<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medlit</journal-id><journal-title-group><journal-title xml:lang="ru">Гигиена и санитария</journal-title><trans-title-group xml:lang="en"><trans-title>Hygiene and Sanitation</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">0016-9900</issn><issn pub-type="epub">2412-0650</issn><publisher><publisher-name>Federal Scientific Center of Hygiene named after F.F. Erisman</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47470/0016-9900-2022-101-12-1521-1527</article-id><article-id custom-type="elpub" pub-id-type="custom">medlit-2753</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>МЕДИЦИНА ТРУДА</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>OCCUPATIONAL HEALTH</subject></subj-group></article-categories><title-group><article-title>Индивидуальные особенности терморегуляции у работников нефтедобывающего производства в охлаждающих метеорологических условиях</article-title><trans-title-group xml:lang="en"><trans-title>The individual characteristics of thermoregulation in oil production workers exposed to cooling meteorological factors</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3493-4592</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Полякова</surname><given-names>Екатерина Михайловна</given-names></name><name name-style="western" xml:lang="en"><surname>Polyakova</surname><given-names>Ekaterina M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ст. науч. сотр. ФБУН «СЗНЦ гигиены и общественного здоровья», 191036, Санкт-Петербург.</p><p>e-mail: USTIMENKOEKATERINA_2009@mail.ru</p><p> </p></bio><bio xml:lang="en"><p>Senior Researcher, North-West Scientific Center for Hygiene and Public Health, Saint Petersburg, 191036, Russian Federation.</p><p>e-mail: USTIMENKOEKATERINA_2009@mail.ru</p></bio><email xlink:type="simple">ustimenkoekaterina_2009@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4186-457X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мельцер</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Meltser</surname><given-names>Alexander V.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0275-0553</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сюрин</surname><given-names>С. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Syurin</surname><given-names>Sergei A.</given-names></name></name-alternatives><email xlink:type="simple">noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФБУН «Северо-Западный научный центр гигиены и общественного здоровья» Роспотребнадзора</institution><country>Россия</country></aff><aff xml:lang="en"><institution>NorthWest Public Health Research Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Северо-Западный государственный медицинский университет имени И.И. Мечникова» Министерства здравоохранения Российской Федерации</institution><country>Россия</country></aff><aff xml:lang="en"><institution>North-Western State Medical University named after I.I. Mechnikov</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>13</day><month>01</month><year>2023</year></pub-date><volume>101</volume><issue>12</issue><fpage>1521</fpage><lpage>1527</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Полякова Е.М., Мельцер А.В., Сюрин С.А., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Полякова Е.М., Мельцер А.В., Сюрин С.А.</copyright-holder><copyright-holder xml:lang="en">Polyakova E.M., Meltser A.V., Syurin S.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.rjhas.ru/jour/article/view/2753">https://www.rjhas.ru/jour/article/view/2753</self-uri><abstract><sec><title>Введение</title><p>Введение. При выполнении трудовых операций в условиях охлаждающих метеорологических воздействий вне производственных помещений возрастает значение оценки индивидуальных особенностей терморегуляции организма для предупреждения холодозависимых нарушений здоровья.</p><p>Цель исследования — оценить индивидуальные варианты терморегуляции у работников, осуществляющих добычу нефти на открытых площадках в охлаждающих метеорологических условиях.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Исследования проведены на одном из предприятий нефтяной промышленности в Западной Сибири у рабочих, осуществляющих технологические операции на открытых участках в холодный период года (слесари-ремонтники, операторы, машинисты технологических установок). Оценка локальных и общих нарушений терморегуляции была выполнена с применением функциональных методов исследования (у 76 человек – определение теплового статуса организма, у 54 человек — измерение температуры кожи с холодовой пробой) по утверждённым методикам. У прошедших обследование работников длительность пребывания на открытых участках колебалась от 12 до 31 ч при 40-часовой рабочей неделе.