INTRODUCTION. Drug-resistant forms of tuberculosis and their prevalence are an urgent problem of modern medicine. Genetic mechanisms of drug resistance are the key to understanding the possibilities of diagnostic methods for therapy-resistant tuberculosis. Currently, both phenotypic signs of pathogen resistance to TB drugs and genetic markers of resistance are being identified. A wide range of thematic publications and studies on gene mutations is associated with resistance to TB drugs. OBJECTIVE. Analyze the most effective molecular biological technologies and methods allowing to determine resistance of the tuberculosis pathogen to drugs recommended by the World Health Organization (WHO) in treatment regimens. To present the highest incidence of individual mutations associated with antibiotic resistance genes, which form a significant level of resistance to antituberculosis drugs. Consider the spectrum of mutations of drug resistance genes that provide the greatest contribution to its formation.

MATERIALS AND METHODS. Materials of Russian and foreign authors, WHO recommendations related to the prevalence and assessment of the significance of mutations of individual antibiotic resistance genes in different countries and regions were used. Periodical literature sources from international and Russian free databases were analyzed: PubMed, WHO website (https://www.who.int), international tuberculosis database - Tuberculosis Drug Resistance Mutation Database (TBDReaMDB). (http://www.tbdreamdb.com), MDPI, eLIBRARY, CyberLeninka, and a sample of articles by keywords for 20 years (from 2004 to 2024).

RESULTS. The most effective molecular biological technologies that enable the detection of mutations in drug resistance genes are presented. Targeted sequencing allows the targeted selection of primers to fragments of genes associated with drug resistance to obtain the results necessary to assess the level of resistance of mycobacteria to the main drugs included in the treatment regimen. The most frequent localizations of mutations in Mycobacterium tuberculosis genes associated with significant levels of drug resistance have been systematized. DISCUSSION. The prevalence of drug-resistant strains varies across countries and regions and can only be compared using a reliable and verifiable genetic method. Targeted sequencing is a method for effective surveillance of drug-resistant TB, and phenotypic testing in the Bactec MGIT system is used to validate this information. Results of the prevalence of single nucleotide polymorphisms obtained by sequencing methods should complement and clarify the data detected by PCR methods.

CONCLUSION. Targeted Sanger sequencing of drug resistance genes occupies a worthy place among other molecular genetic methods of tuberculosis research. Targeted sequencing has a special role in the analysis of genes associated with drug resistance to long-standing first-line drugs with atypical localization of mutations; it is also the only method for the study of genes associated with resistance to new and emerging drugs. Adequate selection of primer sets for the regions of drug resistance genes encoding polypeptide chain positions in M. tuberculosis enzyme complexes that are critical for the correct formation of the globular structure plays a key role in the efficiency of Sanger sequencing.

INTRODUCTION. Among the methods of hypobaric barotherapy a special place is taken by local decompression (LOD), in which the body is affected by pneumatic pulses of excessive negative pressure. The review presents physiological mechanisms and clinical results of LOD influence on the lower part of the body. High efficiency of LOD in complex therapy of various bone and joint pathologies, microcirculation disorders, prevention of pregnancy disorders, detoxification of the organism, etc. is known. Despite the proven high efficiency of LOD in complex therapy and prevention of various conditions and diseases, its therapeutic and preventive potential in the field of extreme and primarily diving medicine is still insufficiently disclosed.

OBJECTIVE. To determine the prospects of applying local decompression of the lower body part to increase the diver’s resistance to adverse factors of hyperbaria and prevention of diving diseases.

MATERIAL AND METHODS. The review of works from scientometric databases and library collections was carried out. Literature sources were analyzed by key words and various sequences of their combinations in Russian and English. We selected 94 literary sources for 1959-2023, of which 59 works were included in the review. Of the works included in the review, 70% have been published within the last twenty years, 30% of the works - within the last ten years.

RESULTS. Physiological justification of LOD application mechanisms is based on the stretching (increase in length) of vessels. It was proven that there is a strong direct correlation between the increase of transmural pressure in vessels and the amount of pressure reduction in the barocamera during LOD. In space medicine negative pressure on the lower part of the body is used, which has shown its effectiveness both as a diagnostic and as a prophylactic means in the action of unfavorable factors of orbital flight. The use of LOD in sports medicine allows to increase the physical performance of athletes. High efficiency of LOD is demonstrated in the complex therapy of various bone and joint pathology, microcirculation disorders, prevention of pregnancy disorders and detoxification of the body. In veterinary medicine high efficiency of LOD is noted in complex treatment of bone fractures, neurological disorders and peripheral circulation disorders in domestic animals.

