Volume 103, Nº 8 (2024)

Introduction. In the context of the change in global climate, the gain in the mortality rate due to an elevation of the temperature in the urban environment with the appearance of “heat waves” becomes an urgent problem.

Materials and methods. To analyze the spatial distribution of risks and damages from premature mortality, there were selected cities located in several climatic zones of Russia including Omsk, Astrakhan, Rostov-on-Don, Lipetsk, Arkhangelsk. For satellite mapping of risks and damages from premature deaths caused by an elevation of the temperature in urban spaces, materials from summer surveys by Landsat series satellites were used.

Results. The analysis of all satellite maps allows concluding the risks of an increase in urban temperature, potential deaths, and economic damage within the territories of the studied cities to be unevenly distributed. Advanced values of potential mortality are localized in places where high population density coincides with an enhanced risk of the temperature rise. The highest damage values were noted in Rostov-on-Don and Astrakhan, the lowest – in Arkhangelsk.

Limitations. Mortality analysis was carried out without taking into account the age and sex structure of the population.

Conclusion. The results of applying the methodology for satellite mapping of risks and economic losses from premature mortality due to rising urban temperatures showed accuracy acceptable for making management decisions to protect the health of the urban population. The results of satellite mapping of these events can be used in the development of preventive measures aimed at reducing premature mortality.

Compliance with ethical standards. The study does not require the submission of a biomedical ethics committee opinion or other documents.

Contribution:
Buzinov R.V. – concept and design of the study, collection of materials;
Noskov S.N. – concept and design of the study, collection of materials, writing the text of the article, editing;
Eremin G.B. – concept and design of the study, editing the article;
Kovshov A.A. – concept and design of the study, editing the article;
Gorny V.I. – concept and design of the study, material processing, data analysis, text writing, article editing;
Kritsuk S.G. – concept and design of the study, material processing, data analysis, text writing, article editing;
Latypov I.Sh. – concept and design of the study, material processing, data analysis, text writing, article editing;
Tronin A.A. – concept and design of the study, material processing, data analysis, text writing, article editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024

Introduction. Due to the tense situation in the world, which may lead to deliberate emergencies at radiation-hazardous facilities as a result of terrorist or sabotage actions, the availability of methods for operational control of radioactive aerosols in the atmospheric air, as well as knowledge of background levels of α- and β-activity of aerosols in the locations of nuclear power facilities, mining and processing facilities

The aim of the study was to assess the radioactivity of aerosols in the atmospheric air according to the indices of α- and β-activity (using the example of the cities of Voronezh, Novovoronezh, Pavlovsk, Lipetsk, Stary Oskol).

Materials and methods. Atmospheric air sampling was carried out using a flow meter-sampler of PU-5 aerosol mixtures. The α- and β-activity of the surface of the AFA-RSP-20 filters was measured with the MKS-AT1117M dosimeter-radiometer with interchangeable detection units BDPA-01 and BDPB-01.

Results. The results of measurements of aerosols α- and β-activity in the atmospheric air in all control points in the territories of populated places established the α-activity of the aerosols to vary from 1.10 • 10^–3 to 6.75 • 10^–3 Bq/m³, total (total) β-activity – from 3. 49 • 10^–3 to 2.12 • 10^–2 Bq/m³. The maximum indices values took place at control points near the open-pit mining of the Shkurlatovsky granite deposit (near Pavlovsk, Voronezh region).

Limitations. The limitations of the study are related to possible errors of the proposed and tested methodology, single (one-time) measurements, variable meteorological conditions affecting a specific result.

Conclusion. The maximum values of aerosols α- and β-activity in the atmospheric air of populated areas are determined by the results of one-time measurements (6.75 • 10^–3 Bq/m³ and 2.12 • 10^–2 Bq/m³) do not cause concerns for the health of the living population.

Compliance with ethical standards. The study does not require the submission of the conclusion of the biomedical ethics committee or other documents.

