У ЧЕБНО-М ЕТОДИЧЕСК ИЙ

К ОМ ПЛЕК С
MILITARY HYGIENE
(Textbookfor students of the Medical Institute)
Areas of study: 5510100 -Treatment
5111000 -Vocational training (medical case 5510100)
5510200 - Pediatric work
5510300 -Medical prevention work

MILITARY HYGIENE
CHAPTER 1. METHODOLOGY OF MILITARY HYGIENE.

FUNDAMENTALS OF STATE SANITATION

EPIDEMIOLOGICAL SUPERVISION

MEDICAL CONTROL OF LIFE AND HOUSEHOLD

 TROOPS
1.1. Military hygiene as a science and area of ​practice​for doctors
The origins of the development of hygiene date back to ancient times. Already
among the peoples of Ancient Greece, Rome, Egypt, India, China and others, the
first attempts to create healthy living conditions were observed. This was expressed
in various measures related to lifestyle, nutrition, prevention of infectious diseases
and the fight against them, physical culture, etc. It is known from historical
documents that many peoples of that time showed concern for public health. The
motto "it is better to prevent disease than to cure" was known in ancient China,
where there was a custom to pay for domestic doctors as long as everyone in the
family was healthy.
The hygiene motto is well formed by the English scientist E.A. Parks:
make human development more perfect, decline less rapid, life- stronger, and
death more distant. A great contribution to the practical part of military hygiene
was made by the prominent organizer of the medical service of the Russian army,
General Staff Doctor Roman Chetyrkin (1797-1865). He and under his leadership
wrote a number of manuals on preventive and curative support of troops, including
such as "Manual on the practical military medical police", "The experience of the
military medical police, or rules for maintaining the health of Russian soldiers in the
ground service". Another the famous Moscow therapist N. G. Zakharyin
(1829-1897) in his speech there in 1873 noted: “We consider hygiene not only a
necessary part of medical education, but also the most important subject of the
activity of any practical doctor. The more mature the doctor is, the more he
understands the power of hygiene and the relative weakness of treatment; the
success of therapy is possible only under the condition of hygiene. " The great
surgeon N.I. Pirogov (1810-1881) wrote: “I believe in hygiene, this is where the true
progress of ourscience: the future belongs to preventive medicine ” . Later I.P.
Pavlov also called hygiene the medicine of the future.
Alexei Petrovich Dobroslavin (1842-1889) can rightfully be considered the
founder of scientific hygiene in our country and, above all, of its experimental
direction. He is known for his works in various fields of hygiene, created the first
Russian textbook on hygiene and the magazine "Health", the first hygienic
experimental laboratory and laid the foundation on which domestic hygiene began
to be built. A.P. Dobroslavin was one of the organizers of the Russian Society for
the Protection of Public Health and Women's Medical Education in Russia. In St.
Petersburg, he organized the first independent department of hygiene in Russia
within the walls of the Military Medical Academy (1871). In 1882, the Department
of Hygiene was created at Moscow University and was headed by F.F. Erisman
(1842-1915), who, like A.P. Dobroslavin, was one of the founders of domestic
hygiene. Pupil F.F. Erisman, Grigory Vitalievich Khlopin (1863-1929), continued
the best traditions of his teacher in improving and developing the experimental
direction in hygiene.
An outstanding role in the development of general, military and radiation
hygiene was played by Fyodor Grigorievich Krotkov (1896-1983). During the Great
Patriotic War F.G. Krotkov, as the chief hygienist of the Soviet Army, supervised
the sanitary and hygienic provision. In the post-warover the years, he directed his
efforts to the development of radiation hygiene in our country.
The development of military hygiene in the post-war period is inextricably
linked with the name of Professor PorUiriy Evdokimovich Kalmykov
(1901-1971). He proposed fundamentally new approaches to the study of military
clothing, to the regulation of the chemical composition of drinking water and the
quantitative norms of water supply to the troops.
A great contribution to the development of military hygiene was made by
Honored Scientist of the Republic of Uzbekistan Professor Nikolai Fedorovich
Koshelev (1915-1996). He directly and under his leadership developed issues of
food hygiene, water supply for troops, and other important areas of hygienic
science.
At present, the development of military hygiene is moving towards further
study of the influence of environmental factors on a serviceman, the influence of
service conditions on his health and performance, the introduction of new physical,
chemical, physiological, toxicological and other methods into hygienic research,
and the convergence of conventional sanitary and hygienic examinations with
scientific research.
Military hygiene is part of the disciplines of the preventive direction of
medicine and, as a science, has four main attributes: purpose, subject, object (s)
and research method (methods). The purpose of military hygiene is to preserve and
strengthen the health of a person (soldier). The subject of the research is the health
of a serviceman and the regularities of the influence of environmental factors on
him.
According to the definition presented in the preamble to the Constitution of
the World Health Organization (1948) " health is a state of complete physical,
mental and social well-being, and not just the absence of disease or physical
defect." In this interpretation, we are talking about three main components of health:
physical, mental and social (Picture 1.1.).
For the study of physical health, it is necessary to assess the structure,
function and adaptive reserves of the body. When measuring the structure,
anthropometric indicators are used (height, body weight, volume of the chest,
abdomen, shoulder, etc.). When measuring the function, physiometric indicators
are used (strength of the hands, back strength, vital capacity of the lungs, etc.). To
identify the adaptive capabilities of the body, stress tests are used (squatting,
push-ups from the floor, step test, pulling up on the bar, bicycle ergometry).

Serviceman health
PHYSICAL STATUS NERVO-MENTAL STATUS
Physical development Mental working capacity
Physical readiness and efficiency Moral normativity
Adaptive reserves Behavioral regulation
Immunoresistance Communication potential
Neurotization personality
SOCIAL STATUS
- Professional and
educational characteristics
Social realization and adaptability
Material security
Family status and reproduction
 Picture 1.1. The main components of a soldier's health.
For the study of mental health, special tests are required, which are widely
used by psychophysiologists, and often by psychiatrists. A number of blank
techniques have been proposed for the hygienic diagnostics of the mental health of
military personnel.
The greatest difficulties are caused by the assessment of the third component
of health - social well-being, since it does not have standards and can vary
significantly depending on the needs and capabilities of people. The environment
Is a combination ofnatural and social elements with which a person is inextricably
linked and which influence him throughout his life, being an external condition or a
way of his existence.
Elements of the environment have certain properties that determine the
specifics of the impact on a person or the need for them to ensure the life of
people. Natural elements affect their physical, biological properties and chemical
composition. The group of social elements also has certain properties that can be
characterized by qualitative or quantitative parameters.
In military hygiene, the listed properties of natural and social elements are
usually called environmental factors. In the process of studying them, the nature of
the factors and the essence of their action on the human body are established, the
boundaries of their negative andpositive influence, that is, hygiene standards,
proposals are being developed to eliminate or weaken the effect of harmful and use
beneficial factors.
The objects of research in military hygiene are a person (soldier), a military
collective and the environment.
Considering the methods of military hygiene, it should be noted that the
method of prevention interpreted in many literary sources is nothing more than a
way to achieve the main goal, and the methods for studying objects are:
the method of hygienic observation and examination, as the main one in the
practice of hygienists;
instrumental and laboratory method using an arsenalphysical, chemical,
physiological, biochemical,microbiological and other methods of studying the
human body and environmental objects;
an experimental method used mainly in scientific research carried out in
laboratory and natural conditions;
a mathematical and statistical method that makes it possible to study the
influence of a particular factor on a person or a team, to determine the reliability of
research, and also to evaluate the effectiveness of hygiene recommendations.
Thus, military hygiene is one of the scientific preventive disciplines and
areas of practical activity of military doctors, which develops ways and methods of
maintaining and strengthening health, increasing the efficiency and combat
effectiveness of military personnel. Has scientifically substantiated basic attributes:
purpose, subject, objects and research methods. On this basis, military hygienists
establish hygienic standards and requirements for working and living conditions,
objects of military equipment and weapons, monitor compliance with standards and
requirements both at the design and construction stage and in the processoperation
of facilities, take part in the development and evaluation of uniforms, equipment,
technical means that ensure proper working and living conditions for military
personnel.

1.2. The purpose andField

objectives
activitiesofoftraining
servicemen
students in military hygiene
(guidelines)
The purpose of training students is to prepare them in theoretical and
practical issues of military hygiene to the extent necessary for the performance of
their duties in accordance with their assignment in wartime and in emergency
situations of peace. The duration of the course of studying the discipline with a
teacher for students of the medical-preventive faculty is 40 academic hours, for
students of the medical and pediatric faculties - 20 hours and the dental one -
The main types of classroom activities are lectures and practical exercises.
as a result of studying the discipline, the student must
Know:
Fundamentals of modern hygiene and its place in medicine:
a short history of the development of hygiene;
social and hygienic foundations of primary prevention of diseases;
legal aspects of protecting the health of the population and military personnel;
the concept of primary prevention of diseases of military personnel;
hygienic diagnostics of human health and the state of the environment;
basics of hygienic regulation;
military hygiene and ecology;
organization of state sanitary and epidemiological supervision;
the basics of personal hygiene and a healthy lifestyle.
Composition of atmospheric air and its hygienic value:
natural chemical composition of the atmosphere;
 physical properties of the air;
biological factors of the air;
 complex indicators of the state of the air environment;
air pollution;
measures to combat atmospheric pollution.
Hygiene of water supply:
water exchange and human health;
standards for the need for drinking water in various living conditions;
hygienic requirements for the quality of drinking water;
sanitary requirements for the extraction and distribution of water;
improving the quality of drinking water in the conditions of stationary and field
deployment of troops;
organization of water supply to the unit and medical control over it in peacetime
and wartime.
Food hygiene:
nutrition and health;
scientific foundations of rational nutrition;
hygienic control over the nutritional value of military personnel;
medical control over the good quality of food;
medical control over food for troops in extreme conditions.
Hygiene of placement:
rules for placement in the barracks;
planning and development of military camps;
features of the field deployment of troops;
soil and its hygienic value;
cleaning of military camps;
medical control over the deployment of troops.
Occupational hygiene:
hygienic characteristics of work;
features of military labor with some occupational hazards;
the principles of rationing in the hygiene of military labor;
prevention of occupational pathology in military personnel;
hygienic requirements for military clothing, footwear and equipment;
medical control over the bath and laundry service for the troops.
Radiation hygiene:

basic physical concepts and units of measurement used in radiation hygiene;

hygienic regulation of ionizing radiation;
medical control and radiation safety in the X-ray room of the infirmary
(polyclinic).
Hospital hygiene:
hospital environment and health;
hygienic foundations for the design and operation of medical rooms of a medical
center (infirmary);
the basis for the prevention of in-hospital diseases (infections).
Be able to:
work with regulatory documents in the implementation of sanitary and
anti-epidemic (preventive) measures in part;
use in their work the provisions of the laws of the Republic of Uzbekistan other
regulatory legal acts in the field of health protection of military personnel and
civilians;
analyze the morbidity of military personnel, the state of their environment and
highlight the priority factors of adverse health effects;
to draw up draft orders, directives, plans and programs on the issues of
maintaining and strengthening the health of personnel;
identify the most pressing issues, effective forms and methods of hygienic
education of personnel, effectively and at a high methodological level to organize
and carry out this work;
Be aware of:
with the prospects and main directions of hygiene development;
with the organizational and staff structure of the SEL connection.
Know and be able to use:
fundamentals of legislation on the protection of the health of
the population and troops,
the structure and basic principles of health care in the country and the Armed
Forces of the Republic of Uzbekistan, the rights, duties and responsibilities of
officials of the unit in maintaining the health of military personnel;
guidance documents regulating the conditions of service and life of personnel,
as well as measures for environmental protection;
Own:
a method of studying and assessing the impact of natural and social
conditions on the health of an individual and military collectives as a whole,
identifying the cause-and-effect relationships of health disorders;
the method of operational and retrospective analysis of morbidity and other
injuries of military personnel in relation to classes and individual nosological forms
of diseases in relation to environmental factors;
a methodology for a comprehensive assessment of the sanitary state of a
military unit and the effectiveness of sanitary and anti-epidemic (practical) measures
when preparing recommendations to the command to optimize the sanitary
situation;
the method of investigation of single and group cases of food poisoning and
other injuries associated with violation of sanitary rules and hygienic standards;
the method of medical control over the placement,
water supply, food and labor of military personnel, bath and laundry services
in combat conditions, as well as for cleaning fieldsbattles and burial of the corpses
of fallen soldiers;
the method of indication of food and water contaminated with radioactive
substances, PNEs, ОВ
SDYAV with the help of the available standard means.
During practical exercises, the main attention should be paid to the analysis of
specific issues using situational tasks.
Independent work is carried out by studying the recommended literature and
lecture material. The study of military hygiene begins after students have passed
general hygiene and the basics of organizing medical support for troops.

1.3. The system of state sanitary and epidemiological surveillance and

medical control over vital activity andeveryday life of troops in peacetime
The system of state sanitary and epidemiological surveillance and medical
control over the vital activity and everyday life of peacetime troops is basic for
ensuring their sanitary and epidemiological well-being in wartime and in emergency
situations.
State sanitary and epidemiological supervision in the Armed Forces and
at defense facilities is the activity of specially authorized bodies and institutions
(officials) of the medical service of the Armed Forces, which are part of the State
Sanitary and Epidemiological Service of the Republic of Uzbekistan, to prevent,
detect and suppress violations of the legislation of the Russian Federation.
Federation in the field of ensuring the sanitary and epidemiological well-being
of the personnel of the Armed Forces in order to protect their health and the
environment.
The activities of the bodies and institutions of the Armed Forces carrying out
state sanitary and epidemiological surveillance in the Armed Forces are organized
by the chief state sanitary doctor of the Ministry of Defense of the Republic of
Uzbekistan - Deputy Head of the Main Military Medical Directorate of the Ministry
of Defense of the Republic of Uzbekistansanitary and epidemiologica providing,
being in its own functional responsibilities Deputy Chief State sanitary doctor in the
Republic of Uzbekistan.
State Sanitary and Epidemiological Service of the Republic of
Uzbekistan includes:
a) bodies and institutions of the Armed Forces exercising state sanitary and
epidemiological supervision in the Armed Forces:
Department (State Sanitary and Epidemiological Surveillance)
The Main Military Medical Directorate of the Ministry of Defense of the
Republic of Uzbekistan;
Main Center for State Sanitary and Epidemiological Surveillance of the
Ministry of Defense of the Republic of Uzbekistan;
centers of state sanitary and epidemiological surveillance of the branches of
the Armed Forces, combat arms, military districts, fleets, associations;
other centers of sanitary and epidemiological surveillance of the Ministry of
Defense of the Republic of Uzbekistan;
b) state research and other institutions of the Armed Forces, carrying out their
activities in order to ensure state sanitary and epidemiological supervision in the
Republic of Uzbekistan.
The main tasks of the bodies and institutions of the Armed Forces, included
state sanitary and epidemiological service of the Russian
Federation, are the prevention of infectious and mass non-infectious diseases
(poisoning) of the personnel of the Armed Forces, the prevention of the harmful
effects of environmental factors on them,as well as hygienic upbringing and
education.
State sanitary and epidemiological supervision is carried out by the medical
service on the basis of the legislation of the Republic of Uzbekistan, the
requirements of the charters of the Armed Forces of the Republic of Uzbekistan,
orders and directives of the Minister of Defense of the Republic of Uzbekistan,
deputy ministers
defense of the Republic of Uzbekistan, determining measures to preserve and
strengthen the health of servicemen and ensure the sanitary and epidemic well-being
of troops and naval forces.

Official by persons empowered to carry outstate sanitary and

epidemiological surveillance in the Armed
Forces from name organs and institutions Armed Forces included in state
sanitary and epidemiological service of the Republic of Uzbekistan, are:
a) Chief State Sanitary Doctor of the Ministry of Defense of the Republic of
Uzbekistan - Deputy Chief of the Main Military Medical Directorate of the Ministry
of Defense of the Republic of Uzbekistan for sanitary and epidemiological support;
b) Head of the Department (State Sanitary and Epidemiological Surveillance)
of the Main Military Medical Directorate of the Ministry of Defense of the Republic
of Uzbekistan - Deputy Chief State Sanitary Doctor of the Ministry of Defense of
the Republic of Uzbekistan;
c) Head of the Main Center for State Sanitary and Epidemiological
Surveillance of the Ministry of Defense of the Republic of Uzbekistan
- Deputy Chief State Sanitary Doctor of the Ministry of Defense of the
Republic of Uzbekistan;
d) chief state sanitary doctors of the branches of the Armed Forces, military
districts, fleets, combat arms of the Armed Forces, 12 of the Main Directorate of
the Ministry of Defense of the Republic of Uzbekistan, associations;
e) heads of centers for state sanitary and epidemiological surveillance of the
branches of the Armed Forces, military districts, fleets, combat arms of the Armed
Forces, associations and other centers of state sanitary and epidemiological
surveillance of the Ministry of Defense of the Republic of Uzbekistan;
f) other specialists:
deputy head and specialists of the medical and preventive profile of the
department (state sanitary and epidemiological supervision)
The Main Military Medical Directorate of the Ministry of Defense of the
Republic of Uzbekistan;
heads of departments and their deputies, senior doctors, general hygiene
doctors, food hygiene doctors, occupational hygiene doctors, communal hygiene
doctors, radiation hygiene doctors, child hygiene
doctors adolescents, epidemiologists, parasitologists, bacteriologists,
doctors-virologists,physi cians
disinfectologists, laboratory doctors and other doctors medical and preventive
profile, physician assistants of the centers of state sanitary and epidemiological
surveillance of the Armed Forces.

State sanitary and epidemiological supervision includes:

observation, assessment and forecasting of the health status of personnel in
connection with the state of the environment;
identification and establishment of the causes and conditions for
the occurrence and
the spread of infectious, occupational and mass non-infectious diseases and
poisoning of personnel;
development of binding proposals on the implementation of measures to
ensure the sanitary and epidemic well-being of the Armed Forces of the Republic
of Uzbekistan;
exercise control over the conduct of sanitary and anti epidemic measures, for
the observance of the current sanitary legislation by associations, formations,
military units (ships), institutions, military educational institutions, enterprises,
organizations of the Ministry of Defense of the Republic of Uzbekistan, as well as
personnel;
who committed them;
keeping records of infectious, mass non-infectious diseases and poisonings
associated with the adverse effect of military service conditions on the health of
personnel.
Medical control over the vital activity and everyday life of the troops is
carried out in the military echelon by doctors-specialists of sanitary
epidemiological platoons brigades, sanitary and epidemiologicallaboratories of
divisions and medical service of military units.
1.4. Features of sanitary and epidemiological surveillance and
medical control over the vital activity and life of troops in wartime and
emergency situations
Most characteristic conditions that complicate sanitary
epidemiological setting v military time and under emergency situations
are:
mass sanitary losses, as the wounded, so and somatic,
mental and infectious patients;
destruction of industrial and communal facilities containing hazardous
biological, chemical and radioactive substances;
emissions, releases and discharges of pathogenic microorganisms into water
sources and air;
mass migration of the population from the combat zone to territories
unsuitable for deployment;
decrease in the possibilities
of treatment- and -prophylactic and sanitary
epidemiological institutions in the areas of hostilities to provide appropriate
medical services for organizing the burial of dead people and animals with a high
degree of epidemic and epizootic danger;
difficulties in organizing the burial of dead people and animals with a high
degree of epidemic and epizootological danger;
insufficient stocks of medicines intended for the treatment and prevention of mass
infectious and non-infectious diseases (poisoning);
the spread of panic and other inadequate psychological reactions of the
population that impede the conduct of sanitaryanti-epidemic (preventive) measures.
Sanitary and epidemiological surveillance and medical control over the vital
activity and everyday life of troops in wartime and emergency situations are
carried out in order to study, identify and eliminate unfavorable environmental
factors affecting the health of military personnel, the occurrence and spread of
diseases among personnel.
Sanitary and epidemiological surveillance and medical control
includes:
control over the state of health of personnel;
control over compliance with the established sanitary norms and rules for
accommodation, food, water supply, military labor conditions and habitability, bath
and laundry service for personnel, burial of the dead and dead;
identification and establishment of the causes and conditions for the
emergence and spread of infectious and mass non-infectious diseases and
poisoning (injuries) of personnel;
study and assessment of the sanitary-epidemic state of compounds (units)
and areas of their location (actions);
development of proposals for the command to eliminate the identified
deficiencies and conduct specific (targeted) sanitaryhygienic and anti-epidemic
measures.
For the implementation of sanitary and epidemiological surveillance, the
forces and means of sanitary and epidemiological institutions of operational
associations, as well as military medical services (SEL, sev compound, medb,
MPP, doctors and paramedics of battalions and divisions) are involved.
The medical service on the organization and conduct of sanitary and
epidemiological surveillance closely interacts with the centers
state sanitary and epidemiological supervision of the country, the medical
service of the allied armies, etc.
Sanitary and Epidemiological supervision and medical supervision over
the deployment of personnel of a military unit includes:
participation of the head of the medical service of a military unit (specialists of
sanitary and epidemiological subdivisions and institutions) in the selection of sites
(areas) for the deployment of troops during sanitary and epidemiological
reconnaissance and as part of a reconnaissance group organized by the command;
control over the implementation of sanitary and hygienic requirements for the
equipment and maintenance of engineering structures (support points,heating
points, shelters, dugouts, dugouts, etc.);
control over the cleaning of the territory, removal of sewage and waste.
Sanitary and epidemiological surveillance and medical control of
nutrition includes:
assessment of the actual nutritional status of personnel, as well as verification
of the quantitative and qualitative nutritional value,good quality of food products,
cooking technology and quality of finished food;
identification of diseases associated with malnutrition;
verification of compliance with the sanitary rules for the transportation,
storage of food products and delivery of finished food to the units;
control of the sanitary state of food items and their location;
control over the preparation of the layout of products and the observance of
the diet in accordance with the conditions of activity of the personnel;
participation in the sanitary and epidemiological examination of products in
case of suspicion of their poor quality, as well as trophy food;
medical monitoring of the health of food service personnel and monitoring
the implementation of personal hygiene rules at food facilities.
Sanitary and epidemiological supervision and medical control over
water supply provides for:
Participation in the exploration of water sources and determination of their
suitability for water supply;
checking (according to indications) the quality of water produced at water supply
points, water points and other water sources, as well as monitoring the sanitary
condition of means of supply, storage and delivery of water to subdivisions;
assessment of the effectiveness of water disinfection by determining the
residual chlorine;
control over bringing to the personnel the norms of water supply, as well as
the availability of individual means of purification and disinfection of water among
military personnel;
medical observation for state health personnel composition, involved in the
extraction, treatment, storage and delivery of water;
conducting a sanitary and epidemiological examination of water in case of
suspicion of its contamination with pathogens of infectious diseases,
poisonous chemicals, etc.
Sanitary and pidemiological supervision and medical supervision over
conditions of military labor and habitability is carried out by:
selective control over the observance of hygienic norms and habitability
parameters at military equipment facilities and in engineering structures;
conducting medical examinations during the inter-combat period and,
according to indications, laboratory studies in order to monitor the health of
personnel exposed to harmful factors(ionizing and non-ionizing radiation,
aggressive and toxic liquids, rocket fuel components, etc.);
selective (together with psychologists, and if necessary - psychiatrists)
checking the state of the neuropsychic status of personnel.
Sanitary and Epidemiological supervision and medical supervision over
bath and laundry service for personnel includes:
control over the timeliness and completeness of washing of personnel,
the quality of washing (disinfection, disinfestation) of linen, uniforms and dry
cleaning of special clothing;
checking the sanitary condition of divisional and regimental baths ( sanitary
passages), the presence of soap, the procedure for disinfecting washcloths and
disinfection of bath rooms (sanitary passages).
Sanitary and epidemiological supervision and medical control over the
burial of the dead (deceased) provides for:
participation of a representative of the medical service of the unit (formation)
in the choice of places (burial points, mass graves) for the burial of those killed in
battle,
those who died from wounds and diseases and control over the observance
of sanitary rules during burial;
checking the provision of units allocated for the disposal and destruction of
sanitary materials with disinfectants, special clothing, as well as the organization of
washing the personnel of these units after the end of work.
The conduct of hostilities in the mountains, deserts, arctic regions imposes
increased sanitary and epidemiological requirements for all aspects of the life and
everyday life of servicemen, maintaining a high combat capability of personnel.
When organizing and implementing sanitary and epidemiological
surveillance and medical control in arid zones (deserts, semi-deserts, steppes)
and other areas with high ambient temperatures, special attention is paid to:
monitoring the health of personnel in order to identify servicemen with low
body weight, manifestations of the initial symptoms of dehydration, vitamin
deficiencies, maladjustment disorders,associated with exposure to high ambient
temperatures;
- provision of personnel with good-quality drinking water in
sufficient quantity, but not less than 25 liters per one soldier per day;
the diet of military personnel, providing the highest energy value of the diet
for a cool time of the day;
introduction to the diet of hot snacks, spices to whet the appetite;
obtaining additional vitamin preparations, especially those containing
water-soluble vitamins;
replacing part of the fat with an additional amount of easily digestible
carbohydrates (sugar, cookies, waffles, etc.);
planning, if possible, basic physical activities for a cool time of the day, limiting
them in the hot time of the day in the open air, creating awnings to protect from
direct sunlight for carrying out service at checkpoints, outposts, checkpoints, etc.;
provision of personnel with individual flasks and their timely filling with
good-quality water (tea), the use of decoctions from herbs, camel thorn, etc.;
conducting classes with the personnel on measures for providing self- and
mutual assistance in case of heat injuries and the rules of behavior in a desert area;
control over the equipment of personnel in accordance with the ambient
temperature.
When organizing and implementing sanitary and epidemiological
surveillance and medical control in the mountains, special attention is paid
to:
identification of servicemen with contraindications to the directionmiddle and
high mountains, as well as persons with initial manifestations of high mountain
lesions;
the correct fit of the equipment of the personnel, the weight of the wearable
equipment and property;
the duration and pace of daily crossings, their correspondence to the
peculiarities (complexity) of the routes of movement;
provision of personnel with drinking water of at least 25 liters per day per
serviceman, availability and condition of means for disinfecting individual water
supplies;
the organization of nutrition and the composition of the daily diet, taking
into account the inclusion of easily digestible foods containing primarily proteins,
fats of animal origin and carbohydrates;
introduction of vitamin-containing preparations into the diet (hexavit, undevit
andetc.);
taking measures to prevent mountain and thermal injuries;
the presence of military personnel means of protecting the organ of vision
from snow ophthalmia (glasses with darkened glasses);
conducting classes with personnel and unit commanders on the basis of mountain
injuries and providing first aid when they appear,

peculiarities of behavior at different times of the year and day, drinking

regime, placement on the ground.
When organizing and implementing sanitary and epidemiological
surveillance and medical control in the northern (arctic) regions, in winter
conditions, special attention is paid to:
equipment of personnel and its compliance with external temperatures, the
tasks performed and the time spent in conditions of exposure to low temperatures,
as well as the availability of eye protection;
identification of persons with initial signs of frostbite, colds;
timely provision of personnel with hot food, as well as vitamin preparations
included in the food ration norm;
equipment of heating points for personnel, especially at outposts,checkpoints
, temporary checkpoints and medical evacuation routes for the wounded and sick;
availability of conditions for drying clothes and shoes in the base camps,
at outposts and checkpoints;
bath and laundry service, timely change of underwear and bed linen,
prevention of head lice;
conducting classes with the personnel on measures of providing self-help and
mutual assistance in case of cold injuries.
1.5. The forces and means of the medical service used in the
organization and conduct of sanitary and epidemiological surveillance and
medical control over the vital activity and life of troopsin times of war and
emergencies
When organizing sanitary and epidemiological surveillance and medical
control over the vital activity and life of troops in wartime and emergency
situations, the existing system of bodies, institutions and units in peacetime is used
primarily. On the basis of the centers of state sanitary and epidemiological
supervision of districts, fleets, garrisons, flotillas, sanitary and epidemiological units
(SEO) of the corresponding level and staff are formed. During the mobilization
period, they are supplemented with specialist doctors, laboratory staff, technical
personnel and service equipment.
To carry out laboratory research, the sanitary and hygienic divisions and the
military medical service are equipped with auto laboratories, sets of laboratory
equipment and individual devices available for supply in the Armed Forces of the
Republic of Uzbekistan.
Representatives of the medical service of the military level mainly use not
technical means of hygienic diagnostics, but methods based on observation,
calculation and graphic methods, which, despite their versatility and simplicity,
provide mainly a qualitative and descriptive characteristic of the state of
environmental objects.
The sanitary-epidemiological laboratory of the compound, as a specialized
unit, has great capabilities, having the equipment that allows you to work directly at
the facilities, move from one object to another. The unit is equipped with a military
medical laboratory (LMV), which is designed to conduct bacteriological,
sanitary-hygienic, radiological studiesindication of chemical warfare agents in the
field.
In general, sanitary and epidemiological institutions of various levels and units
of the military level of wartime are equipped with mobile and stationary means that
allow solving a wide range of tasks,determined by the specific operational-tactical
and sanitary-epidemiological situation. The most important tasks mentioned may be
the following:
sampling of water and food;
determination of organoleptic and chemical quality indicators water;
determination of chlorine water demand, activity of chlorine-containing
preparations and water demand for coagulants;
determination of indicators of good quality and usefulness of food products;
determination (using express methods, apparatus, instruments, test systems ,
etc.) in air, water, food, soil and other objects of the external environment,including
medical items, the presence of OM, RF and BS;
study of alcohol-like liquids (for the presence of methyl and higher alcohols,
ethylene glycol and tetraethyl lead);
determination of pesticides (arsenic and mercury-containing) in food;
determination of vitamin C in vegetables, vegetable dishes and
vitamin-containing preparations;
determination of the energy value of finished food (by dry residuefat content);
measurement of temperature, humidity and velocity of motion of air in field
dwellings, fortifications, objects of military equipment;
- measurement of illumination, noise and vibration levels in fortifications and
military equipment;
determination of the presence of harmful chemical impurities (carbon dioxide,
carbon monoxide, hydrocarbons and rocket fuel components) in the air of field
dwellings, fortifications and military equipment.
Thus, sanitary and epidemiological supervision and medical control are
carried out by the medical service in peacetime and wartime and are an important
preventive direction of its activities. Control over the living conditions of the
troops, the fulfillment of statutory requirements, sanitary rules and norms makes a
great contribution to maintaining the health of servicemen and ensuring the sanitary
and epidemiological well-being of the troops.
Control questions
1.Military hygiene as a scientific discipline. Purpose, subject, object and
research method.
2.Organization of state sanitary and epidemiological supervision and medical
control over the vital activity and everyday life of troops in peacetime.
3.The main tasks of sanitary and epidemiological surveillance and medical
control over the vital activity and life of troops in wartimeemergency situations.

4.Measures for sanitary and epidemiological surveillance and medical control

over the deployment of troops in the field.
5. Measures of sanitary and epidemiological surveillance and medical control
over nutrition.
6.Measures for sanitary and epidemiological surveillance and medical control
over water supply.
7.Sanitary and epidemiological surveillance activitiesmedical control over the
conditions of military work and habitability.
8. Measures of sanitary and epidemiological supervision and medical control
over bath and laundry services.
9. Measures of sanitary and epidemiological supervision and medical control
over the burial of the dead and the dead.
10. Features of sanitary and epidemiological surveillance and medical control
during the conduct of hostilities in arid zones.
11. Features of sanitary and epidemiological surveillance and medical control
during military operations in the mountains.
12. Features of sanitary and epidemiological surveillance and medical control
during the conduct of hostilities in winter conditions.

CHAPTER 2. HYGIENE OF DEPLOYMENT OF TROOPS

The deployment (quartering) of troops - providing them with the necessary
land plots, buildings and structures for housing, combat and special training,
storage of military and special equipment, stocks of material resources, economic,
cultural and other needs.
The deployment of military units and subunits is carried out in accordance
with military-strategic requirements, their operationaltactical purpose,
economic-geographical, demographic, sanitary-anti-epidemic, environmental and
other characteristics of the deployment area, the type of combat training, as well as
taking into account the organizational and staff structure and the current quartering
norms.
The quartering of troops in peacetime is carried out in permanent and
temporary military camps, in separate buildings, structures and premises belonging
to the Ministry of Defense of the Republic of Uzbekistan. In addition, troops can
be deployed in the field, as well as in buildings and structures that do not belong to
the Ministry of Defense of the Republic of Uzbekistan (federal, municipal or private
property).
A military town is a complex of buildings and structures of a certain
purpose for the deployment of a military unit (one or more), institutions, enterprises
or organizations of the Ministry of Defense of the Republic of Uzbekistan located
on the same land plot and used, as a rule, with permanent deployment (basing) of
troops.
By appointment distinguished military towns: army (barracksresidential,
complex, training centers, military administrative institutions, military educational
institutions, military scientific institutions, military medical institutions, military
storage and military production.
field conditions, as well as in buildings and structures of municipal and
private property, military units and subunits are deployed during field exercises,
camp gatherings and long marches;
performing tasks in a state of emergency and in zones of armed
conflict; liquidation of the consequences of catastrophes and natural disasters, as
well as in the performance of other tasks related to the separation of troops from
points of permanent deployment.
Accommodation in the field can be short-term (bivouac) for daytime rest or
overnight stay, or longer with a breakdown and camp equipment.
A camp is understood as a place for long-term deployment of military units
(subunits) outside settlements using dwellings and shelters: tents, collapsible
inventory buildings, inflatable structures, all-metal unified blocks, barriers, huts,
dugouts, snow and ice buildings, etc. ...
2.1. Accommodation in the barracks
Residential buildings in the barracks and residential zones of military camps
are barracks in which conscripts and junior cadets are housed, hostels, hotels and
apartment-type houses intended for officers, warrant officers, contract servicemen
and their families, as well as workers of the Ministry of Defense RU with
families. Senior cadets and students of military academies are accommodated in
hostels.
The hygienic requirements for residential buildings, hotels in military camps
and hostels are similar to those for public buildings and structures. Barracks are a
military feature of a dwelling, characteristic only of military camps. A military hostel
can be viewed as an architectural transition from a barracks to a hotel-type
residential building, a more advanced type of residential building.
One of the most important features of the architectural layout of the barracks
is their division into typical sections, including a full set of necessary living quarters,
which is regulated by the Charterinternal service of the Armed Forces. Each
barracks section for conscripts is designed to accommodate the personnel of a
company (battery) or other unit equal in size to it. The main premises of the
company barracks section is a sleeping room for personnel, the hygienic
characteristics of which should provide the necessary conditions for restoring the
working capacity of people after a working day, orders, exercises, etc. The
composition and layout of all premises of the company section of the barracks,
providing rest, everyday life, storage of personal belongings,also weapons and
other property, regulated by the charter and order of the Minister of Defense.
As a rule, barracks are free-standing buildings 1-4 floors. To accommodate
small military teams, it is allowed to use complex buildings, in which, in addition to
barracks, a dining room with a kitchen, a medical center, office and other premises
are provided.
The main functional link of the barracks is the company section , which has
the capacity of the regular number of company personnel (100 people). The layout
of the section should provide for convenient communication between rooms and an
unhindered quick exit from it when an alarm is declared without counter flows. The
number of sections in a building can be different, because its capacity can be 100,
200, 300, 400 people, and if two sections are symmetrically located on each floor,
it will double.

