[Patterns of the SARS-CoV-2 epidemic spread in a megacity].

The purpose of the study is to analyze patterns demonstrated by the COVID-19 epidemic process in a megacity during the increase, stabilization and reduction in the incidence, and to evaluate the effectiveness of the epidemic prevention measures. MATERIALS AND METHODS: The comprehensive study incorporating epidemiological, molecular genetic and  statistical research methods was conducted to analyze the spread of SARS-CoV-2 in Moscow during the COVID- 19 pandemic. RESULTS AND DISCUSSION: It was found that the exponential growth in COVID-19 cases was prevented due to the most stringent control and restrictive measures deployed in Moscow to break the chains of SARS-CoV-2 transmission and due to people who were very disciplined in complying with the self-isolation rules. The  analysis of the dynamics in detection of new COVID-19 cases showed that in a megacity, the impact of social distancing and self-isolation would become apparent only after 3.5 incubation periods, where the maximum length of the period is 14 days. It was discovered that the detection frequency of SARS-CoV-2 RNA in relatively healthy population and its dynamics are important monitoring parameters, especially during the increase and stabilization in the COVID-19 incidence, and are instrumental in predicting the development of the epidemic situation within a range of 1-2 incubation periods (14-28 days). In Moscow, the case fatality rate was 1.73% over the observation period (6/3/2020-23/6/2020). CONCLUSION: The epidemiological analysis of the COVID-19 situation in Moscow showed certain patterns of the SARS-CoV-2 spread and helped evaluate the effectiveness of the epidemic prevention measures aimed at  breaking the routes of transmission of the pathogen.

[Primary and occupational morbidity among adult population of Moscow].

The authors studied two types of morbidity among adults of Moscow over 2012-2014 - primary and occupational. Findings are that those levels in the city are significantly lower than the general in Russia. Over the studied period, the structure of both types of morbidity did not change, but there was a tendency to decrease both in total and in main entity classes of general and occupational diseases.

[FEATURES OF THE IMMUNE GENETIC PARAMETERS IN WORKERS IN NON-FERROUS METAL INDUSTRY].

There was performed a comparative analysis of immunogenetic indices in non-ferrous metallurgy employees under the exposure to different combinations of harmful occupational factors. The combined effect of chlorine and vanadium fumes, noise, overall vibration appeared to be associated with the gene polymorphism of cytokine regulation--VEGF and TNF (p < 0.05). In workers the combination offactors such as dust containing silicon dioxide, noise, elevated environmental thermal load was associated with cytochrome p450 gene polymorphism, allele variation ofwhich is formed owing to the homozygous genotype. At the same time there was observed an excess production of specific antibodies to vanadium and silicon, significantly differed from that of the indices in the reference group. There are proposed genetic (CYP1A1, VEGF TNFalfa) and immunological (IgG to vanadium and silicon) indices as markers of susceptibility and effect in health risk assessment of different combinations of harmful occupational factors, which will allow to increase the availability of laboratory control during surveillance activities at the objects.

[Improvement of legislation basis for occupational risk analysis in occupational hygiene and work safety].

One among priority trendsin health care in Russian Federation and abroad is minimization of occupational risks. The authors present evaluation of legislation basis for occupational risk analysis. The most promising trend in improvement of national legislation is its development on basis of internationally accepted documents, that-provides legislation basis for analysis of workers' health risk. Findings are that complete evaluation of occupational risk requires combination of data on work conditions and data of occupational control, and sometimes--with results of special research. Further improvement is needed for justifying hygienic norms with applying criteria of allowable risk for workers' health. Now development of risk analysis methodology enables quantitative evaluation of health risk via mathematic models including those describing risk evolution.

[Comparative analysis of occupational risk evaluation results through various methodic approaches].

Comparative analysis covered three models of occupational risk evaluation: (1) Method to evaluate risks at workplace, elaborated in Finland and recommended by International Work Safety Agency for Eastern Europe and Central Asia countries; (2) Method elaborated in Research Institute for Occupational Medicine with RAMSc under the direction of N.F. Izmerov and E.I. Denisov; (3) Method evaluating individual occupational risk, with consideration of work conditions and worker's health state, also elaborated in Research Institute for Occupational Medicine with RAMSc and Klin Institute of Work conditions and safety, approved in 2011 as methodic recommendations. Findings are that in contemporary Russia a unified method evaluating occupational risk is more expedient; the first method satisfactorily describes actual ratio of occupational risk levels and could be useful as an additional method for its evaluation, especially for psycho-social factors; the second method does not allow to evaluate occupational risk acceptably if absent longstanding occupational morbidity, but is recommended for risk evaluation in evidence-based medicine; the third method is recommended at federal level to fulfil requirements of Labour Code in Russian Federation and obligatory social insurance purposes.

[Preventing risk of overexertion in mental workers, depending on work conditions class according to work hardiness parameters].

One of the most important tasks of occupational medicine is prevention of overexertion and occupational diseases in physical workers with various characters and degree of muscular exertion (local, regional and general). The studies demonstrated strong corellation between work conditions class in work hardiness, functional state and level of diseases development among 50 occupational groups examined. The article covers specific and differentiated measures on rational work and rest schedules, and other prophylactic means, with consideration of work conditions class for physical workers.