Contribution:
Kuzmichev M.K. – measurement;
Klepikov O.V. – justification of measurement points, analysis of instrumental measurement materials;
Kurolap S.A. – concept and design of the study;
Kulnev V.V. – general analysis of the material, preparation of conclusions, preparation and editing of the article;
Kizeev A.N., Nikanov A.N. – significant contribution to the concept of research, preparation conclusions, final approval of the manuscript.
All authors are responsible for the integrity of all parts of the manuscript.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgment. The study was carried out within the framework of the Russian Science Foundation (RSF) project No. 20-17-00172 (https://rscf.ru/project/20-17-00172).

Received: May 3, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024

Introduction. GIS is a modern computer technology designed for collecting, storing, analyzing and visualizing spatial data – mapping. GIS is also actively used in healthcare to solve many regional problems, including optimization and management of healthcare resources. Over last decade, many researchers have used mathematical software models for healthcare waste management. A review of the literature shows facility location, risk to the public, and economic feasibility to be among the issues that have been extensively covered in the literature. Designing a reverse logistics network using mathematical software tools is an efficient and effective way to manage healthcare waste.

The objective of the study. To determine the optimal approach to creating a functional model of a system for managing medical waste of class B and C using GIS-technologies for each of the three regions, based on the characteristics of each.

Materials and methods. Medical institutions in three regions (St. Petersburg, Leningrad Region and Krasnoyarsk Territory) as sources of medical waste generation were considered taking into account their capacity and specialization. The composition and volumes of waste by class were determined using a calculation method based on indicative waste generation standards. The identification of local technologies for the neutralization of medical waste existing in medical institutions was carried out. The obtained data was processed statistically and displayed on electronic maps for subsequent use in GIS technologies, as well as for the development and justification of a waste management system for medical institutions, taking into account the prospects for the development of healthcare.

Results. Based on the analysis of data on medical waste of classes B and C in individual medical institutions, as well as an analysis of the power of existing technologies for neutralizing this waste using GIS technologies, proposals were developed to improve the medical waste management system in three regions. The proposals are aimed at improving the sanitary and epidemiological situation in the regions over a five-year period and take into account the features of the existing transport infrastructure and the requirements of sanitary legislation.

Limitations. The model of a medical waste management system using GIS technologies was used only for managing waste of classes B and C.

Conclusion. To ensure the safe and environmentally sustainable functioning of the waste management system of classes B and C in the regions, it is necessary to apply an integrated approach based on GIS technologies. This approach should take into account the regional characteristics of the management of the medical waste disposal system and its economic feasibility and take into account the regional characteristics of transport logistics and the prospects for the development of healthcare.

Compliance with ethical standards. The study does not require the submission of the opinion of the biomedical ethics committee

Contribution:
Mironenko O.V. – scientific leadership, concept and design of the study, editing, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Buzinov R.V. – calculation of gross emissions, maximum single surface concentrations, editing;
Noskov S.N. – calculation of gross emissions, maximum single surface concentrations, editing;
Magomedov Kh.K. – research concept and design of the study, proofreading and editing;
Fedorova E.A. – collection and statistical processing of material, writing the text;
Tovanova A.A. – statistical processing.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024

Introduction. The article considers an approach to be used to delineate the source water protection area for the surface water bodies without putting manufacturing plants within the delineated areas out of action. The approach is based on the assessment of the disposals produced by plants on the water quality at the surface water intake point during the plant’s accident-free operation and both accidents within and beyond the design basis.

Materials and methods. The article used the water protection area laws and regulations, the data observed of the disposal dispersion in the large rivers, and the original articles presented in databases and information systems: RSCI, CyberLeninka, Scopus, Web of Science. The solute transport analytical solutions for the dilution of the linear source in the flow serve as the methodological framework.

Results. The article results have shown the local disposal into the river to form dispersion halo. Due to the specific dispersion processes, an area of a strip-like shape on the opposite shore can be formed where an anthropogenic influence is not present or negligible. This can be considered the background for the safe cooperative operation of the water intake and a manufacturing plant located within the water protection area.

Limitations. The present article outlines the analytical approach for estimating the dilution of wastewater in river waters. The methodologies proposed are subject to several constraints, including the assumption of a constant river channel width and profile, steady discharge of contaminated wastewater, absence of water inflow losses or replenishment, lack of interaction with suspended particulate matter, uniform mixing across all segments of the river, and neglect of wind-induced effects on pollutant dispersion near the water surface. Failure to meet any of these assumptions necessitates recourse to more sophisticated numerical modelling techniques for accurate calculation.

