number and severity of the consequences of manmade disasters. The possibilities of countering threats in the technogenic sphere were limited, mainly due to the human factor. Therefore, the assessment and management of anthropogenic risks is one of the main measures to prevent manmade emergencies. In enterprises with potentially hazardous technologies, this problem is solved mainly by improving the safety culture at work. The lack of scientific research on the development of criteria for assessing anthropogenic risks makes it difficult to solve important practical tasks for ranking hazardous industries according to their anthropogenic hazard, the distribution of forces and facilities of the Emercom, taking into account the most likely place of occurrence of manmade disaster, improving medical and physiological support of personnel of hazardous facilities and industries.
Intention. Development of information technology for the quantitative assessment of anthropogenic risks for personnel at hazardous facilities and industries.
Methodology. The object of the study was the literature data on existing approaches to risk assessment in applied scientific research. The subject of the research is information technology for developing criteria for assessing anthropogenic risks.

Results and discussion. Based on the analysis of literature data, the definition of the concept “anthropogenic risk” and the conceptual model of its quantitative assessment are given. An information technology for human risk assessment has been developed, which includes the following steps: 1) selection of the basic components of anthropogenic risk 2) determination of the values of the basic components; 3) expert assessment of the likelihood of risk realization with the established value
of the basic components; 4) assessment using the risk matrix of the level of anthropogenic risk of the basic components; 5) an assessment of the social acceptability of anthropogenic risk for the basic components; 6) calculation of the weighted average anthropogenic risk; 7) the decision on the level of human risk. The methods of implementing information technology are described. An example of using the developed information technology to assess the anthropogenic risk of nuclear power plant personnel is given. Professional competence, professional success and professional health of an employee were used as a component of anthropogenic risk.
Conclusion. Anthropogenic risk is a quantitative characteristic of the threat to the security of an enterprise from an employee’s professional activities due to the incompatibility of his medical and psychophysiological characteristics with the requirements of professional activity and the anthropogenic vulnerability of equipment and technological processes. Reducing anthropogenic risks is a prerequisite for improving the safety of enterprises with potentially dangerous technologies. The proposed information technology, assessment criteria and classification of levels of human risk can be used in developing a risk management system in order to minimize them.

Relevance. The risks of emergency situations during mass events require the coordination of activities of respective structures and departments of the host country.
Intention. Assessment of ensuring radiation, chemical and biological safety during the 2018 FIFA World Cup matches and the 2017 FIFA Confederations Cup in Kazan on the example of the Department of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in the Republic of Tatarstan, as well as the effectiveness of the forces and assets involved.
Methodology. A retrospective analysis of interdepartmental cooperation and organization of control of the radiation, chemical and biological situation with the forces of Department of Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) in the Republic of Tatarstan, the Ministry of Defense of the Russian Federation, the Ministry of Emergency Situations of the Republic of Tatarstan, performing safety tasks before and during the 2018 FIFA World Cup matches and the FIFA Confederations Cup 2017 in Kazan from 2015 to 2018.
Results and Discussion. Before the 2018 FIFA World Cup and the 2017 FIFA Confederations Cup in Kazan, industrial and infrastructure facilities were identified, which malfunction could jeopardize radiation, chemical and biological safety during the events. Organizational events were held for these facilities. Potentially dangerous processes were temporarily suspended. Laboratory and instrumental studies were conducted at the stage of reconstruction of the involved objects. During the 2018 FIFA World Cup matches and the 2017 FIFA Confederations Cup in Kazan, a two-level radiation, chemical and biological control system was organized. Interdepartmental interaction and interchange of information at the subject level in the field of radiation, chemical and biological safety was organized. During the 2018 FIFA World Cup matches and the 2017 FIFA Confederations Cup in Kazan, the radiation, chemical and biological situation was intensively monitored. Task forces were on duty for radiation, chemical and biological emergencies.
Conclusion. To ensure radiation, chemical and biological safety, a model of interdepartmental interaction was used for mass events. An integrated approach to ensuring radiation, chemical and biological safety has made it possible to maintain a stable radiation, chemical and biological environment. Interdepartmental experience with radiation, chemical and biological safety can be implemented before and during international mass events.

Relevance. Mortality and unsatisfactory results of treatment of combined injuries of the pelvis, especially with pelvic ring fractures, are still high. This is due to the lack of an effective system of specialized medical care for this category of victims.

Intention: To study the frequency, characteristics and structure of combined injuries of the pelvis with damage to the pelvic ring based on the experience of specialized medical care in the level I trauma center (St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine).

Methodology. We analyzed the 10-year (2009–2018) treatment results for 932 victims with a combined pelvic injury at the level I trauma center: St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine. In the study group, 667 victims had unstable pelvic ring injuries.