</p></sec><sec><title>Результаты</title><p>Результаты. Установлено, что у 18,8% обследованных лиц индивидуальные индексы теплового состояния не соответствовали рекомендуемым в методических указаниях значениям. Результаты кожной термометрии с холодовой пробой у лиц, работающих в условиях открытых площадок в холодный период года, позволили выявить начальные проявления нарушений контроля теплового состояния организма и циркуляции кови в кистях и пальцах рук. Анализ индивидуальных особенностей терморегуляции показал, что её общие и локальные нарушения определяются длительностью работы на открытых производственных участках. Курение табака и продолжительность трудового стажа на предприятии оказывали дополнительное негативное влияние на уровень локальных нарушений терморегуляции.</p></sec><sec><title>Ограничения исследования</title><p>Ограничения исследования. Значительные временные затраты на проведение оценки общей и локальной терморегуляции у работников предприятия и отвлечение их от выполнения трудовых операций в течение смены можно отнести к ограничениям методики исследования.</p></sec><sec><title>Заключение</title><p>Заключение. Впервые выявленные особенности терморегуляции позволили разработать целенаправленные медико-профилактические мероприятия для экспонированных к охлаждающим метеорологическим факторам работников нефтедобычи в Западной Сибири.</p><p>Соблюдение этических стандартов. Исследование с участием добровольцев одобрено Локальным этическим комитетом ФГБОУ ВО СЗГМУ им. И.И. Мечникова Минздрава России (выписка из протокола от 22.11.2017 г. № 12).</p></sec><sec><title>Согласие пациентов</title><p>Согласие пациентов. Каждый участник исследования (или его законный представитель) дал информированное добровольное письменное согласие на участие в исследовании и публикацию персональной медицинской информации в обезличенной форме в журнале «Гигиена и санитария».</p></sec><sec><title>Участие авторов</title><p>Участие авторов: Полякова Е.М. — литературный обзор, сбор и обработка данных, создание базы данных, анализ полученных результатов, статистический анализ, написание текста статьи; Мельцер А.В. — концепция и дизайн исследования, выбор аналитических методов, написание текста, утверждение окончательного варианта статьи; Сюрин С.А. — литературный обзор, редактирование статьи.</p></sec><sec><title>Конфликт интересов</title><p>Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.</p></sec><sec><title>Финансирование</title><p>Финансирование. Исследование не имело спонсорской поддержки.</p></sec><sec><title>Поступила</title><p>Поступила: 16.09.2022 / Принята к печати: 08.12.2022 / Опубликована: 12.01.2023</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. To prevent health disorders under the influence of cooling meteorological factors of open production sites, the assessment of the individual characteristics of the employee’s thermoregulation is of particular importance.</p><p>The purpose of the study was to describe the individual characteristics of thermoregulation of employees of an oil producing enterprise when working in open production sites during the cold season.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. We studied the employees of the oil-producing enterprise of Western Siberia, performing labour operations in open production sites during the cold season (operators, process plant machinists, repairmen). An assessment of general and local violations of thermoregulation of the body of workers was carried out using objective assessment methods (assessment of the thermal state of the body in seventy six people, skin thermometry with cold load — 54 people) according to approved methods. The duration of work in the open area of the workers included in the study ranged from 12 to 31 hours during a 40-hour work week.