Accommodation
The norms for in
thetents
quartering
in military
offield
military
conditions
units, institutions and military
educational institutions, announced by order of the Minister of Defense, in sleeping
quarters, the placement of military personnel on bunk beds is allowed only if the
height of the room is not less than 3 m (which corresponds to a floor height of 3.3
m). Violation of this requirement contributes to an increase in the incidence of
respiratory and other aerosol infections. Accommodation of cadets of military
educational institutions and warrant officers' schools is provided for only in one
tier.
The composition and area of ​the premises of the barracks section in
accordance with the current regulatory documents are presented in Table 2.1.
Placing an entire company in one bedroom cannot be considered rational
from a hygienic point of view. Therefore, modern barracks projects provide for the
division of the sleeping quarters into several compartments, each of which houses
one compartment of military personnel and there are exhaust duct ventilation
openings, which, with the correct device, provide a 2-fold air exchange per
3
hour. With a room volume of 12 m for 1 person and the simultaneous use of other
ventilation devices (vents, mechanical exhaust ventilation from the dryer and toilet),
3 of
at least 24 m clean air per hour for each serviceman can be supplied to the
sleeping room . This minimum, dictated by considerations of cost savings, is
insufficient from a hygienic point of view.
The post-war barracks have a common bedroom 3.3 m high, equipped with
forced-in mechanical ventilation with air heating on the inflow to 16 ° C, which
3
provides three times air exchange. With the ventilation in place (9 m of the room
volume per person in a two-tier arrangement), it provided a minimum air exchange,
but often did not function, which made the actual air exchange unacceptably low,
and served as the reason for the increase in the incidence of sickness among
personnel.
Beds in the sleeping area are installed in such a way that each, or near two
shifted ones, has room for bedside tables. The distance of the beds from the outer
walls should be at least 0.5 m in order to weaken the radiation effect of these
surfaces on military personnel.
Table 2.1.
Composition and area of ​premises​of the company barracks section

Square,m 2 / person
Premises (at least)
Leisure room 0.5-0.8
3
Sleeping room - air volume regardless of height 12 m / person
premises
Washing room at the rate of 1 washbasin for 5-7 persons. 0.3
1 foot bath with running water for 30-35 persons
Toilet - 1 toilet and urinal for 10-12 persons. 0.35
Dryer for uniforms and shoes 0.16
Consumer service room 0.16
Premises (place) for sports (total area) 25.0
Shower room - 2-3 shower nets per barracks section 0.1
A place for smoking, cleaning shoes and uniforms 0.1
Company office (total area of ​the​room) 16-20
Platoon Commanders' Room 16-20
Weapon storage room 0.25
Room (place) for cleaning weapons 0.35

Pantry for storing company property and personal belongings

0.25
military personnel
Pantry (cabinet) for cleaning equipment total area 1.5
Those premises of the barracks, the air of which is polluted especially intensively,
are isolated from the general corridor by vestibules (the role of vestibules is usually
played by less polluted premises) and equipped with mechanical exhaust
ventilation. For example, mechanical exhaust ventilation from the lavatory should
3 3
ensure the removal of 50 m / h for each toilet bowl and 25 m / h for each urinal
3
(for the company section - at least 600 m / h of air). The washroom is usually
used as a tambour for a toilet, and a service room for a dryer.
In all rooms of the barracks, windows are equipped with air vents. It is
generally accepted that the ratio of the area of ​the vents (transom) to
the floor area of ​the premises must be at least 1:50, and the ratio of the
window (transom) area to the window area must be at least 1: 8.
Through ventilation using open vents (windows, transoms) on opposite walls
of the room is most effective. So, if the vents in the windows are open, then with an
2
area of ​each of the two vents of 0.5 m and the speed of air movement through
them not exceeding 1 m / s, all the air in these sections will be completely replaced
by clean outside air in just 7-8 minutes.
In connection with the adoption of the target program for the transition of the
Armed Forces of the Republic of Uzbekistan to recruitment on a contract basis in
the future, the concept of "barracks" and the requirements formed for it will be
relegated more and more to the past. For non-family military personnel at the initial
stages, the main type of accommodation will apparently be a dormitory with the
provision of separate rooms for 2-4 people. Family contract servicemen will be
provided with apartment-type service housing. Ideally, each contract soldier,
regardless of marital status, should be provided with individual service housing.
The temperature regime in the main premises is regulated by the Charter of
the internal service in accordance with hygienic data on the optimal conditions for
thermal equilibrium of the body with the environment.
In sleeping rooms the air temperature should be at least 18 ° С, in rooms for
patients - at least 20 ° С. Room thermometers for temperature control should be
placed at a height of 1.5 m from the floor on the inner walls, away from heating
devices and outside the zone of heating by the sun. Thermal insulation and heating
power are calculated for the most severe operating conditions, which are taken as
the average outdoor temperature during the coldest five-day period of the coldest
period of the year, observed over the entire time of meteorological observations in
a given area, or at least over the past 50 years.
The calculated air temperatures and the required air exchange rate in the
premises of the barracks, established by regulatory documents, are givenTable
2.2. In the corner rooms of the barracks in areas with a cold climate for all rooms
of the barracks, the calculated air temperature is taken at2 ° С higher than indicated
in table 2.2.
Table 2.2.
Estimated air temperatures and air exchange ratein the premises of
the barracks

Estimated Multiplicity

Temperature air exchange

Premises

air, ° С on the hood,

volume / h

Leisure room eighteen one

Dormitory eighteen 2
 Office, study room

Platoon commanders' room, corridors eighteen one

Storage room for clothes, room (place) for

cleaning weapons, room consumer services sixteen 1.5

Pantry of company property and personal

belongings

military personnel sixteen one

Smoking room (place) eighteen 3

Washroom twenty 1.5

Toilet sixteen Extractor hood

khanicheskaya

50 cubic meters / h for

1 toilet and

25 cubic meters / h for

 1 urinal

Shower room 25 for 1 shower

howling mesh

Premises (place) for sports sixteen 2

The dryer is provided for drying uniforms and shoes of 60% of the personnel
in 10 hours. The design temperature of the air coming from the corridor to the
dryer is + 16 ° С, for radiators - + 55 ° С.
Heat supply to the barracks is provided by a central heating system. By the
type of coolant, air, steam and water central heating are distinguished.
As a rule, water heating is used in the barracks. The surface temperature of heating
devices is limited to 60 ° C. In this case, the temperature of the inner surface of the
outer walls can be 6 ° C lower than the air temperature of the premises, which for a
sleeping room is12 ° C.
The air inside the barracks is regulated at the level of 30-65% relative
humidity, and the speed of air movement in the living quarters should not exceed
0.2 m / s in order to avoid the cooling effect (feeling of "draft"). Maintaining the
hygienically grounded parameters of the internal environment of the barracks
premises allows the device and correct operation of the premises and its heating
and ventilation systems.
The building classification of the climates of our country divides them into
four regions, which are numbered in Roman numerals from north to south. In
addition, in each subdistricts are allocated, denoted by the Roman numeral of their
area.
One of the capital letters of the Russian alphabet. Subdistricts are distinguished by
the degree of severity, the strength of the winds, humidity and other features of the
climate.
The projected buildings, including barracks buildings, always have projects
designed for operation in specific sub-districts, characterized by a thicker outer
fence and their greater thermal insulation capacity - for colder climates.

Unfavorable microclimatic conditions are one of the most significant factors in

decreasing the level of health and increasing the incidence of sickness among
servicemen. An equally important factor is the low quality of air in residential
premises, on which the incidence of many infections and a decrease in the general
resistance of the organism depend.
When designing the barracks, natural lighting is planned at levels not
exceeding 1% of the actual outdoor illumination. Normalization is carried out
according to the coefficient of natural illumination - KEO. Minimum KEO levels for
barracks premisesare given in table 2.3. The provision of a higher level of natural
light in residential and public areas is limited by climatic conditions and building
requirements for the strength and thermal insulation of buildings. The currently
accepted ratios between the area of ​light openings (glazed surface of windows) and
the floor area, ensuring compliance with the established KEO standards for the
sleeping quarters of the barracks are 1: 10-1: 8, for classes - 1: 5-1: 4, for auxiliary
rooms - 1 : 12-1: 14.
Table 2.3.

Minimum levels of KEO values ​in roomsbarracks (in brackets - for

areas with stable snow cover)

Premises KEO value Surface,

under natural for which
lateral determined
 lighting,% KEO

Dormitory 0.5 (0.4) Floor

Leisure room, office, room Conditional ra-
for training, the commander's room barrel top
dov, consumer service room 1.0 (0.8) ness on the
soté 0.8 m from
sex
Toilet, washroom 0.3 (0.2) Floor
Stairs 0.2 (0.2) Steps and
playgrounds

If there is a lack of natural light, compensation using artificial sources is

allowed. Hygienically and economicallythe most desirable is the maximum use of
the possibilities of natural lighting of premises, workplaces and recreation areas.
The current KEO standards provide acceptable, not optimal, illumination
levels. When standardizing artificial lighting, its levels close to optimal are achieved
only for the most accurate and delicate works. Regulatory standards are based on
considerations of economic feasibility and are alsohygienically justified minimum or
acceptable levels (table 2.4).
Table 2.4.

Electricity consumption rates for lighting the main premises of the

barracks using fluorescent lamps (l) and incandescent lamps (n)

Specific
Illumination, established
Name of premises OK power,

W / sq. m
 l n l n

Sleeping quarters for personal

composition 75 50 5.5 14

Classes, offices, rooms for

preparation for classes, for meetings

and rest of officers 300 200 20.7 51.8

Storage and cleaning rooms

weapons 150 100 10.8 27.8

Consumer service rooms for

shoe and clothing shine 150 100 10.8 27.8

Toilets, showers with changing
rooms,

Smokers 75 50 6.6 16.2

Corridors, stairwells,

dryers 50 30 4.5 9.8

Pantries for storing property

 company and personal belongings of
soldiers 50 30 5.1 10.3

Connection with significant differences in the emission spectra of

incandescent and luminescent lamps and a significantly higher relative visibility of
the radiation of the former both for the eye and for the selenium photocell,with the
help of which the illumination is measured, modern regulatory documents establish
an average of 50% higher illumination standards for fluorescent lamps. The
efficiency of fluorescent lamps allows at the same time to achieve half the
consumption of electrical energy.
Scientists-hygienists back in the 19th century. It was rightly believed that
indoor air quality is the leading determinant of the health impact of the home. Based
on experimental data, scientists argued this approach primarily by the fact that
human consumptionair (about 15 kg per day) significantly exceeds the volume and
mass of consumed liquid (2.5-3 kg) and food (about 1.5 kg). The second serious
motive is the possibility of airborne contamination.
the circulatory system, and with blood - virtually unhindered into any tissue of
the body, while on the way entering with food or drink there is a liver.
Researches of scientists, including in Russia, have found that breathing
polluted air in dwellings is one of the main reasons for high morbidity and disability
("decline into incapable")soldiers as well as other groups of the population.
The patriarch of hygiene M. Pettenkofer proceeded from the fact that the
main cause of air deterioration in living quarters is the breathing of people
there. The exhaled air, enriched with carbon dioxide, acquired, according to the
scientist, the character of a spoiled ("stale") when it contains more than 0.07% CO
2. Air with lower concentrations of CO 2 is perceived as "fresh", unpolluted. On this
basis, he proposed to take the content of CO 2 in the air of dwellings as an
indicator of its purity and set the limit for the accumulation of pollution at 0.07%
CO 2 .
In the external atmosphere, the concentration of CO 2 is 0.04%, therefore, each
cubic meter of air can take up to maximum pollution another 0.03% CO 2 , which is
3 3
0.3 dm CO 2 . An adult, during light work, emits an average of 22.5 dm CO 2 ,
3
and at rest - about 17 dm CO 2 per hour. To dilute this amount of CO 2 without
3
exceeding the limiting concentration (0.07%), in the first case, 75 m will be
3 of
required , and in the second - 57 m clean atmospheric air every hour. Believing
that for people in a room that is not felt as an inconvenience (because of the feeling
of "draft") there can be air exchange up to 2.5 times per hour, M. Pettenkofer
believed that the volume of the living space in which people do light work , should
3
be about 30 m per person.
Over the past hundred years, hundreds of substances have been identified that are
responsible forspoilage of air in living quarters. The greatest danger among them is
represented by the numerous toxic compounds released by people in the process
of life, called anthropotoxins. These include groups of compounds such as toxic
amines, various gaseous sulfur compounds, carbon monoxide and many other
substances, as well as microorganisms. It is well known that the accumulation of
carbon dioxide in the air lags somewhat behind the growth in the concentration of
anthropotoxins and microorganisms.
Currently, the maximum permissible concentration of CO 2 is set at 0.1%, but
the calculations of M. Pettenkofer have not lost their significance.
For example, the standard for the volume of clean air supplied to hospital
3
wards is set in our country at 80 m / h per person. In developed countries, these
standards are at least not lower. In the domestic hygienic literature in the 80s, a lot
of works were published indicating that the air exchange of classrooms, increased
3
from up to 80 m / h per 1 person, contributed to the reduction of trainees' fatigue,
improved well-being and ensured an increase in their health level, a decrease in
overall morbidity. The optimal amount of clean air required for the comfortable
3
sensation of people in it now ranges from 120 to 200 and even 300 m per person
per hour. For an ordinary home, this means 10 times the air exchange and a high
speed of air movement in the room, causing an unpleasant "draft" feeling.
For barracks in our country, the necessary level of air exchange, which was
justified by M. Pettenkofer in the last century, is still a prospect. The standard for
sleeping quarters in barracks is 24 cubic meters per hour per person. Despite the
fact that such a volume of ventilation is not optimal and contributes to maintaining a
sufficiently high level of morbidity, they often try to significantly reduce the
available air exchange "to preserve heat", and the living quarters are "compacted"
by placing more people in them than is stipulated by the standards. Outbreaks of
infectious diseases accompanying such actions, likethe rise in the level of the
general morbidity of residents is quite natural. Adequate ventilation of living
quarters is also necessary becauseair of dwellings constantly accumulates
radon-222 - one of the decay products of natural uranium-238. Diffusing into the air
from soil and building structures, especially those with a lot of granite, it pollutes it
with its daughter products, which combine with air particles and settle in the lungs,
irradiating the nuclei of the bronchial epithelium.
The consequence of this is the destruction of chromosomes and malignant
degeneration of cells, manifested mainly in the form of lung cancer.
Medical control over the conditions for the accommodation of military
personnel is the activity of officials of the medical service of the Armed Forces of
the Republic of Uzbekistan, aimed at ensuring favorable conditions for combat and
special training, work and life of military personnel and the population,
strengthening their health, preventing morbidity and protecting the environment
during the quartering of troops in the military. towns and locations outside of them.
Medical control over the conditions of the deployment of troops includes:
control over the implementation of sanitary legislation, other national
normative legal acts and guidelines of the Ministry of Defense of the Republic of
Uzbekistan, orders and decrees of officials exercising state sanitary and
epidemiological supervision;
observation, assessment and forecasting of the health status of troop
personnel in connection with the specifics of a specific sanitary epidemiological
situation;
establishing causal relationships between conditionsaccommodation, morbidity
and other indicators of the health of military personnel;
development of proposals relevant official persons of conducting sanitary
and anti-epidemic (prophylactic)measures aimed at improving the conditions for the
accommodation of military personnel;
registration of infectious and non-infectious diseases caused by the harmful
effects of factors associated with placement;
control over measures to prevent pollution of the environment (soil, water
sources and atmospheric air) with household waste and hazardous industrial
emissions.
Medical control over the conditions of accommodation of military
personnel is carried out in the form of :

planned inspections of accommodation facilities (military camp, separate

buildings and premises);
unscheduled examinations: at the direction of higher officials or at the request
of military personnel due to the incidence of illness in personnel.
Routine examinations should play a leading role in preventing the negative
impact of accommodation conditions on the health and efficiency (combat
effectiveness) of servicemen.
Hygienic examination includes: examination and assessment of the health of
servicemen and other people living or working on the territory of a military
unit; hygienic assessment of the surveyed object based on the results of
instrumental and laboratory studies.
The study and assessment of health is carried out by analyzing the results of
in-depth and control medical examinations, dispensary dynamic observation,
medical examinations and daily medical supervision, as well as statistical
information on the level, structure and dynamics of morbidity, injuries, labor losses
and hospitalization.
The conclusion on the surveyed object is drawn up on the basis of: study
 of project documentation, technical passports and other materials of the
apartment maintenance service; inspection of the facility on site and
familiarization with the conditions of its operation and maintenance; interviewing
people living or working at this facility (in the room) about theirstate of health,
complaints related to the conditions of accommodation;
At the final stage, the results of modeling specific situations, measurements
with the help of special devices and instruments, laboratory and other studies are
specified.
Based on the materials obtained during the examination, a conclusion is given
on the sanitary and epidemiological state of the surveyed premises, building or the
entire military camp, and specific sanitary and anti-epidemic (preventive) measures
are justified.
Medical examination of accommodation facilities must be carried out in the
presence of representatives of the apartment maintenance service, other interested
persons who provide the necessary information about the state of the buildings and
structures in use and the state of health of the people living or working in them.
Depending on the sanitary and epidemiological indications, the volume of
instrumental and laboratory studies can be increased with the involvement of the
established procedure, for its conduct, specialists from the SEV brigades, SEL
divisions, sanitary and epidemiological institutions of the Ministry of Defense of the
Republic of Uzbekistan.
2.2. Field placement. Collection and disposal of sewage and waste
The process of combat training (field exercises and exits, camp gatherings,
long marches with daily rest), when performing tasks in emergency situations and in
zones of armed conflict, in eliminating the consequences of accidents,
catastrophes and natural disasters, as well as when performing other tasks related to
separation from the points of permanent deployment(basing), the personnel are
accommodated in the field outside settlements in a camp using tents and (or) other
pre-fabricated structures (dugouts, dugouts, collapsible structures, etc.)
For setting up a camp, a dry, unpolluted and sheltered from the winds
place is chosen , at least 3 km away from sources of pollution, taking into account
the direction of the prevailing winds and the availability of convenient access routes
o o
ways. The front of the camp is located on the windward side, within 45 -135
towards the prevailing winds. Preference is given to sandy loam and loamy soils
and areas with woody and shrub vegetation and a groundwater level not higher than
1.5-2 m from the soil surface. The terrain must have a slope for the drainage of
atmospheric waters.
Objects of field deployment of troops, according to habitat conditions, can
be divided into three groups:
a) with living conditions at the level of survival: barriers, canopies, huts,
simplified ground buildings, snow and snow-ice structures;
b) with satisfactory living conditions:
tents (camping, unified, camp, pneumatic,
expeditionary for the Navy, for especially cold regions, etc.);
- dugouts (buried, semi-buried, sloping, horizontal);
c) with relatively good living conditions:
dugouts from collapsible structures;
inventory buildings (collapsible, frame, panel board, large-panel);
container (rectangular, all-metal unified blocks).
Each subdivision is equipped with field washbasins at the rate of 1 faucet
(nipple) for 5-7 people. In the cold season, washbasins are placed in tents and
equipped with water heating devices. At least once every 3 days, washbasins are
cleaned and disinfected with a 1% solution of a chlorine-containing preparation,
followed by rinsing.
Despite the well-known advantages in simplicity of design, ease of
transportation, speed of deployment (folding) and small mass of components, tents
2
do not provide the standard area (3 m ) and volume per person recommended for
field conditions. In addition, tents provide little protection from wind and dust, and
have significantthermal conductivity, which in winter conditions entails high fuel
consumption and requires the organization of a round-the-clock watch of
stokers. In the hot season, the air in the tent heats up significantly.
A promising one that deserves a positive hygienic assessment is the field
deployment of troops in inventory buildings or structures, the structural elements of
which allow them to be used repeatedly.
Clearing the territory of the deployment of troops in the field, both in
normal and, especially, in extreme conditions, is a complex system of
organizational and technical measures for the collection, removal and disposal of
sewage and waste and prevention of negative impact on the environment when
setting up and maintaining a camp.
The territory of the camp and the adjacent areas of the terrain must be kept
clean and tidy in accordance with the Charter of the Internal Service of the Armed
Forces of the Republic of Uzbekistan. For daily cleaning, sections of the territory
in the camp are assigned to units.
For the collection and temporary storage of garbage and solid household
waste at a distance of 50-70 m from residential tents, there is an open area with
convenient entrances for transport with metal container or portable waste bins with
covers that prevent the entry of insects and rodents. The use of durable wooden
boxes with well and tightly closing lids is allowed. The distance from the edge of
the bin to the edge of the site must be at leastm.
When emptying and the platforms on which they are installed, garbage
collectors are thoroughly cleaned of debris and disinfected with a 3% solution of a
chlorine-containing preparation or 1% solution of a two-third base calcium
hypochlorite salt (DTS HA) at least once a week. Metal waste bins are pre-washed
with water.
Food waste is collected only in specially designatedtheir containers (buckets,
barrels) are closed with lids and stored in specially designated places. Waste
storage should not exceed one day. After emptying, the containers for collecting
waste are washed with water using detergents and disinfected with a 2% solution of
soda ash or 3% solution of DTS GK or other chlorine-containing preparations,
followed by repeated rinsing with water.
For collection of liquid household waste at a distance of 40-100 m from
residential tents and a food point, outdoor latrines with a ground part and a
cesspool are equipped. The ground part is constructed of tightly fitted materials
(boards, bricks, etc.), with smooth surfaces and impermeable to insects and
rodents, at the rate of 1 point for 10-20 people.
The depth of the waterproof cesspool depends on the groundwater level, but
should not be more than 3 m. The cesspool is tightly closed with a lid, regularly
cleaned, preventing it from filling above the mark located at a distance of 0.35 m
below ground level, and disinfected.
Toilets are equipped with natural and artificial lighting and ventilation; in
summer, nets with a mesh size of no more than 1.5 x 1.5 mm are installed on the
windows. At night, the paths to the restrooms are illuminated.
Litter pits for collecting liquid household waste are also arranged with a
ground part (with a cover and a grate for collecting solid waste) and are sufficiently
capacious, waterproof, made of stone, brick or wood, and inaccessible to flies and
rodents. The walls and bottom of wooden cesspools are insulated from the
outside with a compacted layer of soft oily clay 20-30 cm thick or other available
material.
Wastewater from washbasins and baths is directed through drainage ditches
to absorption wells filled with slag, gravel or other filtering material. Before descent,
they are preliminarily passed through a soap catcher, which can be used as boxes
with a lattice bottom, filled with straw, shavings or dry grass.
Solid and liquid waste is disposed of daily to landfills, improved landfills,
sewage disposal fields and other places agreedlocal bodies of state sanitary and
epidemiological supervision and removed from the camp at least 3 km in the
direction of the prevailing winds for the area.
With a short-term (up to 12 days) presence of a unit on the ground (in a
camp), it is allowed to set up field ditches, as well as collect solid and liquid
household waste into pits for their disinfection using soil.
In order to control flies during the warmer months, outdoor latrines, waste
bins and the soil around them, and other possible breeding areas for flies are
regularly treated with insecticides. Extermination of flies indoors is carried out
systematically by all available means (nets for windows and doors, insecticides,
crackers, sticky paper, etc.).
The destruction of rodents on the territory and in the premises of the camp is
carried out using traps and poisoned baits.
Upon completion of the troops' stay in the field, the camp area is cleaned of
debris and pollution, the final disinfection with dry chlorine-containing preparations,
followed by filling the absorption wells and cesspools with soil and other measures
to restore the land plot used for the camp placement of military units
(subdivisions).
Field deployment of troops includes deployment in settlements, outside them,
and mixed - partly in the settlement and partly outside it. Accommodation in a
settlement, both in peacetime and in wartime, is preceded by its sanitary and
epidemiological examination. It is prohibited to deploy military units and subunits in
settlements that are unsatisfactory in sanitary and epidemiological terms.
Accommodation in the village , in accordance with the requirements of the
Charter of the Internal Service, implies the immediate equipment of the necessarythe
number of latrines and their maintenance, with particular attention being paid to
this.
The personnel of the subdivisions are accommodated in administrative
buildings, in their absence - in houses and premises free from the population, which
are preliminarily examined by the commanders of the subdivisions. Officers and
warrant officers are accommodated in separate rooms near subordinate personnel.
There are no standards for area, volume, ventilation intensity, room lighting
conditions, etc. for field placement does not exist, although internal routines must
be maintained in accordance with the rules established for barracks placement.
Accommodation outside settlements can be short-term (bivouac) for
daytime rest or overnight stay, or longer, with the equipment of a camp, field
dwellings and shelters. In any case, the choice of a bivouac or camp site is made
taking into account information about its sanitary and epidemiological condition,
and the equipment with strict observance of sanitary and hygienic
requirements. The conditions for the field deployment of military personnel and the
rules for setting up the camp of the unit are determined by the corresponding
official documents.
Hygienic point of view, when choosing a place for a bivouac or camp,
preference should be given to a relatively flat, flood-free,non-swampy areas with
non-dusty soil that absorbs moisture well, with non-contaminated soil covered with
grass and woody vegetation. The groundwater level should be 1.5-2 m or more
below the ground surface. The site should be located at least 3 km from garbage
dumps and other intensively contaminated areas, but close to sources of
good-quality drinking water. The presence of a forest is highly desirable, since, in
addition to masking properties, it provides many other important advantages:
shelter from the wind and excessive heating by the sun, the availability of building
material, fuel, etc. In treeless areas, you can hide from the wind infolds of rough
terrain, behind a steep slope of a hill, etc. Before bivouac placement or when
tracing the site selected for the camp, areas for latrines, cesspools, garbage pits
(garbage bins) are determined so that they cannot cause pollution of water
sources. Therefore, such sites should be at a distance of at least 200 m from the
water source, and located lower along the slope of the terrain and the course of the
river.
As dwellings and shelters when placed outside settlements, service property
and improvised means are used: barriers and huts,snow and snow-ice buildings,
dugouts, tents, collapsible inventory buildings, inflatable structures, dwellings made
of prefabricated sections-blocks (container buildings) - the so-called "modules",
all-metal unified cylindrical blocks (CUB), as well as residential blocks transported
on cars and trailers.
Barriers are a wall or one of the slopes of a hut (canopy). They are made of
tarpaulin, plywood, tin, branches, raincoatsother improvised means, for insulation,
a bedding made of straw, needles, etc. is used. and slow burning bonfires.
Tents differ from canopies by the presence of not one, but two roof slopes and
end walls. It is also possible to arrange bonfires in the hut, but the flammability of
the huts is very high, as evidenced by the experience of the partisans of the Great
Patriotic War. The hut is able to provide quite satisfactory conditions for recreation
in winter and summer. Its construction does not require much time and high
construction qualifications.
Snow and snow-ice structures can be with a frame of poles and branches,
covered with a sufficiently thick layer of dense snow, or frameless, representing a
vaulted structure of dense snow or ice "bricks" - blocks. The most famous are
dome-shaped buildings such as the igloo dwelling of the Eskimos, which require
sufficiently high qualifications of builders for the construction, as well as vaulted
structures that also assume the presence of skill and sufficiently durable material in
the form of caked snow or ice. Servicemen should be able to make
non-destructible blocks of a given design and size from it, and correctly install and
secure them.
The most common type of dwellings made from scrap materials during many
wars, including the Great Patriotic War, were dugouts.The great popularity of this
dwelling is formed by the centuries-old experience of its use. In the dugout, it is
possible to create a relatively acceptable microclimate, and in wartime, to provide
protection from being hit by enemy fire, if its structure is appropriately strengthened
by strengthening the walls and ceilings.
During the Great Patriotic War, various standard designs of dugouts of many
designs and different capacities were distributed among the troops. As a rule, they
had a height of the internal premises of 2.2-2.5 m, the floor area for one person was
2
from 1.5 to 2.4 m , and the capacity was up to one platoon of soldiers. During
the war and in the first post-war years, many military units, especially those located
in the places of recent battles, built andused dugouts as dwellings for
personnel. The population of these territories also lived in dugouts.
The tents are the official property of military units and are designed to
accommodate personnel, property, medical institutions, logistic, automotive and
other service units, their repair units, etc.
Winter tents are equipped with a heater made of heat-insulating materials and
an inner batten, window frames with glass and heating devices.
Accommodation of servicemen in tents . The campground (Picture 2.2) is
usually set up for a battalion or regiment. The tents are arranged in groups by
divisions. The distance between the tents is at least 2.5 m.
Personnel tents in the camp are set up on specially arranged wooden nests
with inclined sides. The site for the nest is arranged 10-15 cm above the ground
level, a wooden shield is laid on it. Depending on the conditions, personnel are
accommodated on the floor, common bunks, separate camp or barracks beds. The
wounded and sick can be accommodated on stretchers. The height of the bunks
from the floor level for the 1st tier is 0.4-0.5 m, for the 2nd tier (with two-tier
placement) - 1.2-1.5 m. Sanitary stretchers for accommodating the wounded and
sick are installed on special metal trestles with a height of 0.4-0.5 m from the floor
level. The ratio of the height of the bunks and the sides of the tent should exclude
the contact of its panel with the pillows.

The average floor area for 1 person in a tent is:

2
when located on camp beds - 2.5 m ;
2
when located on barracks beds - 3 m ;
2
when located next to each other on the floor or on common bunks - 1,2-1.5 m .
Temperature, humidity, speed of air movement in tents differ in
characteristics, depending mainly on external weather factors. Maintaining the air
0
temperature within 15-25 С is possible in winter only with their constant
heating. Temporary stoves of various designs (cast iron, military, camp stoves,
made of scrap materials, etc.) are used to heat the tents.
Deterioration of the gas composition of the air in tents due to their limited
volume and high population density, a decrease (up to 4 times) in the air
permeability of the tarps when wet, and other reasons to a certain extent corrected
by periodic airing, in particular, raising the floor of the tents in the summer in good
weather.
in winter, the tents are insulated with pads. To insulate the floor in the absence
of wooden shields, spruce branches are used in a layer20-30 cm. A roller of snow
is poured outside the tent around the tent to protect it from the wind. Each unit is
equipped with a tent for drying uniforms and shoes, as well as a tent for periodic
heating of personnel in the daytime.
For a long (over three days) stay in the field in tents, a place is equipped for
storing outerwear, duffel bags, toiletries, pots, spoons, mugs and other personal
items.
The exclusion of rodents from entering the tents is achieved by tearing off
ditches of 30x30 cm along their perimeter.
During the operation of tents there is a loss of waterproof and anti-rotting
properties of the tent fabric, which makes them short-lived. The renewal of these
properties in the upper tent layouts is carried out using a special chemical
composition PKhS-55 (impregnating chemical composition). The consumption of
the impregnating solution for processing one outline of the camp soldier's tent (on
both sides over the entire area) is about 25 liters with a time consumption of 3-4
hours.
Elimination of leaks in the tent fabric of tents is also achieved by impregnating
them with a solution of paraffin in gasoline (in a ratio of 1: 4).
When signs of damage by putrefactive microorganisms appear on the internal
basting and curtain walls, the affected tissue areas are disinfected with a 1-2%
formalin solution, followed by rinsing with water.
From a hygienic point of view, tents have both advantages and disadvantages
that are essential for the possibility of their widespread and long-term use in order
to accommodate people and medical units.
In moderate cold weather in continuously heated winter tentsit is possible to
maintain relatively acceptable microclimate conditions, differing, however, by large
vertical air temperature differences. With the intensification of cold weather, the
vertical gradient of air temperature inside the tents increases, reaching 15 ° C and
more per meter of height. In a harsh climate in open treeless areas, even with
continuous heating of stoves, it is almost impossible to provide satisfactory
microclimate conditions inside the service tents. Moreover, in a strong wind, on
frozen snow-free ground, it is not always possible to even set up and secure a tent.

Along with tents for supplying troops, there may be others - quickly
erected, transportable, inexpensive and relatively easy-to-manufacture field
dwellings, more than tents adapted to a harsh climate. One of these dwellings are
yurts, which have proven themselves well during the battles near the
Khalkhin-Gol River and during the winter field trips of the troops of the
Trans-Baikal Military District. Industrial production of yurts has existed in
Kazakhstan for over 20 years.
Pneumatic tents have proven themselves well in relatively warm climates, for
example, in Germany, Hungary, and other countries of Central and Western
Europe, but in the winter conditions of our country, especially in Siberia and
Transbaikalia, they turned out to be insufficiently cold-resistant.
With a relatively long field deployment of troops on one
On the same territory, temporary military camps are being set up for military
units and medical institutions, in which dwellings of various types are used. One of
them is the inventory collapsible buildings , represented most often by the
buildings of the frame-panel structure. They have a frame made of wooden beams,
fences made of wooden boards, thermal insulation made of bulk materials
(sawdust, slag, expanded clay).
Hence the names of such structures - "prefabricated panel board" and
"frame-filling". For transportability and efficiency, the lightweight timber frame has
a relatively low strength, therefore the dimensionssuch buildings and the internal
volumes of premises are significantly inferior to the corresponding indicators of
stationary barracks. The limited volume per person is aggravated by the lack of
effective ventilation, except for the hood when firing low or medium heat capacity
stoves that are used in such buildings.
One of the distinctive features of these buildings is also insufficient thermal
insulation of fences and the associated suboptimal microclimate conditions in
residential premises. There are large differences in air temperature vertically and
horizontally, low temperature of the surfaces of fences, especially floors and outer
walls (and with insufficient insulation - and the ceiling), freezing of corners in the
cold season, dampness in colder parts of the walls and other
disadvantages. Additional embankment with soil, slag, sand of the outer walls up to
the window sills or up to half the height of the building, the device of vestibules at
the external entrances and other methods of reducing heat losses allow to
somewhat reduce temperature drops and freezing of corners, but the main hygienic
disadvantages due to the small volumes of the premises and their insufficient
ventilation, persist.
Dwellings from sections (blocks) of full factory readiness - container type or
all-metal unified blocks (CUB) have the advantage of immediate readiness for
occupancy, because have the necessary built-in equipment inside - folding shelves
for sleeping, tables, sanitary devices, etc. (Picture 2.3). Residential containers with
external walls made of aluminum, interior lining made of synthetic materials,
insulation made of porous plastic can provide satisfactory thermal conditions for
living even in harsh climates, as evidenced by the experience of operating similar
dwellings in northern Canada. However, in mass production there are container
dwellings made of wooden planks on a metal frame with insulation made of slag
wool or sawdust. When using this type of residential containerthe unit used to
deploy troops in Afghanistan, as shown by the extensive experience of operating
such dwellings in this country, as well as in the conditions of the BAM and at the
enterprises of the Kolyma, thermal comfort inside the building is not provided when
the outside air temperature is below -20 ° C, especially when combining it with a
strong wind. Even with less frost, freezing of the corners was noted, and
throughout the winter - an unacceptably low floor temperature. According to
experts, it is possible to provide thermal comfort in buildings of the described
structure only when using electrically heated plastic panels for cladding internal
walls and for covering the floor.
A more successful design is considered to be all-metal cylindrical unified
living blocks, completely manufactured at the factory. Tsub can be populated
immediately. Shortened versions of the TsUB are adapted for transportation on the
external sling of an army helicopter. This facilitates the provision of temporary
shelters for aviation units located away from land transport routes.

The cylindrical shape, which has the smallest possible total surface of the
external enclosures and the smallest amount of heat loss, provides a sufficient
internal volume of the premises. Concave wallseven enhance the effect of the
"spaciousness" of the premises of the Central Control Center. With district
heating, for which there is sufficient space between the floor and the outer railing,
these buildings provide satisfactory microclimate conditions in
winter. Connectable friendanother close to the CUBs can form a whole military
town, well protected from cold and wind. According to experts, the material
costs are 5-7 times lower than in the construction of brick or panel
buildings. From a hygienic point of view, a certain disunity of the military
personnel in the central control centers, compared with their concentration in
large dormitories, can be considered an advantage when ensuring sufficient air
exchange in the residential sections. Built-in furniture made of easily washable
materials deserves a positive assessment. Variants of TsUBs with cast-iron
furnaces of low heat capacity are characterized by large differences in air
temperature both vertically and horizontally, and in time.
Hot time metal container buildings and central control centers need protection
from overheating. For shading, use wooden, straw,reed shields, tarpaulins or
climbing plants, and for extended stays, grow trees to shade buildings.
One of the options for placement in the field can be considered the placement
of military personnel in fortifications (FS) - open, providing wide contact of
people with the external atmosphere and soil, and closed, protecting not only from
enemy weapons, but also from bad weather. A type of closed FS are sealed
military fortifications (VFS), characterized by very small volumes of internal space
3 3
per person (about 1 m / person), small volumes of ventilation (about 5 m / h per
person), lack of communal amenities, etc. .P. The conditions inside such VFS are
distinguished by sharp changes in the physical, chemical and biological
characteristics of the air environment, an extreme limitationmobility of people,
unfavorable features of radiant heat transferthe radiation balance of the body, which
together contributes to a significant decrease in the body's resistance and an
increase in the incidence of sickness in military personnel.
The difference between the conditions of field placement and barracks is
the significantly more pronounced influence of weather and climate factors on the
health of military personnel. This effect is especially pronounced when bivouacking
in open areas, in the simplest shelters and in open fortifications - trenches,
trenches. When placed in dugouts, dugouts, and especially in sealed VFS, natural
and climatic influences are significantly weakened, however, the effect on health of
adverse factors of the field dwelling itself is very noticeable: deterioration of
physical, chemical, biological indicators of indoor air quality, including ozone
deficiency in the air. , light aeroins, high concentrations of anthropotoxins,
extremely high microbial contamination, as well as the absence of insolation, low
levels of artificial illumination, an extreme decrease in the mobility of people due to
the large crowdedness in the room.

