<?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">10.47470/0016-9900-2025-104-12-1642-1648</article-id><article-id custom-type="edn" pub-id-type="custom">tyebax</article-id><article-id custom-type="elpub" pub-id-type="custom">medlit-5336</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>ГИГИЕНА ОКРУЖАЮЩЕЙ СРЕДЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ENVIRONMENTAL HYGIENE</subject></subj-group></article-categories><title-group><article-title>Медико-экологические индикаторы эффективности реализации проекта «Чистый воздух»</article-title><trans-title-group xml:lang="en"><trans-title>Medical and environmental indicators of the efficiency of the implementation of the “Clean air” project</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2536-1550</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рукавишников</surname><given-names>Виктор Степанович</given-names></name><name name-style="western" xml:lang="en"><surname>Rukavishnikov</surname><given-names>Victor S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Член-корр. РАН, доктор мед. наук, профессор, научный руководитель ФГБНУ ВСИМЭИ, 665827, Ангарск, Россия</p><p>e-mail: rvs_2010@mail.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), professor, corresponding member of the RAS, scientific director, East-Siberian Institute of Medical and Ecological Research, Angarsk, 665827, Russian Federation</p><p>e-mail: rvs_2010@mail.ru</p></bio><email xlink:type="simple">rvs_2010@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/0000-0001-7218-2147</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ефимова</surname><given-names>Наталья Васильевна</given-names></name><name name-style="western" xml:lang="en"><surname>Efimova</surname><given-names>Natalya V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор, вед. науч. сотр. лаб. эколого-гигиенических исследований ФГБНУ ВСИМЭИ, 665827, Ангарск, Россия</p><p>e-mail: med_eco_lab@list.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine), professor, leading researcher, East-Siberian Institute of Medical, and Ecological Research, Angarsk, 665827, Russian Federation</p><p>e-mail: med_eco_lab@list.ru</p></bio><email xlink:type="simple">med_eco_lab@list.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/0000-0002-0169-4513</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Мыльникова</surname><given-names>Инна Владимировна</given-names></name><name name-style="western" xml:lang="en"><surname>Mylnikova</surname><given-names>Inna V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, доцент, ст. науч. сотр., ФГБНУ ВСИМЭИ, 665827, Ангарск, Россия</p><p>e-mail: inna.mylnikova.phd.ms@gmail.com</p></bio><bio xml:lang="en"><p>DSc (Medicine), associate professor, senior researcher, East-Siberian Institute of Medical and Ecological Research, Angarsk, 665827, Russian Federation</p><p>e-mail: inna.mylnikova.phd.ms@gmail.com</p></bio><email xlink:type="simple">inna.mylnikova.phd.ms@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0013-8013</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Лахман</surname><given-names>Олег Леонидович</given-names></name><name name-style="western" xml:lang="en"><surname>Lakhman</surname><given-names>Oleg L.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доктор мед. наук, профессор, профессор РАН, директор ФГБНУ ВСИМЭИ, 665827, Ангарск, Россия</p><p>e-mail: lakhman_o_l@mail.ru</p></bio><bio xml:lang="en"><p>DSc (Medicine) DSc (Medicine), professor, director, East-Siberian Institute of Medical and Ecological Research, Angarsk, Russian Federation</p><p>e-mail: lakhman_o_l @mail.ru</p></bio><email xlink:type="simple">lakhman_o_l@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/0000-0001-8914-7903</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бобкова</surname><given-names>Елена Викторовна</given-names></name><name name-style="western" xml:lang="en"><surname>Bobkova</surname><given-names>Elena V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Канд. мед. наук, зам. директора по медицинской статистике, ОГКУЗ «Медицинский информационно-аналитический