</p></sec><sec><title>Results</title><p>Results. According the assessment of the thermal state of workers, in 18.8% of workers, the personal indicators for assessing the thermal state were found to fail to correspond to the recommended values in the guidelines. Evaluation of the results of skin thermometry with a cold load in workers performing labour operations in open production sites under cooling conditions of the cold season of the year made it possible to establish the average values of temperature indicators in the study group to indicate the presence of initial signs of violations of the thermal control of the body and neurocirculatory disorders in the hands and fingers. An assessment of individual characteristics showed general and local violations of thermoregulation to be associated with the duration of work at open production sites, the objective indicators of local violations of thermoregulation were additionally affected by the employee’s smoking habit and work experience.</p></sec><sec><title>Limitations</title><p>Limitations. Significant time costs for assessing the general and local thermoregulation of the employees of the enterprise and distracting them from performing labor operations during the shift can be attributed to the limitations of the methodology.</p></sec><sec><title>Conclusion</title><p>Conclusion. For the first time, the revealed features of thermoregulation in oil production workers in Western Siberia made it possible to develop targeted medical and preventive measures.</p><p>Compliance with ethical standards. The study with the participation of volunteers was approved by the Local Ethics Committee of North-Western State Medical University named after I.I. Mechnikov (Protocol of November 22, 2017, No.12).</p></sec><sec><title>Patient consent</title><p>Patient consent. Each participant of the study (or his/her legal representative) gave informed voluntary written consent to participate in the study and publish personal medical information in an impersonal form in the journal "Gigiena i Sanitariya (Hygiene and Sanitation, Russian journal)".</p></sec><sec><title>Contribution</title><p>Contribution: Meltser A.V. — concept and research design, choice of analytical methods, data collection and processing, writing the text, editing, approval of the final version of the article; Polyakova E.M. — literature review, data collection and processing, database creation, analysis of the results obtained, statistical analysis, writing the text of the article, responsibility for the integrity of all parts of the article; Syurin S.A. — literary review, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version. </p></sec><sec><title>Conflict of interest</title><p>Conflict of interest. The authors declare no conflict of interest. </p></sec><sec><title>Acknowledgement</title><p>Acknowledgement. The study had no sponsorship. </p></sec><sec><title>Received</title><p>Received: September 16, 2022 / Accepted: December 8, 2022 / Published: January 12, 2023</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>особенности терморегуляции</kwd><kwd>работа на открытой территории</kwd><kwd>нефтедобывающее производство</kwd><kwd>охлаждающие метеорологические факторы</kwd><kwd>оценка риска для здоровья</kwd></kwd-group><kwd-group xml:lang="en"><kwd>thermoregulatory individual characteristics</kwd><kwd>outdoor work</kwd><kwd>oil production</kwd><kwd>cooling meteorological factors</kwd><kwd>health risk assessment</kwd><kwd>working in an open area</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Гимранова Г.Г., Бакиров А.Б., Шайхлисламова Э.Р., Каримова Л.К., Бейгул Н.А., Маврина Л.Н. Заболевания костно-мышечной и периферической нервной систем у нефтяников в условиях сочетанного воздействия вибрации и тяжести трудового процесса. Гигиена и санитария. 2017; 96(6): 552-5. https://doi.org/10.18821/0016-9900-2017-96-6-552-555</mixed-citation><mixed-citation xml:lang="en">Gimranova G.G., Bakirov A.B., Shaykhlislamova E.R., Karimova L.K., Beygul N.A., Mavrina L.N. Musculo-skeletal and peripheral nervous diseases in employees of the oil industry in conditions of the combined impact of vibration and the heavy working process. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2017; 96(6): 552–5. https://doi.org/10.18821/0016-9900-2017-96-6-552-555 (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Mäkinen T.M. Health problems in cold work. Ind. Health. 2009; 47(3): 207-20. https://doi.org/10.2486/indhealth.47.207</mixed-citation><mixed-citation xml:lang="en">Mäkinen T.M. Health problems in cold work. Ind. Health. 