DISCUSSION. Most of the analyzed works contain information about direct and reflex mechanisms of LOD action on body tissues. To direct mechanisms of LOD action we can refer the increase of transmural pressure in superficial veins, and also increase of their capacity and blood filling. All other mechanisms of LOD action, in our opinion, can be referred to reflex mechanisms: insignificant change of central hemodynamics, increase of metabolism on the most different levels and increase of physical efficiency of the person.

CONCLUSION. The conducted literature analysis indicates sufficient efficiency of LOD use in various fields of clinical medicine and veterinary medicine. At the same time, the high potential of LOD in the field of diving medicine is not sufficiently disclosed. Nevertheless, it seems that LOD in the field of diving medicine can be used for diagnostic, prophylactic and therapeutic purposes.

OBJECTIVE. Evaluate the capabilities, effectiveness and development trends of ground-based robotic evacuation platforms, and identify factors affecting their introduction into emergency management systems.

MATERIALS AND METHODS. The analysis was based on Russian and foreign publications, comparative assessment of key characteristics (chassis type, payload, autonomy), as well as qualitative study of application scenarios in real conditions or field tests. Sources were searched using the queries “robotic ground vehicles”, “casualty evacuation”, “rescue robotics”, “military medical robotics” in PubMed, Scopus, Web of Science and eLibrary databases, resulting in the identification of 30 relevant articles, of which 16 were directly cited during the writing of the paper.

RESULTS. The comparative review showed that platforms with modular design, improved power and control systems that reduce risks to the evacuee and shorten evacuation times are highly effective.

DISCUSSION. The analysis has shown the need to create unified communication and control standards, as well as to expand the functionality of integrated medical modules and navigation systems, which will make it possible to prepare robotic complexes more effectively for a variety of emergency scenarios and ensure their stable operation in the face of external interference.

CONCLUSION. Ground-based robotic systems have significant potential to improve the speed and safety of rescue operations, but require further improvements in energy efficiency, integration with emergency management systems, the development of medical modules and integrated countermeasures against external factors.

OBJECTIVE. To assess the long-term dynamics of medical and statistical indicators of morbidity among the personnel of the Russian Navy, which will make it possible to specify the forces and means for medical support of servicemen categories in peacetime.

MATERIALS AND METHODS. There has been statistical analysis of the data of medical reports on the health status of personnel and the activity of the medical service in the form 3/MED of military units where at least 70% of the total number of servicemen of the Russian Navy served from 2003 to 2021. The data on health status were calculated per 1000 servicemen, or in ‰, mortality rate – per 100 thousand servicemen per year. The text presents arithmetic averages and their errors (M ± m).

RESULTS. The average annual level of total morbidity of the personnel of the Russian Navy was 1186.9 ‰, the share of morbidity of officers and midshipmen was 27.4 %, sailors and petty officers of contract service – 17.2 %, female servicemen – 6.3 %, conscripts – 49, 1 %, primary morbidity – 571.9 ‰ and 21.6, 17.8 , 4.8 and 55.8 % respectively, hospitalization – 462.3 ‰ and 16.9, 11.7 3.5 and 67.9 % respectively, discharge rate – 18.24 ‰ and 27.6, 9.2, 5.3 and 57.9 % respectively, mortality – 69.56 × 10^-5 and 49.8, 33.7, 4.1 and 12.4 % respectively. The most pronounced levels of registered types of morbidity were found in conscript and female militaries. A significant share of morbidity among conscripts is a consequence of the weakening of the barrier functions of draft commissions of military enlistment offices.

CONCLUSION. Emphasizing the prevention of nosologies in conscripts can significantly reduce the morbidity of Russian Navy personnel. Analyzing the long-term dynamics and structure of morbidity in various categories of the Russian Navy personnel makes it possible to clarify the forces and means for medical support of military personnel.

INTRODUCTION. There is an increased need and insufficient consumption of vitamins and minerals in the conditions of the Far North.

OBJECTIVE. Evaluate the effectiveness of optimizing the nutrition of military personnel in the Arctic with a multicomponent product produced by a critically low-temperature technology of vitamin and mineral saturation of the body.