The discomfort of the conditions is aggravated by the difficulties with the

organization of water supply, food, recreation of personnel and the removal of
waste from the FS and sealed VFS. A complex of unfavorable conditions for
health,weakening the body's resistance to diseases, in combination with many
times increasing in the internal environment of field dwellings and in the territory
occupied by the troops, pollution and microbial contamination, cause a
significant increase in the risk of epidemic outbreaks of infectious diseases. The
adverse effect on human health of the conditions of field placement is aggravated
by difficulties in maintaining cleanliness of the body and clothing, in the
 implementation of other rules of personal and public hygiene and in taking the
necessary preventive measures.
The most effective way to preserve the health, work and combat efficiency
of military personnel is the energetic and unswerving conduct of all mandatory
measures aimed at maintaining the health of personnel by commanders of military
units, their deputies for logistics, chiefs of services in charge of logistics, unit
commanders and company foremen. These activities include: the correct choice
of the location of the bivouac, camp or temporary military camp and the most
appropriate type of field dwellings; timely and accurate organization of the
removal and disposal of sewage and other waste, cleaning and maintaining the
cleanliness of the territory of the location of the unit (subdivision); competent
choice and protection from pollution of sources of good-quality drinking
water; equipment of places and devices for drying and cleaning uniforms and
shoes, washing; organization of regular washing of personnel, especially
personnel employed at food service and water supply facilities; organization of
washing, disinfection, dry cleaning of uniforms, linen; organization of high-grade
and regular meals for personnel, providing them with good-quality clothing,
footwear and other clothing according to needs, climatic characteristics and the
season.
Medical control over the placement of military personnel in the field
consists of:
conducting sanitary and epidemiological reconnaissance of the proposed
camp site;
study and assessment of the health of military personnel and its dynamics;
control over the observance of sanitary norms and rules at the breakdown, the
device and equipment of the camp;

control over the observance by military personnel of the rules of personal and
public hygiene;
control over the maintenance of the territory, latrines, cesspools, garbage
bins, periodic removal of sewage and waste;
checking the implementation of measures to prevent poisoning of personnel
with carbon monoxide and exhaust gases when used for heating and other
purposes of internal combustion engines, stoves and other heating devices and
devices in box bodies, tents, dryersetc .;
implementation of disinfection, disinsection and deratization measures;
monitoring the implementation of measures to protect the natural environment;
analysis of the information received and the development of proposals for
eliminating the identified deficiencies and improving the placement conditions.
Sanitary and epidemiological reconnaissance of the territory of the
proposed camp site is carried out, as a rule, by a commission, which includes
representatives of the medical service, logistic services, engineering services and
the environmental protection inspectorate.
At the same time, a representative of the medical service studies the sanitary
properties of the soil and the nature of the vegetation cover, the hydrogeological
and topographic features of the area and the possibility of providing the camp with
good-quality drinking water in sufficient quantities, the presence of contaminated
sites, landfills, livestock farms and cattle burial grounds, paying special attention to
the incidence of the population, the presence of natural foci of infectious diseases,
the presence of vectors of infectious diseases. The results of sanitary and
epidemiological reconnaissance, proposals and recommendations for carrying out
health-improving measures in the selected area are reported to the command for
decision-making in the form of a report.
the number of necessary health-improving measures in the field deployment
of troops include:
the correct choice of place and type of field dwelling;
installation of waterproofing and drainage systems in dwellings;
equipment of a dwelling with heating, ventilation, construction of field dryers
in it;
rational organization of water supply and disposal of sewage and waste;
providing personnel with uniforms and footwear with sufficient heat, wind and
water protection properties;
hardening of military personnel.
2.3. Bath and laundry service
Bath and laundry service for military personnel includes:
regular weekly bathing in the bathhouse of military personnel,serving on
conscription, with the obligatory change of underwear and bed linen, towels,
footcloths (socks);
washing, bed linen, table and kitchen linen,
cotton uniforms, footcloths (socks) and overalls;
dry cleaning and touch-up of uniforms, blankets and overalls;
if necessary, sanitary treatment of personnel with disinfection and disinsection
of uniforms, linen and bedding;
repair of underwear and bed linen in laundries;
supply of soap, washing powders and other detergents for bath and
laundries, sanitary and hygienic and toilet needs, as well as money to pay the costs
of bathlaundry service;
supply of bath and laundry equipment, spare parts for it, inventory and other
operating materials.
The provision of these measures in military units is entrusted to the clothing
service.
The medical service of the military unit, both in stationary and in the field
conditions of accommodation, carries out medical control over the bath and
laundry service of personnel, conducts a bodily examination of personnel during
washing in a bath, together with the head of the clothing service organizes sanitary
treatment of personnel according to epidemic indications and provides bath and
laundry enterprises with disinfectants for the treatment of premises and equipment
at the request of the clothing service.

Sanitary norms and rules for the device, equipment and

 maintenance of baths and laundries
The layout of a military bath, regardless of the number of washing places,
should be such that it can be used for both hygienic washing and sanitization of
personnel (as a sanitary pass). If necessary, transfer the work of the bath
In the sanitary inspection mode, the location of its premises should allow
them to be divided into two zones ("dirty" and "clean") and ensure the consistent
movement of the processed personnel without crossing the streams through both
zones.
The layout of the laundry and the arrangement of technological equipment
should ensure the continuity and consistency of the process of processing linen
based on the flow system of its movement and the exclusion of contact between
dirty and clean, wet and dry linen.
The "dirty" half of the laundry includes a workshop for receiving and sorting
linen,sanitary lock, shower room, cloakroom and restroom (for the personnel of
this workshop); in the "clean" half, there will be workshops - washing, drying and
ironing, disassembling, repairing and distributing linen, as well as a shower room, a
cloakroom and a restroom. The room "clean" half of the room "dirty" is isolated
by a solid wall. After work, the premises of the "dirty" half of the laundry must be
thoroughly cleaned and disinfected.
Baths and laundries must be provided with water in accordance with the
norms of the order of the Minister of Defense, the quality of which meets the
requirements of sanitary rules and norms for drinking water. They should contain
there are two water supply systems: household and drinking - from external
networks and production - from spare equalizing tanks.
The industrial water supply system provides cold and hot water supply to
shower nets, water columns, washing machines and other technological
equipment. The rest of the water-folding devices are supplied with water from the
drinking water supply system. The capacity of the spare balance tanks is taken on
the basis of providing a half-hour water consumption. In baths and laundries,
separate industrial and domestic sewerage networks should be provided.
Floor coverings in rooms with wet and humid conditions, i.e. in the washing room,
shower, steam room in the bathhouse, washing and drying and ironing shops and a
sanitary checkpoint in the laundry, they are provided from corrugated ceramic tiles,
and the facing - from ceramic or polymer tiles; the slope of the floors is arranged
in the direction of ladders and trays. In rooms with a wet mode, the floors are to be
lowered in relation to neighboring rooms.
Mechanical supply and exhaust ventilation is provided in all industrial
premises of baths, dry cleaners and laundries. It should turn on and work
throughout the entire working day. Natural exhaust ventilation is provided in service
and utility rooms. The design temperature and frequency of air exchange in the
rooms of baths and laundries are shown in Table 2.5. To carry out visual control
over the temperature in the premises, thermometers must be hung out.
All bath rooms on the days of washing should be ventilated before opening
the bath and after it is closed, as well as during cleaning between changes of
washing people.
The speed of air movement in dressing rooms, soap rooms, showers and
bathrooms should not exceed 0.15 m / s, in other rooms - 0.5 m / s.
All rooms of saunas and laundries should have natural light, with the
exception of storage rooms and for cooking.
solutions.

Table 2.5.
Air temperature and air exchange rate
in the premises of baths and laundries

Estimated Air exchange rate in

Premises temperature premises in 1 hour

0
air, С Inflow Hood
 Bathrooms
Lobby with dressing
rooms 18 2 -

Expected 18 2 1

Dressing rooms 25 2.5

Soapy 30 8 9
Tambours between soap
and 25 10

dressing room
Showers (with open
cabins) 25 10 11

Steam rooms 40 - 1
Shower cabins
(closed) 25 10 1

Hairdressers 18 - 2
3
50 m
Dressing rooms 20 - each

toilet
Laundry
facilities
- reception, labeling,
accounting, sorting
and 17 4 5

storing dirty laundry

 - washing, rinsing
and spinning 17 10 13
- preparation of
technological 15 2 3

solutions
- storage of washing
materials 15 1 1
- storage and
delivery of clean linen 15 1 1
By calculation, but not
less
Drying and ironing
shop 15

6 5

Artificial illumination of baths and laundries is being designedtaking into

account the requirements of the order of the Minister of Defense of the Republic of
Uzbekistan. Luminaires in rooms with wet and humid conditions should be
installed, respectively, of a sealed and semi-sealed type. Installation of switches and
sockets in these rooms is not allowed.
The dressing room (dressing room) is not allowed to have unpainted wooden
floors, because this can contribute to the spread of fungal skin diseases. For the
same reason, it is forbidden to cover the walkways with cotton, linen and other
materials instead of rubber tracks, as well as to use wooden lattices for this.
Furniture, installed v of these indoors, can be tough(semi-rigid) upholstered
with leatherette, other materials or painted, easy to wash and disinfect. Equipment
of premises with upholstered furniture is not allowed.
Dressing rooms must be equipped with at least one washbasin and one foot
bath with cold and hot water, as well as a drinking fountain. Baths with more than
10 seats must have restrooms.
A place (corner) for a paramedic on duty (sanitary instructor) is equipped for
carrying out a physical examination and providing medical assistance in the
dressing room. The corner of the paramedic on duty must have the following
property: a table, a chair, a physical examination log, a first aid kit (bag) for
providing medical assistance. The latter should contain: ammonia, alcohol solutions
of brilliant green and iodine, boric petroleum jelly, cotton wool, bandages,
scissors, tweezers, a hemostatic tourniquet, a set of tires, agents used in the event
of acute cardiovascular failure, antifungal drugs, etc.
The washing room is equipped with taps for hot and cold water, at the rate of
one pair for 12 places. The faucet handles are made of wood or other thermal
insulation material and must be tightly attached. In addition, shower nets (one for 12
seats) are installed for the final wash. Water taps and shower valves should be
painted: with hot water - red, with cold - blue.
The layout of the floor in washing rooms should be such that wastewater is
directed to trays and ladders without crossing the main and side aisles.
Bath basins intended for washing must be metal, not subject to
corrosion. Basins for washing feet should be different in shape from the basins
used for washing the body. The use of cans with cracks, notches and poorly
attached handles is prohibited.
Separate rooms should be allocated for clean and dirty linen in the
bath. Collecting and storing dirty and clean linen in one room is strictly
prohibited.
In all rooms of the bath, as well as in the production rooms of the laundries,
proper cleanliness must be maintained throughout the working day. To do this, they
must be provided with a sufficient amount of cleaning equipment, which must be
stored in specially designated rooms or cabinets (boxes). Cleaning equipment and
storage areas should be regularly disinfected.
Baths, after each change of washable outfits, they thoroughly clean the
premises and disinfect them with a solution of a chlorine-containing substance of
the concentration established according to the instructions or a 1% solution of
chloramine.
After washing each shift of servicemen, washcloths are disinfected by boiling
for 15 minutes. If it is not possible to boil the washcloths, they are soaked in a 3%
chloramine solution for 30 minutes. To collect the washcloths, a tank is installed
when leaving the washing room.
Such a procedure for the processing of washcloths can be envisaged during
the actions of troops in emergency situations, in wartime. In peaceful everyday
conditions, conscripts are provided with individual washcloths, the order and place
of storage of which in each specific unit is determined by the commander (placed
after drying in a plastic bag and stored either in a nightstand, or hung on the back
wall of the nightstand, etc.). In this case, there is no need to disinfect washcloths.
The break between changes of rooms that are washed for cleaning and
disinfection should be at least 30 minutes.
In addition to daily cleaning once a week during sanitary days, it is necessary
to carry out general cleaning with disinfection. At the same time, all furniture and
equipment are carefully wiped from all sides with rags,soaked in a 0.5% solution of
chloramine or other chlorine-containing preparation.
During general cleaning, basins for washing the body and feet, as well as
baths, should be cleaned by wiping them with a soap-kerosene emulsion (20 g of
liquid soap and 100 g of kerosene per 1 liter of hot water), followed by rinsing with
water. To remove oily deposits and dark spots, you can use various detergents
(pastes and powders) or fine brick powder.
The benches in soap and steam rooms are washed with stiff brushes with hot
water and soap. Wall panels in soap rooms, steam rooms, showers, bathrooms,
and
protruding structures, pipelines, heating devices, lighting fixtures and lamps,
window panes are washed with brushes. The floors of the premises are wiped with
brushes, continuously pouring water over them.
At the end of cleaning, floors, walls, equipment are washed with hot water
using a hose.
Before opening the bath, the aisles in the washing rooms are watered with hot
water to heat the floors.
Periodically, preventive disinsection of the premises and furniture of baths
and the "dirty" half of the laundries should be carried out using hexachlorane or
other insecticides. Disinsection is carried out by the forces and means of the
medical service.
In the premises of the baths it is not allowed:
store things and objects that are not related to the operation of baths, also
faulty inventory and equipment;
wash and rinse linen;
dry linen in steam rooms and other rooms, on stairs;
bring glassware into the washing room;
without the permission of the paramedic on duty (sanitary instructor)
apply any formulations for rubbing the body;
spend the night or live, whoever.
It is strictly forbidden to use the premises of the baths for other purposes.
Bathhouse workers and laundries, as well as persons on duty, must be
provided with appropriate sanitary clothing.
Personnel health monitoringbath and laundry facilities

The medical service of the military unit also controls the timely passage of the
prescribed preventive medical examinations and examinations of employees of
military baths, laundries, hairdressers and dry cleaners, which should be examined:
for tuberculosis (large-frame fluorography) - upon admission to work;
a dermatovenerologist with laboratory tests for syphilis and gonorrhea - upon
admission to work and then 1 time in 6 months (laboratory tests - for medical
reasons);
therapist - upon admission to work and thereafter once a year.
Officials of the clothing and medical services of a military unit are obliged to
annually conduct classes with the personnel of military bath and laundry facilities
under the program of a sanitary and technical minimum. Persons who have not
undergone the prescribed preventive medical examinations, as well as not certified
in professional hygienic training (about which appropriate notes must be made in
their personal medical books), are not allowed to work in military bath and laundry
facilities.
Before joining the outfit, the person on duty and the workers in the bathhouse
undergo a medical examination by the doctor on duty (paramedic) at the medical
center at the appointed time.
Organization of washing personnel in the bath
Washing v bath military personnel produced weekly from
compulsory simultaneous change complete body kit andbed linen, towels,
footcloths (socks). In winter, warm underwear and winter foot wraps are changed
every two weeks.
The chefs and bakers take a shower every day. They change their underwear
at least twice a week, and work clothes when they get dirty.
Servicemen, whose activities are associated with intense body contamination
(maintenance and operation of equipment, etc.), take a shower as needed, for which
showers are equipped in barracks, car parks, in the household premises of other
facilities.
When sending teams to training centers, training grounds, chores and in other
cases related to the separation of personnel from the military unit, washing must be
carried out with a change of underwear, uniforms and a medical examination. An
entry is made about this in the book (log) for recording the washing of personnel,
as well as a note in the travel (accompanying) documents.
Military units and individual teams following on the railways, when on the way
for more than 7 days, wash personnel at the isolation checkpoints of the Ministry
of Railways, and in their absence - in garrison or railway baths by order of the
military commandants of railway sections (stations) ...
When hospitalized, servicemen are subjected to complete sanitization in the
admission department of a medical institution. After that, they are given hospital
linen, and personal underwear after washing is stored along with the uniform.
Further washing of patients who are undergoing treatment in medical
institutions, and changing their underwear and bed linen is carried out in accordance
with medical indications, but at least once a week.
In order to ensure full coverage of the personnel of the unit (separate battalion,
regiment, etc.) by washing in a bathhouse and monitoring it, the head of the
clothing service draws up a schedule for washing units (teams, shifts), which
approved by the commander or chief of staff of the unit.
The servicemen arrive at the bathhouse at the appointed time, in accordance
with the washing schedule, under the command of the foreman of the unit. By this
time, clean serviceable underwear, footcloths, bath towels are delivered to the
bathhouse for all personnel in a specially designed (marked) clean container (as a
rule, canvas bags). Linen, footcloths and towels are laid out on the shelves pantry
for clean linen. It is strictly forbidden to hand out linen to personnel before
washing.
At the command of the person on duty at the bathhouse, the foreman of the
unit leads the personnel into the bathhouse. The launch of servicemen in the
dressing room of the bath is carried out strictly according to the availability of
seats. When undressing, servicemen hang outerwear on hangers, uniforms are
neatly laid on benches, shoes are placed on the floor, under the benches. Dirty
underwear and footcloths are handed over to the pantry for dirty linen to the person
appointed by the foreman of the unit, about which a note is made in the book (log)
of personnel washing.
dressing room paramedic on duty (sanitary instructorcarries out a bodily
examination of personnel for the purpose of early and active detection of lice,
parasitic, pustular and fungal skin diseases, nutritional disorders, traces of physical
violence, drug use, etc.
At least once a month, physical examinations in the bathhouse should be
carried out by the doctor of the military unit.
The results of physical examinations are recorded in the personnel physical
examination book, which is presented to the medical worker by an official of the
unit.
The results of the bodily examination of servicemen in the bathhouse are
reported to the command of the military unit and the senior medical commander.
After a physical examination, servicemen who do not have head lice,
parasitic, pustular and fungal skin diseases receive soap and go to the washing
room, the residence time in which during hygienic washing should be at least 20-25
minutes.
At the end of the washing, the servicemen, the remains of the soap in a
specially equipped box and leave the washing room in the dressing room (dressing
room). There, servicemen, as a rule, receive bath towels, clean underwear and
footcloths (socks) against signature. After wiping off the body, they dress, hand
over the towels and leave the bath.
Servicemen identified during the bodily examination with pustular fungal
diseases of the skin are washed last separately from the rest. After that, by the
forces of the order, under the supervision of a paramedic, disinfection is carried
out in the bath with a 3% solution of a chlorine-containing substance with an
exposure of at least 30 minutes.
The next change of servicemen is launched into the bath only after the
previous group leaves and after cleaning the bath.
Replacement of bed linen is made on the day of washing the personnel in the
morning after getting up or in the evening before going to bed in such a way that
so that the beds are not left unmade during the day. The person appointed as
the foreman of the unit accepts bed linen from the personnel with an inspection of
its integrity.
Military units that have their own laundries, units hand over linen washing on
the day of washing of personnel. In military units, serviced by garrison and
communal laundries, the units hand over the linen to the unit's clothing warehouse,
where it is stored in a separate room and handed over for washing no later than the
next day after washing. It is prohibited to store dirty linen together with clean
property.
The transportation of dirty linen to the laundry is carried out in specially
marked bags, which, together with the linen, are handed over for
washing. Acceptance of linen in laundries is carried out with a piece count and
verification of the brandparts (subdivisions). During delivery for subsequent
washing, the laundry is sorted by assortment, color, degree of soiling and type of
fabric.
Upon receipt of the linen in the laundry, its receiver is obliged to check by the
brands that the linen belongs to its unit (subdivision), its quantity, and the quality
of washing and repair. The linen is put into the washed container.
Washed but not repaired linen may not be returned from the laundry.
Medical control per bath and laundry service
military personnel carried out v in the interests of preserving their health,
prevention of the emergence and spread of infectious, parasitic and other
diseases. The medical service of military units monitors:
the regularity of washing in the bath and the completeness of its coverage of
military personnel;
timeliness of changing underwear and bed linen, towels, footcloths (socks)
for servicemen, their provision with bath towels,soap and washcloths;
quality and compliance with the technology of washing and dry cleaning of
linen,uniforms and special clothing;
the sanitary condition of the military, as well as communal and departmental
bath and laundry facilities used to service the troops;
compliance with the qualitative and quantitative standards of water supply for
baths and laundries, compliance with the sanitary requirements for cleaning and
disinfecting their wastewater and other waste;
working conditions of those working at military bath and laundry facilities for
compliance with existing sanitary norms and rules;
completeness and regularity of medical preventive examinations and
examinations of the personnel of baths, laundries, dry cleaners and hairdressers;
the effectiveness of disinfection and disinsection of uniforms, linen,
bed accessories, antiparasitic impregnation of underwearlinen.
2.4. Sanitary cleaning of battlefields.
Obligations of the medical service
The burial of human corpses is carried out in cemeteries located no closer
than 500 m from residential and public buildings on elevated areas with breathable
soil and low (below 0.5 m from the bottom of the grave) groundwater table. The
depth of the grave is at least 1.5 m. The grave mound should extend beyond the
edges of the grave to prevent it from being flooded with rain and melt water. The
decomposition rate of a corpse depends on local conditions affecting the vital
activity of saprophytic microorganisms, and can last 7-10 years or more (longer in
damp soils with poor air access). The use of the site for re-burial is permitted no
earlier than 20 years later. Vegetative forms of pathogenic microorganisms die
within the first year. The use of disinfectants under normal conditions is
impractical, because it inhibits the processes of mineralization of the corpse. When
burying those who died from infectious diseases, the corpses are wrapped a cloth
soaked in a 10% solution of a chlorine-containing preparation, and a 2-3 cm layer
of the specified substance or DTS HA is poured onto the bottom of the coffin.
places of burial are presented following sanitary epidemiological
requirements:
the site is selected on poorly filtering soils, well-ventilated and non-flooded
places that allow engineering and disinfection measures and exclude the possibility
of contamination of the territory of permanent or temporary deployment of troops
and sources of drinking water supply;
the burial site is located on the leeward side, below the water intake points,
not closer than 500 m from the places of permanent or temporary accommodation
of military personnel;
the burial site is limited around the perimeter by a barbed fencewire and
drainage for drainage of groundwater and atmospheric precipitation;
- at the disposal site, a disposal zone and economichousehold, separated by a
sanitary gap of at least 25 m;
in the utility area, conditions are provided for storing equipment, ritual
accessories, disinfectants and places for the disinfection of special clothing and
vehicles.
only personnel of special teams provided with special clothing and personal
hygiene items, familiarized with the safety regulations and work performance,
passed a preliminary and current medical examination are allowed to work at the
burial sites .
Burial of the dead and dead, fulfillment of sanitary and epidemiological
requirements for burial sites and
Sanitary and anti-epidemic (preventive) measures are organized by deputy
commanders of military units for the rear and carried out by their own forces and
means in the form of special teams, which are allocated transport, engineering
equipment, inventory, special clothing, detergents and disinfectants.
Constant medical control over the choice of burial places, over the burial of
the dead and the dead, over the health of the personnel of special teams of rear
units is assigned to the medical service of military units.
The main purpose of medical control over the clearance of battlefields
is the prevention of diseases in areas contaminated with garbage, sewage,
corpses of people and animals. For these purposes, the medical service carries out:
control over the observance of hygienic requirements during the burial of
corpses;
control over ensuring the safety of the work of teams,burial;
control over the correct collection and disposal of waste and sewage;
control (together with psychologists) over the state of the neuropsychic status
of servicemen included in the special teams for the burial of the dead and the dead.
the procedure for supervising the observance of the rules for the burial of
corpses, the medical service participates in the selection of a site for burial,
controls the correct placement of corpses in graves, filling the graves and
their designation, monitors the health of personnel involved in the burial of corpses.
Burial in mass graves should be carried out in accordance with sanitary rules that
provide optimal conditions for mineralization and exclude contamination of soil and
groundwater. When clearing battlefields, it is also allowed to burn corpses in
specially arranged earthen pits and ovens.
When collecting and burying the corpses of people and animals on the
territory,infected poisonous radioactive substances andbacterial agents, it is
necessary:
provide the personnel of the teams assigned for the burial of corpses,
personal protective equipment;
organize accounting of their exposure doses;
strictly observe the rules of personal hygiene;
to ensure the possibility of complete sanitization of personnel of units before
meals and at the end of the working day.
All organic waste on the battlefield must be collected and destroyed by
incineration or buried.
Control questions
1.Medical control over the deployment of troops in stationary conditions.
2.The content and algorithm of the hygienic examination of the barracks.
3.Medical control over the field deployment of troops.
4.Hygienic characteristics of field dwellings.
5.Hygienic characteristics of fortifications.
6.Medical control over bath and laundry service for troops in stationary and
field conditions.
7.Medical control over the cleaning of military camps.
8.Medical control over the burial of those killed on the battlefields.
Test questions on the topic
1. The required frequency of air exchange in the bedrooms in the two-story
barracks (number of times):
a) 1;
b) 2;
v) 3;
d) 5.
2. Modern types of field accommodation for air defense radio engineering
troops are:
a) pneumatic tent;
b) full metal composite block (TsUB);
c) container type accommodation;
g) a building attached to the ground (NUZ).
3. Minimum level of TYOK value in barracks training rooms
must be at least (in%):
a) 0.3-0.5;
b) 0.5-0.7;
v) 0.8-1.0;
g) 1.0-1.2.
4. An indirect integral indicator describing the sanitary condition of the air in
residential buildings for servicemen
a) carbon dioxide;
b) carbon monoxide;
v) ammonia;
g) microorganisms.
5. From the point of view of hygiene, tents with increased water resistance are
ideal:
a) true;
b) incorrect.
6. When choosing a plot of land for a field camp, how far (in km) is it planned
to place it from landfills, farms and other polluting structures:
a) 1;
b) 2;
v) 3;
g) 5.
7. Favorable living conditions when placing neighbors in the field
a) tents
b) snowy buildings
c) basements
d) obstacles
8. Types of deployment of troops in the field:
a) placement in barracks;
b) living in an apartment;
c) bivouac, apartment, flat and bivuac
9. Sanitary-epidemiological intelligence of the area intended for placement of
servicemen in the field:
a) radiation, chemical and biological protection services;
b) engineering services;
c) apartment repair service;
g) medical care
10. The best type of field structures designed for long-term deployment of
troops
a) tents;
b) huts;
c) screens;
g) sewerage
11. Advantages of basements as a type of field structures
a) the possibility of construction in a short time;
b) reliable protection from adverse weather conditions;
c) reliable protection from adverse weather conditions, enemy fire, protection
from the harmful factors of weapons of mass destruction.
12. The most important shortcomings of the basement, which negatively
affects the staff
a) low temperature;
b) high content of gas in the indoor air;
c) high humidity
13. Types of open fortifications
a) ditches, trenches, communication ditches;
b) long-range firing points;
v) fortification
g) shelter
14. Types of closed fortifications
a) ditches, trenches;
b) long-term firing points, fortifications, shelters
15. Shelters are radically different from other closed fortifications
a) equipment with heating system;
b) equipment with drainage system;
c) provide room closure and filtration and ventilation facilities.
CHAPTER 3. FOOD HYGIENE OF THE TROOPS
In addition to the usual, daily training and combat activities and related
By this activity, by the conditions of deployment, work and life, the troops
can and even are called upon to carry out military operations in wartime and during
local wars and armed conflicts, as well as to serve in various extreme conditions
and emergencies of a natural and man-made nature. It is quite natural that such an
activity and the conditions in which it is carried out form the specificity of the
organization of food in general and the implementation of sanitary and
epidemiological supervision and medical control over it, in particular.
The actions of troops in the field can occur both during war and local armed
conflicts, and in peacetime (during exercises, maneuvers, etc.), including in the
territory contaminated with radioactive and toxic substances as a result of
man-made accidents and disasters. In the latter case, the organization of all troop
activities,including food and medical services, should be as close to wartime
conditions as possible. In this regard, the concept of "field conditions" includes
both wartime and peacetime, and their specificity should be considered
simultaneously.
The main features of the organization of food, sanitary and epidemiological
supervision over it and medical control in the field are:
difficulties in providing food and food to military units and subunits due to
the lack of food, the difficulty of transporting them, storing, preparing food and
delivering it to personnel;
deterioration in the quality of food and food due to the use of canned and
concentrated products, deterioration of the conditions for their storage, a decrease
in the professional level of food service personnel, especially the cook;
the possibility of contamination of food service facilities, products and food
with radioactive, toxic substances and bacterial agents.
As in the case of a stationary (barracks) arrangement, planning and organizing
food for troops includes the necessary sanitary and hygienic measures aimed at
preserving, strengthening, increasing and protecting the health of personnel, which
is carried out with the participation of the command of military units (formations,
etc.) and relevant officials. These services and officials include: deputy commander
of a military unit for logistics, food, medical, veterinary, RChBZ and engineering
services.
Due to the fact that the supply of troops is part of the logistic support
system, and most services are constituent parts of this system, their activities in
 this area are coordinated, as a rule, by the deputy commander of a military unit
(formation, formation) for the rear.
The commanders of military units (formations) bear full responsibility for the
organization of food, timely and complete delivery to the personnel of the
allowance set according to the standards. They carry out their duties personally and
with the help of the chief of staff of the unit. In addition, the unit commanders
control the quality of the prepared food and make a decision (allow) the use of
food and food, for which an expert opinion has been received.
The food service of military units (formations, associations, etc.) organizes
and carries out the procurement, storage, transportation, processing of food,
preparation and distribution of food to personnel; conducts current control over
the quality of food products; organizes an examination of substandard food, as
well as food contaminated with substances, radioactive substances and BS,
involving representatives of the chemical and medical services in it; carries out
decontamination, degassing of food, property and equipment; together with the
RChBZ troops and independently conduct continuous radiation, chemical
bacteriological reconnaissance in the areas of deployment and deployment of their
service facilities. In preparation for the operation (training), the chiefsfood service
units and formations calculate the needs for food and technical means of the
service; organize the receipt of the missing food and the delivery of it to the
personnel of the subdivisions; train service personnel to operate in the
field; organize the preparation of food, equipment and property for use in the
field; present personnel for examination at a medical center. During the operation
(training), functional responsibilities expand, responsibility increases, since the
chiefs of the food service:
participate in logistic reconnaissance in order to determine the place for the
deployment of the corresponding objects;
carry out systematic control over the work of battalion food points (BPP),
food warehouses, bakeries (bakeries),mobile meat processing plants, food and
water supply facilities, and also monitor their sanitary condition;
control the observance of the technology of cooking, its quality and bringing the
required rations to the personnel;
organize food protection from weapons of mass destruction
(WMD), supervise the implementation of measures to eliminate the
consequences of its use at subordinate facilities; evaluate the effectiveness of
special processing of foodstuffs exposed to weapons of mass destruction;
at the end of the exercise (operation), they analyze the actions of the service
personnel, determine the availability and condition of food, service personnel,
organize their repair and putting in order. If necessary, the personnel of their units
are sent for examination to medical centers.
The chiefs of the engineering service of military units and formations organize:
reconnaissance of water sources, including sources used to supply water to food
service facilities; water treatment and determination of the completeness and
reliability of its decontamination, neutralization and disinfection; current
(technological) laboratory control over water quality at water supply points,
including when using weapons of mass destruction.
The chiefs of the RChBZ service of military units and formations organize
chemical reconnaissance and indication of weapons of mass destruction (NSR) on
the ground, participate in identifying and determining the degree of food
contamination by the NSR; provide data on the radiation and chemical situation to
the chiefs of food and medical services, as well as the commander of a sanitary and
epidemiological institution (SEU), who are responsible for the examination of food
in the context of the use of weapons of mass destruction.
The chiefs of the veterinary service organize veterinary
reconnaissance; develop measures to prevent the introduction of pathogens of
infectious diseases from animals into the troops; organize and conduct veterinary
and sanitary examination of food, including those infected with weapons of mass
destruction, coordinating their actions with medical and chemical services.
The chiefs of the medical service of military units and formations and
specialists of sanitary and epidemiological institutions and subdivisions also
exercise control over the quantitative, qualitative adequacy of nutrition, adherence
to the diet; take part in the development of temporary nutritional standards, monitor
and assess the health status of personnel related to nutrition (nutritional status), as
well as the health of personnel working at food facilities; take part in the
examination of products and food, including trophy, contaminated with OM,
radioactive substances and BS; organize and conduct sanitary and epidemiological
reconnaissance of the places of the proposed deployment of food service facilities,
monitor their sanitary condition and compliance with sanitary rules during
operation. The medical service carries out its control activities in the places of
procurement and processing of food (field mills, grinders, meat processing plants,
bakeries, etc.), in places where food is stored and at all stages of its delivery, at
BPP and directly in subdivisions.
Successful performance of the listed functions presupposes knowledge of its
organization and implementation procedure.
3.1. Organization of catering for personnel in the field
Food for the personnel of the military unit is organized by the head of the
food service of the unit from the field kitchens for the contented units. The
contenders are units that have regular means for cooking in the field (battalion,
division, separate company, etc.). Units that do not have the specified funds, by
order of the deputy commander of the military unit for the rear, are assigned to
food supplies to the subunits, taking into account the tasks performed and the
convenience of obtaining food.
The subunit commander is responsible for the organization of meals, the
timely and complete delivery of the prescribed norms of daily allowance to the
personnel. He organizes meals personally, as well as through the chief of staff and
the commander of the support platoon, and takes all measures to ensure that hot
food and drinking water are provided to the personnel in full and at the specified
time. The commander of the support platoon of the battalion (division), the
economic platoon of the regiment organizes the work of the economic department
of the platoon and is responsible for the safety of food, timely and high-quality
preparation of hot food, delivery and delivery of it to units.
Food for personnel is carried out according to the norm 1 (combined arms
rations), established by order of the Minister of Defense of the Republic of
Uzbekistan, which is presented in Table 3.1.
Table
3.1
Combined arms rationNorm No. 1

Name Quantity
products for 1 person
per day, g
Bread from a mixture of peeled rye and wheat flour 1 sec. 350
White bread from wheat flour 1 grade 400
Wheat flour 2 grades 10
Different groats 120
Pasta 40
Meat 200
A fish 120
Rendered animal fats, margarine 20
Vegetable oil 20
Cow butter 30
Cow's milk 100
Chicken eggs, pcs. (in Week) 4
Sugar 70
Edible salt 20
Tea 1,2
Bay leaf 0.2
Pepper 0.3
Mustard powder 0.3
Vinegar 2
Tomato paste 6
Potatoes and vegetables, total 900
 Including:
potato 600
cabbage 130
beet 30
carrot 50
onion 50
cucumbers, tomatoes, roots, herbs 40
Fruit and berry juices 50
or fruit drinks 65
Jelly concentrate on fruit and berry extracts 30
or dried fruit 20
Multivitamin preparation "Geksavit", dragee 1
In cases where the preparation of hot food from the products of this ration is
not possible, meals are organized according to the rate 10, presented in table
3.2. However, it must be borne in mind that continuous nutrition at this rate should
not exceed 3 days.

Table 3.2
Individual diet for everyday troop activities (IRP-P) Norm No. 10
Name products Quantity on
person per
day, G
Army crispbread from wheat flour 1 grade 300
Canned meat different 350
Canned meat and vegetable different 500
Sugar
45
Beverage concentrate
25
Instant tea with sugar
32
Fruit jam (jam)
Candy caramel 45
Multivitamins, pills 10
Portable heater, pcs. 1
Canned food opener, pcs.
 Paper napkins, pcs. 1
1
3

When the personnel perform tasks in the conditions of local wars and
armed conflicts To the basic norm provides for the issuance additional products
(table 3.3.), and in cases where cookinghot food is not possible, it is provided by
foodnorm 9 (table 3.4). At the same time, the food for servicemen according to this
norm is notmust exceed 7 days.
For the preparation of hot food, its delivery, the provision of personnel
bread, sugar, tea, tobacco products, matches and drinking water
economic branch platoon battalion support is deployed battalion food point (BPP),
and the economic departmentthe economic platoon of the regiment - the regimental
food point (PPP).

Table 3.3
Contents of the set of additionally dispensed products

Product name Number for 1 person per day, g

Meat or lard one hundred

Cow butter 10

Sugar thirty

Canned fish 50
 Condensed milk twenty

Multivitamins 1 tablet

Table 3.4
Individual dietfor combat activities of troops (IRP-B)
Norm number 9
Name Quantity on
products 1 person per day, g
Army crispbread from wheat flour 1 200
varieties
Canned meat different 250
Canned minced meat different one hundred
meat
and
Canned food vegetable and 250
meat and vegetable different
Different canned fish one hundred
Groats and vegetables side dishes one hundred
Sugar 75
Instant coffee 2
Instant tea with sugar sixteen
Caramel 10
Dry milk drink thirty
Beverage concentrates 25
Fruit jam miscellaneous 45
Dried fruits twenty
Canned Vegetable Snacks 60
Multivitamins, pills one
Portable heater, pcs. one
Water-resistant matches, pcs. 6
 Sanitary napkins, pcs. 3
Paper napkins, pcs. 3
Water disinfection means, pcs. 6
Plastic spoon, pcs. one
Canned food packaging opener, pcs. one

The head of the food post is the commander of the economic department,
who organizes the work of the post in accordance with the tasks received from the
battalion commander (chief of staff) directly or through the support platoon
commander.
Dowries battalion subdivisions are provided with food as
usually across food points of their subdivisions (units).
Divisions, not having their regular means of cooking food, are provided with
food through the food station of the battalion, whichthey are attached.
V dependencies from combat destinations subdivisionsequipped with trailer
or car kitchens.
For each hook-on kitchen, the following basic equipment is provided by the
relevant standards: six TVN-12 thermos flasks, containing 17 servings of the
first course or 26 servings of the second course, a frame tent, a folding or
removable kitchen table, a box for storing and transporting food, various kitchen
utensils. In addition, for storing and transporting water, each kitchen is attached
to a TsV-4 cistern with a capacityl.
The battalion food post is deployed in the area designated by the battalion
commander at a safe distance from targets of possible enemy strikes and probable
sources of pollution (dumps, cemeteries, transport highways, etc.), taking into
account the maximum use of the protective and camouflage properties of the
terrain, available engineering structures and other shelters, access roads and
sources of water supply, the ability to quickly deploy, roll up and move to a new
area, as well as in compliance with fire safety.
To accommodate the battalion food station, an area of ​80 x 100 m is selected. The
kitchens are detached from the vehicles and dispersed from one another at a
distance of up to 30 m. Towing vehicles are placed at a distance of up to 10 m
from them. Kitchens are set in working position, cleaned of dirt, washed, put in
order, frame tents are deployed above them and places for washing hands of cooks
are equipped.
At a distance of 15 m from the kitchens, a place is arranged for cleaning
potatoes and vegetables: a pit for cleaning is torn off, benches are made from scrap
materials. At a distance of 50 m from the kitchens, a waste pit is opened, which is
closed with a lid, also made of scrap materials.
Separately, at a distance of 20-25 m from the kitchens, tables for eating by
personnel are equipped, as well as at a distance of 50-70 m - a place for washing
individual pots, where a boiler for boiling water or thermoses with hot water is
installed.
The distribution of water for washing the pots is carried out only by the
personnel of the food station.

At the same time, a place for cooking and eating by the battalion's officers is
being equipped: a tent USB-56 (UZ-18), a PP-40 plate with the necessary set of
kitchen utensils and a set of field furniture are installed. A set of tableware is
provided for eating.
A variant of the location of a food station for a motorized rifle battalion is
shown in Picture 3.1.