центр Иркутской области», 664003, Иркутск, Россия</p><p>e-mail: evb@miac-io.ru</p></bio><bio xml:lang="en"><p>PhD (Medicine), deputy director for medical statistics, Medical Information and Analytical Center of the Irkutsk Region, Irkutsk, 664003, Russian Federation</p><p>e-mail: evb@miac-io.ru</p></bio><email xlink:type="simple">evb@miac-io.ru</email><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «Восточно-Сибирский институт медико-экологических исследований»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>East Siberian Institute of Medical and Ecological Research</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ОГКУЗ «Медицинский информационно-аналитический центр Иркутской области»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Medical Information and Analytical Center of the Irkutsk Region</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>19</day><month>01</month><year>2026</year></pub-date><volume>104</volume><issue>12</issue><fpage>1642</fpage><lpage>1648</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Рукавишников В.С., Ефимова Н.В., Мыльникова И.В., Лахман О.Л., Бобкова Е.В., 2026</copyright-statement><copyright-year>2026</copyright-year><copyright-holder xml:lang="ru">Рукавишников В.С., Ефимова Н.В., Мыльникова И.В., Лахман О.Л., Бобкова Е.В.</copyright-holder><copyright-holder xml:lang="en">Rukavishnikov V.S., Efimova N.V., Mylnikova I.V., Lakhman O.L., Bobkova E.V.</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/5336">https://www.rjhas.ru/jour/article/view/5336</self-uri><abstract><sec><title>Введение</title><p>Введение. В связи с актуальностью проблемы загрязнения атмосферного воздуха необходимо рассмотреть индикаторы эффективности реализации проектов, направленных на улучшение качества среды обитания.</p><p>Цель – дать оценку эффективности реализации проекта «Чистый воздух» по медико-экологическим индикаторам на примере г. Братска.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Проанализированы данные постов наблюдения гидрометцентра за 2015–2024 гг. в городе с развитым промышленно-энергетическим комплексом. Характеристика риска для здоровья населения представлена по коэффициентам и индексам опасности (HQ, HI), относительному риску болезней органов дыхания, его 95%-му доверительному интервалу RR (CI) и этиологической доле (EF). Показатели рассчитаны с учётом двух периодов: данные за 2022–2024 гг. рассматривались как результат реализации комплекса мероприятий.</p></sec><sec><title>Результаты</title><p>Результаты. В 2022–2024 гг. в городе отмечено снижение содержания 3,4-бенз(а)пирена в 1,8 раза, сероуглерода – в 3,2 раза, диоксида азота – в 2,7, взвешенных веществ – в 1,9, фтористого водорода в 1,7 раза. Это привело к снижению частоты болезней органов дыхания у детей: RR составил 1,28 CI (1,19–1,37), этиологическая доля внешних факторов оценивается в 21,8%, по ОРЗ – 1,28 CI (1,22–1,34), EF = 21,7. По частоте бронхиальной астмы и астматического статуса можно выделить две группы риска: 0–4 года (RR = 1,84; EF = 45,6) и 10–14 лет (RR = 1,95; EF = 48,1).</p></sec><sec><title>Ограничения исследования</title><p>Ограничения исследования. Неопределённости результатов связаны с особенностями использования отчётных форм медицинской документации, недостаточностью эпидемиологических знаний о зависимости заболеваемости от загрязнения атмосферного воздуха.</p></sec><sec><title>Заключение</title><p>Заключение. Для оценки эффективности программы целесообразно провести анализ динамики содержания аэрополлютантов с учётом вклада климатического фактора и сезонной зависимости эмиссии предприятий теплоэнергетики и концентраций приоритетных веществ.</p><p>Соблюдение этических стандартов. Исследование не требует представления заключения комитета по биомедицинской этике или иных документов.</p></sec><sec><title>Участие авторов</title><p>Участие авторов: Рукавишников В.С., Лахман О.Л. – концепция и дизайн исследования, редактирование;Ефимова Н.В. – дизайн исследования, сбор материала, написание текста, редактирование; Мыльникова И.В. – статистическая обработка данных, написание текста; Бобкова Е.