Conclusion. The use of the approach presented in the paper allows justifying the manufacturing plant’s operation within the source water protection area for the surface water bodies.

Compliance with ethical standards. The opinion of the ethics committee is not required.

Contribution:
Nikulenkov A.M. – the concept and design of the study, collection and processing of materials, writing the text;
Yeremin G.B. – the concept and design of the study, approval of the final version of the article, responsibility for the integrity of all parts of the article;
Stepaikina P.V. – the concept and design of the study, collection and processing of materials, editing;
Borisova D.S. – collection and processing of materials, editing;
Mozzhukhina N.A. – writing the text, editing;
Isaev D.S. – editing.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 // Accepted: June 19, 2024 / Published: September 10, 2024

Introduction. Preserving public health in the cold climate regions of the Russian Federation continues to be a significant challenge. Concerns arise because intense production activities in the Murmansk region are associated with a high prevalence of reproduction losses in working females. The apatite and nepheline mining and chemical complex occupies one of the leading places in terms of the number of workers in the industry of the Murmansk region. The share of women employed in these industries exceeds 40% of the total number of workers. Of these, up to 23% of women are employed in adverse and dangerous working conditions.

The purpose of the work. To study working conditions and the state of reproductive health in female workers in the mining and processing industrial complex, as well as the share of the contribution of adverse occupational factors to reproductive health, develop preventive measures aimed at preserving reproductive health and reducing reproductive losses of women employed in the mining and chemical industry.

Materials and methods. We performed an in-depth medical examination on eight hundred ninety five female workers who had been employed at the mining and processing complex for at least one year. We conducted a questionnaire survey of 818 female workers who performed labour operations at ore processing plants and also analyzed 611 cards of those females from antenatal clinics and obstetric institutions. As we accepted statistical processing methods, we used a personal computer industry showed the intense occupational exposure to characterize many types of labour processes in this industry, including the airborne particulate matter, carbon monoxide, nitrogen oxides, phenol, sulfur dioxide, and sulfuric acid. Beneficiation processes of apatite-nepheline ores can be hazardous to reproductive health, increasing the risks of gynecological diseases and contributing to pregnancy complications and perinatal outcomes.

Limitations. The period of the study is from 2018 to 2022.

Conclusion. To solve one of the main national security problems related to the fast depopulation of the Arctic regions, besides socio-economic measures to preserve the population and enhance the total fertility rate, it is necessary to improve the regulations governing the protection of reproductive health in female workers exposed to occupational hazards in the workplaces at the beneficiation of the processes of apatite-nepheline ores.

Compliance with ethical standards. The study was approved by the Local Ethics Committee of the North-Western State Medical University named after I.I. Mechnikov (protocol № 10 dated November 7, 2018). Before the study, each subject gave written informed consent to participate in the study in 2 copies, one of which remained with the subject.

Contribution:
Nikanov A.A., Borisova D.S. – concept and design of the study, collection and processing of materials, data analysis, writing the text of the article, editing;
Kovshov A.A. – processing of materials, data analysis;
Chashchin V.P., Nikanov A.A. – conceptualization, verification.
All authors are responsible for the integrity of all parts of the article and approval of the article final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgment. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024

Introduction. The impact of occupational stressors leaves negative consequences on the physiological and mental health in workers in socially significant occupations. Studying the neurophysiological characteristics of stress response in nurses will make it possible to predict the risks of developing maladaptive states that reduce the quality of life and the effectiveness of professional activity.

The aim of the study is to identify the features of cerebral energy metabolism (CEM) and its adaptive reactivity in medical professionals to increase individual resistance to stress.

Materials and methods. Features of cerebral energy metabolism were studied using the method of neuroenergy mapping (NEC), recording the constant potential level (CPL). The study involved thirty five female specialists with secondary medical education.