The order of deployment of the tank battalion's food station is the same, only
instead of four trailed kitchens, one PAK-200 automobile kitchen with a PS-2
warehouse trailer is located on the site.
The storage of the established stocks of food and property of the food
service is carried out in the bodies of vehicles towing the kitchens, or in a
trailer-warehouse. Food and property are placed in such a way as to ensure the
autonomy of the operation of each kitchen, protection from weapons of mass
destruction and quick unloading when a food station is deployed.
The emergency stock is stored in the duffel bags of the personnel or in special
inventory stowage boxes of combat vehicles.
The emergency reserve is spent with the permission of the regiment
commander, and in urgent cases, with the permission of the battalion commander,
followed by a report to the senior commander.
The delivery of food to the units to replenish stocks to the established size is
carried out by the transport of the military unit from the food warehouse of the
unit. When receiving food, its quality and quantity are checked.
Food is prepared according to a single product layout for all units of a military
unit, drawn up by the head of the food service with the participation of the head of
the medical service and the cook-instructor, which is approved by the commander
of the unit.
When compiling a layout, relatively constant sets of products are used. So,
for example, according to the first option, the set of products includes: bread,
cereals, pasta, vegetables (potatoes, cabbage, beets, pickles, carrots, onions),
meat, fats and sugar; on the second - bread, food concentrates of the first and
second lunch courses, canned meat, fats and sugar; on the third - bread, food
concentrates of second courses, dried potatoes, dried vegetables, canned meat,
fats and sugar; on the fourth - bread, cereals, canned first courses without meat,
canned meat, fats and sugar.
In the field, as well as in the barracks deployment of troops, food should, as
a rule, be three times a day. By meals, the energy value of the daily ration is
distributed as follows: for breakfast - 30 - 35%, for lunch - 40 - 45%, for dinner -
20 - 30%.
If it is impossible, according to the conditions of the situation, to organize
three meals a day with the permission of the unit commander, the personnel are
provided with hot food at least twice a day (for breakfast and dinner) with the
issuance of intermediate meals at the expense of the daily allowance. For
intermediate nutrition, military personnel are given bread, meat, meat and vegetable
canned food sugar. Other non-perishable, ready-to-eat products (bacon fat,
semi-smoked sausage) may also be issued. In this case, the energy value of the
daily ration by meals is distributed as follows: for breakfast - 40%, for dinner -
35%, intermediate meals 25%. Boiling water is prepared for each meal and for
filling the flasks.
With three meals a day, hot food should be served as follows: for breakfast -
before the start of the main events or hostilities, for lunch - during the hours of
decline in the intensity of combat training activities or combat tension, for dinner -
at the end of the day or after completing assigned tasks. When developing a diet in
battle, one should strive to ensure that the main food intake falls on the hours of the
decline in combat tension.
If hot food is given to the personnel twice a day, then at the first appointment
it is planned to prepare one dish, and at the second appointment - two dishes. In
this case, the products are distributed as follows: for breakfast - bread, food
concentrates, cereals, canned meat, fats, sugar; for dinner - bread, cereals, canned
meat, vegetables (potatoes, cabbage, carrots, onions). For intermediate nutrition,
each serviceman is given 250-300 g of bread or 150 g of crackers (biscuits), 15 g
of sugar and one or one and a half cans of canned meat and vegetables (265 - 397.5
g).
Based on the conditions of the environment, it is necessary to strive to
prepare food mainly from fresh products and only during the period of
deterioration.
setting to provide meals from concentrated and canned foods. It should be
borne in mind that in the field, rusks, dried vegetables, including potatoes, food
concentrates, barley and pearl barley, become bored especially quickly.
Food for battalion officers is carried out according to the standard of
combined arms rations with the issuance of additional products (in peacetime for a
fee, in wartime - free of charge). Food for officers is prepared according to a
separate layout of products, also the same unit for all units, which is compiled and
approved by the established procedure. First lunch dishes are preparedcommon in
field kitchens, second courses are prepared, as a rule, separately on the PP-40
stove.
There is a set of tableware for eating. In cases where, according to the
conditions of the situation, it is not possible to equip a place for eating with
officers, officers of the battalion's subdivisions receive hot food with personnel
from the field kitchens.
Hot food products are provided to the chef for each meal. Products that do
not require heat treatment (bread, sugar and tobacco rations), as well as
intermediate food products, are given to the chiefs of divisions once a day.
The provision of the economic department of the supply platoon (the
economic platoon) with water for drinking and household needs is carried out from
the battalion water supply point and the regimental water point. It is prohibited to
use water for these purposes from other sources. The supply of water from the
water supply points, as well as to the water points and to the battalion food points,
is organized by the deputy commander of the military unit for the rear. To maintain
the required supply of water at food points, all available containers are used,
including kitchen boilers and thermoses for distributing food.
Food intake by personnel is carried out directly at the battalion food point
using individual pots. If necessary, hot food can be delivered to the location of
the personnel in thermoses. Store food in thermos flasks for no more than two
hours.
Catering on the offensive
Before the offensive, in the initial area, preparations are being made to carry
out specific tasks to provide personnel with food in the offensive: food reserves are
replenished to the established size, maintenance of kitchens and other service
equipment is carried out, a weekly layout of products is being specified, to be
specifiedthe number of contented personnel.
The commander of the support platoon, in accordance with the order
received and the instructions of the battalion chief of staff, sets tasks for the
commander of the economic department, in which he determines: the order of
movement, the place the time of the deployment of the food point, for how many
personnel and for which subunits to prepare food, the time of its readiness, the
procedure for delivering (issuing) it to subdivisions, the procedure for providing
water.
Before the start of the nomination, hot food is given to all personnel.
In the course of the battle, the economic department moves behind the
second echelon of the battle formation of its battalion, not breaking away from it by
more than 3 km.
Food is prepared mainly from canned and concentrated products on the go,
and at short stops only food is loaded into the kettles.
Hot food is dispensed after checking its quality by the paramedic of the
battalion. The order of delivery and delivery of food is determined each time by the
battalion commander, depending on the specific combat situation.
Field kitchens with ready-made food, as a rule, are moved to company points
of delivery. If the situation allows you to bring the company food delivery point as
close as possible to the front edge and organize it in a shelter, to which there are
hidden approaches, then food is given to the personnel directly into individual
bowlers. In most cases, hot food from company commanders to platoon
distribution points is delivered in thermoses by carriers allocated from platoons.
At the same time, trays deliver flasks of boiling water for replenishing water in
flasks and washing pots.
Organization of catering in defense
In a defensive battle, a food point is placed withinbattalion defense area is
usually behind the second echelon of the battalion. If necessary and with the
availability of time, special engineering structures can be equipped to shelter
personnel, kitchens and cars, or adapted rooms can be used. In defense, there are
certain possibilities for deploying a food post not only in accordance with the
previously stated procedure, but also for equipping additional tents (rooms) for
washing dishes, making tea, and washing hands.
Hot food is prepared three times a day with mostly fresh ingredients. The diet
is more strictly regulated in terms of time and range of products (dishes). The
order of delivery and distribution of food to personnel is the same as in an
offensive battle.
Once a day, usually for breakfast, bread, sugar, tobacco products are
delivered along with hot food to the company posts at the rate of the daily
rate. Additional rations may be issued to the officers for several days in advance.
Catering at the stages of medical evacuation
Nutritional therapy is an integral part of the complex therapy of the wounded,
injured and sick. It has a great effect on metabolism and the general condition of the
body, increases resistance to the influence of various unfavorable environmental
factors. Nutrition adequate to the needs of the body prevents the development of
complications and chronic diseases, accelerates the healing of wounds and the
restoration of impaired functions, and shortens the recovery time for working
capacity and fighting efficiency.
The organization of food for the wounded, injured and sick at the stages of
medical evacuation has significant features. They are due to the possible
massiveness of sanitary losses; the need to combine medical care and treatment
with evacuation to the rear; the complexity and instability of the environment in
which hospitals operate, and theirmaneuverability; the originality of military
pathology; difficulties in the deployment of hospitals and the organization of
differentiated and evidence-based nutrition, adherence to an appropriate diet and
food supply.
Before the regiment (medical company) medical center, the wounded and sick
eat according to the food supply norms of military units. The nature of the food
(first and second courses, bread, tea with sugar) depends on the type of lesion and
the state of the body. Diet restrictions are established by a doctor who examines
the wounded and sick and provides them with medical assistance.
Starting from the separate medical battalion of the division (the medical
company of the brigade) and at the subsequent stages of medical evacuation, it is
planned to prepare food according to hospital norms and therapeutic diets. These
diets are different from peacetime diets. They are less differentiated and therefore
are designed for a wider range of wounded, affected and sick.
For the stages of medical evacuation, the contingent of the wounded and
sick, the features of the combat situation and the scheme for unifying therapeutic
diets are taken into account. 8 therapeutic diets are used, which (with the exception
of the zero diet) provide a varied nutrition, high in energy and quality, for the main
categories of the wounded, affected and sick:
hospital general diet (according to the type of diet No. 15);
hospital diet, mechanically sparing (like diet number 2, moderately
chopped);
hospital diet, mechanically and chemically sparing (by the type of dietone);
jaw diet (according to the type of diet No. 1, thoroughly crushed);
probe diet (like diet No. 1, thoroughly crushed, liquid);
general diet for patients with radiation and burn diseases (by type of diet 11
b);
diet for patients with radiation and burn diseases mechanically and chemically
sparing (like diet number 11 a);
zero diet (like diet number 0).
The main ones are three diets: hospital general, hospital mechanically and
chemically sparing and zero. The first two main diets are prepared separately. All
the others are formed from these diets, for which they are subjected to either
grinding, or dilution, or enrichment with additional products.

Dishes prepared according to the general hospital diet, after moderate

grinding, are used as a mechanically sparing diet, and after reinforcement with an
additional ration - as a general diet for patients with radiation and burn diseases.
Meals of a mechanically and chemically gentle diet, after thorough grinding,
are used as a jaw diet. Shredded food after additional dilution is used as a probe
diet. The hospital diet is mechanically and chemically sparing, reinforced with
additional rations, is used to feed patients with radiation and burn diseases who
need sparing nutrition.
Diet meals are prepared separately. Partially they use dishes prepared
according to other diets - broths, mashed cereals, jelly, decoctions, tea with sugar.
If it is not possible to cook food separately according to a common diet, as
well as mechanically and chemically gentle diets, you should prepare food
according to the same mechanically and chemically gentle diet. It can be used to
feed all the wounded and sick.
According to mechanically and chemically sparing, jaw and probe diets,
meals are prepared from pre-chopped food products (minced meat and fish,
finely chopped vegetables, etc.).
According to the jaw and probe diets, prepared food is also subjected to
additional grinding.
First courses for general and mechanically sparing diets are prepared in meat
(fish) broth, for mechanically and chemically sparing (jaw, probe) diets - vegetarian,
dairy or cereal.
Meat and fish dishes are fried without breading according to a mechanically
sparing diet, and steamed or boiled according to a mechanically and chemically
sparing diet.
It should be borne in mind that in some situations it may be impossible to use
fresh products, then it is planned to use canned and concentrated products: meat,
fish, meat and vegetable, vegetables, canned milk, cereal and vegetable
concentrates, milk powder, etc.
Replacements for hospital rations should be limited. For example, meat and
fish can only be substituted for eggs and cottage cheese.
Catering for the use of weapons of mass destruction.
At application adversary Weapons of mass estruction or upon occurrence
emergency situations leading to the contamination of the territory with radioactive,
toxic substances or bacterial agents, it is possible that they contaminate food
products and prepared food during the storage and transportation of food, during
the preparation of food and its distribution. In these cases, food and food can
cause massive casualties to the personnel of the troops, which makes special
demands on the protection of food service facilities from weapons of mass
destruction.
At organization nutrition v case use of weapons of mass defeat is provided
for:
continuous reconnaissance and information about the nature of its use and
areas of contamination;
maneuvering to select uninfected or less contaminated sites;
carrying out special measures to protect property, food products and
prepared food;
systematic control of contamination of food, food, tools and equipment of
the food service;
decontamination and degassing of the listed facilities;
compliance with the rules of cooking and eating;
training of personnel and personnel on the rules of conduct in the
contaminated area.

Reconnaissance is conducted by all parts of the food service in cooperation

with the RCB protection troops and the medical service. In accordance with the
information received, the radiation, chemical and biological conditions are assessed
and the food service facilities are moved to less contaminated areas.
When placing food on the ground, first of all, local storage facilities are used,
previously used for storing food, engineering structures of troops, shelters arranged
in the ground, and natural shelters of the terrain (underground workings, quarries,
ravines, ravines, etc.). When using adapted rooms or shelters, if possible, they are
sealed. However, when determining the protective properties of adapted rooms,
their capabilities cannot be overestimated, since even with careful sealing of the
object by sealing all cracks in windows, doors, enclosing structures gaseous and
vaporous toxic substances and bacterial aerosols can penetrate into the storage
rooms. Therefore, it is advisable to additionally cover all products.
Protective materials (tarpaulin, synthetic film, thick paper, etc.). When lack
of power, resources and time to the construction of shelters, with a high level of
ground water for short-term storage in the field of food laid on specially prepared
sites in riots and hiding canvas or improvised materials which are firmly entrenched.
Places for sites are chosen dry, with a slight slope for water drainage and
convenient entrances for cars. The platforms are cleaned, tamped and dug in with
grooves 20–25 cm deep at a distance of 1 m from the edge of the platform. On the
platforms, the flooring is laid: continuous for bulk products, and with gaps of 8 -
10 cm for products in rigid containers. When covering the riots with tarpaulins or
other coverings, it is necessary that between the inside of the cover and the
products a spacer made of wooden blocks, branches, straw up to 10 cm thick is
created.This creates additional food protection in the event of the penetration of
toxic substances and aerosols of biological agents. It is most expedient to equip
rebellious platforms in hollows, ravines or beams with convenient entrances.
In areas with a high level of groundwater, bulk-type shelters can be
arranged. Shelters are a driveway with riots on either side. An earthen rampart up to
3 m high is arranged around the site.
The pit-type shelters are torn off to a depth of 1 - 1.5 m. On both sides of the
pit, a shaft of soil up to 1 - 1.5 m high is also built, on which a soft tarpaulin
covering is fixed.
Of all earthen structures, the most reliable are pit-type shelters with soil
overlap.
Along with the use of various shelters, containers and packaging are one of
the main means of protecting food from contamination with radioactive, toxic
substances and bacterial agents. Adequate protective properties of containers and
packaging are achieved by using its design of packaging materials impermeable to
harmful substances with smooth surfaces that facilitate their disinfection and
resistant to the effects of disinfecting formulations.
It must be borne in mind that meat, fish, meat and vegetable, vegetable, dairy
and other canned food, vegetable fats, as well as briquetted vegetable mixtures,
fruit juices and drinks, meat products, fish and fish products, frozen ready meals,
packaged in airtight metal and glass containers, as well as in jellied wooden barrels,
are reliably protected from radioactive, poisonous substances bacterial
agents. Such a container withstands well the effects of disinfecting formulations and
their solutions, protecting products from damage during decontamination,
degassing and disinfection.
Rectangular combined cans, bags made of paper covered with polyethylene,
as well as cardboard boxes covered with micro wax, provide protection from
radioactive substances, bacterial agents and partially from vapors of toxic
substances. The same protection of products is provided when packing them in
linen grocery bags, multilayer paper bags, plywood and cardboard boxes with a
polyethylene liner, boxes made of moisture-resistant solid glued cardboard, as well
as boxes made of solid glued cardboard or corrugated cardboard, sealed with
polyethylene adhesive tape.
Ordinary plywood and cardboard boxes and drums, wooden dry barrels
provide protection of products from the penetration of radioactive substances and
do not protect against toxic substances and bacterial agents. Single-layer fabric
bags for flour, cereals, sugar, salt, etc. practically do not provide protection of
food from contamination. The protective properties of plywood and cardboard
boxes, linen and paper bags are increased when using liners made of polymer
films. Such a combined container ensures the safety and protection of food
concentrates, refined sugar, pasta, flour, cereals, dried vegetables and fruits, one
hundredsolid fats and other products from exposure to radioactive dust, bacterial
agents and partially vapors of toxic substances. The protective properties of the
main types of containers and packaging are shown in Table 3.5.
Thus, different types of containers and packaging do not provide the same
protection of food from contamination with radioactive, toxic substances and
bacterial agents. The most difficult to protect against contamination with vapors,
aerosols of toxic substances and bacterial agents. In accordance with the ability of
containers and packaging to protect food from contamination, they are divided into
three categories of protection: higher, first and second.
The highest category of protection is possessed by containers and packaging
that protect food from all types of contamination. The first category of protection
includes containers and packaging that protect food from two types of
contamination (RV and BS). The second category of protection has containers and
packaging that provide protection of products only from contamination with
radioactive substances.
Table 3.5
Protective properties of containers and packaging
No. Type of container, Degree of protection food Categories

packaging and their (protection provided +, no protection I am

provided -) protection
purpose

from PB from OV from BS

1 Banks + + + The highest
2 tin
and
+ + + The highest
tubes
3
aluminum for The highest
+ + + of
4 allspecies
canned food. + + + The highest
5 Banks
The highest glass
+ + +
and
6
bottle The first
for + - +

of
all species canned food,
 drinks.
Barrels
metal
for
vegetable fats.
Wooden jellied barrels
for
salting fish, meat,
cabbage,
cucumbers, etc
Hermetically
closed
cans,
cans, thermoses.
Rectangular

Double bags from the bag paper with polyethylene coating for dry
rations. Linen grocery bags with a loose polyethylene liner for flour and cereals.
Bags papermultilayer Withpolyethylene liner for flour, cereals, dried vegetables
and fruits.
Drums cardboard for dried vegetables and animal fats.
Container cardboardisothermal for frozen meat.
Boxes are cardboard, plywood, board with polyethyleneinsert for food
concentrates.
Boxes made of waterproof solid glued cardboard for food concentrates,
pasta, etc.
Individual packing made of parchment or paper ODP-42 polyethylene coating
for food concentrates. Polyethylene coated paper bags for bulkproducts (flour,
cereals, dried fruits).
Paper bags, reinforced (laminated) with polyethylene, for crackers, dried
vegetables and fruits, pasta.
Barrels Wooden suhotarnye for animal fats and mixed fats.
The drums and crates plywood for dried vegetables, pasta, etc. Linen bags for
bulk products (flour, cereals, grain, etc.).
Given this, it is advisable when storing and transporting food, especially
packaged in containers of the first and second categories, to use additional
materials that enhance their protection. The lower the category of protection the
containers and packaging of food have, the higher the requirements should be
imposed on measures for additional protection of products. At the same time,
whenever possible, it is necessary to apply various coatings for products packed in
materials of the highest protection category. This will protect and significantly
reduce the contamination of the container and packaging itself and thereby reduce
the time and cost of carrying out their special processing. When removing
protective materials, measures are taken to ensure that possible contamination from
the blankets is less likely to get onto the covered food.
However, when evaluating the protective properties of containers and
packaging and the good quality of the products contained in them, which are in the
zone of exposure to penetrating radiation, one should take into account the
possibility of the formation of induced radioactivity in them. In this case,
dosimetric control is carried out to determine the level of activity.
Control over compliance with the requirements for the protection of food
during its transportation is carried out in several directions. First of all, the
correctness of the stowage of goods on transport and the thoroughness of their
covering with protective covers (tarpaulins, synthetic films and other service and
improvised means) are monitored, and also the use of specialized transport for
transportation and storage of food. For the transportation of food, only vehicles
specially prepared for this are allowed. When delivering, as a rule, vehicles with
bodies covered with tarpaulin are used. If cars without awnings are used, then food
from above and from the sidesis covered with protective materials, which are then
strengthened. Particular attention is paid to the integrity of the front and rear of the
awnings and coverings. Before loading food, the bottom of the body is lined with a
tarpaulin (protective sheet) or plywood.
Food should be packed tightly in the body, if possible without gaps between
individual container places. If food packaged in containers with different protective
properties is subject to transportation by one car, then in front and on the sides,
food packed in a serviceable container with better protective properties is
placed. When unloading food, the protective covers are removed carefully, not
allowing dust to fall on the cargo. This is especially important if the transport with
food passed the contamination zones.
After the arrival of such food in the destination area, a complete special
treatment of vehicles and protective materials that covered the food during the
passage of contaminated zones (tents, tarpaulins, bodies, etc.) should be carried
out. Then, depending on the indications, dosimetric control of radioactive
substances contamination is carried out, preliminary control of contamination of
substances is carried out, and if necessary, samples are taken for radiometric
studies, quantitative determination of contamination of substances, specific
indication of BS.
Specialized transport is intended for the delivery and storage of a certain type
of food and usually it has higher protective properties than general purpose vehicles
used for these purposes. For the transportation of perishable food and bread,
vehicles with combined bodies, box trailers, refrigerators, and refrigerated trucks
are used. The protection of products in them from contamination with radioactive,
toxic substances and bacterial agents is achieved by a good sealing of the body.
Military echelon, mainly in the absence of specialized transport, is allowed
to transport meat and bread over short distances and insmall quantities in
containers or wooden boxes. The boxes should be filled and painted on the
outside and have a tight lid. The meat boxes are additionally upholstered with
galvanized iron from the inside, and the seams between the iron sheets are
soldered. To improve the protection of transported products, containers or
boxes are additionally covered with covers made of dense materials.
Cooking in contaminated areas is greatly facilitated by using foods that meet
the following requirements:
do not require complex culinary processing and provide food preparation in a
short time;
have a small volume and weight;
withstand long-term storage in unfavorable conditions, as well as the effect
of decontamination formulations during special processing of the outer surfaces
of containers.
such products include: canned meat, fish and meat and vegetable
products; food concentrates of the first and second meals of instant preparation,
quick-digesting dried vegetables, cereals and pasta, dry mashed potatoes, long-term
storage bread, rusks, army bread, tea, sugar and others.
Battalion food items are located at the direction of the subunit commander,
taking into account the level of radioactive contamination of the area and the
established doses of external exposure of personnel. The site for them is selected
after the reconnaissance data has been clarified on the spot.
In order to protect food stocks, kitchens and equipment from contamination
with radioactive substances, when equipping a food point, if possible, brick
buildings, basements should be used to accommodate kitchens basement
rooms. When placed outside settlements, it is necessary to place them in pits in
service frame tents.
The installation site of the frame tent, if necessary, remove a layer of soil with
a thickness of 3 - 4 cm (snow 20 cm), embank the tent alongperimeter, all the
cracks are carefully sealed. The contaminated soil is carried downwind at a distance
of at least 150 m from the kitchen location. Restrict movement in the vicinity of the
tent to reduce dust formation. The personnel undergo sanitization, wash their
hands and put on clean overalls.
Inventory items (scoops, knives, forks, cutting boards, buckets, dishes,
thermoses) are stored in covers made of protective fabric (polymer film) or in
tightly closed boxes.
Before preparing food, cutting tables, kitchen utensils and equipment are
thoroughly washed, checked for contamination with radioactive substances using
standard dosimetric devices. This is also done when removing products from
packaging.
When processing food and preparing food, special attention is paid to
limiting the time of their contact with the environment as much as possible. The
kettle lids can only be opened for loading food and serving food.
-6
When the radiation level in the territory is up to 1 R / h (3 * 10 Gy / s), the
battalion food post works as usual. Food processing is carried out in a tent, access
to which is strictly limited, in front of the entrance her shoes are carefully wiped
off. The delivery and reception of prepared food in these conditions is also carried
out in the usual manner, subject to the personal hygiene rules by the personnel.
-6 -6
At radiation levels of 1-5 R / h (3 * 10 - 14 * 10 Gy / s), trailer kitchens
must be deployed in tents or in decontaminated structures (basements and
semi-basements of stone buildings, dugouts, etc.). Eating can be carried out in
open areas and open defensive structures.
-6
At radiation levels of 5 R / h (14 * 10 Gy / s) and above, it is necessary to
cook, distribute and take food only in closed, deactivated rooms.
Routine monitoring of radioactive contamination of the area, food products
and prepared food is carried out directly at the food service facilities by regular
or non-standard dosimetrists using standard instruments.
Selective laboratory control carried out specialized medical laboratories
(sanitary and epidemiological institutions), veterinary and sanitary services and the
RCB protection troops. The volume and frequency of sampling depends on the
radiation environment and the range of products.
Zones of dangerous and severe contamination to feed the wounded and sick,
as well as personnel in shelters, hot food is delivered in thermoses. Before bringing
ready-made food, bread and other products into the shelters, the outer surfaces of
thermoses, boxes are decontaminated. In the shelter, food is handed out and taken
in the usual way.
Cooking, serving and eating is prohibited in zones of contamination with toxic
substances and bacterial agents, as well as at high levels of radiation, when there is
a danger of overexposure of personnel during the preparation, distribution and
consumption of food and during the period of radioactive fallout.
In those cases when the situation does not allow preparing hot food, the
personnel eat dry ration products, an individual diet.

When a battalion food point is contaminated, it is disinfected. Full special

treatment is carried out on site or at a specially equipped site with the permission of
the battalion commander. Decontamination of surfaces of cars, kitchens and other
equipment, also equipment, inventory and food stocks are carried out using
timetablekits for special processing. It consists in carefully sweeping surfaces with
brooms, rubbing with a rag,moistened with decontamination solution or water.

3.2. Organization of medical control over nutritionpersonnel in the field

Medical control over the nutrition of personnel is the activity of officials of

the military medical service, aimed at improving the organization and ensuring the
nutritional value of personnel, as well as preventing the occurrence of diseases of
alimentary origin in servicemen.

In accordance with the tasks solved by the medical service in the field of
nutrition, the company sanitary instructor is obliged to control :

- timely delivery and reception of food by the personnel of the company;

- observance of sanitary rules during its distribution and reception, especially when
located in an infected area;

- compliance with the rules for storing company food supplies, personal hygiene
and keeping pots and spoons clean;

- the state of health of the company personnel associated with nutrition

timely report on his change to the battalion's senior paramedic. The senior
paramedic of the battalion is obliged to solve the same tasks, only in battalion
scale, and in addition:

- to take part in assessing the quality of products entering the economic department
of the battalion supply platoon;

- to carry out together with the commander of the economic department and the
chemist-by the instructor, preliminary sorting of products in case of contamination
of their SMP and make a decision on the possibility of using products for food,
packed in containers of the highest category;

- take part in the choice of the location for the deployment of the battalion food
station, control the correctness of its planning and compliance with sanitary
requirements in the preparation and distribution of food;

- evaluate the quality of cooked food and the compliance of its food composition
with an extract (card) from the layout;

- control the quality of water supplied to the BPP, and sanitary requirements when it
is spent on household and drinking needs;

- monitor the state of health of the personnel of the economic department and
promptly remove the sick from work with food and food;

- report to the head of the medical service of the military unit (regiment) about all
changes in the battalion's nutrition and the state of health of the personnel, including
those related to nutrition.

The head of the medical service of the unit (regiment) is obliged:

- monitor compliance with the sanitary rules for the storage, transportation and
distribution of food products to battalions, take part in the assessment of their
quality and expertise, including when contaminated with weapons of mass
destruction. Give an opinion on the suitability of products for use according to the
examination data;

- monitor the sanitary condition, compliance with the rules of preparation and
the quality of food at the food control point of the regiment and periodically at the
battalion food points;
- systematically study the health status of the unit's personnel, including those
related to nutrition (nutritional status), report on its changes, especially sharp ones
(food poisoning), to the unit commander and a higher medical commander, to
improve nutrition, eliminate sanitary violations and increase the level of health of
personnel;

- to provide methodological and organizational assistance to paramedics of

battalions for medical control over nutrition, monitor their work in this area and
ensure compliance with sanitary requirements.

Boss medical service formations (divisions, brigades)

independently and through a subordinate sanitary and epidemiological

laboratory is obliged to provide:

participation in planning the food supply of the compound;

control over the observance of sanitary rules during storage, transportation

and distribution of food in the divisional warehouse;

participation in the examination of food and making a decision on its use,

including when contaminating the NSR;

control and provision of organizational and methodological assistance to the

medical service of the units in carrying out medical control over nutrition;

studying the nutritional status of the unit's personnel and taking measures to
improve it.

Thus, as in stationary conditions of the deployment of troops, the main areas

of activity of the medical service in the field are control over the usefulness, quality
and safety of food for servicemen; compliance with sanitary standards and rules at
food service facilities.

Medical control over the nutritional value includes:

participation in the development of the diet and the preparation of the layout
of the products;
determination of the chemical composition and energy value of the planned food
ration according to the distribution of products by the calculation method;

checking the completeness of bringing to the personnel the norms of

allowance;

assessment of the level of health of military personnel due to nutrition (study

of the dynamics of the nutritional status of personnel).

When developing a diet and drawing up a layout of products, the following

basic principles must be observed:

intervals between doses of food did not have to exceed 7 hours the energy
value of the daily diet with three meals a day should be distributed as follows: for
breakfast 30-35%, for lunch - 40-45%, for dinner - 30-20%;

meat, fish, legumes and other protein-rich foods should be distributed at all
meals, while it is advisable to alternate the preparation of meat and fish dishes for
breakfast and dinner;

cold snacks are planned for lunch every day;

in the spring andsummer period broader practice preparing dishes from

pickled and salted vegetables, without subjecting them to heat treatment;

to replace some products with others, taking into account their biological and
nutritional value, paying special attention to the validity of replacing fresh products
with canned and concentrated, vegetables - cereals, etc.

It is prohibited:

repeat the same dishes more than 2-3 times a week, and dishes from the same
products during the day;

use salted herring to prepare a separate fish dish;

cook cutlets and other minced meat products during the warm season, and
naval pasta - throughout the year;
use raw and pasteurized flask milk in its natural form without preliminary boiling;

use yogurt-samokvass as a drink or for making cottage cheese from it.

The energy value and chemical composition of the planned food ration
according to the distribution of products by the calculation method is determined
according to unified tables (Guidelines for determining the chemical composition
and energy value of food products, food rations and rations supplied to provide
the Armed Forces of the Republic of Uzbekistan). The results obtained are
compared with the average values ​of the energy content and the chemical
composition of the allowance norm. The deviation between them should not exceed
± 5%.

Checking the completeness of bringing the allowance standards to the

personnel includes:

control over the implementation of the layout of products;

carrying out weight control over the completeness of receipt of products from
the warehouse, their insertion into the boiler, the actual output of finished food;

control over the issuance of vitamin preparations, as well as over compliance

technological methods to ensure the preservation of vitamins during cooking;

sampling of ready-made meals and rations for their laboratory research for
energy content and chemical composition.

the layout of products consists in assessing the compliance of the prepared

dishes and the completeness of the range of products obtained for their preparation
with the layout data.

Food preparation should be carried out in strict accordance with the

layout. Changes to it without the written permission of the commander of the
military unit is prohibited. The correspondence of the name of the prepared dishes
to the layout is established by interviewing the dining room attendant, the chef
instructor and visually.
The completeness of the assortment of products obtained for cooking is
determined by comparing the data of the layout of the products and the invoice for
their receipt.

Weight control over the completeness of bringing the food ration norms to
servicemen includes:

selective, periodic determination of the mass of products received from the

warehouse and put into the boiler;

selective, at least once a week, determination of the actual output and

uniformity of distribution of cold snacks, first courses, side dishes and sweet
dishes issued to servicemen (on dining tables), as well as the correspondence of the
total and thick mass of the first course;

selective, at each sampling, determination of the completeness and

uniformity of the delivery of sugar, cow butter, bread, smoked meats and other
products that are not subjected to heat treatment, as well as milk, meat and fish
portions.

The completeness of receiving food from the warehouse in terms of quantity

and assortment, its safety at the food point before it is loaded into the boiler should
be established by selective weighing of products andcomparison of the results
obtained with the data of the invoice for the receipt of products. Food preparation
must be dispensed separately for breakfast, lunch and dinner.

The mass of the products put into the boiler should be determined taking into
account the average waste rates during the processing of products (Guidelines for
the preparation of food in military units, military educational institutions and
institutions of the Army and Navy).

if the established waste standards are exceeded or the products put into the
boiler are not supplied, the doctor of the unit must report this to the commander in
order to take measures to identify and eliminate the causes,contributing to this.

The actual yield of the dispensed dishes is determined by weighing and

compared with the calculated yield rates. For an example, the output rates of cereal
side dishes and meat products are presented in tables 3.6 and 3.7.
The deviation of the actual mass of the portion from the calculated one should
not exceed:
for meat portions - ± 1-2 g;
for products from fish and cutlet mass - ± 3%;
for first courses and side dishes - ± 10%.
When determining the actual yield, the uniformity of the delivery of dishes
should also be determined, and for meat, fish portions, cow butter - uniformity
of cutting (portioning). Uniformity of cutting (portioning) is set by weighing at
least 10-12 portions. For the first courses, you should also determine the mass of
the thick part. To do this, filter the contents of the dish, weigh the dense part and
calculate share. Subject to the norms of filling with water and laying products, the
dense part should be from 40 to 50% of the mass of the dish.
The weight of the portions of sugar, cow butter, smoked meats and other
products that are not cooked must correspond to the values ​indicated in the
product layout. Mass deviations in relation to these
products not allowed. Bread must be issued to servicemen in the limits of the
allowance and in quantities actually required fornutrition.
Table 3.6
Porridge yield (per 100 g of product)), in grams
Dish Quantity Quantity Exit
water salt dishes
one 2 3 4
Buckwheat:
crumbly 150 2 210
viscous 320 4 400
Millet:
crumbly 180 2.5 250
one 2 3 4
viscous 320 4 400
 Pearl barley:
crumbly 240 3 300
viscous 370 4.5 450
Barley:
crumbly 240 3 300
viscous 370 4.5 450
Oatmeal 320 4 400
Wheat:
crumbly 180 2.5 250
viscous 320 4 400
Pic:
crumbly 210 3 280
viscous 370 4.5 450
Pea mash 250 3 210
Folding pasta 600 5 250

For appraisals completeness consumption food rations periodically determine

the mass of food residues that are appropriate weigh on a eparate dishes. Grade
the eatability of food allows estimate actual consumption military personnel
of energy and basic nutritious substances a also is an informative indicator
of its flavoring qualities, a hence level professionalpreparedness of the cook staff.
Control per compliance technological techniques to ensure the preservation
of vitamins during cooking, which is carried out in the usual manner, is mainly
reduced to monitoring compliance with the rules that ensure the preservation of
vitamin C in vegetable dishes. Their implementation simultaneously increases the
safety of vitamins of all other groups, since ascorbic acid is the least stable and its
losses during heat treatment are the most significant.
Table 3.7
Average rates of food waste during processing, outputs of semi-finished
products and ready-made portions in canteensmilitary units (per 100 g of
product)
No. Product View and Waste Exit Exit
 way at first semi-factory Losses ready
thermal HIV after at oops
education processing primary thermal portion
boots G processing, g processing st, r
% G
1 2 3 4 5 6 7
Meat
products
1 Beef Cooking 26 74 38 28 46
1st large
categories in pieces
and 26 74 40 44
Extinguishing 30
large
in pieces
26 74 35 48
26
Frying
large
in pieces 26 74 40 44

Extinguishing 30
portionedyim
in pieces
26 74 37 47

Frying
portioned 27

yimin pieces
without
breading 26 74+7* 27 59

Frying
portioned 22
yim
in pieces
26 74+47** 19 98
With
breadcrumbs
th 23

Cutlets,
bitlets
fried

2 Pork Cooking 17 83 19 33 50
nineteen edged in large
pieces 116 40
 Coarse stewing 17 83 32 27 56
Coarse roasting
pieces of
17 83 32 27 56

cutlets, fried
meatballs
nineteen 17 83+47** 19 25 105

Demanding vitamin preparations and providing them with personnel in

accordance with the established norm of allowance, is carried out by the food
service, and control over their delivery is carried out by the medical service of the
unit.
The purpose of an objective assessment of bringing the rate of food rations to
the military and performing the layout of products can be used by the laboratory
method of control - laboratory determination of the chemical composition and
energy content of the ration (dish).
For laboratory research, only ready-made meals (first, second, cold snacks,
sweet dishes) of the daily diet or part of it (breakfast, lunch or dinner) are
selected. The finishing of products dispensed in portions without cooking (butter,
sugar, etc.) is assessed by the gravimetric method.
Samples of ready-made meals can be taken by the head of the medical service
of a military unit in the presence of representatives of the food service and a
canteen duty officer, or by a commission, as part of a doctor, the representatives
listed above and other interested persons. For laboratory research, an average
sample is taken, the mass of which must correspond to the established actual
output of the dish. The samples are placed in glass jars, which are sealed. A label is
attached to the sample jar indicating the military unit, the name of the dish and the
time of sampling.
For the selected samples, an act of seizure approved by the commander of
the unit is drawn up, to which an extract from the distribution of products with the
exact name of the products used for cooking is attached, certified by the seal of the
military unit.
For meat, the extract should indicate: its type and category (for example, beef,
category 1; pork, category 2); for vegetables - type and processing (sauerkraut,
fresh, etc.). The act must also indicate the purpose of the study of directed samples
(determination of energy value, chemical composition, vitamin content, etc.).
Simultaneously with the direction for laboratory research of samples of
ready-made food to determine the content of ascorbic acid in them, vegetables that
are included in the food set of dishes should be sent for research. This will allow
you to more accurately determine the loss of vitamin C during the cooking phase.
Samples finished food direct on the research in sanitary the epidemiological
laboratory of the compound (sanitary-epidemiological detachment), which provides
the military unit.
Evaluation of the results of laboratory tests is carried out by comparing the
actual values ​of the chemical composition and energy value of the sample with their
calculated data on the layout of the products. The discrepancy between them
should not exceed ± 10% both in terms of energy content and in the content of
individual nutrients (proteins, fats, carbohydrates).
In laboratory studies of samples for the content of vitamin C in them, its
losses during heat treatment should be taken into account.
The study and assessment of the level of health due to nutrition (study of the
dynamics of nutritional status) is an informative indicator of the nutritional value of
personnel.
Nutritional status is such a state of the structure, function and adaptive
resources of the body, which has developed under the influence ofthe actual diet,
as well as the conditions of food consumption.
VS RU individual assessment of nutritional status is based on
anthropometric measurements and determination of body mass index (BMI ),which
is the ratio of body weight (kg) to body length (m) squared:

body weight (kg)

BMI = ----------------------------
 2
body length (m)

For example: private Ivanov I.I. has a body length of 176 cm, body weight - 53kg.