2009; 47(3): 207–20. https://doi.org/10.2486/indhealth.47.207</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Korhonen I. Blood pressure and heart rate responses in men exposed to arm and leg cold pressor tests and whole-body cold exposure.Int. J. Circumpolar Health. 2006; 65(2): 178-84. https://doi.org/10.3402/ijch.v65i2.18090</mixed-citation><mixed-citation xml:lang="en">Korhonen I. Blood pressure and heart rate responses in men exposed to arm and leg cold pressor tests and whole-body cold exposure. Int. J. Circumpolar Health. 2006; 65(2): 178–84. https://doi.org/10.3402/ijch.v65i2.18090</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Нагибович О.А., Уховский Д.М., Жекалов А.Н., Ткачук Н.А., Аржавкина Л.Г., Богданова Е.Г. и др. Механизмы гипоксии в Арктической зоне Российской Федерации. Вестник Российской Военно-медицинской академии. 2016; (2): 202-5.</mixed-citation><mixed-citation xml:lang="en">Nagibovich O.A., Ukhovskiy D.M., Zhekalov A.N., Tkachuk N.A., Arzhavkina L.G., Bogdanova E.G., et al. Mechanisms of hypoxia in Arctic zone of Russian Federation. Vestnik Rossiyskoy Voenno-meditsinskoy akademii. 2016; (2): 202–5. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Солонин Ю.Г., Бойко Е.Р., Величковский Б.Т. Физиологические нормы напряжения организма при физическом труде в высоких широтах. Журнал медико-биологических исследований. 2017; 5(1): 25-36. https://doi.org/10.17238/issn2542-1298.2017.5.1.25</mixed-citation><mixed-citation xml:lang="en">Solonin Yu.G., Boyko E.R., Velichkovskiy B.T. Physiological stress standards at manual labour in high latitudes. Zhurnal mediko-biologicheskikh issledovaniy. 2017; 5(1): 25–36. https://doi.org/10.17238/issn2542-1298.2017.5.1.25 (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Чащин В.П., Гудков А.Б., Попова О.Н., Одланд Ю.О., Ковшов А.А. Характеристика основных факторов риска нарушений здоровья населения, проживающего на территориях активного природопользования в Арктике. Экология человека. 2014; (1): 3-12.</mixed-citation><mixed-citation xml:lang="en">Chashchin V.P., Gudkov A.B., Popova O.N., Odland Yu.O., Kovshov A.A. Description of main health deterioration risk factors for population living on territories of active natural management in the Arctic. Ekologiya cheloveka. 2014; (1): 3–12. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Алексеев В.Б., Зайцева Н.В., Шур П.З. Перспективы управления профессиональными рисками в условиях реформ нормативно-правовой базы. Медицина труда и промышленная экология. 2018; (10): 39-44. https://doi.org/10.31089/1026-9428-2018-10-39-44</mixed-citation><mixed-citation xml:lang="en">Alekseev V.B., Zaytseva N.V., Shur P.Z. The prospects of occupational risk management during reforms of regulatory legislation basis. Meditsina truda i promyshlennaya ekologiya. 2018; (10): 39–44. https://doi.org/10.31089/1026-9428-2018-10-39-44 (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Шляпников Д.М., Шур П.З., Алексеев В.Б., Лебедева Т.М., Костарев В.Г. Методические подходы к комплексному анализу экспозиции и стажа в оценке профессионального риска. Гигиена и санитария. 2016; 95(1): 33-6. https://doi.org/10.18821/0016-9900-2016-95-1-33-36</mixed-citation><mixed-citation xml:lang="en">Shlyapnikov D.M., Shur P.Z., Alekseev V.B., Lebedeva T.M., Kostarev V.G. Methodological approaches to the integrated evaluation of the exposure and length of service in the occupational risk assessment. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2016; 95(1): 33–6. https://doi.org/10.18821/0016-9900-2016-95-1-33-36 (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Измеров Н.Ф., Бухтияров И.В., Прокопенко Л.В., Кузьмина Л.П. Сбережение здоровья работающих и предиктивно-превентивно-персонифицированная медицина. Медицина труда и промышленная экология. 2013; (6): 7-12.</mixed-citation><mixed-citation xml:lang="en">Izmerov N.F., Bukhtiyarov I.V., Prokopenko L.V., Kuz’mina L.P. Protecting health of workers and predictive preventive personified medicine. Meditsina truda i promyshlennaya ekologiya. 2013; (6): 7–12. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Чащин В.П., Гудков А.Б., Чащин М.В., Попова О.Н. Предиктивная оценка индивидуальной восприимчивости организма человека к опасному воздействию холода. Экология человека. 2017; (5): 3-13. https://doi.org/10.33396/1728-0869-2017-5-3-13</mixed-citation><mixed-citation xml:lang="en">Chashchin V.P., Gudkov A.B., Chashchin M.V., Popova O.N. Predictive assessment of individual human susceptibility to damaging cold exposure. Ekologiya cheloveka. 