В. – сбор материала и статистическая обработка данных, написание текста. Все соавторы – утверждение окончательного варианта статьи, ответственность за целостность всех её частей.</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. Работа не имела спонсорской поддержки.</p></sec><sec><title>Поступила</title><p>Поступила: 29.10.2025 / Принята к печати: 02.12.2025 / Опубликована: 15.01.2026</p></sec></abstract><trans-abstract xml:lang="en"><sec><title>Introduction</title><p>Introduction. Given the relevance of air pollution, it is necessary to examine the effectiveness of projects aimed at improving environmental quality.</p></sec><sec><title>Objective</title><p>Objective. To assess the effectiveness of the “Clean Air” project using medical and environmental indicators, using the city of Bratsk as an example.</p></sec><sec><title>Materials and Methods</title><p>Materials and Methods. Data of monitoring for 2015–2024 in a city with a developed industrial and energy complex was analyzed. Health risks were characterized using hazard coefficients and indices (HQ, HI), relative risk of respiratory diseases. The indicators were calculated taking into account two periods, with 2022–2024 considered as the result of implementing a set of measures.</p></sec><sec><title>Results</title><p>Results. In 2022–2024, the city saw a decrease in the content of 3,4-benzo(a)pyrene by 1.8 times, carbon disulfide by 3.2 times, nitrogen dioxide by 2.7 times, suspended matter by 1.9 times, and hydrogen fluoride by 1.7 times. This led to a decrease in the incidence of respiratory diseases in children: RR was 1.28 CI (1.19–1.37), the etiologic share of external factors (EF) is estimated at 21.8%, for ARI – 1.28 CI (1.22–1.34), EF = 21.7. According to the incidence of bronchial asthma and asthmatic status, two risk groups can be distinguished: 0–4 years (RR = 1.84; EF = 45.6) and 10–14 years (RR = 1.95; EF = 48.1).</p></sec><sec><title>Limitation</title><p>Limitation. Uncertainties in the results are related to the specifics of using medical documentation reporting forms and insufficient epidemiological knowledge about the relationship between morbidity and air pollution.</p></sec><sec><title>Conclusion</title><p>Conclusion. To assess the effectiveness of the program, it is advisable to analyze the trend in airborne pollutant levels, taking into account seasonal changes.</p><p>Compliance with ethical standards. The study does not require the submission of a biomedical ethics committee opinion or other documents.</p></sec><sec><title>Contributions</title><p>Contributions: Rukavishnikov V.S., Lakhman O.L. – study concept and design, editing; Efimova N.V. – study design, data collection, writing, editing; Mylnikova I.V. – statistical data processing, writing; Bobkova E.V. – data collection, statistical data processing, writing. 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>Funding</title><p>Funding. The study had no sponsorship.</p></sec><sec><title>Received</title><p>Received: October 29, 2025 / Accepted: December 2, 2025 / Published: January 15, 2026</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>проект «Чистый воздух»</kwd><kwd>загрязнители</kwd><kwd>риск для здоровья</kwd><kwd>детское население</kwd><kwd>эффективность</kwd><kwd>индикаторы</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Clean Air Project</kwd><kwd>pollutants</kwd><kwd>health risk</kwd><kwd>child population</kwd><kwd>effectiveness</kwd><kwd>indicators</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">State of Global Air / 2024. A special report on global exposure to air pollution and its health impacts, with a focus on children’s health. Boston: Health Effects Institute; 2024. Available at: https://stateofglobalair.org/sites/default/files/documents/2024-06/soga-2024-report_0.pdf</mixed-citation><mixed-citation xml:lang="en">State of Global Air / 2024. A special report on global exposure to air pollution and its health impacts, with a focus on children’s health. Boston: Health Effects Institute; 2024. Available at: https://stateofglobalair.org/sites/default/files/documents/2024-06/soga-2024-report_0.pdf</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024; 403(10440): 2162–203. https://doi.org/10.1016/S0140-6736(24)00933-4</mixed-citation><mixed-citation xml:lang="en">GBD 2021 Risk Factors Collaborators. Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. Lancet. 2024; 403(10440): 2162–203. https://doi.org/10.1016/S0140-6736(24)00933-4</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Гурвич В.Б., Козловских Д.Н., Власов И.А., Чистякова И.В., Ярушин С.В., Корнилков А.С. и др. Методические подходы к оптимизации программ мониторинга загрязнения атмосферного воздуха в рамках реализации федерального проекта «Чистый воздух» (на примере города Нижнего Тагила). Здоровье населения и среда обитания – ЗНиСО. 2020; (9): 38–47. https://doi.org/10.35627/2219-5238/2020-330-9-38-47 https://elibrary.ru/mgxfam</mixed-citation><mixed-citation xml:lang="en">Gurvich V.B., Kozlovskikh D.N., Vlasov I.A., Chistyakova I.V., Yarushin S.V., Kornilkov A.S., et al. Methodological approaches to optimizing ambient air quality monitoring programs within the framework of the federal clean air project (on the example of Nizhny Tagil). Zdorov’e naseleniya i sreda obitaniya – ZNiSO. 2020; (9): 38–47. https://doi.org/10.35627/2219-5238/2020-330-9-38-47 https://elibrary.ru/mgxfam (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Veremchuk L.V., Vitkina T.I., Barskova L.S., Gvozdenko T.A., Mineeva E.E. Estimation of the size distribution of suspended particulate matters in the urban atmospheric surface layer and its influence on bronchopulmonary pathology. Atmosphere. 2021; 12(8): 1010. https://doi.org/10.3390/atmos12081010</mixed-citation><mixed-citation xml:lang="en">Veremchuk L.V., Vitkina T.I., Barskova L.S., Gvozdenko T.A., Mineeva E.E. Estimation of the size distribution of suspended particulate matters in the urban atmospheric surface layer and its influence on bronchopulmonary pathology. Atmosphere. 2021; 12(8): 1010. https://doi.org/10.3390/atmos12081010</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Paulin L., Hansel N. Particulate air pollution and impaired lung function. F1000Res. 2016; 5: F1000 Faculty Rev-201. https://doi.org/10.12688/f1000research.7108.1</mixed-citation><mixed-citation xml:lang="en">Paulin L., Hansel N. Particulate air pollution and impaired lung function. F1000Res. 2016; 5: F1000 Faculty Rev-201. https://doi.org/10.12688/f1000research.7108.1</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">Зайцева Н.В., Май И.В. Основные итоги, перспективы применения и совершенствования оценки риска здоровью населения сибирских городов – участников проекта «Чистый воздух» (Братск, Норильск, Красноярск, Чита). Гигиена и санитария. 2021; 100(5): 519–27. https://doi.org/10.47470/0016-9900-2021-100-5-519-527 https://elibrary.ru/ogjjxt</mixed-citation><mixed-citation xml:lang="en">Zaitseva N.V., May I.V. Main results, prospects of application and improvement of the health risk assessment of the population of Siberian cities – participants of the «Clean air» project (Bratsk, Norilsk, Krasnoyarsk, Chita). Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2021; 100(5): 519–27. https://doi.org/10.47470/0016-9900-2021-100-5-519-527 https://elibrary.ru/ogjjxt (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Кузьмин С.В., Авалиани С.Л., Додина Н.С., Шашина Т.А., Кислицин В.А., Синицына О.О. Практика применения оценки риска здоровью в федеральном проекте «Чистый воздух» в городах-участниках (Череповец, Липецк, Омск, Новокузнецк): проблемы и перспективы. Гигиена и санитария. 2021; 100(9): 890–6. https://doi.org/10.47470/0016-9900-2021-100-9-890-896 https://elibrary.ru/sybxwe</mixed-citation><mixed-citation xml:lang="en">Kuzmin S.V., Avaliani S.L., Dodina N.S., Shashina T.A., Kislitsin V.A., Sinitsyna O.O. The practice of applying health risk assessment in the federal project «Clean air» in the participating cities (Cherepovets, Lipetsk, Omsk, Novokuznetsk): problems and prospects. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2021; 100(9): 890–6. https://doi.org/10.47470/0016-9900-2021-100-9-890-896 https://elibrary.ru/sybxwe (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Май И.