53 kg 53 kg
BMI
= ------------ = ---------- = 17.1 kg
2
1.76 x 1.76 3.09 m

depending on the value of BMI, the nutritional status of servicemen is ssessed. The
criteria for such an assessment are presented in table 3.9.

Table 3.9
Criteria for assessing the nutritional status of military personnel

Body mass index

Power status
18-25 years old 26-45 years old
Malnutrition less than 18.5 Less than 19.0
Reduced nutrition 18.5-19.4 19.0-19.9
Normal food 19.5-22.9 20.0-25.9
Increased nutrition 23.0-27.4 26.0-27.9
Obesity I tbsp. 27.5-29.9 28.0-30.9
Obesity II degree 30.0-34.9 31.0-35.9
Obesity III degree 35.0-39.9 36.0-40.9
Obesity IV Art. 40.0 and more 41.0 and more

Military personnel who have a low nutritional value according to their BMI
value are subjected to additional examination to clarify the assessment of nutritional
status. This examination includes:
measuring shoulder circumference as an indicator of the degree of muscle
developmentbody weight;
assessment of physical performance as an indicator of the functional state of the
body.
The shoulder circumference is measured on the left arm at the level of its
middle third using a measuring tape. The normative value of this indicator for the
age group from 18 to 25 years is at least 26 cm.
Physical performance is determined by the results of two physical exercises -
squats and push-ups on the hands from the floor. The maximum number of squats
that can be performed by a soldier in 60 seconds and the maximum number of
push-ups in 30 seconds are determined. The results obtained are compared with the
standards. The standard value for squats is 45-50 times / 60s; for push-ups - 15-20
times / 30s.
The nutritional status of servicemen with reduced nutrition with normal values
​of additional indicators is assessed as normal.
If servicemen are found to have low nutrition (including insufficient nutrition)
or obesity, they are taken under dynamic observation.
peacetime conditions for servicemen with reduced nutritionadditional food is
provided within half of the food ration norms provided for them for a period not
exceeding 3- months. Additional food is assigned by order of the commander of a
military unit at the suggestion of the head of the medical service on the basis of a
resolution of the garrison military medical commission.
The criterion for canceling or continuing the provision of additional food is
the achievement or non-achievement of the normal values ​of the body weight of a
soldier and his physical performance.
If there are clinical indications or if a reduced body weight is maintained after a
three-month period of dispensary observation and receiving additional food,
servicemen are to be sent tomedical institution for inpatient examination and
treatment.
For servicemen with a reduced body weight, recommendations are
compulsorily developed, providing for a sparing mode of physical activity and
classes:
reducing the time of combat training to 5 hours and self-training to 2 hours a
day, exemption from guard duty internal outfits;
carrying out physical exercises only according to the first and second variants
of NFP, excluding running for 1000 meters;
reduction of planned physical training to 1 hour per week, exclusion of
hand-to-hand combat, long-distance running, obstacle overcoming, ski training.
Servicemen with insufficient nutrition (malnutrition) are subject to compulsory
hospitalization in medical institutions for examination, treatment and the decision of
an expert question about the possibility of continuing military service.
In addition to the listed criteria for assessing nutritional status, early diagnosis
of pre-pathological conditions associated with vitamin deficiency is important.
Taking into account the limited capabilities of the medical service of the
military level to carry out laboratory and instrumental studies, the main diagnostic
methods for detecting vitamin deficiency in military personnel during medical
control are: analysis of complaints, assessment of anamnestic data, external
examination with the identification of clinical manifestations of vitamin deficiency.
To objectify the control over the vitamin supply of military personnel on the
basis of the sanitary-epidemiological laboratory of the compound, a laboratory
determination of the value of the milligram-hour excretion of ascorbic acid in the
urine can be carried out, which is an informative indicator of the vitamin supply of
the organism inthe whole.
In peacetime conditions, servicemen who present appropriate complaints
and have clinical symptoms of vitamin deficiency, taking into account the study
of the actual nutrition, are diagnosed"polyhypovitaminosis state", which is
recorded in a serviceman's medical book and in an outpatient journal. These
persons are registered and they are prescribed outpatient treatment with
multivitamin preparations (such as "Undevit", "Geksavit", "Aerovit", Tetravit,
etc.) according to the scheme - one tablet 1-2 times a day for 20-30 days. If
 necessary, the course of treatment can be repeated under the supervision of a
physician, with caution regarding the possible manifestation of allergic reactions.
The criterion for canceling the issuance of a multivitamin preparation is the
disappearance of the symptoms of polyhypovitaminosis.
Without fail, proposals and recommendations are developed to improve the
actual nutrition in relation to the provision of military personnel vitamins,
enhanced control of compliance with sanitaryepidemiological requirements,
contributing to the preservation of vitamins during the storage of food products,
their primary and thermal processing, the sale of finished food. To objectify the
control over compliance with these requirements, as already noted, a laboratory
method for determining the content of ascorbic acid in foods, semi-finished
products and ready-made meals is used, carried out in sanitary and
epidemiological institutions (divisions).
Medical control over the good quality and harmlessness of food products
and prepared food is one of the most important and difficult areas of work of the
medical service in the field of food control for military personnel in the field. Its
main task is to prevent foodstuffs from entering food that can have a harmful
(including long-term) effect on the health and performance of military
personnel. However, it should be borne in mind that an unreasonable prohibition
on the use ofand, moreover, unauthorized destruction of products can be
contested with a claim for compensation for material damage caused by an
erroneous decision or action.
Hygienic positions under the good quality of food is understood as a set of
properties that determine their suitability for human nutrition. This concept includes
nutritional value (protein, fat,carbohydrates, vitamins, macro and microelements,
digestibility of nutrients etc.) and consumer (organoleptic and physicochemical)
properties of food products.
However, only the high nutritional value of food products and good consumer
properties are not enough to ensure human health.
It is necessary that they, in addition, be impeccable in sanitary and
 epidemiological terms, that is, they are harmless.
Food safety is understood as the totality of their properties, which give
reasonable confidence that, when consumed for nutrition under normal
conditions and in generally accepted quantities, they will not harm the health of
the present and future generations. The harmlessness of food products is
determined by the absence in them of elements (xenobiotics) of a biological,
chemical and physical (mechanical impurities, radioactive substances) nature that
are alien to the human body. Measures to ensure the safety of finished food and
food products are aimed, first of all, at creating conditions that prevent their
contamination, and if it occurs, then prevent its accumulation, for example, in the
case of contamination by microorganisms. Finally, trapped or accumulated
xenobiotics can be removed, destroyed, or converted into indifferent forms.
Contamination of foodstuffs is understood as the content of foreign
substancesin them in quantities exceeding the established hygienic standards.
Pollution food products pathogenic microorganisms, their toxins, chemicals,
etc. possibly as a result of violation of sanitary norms and rules during the receipt
and processing of food raw materials, production and transportation of food
products, food preparation, as well as due to violation of the conditions and terms
of their storage and sale.
System of control measures for ensuring good quality food safety includes:
determination of the good quality of food products;
assessment of the quality of cooked food.
Monitoring the health of persons who permanently and temporarily work at
food facilities;
Control over the sanitary and epidemiological state of food items.
Control over the good quality and harmlessness of food on the part of the
medical service of the military unit is carried out in two versions: in the order of
planned work and outside the plan (in the presence of special sanitary and
epidemiological indications).
Planned work is carried out in the form of testing ready-made food at food
points, monitoring compliance with sanitary rules and regulations during storage,
transportation, preparation and sale of food and ready-made food.
Unscheduled - in the form of food research in cases of: occurrence of
poisoning or acute intestinal infections associated with the consumption of food or
suspicion of it; suspected bacterial, chemical or mechanical contamination of
food; violations of food production technology and recipes; violations of sanitary
norms and rules during the production, transportation, storage and sale of food
products; when deciding on the suitability for food of products with expired shelf
life or after long-term storage in warehouses, products that do not meet the
requirements of standards and technicalconditions.
The quality of products is assessed by their organoleptic characteristics when
they are received for cooking.
If low-quality products are identified, this is immediately reported to the head
of the food service, who must give instructions to suspend their sale and oblige to
issue good-quality products instead of those withdrawn from sale.
To resolve the issue of the further use of products of dubious quality, by the
decision of the commander of the military unit, a commission is created, which
should include a representative of the medical service, which examines these
products.
The quality assessment is carried out for the entire batch of a product of
questionable quality, in a certain sequence, including several stages:
Exploring product information.
External inspection of a batch of products.
Sorting into homogeneous lots.
Organoleptic examination of products on site.
If necessary, the selection of representative samples (samples) for laboratory
research.
The term "batch of products" means a certain part of products of the same
type and grade, in containers (or without them) of the same type and size, the same
date and production change, manufactured by one enterprise, and also issued with
one quality certificate (certificate). It is important to distinguish between products
that are similar in their characteristics, but are not a batch. These products include,
for example, canned food of the same type and variety, made at the same
enterprise, but at different times (different dates and changes in production).
The study of information about the product (sanitary history of a batch of
food products) is aimed at finding out the entire path of the food productfrom the
moment of its manufacture through the entire system of production, inspection and
other types of control until it arrives at the food warehouse of a military unit. It is
necessary to study a number of documents characterizing a batch of food products
- waybills, quality certificates (certificates), veterinaryhealth certificates, vendor
invoices, laboratory records, and product standards and specifications. The main
document for the receipt of food by the military unit is a check requirement, on
which the laboratory of the warehouse or enterprise puts a mark on the quality of
the released food.
The task of this stage is to establish the quantity and quality condition of the
shipped batch of products, the conditions of transportation and its duration, which
could affect the quality of the products. At the same time, attention is drawn to the
validity period of quality certificates, possible restrictive information
(implementation period, conditions of culinary processing, etc.). In addition,
information is being studied about the re-sorting of a batch of products, their
disinfestation and the reasons that prompted these treatments.
During an external examination of a batch of products, first of all, attention is
paid to the conditions of their storage, the sanitary condition of storage facilities,
temperature and humidity conditions, the presence of granary pests, rodents or
traces of their attack on products, as well as compliance with the rules of storage,
including commodity neighborhood. According to stencil inscriptions on
containers, stamps on meat carcasses, labels on bags with bulk products, marking
of canned food, it is established that a given batch of products corresponds to the
accompanying documents presented for it and its uniformity by type of product,
time and place of manufacture. The task of this stage is to assess the quality of the
products in advance and decide on their further use and the transition, if necessary,
to the next stageresearch.
After external examination, in case of non-uniformity of packages, the
products are sorted into homogeneous lots with opening of the packages. If there
are up to 5 packages in a batch, they are all opened. Products in containers that
have any external defects, including contamination, are inspected especially
carefully. In this case, depending on the type of damage and the quality of the
products, all damaged packaging units may be opened.
When organoleptic examination of a food product on the spot, attention is
paid to the shape, color, consistency, uniformity, presence of foreign inclusions,
smell, taste, and other properties that may indicate its poor quality.
Taste properties are determined only if there is no suspicion of poor quality,
chemical or bacterial contamination of products. Organoleptic research, despite its
apparent simplicity, is essentially very responsible and in many cases is of decisive
importance in assessing the good quality and suitability of a food product for
nutrition. In terms of speed and sensitivity, with proper experience, it often
surpasses conventional chemical and other analyzes, which, as a rule, do not can
provide identification of some complex properties of poor quality food products,
for example, such as mustiness of flour and cereals, "staleness" of eggs and butter,
the taste and smell of oil products, naphthalene and many other foreign
substances. Products that are eaten only after being cooked are subjected to trial
cooking and tested hot, reheated or reconstituted.
According to the results of organoleptic research, products are additionally
divided into obviously spoiled, benign and questionable quality.
When performing these studies, some general rules should be
observed. Inspection must be carried out with sufficientpreferably natural
light. Smoking, drinking alcohol, odors in the room distort the perception of the
organoleptic properties of products. When re-determining the taste, it is necessary
to rinse the mouth with water at room temperature. In difficult cases for making a
decision, it is advisable to carry out a commission organoleptic assessment.
Products with obvious signs of spoilage (soaked soft containers, rotten vegetables,
damage to bread by "potato disease", impurities in the form of broken glass, sand,
rodent droppings, etc.), as a rule, are rejected without additional research and
without the participation of a medical service.
From that part of the products, the quality of which is in doubt, samples are
taken for laboratory research. The norms and procedure for the selection of
samples of products sent for laboratory research are determined by the
requirements of the relevant official documents.
of the military unit, sampling is carried out by a commission appointed by
the established procedure.
Samples are taken only from homogeneous lots or parts thereof. The
samples are placed in a clean container that ensures the preservation of the
properties of the product during transportation; sealed and provided with a label
indicating the number of the container, the name of the product, its weight or
volume. Removal of samples for bacteriological research is carried out with a
sterile instrument in a sterile container.
Sampling is drawn up in an act, which should reflect: the date and place of
sampling of food products, the names and military ranks of officials involved in
the seizure, the mass (volume) of the batch, where, when the product was made,
where and by what document it was received, conditions storage, the results of
the previous stages of the on-site examination, the procedure for compiling the
average sample, the purpose of the study, the method of packaging and the seal
number. If food samples are sent on suspicion of food poisoning, the
accompanying document will indicate the results of the preliminary investigations:
the incubation period, clinical manifestations and other information necessary to
clarify the laboratory diagnosis plan. The act is drawn up in two copies, one of
which remains in the military unit.
Samples are delivered to the SEU laboratory as soon as possible. If
perishable products cannot be delivered within 2 hours, they must be transported
chilled. The study of samples of perishable products in the laboratory begins
 immediately after their receipt, and before the start of the study, they must be
stored in the refrigerator. Remains of products are stored in the refrigerator until
the results of the analysis are issued, after which they are destroyed with the
permission of the head of the laboratory.
The research results are documented in the form of a protocol. The protocol
for the analysis of food products is an official document indicating the properties
and quality of the sample under study, compliance with its requirements of
regulatory and technical documentation, the presence or absence of foreign
inclusions, harmful impurities, foreign substances and bacterial contamination. At
the same time, it is also a legal document on which the conclusion of experts of the
SEU, investigative and judicial authorities, arbitration and other specialists is based.
At the same time, the protocol and the conclusion of the laboratory on the
quality of the product applies only to the sample delivered to the laboratory. The
right to decide the issue of the quality of a batch of products, its suitability or
unsuitability for human nutrition is granted exclusively to persons authorized to
exercise state sanitary and epidemiological supervision. In cases where the
laboratory data of the samples differ from the results obtained on the spot, the
batch is re-inspected and new samples are taken for laboratory research. Only after
that a final decision is made, taking into account all the materials and circumstances
of the first and second examination.
The quality of food products can be assessed by the following options of
conclusions:
a) a food product is suitable for human nutrition without restrictions, it is a
complete food product with good organoleptic properties, harmless to health and
meeting all the requirements of the standard or technical conditions for hygienic
indicators.
b) a food product conditionally suitable for human nutrition - a product that
has defects that make it impossible to use it in human nutrition without preliminary
processing in order to improve organoleptic properties or neutralize it (urgent
implementation, heat treatment, bulkheading of cereals, stripping butter bars, etc.)
P.). The same group includes food products of reduced nutritional value that have
any drawback (or drawbacks) in terms of certain hygienic indicators. However,
these disadvantages do not impair the organoleptic properties of the food product
and do not make it hazardous to human health (milk and dairy products with a
reduced fat content; bread, butter and other products with a high moisture content;
drinks and confectionery products with a reduced sugar content). Such products,
after the implementation of the relevant recommendations, can also be used in the
diet of military personnel.
c) a food product of poor quality (certainly unsuitable for human nutrition) is a
food product that has drawbacks that prevent its use in human nutrition.
For the nutrition of military personnel, food products cannot be used that:

do not meet the requirements of regulatory documents;

have clear signs of poor quality;
do not have quality and safety certificates, manufacturer's or supplier's
documents confirming their origin;
do not correspond to the submitted documentation;
are reasonably suspected of falsification;
do not have established expiration dates or which expiration datesexpired.
Poor quality food products, in agreement with the veterinary and sanitary
service, can be fed to animals or transferred for technical disposal.
When the enemy uses weapons of mass destruction or in areas of man-made
accidents and disasters leading to contamination of the area with radioactive and
toxic substances, it is possible for them to contaminate food products and
prepared food. Food contamination is possible when spraying OF or BS from
special aviation devices; rupture of shells and bombs loaded with OF or BS; the
fallout of the products of a nuclear explosion from a radioactive cloud; when using
contaminated water and equipment for food processing. Food products can be
exposed to weapons of mass destruction in warehouses, during transportation,
processing and storage.
It is not excluded that food contamination by the enemy during the withdrawal from
the occupied territory or by sabotage. In the latter case, bacterial formulations, OM
and highly toxic substances, alkaloids, salts of heavy metals, agricultural
pesticides, low-toxic substances that do not change the color, smell and taste of the
food product can be used.
In wartime, food supplies, if they ended up in the zone where weapons
of mass destruction were used, during transportation through the contaminated
zone, or were in the territory occupied by the enemy, are considered contaminated.
Use of such products for their intended purpose can only be with the
permission of the medical service. This provision also applies to trophy food.
In order to issue a permit for the use of food by personnel suspected of being
infected or contaminated with agents, radioactive substances, BS or other
life-threatening agents, a sanitary and epidemiological examination of the products
is carried out, the procedure for which differs from the usual scheme for
determining the qualityfood. Along with the medical and veterinary services,
specialists from the RChBZ troops and their laboratories are involved in its
implementation. Start can be placed in the battalion level, where the fact of
infection is established, products are sorted according to the likelihood of their
infection,which are then submitted for peer review and opinion. In other cases, for
example, when regimental, divisional, army and front-line food supplies enter the
contaminated zone, the expert group carries out its work from start to finish,
leaving the site.
When conducting an examination of food suspicious of infection or
contaminated with agents, BS, radioactive substances or other life-threatening
agents, they are guided by the dose rates established for wartime, the permissible
concentrations of toxic substances and the corresponding sampling rules set forth
in the regulatory documents.
The first stage of the examination is familiarization with the general radiation,
chemical and bacteriological situation according to the data of combined arms,
rear, chemical and bacteriological reconnaissance. Such familiarization allows you
to determine the likelihood, type and even intensity of infection.
At the second stage, a batch of products is inspected. At the same time,
attention is drawn to the condition of the transport and consumer packaging, the
presence of contamination, damage, deformation, traces of opening, and its
marking.
The third stage is sorting products according to the state of containers and
packaging. In this case, food is divided into three groups. The first group includes
clearly contaminated food that turned out to be unpacked or packed in damaged or
well-permeable containers for OM, RV or BS, food with visible signs of
contamination, as well as obviously spoiled food. The food that ends up in this
group is not investigated, but must either be disposed of (destroyed) or sent for
special processing.
In second group selected uninfected food, i.e.
Packed in containers of the highest protective category. After
decontamination, degassing and disinfection of containers, such food is allowed to
be consumed without restrictions.
The third group is selected food suspicious of being infected with any or all
types of weapons of mass destruction. At the same time, food packed in containers
of the first protective category is considered suspicious of OM contamination and
not contaminated with RV and BS. Food packed in containers of the second
protective category is considered suspicious of OM and BS contamination and not
contaminated with RS. This group also includes foodstuffs,located in the first layer
of collars covered with tarpaulin or other protective materials. As for the
subsequent layers, they, as a rule, turn out to be uninfected.

Thus, only the third group of food is subjected to further research; it can be
carried out on site or in medical, veterinary and chemical mobile laboratories or in
the form of samples sent to the laboratories of basic institutions.
Ready food that is not sufficiently protected and found itself in the zones of
contamination is not subject to research and special processing and is destroyed.
The examination of food when it is contaminated with radioactive and toxic
substances has certain differences.
To assess the contamination of food with radioactive substances, the military
level uses the field method - according to the data of dosimetric control.
As a consequence, the control results should reflect as much as possible the
actual radioactive contamination of food in this particular homogeneous batch. A
homogeneous batch of contaminated food is considered a batch that is packed in
the same container products of the same name. In order to fulfill this condition,
samples are taken to control radioactive contamination, following a certain
sequence.
First, in each homogeneous lot, separate, most contaminated container units
or areas are designated from which samples are supposed to be taken. Depending
on the type of food, the size of stocks, storage conditions, the number of packages
to be opened must be at least three from one batch.
The sampling of point samples of food is carried out using a probe, a
measuring instrument and other instruments.
A thoroughly mixed pooled sample, made up of spot samples, characterizes
the degree of contamination of a homogeneous batch of food. In terms of its
volume, the combined sample for dosimetric control of radioactive contamination
3
of products should be about 1000 cm .
Spot samples from liquid and puree products (milk, sour cream, vegetable oil)
are taken after thorough mixing. The number of incremental samples from each
container to be opened must be the same.
Samples of bulk products (flour, cereals, etc.) packed in bags, boxes and
other types of containers are taken after disinfection of the outer surfaces of the
container from the top layer 10-15 cm thick.To do this, open the package,
thoroughly mix the product to a depth of at least 15 cm and then a sample is taken.
To carry out dosimetric control, standard equipment is used. The data
obtained are the basis for issuing an expert opinion on the suitability of food for the
provision of personnel. For this, the results obtained (exposure dose rate of
gamma radiation) are compared with safe values ​(Table 3.10) and, if they are
exceeded, the expert opinion indicates that the food is unsuitable for use by
personnel. At the same time, the conclusion must indicate practical
recommendations on the further use of food (for example, temporary holding until
the radioactivity decays, issuing a product to personnel for nutrition inreduced size
in comparison with the current norm, direction for decontamination. If a decision is
made to decontaminate food, then in the future, the order and completeness of its
disinfection is monitored.
In order to give an expert opinion on the possibility of using large
consignments of contaminated food to supply, along with dosimetric control,
radiometric control is also carried out in laboratories equipped with standard
service equipment.
Table 3.10

Dose rate (mR / h) corresponding to food contamination (kg)

radioactive substances in quantities that do not lead
to radiation injury
Consumption terms, days

Product one Up to 30 Over 30

one 2 3 4

Liquid, bulk food products, 14 3 1.4

prepared food
 Pasta, dried fruits eight 1.6 0.8

Bread 14 3 1.4

one 2 3 4

Raw meat 14 3 1.4

Raw fish 14 3 1.4

Water 14 3 1.4

Work on establishing degree infestations foodpoisonous and other poisonous

chemicals is carried out in two stages. At the first stage, preliminary control of its
contamination is carried out on the spot, at the second - laboratory studies of
samples taken from contaminated food lots, which are analyzed outside the
contaminated zones. This takes into account the nature and methods of using OM,
the protective properties of containers and packaging, shelters used to protect food
supplies.
Preliminary control of chemical contamination of food is carried out in places of its
storage with the help of chemical reconnaissance devices of medical and veterinary
services. The work is carried out in personal protective equipment.
When conducting preliminary control, first of all, the presence of OM in the
air is determined, and then the approximate degree of food contamination is already
established. However, it must be remembered that the results obtained are not
conclusive for giving a conclusion about the possibility of using food for its
intended purpose, but serve only as a basis for sorting them by type and degree of
contamination in order to subsequently conduct degassing.
The completeness of the degassing of food is checked only by laboratory
methods, based on the results of which a conclusion is made on the suitability of
food products with practical recommendations for their use.
If, during the preliminary control, it is not possible with the help of chemical
reconnaissance devices to detect OM or other toxic chemicals, then samples are
taken and sent for laboratory research. Sampling is also carried out in case of any
doubt or suspicion of contamination of OM, after degassing for
verification efficiency, if necessary, the use of trophy food.
The number of packaging units to be opened when sampling is established in
each specific case, depending on the type and quantity of the product, but without
fail there must be at least three units from a homogeneous batch.
Sampling of food is carried out in the following sequence: first, in each
homogeneous batch, individual containers are selected that have the most
noticeable external signs of contamination, which are then degassed and
numbered; in conditionsexcluding re-contamination, the package is opened and
combined samples are taken from each homogeneous batch of products. The
collected pooled samples are packaged and sent to the laboratory. To form a
combined sample, initially, spot samples of products are taken from 5-10 places or
storage units, which are thoroughly mixed, and then the product is taken from this
sample in the amount necessary for the study.
It should be borne in mind that the combined sample characterizes the degree
of contamination of the entire homogeneous batch of food. It is impossible to take
combined samples, mixing the most infected surface layers and less infected inner
layers of food, as this can lead to underestimated values ​when determining the
degree of its contamination.

Samples from bulk products stored in sack containers are taken from the
layers adjacent to the container, where OM is most likely to enter. Samples from
bulk products stored in bulk are taken from the upper, middle and lower layers of
the embankment at a depth of 2 - 5 cm in areas most suspicious of
infection. Samples from liquid, semi-liquid and thick products are taken after
thoroughly mixing them. Samples are taken from meat in carcasses, half carcasses,
large fish, hard fats, cheese, large vegetables and other solid products by taking 1
cm sections from the surface layers. Small fish and vegetables are sent whole for
research.
The amount of the product in the combined sample sent for research should
be 500 g for liquid products; for semi-liquid and thick products - 100 g, for meat
and meat products, fish and fish products, animal fats - 100 g, for fresh vegetables
and fruits - 200 g, for dried vegetables and fruits - 100 g; for packaged products in
a package weighing no more than 0.5 kg - 1 package; for bakery products - 1 pc.
Selected samples of the combined samples are hermetically packed in a dry
tube, the outer surface of which is degassed, if necessary. Before sending for
research, each container with samples is numbered andsealed, supplied with
accompanying documents and acts of sampling of the established form.
The purpose of laboratory control is the qualitative and quantitative
determination of the OM used in food products before or after their neutralization
(degassing) to give an expert opinion on the subsequent use of contaminated food
for its intended purpose.
An expert opinion on the possibility of using food products for their intended
purpose located in zones of chemical contamination or subjected to degassing is
based on the data established during the preliminary control process, as well as on
the results of laboratory control, taking into account the established maximum
permissible contamination and the maximum permissible concentration.
The maximum permissible infestation (MDZ) is understood as the largest
amount of toxic substances contained in food, which can be neutralized by
degassing, which reduces its contamination to the maximum permissible
concentration.
The maximum allowable concentration (MPC) is the amount of toxic
substances, the content of which is allowed in food when it is used for its intended
purpose.
As a result of the research carried out, the following conclusion can be given:
food is suitable for its intended use without restrictions;

food can be used with restriction, while the necessaryrecommendations are

indicated;
food is unsuitable for its intended use; in this case, specific measures are
determined, the implementation of which will finally resolve the issue of the
possibility of using food.
On the the basis taken out conclusions unit commanders accept decision on
the procedure for the use of food.
The quality of the finished food is assessed by a doctor (paramedic) before
the start of its distribution. A food sample should be taken from each
cauldron. Before tasting the first course, the chef should stir the contents of the
cauldron and take a small amount of the dish from the middle of it and pour it into a
plate. When tasting a second course, a small amount of a side dish and a meat
(fish) portion, dispensed by weight, are placed on the plate. Meat and fish dishes,
dispensed by the piece, are tested in their entirety. First, the side dish is tested, then
the meat (fish) dish, and then the sauce.
The quality of food is determined by the organoleptic method: visual
inspection, determination of consistency, color, smell, taste.
Evaluation of smell and taste should begin with the dish with the least
pronounced taste properties. For example, after tasting salted fish, any dish is
perceived as not salted. Do not start tasting with sweet foods. A doctor
(paramedic) who evaluates the quality of food should be moderately full, since even
with a slight feeling of hunger, the requirements for taste are reduced. Rinse your
mouth with water before trying a new dish. The susceptibility of smell is enhanced
if, after a moderate inhalation and swallowing of food, exhale through the nose.
Dishes prepared in strict accordance with the product layout and full
compliance with culinary rules and sanitary and hygienic equirements, are rated
"excellent".
Dishes with one deviation in organoleptic characteristics are rated
"good". Dishes with deviations in several indicators,but not hindering the delivery
of food, are rated "Satisfactory".
If the dish has an unusual smell, taste (tastes) - burnt, undersalted,
undercooked, undercooked, rotten, as well as an inherent consistency, it is
assessed as unsatisfactory, rejected and the question of its use is resolved after an
immediate report to the commander of a military unit in each case separately.

If the defects of the cooked dish can be eliminated (the dish is cooked, fried)
or weakened, after which it will be assessed as "satisfactory", then it can be
allowed to be dispensed.
Due to the fact that the main sources of food contamination with
bioxenobiotics are sick people or bacilli carriers, special attention in the system of
medical control over food safety is given to systematic monitoring of the health of
individuals,working at food service facilities.
The volume and frequency of medical examinations and examinations of food
workers while in the field are the same as in the stationary deployment of troops
and provide for:
large-frame fluorography of the chest organs upon admission to work, in the
future - once a year;
research on the carriage of pathogens of intestinal infectious diseases - three
times, with an interval of one day upon admission to work, in the future - once a
quarter or according to epidemiological indications;
study of feces for helminths upon admission to work, in the future - according
to epidemiological indications;
urethral smear for gonococci upon admission to work, in the future Once a
year;
blood test for syphilis upon admission to work, in the future - once a year;
blood test for hepatitis B and HIV infection upon admission to work, later -
according to epidemiological indications;
examination by a dermatovenerologist upon admission to work, in the future
- once a year.
In the course of work, medical examinations of employees of food service
facilities are carried out once a week.
Immediately before entering the field, all food workers pass extraordinary
medical examination and examination for the carriage of pathogens of intestinal
infectious diseases.
Medical control over the sanitary condition of the battalion point is carried out
by the battalion's paramedic, periodically, but at least once a week, by the head of
the medical service of the military unit, as well as by the division's SEL
specialists. It includes monitoring compliance with the rules and regulations:
in the process of storing and dispensing food products for cookingfood;
in the culinary processing of food products, preparation, storage, delivery
and reception of prepared food in the dining room;
maintenance of technological equipment, dining and kitchen utensils, as well as
the territory;
following the rules of personal hygiene.
These norms and rules basically correspond to the requirements for the
sanitary condition of food facilities during stationary deployment of troops.
At the same time, at the battalion food points, which have limited possibilities
for processing and storing food, their culinary processing and preparation of food
have some peculiarities.
So, frozen meat is cooked without preliminary thawing. It is cleaned of
external contaminants, washed in cold water, chopped into pieces weighing 1-1.5
kg, washed again, put into a kettle and cooked until cooked, and then the meat is
cooled and cut.
Meat is given out in portions. Before serving, the meat is boiled in a boiling
broth for at least 15 minutes. In exceptional cases, when the situation does not
allow, the meat can be released along with the first course.
Frozen potatoes are used for cooking without first being thawed. Potatoes are
immersed in boiling water for 2 minutes and peeled, then washed in cold water,
chopped and placed inboiling water, cook until tender.
Processing of frozen potatoes can be done in another way. Unpeeled potatoes
are washed in warm water, laid boiling water and cook until half cooked. The
water is drained, the potatoes are cleaned, sliced ​and used for cooking.
Dried vegetables are sorted out, washed and soaked in cold water. Potatoes
are soaked for 1.5-2 hours, carrots - 0.5-1 hours, onions - 0.5 hours,beets - 2.5
hours. The need for water for soaking 1 kg is 3-4 liters for potatoes, 5-6 liters for
onions, beets, carrots. The water in which the vegetables were soaked is
recommended to be used for preparing the first and second courses.
After the initial processing, the products are immediately put into the boiler.
Cooked hot food must be handed out to personnel immediately. It is
prohibited to store prepared food in kitchen boilers and thermoses for more than
two hours. Before serving food, the surface of field kitchens is thoroughly cleaned
of dust and washed. It is strictly forbidden to release food into dirty, unwashed
thermos and individual pots.
Kitchen boilers, utensils and utensils are washed after each preparation and
distribution of food, the boilers are filled with water after washing, and the kitchens
are prepared for the next cooking.

After washing, cutting knives, boards and other equipment are scalded with
boiling water, dried and put into a box. The accessory boxes are periodically
washed with hot water and dried. It is forbidden to store food leftovers, food and
foreign objects in them.
Tanks for storing and delivering water at least once a week are disinfected with
suitable disinfectants, followed by rinsing.
In addition, it is mandatory to monitor the provision of personnel of a military
unit (subunit) with individual bowlers, mugs, spoons and flasks and their
knowledge of the rules of personal and publichygiene and their implementation.
3.3. Hygienic features of troop nutrition in extreme conditions Nutrition
in hot climates
In areas of hot climates, a person is in a state of permanent heat
pressure, especially in the summer months. At a living environment temperature
equal to or higher than the average body surface temperature,evaporation of sweat
turns out to be the only way to maintain the thermal equilibrium of the
body. Calculations show that in such conditions, to remove every 4.2 megajoules
(1000 kcal) of metabolic heat, at least 1725 g of moisture must evaporate from the
surface of the body and upper respiratory tract. This moisture comes mainly
through the sweat glands, which are capable of secreting 10-12 and even up to 15
liters of sweat per day under conditions of heat stress.
Sweat is mainly composed of water, which is broadly regarded as an essential
nutrient. In addition, it includes nitrogen-containing substances, mineral salts, trace
elements, vitamins, etc. Therefore, sweating as a link in the thermoregulation system
is closely related to nutrition. This connection is expressed primarily in the fact that
the excitation and overexcitation of the parts of the central nervous system, which
regulate water metabolism according to the principle of negative induction, coupled
with water deficiency, causes inhibition of the food and motor centers, which
results in a decrease in motor activity (protective hypokinesia), suppression of
appetite, slowing down the motor (evacuation) function of the gastrointestinal tract,
inhibition of salivation, secretion of the glands of the stomach and pancreas, a
decrease in the secretion of bile and the total amount of enzymes entering the
gastrointestinal tract.
Increased sweating, along with dehydration of the body, leads to losses of the
listed substances with sweat. Significant losses with sweat nitrogen-containing
substances were first indicated by Mitchell and Hamilton in 1949 and proposed to
take these losses into account when determining the body's need for protein. They
found that with minimal sweating (body weight loss up to 90 g / h), nitrogen losses
with sweat are 15 mg / h (2.7% of total nitrogen losses), and with maximum
sweating - 152 mg / h (22.5% of total losses).
Experiments Consolatio nitrogen losses reached up to 300 mg / h, as a result
of which he recommends increasing the rate of protein intake in the tropics by
13-14%.
Later it was found that nitrogen losses with sweat decrease with
acclimatization to heat, with a decrease in the amount of protein in the diet and with
an increase in the rate of sweating. At the same time, there is also a compensated
decrease in urinary nitrogen excretion.
The total excretion of nitrogen from the human body, which has been at high
temperatures for a long time, and the nitrogen balance practically do not change. In
this regard, FAO / WHO experts believe that a significant increase in protein
requirements in hot climates does not occur. Apparently, the consumption of more
than 110 g of protein contained in the products of the soldier's diet allows you to
fully meet the needs for proteins in hot climates. Losses of minerals can also be
very significant and In the case of intense prolonged sweating, they can cause salt
depletion, accompanied by a sharp decrease in performance, cramps and muscle
necrosis - rhabdomyolysis, disruption of the transmembrane potential in cells, the
accumulation of salts and water in them, and muscle loss of creatine
phosphokinase. Moreover, it is believed that the main reason for these phenomena
is the loss of potassium, which can reach 40 meq per day (1.6 g), and sodium
chloride - 70 g per day. The rest of the elements are contained in sweat in small
amounts (calcium - from 1 to 8 mg%; magnesium - 0.4 mg%; iron up to 6 mg%)
and can hardly significantly affect their overall balance, with the exception of iron,
the loss of which can reach 37% of thethe body and cause iron deficiency anemia,
as well as iodine, the excretion of which can exceed that in urine by 2-2.5 times,
which should be taken into account,especially in iodine-deficient geochemical
regions.
practically all vitamins and their metabolites are found in sweat, but their
amount is relatively small, and therefore there is no consensus regarding the effect
of sweating on the balance of vitamins.
Domestic scientists consider this influence to be significant, while foreign
scientists, including FAO / WHO experts (1974), believe that it does not play a
significant role.

The unfavorable effect of the listed nutritional features in hot conditions can
be limited by the implementation of some organizational, economic, technological
and other measures.
First of all, measures should be taken to reduce people's overheating. This is
achieved by reducing the generation of metabolic heat and limiting the influx of
external heat. The first is ensured by the rational organization of work and rest; the
second - the transfer of working hours to morning and evening hours; the use of
appropriate clothing and the use of natural and man-made shelters to protect people
from direct sunlight, while providing ventilation.
This is followed by the organization of the so-called shifted diet, that is, the
transfer of the main meals to relatively cool hours of the day, when the thermal state
of a person is to a certain extent normalized, digestive secretion improves and
appetite is restored. According to this regime, it is recommended to start breakfast
at 5.30-6.00 and at the same time give out about 35% of the energy content of the
daily ration. Lunch at 11-11.30 am, when the sun has not yet reached its zenith; its
energy content is reduced to 25%. It is recommended to strengthen the dinner,
giving out about 40% of the daily ration for this meal, and end it at 18-18.30 local
time.
From a wide range of first courses, preference should be given to low-fat
vegetable and milk soups. It is advisable to prepare hot sauces for the second meat,
fish and vegetable dishes, and the third dishes - traditional jelly and compotes -
should be served only chilled.
Main dishes should be complemented with cold appetizers (salads,
vinaigrettes) and tea should be provided on demand. When preparing food, it is
important to fully use the flavoring substances (salt, pepper, bay leaf, garlic, etc.)
for their intended purpose, as well as to prepare dishes with an increased
concentration of extractive substances, which are known to stimulate the secretion
of digestive juices and appetite. This is achieved by stricter observance of the
established recipes and technological regimes of military cooking, as well as a slight
reduction in the yield of ready-made dishes, for example, first courses to 500 g,
but while maintaining the norms for laying all products.
The amount and frequency of fluid intake in the situations under consideration
are of particular importance. These issues are considered in detail in the hygiene of
the water supply to the troops. Here it is necessary to recall one of the basic rules
of the drinking regime: drink water as thirst arises and until it is completely
quenched.