2017; (5): 3–13. https://doi.org/10.33396/1728-0869-2017-5-3-13 (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Buijze G.A., Sierevelt I.N., van der Heijden B.C.J.M., Dijkgraaf M.G., Frings-Dresen M.H.W. The effect of cold showering on health and work: a randomized controlled trial. PLoS One. 2016; 11(9): e0161749. https://doi.org/10.1371/journal.pone.0161749</mixed-citation><mixed-citation xml:lang="en">Buijze G.A., Sierevelt I.N., van der Heijden B.C.J.M., Dijkgraaf M.G., Frings-Dresen M.H.W. The effect of cold showering on health and work: a randomized controlled trial. PLoS One. 2016; 11(9): e0161749. https://doi.org/10.1371/journal.pone.0161749</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Burström L., Nilsson T., Wahlström J. Whole-body vibration and the risk of low back pain and sciatica: a systematic review and meta-analysis.Int. Arch. Occup. Environ. Health. 2014; 88(4): 403-18. https://doi.org/10.1007/s00420-014-0971-4</mixed-citation><mixed-citation xml:lang="en">Burström L., Nilsson T., Wahlström J. Whole-body vibration and the risk of low back pain and sciatica: a systematic review and meta-analysis. Int. Arch. Occup. Environ. Health. 2014; 88(4): 403–18. https://doi.org/10.1007/s00420-014-0971-4</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Kim F., Nichol G., Maynard C., Hallstrom A., Kudenchuk P.J., Rea T., et al. Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA. 2014; 311(1): 45-52. https://doi.org/10.1001/jama.2013.282173</mixed-citation><mixed-citation xml:lang="en">Kim F., Nichol G., Maynard C., Hallstrom A., Kudenchuk P.J., Rea T., et al. Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA. 2014; 311(1): 45–52. https://doi.org/10.1001/jama.2013.282173</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Kraemer H.C. Statistical issues in assessing comorbidity. Stat. Med. 1995; 14(8): 721-33. https://doi.org/10.1002/sim.4780140803</mixed-citation><mixed-citation xml:lang="en">Kraemer H.C. Statistical issues in assessing comorbidity. Stat. Med. 1995; 14(8): 721–33. https://doi.org/10.1002/sim.4780140803</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Lim S.T., Sohn M.H., Jeong H.J. Cold exposure-induced rhabdomyolysis demonstrated by bone scintigraphy. Clin. Nucl. Med. 2008; 33(5): 349-50. https://doi.org/10.1097/RLU.0b013e31816a78f8</mixed-citation><mixed-citation xml:lang="en">Lim S.T., Sohn M.H., Jeong H.J. Cold exposure-induced rhabdomyolysis demonstrated by bone scintigraphy. Clin. Nucl. Med. 2008; 33(5): 349–50. https://doi.org/10.1097/RLU.0b013e31816a78f8</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Long W.B. III, Edlich R.F., Winters K.L., Britt L.D. Cold injuries. J. Long Term Eff. Med. Implants. 2005; 15(1): 67-78. https://doi.org/10.1615/jlongtermeffmedimplants.v15.i1.80</mixed-citation><mixed-citation xml:lang="en">Long W.B. III, Edlich R.F., Winters K.L., Britt L.D. Cold injuries. J. Long Term Eff. Med. Implants. 2005; 15(1): 67–78. https://doi.org/10.1615/jlongtermeffmedimplants.v15.i1.80</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Petrone P., Asensio J.A., Marini C.P. Management of accidental hypothermia and cold injury. Curr. Probl. Surg. 2014; 51(10): 417-31. https://doi.org/10.1067/j.cpsurg.2014.07.004</mixed-citation><mixed-citation xml:lang="en">Petrone P., Asensio J.A., Marini C.P. Management of accidental hypothermia and cold injury. Curr. Probl. Surg. 2014; 51(10): 417–31. https://doi.org/10.1067/j.cpsurg.2014.07.004</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">SPRINT Research Group. Wright J.T. Jr., Williamson J.D., Whelton P.K., Snyder J.K., Sink K.M., Rocco M.V., et al. A randomized trial of intensive versus standard blood-pressure control. N. Engl. J. Med. 2015; 373(22): 2103-16. https://doi.org/10.1056/NEJMoa1511939</mixed-citation><mixed-citation xml:lang="en">SPRINT Research Group. Wright J.T. Jr., Williamson J.D., Whelton P.K., Snyder J.K., Sink K.M., Rocco M.V., et al. A randomized trial of intensive versus standard blood-pressure control. N. Engl. J. Med. 2015; 373(22): 2103–16. https://doi.org/10.1056/NEJMoa1511939</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Mäkinen T.M., Hassi J. Health problems in cold work. Ind. Health. 2009; 47(3): 207-20. https://doi.org/10.2486/indhealth.47.207</mixed-citation><mixed-citation xml:lang="en">Mäkinen T.M., Hassi J. Health problems in cold work. Ind. Health. 