Results and Discussion. Combined injuries of the pelvis, accompanied by damage to the pelvic ring in a large urban agglomeration as a result of high-kinetic injuries (road traffic injury, catatrauma, etc.) were observed in 16.3% of the structure of polytrauma. 75.8% of the victims were of working age. In the structure of injuries, pelvic ring injuries among polytrauma mainly resulted from traffic accidents (57.9 %). The initial fractures were classified as stable type A (265; 28.5 %), partially stable type B (485; 52 %), and vertically unstable type C (182; 19,5 %) according classification М. Tile и М.Е. Muller (AO/ASIF). Four or more areas of the body were affected int 60.8 %, and pelvic injuries dominated in 62.8 % of observations. Half of the patients with pelvic ring injury were diagnosed with more than 25 points by the ISS. Among them, life-threatening complications were identified in 77.7 %. Of these, 33.6 % had pelvic bleeding, the second largest source of acute blood loss was intra-abdominal – 12 % of observations. The mechanism of damage to the pelvic ring was lateral compression (LCI) – 54 % and vertical shift – 57.7 %. In the structure of morphological damage to the posterior pelvic ring, unilateral and bilateral fractures of the sacrum were more common: 51.7 and 13.2 %, respectively. Multiple pelvic injuries was diagnosed in 7.3 % of victims, most had ruptures of the bladder and posterior urethra; open pelvic injuries, including extensive traumatic skin detachment were observed in a small percentage of observations (3.4 %).

Conclusion. Unstable pelvic ring injuries differ from other types of pelvic injuries due to more common (33.1 %) traumatic shock (grade III traumatic shock) and greater acute blood loss (> 20 % blood volume; 35.9 %), especially in victims with vertically unstable pelvic injuries. This requires rapid transportation of the victim to the trauma center, proper organization of pre-hospital care, including temporary fixation of the pelvis and early specialized medical care.

Relevance. One of the important tasks in the provision of emergency medical care to victims of the mass-causalty incident is a medical triage in order to determine the priority of medical care and the priority of medical evacuation.
Intention. To work out issues of interaction between the medical service of the Armed Forces of Russia, the Disaster Medicine Service and the Ambulance Service.
Methodology. The program of the 16th All-Russian Congress “Ambulance 2017”, tactical and special exercises on the deployment of airfield evacuation center were included as a training and demonstration event . According to the plan of the exercise, several mass-causalty areas resulted from terrorist attacks along the border of the Leningrad Region.
Results and discussion. To accomplish the tasks, an evacuation center was deployed with a capacity of up to 200 wounded and sick per day, evacuation capability of 32 stretcher wounded, and 4 h deployment time. During the exercise, non-invasive screening studies to proactively diagnose intracranial hematomas (portable infrared scanner), tension pneumothorax, hemopericardium, intrapleural and intra-abdominal bleeding (portable US device using FAST protocol), acute blood loss (portable laboratory analyzer) were performed in addition to standard examinations. To determine the priority of medical evacuation of victims, an improved Revised Trauma Score (RTS) scale with user-friendly software for Android mobile devices (smartphone, tablet) was used. In case of mass-causalty event and a shortage of specialized sanitary transport, those who needed urgent specialized medical care were transferred from an evacuation center via radial evacuation to specialized medical organizations subordinated to the Ministry of Defense, the Ministry of Health and the subjects of Russia.
Conclusion. The feasibility of deploying an airfield evacuation center to eliminate the health effects of emergencies was determined by potential discrepancy between evacuation capacities of air transport and ambulances, on one hand, and the need to temporarily accommodate (including isolation) and provide emergency health care to victims. 

Relevance. In the concept of long-term development of social and economic policy of the Russian Federation, the problem of preservation and strengthening of employees’ health is given a top priority and requires improvement of the citizen health protection. Risk assessment and, in particular, occupational risk assessment is part of the process that includes probability analysis of dangerous events for employees’ health and decision-making about the necessity of risk reduction. The principles of prevention and constant improvement of the assessment system and occupational risk management in accordance with the Concept of demographic policy of the Russian Federation have determined the relevance of this research.
Purpose: To assess individual occupational risks in employees based on regular medical examination data and obligatory psychophysiological tests.
Methodology. Due to the absence of professional diseases associated with the exposure to ionizing radiation and a low level of work-related injuries at high-tech nuclear enterprises, it is not reasonable to consider current indicators of occupational risk and working conditions while assessing individual occupational risks. Classes of working conditions in terms of harm and danger, the employee’s health group, the presence of work-related diseases and the level of allostatic load are sufficient for practical assessment.
Results and analysis. The article presents the formula for calculating the allostatic load index based on the psychophysiological examination data, which are mandatory for periodic medical examinations of nuclear industry workers. A one-dimensional multi-parameter indicator and critical rules to assess employee health loss were developed, along with a regression model to forecast the employee health loss by classes of working conditions. The risk matrix was developed to assess the individual occupational risks.
Conclusion. For the high-tech nuclear industry, where the safety culture is monitored at the enterprises in accordance with the IAEA recommendations, the classes of working conditions in terms of harm and danger, the employee’s health group, the group of work-related hazards and the level of allostatic load are sufficient for practical assessment of individual occupational risks. 