Recommendations regarding the water-salt regime cannot be unambiguous. If

the secretion of sweat does not exceed 4-6 kg per day, additional salting of water,
as recommended by some experts for hot climates, is not necessary. Since sweat is
hypotonic in relation to plasma, its abundant secretion creates a relative excess of
osmotically active substances in the internal environment of the body. Additional
salt loads before or during work only aggravate the water deficit, practically do not
affect the intensity of sweating, and increase the excretion of fluid in the
urine. Food containing table salt within the range of palatability usually meets the
physiological needs for it. Therefore, the distribution and replenishment of table salt
before each distribution of food for its individual salting are the simplest, but
important in the conditions under consideration, elements of serving dining tables in
military canteens.
At multi-day losses large quantities sweat (over 4-5 ldeficiency of mineral salts,
especially potassium, and vitamins can be significant, which necessitates correction
of dietary intake in order to prevent salt depletion and devitaminization.
In some foreign armies, it is recommended to consume 0.9-1% saline drinks
containing a complex of essential elements, primarily potassium. There is reason to
recommend the issuance of water-soluble vitamins and, in particular, to strengthen
control over the observance of the rules for preserving vitamins during the
preparation of food and the delivery of ready-made meals, as well as
comprehensive control over the vitamin supply of military personnel, including
monitoring the nutritional status of control groups. Particular attention should be
paid to persons who are on dietetic food, bearing in mind that the culinary methods
of preparing dietary meals increase the loss (destruction) of vitamins, and the need
for them of persons in need of dietetic food is increased.
There is no consensus on the need to change the energy content of rations in a
hot climate. Some researchers (Johnson, Kark, Mitchell) believe that energy
demand in these conditions decreases due to a decrease in basal metabolism, light
clothing and less mobility. Others (Consolatio, Adolf) cite evidence of an increase
in energy expenditure due to the work of sweat glands, an increase in body
temperature, and an increase in the work of the cardiovascular system. However,
the FAO / WHO Expert Committee (1973), based on a study of the existing
literature, concluded that there is no theoretical basis for climate-dependent energy
demand adjustments.
In hot climates, the importance of preventing gastrointestinal, infectious,
protozoal diseases and helminthiasis increases,having an alimentary transmission
mechanism. As noted earlier, primary prevention of this group of diseases should
extend to all three links of the epidemic process. All sources of entry into the
military unit of perishable products, the system of their storage and processing in
the militarycanteens must be under strict industrial and medical
supervision. Particular attention is paid to control over the sufficiency and
uninterrupted operation of military refrigeration devices, compliance with the terms
 and temperature conditions for storing perishable products. You should also take
into account the peculiarities of transportation and storage of grain products -
flour, cereals, pasta, rusks, etc. High external temperature, especially combined
with high air humidity ("hot humid climate") or periodic humidification products,
favor the reproduction of barn pests, microscopic fungi (molds), including those
producing mycotoxins, as well as pathogens of wheat bread “potato disease”.

Eating in cold climates

Areas with a cold climate are characterized by low air temperatures,
significant humidity, high wind speeds, sharp changes in atmospheric pressure and
unusual photoperiodicity associated with the absence of night during the polar day
and long polar nights in winter, and a number of other features. These features
affect, first of all, the way of life, work and life of servicemen and determine a
certain stereotype of balancing the organism with the environment. Nutrition is an
important component of this stereotype.
Most scientists believe that in cold conditions, a person's energy consumption
increases, in accordance with which the energy content of food rations should
increase. In general terms, apparently, one can agree with this opinion, however,
when deciding on specific situations, it may turn out to be untenable. The fact is
thatan increase in energy consumption in cold conditions is apparently associated
with a way of life, and not with fundamental restructuring of energy
exchange. Adequate clothing and housing, combined with a sedentary lifestyle,
provide the usual level of energy exchange, although there are other considerations
on this score, especially from domestic researchers. So, I.S. at the level of
115-117%, indicating a stable physiological adaptation. A.P. Dobronravova (1969)
found that such an increase in metabolism is observed only in summer, and in
winter it decreases to 94%. She and many other researchers found an increased
basal metabolic rate in the summer in the indigenous population of the North. VV
Boriskin (1973) in numerous observations of the main exchange of winterers in the
Arctic and Antarctic did not find a noticeable increase in the main exchange; on the
contrary, in winter it decreased by an average of 7% due to the inductive effect of
decreased physical activity. There were also no deviations from the usual level of
metabolic thermogenesis for the introduced food of various composition.
Thus, the proposition about the absence of noticeable effects of the basal
metabolism on the general energy exchange, apparently, should be considered
correct. This is confirmed by the low energy consumption of the indigenous people
of the North. So, adult Eskimos with a body weight of 65 kg consume 2800-2900
kcal per day. Polar animals protect themselves from the cold not by increasing heat
production, but by increasing thermal insulation (A.D. Slonim, 1941).
Exchange is only significantly increased if housing or clothing is insufficient
for protection from the cold. Then there is a primary reaction to cooling, and then
the so-called cold shiver, as a result of which the exchange significantly increases
(up to 170% according to V.V. Boriskin, 1973), and especially during the primary
reaction, when there is still no sensation of significant cooling. However, this
condition is long-termcannot continue, and the person will be forced to either take
refuge in a dwelling, or increase his physical activity. Otherwise, hypothermia
occurs with all the ensuing consequences.
The possibility of getting used to the cold after repeated 5-10 exposures is
allowed, as a result of which the threshold of skin temperature at which cold
shivering occurs, the ability to sleep in the cold appears and preference for lighter
clothes and lower temperatures in the room. However, the metabolic rate, as shown
by studies in cold chambers, does not noticeably increase even during sleep, and
the possibilities of such an adaptation are limited. The critical air temperature for a
naked person during a long stay turned out to be 26-29 ° C, and its further decrease
does not lead to adaptation.
Thus, the level of energy consumption is mainly influenced by the increase in
physical activity, either forced or caused by household or military necessities. In
addition, clothing contributes not a small share, primarily its weight, sometimes
reaching 10 kg or more (V.S.Koshcheev, 1970), as well as the ability to impede the
movement of individual parts of the body and the entire body as a
whole. According to Gray et al. (1951), energy expenditure due to Arctic clothing
can increase by 16% against tropical clothing and by 8% against clothing in
temperate climatic zones. V.V. Boriskin (1973) believes that such an increase can
reach 30%.

A well-known feature of the Arctic regions is the presence of snow cover,

which significantly impedes the movement of people and necessitates additional
energy consumption. Experiments have shown (McCarrol, Goldman et al., 1979)
that when walking at a speed of 2.4
km / h and a carried load of 9 kg, energy consumption with a snow depth of
10 cm is 6.2 kcal / min, 20 cm - 9.3 kcal / min, 30 cm - 12.4 kcal / min, and when
driving at a speed of 4 km / h, respectively 10, 13 and 16 kcal / min. It should be
borne in mind that the maximum speed of a trained soldier's voluntary work is 7
kcal / min. Energy costs of 10 kcal / min are transferred within onehours, and 15-20
kcal / min - only 6-7 minutes. Skiing is more efficient but also energy-intensive. So,
at a walking speed of 3.7 km / h on a track on flat terrain and a load of 15-35 kg,
energy consumption is 6.6 kcal / min, at a speed of 6.6 km / h - 7.9 kcal / min, at a
speed of 10 km / h - 14.8 kcal / min.
Pandolph et al. (1976) proposed an equation that predicts energy
consumption (M) when the load carried, the weight of the clothing, the speed of
movement, and the type of soil are known :
2 2
M= 0.86ŋ​(m t ,) (1.5 V ) + 1.5V + 2 m t ∙​(cl / B)
where .M is the exchange rate, kcal / h;
m t - body weight (B) + clothing weight and cargo weight (cl
) , kg; с1 is the mass of the cargo, kg;
- movement speed, m / h;
- soil coefficient (for asphalt and treadmill 1.0; dirty road 1.1;
small shrub 1,2; dense bush and forest 1.5; swamp 1.8; dense snow 1.3; deep
snow - up to 5).
Due to the fact that physical activity, clothing and housing may be
different, the recommendations regarding energy consumption and energy content
of food rations will also be different. So, Rodal (1954) recommends 5500-6000
kcal, Buskirk et al. (1957) - 4500 kcal, Welch et al. (1958), McCarroll et al. (1979) -
4340-4368 kcal. For miners in Svalbard, these rations increase their body weight
due to the accumulation of fat. Research,conducted in the Canadian infantry
troops, who were training in the winter in the Subarctic, showed that the energy
consumption did not exceed 3484 kcal. On this basis, a norm for these conditions
was proposed - 3600 kcal per day (1973).
A. Ya. Shamis (1969), studying the nutritional status of winterers in Antarctica
(Vostok station), found that their energy requirement does not exceed 3650 kcal /
day. Taking into account the possibility of emergency work, the energy content of
the diet can be increased to 3800-4000 kcal. The same conclusion was reached by
V.V. Boriskin (1973), who established the average level of energy consumption of
winterers at st.
Novolazarevskaya, equal to 3510 kcal / day, and the maximum - 3730 kcal /
day. In his opinion, 3500 kcal / day is enough for persons performing work in
office premises; for additional work outdoors for 3-4 hours - 4000 kcal / day. and
with daily hours of work in the field (sledge-caterpillar trips) - 5000 kcal / day. The
energy content of domestic diets is more than 4000 kcal, which means that it may
be excessive in case of a sedentary lifestyle. It must be assumed that the most
correct would be a differential approach to the problem of ensuring the energy
quota of northern rations, taking into account their purpose for certain groups of
the population and military contingents leading a certain way of life. In other words,
the Nordic diet should be categorized by exercise, with an addition of 10-15% for
wearing heavy clothing. Less differentiation in relation to lifestyle is required when
establishing the qualitative composition of diets. It is known that for temperate
climatic zones the optimal ratio of proteins, fats and carbohydrates is 1: 1: 5. For a
long time, there was an opinion that these ratios should also be preserved in
northern diets. However, recent studies (V.P. Kaznacheev et al., 1980) have
established that in the process of human adaptation to living conditions in high
latitudes, noticeable changes in the biochemical stereotype of metabolism occur,
due to the restructuring of the spectrum of enzymatic constellations at the level of
the gastrointestinal tract, liver, tissues and cells. In particular, the activity of key
enzymes of carbohydrate metabolism (hexokinase, glucose-6-phosphate
dehydrogenase) decreases, the processes associated with the mobilization and use
of fat and proteins in the energy supply of the body are enhanced. Therefore, the
formula for a balanced diet for people moving to cold climatic zones should
include "protein-lipid accents" typical for the nutrition of local residents
(aborigines). However, there are other opinions on this score. So, V.V. Boriskin
(1973), analyzing the composition of the rations preferred by winterers in
Antarctica, came to the conclusion thatif the ratio of fats, proteins and
carbohydrates in them differs from the usual, then only in the direction of the
consumption of proteins supplied by meat dishes. However, he also believes that in
the case of an increase in energy consumption to 4000 kcal, the fat quota in the
diet should be increased. Such a change in the structure of the diet naturally
changes a person's needs for other essential components, in particular
vitamins. The need for fat-soluble vitamins increases, in particular for tocopherols,
which, along with the effect on numerous body functions (muscle, sexual, etc.),
being antioxidants, protect highly unsaturated fatty acids from non-enzymatic free
radical oxidation.
A person reduces the negative impact of a cold climate by creating two belts
of protection around him - clothing and shelter. However, both have negative sides.
Long polar night, prolonged stay in the room cause light, or rather, solar
starvation. The latter is manifested in a decrease in the endogenous synthesis of
vitamin D, the deficiency of which can negatively affect the phosphorus-calcium
metabolism, which is facilitated by the consumption of low-mineralized
water. Therefore, there is reason to believe that in the conditions of the Far North,
additional D-vitaminization of food is necessary, as well as prophylactic ultraviolet
irradiation, especially for the child population.
The need for vitamin C of the population of the northern regions of the
country, studied by GM Danishevsky, NN Pushkina and others, is considered
higher (by 30-50%) than in temperate climatic zones. Due to the shift in metabolism
in the lipid-protein direction, the need for vitamin B groups (B 1 , B 2 , B 6 and
nicotinamide) increases, as evidenced by an increase in blood sugar, pyruvate and
lactate, a decrease in thiamine levels (V.P. Kaznacheev et al. , 1980).
According to V.V. Efremov, the daily dose of vitamin B for northerners
should be almost doubled and amount to: thiamine 4-5 mg,riboflavin 3-4 mg, niacin
30-40 mg per day.
Thus, in conditions of high latitudes, the need for essential essential nutrients
changes. Unfortunately, it is not yet possible to substantiate a variant of the optimal
balanced nutrition formula for these conditions. But the facts considered allow us
to single out those areas of nutritional rationalization that require increased attention
from officials of medical and food services.
The main feature of the food supply in high-latitude areas is the limited ability
to produce food products locally, the seasonal nature of their import and the need,
therefore, to accumulate large reserves of food for current use. Most food in these
areas is easy to store. However, there are difficulties in protecting imported
vegetables and fruits from freezing. In practice, some useful and effective
techniques have been developed, for example, snowing cabbage, cooking frozen
potatoes without preliminary thawing, etc. Thawing and re-freezing reduce not only
the organoleptic properties, but also the nutritional value of all types of food
products.
At present, in many garrisons located in the Far North, greenhouse cultivation
of fresh herbs (onions, radishes) is expanding.
This should be promoted in every possible way and arranged at the slightest
opportunity.
As already mentioned, due to the prolonged use of low-mineralized water,
mineral and, above all, phosphorus-calcium metabolism can be disrupted, in
connection with which it is necessary to pay attention to the adequacy of the
provision of salts and microelements. It should be noted that there is also no
consensus on this issue. Many researchers argue that low-mineralized, especially
distilled, water used on ships, in waterless areas and in high latitudes (snow water),
has a significant impact on human health.
Up to an increase in the incidence of cardiovascular diseases, tumors, etc. In
this regard, it is recommended to add special salt mixtures, sea water to such water
or filter it through marble chips. Others do not attach such great importance to the
mineral substances of water, believing that the main supplier of them to the body is
food. The value of water as a carrier of mineral substances has been established
only for calcium and fluorine, and the value of the first is manifested only when it is
insufficiently supplied with food, the second- with a lack of it in water. In this
regard, people are more likely to suffer from dental caries.
At present, it is customary to fluoridate drinking water containing a little
named element by adding sodium fluoride or phosphoric acid fluoride to 1-1.5 mg /
l in terms of fluorine. This activity is especially useful in high latitudes when using
low-mineralized water.
As for the magnitude of the demand for drinking water in these latitudes, it can
be significant and close to the demand in hot regions. This is associated with an
increase in energy consumption due to heavy clothing, movement on snow cover,
etc., which is accompanied by significant sweating, leading in some cases to
uncompensated dehydration, which is facilitated by low-mineralized water, which,
as a rule, is drunk less even with sufficient supply of it ...
Food in the highlands
Mountain and high-mountain climatic regions are characterized by:- a lowered
atmospheric pressure and, accordingly, a reduced partial pressure of oxygen,
which, to one degree or another, causes the phenomenon of hypoxia;

- significant daily fluctuations in air temperature (the possibility of overheating

during the day and hypothermia at night, intense solar radiation);
- steep ascents and descents, the overcoming of which requires high physical
stress;
- a limited number of roads and sites convenient for the deployment of battalion
food points;
- difficulties in providing good-quality water. Among the extreme factors
affecting humans in high altitude conditions,oxygen starvation has the most
unfavorable effect. Therefore, in the systemic changes that occur in the body in the
process of adaptation, metabolic changes are most pronounced, aimed at
maintaining homeostasis and adapting to a low-oxygen regime.
When studying the characteristics of exchange in highlands, it was noted that
there are differences between the physiological reactions of aborigines who live for
a long time in the highlands and have persistent, including genetically determined,
adaptive mechanisms, and people moving from the plain.
In high altitude conditions, suppression of the secretory and motor
functions of the gastrointestinal tract is observed. Oxygen deficiency affects the
triggering complex reflex mechanisms of regulation of the secretory functions of the
digestive system - salivation and the first phase of gastric secretion. The functions
that depend on humoral mechanisms of regulation are more resistant to the effects
of this factor: the secretion of pancreatic juice and bile formation. Under the
influence of hypoxia, the secretion of the digestive glands decreases, but the "high
threshold" for different glands is different.
According to Barcroft (1934), for the salivary glands it was 3500-4000 m, for
the intestinal - 7000-8000 m. The peristalsis of the small and, to a lesser extent,
large intestines is inhibited under these conditions. The combined effect of hypoxia
and significant dehydration at altitude has a pronounced effect on intestinal motility
and leads to adverse events such as constipation.
With a long stay of a person in high altitude conditions, a disorder of the
function of the small intestines is possible, leading to a violation of the absorption
of fats and, possibly, other nutrients.
Due to incomplete oxidation of the products of protein and fat metabolism,
the concentration of residual nitrogen increases; in the blood, in the urine, there are
under-oxidized products: acetone, acetoacetic acid, etc. Basal metabolism per unit
of body weight increases, and body weight decreases, which is associated with the
activation of the thyroid gland function.
Water exchange changes towards tissue hypohydration due to increased urine
output and water loss with exhaled air. As a result of the listed changes in
metabolism, servicemen have anorexia, weight loss, a decrease in the amount of
adipose tissue and a negative nitrogen balance.
In the experiments of Hennon and others (1969), appetite, especially on the
second day, decreased by more than 40%, but by the 7th day of stay at the altitude
it reached the level that it had before climbing to the altitude.
The listed indicators change depending on gender, age and degree of
adaptation, however, their general direction remains approximately the same and
should be taken into account when organizing and implementing food for
personnel. First of all, the energy content of food rations is envisaged, since actions
in the mountains are associated with significant energy consumption.
It is recommended to provide personnel operating in the mountains with a diet
containing up to 4500 kcal (about 17 MJ). As for the qualitative composition, given
the difficulties in metabolizing fat and partly proteins, a tilt towards an increase in
the quota of carbohydrates is envisaged, and preference is given not to one of
them, but to their mixtures. In this case, a kind of echeloning of the intake of
carbohydrates onto the metabolic conveyor is ensured: while rapidly absorbing
mono- and disaccharides (carbohydrates of immediate action) are absorbed, the
enterogenic preparation of polysaccharides for absorption and further
transportation of their energy substations of cells - mitochondria is completed.
Close to optimal can be considered the ratio of proteins, fats and
carbohydrates as 2: 1: 10, instead of 1: 1: 5 under normal conditions. However,
according tosome researchers (Hennon et al., 1969), the requirements for a
carbohydrate diet, starting from the 4th-5th day of stay at altitude, begin to
decrease, and the need for fat - to increase, and by the 7th-8th day of stay at
altitude, they are together with appetite, they reach the initial level, while the
requirements for proteins remain low.
Studies by Johnson, Consolatio, et al (1969) found that a high-carb diet combined
with exercise is beneficial for a few days before climbing to altitude.
It is believed that in high altitude conditions there is an increased need for
vitamins, but there has been little experimental research on this. P.I.Shilov and T.N.
Yakovlev (1970), based on literature data, offer the following approximate
standards for vitamins for highlands (table 3.11).
Tabl.3.11
The need for vitamins in the highlands
Conditions Vitamins, mg
С В2 А
В1 РР
Height 1500-3000 m,
100-125 5-7 5 30-40 3-4
energy consumption
4000-5000 kcal / day
Height over 3000 m,125-150 7-10 8 40-50 4-5
energy consumption
over 5000 kcal / day

There are indications of an increase in the body's need for minerals (calcium,
magnesium, phosphorus), and especially in iron, due to an increase in hemoglobin
synthesis. With a long stay in the mountains, there may be a lack of iodine, and
therefore it is useful to establish the provision of personnel with iodized salt.
The diet of personnel in mountainous areas basically corresponds to the
regime observed in the plains. When hikingclimbing mountain peaks, it is advisable
to organize four meals a day: before going out, about 30% of the energy content of
the diet is given, for lunch during one of the halts (at 12-13 hours) - 10-15%, at
lunch - 35-40% and at dinner - 20-25% of the diet. Part of the sugar, biscuits is
recommended to be handed out for use at your own discretion during periods of
greatest physical activity.
It should be borne in mind that at low atmospheric pressure, water boils at
lower temperatures (3-4 ° C for every 1000 m), as a result of which the duration of
cooking food, for example, at an altitude of 2000 m above sea level, increases by
20-30%, and at an altitude of 4000 m - by 50-80%. As a result, it is recommended
to form food stocks from canned food, concentrates, quick-digesting
cereals; when preparing food, practice pre-soaking dry vegetables, cereals
(especially legumes), cut meat into small pieces and provide troops with
hermetically sealed boilers and pressure cookers for cooking food under pressure.
Control questions:
1.Organization of food and medical control over it in the field.
2.Organization of food and medical control over it at the stages of medical
evacuation.
3.Organization of food and medical control over him in the conditions of the
use of weapons of mass destruction.
4.Features of the organization of food and medical control over it in a hot
climate and high mountains.
5.Sanitary and epidemiological examination of products, purpose, procedure,
options for conclusions.
6.Sanitary and epidemiological examination of products when they are
contaminated with radioactive and toxic substances, purpose, procedure, options
for conclusions.
Test questions on the topic
1. Meals can also be prepared while driving in a field car kitchen:
a) PAK-170;
b) KP-125;
v) KP-2-49.
2. The main disadvantages of the ration of rat 1 in terms of biological value are
as follows:
a) imbalance and deficiency of animal proteins;
b) lack of fat;
c) low energy value;
g) vitamin deficiency.
3. Diet for servicemen is determined for the meal period (number of months):
a) 1;
b) 2;
v) 3;
d) 6.
4. In hot climates, servicemen are provided with the main amounts of proteins, fats
and vitamins in the organization of meals:
a) for breakfast;
b) during lunch;
c) for dinner.
5. The nutritional status of a serviceman with an ideal body weight of less than
70% is assessed as follows:
a) defective;
b) premorbid;
c) painful.
6. For conveying the established nutrition standards to each serviceman
The official assumes responsibility:
a) the head of the food service;
b) Deputy Commander for Logistics;
c) the head of the medical service.
7. The minimum required content of carbohydrates in the "survival" diet (in g):
a) 50;
b) 75;
v) 100;
g) 200.
8. The most common causes of food poisoning in the army are (indicate 3
foods):
a) first hot meals;
b) cold snacks - salads, vinaigrettes;
c) desserts;
g) garnishes from cereals;
d) mashed potatoes.
9. Supplementary food for servicemen with a height of 190 cm and above (%
of the ration):
a) 25;
b) 50;
v) 75;
g) 100.
10. With a decrease in body weight of servicemen by 10% of the initial value
within a month, they should be sent to medical institutions:
a) true;
b) incorrect.
11. If vitamin C deficiency is detected in ready-to-eat foods and vegetables,
vitamin C supplementation of third meals is carried out per person (in mg, not less):
a) 25;
b) 50;
v) 75;
g) 100.
12. Tin cans with "tongues" at the seams are allowed for use in the food of
servicemen:
a) true;
b) incorrect.
13Energy consumption of total military food (kcal)
a) 3500
b) 4374
c) 5000
d) 4800
14. The share of vitamin A (g) in the total diet
a) 0.2
b) 0.4
c) 0.3
d) 1.0
15. The amount of vitamins C (mg) in the total diet
a) 70
b) 90
c) 120
d) 116
CHAPTER 4. WATER SUPPLY HYGIENE TROOPS
Water supply - a set of measures to provide water to various consumers - the
population, industrial enterprises, etc.
Along with the term "water supply" in some cases the concept of "water
supply" is used. This should be understood as a wider range of tasks that are
solved only at the local, federal or regional levels, but even with coverage of state
and interstate problems.
areas of providing the population with water. For the Republic of
Uzbekistan, this problem has grown into a number of factors in the last decade.
directly related to ensuring the national security of the country in the field of
health protection, to which attention has been repeatedly drawn resolutions and
decisions of the highest level. It is no coincidence that the issue of guaranteed
provision of the population with drinking water of the required quality and in the
proper quantity was twice put on the agenda of the Security Council of the
Republic of Uzbekistan (1995 and 2001), and in 2003 the state of the water sector
and the state's tasks to provide the population with good-quality water were
discussed at a field trip. meeting of the Presidium of the State Council of the
Republic of Uzbekistan in Rostov-on-Don chaired by the President of the country.
From what has been said, it becomes clear that in relation to the Armed
Forces of the Republic of Uzbekistan, the term "water supply" will be more
appropriate and targeted.
Water supply to troops (forces) - a set of measures carried out by forces and
means specially designed for this in order to provide troops (forces) with water in
the required quantity and of the established quality. Among the measures that
ensure the health and combat effectiveness of troops, water supply occupies one of
the important places.

The conditions for the deployment of military personnel in military camps and
on ships, training and combat activities on land, in the air and at sea place high
demands on water supply, which includes exploration of sourceswater, equipment
of water intake and water points, improvement of quality, transportation, storage
and delivery of water to the personnel.
When contaminated, water may contain radioactive, war-poisoning and
hazardous chemicals, causative agents of a number of infectious diseases, for
example, dangerous viral hemorrhagic fevers, anthrax, cholera, viral hepatitis A and
E, typhoid fever, dysentery, etc. vitality in water. Therefore, great importance
should be attached to medical control over the organization of water supply for
personnel, purification and disinfection of water. In this case, medical service
specialists proceed from the following principles:
large-scale warfare always leads to massive pollution of water sources;
in wartime, special contamination of water sources with radiological and
chemical-biological agents is possible, which retain their damaging properties for a
long time;
when organizing water supply to troops (forces), first of all, stationary water intake
structures of settlements and military towns are used;
field deployment of troops and the movement of personnel lead to the use of
various sources of water supply, which requires the availability of certain water
reserves and constant readiness to improve water quality with the help of technical
means, portable water treatment devices and medical supplies;
actions in personal protective equipment, extreme climatic and geographical
regions, closed spaces with a large number of heat-producing elements, with high
physical and psycho-emotional stress, sharply increase the need for
personnel good quality drinking water.
Water is an absolutely essential attribute to preserve and maintainhuman
life. In case of complete deprivation of water consumption, death can occur in 5-7
days. With the sharply limited availability of good-quality water, especially in field
(combat) conditions, there is always a temptation, dangerous to health and life, to
use any available water, which can dramatically complicate the sanitary and
hygienic situation in the troops.
Water is essential for the normal functioning of the human body. Many
processes in the human body are associated with the presence of water and
substances soluble in it. Water contributes to the delivery of essential nutrients to
tissues and organs.
With its help, harmful metabolic products are removed from the body, a
significant part of the heat is removed when overheated by sweating.
The hygienic value of water is very important: for washing, washing in a bath,
cooking, cleaning rooms and other purposes. At the same time, when polluted,
water plays a decisive role in the transfer of pathogens of a number of dangerous
diseases, for example, cholera, viral hepatitis A, dysentery,typhoid fever, etc. Many
microorganisms retain their viability in water for a long time. Therefore, great
importance should be attached to medical control over the organization of water
supply for personnel, purification and disinfection of water.
Responsibility for providing troops with water in the field is assigned to the
commanders of military units. On their instructions, a set of measures is being taken
to provide the troops with water, which includes an assessment of the water
supply of the area, the identification of the main consumers of water, as well as the
exploration of water sources, its extraction, quality improvement, storage, delivery
and delivery to personnel. The direct fulfillment of the tasks of field water supply to
the troops is organized by: the chief of staff of a military unit, the deputy
commander for logistics, the chiefs of services: engineering, medical, NBC
protection.
Boss headquarters military parts responsible for coordinated actions of chiefs
of services and interaction between them on water supply, planning of supplying
troops with water, preparation of governing documents (orders, orders) and
control over the implementation of tasks, organization of protection and defense of
field water supply points and water points; rationing of water consumption for a
military unit and subdivisions.
The deputy commander for logistics ensures timely delivery (transportation)
of drinking water in the required amount to consumers; organizes the equipment
and maintenance of water points and its storage; provides facilities for the supply
and storage of drinking water.
The head of the engineering service is obliged to: organize engineering
exploration of water sources; to prepare for the commander, together with the
deputy commander for logistics, proposals for water supply; organize the
extraction, purification of water, equipment and maintenance of field water supply
points; to provide the means of field water supply, to organize their operation and
repair, as well as the supply of consumables.
The head of the NBC protection service : organizes radiation,
chemical biological prospecting of the area and water sources in the areas of
equipment for field water supply points and water points;

permanent radiation, chemical and biological monitoring of water sources and

terrain at field water supply points and water points.
The head of the medical service is obliged: to assess the sanitary-epidemic and
epizootic state of the areas of equipment for field water supply points and water
points; organize the provision of a part (subdivisions) with means of disinfecting
individual water supplies, as well as medical control over the state of field water
supply points, water points, means of supply (transportation), storage of water and
its quality. Organizes and implements medical control over the health of personnel
working at facilitieswater supply for troops.
The provision of the troops with drinking water in the field is carried out, as a
rule, from the centralized water supply systems of the nearest military towns or
settlements, and in their absence - from water supply points (PW) arranged at the
available water sources (water intake wells, mine wells, springs, etc.), and from
water points deployed and equipped for the distribution of imported water.
The most preferable for camps for long-term operation is the equipment of
their own distribution network with its connection to the centralized water supply
main.
The use of open reservoirs (rivers, lakes, ponds, etc.) as water sources is
allowed only on condition of their engineering equipment.
Measures for medical control over the water supply of troops when located in
the field (camps) include:
participation of the medical service in the selection of water sources;
control over the quantity and quality of water provided to personnel;
participation of the medical service in determining measures to improve water
quality and monitoring compliance with the technological regime of water treatment;
control over the sanitary and epidemiological state of the water supply, means
of storage and transportation of water;
checking the observance of the drinking regime by the military;
providing personnel with drugs for disinfecting individual water supplies and
instructing them on the rules for using them.
4.1. Water consumption norms and requirements for water quality
The need of troops for water depends on the nature of their actions and
climatic conditions. Troops in the field are provided with water in accordance with
established standards based on the number of personnel and the number of
equipment. Water consumption rates in the fieldinclude water for drinking
(household and drinking) and technical needs. Drinking water is used for drinking,
cooking, bakingbread, for washing, washing in a bath, washing dishes and kitchen
utensils, medical needs, cleaning premises and for keeping animals.
Industrial water is used for the preparation of degassing and disinfecting
solutions, for washing equipment, weapons and materiel, as well as for refueling
(refueling) engine cooling systems.
The total rates of water consumption in a field camp for household and
drinking needs in the absence of running water and sewerage (imported water) are
taken at the rate of 40 liters per 1 serviceman per day, in the presence of a
distribution network (water supply system) without sewerage - 100 liters per 1
serviceman per day.
When units, groups and individual servicemen perform combat training and
other tasks in isolation from their units, the water consumption rates (table 4.1) are
0 0
set depending on the weather (moderate - up to +25 С and hot over +25 С) and
amount accordingly : for household and drinking needs - 20 and 30 liters per
serviceman per day; for sanitary needs - 40 and 50 liters, and the total drinking
water required, respectively, 60 and 80 liters per one soldier per day. The minimum
rate of water consumption at which the active activity of military personnel is
maintained is from 5.5 to 9.0 liters per day per person (Table 4.2). In an exceptional
setting (for a period not exceeding 3 days), it is allowed to issue water only for
drinking purposes (making tea and creating a supply of water in flasks) in the
amount of 3.5 and 6.0 liters per person.
In conditions of water shortage, the water consumption rate includes only that
part of it that is used to meet physiological needs and personal hygiene needs, and
in an acute water shortage - only for physiological needs. The minimum rate of
water consumption is introduced in exceptional cases during the operation of
troops in the desert andlow-water areas or with massive contamination of water
sources. In areas with salt water, fresh water is consumed primarily for drinking and
cooking.
The water consumption for the medical posts of the battalion, regiment
(brigade) is determined based on the number of personnel at the rate of 1.5 liters
per person. The daily rate of water consumption for a separate medical battalion of
3
the division is 30 m per day.
Table 4.1.

Daily norms of drinking water consumption by personnel(liters per

soldier)
Type of water
At At
Consumption weather moderate When hot
weather Up to + 25 °
For household and drinking needs:

Making tea and supplying water in flasks 3,0 4.0

Cooking food 3,0 3.5
Baking bread 1,0 1.0

Washing kitchen utensils 2,0 2.5

Washing individual dishes 1,0 2.0

Washing and washing hands 5,0 7.0
Daily rubdown 5,0 10.0
TOTAL: 20,0 30.0
For sanitary needs:
Washing of personnel 10,0 14.0
Washing of linen, uniforms (2 kg) 20,0 20.0
Medical Needs 4,0 6.0
Cleaning and sanitization of residential 6,0 10.0
premises and common areas

TOTAL: 40,0 50.0

 TOTAL: 60,0 80.0

Table 4.2.
Minimum rates of water consumption by personnel
(for one person), liters per day
o
Below +25 0
At air temperature, С
Purpose of water C o
Above +25
C
Preparation tea and creation 3.5 / 2.5 6.0 / 4.5
stock of water in jars.
Washing 1.0 1.0
Preparation food and washing 2.0 2.0
bowlers
TOTAL: 6.5 / 5.5 9.0 / 7.5
NOTES:
The minimum water consumption rate ensures the vigorous activity of
military personnel for 5-7 days.
Values ​of standards: in the numerator - for the offensive, in the denominator -
on the defensive.
When wearing protective clothing, the need for drinking water increases by 2-5
liters, depending on the air temperature, the severity of the load and the type of
clothing (everyday, insulating).
The medical service of the military unit is responsible for monitoring
compliance with water consumption standards. Unlike all other types of supply, the
provision of troops with water is based on the assumption that the rates of water
consumption under any conditions should not be lower than the established
value. At the first opportunity, they must certainly be increased. It is the duty of the
unit physician to ensure that the water intake rates are increased whenever the
appropriate conditions arise.
At present, the most appropriate, scientifically grounded drinking regimen,
recommending timely quenching of thirstmoderate portions of water. Intentional
abstinence from drinking water during periods of heat stress contributes to a
decrease in the work and combat efficiency of military personnel. With a water
deficit in the body equal to 0.7-1.0% of the body weight, dry mouth appears,
moderate thirst, and efficiency does not decrease. With a deficit of 1.5-2.0%,
diuresis decreases, appetite decreases. Performance is reduced mainly due to an
overwhelming feeling of thirst. With dehydration in the range of 4.0-5.0% of body
weight, there is a decrease in sweating, secretion of salivary glands and diuresis,
there is significant dryness of the skin and mucous membranes, complete anorexia
occurs, unquenchable thirst, a drop in working capacity, mental disorders are
possible.
With a water deficit in the body equal to 8.0-10.0%, the saliva separation
stops, the skin becomes dry, wrinkled and flabby, and becomes covered with
cracks. Physical and mental exhaustion sets in, death is possible. With further
dehydration, urination completely stops, vision and hearing are impaired, and
hallucinations appear.
Loss of 15.0-20.0% of body weight due to dehydration is incompatible with
life.
Requirements for the quality of water in the field should ensure the
preservation of the combat effectiveness and health of servicemen during the time
determined by the actual combat situation (Table 4.3).
Table 4.3.
Requirements for the quality of drinking water in the field
Name Indicators
Maximum permissible indicators No more than 20
of toxic substances:
Products of nuclear explosions, μCi / L
Microbiological indicators: Absence
Total coliform bacteria, CFU / 100ml Absence
Thermotolerant
No more than 100
coliform
Absence
CFU / 100ml
Total microbial count, CFU / 1ml Absence
Coliphages, pfu / 100ml
bacteria,
Organoleptic indicators: No more than 20
transparency, cm No more than 35
chromaticity, hail No more than 2
Turbidity, mg / l No more than 3
Smell, points No more than 3
Taste and smack, points 0.8 ... 1.2
Residual active chlorine, mg / l
Chemical indicators: No more than 3
Copper, mg \ l No more than 350
Chlorides, mg / l No more than 45
Nitrates, mg / l No more than 1500
Mineralization (dry residue), mg / l

The maximum permissible concentrations of OM and BS are specified in the

relevant instructions.
Depending on the sanitary and epidemiological situation, the list of monitored
indicators of water quality can be expanded in agreement with the Chief State
Sanitary Doctor, in whose area of ​responsibility this garrison (ship) is located.
It should be borne in mind that the value of sanitary and bacteriological
indicators used under normal conditions (coliform bacteria, coliphages) in wartime
can be very arbitrary, since they are designed to determine microorganisms that
enter the water along with household waste. If a pure culture of microorganisms is
introduced into the water source as a result of the use of the BS by the enemy, do
notcontaining Escherichia coli as a passing flora, the coli-index, despite the high
microbial contamination, will not change. Consequently, E. coli in these conditions
loses its sanitary-indicative value. Nevertheless, it retains its importance (like other
sanitary and bacteriological indicators) for assessing the effectiveness of water
disinfection.
Conditions of the enemy's use of weapons of mass destruction, oxidizability,
ammonia, nitrites also lose their sanitary-indicative value nitrates ,
chlorides. However, in those cases when the enemy does not use BS, as well as
with prolonged use of the same water source, the sanitary-bacteriological and
general sanitary indicators retain their value and one cannot refuse to determine
them.
For sanitary treatment (washing) of personnel and washing of linen, in
agreement with the medical service, source water can be used without treatment,
provided that the content of radioactive and toxic substances, pathogenic
microorganisms and toxins in it does not exceed the established values.
4.2. Water exploration and hygienic assessment of water sources
To identify water sources and determine their feasibilityuse by engineering
reconnaissance patrols is conducting reconnaissance for water. Specialists of the
medical service are included in the patrol if necessary.
The task of water exploration is to establish the type, quantity,location, as well
as the sanitary condition of water sources and the surrounding area; determine the
suitability of water for drinking and other needs; assess the technical condition of
sources, flow rate and water supply in them; the possibility of equipping water
supply points and approaches to them.
The following can be used as water sources:
open reservoirs (rivers, lakes, ponds, reservoirs, seas);
groundwater sources (wells, wells, springs, etc.);
atmospheric precipitation (rainwater, snow, ice).
Open water bodies are often polluted by domestic and industrial wastewater,
rain and melt water. Therefore, preference should always be given to groundwater
sources, as they are protected from surface contamination by the overlying soil
layers. The greater the depth of the aquifer, the better the sanitary water.
When using rivers with turbulent currents, turbid water with a large amount of
suspended particles, filtration wells are arranged for water intake at a distance of
15-20 m from the water's edge. With a watertight bottom and shores soil through
which water filtration is impossible, it is necessary to arrange wells with filtration
trenches for water intake (Picture 4.1). Water, passing through a layer of soil or a
filtration trench, is largely freed from color and suspended solids, which facilitates
its further purification and disinfection. In addition, the soil and filtration material of
the trench retain some of the microorganisms, as well as radioactive and toxic
substances.