2009; 47(3): 207–20. https://doi.org/10.2486/indhealth.47.207</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Pienimäki T. Cold exposure and musculoskeletal disorders and diseases. A review.Int. J. Circumpolar Health. 2002; 61(2): 173-82. https://doi.org/10.3402/ijch.v61i2.17450</mixed-citation><mixed-citation xml:lang="en">Pienimäki T. Cold exposure and musculoskeletal disorders and diseases. A review. Int. J. Circumpolar Health. 2002; 61(2): 173–82. https://doi.org/10.3402/ijch.v61i2.17450</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Näyhä S. Cold and the risk of cardiovascular diseases. A review.Int. J. Circumpolar Health. 2002; 61(4): 373-80. https://doi.org/10.3402/ijch.v61i4.17495</mixed-citation><mixed-citation xml:lang="en">Näyhä S. Cold and the risk of cardiovascular diseases. A review. Int. J. Circumpolar Health. 2002; 61(4): 373–80. https://doi.org/10.3402/ijch.v61i4.17495</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Holmér I., Hassi J., Ikäheimo T.M., Jaakkola J.J. Cold Stress: Effects on Performance and Health. In: Patty’s Toxicology. John Wiley &amp; Sons; 2012: 1-26. https://doi.org/10.1002/0471435139.tox097.pub2</mixed-citation><mixed-citation xml:lang="en">Holmér I., Hassi J., Ikäheimo T.M., Jaakkola J.J. Cold Stress: Effects on Performance and Health. In: Patty’s Toxicology. John Wiley &amp; Sons; 2012: 1–26. https://doi.org/10.1002/0471435139.tox097.pub2</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Дмитрук Л.И., Любченко П.Н., Рогаткин Д.А. Модификация функциональной холодовой пробы, используемой для диагностики вибрационной болезни, на основе новейших методов спектрофотометрии in vivo. Альманах клинической медицины. 2008; (17-2): 180-3.</mixed-citation><mixed-citation xml:lang="en">Dmitruk L.I., Lyubchenko P.N., Rogatkin D.A. Modification of the functional cold test used to diagnose vibration disease based on the latest methods of in vivo spectrophotometry. Al’manakh klinicheskoy meditsiny. 2008; (17–2): 180–3. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Измеров Н.Ф., Бухтияров И.В., Денисов Э.И. Оценка профессиональных рисков для здоровья в системе доказательной медицины. Вопросы школьной и университетской медицины и здоровья. 2016; (1): 14-20.</mixed-citation><mixed-citation xml:lang="en">Izmerov N.F., Bukhtiyarov I.V., Denisov E.I. Evaluation of occupational risks in the system of evidence-based medicine. Voprosy shkol’noy i universitetskoy meditsiny i zdorov’ya. 2016; (1): 14–20. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Polyakova E.M., Meltser A.V., Iakubova I.S., Erastova N.V., Suvorova A.V.Integrated model of health risk assessment for workers having to work outdoors under exposure to cooling meteorological factors. Health Risk Analysis. 2022; (2): 88-97. https://doi.org/10.21668/health.risk/2022.2.08.eng</mixed-citation><mixed-citation xml:lang="en">Polyakova E.M., Meltser A.V., Iakubova I.S., Erastova N.V., Suvorova A.V. Integrated model of health risk assessment for workers having to work outdoors under exposure to cooling meteorological factors. Health Risk Analysis. 2022; (2): 88–97. https://doi.org/10.21668/health.risk/2022.2.08.eng</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Мельцер А.В., Полякова Е.М., Якубова И.Ш., Ерастова Н.В., Кропот А.И. Разработка профилактических мероприятий при работе на открытой территории в холодный период года. Гигиена и санитария. 2022; 101(8): 947-53. https://doi.org/10.47470/0016-9900-2022-101-8-947-953</mixed-citation><mixed-citation xml:lang="en">Mel’tser A.V., Polyakova E.M., Yakubova I.Sh., Erastova N.V., Kropot A.I. The elaboration of preventive measures when working in an open area during the cold season of the year. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2022; 101(8): 947–53. https://doi.org/10.47470/0016-9900-2022-101-8-947-953 (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Мельцер А.В., Полякова Е.М. Оценка комбинированного профессионального риска при выполнении трудовых операций на открытой территории в холодный период года. Профилактическая и клиническая медицина. 2019; (3): 4-13.</mixed-citation><mixed-citation xml:lang="en">Mel’tser A.V., Polyakova E.M. Assessment of the combined professional risk working in open territory in the cold period of the year. Profilakticheskaya i klinicheskaya meditsina. 2019; (3): 4–13. (in Russian)</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