MATERIALS AND METHODS. Vitamins (B₉, B₁₂ and D - 25-hydroxyvitamin D each) and minerals (K, Na, Ca ionized and total, P, Mg, Fe) were determined in blood samples from servicemen. The main group (n = 30) took the product produced by critically low-temperature technology for 21 days (declaration of conformity of the EAEC: No. RU D-RU. RA03.B69039/24 of 19.04.2024); comparisons (n = 28) took the usual diet. The content of macronutrients, vitamins and minerals was determined by the calculation method.

RESULTS. Deficiency of vitamin B₉ was revealed (in comparison groups - basic in 32,1-53,3 %); iron was in the lower zone of reference value, deficiency and insufficiency of vitamin D (in 70,0-93,3 %), ionized calcium (in 35,7 % and 16,7 %), magnesium (in 20,0 % and 16,7 %); phosphorus at the level of lower limit of norm. The effectiveness of the multicomponent product in nutrition was manifested by the presence of statistically significant differences between the initial indicators and after its intake - an increase in vitamins (B₉ - by 9.9 %, B₁₂ - by 15.2 %, 25OH vitamin D - by 13.4 %), minerals (Ca ionized - by 5.0 %, Ca total - by 6.0 %, P - by 11.1 %, Fe - by 29.8 %, Mg - by 2.6 %).

DISCUSSION. In the North, the issuance of vitamin preparations is not efficient enough, nutrition with products from the local raw material base makes it difficult to implement; the vitamin-mineral complex developed to fill the deficiency of vitamins and minerals has not been tested in the diet of servicemen. The product from vegetable raw materials and eggshells, in addition to vitamins, minerals and macronutrients, contains components that perform the functions of exogenous regulators of metabolism.

CONCLUSION. Insufficient supply of vitamins D, B₉ and minerals indicated signs of folium-deficiency anemia and possible disorder of phosphorus-calcium-magnesium metabolism. Concentrated food product provides nutrients that increase vitamin and mineral saturation of the body.

OBJECTIVE. Изучить особенности офтальмологической заболеваемости взрослого населения архипелага Новая Земля по результатам ретроспективного эпидемиологического анализа заболеваемости за 2019–2022 гг.

MATERIALS AND METHODS. A retrospective epidemiologic analysis of ophthalmologic morbidity among the adult population of the Novaya Zemlya archipelago was performed. The studied contingent includes men (n = 1630) aged from 18 to 65 years and women (n = 698) aged from 22 to 45 years living on the Novaya Zemlya archipelago. According to the data on the population’s demand for medical care, the primary medical documentation “Outpatient coupon (form No. 025-2/c)” was analyzed to record acute diseases in the field of ophthalmology. To record chronic diseases of the ophthalmological profile, the medical records “Medical card of an outpatient (form No. 025/c)” and “Journal of occupational examinations” were analyzed according to the data of medical examinations and dispensary observation of the allocated contingents. Hospitalized morbidity was studied according to the “Statistical card of the discharged from hospital (form 066/c)”.

RESULTS. In the four-year period we studied, 894 ophthalmologic referrals (2019 - 217, 2020 - 238, 2021 - 209, 2022 - 230) were registered in branch No. 8 of FSI “1469 Naval Clinical Hospital” of the Ministry of Defense of the Russian Federation (No. 8 FSI 1469 NCH of the Ministry of Defense of the Russian Federation). Based on the results of the analysis of indicators, it was found that diseases of the eye and its appendages ranked 5th in the statistics on the morbidity of the adult population of the Novaya Zemlya archipelago by ICD-10 disease classes over a four-year period (2019-2022). The total index of acute and chronic cases, calculated as an aggregate of average values for four years, characterizes the prevalence of diseases of the visual organ on the archipelago of Novaya Zemlya in the order of 96 cases per 1000 people. The average values of pathologic lesions in the studied profile on Novaya Zemlya are 10.1 %. It was determined that the most frequent pathology is conjunctiva pathology 383 (42.8 %) cases. Analysis of the distribution of ophthalmologic profile pathology by age groups shows that the highest morbidity rate is observed in the 1st age group (170.1 ‰). The lowest level of morbidity in the Novaya Zemlya archipelago is in the 3rd age group (46.4 ‰).

DISCUSSION. It has been established that in the period under study the ophthalmologic morbidity of the adult population of the Novaya Zemlya archipelago occupies the 5th rank by epidemiologic significance and is represented mainly by conjunctival diseases (42.8 %), refractive disorders (41.9 %), eyelid diseases (6.3 %) and retinal diseases (4.8 %). The leading risk factors provoking the development of ophthalmologic pathology in the conditions of the Arctic region are its climatogeographical features: low negative temperature, runoff winds, increased air humidity, insufficient natural illumination, excessive ultraviolet radiation, photoperiodism phenomena.