Relevance. More than 13.2 million injuries are recorded every year in Russia. For example, in 2005–2015 the level of injuries among the population of Russia was 92 ‰. Severe and combined injuries can be complicated by traumatic disease, which often occurred in the military when conducting combat operations.
Intention.To present the mechanism of chronic adaptive overstrain syndrome in the pathogenesis of wound disease.
Methodology. Wound disease is a special case of a traumatic disease, with an open wound with disrupted integrity of the skin and adjacent internal organs due to traumatic factors. The basis of the material was the author’s research on the study of chronic adaptive overstrain syndrome in 2500 servicemen of the Soviet Army in combat operations in the Republic of Afghanistan in 1979–1989.
Results and Discussion. In contrast to a traumatic disease of peacetime, wound disease in a war is accompanied by impaired functional reserves in the form of an adaptive (environmental-occupational) stress syndrome due to “disturbing” combat stress factors. The main manifestations of chronic adaptive overstrain syndrome in military personnel are decreased body resistance to banal infections; high infectious morbidity throughout the year, regardless of the season; the growth of areactive forms of infectious diseases against the background of allergization; chronic inflammatory and recurrent processes; low rates of wound and other injuries healing; high frequency of infectious complications in the treatment of wounds; a significant weakening of the bactericidal properties of the skin; frequent occurrence of reactive arthritis in diseases for which joint damage is not typical.
Conclusion. Extreme military factors result in depletion of the functional and structural reserve of compensatory processes of the body, with a state of pre-disease and complicated wound healing. Thus, initial manifestations of chronic adaptive overstrain syndrome due to combat stress in soldiers should be corrected as soon as possible. 

Relevance. Professional activities of the officers of the Navy of Russia and the Ground Forces of Russia are obviously different. Due to autonomous combat missions, medical support for the officers of the Russian Navy is quite specific, with high requirements to the health status of the navy personnel.
Intention. To analyze morbidity of officers of the Russian Navy and the Ground Forces in 2003–2018.
Methodology. A selective statistical analysis was performed using medical reports on the state of health of personnel and activities of the medical service according to Form 3 / MED in military units, in which about 60% of the total number of officers of the Armed Forces of Russia served in 2003–2018. Commonly accepted medical and statistical morbidity indicators were analyzed by disease categories of the International Statistical Classification of Diseases and Health Problems, 10th revision.
Results and Discussion. The average annual morbidity rates for Russian Navy officers were (918.9 ± 35.3) and (1014.0 ± 79.2) ‰ for the Russian Navy and Ground Forces officers, respectively; primary morbidity rates were (351.0 ± 9.2) and (473.5 ± 38.0) ‰, respectively (p < 0.01); the need for case follow-up was (151.0 ± 9.1) and (114.2 ± 9.2) ‰, respectively (p <0.05); hospital admissions (236.5 ± 11.1) and (194.6 ± 17.8) ‰, respectively; work days lost (4997 ± 183) and (4180 ± 354) ‰, respectively; dismissal rates (15.90 ± 1.36) and (12.27 ± 2.72) ‰, respectively; mortality rates were (102.53 ± 5.95) and (138.35 ± 9.49) per 100 thousand officers of the respective cohort (p < 0.01). The trends in almost all morbidity and mortality types are not consistent, which may indicate the influence of various factors, for example, military-professional ones. The consistency of the trends of dismissal rates is moderate and statistically significant (r = 0.56; p <0.05), which indicates the influence of unidirectional factors, possibly organizational ones. When assessing the military-epidemiological significance of disase categories, the following diseases ranked first: acute respiratory infections of the upper respiratory tract (J00 – J06 by ICD-10), coronary heart disease (I20 – I25), hypertensive diseases (I10 – I15), diseases of the esophagus, stomach and duodenum (K20 – K31). In the Russian Navy officers, the leading 10 disease categories included malignant neoplasms (C00 – C80), obesity and other hyperalimentation (E65 – E68); other acute respiratory infections of the lower respiratory tract (J20 – J22), infections of the skin and subcutaneous tissue (L00 – L08).
Conclusion. Prevention, timely treatment and rehabilitation will help improve the health status of officers. Taking into account the rates and structure of morbidity will optimize allocation of resources the medical service of the Armed Forces of Russia.