В., Клейн С.В., Максимова Е.В. Результативность мероприятий федерального проекта «Чистый воздух» по ключевым показателям – качеству атмосферного воздуха и риску для здоровья населения г. Братска. Гигиена и санитария. 2023; 102(12): 1367–74. https://doi.org/10.47470/0016-9900-2023-102-12-1364-1374 https://elibrary.ru/zkowwh</mixed-citation><mixed-citation xml:lang="en">May I.V., Klein S.V., Maksimova E.V. Effectiveness of the activities of the federal project «Clean air» by the quality of atmospheric air and risk for the health (by means of the example of the city Bratsk). Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2023; 102(12): 1367–74. https://doi.org/10.47470/0016-9900-2023-102-12-1364-1374 https://elibrary.ru/zkowwh (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">Ефимова Н.В., Маторова Н.И., Юшков Н.Н., Никифорова В.А., Перцева Т.Г. Медико-экологические риски современного города. Братск; 2008. https://elibrary.ru/qioqff</mixed-citation><mixed-citation xml:lang="en">Efimova N.V., Matorova N.I., Yushkov N.N., Nikiforova V.A., Pertseva T.G. Medical and Environmental Risks of a Modern City [Mediko-ekologicheskie riski sovremennogo goroda]. Bratsk; 2008. https://elibrary.ru/qioqff (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Ефимова Н.В., Рукавишников В.С. Оценка загрязнения атмосферного воздуха г. Братска на основе анализа многолетних наблюдений. Гигиена и санитария. 2022; 101(9): 998–1003. https://doi.org/10.47470/0016-9900-2022-101-9-998-1003 https://elibrary.ru/aaoibc</mixed-citation><mixed-citation xml:lang="en">Efimova N.V., Rukavishnikov V.S. Assessment of air pollution based on the analysis of long-term observations in the city of Bratsk. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2022; 101(9): 998–1003. https://doi.org/10.47470/0016-9900-2022-101-9-998-1003 https://elibrary.ru/aaoibc (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Пинигин М.А. Теория и практика оценки комбинированного действия химического загрязнения атмосферного воздуха. Гигиена и санитария. 2001; 80(1): 9–14.</mixed-citation><mixed-citation xml:lang="en">Pinigin M.A. Theory and practice of evaluating the combined effect of air chemical pollution. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2001; 80(1): 9–14. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">Онищенко Г.Г., Новиков С.М., Рахманин Ю.А., Авалиани С.Л., Буштуева К.А. Основы оценки риска для здоровья населения при воздействии химических веществ, загрязняющих окружающую среду. М.; 2002.</mixed-citation><mixed-citation xml:lang="en">Onishchenko G.G., Novikov S.M., Rakhmanin Yu.A., Avaliani S.L., Bushtueva K.A. Basics of Health Risk Assessment Under Exposure to Chemicals that Pollute the Environment [Osnovy otsenki riska dlya zdorov’ya naseleniya pri vozdeistvii khimicheskikh veshchestv, zagryaznyayushchikh okruzhayushchuyu sredu]. Moscow; 2002. (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Суворова Е.И., Концевая А.В., Рыжов А.П., Мырзаматова А.О., Муканеева Д.К., Худяков М.Б. и др. Систематизация эффективных мер популяционной профилактики в условиях неопределённости: онтологический подход. Кардиоваскулярная терапия и профилактика. 2020; 19(5): 2505. https://doi.org/10.15829/1728-8800-2020-2505 https://elibrary.ru/sfmizf</mixed-citation><mixed-citation xml:lang="en">Suvorova E.I., Kontsevaya A.V., Ryzhov A.P., Myrzamatova A.O., Mukaneeva D.K., Khudyakov M.B., et al. Systematization of effective population-based preventive measures under uncertainty: an ontological approach. Kardiovaskulyarnaya terapiya i profilaktika. 2020; 19(5): 2505. https://doi.org/10.15829/1728-8800-2020-2505 https://elibrary.ru/sfmizf (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">Xu J., Su Z., Liu C., Nie Y., Cui L. Climate change, air pollution and chronic respiratory diseases: understanding risk factors and the need for adaptive strategies. Environ. Health Prev. Med. 2025; 30: 7. https://doi.org/10.1265/ehpm.24-00243</mixed-citation><mixed-citation xml:lang="en">Xu J., Su Z., Liu C., Nie Y., Cui L. Climate change, air pollution and chronic respiratory diseases: understanding risk factors and the need for adaptive strategies. Environ. Health Prev. Med. 2025; 30: 7. https://doi.org/10.1265/ehpm.24-00243</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Валеев Т.