Results. In medical workers elevated CPL values were established in 88.6% of cases. Accordingly, in 8.6% and 2.8% of cases there was a reduced and normal level of cerebral energy metabolism (CEM). An increase in SPP indices in the central Fpz-Cz (–4.3 (–10.7–3.3) mV) and parietal Fpz-Pz (–5.4 (–11.4–1.1) mV) leads was accompanied by decrease in the frontal abduction. More than 84% of those examined have a rigid response to physical and emotional stress. The response of restoration of the central nervous system in the post-hyperventilation period was of a rigid nature and was observed in 57% of cases, characterizing a decrease in neurovegetative adaptive responses.

Limitations. The study is limited by the sample of one professional group – 35 nurses, the lack of a comparison group and the lack of clinical characteristics of those examined.

Conclusion. In medical workers, impaired adaptation to stress is confirmed by the rigidity of the CPL index in response to physical and emotional stress, as well as the lack of restoration of the CPL to its background value in the post-hyperventilation period.

Compliance with ethical standards. The study was carried out with the permission of the local ethics committee, in accordance with the principles of the Declaration of Helsinki of the World Medical Association “Ethical principles for conducting scientific medical research involving humans” (as amended in 2008), “Rules of Good Clinical Practice” (approved by order of the Ministry of Health of Russia 01.04. 2016 No. 200n). All those examined signed an informed consent to participate in the study and there is a conclusion from the local ethics committee (LEC) (protocol No. 5 of March 21, 2023).

Contribution:
Shevchenko O.I. – formed the concept and design of the study, developed a study plan, formed a common base, collected and analyzed data on NEC, wrote and designed an article, formulated conclusions;
Lakhman O.L. – took part in the formation of the concept of the study, took part in editing the article.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Revised: June 6, 2024 / Published: September 10, 2024

Introduction. The functional state and adaptive potential in workers employed at mining enterprises in the Arctic territories are influenced both harmful environmental factors and specific climatic conditions, age and work experience in contact with harmful working conditions. Assessing the impact of work experience on the health in employees to reduce occupational risks and prospects for preserving and strengthening the health of workers at mining enterprises remains an extremely relevant and timely task.

Materials and methods. A cross-sectional study of workers was based on a mining and processing plant for the extraction of loparite ore in the Murmansk region. Two hundred one male employee participated in the study. Cardiohemodynamic and somatometric indices were evaluated, on the basis of which integrative indices for assessing functional changes were calculated. The subjects were ranked into groups by work time and age.

Results. The analysis of somatometric indices, depending on work experience, revealed significant intergroup differences in body mass index, index of physical changes, blood pressure and heart rate. The analysis of heart rate variability showed that with an increase in work experience, there is a unidirectional, negative change in time indices and the wave structure of the heart rhythm towards suppressing the activity of the autonomous regulation circuit with an increased contribution of sympathetic influences on the heart rate.

Limitations. Difficult access to medical information and employees’ fears of participating in the study due to fear of dismissal for health reasons.

Conclusion. With an increase in work experience, negative changes in the functional state of the body of mining workers in the Arctic zone of the Russian Federation are comprehensively manifested (overweight, an increase in the index of functional changes, an increase in blood pressure). The increased influence of sympathetic influences on the heart rhythm, with the suppression of self-regulation processes, is reflected in the tension of regulatory mechanisms leading to a decrease in adaptive potential and the development of a premorbid state.

Compliance with ethical standards. The study was carried out in compliance with the norms and rules of biomedical ethics presented in the Helsinki Declaration of the World Medical Association on Ethical Principles of Medical Research (2013). The conclusion of the Ethics Committee at the hospital of the Federal Research Centre “Kola Science of the Russian Academy of Sciences on the possibility of conducting research No. 163 from 2013 was received.

Contribution:
Martynova A.A. – the concept and design of the study, the collection of material and data processing, statistical processing, writing the text;
Pryanichnikov S.V. – material collection and data processing, text writing, statistical processing, editing, article design.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024

Introduction. In industrial environments, at the workplaces of hand tool operators, it is not always possible to completely eliminate increased levels of vibration exposure. The power and speed characteristics of modern hand-held machines are constantly increasing. The impact of local vibration on a person has a negative effect on his body. When working with hand tools, personal protective equipment is used. The purpose of personal hand protection against vibration is to reduce the vibration impact on a person.