Relevance. Shift work was found to induce pathological processes due to desynchronization of human circadian biorhythms.
Intention. To determine incidence of hemostasis disorders and their relation to labour nature in employees of EMERCOM of Russia.
Methodology.There were examined 37 employees of EMERCOM of Russia aged 32–58 (42.0 ± 6.8) with work experience (12.0 ± 6.9) years, high level of psychosocial stress and different work schedules: day (n = 11), shift (n = 14), irregular working hours (n = 12). The level of professional stress was studied using a specially developed questionnaire and the night sleep – using Pittsburgh Sleep Quality Index (PSQI). Сortisol circadian dynamics was evaluated, hemostasis state was fully assessed.
Results and Discussion.The questionnaire showed irregularity of work schedule, additional working hours, decreased leisure time and high intensity of work in all study groups. High incidence of arterial hypertension (44 %) was registered without constant antihypertensive therapy. Pittsburgh Sleep Quality Index (PSQI) indicated sleep disorders among 24 (65 %) EMERCOM employees. Сortisol circadian dynamics test demonstrated increased level of the evening cortisol in 40 % of EMERCOM employees indicating widespread desynchronosis signs in the study group. Hemostatic system comprehensive assessment showed absence of considerable changes in thrombocytic component and a significant activation of plasma hemostasis according to the thrombodynamics assay. Hemostasis disorders were most expressed in the group with shift work and high psychosocial stress; they manifested in increased clots formation, spontaneous clots formation and increased VIII coagulation factor activity.
Conclusion. The study confirmed the existing vision that chronic stress and desynchronosis change the hemostatic balance into chronic hypercoagulation state.

Relevance. Due to their carcinogenic, oxidative and toxic potential, chemical compounds from burning products are especially dangerous for rescuers and firefighters and result in the oxidative stress as a precursor of many diseases. Therefore, it is necessary to diagnose the oxidative stress before its serious effects.
Intention. To assess oxidative stress markers in plasma of rescuers and firefighters of EMERCOM of Russia via modern methods for targeted treatment and preventive actions.
Methodology. Malonic dialdehyde, fat-soluble vitamins (A and E), polyunsaturated omega-3 and omega-6 fatty acids in plasma were determined by gas and liquid chromatography during routine periodical medical examination of 98 rescuers and firefighters of rescue units of EMERCOM of Russia. The average age of the examined persons was (32.1 ± 0.5) years; of them, 21 were rescuers from the North-West Regional Search and Rescue Squad and 77 were firefighters from the territorial fire departments of St. Petersburg.
Results and Discussion. Malonic dialdehyde plasma concentrations in rescuers and firefighters were 1.5-1.7-fold higher than reference values. Docosahexaenoic and arachidonic acids were increased in all examined groups. In firefighters with work experience of > 10 years, plasma concentrations of eicosapentaenoic and docosahexaenoic acids were increased. Their antioxidative potential is decreased.
Conclusion. According to the obtained results, rescuers and firefighters can be assigned to a high-risk group in terms of health deterioretion, especially those with work experience for more than 5 years. Periodic correction of the observed changes is recommended.

Relevance. Improvement of the medico-psycho-physiological support of professional activity of employees of hazardous production facilities is associated with the development of methods for rapid diagnostics of psycho-physiological state in order to significantly reduce examination time. In particular, vibration imaging takes only one minute. Currently, there are no quantitative criteria for assessing the psychophysiological state based on vibration imaging in employees involved in hazardous work at the stages of periodic, pre-shift medical examinations and training.
Intention. Development of non-contact rapid diagnostics of psychophysiological status of employees involved in hazardous work based on vibration imaging parameters for periodic and pre-shift medical examinations, and assessing their current state during training.
Methodology. The object of the study was the psychophysiological state of employees of the temporary storage of spent nuclear fuel and radioactive waste at the stages of periodic and pre-shift medical examination, as well as during training. The subject of the study is assessment of relationship of indicators of psychophysiological state with the parameters of vibration imaging.
Results and Discussion. According to comprehensive tests with the use of regulated and non-contact methods of assessing psychophysiological state of the workers of hazardous facilities, the parameters of vibration imaging reflect the systemic response of the body. Using the developed criterion of the rapid diagnostics of psychophysiological state at the stage of periodic medical examinations, it takes 1 minute to identify persons with psychophysiological disorders. For the stage of pre-shift medical examinations, a criterion has been developed to make a decision on admission/non-admission to work. The obtained criterion helps to quantify the psychophysiological “price” of training activities in order to optimize their regimens based on the current psychophysiological state as assessed via vibration image parameters.
Conclusion. The developed criteria for rapid diagnostics of psychophysiological status, if introduced in scientific-practical activities, will help to monitor the psychophysiological adaptation of workers of hazardous facilities in order to maintain their occupational health and minimize anthropogenic risks.