К., Сулейманов Р.А., Рахманин Ю.А., Малышева А.Г., Рахматуллина Л.Р. Методические подходы к гигиенической оценке объектов окружающей среды и обоснованию профилактических мероприятий на территориях размещения предприятий нефтехимии и нефтепереработки. Гигиена и санитария. 2019; 98(9): 923–9. https://elibrary.ru/cnazrc</mixed-citation><mixed-citation xml:lang="en">Valeev T.K., Suleimanov R.A., Rakhmanin Yu.A., Malysheva A.G., Rakhmatullina L.R. Methodical approaches to hygienic evaluation of environmental objects and the justification of preventive measures on the territory of accommodation of the enterprises of the petrochemical and refining industries. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2019; 98(9): 923–9. https://elibrary.ru/cnazrc (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Gartland N., Aljofi H.E., Dienes K., Munford L.A., Theakston A.L., van Tongeren M. The effects of traffic air pollution in and around schools on executive function and academic performance in children: a rapid review. Int. J. Environ. Res. Public Health. 2022; 19(2): 749. https://doi.org/10.3390/ijerph19020749</mixed-citation><mixed-citation xml:lang="en">Gartland N., Aljofi H.E., Dienes K., Munford L.A., Theakston A.L., van Tongeren M. The effects of traffic air pollution in and around schools on executive function and academic performance in children: a rapid review. Int. J. Environ. Res. Public Health. 2022; 19(2): 749. https://doi.org/10.3390/ijerph19020749</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Wang F., Wang R., Yan M., Zhao J. Does air pollution affect traffic safety? Evidence from cities in China. Environ. Sci. Pollut. Res. Int. 2023; 30(38): 88998–9011. https://doi.org/10.1007/s11356-023-28560-3</mixed-citation><mixed-citation xml:lang="en">Wang F., Wang R., Yan M., Zhao J. Does air pollution affect traffic safety? Evidence from cities in China. Environ. Sci. Pollut. Res. Int. 2023; 30(38): 88998–9011. https://doi.org/10.1007/s11356-023-28560-3</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Кушелева Е.В., Резчиков А.Ф., Кушников В.А., Иващенко В.А., Богомолов А.С., Кушникова Е.В. и др. Математическое моделирование определения степени загрязнения атмосферы при выбросах химических веществ. Вестник Астраханского государственного технического университета. Серия: Управление, вычислительная техника и информатика. 2018; (2): 17–25. https://doi.org/10.24143/2072-9502-2018-2-17-25 https://elibrary.ru/wcjmlj</mixed-citation><mixed-citation xml:lang="en">Kusheleva E.V., Rezchikov A.F., Kushnikov V.A., Ivashchenko V.A., Bogomolov A.S., Kushnikova E.V., et al. Mathematical modeling of the determination of the degree of atmosphere pollution during emissions of chemical substances. Vestnik Astrakhanskogo gosudarstvennogo tekhnicheskogo universiteta. Seriya: Upravlenie, vychislitel’naya tekhnika i informatika. 2018; (2): 17–25. https://doi.org/10.24143/2072-9502-2018-2-17-25 https://elibrary.ru/wcjmlj (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Koterov A.N., Ushenkova L.N. Causal criteria in medical and biological disciplines: history, essence, and radiation aspects. Report 4, Part 1: The post-hill criteria and ecolgoical criteria. Biol. Bull. Russ. Acad. Sci. 2022; 49(12): 2423–66. https://doi.org/10.1134/S1062359022120068</mixed-citation><mixed-citation xml:lang="en">Koterov A.N., Ushenkova L.N. Causal criteria in medical and biological disciplines: history, essence, and radiation aspects. Report 4, Part 1: The post-hill criteria and ecolgoical criteria. Biol. Bull. Russ. Acad. Sci. 2022; 49(12): 2423–66. https://doi.org/10.1134/S1062359022120068</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Попова А.Ю., Кузьмин С.В., Механтьев И.