Materials and methods. Bench tests were carried out on hand protection products consisting of damping materials of various shapes and locations in the product. The vibration sensor was installed and fastened in places where the operator’s hands came into contact with vibration and on the forearm. The effectiveness of protection was determined by the difference in measurement levels.

Results. During the tests, vibration levels were recorded on the handle of the vibration stand, the palmar surface, the fingers, and the operator’s forearm. In the low-frequency region of the spectrum, vibration attenuation is minimal, and as the frequency range increases, the attenuation increases. Across all areas of the spectrum, performance levels for mittens are higher than for gloves. In places where the fingers come into contact with vibration, the efficiency is less than when in contact with the hand, and in the low-frequency region of the spectrum a negative efficiency of up to 0.8 dB is noted. Vibration measurements on the operator’s forearm showed vibration levels in the forearm to be lower than in the hand.

Limitations. The study was conducted over a period of one year, in laboratory conditions, and was limited to two thousand measurements.

Conclusion. Hygienic assessment of the effectiveness of the protective properties of personal protective equipment for hands was carried out in accordance with developed laboratory test methods when installing and securing a vibration sensor on the handle, hand, and forearm of the operator. Determining the effectiveness of the entire product model should be considered when designing and manufacturing new hand protection against vibration.

Compliance with ethical standards. The study was conducted in accordance with the ethical standards of the Declaration of Helsinki of the World Medical Association. The conclusion of the Local Ethical Committee of the Federal Budgetary Institution “North-West Scientific Center for Hygiene and Public Health” was received, protocol No. 2024/66.3 dated January 26, 2024. Each study participant gave informed voluntary written consent to participate in the study and publish personal information in anonymized form in the journal “Hygiene and Sanitation”.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Revised: June 6, 2024 / Published: September 10, 2024

Regulatory control of the quality of bottled drinking water is an important area of protecting health and enhancing quality of life in population, including children.

The aim of the study is to conduct a comparative analysis of regulatory measures for the quality of bottled drinking water based on chemical indices, with a view to considering international standards to improve the Russian legal framework in this field. The analysis incorporates foreign regulatory and legal instruments in the area of control and monitoring of the quality of packaged drinking water, such as the Codex Alimentarius and directives of the European Parliament, Council of the European Union, Code of Special Regulations of Food and Drug Administration, ТР ЕАЭС 044/2017 Technical Regulations.Current international and domestic regulations, ensuring bottled water quality, have been analyzed. In spite of the fact that regulatory documents comprise fifty three common indices, over half of the international standard values differ significantly as compared to ТР ЕАЭС 044/2017 Regulations. There are noted advantages of domestic regulations, considering the specific requirements for bottled drinking water for children and the physiological benefits of water. In this study, only the regulation of chemical indices in packaged drinking water has been considered based on 4 regulatory documents. Additionally, the work has not taken into account in detail those indices that are not included in domestic regulations.

Conclusion. A comparative analysis of international and national regulations has shown the Russian Federation to have more stringent requirements for the regulatory values of bottled water quality. Taking into account current trends it is necessary to improve and expand constantly the system of regulatory quality control of bottled drinking water by including those indices concentrations of which are regulated by international legislation.

Contribution of the authors:
Shilov V.V. – the concept and design of the study, writing the text, editing;
Markova O.L. – the concept and design of the study, writing the text;
Yeremin G.B. – writing the text, editing;
Isaev D.S. – writing the text, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Revised: June 6, 2024 / Published: September 10, 2024

Introduction. Nowadays, working conditions in industry are often associated with chemical exposure along with manual labour. Given the evidence of the combined effect of heavy metals and muscular work, an increase in cadmium toxicity can be expected. However, an experimental study and actual assessment of exposure to both factors are necessary to avoid underestimation or overestimation of real risks.

The purpose of our study was to establish health effects of subchronic cadmium toxicity against background of physical exercise.