CONCLUSION. The process of adaptation of the organism to the extreme conditions of the Arctic region causes a profound restructuring of all regulatory physiological and metabolic processes. Climatogeographical conditions, inherent exclusively to the Arctic, have an adverse effect on the visual analyzer and, being an active catalyst of a number of pathogenetic mechanisms, contribute to refractive disorders, including irreversible ones, the emergence and development of inflammatory diseases of the eyes and their appendages, as well as pathology based on abnormalities in metabolic processes.

OBJECTIVE. Analyze the specifics and problematic issues of regulatory support for habitability and safe working conditions at nuclear-powered offshore facilities (nuclear icebreakers, nuclear service vessels and floating nuclear power plants) at all stages of their life cycle: from design to decommissioning.

MATERIALS AND METHODS. The current documents of the state sanitary and epidemiological standardization system in the field of ensuring safe working conditions for personnel, radiation safety, habitability of nuclear marine facilities during their design, construction, operation, decommissioning, requirements for the protection of the public and the environment, as well as design documentation for their construction and utilization were studied.

RESULTS. The need to eliminate discrepancies in the current regulatory documents on radiation safety during design, construction, operation, and decommissioning of nuclear offshore facilities has been identified. It is established that a part of sanitary rules in this area requires revision, and a part - development. The actual directions of standardization of habitability factors for the ships under consideration have been determined.

DISCUSSION. To ensure a stable safety level of operating nuclear marine facilities in order to implement the strategic directions of development of the Arctic zone of the Russian Federation, it is necessary to timely identify the risks of damage to the health of personnel. The article substantiates the need to update the regulatory and legal framework containing sanitary and epidemiological, organizational and technical requirements to ensure the safety of personnel and population, as well as environmental protection at various stages of the life cycle of nuclear offshore facilities.

INTRODUCTION. The article is devoted to the data concerning the safety control of platelet concentrate (PC). Due to the increased need for the use of this blood component, the assessment of its quality and safety has received increased attention.

OBJECTIVE. Evaluate a promising approach to assess the quality of PC to improve the efficacy and safety of its transfusions.

MATERIALS AND METHODS. The object of the study was apheresis PCs. After harvesting, each PC sample was examined for microparticle content. The index was measured before and after the PC pathogenreduction procedure. Measurement of platelet microparticle sizes in PC samples was performed by the dynamic light scattering method based on the determination of the diffusion coefficient of colloidal particles in liquid on a nanoparticle size analyzer Malvern Zetasizer Nano ZS.

RESULTS. The possibilities and advantages of a rational approach to PC transfusion are revealed taking into account the degree of platelet activation for optimization of component procurement . Special attention is paid to the methods of platelet activation assessment in PC. Transfusion of non-activated platelets for use in hematologic and oncologic patients will reduce the risk of refractoriness development.

DISCUSSION. Detection of microparticles based on DLS will allow differentiating activated (with high microparticle content) from non-activated (with low microparticle content) platelets during therapeutic transfusions and optimize the use of this scarce blood component.

CONCLUSION. The ability to differentiate PTs based on screening of the microparticle content resulting from activation will improve the efficacy and safety of transfusion therapy.

INTRODUCTION. One of the ecopathogenic factors of military labor for the crew of the electromechanical warhead of the ship is the general vibration. Its regular exposure can lead to the formation and progression of diseases of the temporomandibular joint. Laboratory examination of the composition and properties of synovial fluid fully characterizes the pathological processes occurring in the joint. Establishing the relationship between exposure to the influence of general vibration and pathologies of the temporomandibular joint will allow the development of preventive and rehabilitation measures for military personnel whose service is associated with regular exposure to general vibration.

OBJECTIVE. To determine the cytological profile of synovial fluid and the severity of temporomandibular joint disease depending on exposure to general vibration in Navy seafarers.

MATERIALS AND METHODS. A multi-level clinical and pathophysiological examination of Navy servicemen with varying exposure to general vibration was conducted. Clinical manifestations of masticatory apparatus pathology in seafarers were assessed, and a pathophysiological study of synovial fluid was conducted in servicemen with signs of TMJ damage.