И. Оценка эффективности реализации системного подхода к обеспечению гигиенической безопасности питьевого и рекреационного водопользования населения на примере Воронежской области. Здоровье населения и среда обитания – ЗНиСО. 2021; 29(8): 7–14. https://doi.org/10.35627/2219-5238/2021-29-8-7-14 https://elibrary.ru/fdconj</mixed-citation><mixed-citation xml:lang="en">Popova A.Yu., Kuz’min S.V., Mekhantev I.I. Assessment of implementation efficiency of the system approach to ensuring safety of public drinking and recreational water use on the example of the Voronezh region. Zdorov’e naseleniya i sreda obitaniya – ZNiSO. 2021; 29(8): 7–14. https://doi.org/10.35627/2219-5238/2021-29-8-7-14 https://elibrary.ru/fdconj (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Онищенко Г.Г., Зайцева Н.В., Клейн С.В., Глухих М.В. Методы комплексной оценки общественного здоровья в связи с факторами среды обитания на основе использования интегральных показателей. Описательный обзор (сообщение 1). Здравоохранение Российской Федерации. 2024; 68(6): 449–58. https://doi.org/10.47470/0044-197X-2024-68-6-449-458 https://elibrary.ru/okeywi</mixed-citation><mixed-citation xml:lang="en">Onishchenko G.G., Zaitseva N.V., Klein S.V., Glukhikh M.V. Methods for complex population health evaluation in relation to environmental factors based on use of integral indices. Descriptive review (report 1). Zdravookhranenie Rossiiskoi Federatsii. 2024; 68(6): 449–58. https://doi.org/10.47470/0044-197X-2024-68-6-449-458 https://elibrary.ru/okeywi (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Salamh P., Stoner B., Ruley N., Zhu H., Bateman M., Chester R., et al. An international consensus on the etiology, risk factors, diagnosis and Management for individuals with Frozen Shoulder: a Delphi study. J. Man. Manip. Ther. 2025; 33(4): 309–20. https://doi.org/10.1080/10669817.2025.2470461</mixed-citation><mixed-citation xml:lang="en">Salamh P., Stoner B., Ruley N., Zhu H., Bateman M., Chester R., et al. An international consensus on the etiology, risk factors, diagnosis and Management for individuals with Frozen Shoulder: a Delphi study. J. Man. Manip. Ther. 2025; 33(4): 309–20. https://doi.org/10.1080/10669817.2025.2470461</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Haskins J.D., Lopez-Hilfiker F.D., Lee B.H., Shah V., Wolfe G.M., DiGangi J., et al. Anthropogenic control over wintertime oxidation of atmospheric pollutants. Geophys. Res. Lett. 2019; 46(24): 14826–35. https://doi.org/10.1029/2019GL085498</mixed-citation><mixed-citation xml:lang="en">Haskins J.D., Lopez-Hilfiker F.D., Lee B.H., Shah V., Wolfe G.M., DiGangi J., et al. Anthropogenic control over wintertime oxidation of atmospheric pollutants. Geophys. Res. Lett. 2019; 46(24): 14826–35. https://doi.org/10.1029/2019GL085498</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Goel V., Tripathi N., Gupta M., Sahu L.K., Singh V., Kumar M. Study of secondary organic aerosol formation and aging using ambient air in an oxidation flow reactor during high pollution events over Delhi. Environ. Res. 2024; 251(Pt. 1): 118542. https://doi.org/10.1016/j.envres.2024.118542</mixed-citation><mixed-citation xml:lang="en">Goel V., Tripathi N., Gupta M., Sahu L.K., Singh V., Kumar M. Study of secondary organic aerosol formation and aging using ambient air in an oxidation flow reactor during high pollution events over Delhi. Environ. Res. 2024; 251(Pt. 1): 118542. https://doi.org/10.1016/j.envres.2024.118542</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Yuan Y.Q., Ding J.N., Bi N., Wang M.J., Zhou S.C., Wang X.L., et al. Physical activity and sedentary behaviour among children and adolescents with intellectual disabilities during the COVID-19 lockdown in China. J. Intellect. Disabil. Res. 2022; 66(12): 913–23. https://doi.org/10.1111/jir.12898</mixed-citation><mixed-citation xml:lang="en">Yuan Y.Q., Ding J.N., Bi N., Wang M.J., Zhou S.C., Wang X.L., et al. Physical activity and sedentary behaviour among children and adolescents with intellectual disabilities during the COVID-19 lockdown in China. J. Intellect. Disabil. Res. 2022; 66(12): 913–23. https://doi.org/10.1111/jir.12898</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Евсеева Г.