Picture: 4. TUF-200 fabric-carbon filter. 1 - introduction of chlorinated and coagulated water; 2 -

cloth bag; 3 - willow basket; 4 - valve to remove the filtrate after the fabric filter; 5 - activated carbon;
6 - perforated discs (top and bottom); 7 - Valve for discharge of filtrate after TUF; 8 - support ring; 9 -
rubber gasket; 10 - bars (top and bottom); 11 - rubber seals.
Picture: 4.1TUF-200 filter operation.1 - RDV-100 reservoirs for untreated water; 2
- pump; 3 - fabric-carbon filter; 4 - RDV-100 reservoir for fresh water.

Wells are torn off in places convenient for approach and entrance, however,
no closer than the established distances from possible foci of soil and groundwater
pollution (latrines, cesspools and manure pits, cattle yards, etc.), necessarily higher
up the slope than the detected foci pollution. The walls of the well are reinforced
with a frame made of plates, logs or beams, reinforced concrete rings, brick or
stone. The structure of the mine well should rise 0.7-0.8 m above the ground (head)
and have a tight lid with a lock. To protect the water in the well from contamination
from the soil surface, a clay castle made of washed and well-compacted clay, 2 m
deep and 1 m wide, is arranged around its perimeter. sides of the frame of the well,
as well as open the drainage groove. The well should be equipped with a bucket
(bucket), or better equipped with water-lifting means. To protect the wells from
destruction and the ingress of radioactive and toxic substances, they are torn off at
the bottom of the pits, which are covered with a roll of logs and soil.

Artesian water is of the highest quality. It is most often located at a great

depth between two waterproof layers and is under high pressure. Therefore, after
the laying of an artesian well, water often rises through pipes to a certain height
or even pours out onto the surface in the form of a fountain. Artesian waters have
a stable chemical composition, little subject to seasonal fluctuations. In
bacteriological terms, they also differ in good performance. Therefore, water
 from artesian wells is used for immediate water consumption, as a rule, without
treatment, but during transportation or storage for more than 2 hours in warm
weather and more than 6 hours in cold weather, either disinfection or treatment is
carried out on portable water treatment devices ..

Water good quality have springs or keys that can used to provide water to
small units. Springs are the outcrops of groundwater to the surface of the
earth. When the water rises along the cracks in the rocks and beats from the bottom
up, the spring is called ascending; if the water comes to the surface on the side of
a mountain and flows from top to bottom, the spring is called descending. Spring
water is usually just as reliable sanitary terms, as well as artesian. For the correct
exploitation of the springs, their capturing is carried out (Picture 4.2). Capturing
springs is understood as clearing the place of their exit, setting up a foundation pit,
strengthening the bottom and walls, setting up a cover, a drainage device, etc.

Shallow groundwater (especially upper water) insettlements and places of

concentration of troops can be contaminated. The groundwater occurs at a greater
depth than the perch and does not have such close contact with the soil
cover. However, the possibility of contamination of these waters remains high
enough. This is why the unpavedwater from shallow wells taken for drinking and
household purposes must be purified and decontaminated.
In low-water areas in the absence of other sources in the summer, rainwater
can be used for water supply, and in winter
- water obtained from snow and ice. The quality of rainwater depends on the
cleanliness of the air in the area where it is collected and the areas where the
rainwater is collected. To collect rainwater, tarps, tents are spread on a flat, clean
area, and fabric tanks are installed. Large amounts of rainwater can be collected by
constructing dams in natural folds in the area (ravines, ditches). It is allowed to use
snow to obtain water from clean, unpolluted areas, far enough from roadways,
housing, latrines, places for keeping livestock, etc.
Snow is collected in clean containers (buckets, pots, field kitchens). Rain and
snow water must be disinfected.
In wartime, both rain and snow water can be radioactively contaminated, so it
must be subjected to radiometric research.

Preparation of ice for water production is carried out at a distance of at least

200 m from the centers of pollution. Water obtained by melting ice must be
disinfected. On some sea coasts, sea water is often the only source of water. Fresh
water from sea water is obtained by distillation or freezing at an air temperature not
higher than - 3 ° С, -4 ° С. The freezing method is based on the fact that fresh
water freezes faster than salt water. Therefore, the ice crust on seawater contains
almost no salts.
The task of medical reconnaissance of water sources includes:
-sanitary and epidemiological survey of areas where water sources are located;
-sanitary and topographic survey of water sources;
- determination of water quality and its suitability for drinking and other
purposes;
if necessary - sampling for laboratory research;
- substantiation of the conclusion on the suitability of the water source for
water supply and the necessary measures for cleaning, disinfection, degassing and
decontamination of water.
At the direction of a doctor (paramedic), a sanitary instructor may be involved
in the exploration of water sources, taking samples for research and sending them
to the laboratory.
When choosing a water source, first of all, it is necessary to establish whether the
enemy has used weapons of mass destruction in a given territory. This has to be
established by a number of indirect signs, since radioactive and some toxic
substances have no odor and do not give water an unusual look and
taste. However, the presence of some 0V in the water can be suspected by the
appearance of an unusual odor in it, by oily greasy spots around the springs,
individual oily drops on the surface of the water and at the bottom of the
reservoir. Indirect signs of water contamination and poisoning can be the corpses
of dead animals in the surrounding area and the presence of dead fish in the
reservoir.
Water from mine wells and wells located in the territory left by the enemy can
be used only after examination for the presence of OM, radioactive substances,
bacterial contamination and after its treatment. It is better not to use rivers and
streams flowing from the territory occupied by the enemy for water supply,
especially in areas close to the front edge.
The sanitary and epidemiological survey of the area where the water source
is located is an integral part of the sanitary and epidemiological reconnaissance
conducted by the medical service.
A sanitary-topographic survey is carried out in order to establish the
location, type, flow rate of the water source and its technical condition, the sanitary
state of the surrounding area, the presence of pollution centers and the possible
connection of water sources with them.
Before Total, appreciate sanitary condition territory,adjacent to the water
source, identifying possible sources of pollution (wastewater from baths, laundries,
industrial enterprises, latrines, cesspools, landfills, stockyards, etc.), and determine
the distance between them and the water source. If there is a suspicion of a
connection between a water source and pollution foci, it is determined
empirically. The easiest way is as follows. 3-5 liters of a 2% solution of a special
paint, fluorescein, are poured into the center of pollution (for example, a
cesspool). This paint has the property of imparting a greenish-yellow color to water
even at very large dilutions (1: 10000000). Every 3-6 hours for 2-3 days, take water
samples from a source (for example, a well) into a test tube and examine it, looking
from above; in the presence of a connection with the source of pollution, the water
takes on a greenish-yellow color.
Assessing the sanitary and technical condition of the water source, they pay
attention to its equipment (the presence of a log house, a lid, a bucket near a well, a
clay castle, a drainage groove, the state of capturing near springs, etc.) and outline
the necessary measures for its improvement.
When inspecting a water source, a simple assessment of the physical qualities
and organoleptic properties of water is made - its temperature, transparency, color,
odor; the taste of water can be determined only in the absence of 0V, PB and
bacterial contamination in it.
Taking water samples and sending them for laboratory research
The reliability of the results of laboratory analysis of water largely depends on
how correctly the samples are taken. Water sampling is performed using a
bathometer (Picture 4.3), allowing you to take a water sample at the desired
depth. In the absence of a bottle, the sample is taken with a bottle with a load
adapted for this.
For chemical analysis, take 2-4 liters of water into clean bottles, twice rinsed
with water, which is taken for analysis. A water sample for bacteriological analysis
is taken into a sterile (disinfected) container.
Front filling bottle water her neck is burned over flamespirit lamps; closing the
bottle, burn the cork. The sample bottles are wrapped in paper and tied with
string. The volume of the sample for the determination of coliform bacteria and the
microbial number is 0.5 liters, for the study for the presence of pathogens - 3 liters.
Open reservoirs, water samples are taken at the place and at the depth where
it is supposed to take water in the future.

During wartime, the correct sampling of water for radiometric analysis is of

particular importance. For this purpose, in the reservoir, as a rule, two samples are
taken - from the surface and bottom layers of water; a sample of water from the
bottom layer is taken after preliminary stirring up of water near the bottom, so that
bottom sediments also get into the sample. In some cases, on special instructions,
samples of algae, fish,plant and animal organisms suspended in water, as well as
samples of surface soil layers along the banks of the reservoir.

Picture 4.2. Vinogradov's batometer

Water intake from wells with pumps or from water taps is carried out after
pumping out or draining water for 5-10 minutes. The analysis of the sample should
be carried out no later than 2 hours after its collection. Atthe impossibility of the
analysis can be submitted no later than 6 hours after sampling, but in this case it
must be stored at a temperature of 1 to 5 ° C.
Together with the sample, an accompanying document (act) is sent to the
laboratory, which must indicate:
name of the water source and its location, date of sampling;
for open reservoirs, the distance from the coast and the depth from which the
sample was taken, counting from the surface and from the bottom of the reservoir;
organoleptic properties of water (transparency, color, smell,temperature);
meteorological conditions (air temperature and precipitation) the day of
sampling and on each of the ten preceding days; for open reservoirs - also the
strength and direction of the wind;
sanitary and technical condition of the water source;
special conditions that can affect the quality of the water at the source;
surname, name, patronymic and position of the persons who took the
samples.
The act is signed by the persons who took the sample.
After conducting exploration of water sources, the reconnaissance group
draws up a reporting scheme for exploration and enters the data obtained into the
card of water sources. On-site survey of springs can give a lot for judging the
quality of water. So, when examining them, you can find indirect signs of water
poisoning, which include: odors (mustard, garlic, geranium, bitter almonds) and
tastes (bitter, metallic, astringent), unusual for good-quality water; oily greasy spots
or droplets on the surface of the water or around the source; dead fish in the water
source. A thorough and complete on-site survey of the water source greatly
facilitates the task of sanitary assessment of water in the field.
4.3. Service means of field water supply for troops
Service equipment for providing troops with water in the field are subdivided
into means of extraction, means of cleaning and means of delivery andstorage of
water.
Water extraction facilities are subdivided into shallow (up to 25 and 50 m)
and deep (up to 200 m) groundwater production facilities. 15), water production
unit (UDV-15, UDV-25).
Means for the extraction of groundwater with a depth of 50 m include mobile
drilling rigs (PBU-50 and PBU-50M). The PBU-50M unit, in comparison with
PBU-50, has a modified design of a drill, a filter and a mine well digger, which
increased its ability to extract water.
Extraction of deep groundwater is provided by a mobile drilling rig (PBU-200)
and a rotary drilling rig (URB-3-AM).
Means of raising water include hand pumps (BKF-4, "Hydropult") and
electric (KPN-5) pumps and water lifters.
Technical data of the named means are presented in table 4.4.
Water purification means include field filters (NF-30, TUF-200, PF-200),
portable water treatment plant PVU-300, military filter stations (VFS-2.5, MAFS-3,
VFS-10), water desalination means (OPS, OPS-5). Recently, the supply of troops
began to receive integrated treatment stations (SCO), allowing, within the
framework of a single technological scheme, to purify and desalinate water (Table
4.5)
These funds allow you to remove natural pollution, radioactive and toxic
substances, toxins and pathogens from the water. The most common water
treatment scheme can be represented by examples of the operation of the TUF-200
filter and the VFS-10 military filter station.
Filter TUF-200 (Picture 4.4) is intended for clarification and discoloration of
water, freeing it from 0V and pathogenicmicroorganisms. The filter can be used to
purify from 200 to 400 liters of water per hour. The set TUF-200 includes: the filter
itself, equipped in the upper half with a fabric bag, and in the lower half with
activated carbon; hydraulic control pump; four rubber tanks RDV-100; two canvas
buckets, reserves of coal, alumina, bleach; spare parts, accessories and tools. Each
kit comes with instructions for working with the filter.
The filter scheme is shown in Picture 4.5. Three reservoirs RDV-100 are filled
with the water to be treated using tarpaulin buckets and subjected to coagulation
and re-chlorination. When the water settles and the flakes settle to the bottom, it is
passed through a filter using a hydraulic pump; clean water is collected in the fourth
tank PE-100. Passing through the filter, the water in the fabric bag is freed from
suspended particles and coagulant flakes, and in the activated carbon layer - from
excess chlorine.
Sufficient clarification and reliable disinfection of water are convinced by
closing the lower and opening the upper outlet taps: clear water with a pungent
chlorine smell should come from the tap. The completeness of the removal of
excess chlorine from the water, or dechlorination, is checked,evaluating the water
coming from the bottom tap: here the water should not smell of chlorine. After 4-6
hours of operation, the cloth bag must be replaceda new or used, washed cloth
filter. The activated carbon is replaced with a new one after 20 - 40 hours of
operation. An indication of the need to replace it is the appearance of a chlorine
odor in the filtrate.

Table 4.4
.
Technical means for water purification and desalination

No. Name Performance Payment, Time Resource Weight

3
P/ b, m / h deployment work before , kg
P human i am up replacements
To receiving filtering
pure water, th load, h
h
1
one. Wearable 0.03 one - 75/1000 3
filter NF-30
2. Tissue 0.2 2 1-1.5 40 95
carbonic
filter TUF-
200
one
1
3. Portable 0.2-0.3 2 0.8 50/100 hundred
filter PF-
 200
2
4. Portable 0.3 2 0.2 / 4.7 No less 150
water
treatment one hundred
installation
PVU-300
5. Military 2.5 3 0.7 one hundred -
filtering
i am station
VFS-2.5
6. Military 10 2 1.5-2 one hundred -
filtering
i am station
VFS-10
7. Automotive 7-8 5 2-3 20-100 -
I am
filtering
i am station
MAFS-3
eight. Mobile 2 3 1.5-2 - -
desalination
I am an OPS
station
9. Desalination Cleaning - 8 5 2 one hundred 21600
th station Desalination - 3-6
OPS-5
2
10. Station eight 3 0.5 / 4 1000 4400
an integrated
water
purification
SKO-8BS-K

Note: 1 - in the numerator - the resource of work when cleaning water from
organic matter, radioactive substances and BS, in the denominator - when cleaning
from natural pollution;
2 - in the numerator - the deployment time without de-conservation, in the
denominator - during de-conservation.
TUF-200 is served by two soldiers. When treating contaminated water, the
calculation should be in protective equipment. After cleaning, the filter, pump and
reservoirs for contaminated water are decontaminated, rendered harmless or
disinfected, depending on the type of water contamination.
The military filtering station VFS-10 (Picture 4.6) is designed to purify water
from natural contamination, neutralize it and disinfect it. The station is mounted on
the chassis of a ZIL-131 vehicle and a two-axle trailer and consists of a filter, a
dechlorinator, two external electric pumps, RDV-5000 reservoirs, communications,
a laboratory for monitoring the quality of water, reagents, and filter
materials. VFS-10 is deployed at the working site of the water supply point at a
distance of no more than 50 m from the water source. The working site is divided
into clean and dirty halves.In the clean half, there are clean water tanks, a trailer, and
a shelter for personnel. The rest of the station funds are placed on the dirty half.
For purification, water from the source is supplied by an electric lift pump
to the sedimentation tanks, into which chemical reagents (coagulant, DTS GK,
NGK) are simultaneously injected with special dosing pumps. After the required
contact time has elapsed, the water from the settling tanks is pumped by a pump
of the second rise to the clarifier filter, then it passes the dechlorinator and enters
the clean water reservoirs, where, in the absence of chlorine, it is additionally
treated with a clarified solution of DTS GK (bleach) at the rate of 0, 8-1.2 mg / l
of active chlorine.
For water desalination, mobile desalination engineering means are used - OPS
and OPS-5 stations (Picture 4.7). In the presence of radioactive substances in the
water, suspended radioactive particles are removed simultaneously with desalination
and the content of dissolved radioactive substances is reduced.
 Water extracted and purified at water supply points is transported places of
its consumption in special tank trucks or other containers. The medical service
draws up sanitary passports for the means of supplying water. Water supply
workers, including those involved in the delivery of water to the points of analysis,
are subject to periodic medical examinations and examinations with marks in their
personal sanitary books.
Water is dispensed from tanks only with the help of drain taps or standard
pumps. The suction or overflow arms are flushed with clean water before each
use. Tanks and reservoirs for transportation and storage of water, drain and
overflow pipelines are washed and disinfected at least once a week,filling with water
with an active chlorine content of 25-30 mg / l. 1 hour afterfilling them is washed
with clean water until the smell of chlorine disappears. In addition to the specified
standard engineering means for water purificationvarious non-cable devices can be
used: filters made from scrap materials, some technical means of the food service,
certain reagents of the chemical and medical services, etc. (Table 4.6). During the
Great Patriotic War, homemade filters with a body made of a barrel, metal tank or
tightly knocked down box justified themselves. River sand with a particle diameter
of 0.5-3 mm, charcoal or activated carbon, sawdust, raw cotton or cotton wool are
used as a filtering medium. Filter materials are pretreated before loading. Wood
sawdust and cotton wool are first boiled for 30 minutes in a 0.5% solution of a
chlorine-containing preparation, and then for 30 minutes in pure water. River sand
is thoroughly washed before removing clay substances from it. Charcoal after
grinding is washed with water until dust is removed. Fabrics are washed in hot
water and soap and boiled, and dyed fabrics are discolored with 10% bleached
bleach solution.

Table 4.6.
Unstable remedies for improving water quality
Name Appointment Application
 facilities

Filter type TUF-200 Lightening and Made by forces

from henchmen disinfection of water military unit
materials
Disinfection, Property
Camping kitchens and
storage and food
Boilers
water transportation service
Accessories for
Water disinfection Property
cooking on
for small groups Food
exhaust gases Reagents:
military personnel service
iodine, potassium Disinfection of individual or Medical service property
permanganate, group water supplies in special
Chemical property
hydrogen peroxide, conditions
service
chloramines
Disinfection of water in a well Issued
DTS GK, NGK,
industry
chloramines
Cartridge for
continuous
chlorination

4.4. Field water supply points and water points

A field water supply point (FW) is a place where water is extracted, treated,
stored and dispensed. The place intended for the issuance of water supplies is
called a draw-off point.
When choosing a place for the deployment of a water supply point, the
sanitary and epidemic state of the territory and closely located settlements, the
possibility of contamination of water with bacterial agents, radioactive and toxic
substances, sanitary-topographic and sanitary-technical data of the water source, its
flow rate are taken into account.
At the water supply point, as a rule, a working site is equipped where water is
extracted, cleaned, stored and dispensed; a tare-washing room for washing and
disinfecting (if necessary) containers and individual dishes; a platform for transport
arriving for water. In the area of ​large water supply points, an observation post is
set up, equipped with means for conducting radiation and chemical reconnaissance
To protect the water source from possible pollution and contamination, a
sanitary protection zone is created within a radius of 50-100 m from the water
supply point, where garbage dumping, latrines and cesspools are prohibited. A
place for a tart-washing platform is chosen 25-30 m from the place of water
intake. Contaminated water is discharged to collecting water-absorbing wells.
For PV equipment onshore, a surface source is used depending on the need
for water TUF-200, VFS-2.5, UDV-15 or MAFS-3, with the equipment of PV at an
underground source - MTK-2M,MShK-15 or UDV-15 (25).
In the absence of local water sources, company (battalion) water points are
arranged. Water is delivered to them by all types of transport or through field water
pipelines. At the water points, containers are installed to create water supplies and
means for distributing it to the troops.
 Picture 4.9. Water storage tank TsV-4
Water storage at water supply points and water points, as well as its
transportation, is carried out in service means or in auxiliary containers (barrels,
cans, cans, tanks, etc.). The container used for the transportation and storage of
water (tables 4.7 and 4.8, fig. 4.9) must be clean, have tightly closed lids. Her
periodicallydisinfect with a solution of a chlorine-containing preparation at the rate
of 50-100 mg of active chlorine per 1 liter of water. Chlorination lasts 30 minutes -
1 hour. For chlorination of containers with a smooth surface with a lack of water,
they resort to repeated (3-4 times) wiping of the container with a rag soaked in a
3-5% solution of a chlorine-containing preparation or in a 2-3% solution of DTS
HA. After 10-15 minutes, the container is rinsed with a small amount of water
containing 1-2 mg / l of chlorine. Disinfection of reservoirs in the field is carried out
in the summer every 2-3 days, in the winter - after 3-5 days. In case of accidental
contamination, the tanks are disinfected immediately.
Individual flasks are disinfected by boiling or chlorination by adding 4 ml of
a 1% solution of DTS HA or another drug to a flask filled with water, exposure -
30 minutes. After disinfection, the flask should be rinsed with clean water.
Table 4.7

Means for transporting drinking water

ATsPT- CV-1,2 -
Characteristic 5* ATsPT- AVC -1.7 PCPT - TSPT- CV-4 ATsPT- ATsPT-

(TsV-50M)

4.1 * 1,2 0.4 * 4.7 * 8.2 *

Base (chassis) ZIL-130 ZIL-130 GAZ-66 IAPZ-7 IAPZ- - - URAL- URAL-

738 4320-31 4320-30

Capacity, l 5000 4100 1700 1200 1200 350 350 4700 8200
 Weight, kg:

without water 5525 5200 4100 860 950 100 80 8230 10660

with water 10525 9300 5800 2060 2150 450 430 12930 18610
Overall
dimensions
dimensions,
mm:
length 6300 6703 5650 3950 3940 1140 1070 8570 9280
width 2500 2450 2340 2100 2070 750 600 2500 2500
height 2850 2700 2440 1700 1670 910 870 2730 2730
Filling time 43-50 36-50 20-30 25-30 25-30 7-10 7-10 20-30 20-40
with own
pump, min

Table 4.8
Rubber-fabric containers for storing drinking water

Characteristic RDV-5000 RDV-1500 RDV-100 RDV-12

Capacity, l 5000 1500 100 12

Weight in a case, kg 60 40 4.5 2

Tank sizes,
filled with water, cm

base diameter 300 - 64 48

 length - 220 - 30
width - 185 - -
height 108 79 70 11

Time to deploy
or folding
tank, min:
1 person - - 2 2
2 people 6 5 - -

4.5. Field water treatment

Drinking water purification is such a treatment that restores or gives water
the necessary hygienic properties. Depending on the task, the following types of
cleaning are distinguished:
clarification (discoloration, deodorization), disinfection, neutralization,
decontamination and desalination.
For each type of water purification, several treatment methods (or methods of
improving water quality) are used. Each of them is based on one or another
method - chemical, physical or mechanical.
At large POs, disinfection is carried out by engineering troops, at
company, battalion and regimental POs - by personalthe composition of the
subdivision (unit) using service or improvised means. To disinfect water in the
field, boiling, chlorination, coagulation, settling, filtration, UV irradiation and
treatment with special tablets are used. Monitoring compliance with the rules for
water disinfection and the supply of tablets is entrusted to the medical service.
Boiling is a reliable method of disinfection. In the absence of suspicion of
infection with bacterial agents, the duration of boiling, counting from the moment of
boiling, is limited to 10 minutes, with suspicion of BS infection - 1 hour. Water is
usually boiled at food points. The list of relevant technical means is given
Table 4.9. Boiled water must be stored in a clean, well-closing container,
since when microbes enter it, it is rapidly and massively seeding. Boiled water is not
stored for more than a day.
The high fuel consumption and the duration of the boiling process limit the use
of this method. Most often, it is used to disinfect small (group or individual) water
supplies.
Chlorination of water in the field is carried out by the introduction of
chlorine-containing ones permitted for these purposes (neutral calcium hypochlorite
(NGC) (70% of active chlorine), two-tetrabasic calcium hypochlorite salt (DTS
HA) (up to 55% of active chlorine), etc.
method: chlorination with normal doses of chlorine and overchlorination - the
use of large doses. The latter method is preferred.
Table
4.9.
The main technical means of the food service, used to boil water
Product name Number of boilers Total capacity
boilers, l

Camping kitchens: 2 200

KP-2-48 2 280
KP-2-49 4 296
KP-125 3 300
Field auto kitchen PAK-
1 110
170
Portable bulk
boiler PNK-2

Chlorination with normal doses is carried out according to the same rules as in
stationary conditions, that is, with the determination of the chlorine demand of
water, the calculation of the required amount of the drug and subsequent control of
the effectiveness of disinfection with respect to residual chlorine. Chlorine is
introduced in such an amount that after the oxidation of organic and inorganic
substances dissolved and suspended in water and the death of microorganisms, an
excess of active chlorine (residual chlorine) in the amount of 0.3-0.5 mg / l remains
in the water. The more polluted the water, the more active chlorine is required and
the higher its chlorine demand. Correct determination of chlorine demand is
necessary in order not to introduce an excessive amount of chlorine, which spoils
the taste of water and gives it an unpleasant odor. To determine the chlorine
demand, an experimental chlorination of water is carried out in three containers of a
known volume (glasses, cans, pots, buckets). With no time conditions for
determining the chlorine demand of water empirically, the amount of bleach
required for disinfection can be calculated using the data in Table 4.10.
Usable chlorinated water should have a slight chlorine flavor. In the absence of
such an aftertaste, chlorination is repeated.
If the water after chlorination has a pungent smell and a strong taste of
chlorine, it is filtered through a layer of active (30 cm) or crushed charcoal (50 cm).
Table 4.10.

The amount of chlorine required for disinfection

water from various sources

The nature of the source, the quality of the

water Required for water disinfection
gram per 1 cbm or milligram per
1 liter of water (active chlorine)
Artesian waters, pure waters
mountain river, clarified water
large rivers and lakes. 1-1.5
Transparent well and
filtered water of small rivers. 1.5-2
Water from large rivers and lakes. 2-3
Turbid well water and water from
ponds, irrigation 3-5
 ditches
Heavily polluted bog water ,
ponds, irrigation ditches, rain pits, etc. 5-10 and more

In the field, chlorination with normal doses is allowed only for water with
good sanitary characteristics.
More reliable way is overchlorination when water are treated with large doses
of active chlorine, obviously exceedingchloropb water demand. Usually doses of
chlorine are used in the range of 10-30mg / l, and in some cases - 50-100 mg / l.
Superchlorination of water versus normal chlorinationdoses has a number of
advantages: it is not necessary to determine the chlorine demand of water;
the time of neutralization is reduced to 15-20 minutes in summer and to 30
minutes - 1 hour in winter; turbid waters with high chromaticity are reliably
disinfected; odors and tastes unusual for good-quality water are eliminated
better. The process of water re-chlorination consists of the following stages:
determination of the percentage of active chlorine in the apparatus; calculating the
amount of the drug required to disinfect the entire volumetaken water, and bringing
it into the water tank; determination of residual chlorine after the time required for
contact of water with chlorine; calculating the amount of sodium hyposulfite
required for dechlorination of water.
In the absence of conditions for the superchlorination of water in the
described way, the calculated data given in Table 4.11 can be used.
Table
4.11.

The amount of bleach and hyposulfite used foroverchlorination of water

Required dose for 10 buckets of water

Character source, preparation (with
water quality content of active sodium hyposulfite
 chlorine at least 20%)
Water ground 3 g (one tea spoonful 1.4 g (corresponding
wells; transparent the
o corresponding measure)
o
meas
colorless river water and ure
lakes
6 g (two tea spoons 2.8 g (corresponding
Muddy noticeably the
o corresponding measure)
o
meas
colored river water and ure

lakes

Note: 3 g of the drug or sodium hyposulfite are contained in 1 teaspoon.

A measured sample of the drug is dissolved in a small amount of water (mug,
jar, pot), poured into water, stirred for 3 minutes and after the time required for
contact has elapsed, the smell of chlorine is determined. A strong smell of chlorine
indicates that the dose is sufficient. If there is no smell, add another drug in an
amount equal to 1/4 - 1/3 of the original.
Disadvantages of decontamination by overchlorination: the need to
determine the active chlorine in the preparation; increased reagent consumption;
the need to dechlorinate water and observe precautions when working with
concentrated solutions of chlorine-containing preparations.

Disinfection of water by standard reagent methods (chlorination and

perchlorination) is carried out with the help of standard or non-cable means of
improving water quality. In this case, the water is first subjected to chlorination,
coagulation and settling, and then, after the required time has elapsed, it is
filtered. To simplify the water treatment process and increase the reliability of
disinfection, it is recommended to use the following combined method: regardless
of the quality of the water, take 100 mg of aluminum sulfate and the amount of a
chlorine-containing preparation equivalent to 50 mg of bleach (20%) for each liter
of treated water. Exposure: in summer - 30 min, in winter - 1 '/ 2 h. In cases where
the possibility of water contamination by regular enemy troops or saboteurs is
excluded, as well as in the absence of service or improvised containers, water can
be disinfected directly in the well. To do this, first clean the well and the
surrounding area, then pour a 3% solution of a chlorine-containing preparation into
the well and thoroughly mix the water. After 2 hours, the water is pumped out, the
bottom of the well is poured with a chlorine-containing solution and mixed with
sludge, which is then discarded. The inner surface of the log house is irrigated with
the same disinfectant solution and, after waiting for the well to be filled, it is
disinfected again. After 5-8 hours, the water is pumped out until the chlorine odor
disappears. It is irrational to disinfect the well without eliminating the nearby source
of pollution (cesspool, garbage can).
After the disinfection of the well is completed, the water is
chlorinated. Chlorination is carried out once a day 4-6 hours before the start of the
water intake, and with intensive water intake - 2-3 times a day.
conditions of exposure to low temperatures bactericidal effectchlorine slows
down, so the contact time of water with chlorine is increased to 2 hours, and when
disinfected with neoaquasept tablets - up to 1.5 hours. Higher doses of active
chlorine are also required. So, at a water temperature of 4-6 ° C, the effective dose
of active chlorine should be approximately 2 times higher than at 15-18 ° C.
The effectiveness of water disinfection by chlorination in peacetime is
controlled in accordance with the requirements of SanPiN bacteriologically
- determination of the coli-index and the total microbial number,
chemically - determination of residual chlorine. The coli-index for barracks
placement should be more than 3, in the field, during exercises and maneuvers - no
more than 10, and the amount of residual chlorine should be 0.3-0.5 mg / l, and
when using the starch iodine method for its determination - 0 , 8 -1.2 mg / l. In
wartime, systematic bacteriological control over the disinfection of water in a
military unit is impossible. Therefore, the chlorination efficiency of water is
monitored by determining the residual chlorine after a specified contact time.
For the disinfection of individual water reserves in the field, engineering
services are used - an individual water treatment device IVU and medical tablets
"Aquasept", "Neoaquasept", "Aquasan".
IWU is intended for purification of fresh water from natural, anthropogenic
and technogenic pollution, oil products and surfactants, salts of heavy metals,
radionuclides, bacteria and viruses in the field. It is a filter flask and is placed on a
waist belt, consists of a body with a neck and a dirt-proof cap, a body cover, a
replaceable filter element, a container for storing purified water, a preparation for
coagulation and disinfection, a cover. Productivity 10 l / h, deployment time 0.5
min, coagulation and disinfection time - 15 min, resourcefilter element - up to 150 l
(with an underground water source of 500 l), weight - 0.7 kg, overall dimensions in
mm - length 140, width 80, height 280.
"Aquasept" tablets are a mixture of dichloroisocyanuric acid monosodium salt
with various technological additives. The tablet dissolves within 10-15
minutes. and releases 4 mg of active chlorine, providing disinfection of 700-800 ml
of water, provided that it is in contact with the drug for 30 minutes. The disinfecting
effect of "Aquasept" is reduced when treating water with increased turbidity and
color. In addition, the drug is not effective enough against certain viruses.
Tablets "Neoaquasept" - a mixture of monosodium salt of dichloroisocyanuric
acid (38%), adipic acid (22%),sodium bicarbonate (39.5%) and calcium stearate
(0.5%). The active chlorine content reaches 10-12%. They have good solubility in
°
water (2 minutes at a temperature of 20 C), have sufficient antimicrobial activity
and are intended for disinfection of relatively pure water low color and
turbidity. The drug also has a long-term effect and can be used for conservation
(up to 2 days).
"Aquasan" tablets - contain dichloroisocyanuric acid salt , coagulant and
other components. Due to the use of a flocculant in the "Aquasan" tablet, the color
and turbidity of the water decreases, there is a partial purification of oil products, a
number of heavy metals. Possessing good flocculating properties, this product
provides flocculation without regulating the pH of the treated water. Water
purification and clarification is achieved within 10-15 minutes regardless of
temperature. In the warm season, it disinfects water in 20 minutes, in the cold
season - in 60 minutes.
In the absence of the above means for disinfecting small amounts of water,
iodine, hydrogen peroxide, potassium permanganate can be used. At an iodine
concentration of 6-8 mg / l, it is possible within 2 minutesget quite good-quality
water. It is advisable to use hydrogen peroxide in the form of a ready-made
solution containing about 3% perhydrol. The bactericidal effect is manifested at a
concentration of 3 mg / l and an exposure of 30 minutes. Potassium permanganate
has a less pronounced bactericidal effect, but significantly improves the
organoleptic properties of water. For disinfection, use a 1% solution. The effect is
observed at concentrations of 7-10 mg / l and exposure for at least 30 minutes.
Preservation and desalination of water. Chlorination is used to preserve
water. Active chlorine is introduced at the rate of 1 mg / l for each day of
storage. This chlorination method causes a sharp deterioration in the organoleptic
qualities of canned water. It is more advisable to take sufficiently good-quality
water to create a reserve and subject it to chlorination only before dispensing.
In the field, water desalination can be carried out by freezing. The method is
based on the fact that fresh water freezes out when cooled to 0 ° C, and salty water
- at a lower temperature. Thus, at a temperature of 3-4 ° C and below, a crust of
fresh ice forms on the surface of the salt water. If the demand for desalinated water
exceeds 100-200 l / day, special shallow pools are arranged,called cards. Maps can
be dug in the ground or made from planks on the surface of the
ground. Demineralized water obtained in desalination plants, as well as from snow
or ice, is tasteless and lacks iodine, fluorine, copper, manganese, iron, cobalt and
some other trace elements necessary for the normal functioning of the
body. Therefore, with the systematic use of such water, it is necessary to introduce
mineral substances into it. To do this, add 0.2-0.3 g of slaked lime and 0.1 g of
sodium chloride per daily rate of drinking water. In the field, it is also
recommended to add sodium fluoride (1.8 mg / l), potassium iodide (0.1 mg / l)
and ascorbic acid to demineralized water.acid (50 mg / l).
Obtaining fresh water by any method should be carried out under conditions
that exclude its contamination with bacterial agents, poisonous and radioactive
substances. In all cases, the resulting water must be disinfected.
4.6. Water quality control
Water quality control is subdivided into technological, medical and
command. Technological control is organized by the commanders of subdivisions
(calculations) of field water supply and is carried out by laboratory technicians of
water purification and desalination facilities, laboratories of subdivisions during the
operation of field water supply points.
Medical control includes sampling from a water source, checking the sanitary
state of field water supply points, water points and water delivery and storage
facilities. Whencomplications sanitary and epidemiological setting,unsatisfactory or
questionable results of technological control at points of field water supply and
suspicion of water contamination with radioactive substances, organic substances
and infectious agents, an expert (unscheduled) assessment of water quality is
carried out.
Water quality control carried out by commanders (chiefs) includes:
in a link from an individual soldier to a unit (platoon, company)
- control over the disinfection (cleaning) of flasks, the correct use of individual
water purification products, the prevention of the use of water from unverified
sources and the observance of the rules of personal hygiene;
at the battalion (division) level - periodic monitoring of the condition of the
battalion field water supply points (water points),means of storage and delivery of
water, their timely disinfection.
At military water treatment plants, water quality is monitored at the stage of
reagent treatment and after final treatment.
In the case of the enemy's use of weapons of mass destruction, as well as in
the elimination of the consequences of accidents (destruction) on potential
hazardous facilities, in the source and purified water, the presence of radioactive
and toxic substances is monitored using laboratories such as PLVS PKhL -54,
located in the sets of water treatment and desalination plants.
Microbiological indicators of water quality (BS content) at water treatment
plants are not controlled by calculation. Indirect indicators guaranteeing water
disinfection is strictcompliance with water treatment regimes. If necessary, the
microbiological parameters of the treated water are monitored by the medical
service. Samples for microbiological analysis are taken into sterile glass (obtained in
a microbiological laboratory) dishes,closed with ground glass stoppers. The
container is opened immediately prior to sampling. During sampling, the dishes
should not touch non-sterile objects. The taken sample, together with the
accompanying sheet, is sent to the laboratory of the medical service. Samples must
be examined no later than 2 hours after collection.
Dosimetric control of radioactive contamination of water is carried out using
standard dose rate meters and other radiometric devices.
When equipping a field water supply point at a reactivated well, water samples
are sent to the laboratories of a field water supply unit (company) or a medical
service.
For field water supply points equipped in deep (25 m and more) wells, a single
study of water after pumping (flushing) is sufficient. In the future, control is carried
out over the observance of the rules for the operation of wells and the sealing of
water storage tanks. The containers are subject to periodic disinfection.
Responsibility for issuing a permit for the use of water from field water supply
points rests with the head of the field water supply point - the commander of the
field water supply unit (head of the water treatment plant). The delivery of water
from field water supply points and water points is carried out with the permission
of the commander of the unit (subunit), after a report from officials on the
compliance of the deployed points and the quality of the supplied water with the
established requirements.
Responsibility for the objectivity of the results of the study of the treated
water rests with the head of the laboratory (laboratory assistant), who is obliged to:
determine the water quality indicators necessary to maintain the required
purification regime, as well as water quality indicators,issued to consumers for
compliance with their requirements for purified water;
enter the results of the analyzes into the logbook of the work of the water
treatment plant;
keep water quality control devices in constant readiness for work;
monitor the sanitary condition of the field water supply point,a water treatment
plant, clean water tanks, a water distribution pump and its hoses;
control the level of contamination of the station and work site, reporting to the
head of the field water supply point on the need for disinfection, degassing and
decontamination of funds and property;
- check the availability of a passport of the sanitary condition of consumers'
containers, by external inspection, check its cleanliness and tightness of the hatches
and only then allow water to be dispensed;
control the content of active chlorine in purified water;
if necessary, take and prepare samples of purified water for analysis in the
laboratory of the medical service.