RESULTS. It was found that servicemen from the electromechanical combat unit of the ship (the main group), who are constantly exposed to general vibration, more often have masticatory apparatus pathology in a moderate to severe form. As a result of the analysis of laboratory data of the TMJ synovial fluid, an increase in proinflammatory cytokines was revealed in the main group, as well as a decrease in the content of hyaluronic acid.

DISCUSSION. In military personnel more exposed to general vibration, TMJ pathology is more often detected, occurring in a moderate-severe form.

CONCLUSION. The advisability of paying more attention to the problem of the influence of general vibration on the development and progression of TMJ pathology in Navy servicemen has been proven.

OBJECTIVE. Develop a model for predicting stress-associated somatic diseases in servicemen.

MATERIALS AND METHODS. 78 men aged 38.2 ± 5 years were examined. Of them, 33 suffered from stress-associated somatic diseases (SASD), 45 were practically healthy. Psychophysiologic, psychological and physiologic examination was carried out, and service performance indicators were evaluated.

RESULTS. In servicemen suffering from SASD, unlike healthy individuals, a satisfactory level of cardiovascular system reserves is diagnosed more often, among them a greater number of persons have signs of decompensated distress; there are no persons with a strong type of nervous system (NS), mainly middle and weak types of NS are represented; a high level of neuropsychic stability is determined in them less often, among them there are fewer examined persons with a high level and more with an average level of success in professional activity.

DISCUSSION. The obtained results are consistent with the data of other scientists. The developed model for predicting the development of SASD in servicemen contains indicators of physiological, psychophysiological and psychological levels. This indicates the presence of a complex influence of biopsychosocial factors on the development of SASD.

CONCLUSION. The developed model for predicting the development of SASD should be used in the medical and psychological support of military personnel. If the risk of developing SASD is identified, it is necessary to carry out preventive measures.

INTRODUCTION. The individual level of general nonspecific organism reactivity (GNORL), based on the ratio of catatoxic and syntoxic response mechanisms, endowed with appropriate psychophysiological and psychoemotional support, somehow predetermines the severity of the risk of functional and mental maladaptation development in a person. As a result of previously performed own research the possibility of express-assessment of GNORL by means of questionnaire testing was substantiated.

OBJECTIVE. To identify and characterize the links of the GNORL with the main indicators of a person’s propensity to functional and mental maladaptation.

MATERIALS AND METHODS. The study involved 379 participants: 151 men and 228 women, 18-25 years old, native residents of the Republic of Crimea, Volgograd, Vologda and Arkhangelsk regions. The test subjects were students of state universities. The propensity of the study participants to functional and mental maladaptation was assessed through the use of standard methods of psychophysiological and psychological testing. Statistical analysis of the data was performed by calculating the Spearman correlation coefficient and Fisher’s F-criterion.

RESULTS. The results of the study confirm the presence of statistically significant correlations of the GNOR level with the indicators of men’s and women’s propensity to functional and mental maladaptation. First of all, it is necessary to emphasize stressreactivity, reflecting the physiological component of the organism’s response to an exogenous stimulus. The obtained result indicates an increase in stressreactivity and, accordingly, in the tendency to maladaptation with the growth of GNORL. Subsequent distribution of subjects with different GNORL into groups of high, medium and low degree of manifestation of risk indicators of functional and mental maladaptation development allowed us to specify the significance of differences in the frequency of occurrence of representatives of each level of reactivity in all selected groups. For the absolute majority of psychosomatic indicators in groups with a high degree of maladaptation risk, both male and female subjects are either completely absent (heart pain) or their number is limited to single cases (headache, stomach pain, abdominal pain, allergization, physical fatigue, insomnia). With regard to psychological indicators, a similar situation arises in the high-risk maladaptation groups, with the exception of depression in males, where those with high GNORL account for 46% of the total number of males with high GNORL. In groups with a low degree of maladaptation risk, the maximum concentration of expression of this trait is manifested in men and women with low GNORL, reaching a statistically significant level of difference with respect to representatives of high GNORL. Moreover, in men this difference is most pronounced for the whole spectrum of psychosomatic indicators, and in women - for the indicators of psychological risk of maladaptation and separate indicators of psychosomatic tension (headache, stomach pain, physical fatigue). The groups of men and women with an average degree of maladaptation risk for most of the analyzed indicators demonstrate intermediate expression of the frequency of occurrence of representatives of each level of reactivity relative to the groups of men and women with an average and low degree of propensity to maladaptation.