Materials and methods. In a subchronic animal experiment, four groups of outbred male rats, 14 animals each, were exposed to cadmium chloride at a single dose of 0.77 mg/kg body weight, forced physical exercise (treadmill running), both factors combined, or acted as a control group. Hematological, biochemical, and morphometric indices in rodents were assessed at the end of the experiment. The statistical significance of differences between the groups was established using Student’s t-test (p<0.05). For mathematical modelling, we used the Response Surface Methodology (RSM) with the construction of Loewe isoboles.

Results. We observed significant unfavorauble shifts in 27.5% of the assessed morphometric, hematological, biochemical, cytological, and histomorphometric indices in rats following the exposure to cadmium only and in combination with exercise. The mathematical analysis based on the response surface modelling showed the typology of the combined impact of chemical and physical factors to vary depending on the specific effect by which it is assessed, as well as on the dose and level of effect.

Limitations. Laboratory animals of only one biological species and sex were used for the experiment, exposed to a single concentration of cadmium and physical exercise of only one intensity level.

Conclusion. The principles of health effects of cadmium and physical stress as risk factors of the workplace environment specified in the in vivo experiment may serve as a basis for scientific justification of risk assessment criteria to avoid under- or overestimation of real risks in the occupational setting.

Compliance with ethical standards. Ethics approval was provided by the Ethics Committee of the Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers (protocol No. 4 of September 30, 2022).

Contribution:
Minigalieva I.A., Ryabova Yu.V. – study conception and design;
Shabardina L.V., Ryabova Yu.V., Kungurtseva A.K., Sakhautdinova R.R. – data collection and processing;
Panov V.G. – statistical data analysis;
Shabardina L.V., Panov V.G., Kungurtseva A.K., Sakhautdinova R.R. – figure preparation;
Shabardina L.V., Ryabova Yu.V. – draft manuscript preparation;
Minigalieva I.A. – scientific editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: June 20, 2024 / Accepted: July 31, 2024 / Published: September 10, 2024

Introduction. Despite the relatively low average annual mortality rate, the increased incidence of cancer in the population of the Omsk region, together with indicators of the quality of oncological care, indicate a tense epidemiological situation.

The purpose of the study is to determine priority environments and routes of exposure to chemicals in the formation of long-term carcinogenic risks in the city of Omsk.

Materials and methods. There were used results of environmental and social-hygienic monitoring of habitat objects for the period 2017–2022. To assess the cumulative carcinogenic risk, atmospheric air, drinking tap water, open water, soil, food products, and 3 routes of exposure were taken into account: inhalation, oral and cutaneous. The assessment of carcinogenic risks was carried out in accordance with Guideline R 2.1.10.3968–23, taking into account the severity coefficient of malignant neoplasms.

Results. The carcinogenic risk to the health of the population of the city of Omsk as a result of multi–environmenal and multi-route exposure to chemicals was assessed as alarming (high in an the engraved script). The structure of contributions to the cumulative carcinogenic risk: drinking water – 63.3%, atmospheric air – 33.1%, food products – 3.3 %, other environments less than 0.5%. The main route of entry of chemical carcinogens is inhalation (77.4%). Alarming carcinogenic risks were formed through the inhalation route of chloroform from drinking water; chromium VI, formaldehyde, benzene, and soot from atmospheric air. Among the target organs of malignant neoplasms, the greatest risk was in the gastrointestinal tract, which was assessed as alarming.

Limitations. Not all habitat objects were analyzed, which may reduce the objectivity of the conclusions.

Conclusion. An assessment of the long-term cumulative carcinogenic risk made it possible to prioritize the list of chemical pollutants, environmental objects, and routes of exposure to carcinogens. For more accurate planning of sanitary and hygienic measures to reduce public health risks, improve comprehensive monitoring of pollutants in all environments, taking into account all routes of entry into the human body, it is advisable to analyze the total risks for multi-environmental and multi-route exposure with an analysis of the contribution of chemicals, media, routes to their formation.

Compliance with ethical standards. The study does not require the presentation of the conclusion of the biomedical ethics committee or other documents.

Contribution:
Ovchinnikova E.L. – concept of the study, statistical processing of the material, writing the text;
Kolchin A.S. – research design, data collection and statistical processing, text writing;
Kriga A.S. – research concept, editing;
Novikova Yu.A. – collection of literature data, editing.
All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 3, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024