П., Телепнёва Р.С., Книжникова Е.В., Супрун С.В., Пичугина С.В., Яковлев Е.И. и др. COVID-19 в педиатрической популяции. Бюллетень физиологии и патологии дыхания. 2021; (80): 100–14. https://doi.org/10.36604/1998-5029-2021-80-100-114 https://elibrary.ru/fafnrx</mixed-citation><mixed-citation xml:lang="en">Evseeva G.P., Telepneva R.S., Knizhnikova E.V., Suprun S.V., Pichugina S.V., Yakovlev E.I., et al. Assessment of the level of immune layer to SARS-CoV-2 in children under conditions of novel coronavirus infection COVID-19. Byulleten’ fiziologii i patologii dykhaniya. 2021; (80): 100–14. https://doi.org/10.36604/1998-5029-2021-80-100-114 https://elibrary.ru/fafnrx (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Tran H.M., Tsai F.J., Lee Y.L., Chang J.H., Chang L.T., Chang T.Y., et al. The impact of air pollution on respiratory diseases in an era of climate change: A review of the current evidence. Sci. Total. Environ. 2023; 898: 166340. https://doi.org/10.1016/j.scitotenv.2023.166340</mixed-citation><mixed-citation xml:lang="en">Tran H.M., Tsai F.J., Lee Y.L., Chang J.H., Chang L.T., Chang T.Y., et al. The impact of air pollution on respiratory diseases in an era of climate change: A review of the current evidence. Sci. Total. Environ. 2023; 898: 166340. https://doi.org/10.1016/j.scitotenv.2023.166340</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Макунина О.А., Коваленко А.Н., Быков Е.В., Коломиец О.И. Особенности распространения табакокурения и болезней органов дыхания среди студентов-спортсменов города Челябинска. Гигиена и санитария. 2018; 97(9): 854–7. https://elibrary.ru/ymkayp</mixed-citation><mixed-citation xml:lang="en">Makunina O.A., Kovalenko A.N., Bykov E.V., Kolomiets O.I. The prevalence of tobacco smoking habit and peculiarities of respiratory diseases among students-sportsmen of higher educational establishments (Chelyabinsk). Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2018; 97(9): 854–7. https://elibrary.ru/ymkayp (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Wawrzyniak A., Lipińska-Opałka A., Kalicki B., Kloc M. The effect of passive exposure to tobacco smoke on the immune response in children with asthma. Subst. Use Misuse. 2021; 56(3): 424–30. https://doi.org/10.1080/10826084.2020.1869263</mixed-citation><mixed-citation xml:lang="en">Wawrzyniak A., Lipińska-Opałka A., Kalicki B., Kloc M. The effect of passive exposure to tobacco smoke on the immune response in children with asthma. Subst. Use Misuse. 2021; 56(3): 424–30. https://doi.org/10.1080/10826084.2020.1869263</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Ефимова Н.В., Абраматец Е.А., Тихонова И.В. Влияние химического фактора на здоровье детей с учетом ранних этапов онтогенеза. Гигиена и санитария. 2014; 93(6): 83–6. https://elibrary.ru/tfaoal</mixed-citation><mixed-citation xml:lang="en">Efimova N.V., Abramatets E.A., Tikhonova I.V. The impact of the chemical factor on children’s health with account of the early stages of ontogenesis. Gigiena i Sanitaria (Hygiene and Sanitation, Russian journal). 2014; 93(6): 83–6. https://elibrary.ru/tfaoal (in Russian)</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Huuskonen P., Keski-Nisula L., Heinonen S., Voutilainen S., Tuomainen T.P., Pekkanen J., et al. Kuopio birth cohort – design of a Finnish joint research effort for identification of environmental and lifestyle risk factors for the wellbeing of the mother and the newborn child. BMC Pregnancy Childbirth. 2018; 18(1): 381. https://doi.org/10.1186/s12884-018-2013-9</mixed-citation><mixed-citation xml:lang="en">Huuskonen P., Keski-Nisula L., Heinonen S., Voutilainen S., Tuomainen T.P., Pekkanen J., et al. Kuopio birth cohort – design of a Finnish joint research effort for identification of environmental and lifestyle risk factors for the wellbeing of the mother and the newborn child. BMC Pregnancy Childbirth. 2018; 18(1): 381. https://doi.org/10.1186/s12884-018-2013-9</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>