DISCUSSION. There have been revealed systemic interrelations of physiological manifestation of stress reactivity, determined by the expression of nociceptive sensitivity of the organism and subjective self-perception of a person in relation to various situational presentations of exogenous stimuli, retrospectively evaluated by means of questionnaire testing. Unidirectional positive correlation of GNORL with psychosomatic and psychological indicators of maladaptation risk confirms the complex nature of homeostasis organization in humans depending on their individual psychophysiological status. The presented data substantiate the expediency of using GNORL as an indicator of a person’s propensity to functional and mental maladaptation.

CONCLUSION. As a result of the performed research the links of GNORL with the main indicators of a person’s propensity to functional and mental maladaptation have been revealed and characterized. The use of questionnaire express-metho- dology of GNORL determination is able to optimize the primary assessment of the risk of systemic human maladaptation.

OBJECTIVE. To determine an effective organizational and methodological solution to optimize the provision of medical care to a large number of population of a large regional city and the region as a whole during a pandemic of acute viral (infectious) disease by creating an outpatient and polyclinic center.

MATERIALS AND METHODS. The material of the study was 27990 cases of outpatient and polyclinic care during the pandemic of acute coronavirus infection to the population in the State budgetary health care institution “Murmansk city polyclinic №1” for the period of January 2021 to March 2022.

RESULTS. The Outpatient and Polyclinic Center deployed for the first time in the Russian Federation to fight the pandemic of acute coronavirus infection created an integrated coordination of outpatient admission data, the use of polyclinic facilities, audio-distance methods, modern computer technologies, a system of telemedicine consultations, the work of mobile medical teams, routing, examination and treatment of a significant excess number of patients during the pandemic period with the definition of clear criteria for evacuation and treatment.

DISCUSSION. The experience of the first organized and deployed new temporary formation of the state health care institution - Outpatient and Polyclinic Center in the acute pandemic period will allow to use it in case of other possible emergencies of biological and social nature in all territories and subjects of the Russian Federation.

CONCLUSION. As a result of the conducted work, the main directions are outlined for improving methodological and scientific approaches to the organization of outpatient and polyclinic treatment of a significant number of patients in the acute pandemic period of infectious and viral diseases on the whole territory and in all climatic zones of the country.

OBJECTIVE. To study the organization of occupational medicine in Joint Stock Company “Sredne-Nevsky Shipyard” (JSC SNS).

MATERIALS AND METHODS. Guiding documents on the issue of occupational medicine are studied. The structure of occupational medicine in the joint-stock company “Sredne-Nevsky Shipyard” is considered. The results of health monitoring at the enterprise, in which 270 employees (men and women) took part, were presented, the comparison group included 78 residents of St. Petersburg. The study of elemental status was carried out. The examination included general medical questioning and examination of hair samples for the content of macro- and microelements.

RESULTS. Prior to employment, employees engaged in work with harmful production factors revealed by a special assessment of working conditions were obliged to undergo a preliminary medical examination. Subsequently, employees underwent annual periodic medical examinations, and every 5 years - an examination at the occupational pathology center. JSC SNS has organized a medical station where medical workers - a general practitioner and a paramedic - receive patients. Employees receive the necessary medical care virtually without interrupting the production process. Special attention is paid to employees with chronic diseases. Based on the analysis results of the employees’ elemental status, a number of chemical elements were found to have deviations beyond the normal range and, accordingly, increasing the probability of health disorders and the risk of developing element-dependent diseases. First of all, it concerns the deficiency of macronutrients. Deficiency of potassium, calcium, magnesium, sodium, iodine was very common in workers. No deviations from the norm were noted with regard to toxic chemical elements.

DISCUSSION. Based on the obtained data, it was concluded that the working conditions of JSC SNS employees working in harmful labor conditions moderately disturb the metabolism of macro- and microelements. Optimizing the intake of deficient elements and eliminating imbalances can be an effective measure to increase labor productivity and reduce the general morbidity of JSC SNS employees. Based on the results of the examination and doctor’s conclusions, we evaluated the micronutrient content of the organized nutrition of employees at JSC SNS and corrected macro- and micronutrient metabolism disorders using specialized products of functional nutrition. A fruit and cereal specialized detoxification bar was introduced into the therapeutic and preventive diet, which took into account the needs of JSC SNS employees to reduce the risk of occupational and general diseases, as well as to compensate for insufficient intake of vitamins and minerals.

CONCLUSION. Application of industrial medicine achievements at the Sredne-Nevsky Shipyard allows effective disease prevention for employees working with harmful labor factors.