Accounting documents for water quality control at the field water supply point
are the logs of the operation of the water treatment plant, water delivery from the
field water supply point.
At the water points, a log of the work of the water point is kept.
4.7. Hygienic features of water supply to a military unit in a combat
situation and in conditions of the use of weapons of mass destruction
The water supply of the advancing troops is carried out by using the
transportable and portable water supplies for the supply of water from the rear POs
and the deployment of new points.
During the preparation period for an offensive operation in the concentration
area, personnel are provided with water from previously deployed water supply
points and water supply from rear PWs. At the same time, a transportable supply is
created, for which all special and adapted containers are filled with water. Drinking
water supplies are also created at the water supply points in the concentration
area. The medical service monitors the quality of the water used, monitors the
preparation of containers and directs the work on its disinfection.
During the development of the offensive operation, they organize sanitary
epidemiological reconnaissance of water sources in the territory left by the
enemy. In a motorized rifle regiment and a military unit equal to it, an engineer
reconnaissance patrol is allocated for reconnaissance on water with the
participation of a representative of the medical service.
In defensive conditions, the impact of enemy fire weapons almost excludes
the possibility of organizing the supply of water to military units from large
POs. During World War II 1941-1945biennium The water supply to units and
subunits conducting defensive battles was carried out mainly from PV deployed on
mine wells.
For the defense, troops are provided with water from a water supply station
located directly at the location of subunits or near them.
Units operating in isolation from the main forces are usually supplied with
water using RDV-12 thermoses or other containers.
The conditions of defense in the settlement require a particularly thorough
examination of the city water supply system and its protection. The most important
resistance nodes must have an autonomous source of water supply and a sufficient
supply of disinfected water. The garrison of the resistance knot must know the
rules for preserving drinking water.

The issues of organizing water supply in conditions of the use of weapons of

mass destruction by the enemy are planned with the participation of the command
and all interested services - food, engineering, chemical and medical. Water supply
for troops in the context of the use of weapons of mass destruction consists of
preparatory and special measures.
Preparatory measures are carried out before the enemy uses weapons of mass
destruction or before overcoming the infected area. These activities include training
personnel in the rules of action in the conditions of the use of weapons of mass
destruction, checking the protection against weapons of mass destruction of water
sources and the corresponding material and technical means intended for the
transportation and storage of water supplies. The main task of thesemeasures -
protection of water sources and reserves from contamination of organic matter,
radioactive substances or BS.
Special events are carried out after the use of weapons of mass
destruction. They include the indication and examination of water for organic
matter, radioactive substances and BS, as well as its special treatment -
disinfection, decontamination and neutralization.
On the march, all personnel must be provided with flasks filled with clean
water. The subdivisions must also have a transportable supply of water in a tightly
closed container - barrels, cisterns. To protect against RV, OV or BS, flasks are
wrapped in thick paper (or rags) and worn under protective clothing. Large
containers are protected from contamination by covering it with tarpaulins,
raincoats and various improvised means.
If you are in a contaminated area for a short time, you must refrain from
drinking. Water can be drunk only after overcoming the contaminated site and
carrying out partial sanitization - washing hands, rinsing the mouth and
decontamination, neutralization or disinfection of the flask.
In case of contamination of drinking water by means of mass destruction, its
use is prohibited and, if necessary, special treatment is carried out. For this,
TUF-200 and MAFS can be used in the regiment.
If there is a suspicion of contamination of BS water, disinfection is carried out
according to a special regime. Decontamination and disinfection of water in a
military unit is carried out only when it is impossible to obtain potable water in
another way. In this case, the personnel of the unit, under the guidance of a
specialist in the engineering troops, organizes the necessary water treatment at the
PVS using service equipment.
Decontamination of water using TUF-200 includes coagulation, chlorination,
settling and filtration through a special charge. Atwater treatment according to the
usual scheme (release from suspended particles and bacteria) during coagulation,
sedimentation and filtration can retain up to 50-80% of radioactive substances.
For neutralization (degassing) at TUF-200, it is more expedient to use water
overchlorination. In some cases, the water can be degassed by boiling. It should be
noted that the neutralization of water from toxic substances is a very complex
process. Even with the participation of specialists and the use of the necessary
technical means, it does not always give a positive result.
When neutralizing and decontaminating water, the TUF-200 deployment
scheme does not change, but instead of a fabric bag and active carbon, special coal
(KFG-M) is loaded into the filter housing. A chlorine-containing preparation and a
coagulant are introduced into sedimentation tanks filled with water. After settling for
30 minutes, the water is pumped to the filter, passing through which it is
dechlorinated and deactivated.
Drinking water after disinfection (disinfection), decontamination (degassing)
and decontamination can be used only with the permission of the medical
service. The permissible levels of radioactive contamination of water are given in
table. 4.12.
Table
4.12.
Dose rate, mR / h, corresponding to water pollution by products
nuclear explosions (UNE) in quantities that do not lead to
radiationdefeat

Measurable
volume Consumption terms, days

one Up to 30 Over 30
 Bowler hat 14 3 1.4
Bucket 40 8 4

The personnel involved in the performance of water supply tasks must strictly
observe the rules of personal and public hygiene and are allowed to work with the
permission of the medical service. When working on disinfection, neutralization and
decontamination of water, he must wear protective clothing.
The spent filter batch and other contaminated materials are collected in special
wells or buried in the ground at a distance of at least 50 m from the PVS. At the
same time, the necessary measures are taken to prevent contamination of the
environment: if possible, the specified waste is neutralized; the construction of wells
and their placement should exclude the possibility of ground and flood waters
getting into them; such wells should be clearly marked on the ground with warning
signs.
Control questions
1.Officials of the military unit responsible for providing the personnel with
good-quality water, their duties.
2.Features and organization of water supply in the field.
3.The value of indirect sanitary and microbiological indicators of drinking
water quality.
4.Exploration for water, performers and their tasks. Scheme of hygienic
assessment of water supply sources.
5.Sanitary and Epidemiological Requirements for the Water Supply Point and
the Water Dispensing Point.
6.Features of water supply for troops in the offensive and defense.
7.Military means of water supply, their characteristics.
8.Water disinfection methods, their hygienic assessment and disadvantages.
9.Preservation and desalination of water.
10.Peculiarities of water supply to troops in conditions of the use of weapons of
mass destruction by the enemy.
Test questions on the topic
1. Selection of water from the source for further laboratory research consists
of two layers:
a) superficial;
b) medium;
v) traps.
2. Control over observance of rules of water purification and disinfection in
field conditions is carried out by the following service:
a) food;
b) medical;
c) engineering.
3. Field water supply points are equipped for:
a) companies;
b) battalion;
c) shelf;
g) divisions.
4. The main indicators of reliability of field water disinfection:
a) the amount of residual chlorine in the amount of 0.8-1.2 mg / l;
b) microbiological indicators.
5. Hyperchlorination of water in the field is carried out taking into account the
amount of active chlorine in the drugs used:
a) true;
b) incorrect.
6. Maximum permissible values ​f or the smell and taste of field water (in
points):
a) 1;
b) 2;
v) 3;
g) 4.
7. The maximum amount of active chlorine in the drug:
a) bleaching;
b) chloramine;
v) DTS GK;
g) NGK.
8. When choosing a source of water supply in the field, water is preferred:
a) grunt;
b) artesian;
v) river;
g) lake.
9. Which service provides servicemen with individual means of water
disinfection:
a) food;
b) RChBZ;
c) medical.
10. Permissible time of storage of boiled water in the field (in hours):
a) 8;
b) 12;
c) in 20 years;
g) 24;
d) 30.
11. When treating water contaminated with TUF-200, it is possible to
simultaneously add a drug containing coagulant and chlorine:
a) true;
b) incorrect.
12. Physical inactivity refers to a number of factors as a condition for military
personnel to live in shelters:
a) chemical;
b) physical;
v) biological
13. The norm of chloride (MG / L) in drinking water during the war.
a) 350
b) 400
c) 530
d) 640
14. Service involved in water supply of troops in the field.
a) medical, rchbz
b) logistics service
c) veterinary, reserve
d) transport
15. The rate of water consumption in the field depends on:
a) water supply system
b) availability of hot water
c) climate zone
d) combat situation features

CHAPTER 5. HYGIENE OF MILITARY LABOR

 5.1. Hygiene of military labor and its place among other sciences
Hygiene of military labor is a section of military hygiene and the most
important branch of military medicine. The legitimacy of the existence of this
discipline is determined by the fact that the nature and content of military service,
even in peacetime, differ significantly from the daily life and labor activity of the
civilian population by a combination of a number of significant specific features.
The work of military personnel is not only their professional activity in their
specialty, but also physical, fire, public and state and drill training, duty, outfits,
freelance duties, chores, participation in the elimination of accidents and disasters,
field exercises, hostilities, etc. .P. It is often devoid of strict regulation of the
magnitude and duration of physical, intellectual and emotional stress, is
characterized by violations of the stereotype of the body's functional activity in time
and its inconsistency with biological rhythms (duty, alarm, teaching).
Compared to other professional groups of the population, military personnel
are much more likely to be exposed to unfavorable natural and climatic
environmental factors and factors that the human body has not encountered during
evolution and to which defense reactions have not developed and adaptation
mechanisms have been formed (weightlessness, aerobatic and shock overload ,
changing the barometricpressure, electromagnetic radiation, ionizing radiation,
highly toxic and corrosive liquids, super strong impulse noise, shock and ballistic
waves, etc.).
Military service is often associated with a change in climatic and geographical
regions, living conditions and everyday life, it is distinguished by a certain isolation
from the usual outside world.
The social side of military service is also specific, since servicemen practically
cannot change the place and conditions of their activities, change their
environment, life, work and rest regime, diet, etc., are limited in many freedoms and
rights. The personal time of servicemen, strictly speaking, is difficult to attribute to
rest, since it is often spent on putting oneself, uniforms, equipment in proper
order. etc. At any time of the day, they can be raised by alarm, involved in
measures to combat natural disasters, unexpectedly summoned to the authorities,
assigned to duty.
Taking into account the listed specific features of military service, a different
meaning is put into the concept of "labor" for the civilian population and military
personnel. Civilian labor is understood as activity in a certain position (in a
specialty) at a permanent place during normalized working hours. The work of
military personnel, in addition to fulfilling official duties in their specialty, includes
other types of activities due to official necessity, the implementation of which
occurs often in isolation from the permanent place of deployment of a military unit
and irregular in time.
Therefore, the essence of the work of military personnel is more adequately
reflected by the definition of "military-professional activity of military
personnel" , which should be understood as the performance by military personnel
of their official(in the specialty) and other duties and work due to the need for
service.

Thus, the hygiene of military labor is a section of military hygiene, which

studies the factors of military professional activity and their influence on the health
and performance of military personnel; hygiene standards and requirements are
established, hygienic, administrative, technical and other measures are developed to
preserve and strengthen the health of servicemen, to prevent occupational diseases
and injuries, and, ultimately, toincreasing the combat effectiveness of troops.
In addition to human labor hygiene, other sciences are also studied in the
process of his professional activity, such as: labor physiology, sanitary toxicology,
ergonomics.
Physiology of labor , as a section of general human physiology, studies the
regularities of the functioning of the physiological systems of the body of a working
person under the influence of working conditions, mechanisms andpatterns of
fatigue and recovery of working capacity, fitness and adaptation, as well as
functional reserves of the human body; establishes criteria for evaluating
physiological functions and standards for the functional state of the body and its
systems in the process of labor.
The main practical task (goal) of labor physiology is the physiological
substantiation of the scientific organization of labor to maintain a high level of
human performance in the process of labor activity.
to a certain extent, the physiology of labor is the theoretical basis of labor
hygiene, since the hygienic standards of the factors of the labor process
the working environment is developed on the basis of physiological
standards.
Sanitary toxicology , which is a section of general toxicology,
studies the mechanisms of action on the body of chemicals used or formed in
the production process, the parameters of their toxicity, the individual sensitivity of
the body, thereby preparing a laboratory-experimental basis for hygienists to
establish the maximum permissible concentrations of exposure to these
substances. In addition, she develops methods for the determination of chemicals
and products of their transformation in biological media of the body, gives
recommendations on the provision of first aid and treatment of those affected by
toxic substances, provides experimental and theoretical data for the organization
and implementation of sanitary and anti-epidemic (preventive) measures.
Ergonomics is one of the areas in the study of labor, claiming to be a
complex interdisciplinary field of knowledge. The term "ergonomics " translated
from Greek means "ergon" - work, "nomos" - law. This is an applied science that
studies a person in the labor process with the aim of rationalizing labor processes,
adapting labor tools (machines) and the working environment to anatomical,
physiological and psychological characteristics (characteristics) of a person,
i.e. creating conditions that, while making work highly productive and reliable, at the
same time provide a person with the necessary amenities and preserve his strength,
health and efficiency.
Ergonomics has objects of study in common with occupational health: a
person environment (mainly machine). However, they differ in the purpose and
subject of research.
The aim of ergonomics is to increase labor productivity , creation of highly
effective systems "man - machine" based on the rational use of the capabilities of
man and technology, while the goal of occupational health is to preserve and
strengthen human health and prevent premature wear of his body. And although the
means to achieve the goal in both cases is the optimization ("humanization") of the
labor process and the external conditions in which it takes place, ergonomics has
no criteria and methods for assessing the health of a working person, and it does
not assess the possible damage to his health. In accordance with different target
settings, these sciences also have a different subject of their research: occupational
health studies human health and its change under the influence of labor, and
ergonomics - the efficiency, productivity of his labor.
The problem of habitability is a complex scientific area that combines the
goals of hygiene and ergonomics . This problem arose in the 20s of the last century
and has been developing especially intensively in recent years due to the need to
substantiate and hygienic regulation of a complex of conditions in inhabited partially
or completely isolated fromatmosphere spaces of modern samples of mobile
equipment and engineering structures (submarines and surface ships, armored
vehicles, aircraft, fortifications, etc.).
Habitability is understood as the living conditions, everyday life and
activities of personnel created during the development (modernization) and
production of a military-technical facility, necessary to preserve human health and
performance, effective operation and combat use of modern military-technical
complexes in specified modes and different climatic zones (areas).
The main directions in which the problem of habitability is being developed
are the study of the nature and parameters of the impact on a person of unfavorable
labor factors in objects of weapons and military equipment (OVVT); regulation of
habitability factors and permissible shifts in the functional state of people in the
process of servicing OVHT; development of methods and criteria for professional
psychological selection and training of personnel in order to ensure the rational
distribution of military contingents and preparation for the successful fulfillment of
functional duties according to their official designation in any conditions.
The goal of solving the habitability problem is to increase the combat
effectiveness of modern weapons systems and complexes by preserving the health
and functional state of the body of the servicemen in them.
the development of the problem of habitability is attended by
representatives of many sciences and specialties - hygienists, physiologists,
toxicologists,mathematicians, biologists, engineers of various training profiles,
psychologists, specialists in organization and management, etc.
5.2. Working conditions (factors) and their hygienic classification
Under the conditions of work to understand the totality of the characteristics
of labor (the labor process) and environmental (production, working) environment
in which to carry out labor activity of the person . These characteristicscan also be
called the factors of labor, through which labor manifests its effect on the health
and functional state of working people .
The labor process is characterized by its type, severity, tension, structure,
mode and nature of the person's connection with the tools of labor.
The type of work is determined by the nature of the load on the main
functional systems of the body. On this basis, labor is divided into predominantly
physical and predominantly mental.
Physical labor is a type of activity associated with significant energy costs,
providing the efforts of the musculoskeletal system and systems necessary for its
functioning. At the same time, the higher mental functions (attention, memory) and,
in general, the emotional and intellectual spheres do not experience significant
stress.
Physical activity is divided into dynamic and static. Dynamic loads are
associated with movement, movement of a person (walking, running), as well as
lifting weights. Static loads are caused by a person's long-term maintenance of a
working posture or holding a load. This division is very arbitrary, since any work
includes elements of dynamic and static loads.
Mental work is work associated with the reception and processing of information,
requiring the predominant tension of the sensory apparatus, attention, memory, as
well as the activation of thinking processes, the emotional sphere. It is subdivided
into operator, managerial, creative, teaching, student, etc.
Severity labor - characteristics of the labor process, reflecting the
predominant load on the musculoskeletal system and functional systems of the
body (cardiovascular, respiratory, etc.), ensuring its activity.
It is generally accepted to assess the severity of labor according to the
following indicators: physical dynamic load, the mass of the lifted and moved load,
the total number of stereotypical working movements, the value of the static
loads, working posture, degree of inclination of the body, movement in space,
etc.
Excessive physical activity, especially for a long time, initially causes fatigue,
and then leads to a decrease in health and the development of diseases. Insufficient
physical activity after a while also leads to the development of diseases (a person
degrades as a biomechanical system).
Labor intensity is a characteristic of the labor process, reflecting the load
mainly on the central nervous system, sensory organs, and the emotional sphere of
the employee.
The factors that characterize the intensity of labor include: intellectual,
sensory, emotional stress, the degree of monotony of the work performed and its
mode. Specific indicators of labor intensity are the novelty, complexity and scale of
the tasks being solved; the measure of responsibility for the decision taken; the
amount of time allotted forcompleting of the work; the amount of information
received or processed per unit of time or per working day; the number of decisions
made per unit of time or per working day; the presence of interference and their
intensity, etc.
Like the severity of labor, excessive labor intensity, or, conversely, its
insufficiency, ultimately lead to a decrease in human health indicators.
It should be borne in mind that in the functional state of a person in the
process of work, physical, mental and emotional components are distinguished,
between which there is a direct close relationship. The deterioration of one of the
components reduces the indicators of the functional state of a person as a whole,
as well as the productivity and quality of labor, and, on the contrary, the positive
characteristics of each have a favorable effect on other components and labor
results.
The structure of labor is characterized by the distribution of labor operations
inspace and time.
The work schedule is the alternation of periods of work and rest during a
certain period of time (working day, week, year).
It would be advisable to have such a duration of these periods and such their
alternation, in which the working person retains maximum performance with
minimal physical, mental and emotional costs.
There are 3 types of communication with the tool of labor : simple,
machine and system. When a simple communication tool of labor is
a direct continuation of the human limbs. From a hygienic point of view, this is the
most favorable type of connection. The entire labor process takes place under
direct control employee.
The emergence of machines, various mechanisms, communication becomes
machine, i.e. there is an intermediary between a person and an instrument of labor
(intermediate). Consequently, many actions of the employee are already
predetermined and complete control over the labor process is impossible. The
result of labor in this case is not always clearly visible.
The most complex type of communication is systemic, when a person is only
a separate link in a complex "machine-person" system, united by a common goal
and a single rhythm. A person most often performs any one operation, his work is
monotonous and monotonous, he himself almost completely in his actions depends
on this system, having the most vague idea of ​the final results of the work. A
typical example of such a connection is working on a conveyor belt.
The working environment is a combination of physical, chemical, biological
and socio-psychological factors in which the labor activity of a person (work
collective) is carried out.
Physical factors include:
temperature, humidity and air mobility, thermal radiation;
non-ionizing electromagnetic fields and emissions:
electrostatic and constant magnetic fields (including geomagnetic), electric and
magnetic fields of industrial frequency (60 Hz), electromagnetic radiation in the
radio frequency range, electromagnetic radiation in the optical range (including laser
and ultraviolet);
ionizing radiation;
acoustic noise, ultrasound, infrasound;
lighting (natural, artificial);
vibration (local, general);
atmospheric pressure, weightlessness, accelerations, impacts, etc
aerosols (dust), air ions.
A group of chemical factors includes: the natural composition of air and
impurities to it (powder gases, exhaust gases of internal combustion engines,
refrigerants, emissions from finishing and building materials,products of human
metabolism, etc.), substances used in a particular labor activity, as well as products
of production (fuels and lubricants, acids and alkalis, paints, reagents, antibiotics,
protein preparations, pesticides), etc.
The group of biological factors includes: plants, microorganisms, protozoa,
insects, rodents, their tissues and waste products.
Socio-psychological factors are: the relationship between team members,
including between the boss and subordinates, the presence of a threat to health and
life, well-organized life, etc.
The factors of the environment and the labor process, depending on the
severity of the adverse effect on the working person, are divided into harmful and
dangerous.
Harmful factor of labor - a factor whose impact on servicemen (workers)
under certain conditions (intensity, duration, etc.) can cause them an occupational
1
disease ,
1
Occupational disease is a disease in the occurrence of which the decisive
role belongs to the influence of unfavorable factors of the working environment and
the labor process (must be confirmed by the established procedure).
temporary or permanent decrease in working capacity, increase the frequency
of infectious and non-infectious diseases and negatively affect the health of their
offspring.
A hazardous factor of labor is a factor that can cause an acute illness or a
sudden sharp deterioration in the health of a serviceman (worker) and even his
death.
The conditions of military professional activity (working conditions),
depending on the level of environmental factors and the labor process, are divided
into 4 classes: optimal, permissible, harmful and dangerous.
Optimal working conditions (class 1) are those conditions under which the
health of working people is preserved and real prerequisites are created for
maintaining a high level of their performance. In these conditions, the factors of the
working environment and labor itself do not have a negative impact on the working
person.
Optimal standards of production factors are established for microclimatic
parameters and factors of the labor process. For other factors, conditionally, the
optimal conditions are those under which unfavorable factors in the workplace are
either absent or do not exceed the levels accepted as safe for the population.
Permissible working conditions (class 2) are conditions under which the
levels of harmful environmental factors and the labor process do not exceed the
established hygienic standards for workplaces, do not cause deviations in the health
status of workers, detected by modern research methods, both during work and in
the distant terms of their life, as well as in subsequent generations. Possible
changes in the functional state of the body are restored during the regulated rest (by
the beginning of the next working day, shift). Permissible working conditions are
classified as conditionally safe.
Harmful working conditions (class 3) are characterized by the presence of
harmful production factors exceeding hygienicstandards and having an adverse
effect on the body of workers (or) their offspring. Depending on the magnitude of
the deviation of production factors from hygienic standards and the severity of
violations in the body of working people, they are divided into 4 degrees:
1st degree (class 3.1.) - the deviation of the levels of harmful factors from
hygienic standards is such that the changes caused by them in the functional state
of workers are not restored by the beginning of the next working day (shift), and
2
occupational health risk workers is increasing.
2nd degree (class 3.2.) - harmful factors reach values ​at which they cause
persistent changes in the functional state of workers, lead to an increase in
3
production-related morbidity temporary disability and the appearance of light
(without loss of professional ability to work) forms of occupational diseases arising
after 15 or more years.
3rd degree (class 3.3) - the level of harmful factors is such that their impact,
along with an increase in production-related pathology temporary disability, leads
to the development of mild and moderate occupational diseases in working people
(with the loss of occupational ability to work) during the period of employment).
4th degree (class 3.4.) - working conditions under which severe forms of
occupational diseases occur (with loss of general working capacity),
celebrated significant growth the number of chronic diseases, as well as high level
of general morbidity with temporary disability.
Hazardous (extreme) working conditions (grade 4) are characterized by
the levels of production factors, the impact of which in the course of the working
2
Occupational health risk - the likelihood of impairment (decrease) in the
health of an employee as a result of exposure to harmful (dangerous) factors of
professional activity.
Occupationally-related morbidity - general morbidity (different in etiology
 not related to professional) among workers in contact with certain production
factors, which tends to increase with increasing length of service and exceeds that
in professional groups not exposed to these factors.
Change (or part of it) poses a threat to life, a high risk of developing acute
occupational injuries, including severe forms.
5.3. Hygienic characteristics of the main chemical and physical factors
of the working environment of military specialists 5.3.1. Chemical factors
Technological progress, accompanied by a significant increase in the
chemicalization of all branches of human activity, has led to an increase in the role
of the chemical factor in military affairs. Accordingly, the number of military
specialists who, in the performance of their duties, encounter certain abiotic
substances has increased. Most often they are exposed to toxic industrial fluids and
compounds that pollute the air in the workplace.
Poisonous technical liquids. The operation and maintenance of modern
military equipment and weapons requires the use of a wide range of technical fluids
and oils with additives - substances added in certain quantities to improve their
operational properties. Many of them are poisonous and even aggressive, which is
why they are collectively called poisonous technical fluids (YATL). Of these,
military personnel most often come into contact with fuels and lubricants, antiknock
agents and antifreezes.
Fuels and lubricants consist of substances that can have a toxic effect on
humans. According to the boiling point and composition, mainly in the distillation
of oil, light, with a low molecular weight, and heavy, with a relatively large molecular
weight, fuel are distinguished. Light fuel (gasoline, naphtha) is used for carburetor
engines, heavy fuel (kerosene, diesel oil, gas oil or their mixture - diesel fuel) - for
diesel engines. In terms of composition, fuels and lubricants (fuels and lubricants)
can only consist of hydrocarbonsfatty series or contain a certain part of aromatic
hydrocarbons.
In contact with the skin and mucous membranes, fuels and lubricants can
have a local effect, and if the vapors of these substances are inhaled or enter the
gastrointestinal tract, they can have a general effect on the human body.
Light fuel, especially gasolines with a high content of aromatic hydrocarbons,
upon local action causes changes in the surface layers of the skin - defatting,
irritation, cracking, and inflammatory diseases. With local action of heavy fuel of
lubricating oils, pathological changes appear in the deeper layers of the skin:
inflammatory diseases of the hair follicles and sebaceous glands (folliculitis, boils)
occur, acne is formed, and hyperkeratosis sometimes develops.
The ingress of fuel inside most often occurs with a gross violation of safety
measures - when it is sucked through a hose through the mouth to obtain a siphon
effect. This causes gastroenteritis, which is accompanied by damage to the central
nervous system, and in severe cases, paralysis may develop. By inhalation, fuels
and lubricants enter the body in the form of vapors.
The accumulation of vapors in the air of the working area is facilitated by the
high temperature, large evaporation area and insufficient air exchange in the
premises.
The severity of poisoning with fuel vapors depends mainly on their chemical
composition, content in the air and duration of action on humans. The most toxic
fuels are those containing many aromatic hydrocarbons. The severity of the lesion
also depends on the general condition of the body, individual sensitivity, the
amount of physical activity, air temperature and other factors.
The toxicity of fuels and lubricants vapors is relatively low, but their long-term
exposure can cause chronic poisoning of people, which is characterized by
headaches, drowsiness, itching, loss of appetite, decreased performance and other
nonspecificsymptoms.
MPC of vapors of gasoline, kerosene, naphtha and mineral oil in the air of the
3
working area - 300 mg / m .
Measures to prevent the harmful effects of fuels and lubricants on the human
body include: compliance with hygiene standards in the construction of parks,
workshops, garages and fuel depots; maintenance and storage of fuels and
lubricants tightly closed containers; mechanized filling of equipment in a closed
way; equipping premises for work with a high content of fuel vapors with artificial
ventilation of sufficient power; provision of personnel with overalls and their timely
change, adherence to the rules of personal hygiene.
Antiknock agents are added to motor fuel to reduce its ability to explode the
entire mass of the mixture at the same time (detonation),disrupting the normal
operation of the internal combustion engine, reducing the efficiency and
accelerating the wear of the latter.
The most widely used antiknock agent is tetraethyl lead (TPP), more
precisely, ethyl liquid containing 50-60% TPP and added to gasoline in an amount
of 1.5-4 mg / l.

Leaded gasoline is less toxic than TPP or ethyl liquid, however, if sanitary
rules are violated, it can cause both acute and chronic poisoning.
Acute poisoning is possible when TPP or ethyl liquid enters the body (when
swallowed by the mouth), through the respiratory tract and intact skin (when used
for washing hands and washing uniforms, as well as as a solvent in the repair and
maintenance of equipment).
Serious consequences can be when eating food contaminated during
transportation with ethyl liquid and when it is mistakenly ingested. TPP has
cumulative properties. At the moment of contact with EFT, irritation symptoms are
not observed. The clinical picture of acute
TPP poisoning develops after a latent period - from several hours to 3-5
days. In mild cases of acute poisoning, headache, dizziness, nausea, vomiting,
general weakness, a metallic taste in the mouth, restless sleep with nightmares, and
decreased performance appear. A triad of symptoms is characteristic: bradycardia,
a decrease in blood pressure, a decrease in body temperature. In severe cases,
poisoning is accompanied by severe psychomotor agitation, confusion, delusions
of persecution, visual and auditory hallucinations, mental disorder of a
manic-delirious nature. These disorders are accompanied by lesions of the kidneys,
liver and motor nerve palsy. At the height of nervous excitement, the body
 0
temperature rises to 39-40 C. Overexcitation is followed by depression of the
central nervous system, respiratory failure, weakening of cardiac activity and a drop
in vascular tone.
In chronic poisoning, psychosis does not develop. Severe asthenization
occurs, sleep is disturbed, in some cases, the above triad of symptoms is
observed. This is accompanied by dysfunctions of the autonomic nervous system -
hyperhidrosis, hypersalivation, acrocyanosis, tremor of the fingers. The content of
lead in urine more than 0.07 mg / l is an additional confirmation of TPP
intoxication.
In the prevention of poisoning at thermal power plants, the leading role
belongs to organizational measures. The personnel must strictly observe the
requirements of the instructions for handling YATZh. Leaded gasoline is prepared
only at specially equipped ethyl mixing stations, provided with sufficient ventilation,
and in the field - under a canopy, away from residential and work premises. The
personnel are allowed to work after preliminary instruction, provided, in addition to
uniforms and overalls, rubber suits, boots, gloves and filtering gas masks. Ethyl
liquid and leaded gasoline should be stored and transported tightly unopened
containers with clear warning labels. MPC TPP in the air of the working area -
3
0.005 mg / m .
Antifreezes are aqueous solutions of certain substances (glycols, glycerin,
etc.) that do not freeze at low temperatures and are used in engine cooling systems
0
at temperatures below 0 C. Antifreezes containing ethylene glycol are most often
used, depending on the brand, in an amount of 30 60% of the total. Ethylene glycol
is the main toxic agent in glycol-based antifreezes. Poisoning is possible only when
these YATF enter the body. Inhalation poisoning is unlikely, since the volatility of
ethylene glycol at normal temperatures is insufficient to create toxic concentrations
in the air. Mistaken ingestion of glycol-based YATZh due to the similarity of smell
and taste with ethyl alcohol is the most common cause of acute poisoning with a
fatal outcome.
The toxicity of antifreeze is due to the presence of denatured alcohol and
glycols. They have a narcotic and paralytic effect, affecting mainly the central
nervous system, liver and kidneys.
When taking 100 ml of antifreeze, moderate poisoning occurs, manifested first
by agitation, and then lethargy, drowsiness, vomiting weakening of
consciousness. Subsequently, from the 4-5th day, the phenomena either gradually
fade away and recovery occurs, or the temperature rises,symptoms of nephritis and
pyelonephritis appear with the development of anuria and uremic coma. In the
urine, atypical crystals of calcium oxalate (oxalates) are found.
A dose of 150-200 ml of antifreeze causes severe poisoning, characterized by
a rapid onset of unconsciousness with pronounced symptoms of CNS
damage. Mortality reaches 50%, the outcome often occurs in the first two
days. Taking 400 ml of antifreeze or more causes fatal poisoning, in which the
arousal phase may be absent, unconsciousness, coma and death quickly occur.
The main measure to prevent poisoning with antifreezes is to educate
personnel about the toxicity of ethylene glycol, the danger of accidentally
swallowing it or using it as a surrogate for alcohol, and thoroughly instructing
persons working with antifreeze about the rules for handling them, how to store and
refuel vehicles. To exclude the possibility of using antifreeze not for its intended
purpose, the container in which it is transported or stored is supplied with warning
inscriptions "poison", "you must not drink", etc., and the antifreeze itself is tinted,
or substances that give an extremely unpleasant taste are added to it and smell.
Substances that pollute the air. The chemical composition of the air is one
of the main characteristics of the working conditions of military personnel,
especially in sealed samples of weapons and military equipment. Its formation
depends on changes in the natural composition of the air and on the entry into the
atmosphere of various harmful impurities released during the operation of weapons,
mechanisms, systems, devices and materials.
The natural chemical composition of the air environment and the dynamics of
the concentration of toxic impurities are influenced by the design features of the
object and its technical means: the volume of the premises and their mutual
arrangement, the type of power plant, the type and number of standard weapons
and methods of its use, saturation with devices, mechanisms, synthetic materials,
temperature air, humidity, barometric pressure, life support efficiency. The number
and conditions of combat activity of personnel are also of great importance.
The substances most often polluting the air of inhabited HHVT compartments
include powder, exhaust and battery gases, emissions from building and finishing
materials, aerosols, anthropotoxins, etc.
Powder gases are a mixture of gaseous, vaporous andsolids formed at the
time of firing in the bore of the firearm. Their composition depends on the
composition of the propellants and the conditions for the decomposition of the
charge when fired (temperature, pressure at which the propellant burns, etc.). The
concentration of powder gases depends on the caliber and number of weapons, the
power of the charges, the rate of fire, the performance of the ventilation means, the
volume of the manned compartment, etc.
The tendency currently observed in most armies to increase the calibers of
artillery systems and their rate of fire creates a real danger of lethal concentrations
of powder gases in the air of pressurized combat vehicles and closed artillery
systems
The main components of powder gases that have a toxic effect are carbon
monoxide, nitrogen oxides, carbon dioxide. In a normal shot, the propellant gases
contain almost no nitrogen oxides and have the minimum amount of carbon
monoxide for a given propellant. In the case of combustion of gunpowder at low
(below 50 atmospheres) pressure, more carbon monoxide and a significant amount
of nitrogen oxides are formed. This takes place when the remnants of the charge in
the casings are burned out, when training ("blank") charges are fired, and at low
charging densities (incomplete charges). Poisoning with powder gases is possible
when a high concentration is reached in poorly ventilated structures (rooms) during
firing.
The clinical picture of powder gas poisoning is mainly caused by carbon
monoxide. In the case of a predominance of nitrogen oxides in the powder gases,
respiratory dysfunctions develop - from symptoms of irritation of the mucous
membranes to pulmonary edema.
The prevention of powder gas poisoning involves the use of special technical
means that ensure the rapid removal of gases from the working area or a decrease
in their concentration (the use of ejection devices to remove powder gases from
barrel bore, devices for ejecting sleeves after firing from the inhabited
compartments, the use of burning sleeves, etc.).
The maximum permissible concentration of powder gases is established for
carbon monoxide differentially, depending on the exposure and the conditions of
their action on people. For the first time, MPC for powder gases for objects of
armored vehicles were developed by Professor of the Department of General and
Military Hygiene of the Military Medical Academy N.F. Koshelev in 1951: 0.25 mg /
l - for a period not exceeding min, 0.5 mg / l - no more than 10 minutes, 0.6-0.7
mg / l - no more than 5-6 minutes, 1.5 mg / l(maximum concentration) - no more
than 5-6 s. The currently valid official documents provide for standards that do not
fundamentally differ from those listed above.
Exhaust gases (formerly called exhaust gases) are a complex mixture of
gaseous, vaporous substances and aerodispersions formed when fuel is burned in
internal combustion engines.
The reasons for the flow of exhaust gases into the inhabited compartments of
the OVHT are leaks in the engine partitions, the irrational position of the air intake
openings of the filtering units (FVU) when cars move in columns or in the direction
of the wind, "reverse" diesel engines, heater malfunctions, etc.
The composition of the exhaust gases fluctuates to a large extent and depends
on the type of engine, its operating mode and load, technical condition, type
fuel quality, driver qualifications and experience and other factors. The main
harmful products in the emissions of carburetor engines are carbon monoxide,
hydrocarbons and nitrogen oxides. When a TPP antiknock agent is added to the
fuel, inorganic lead compounds are found in the exhaust gases. Some components
of the exhaust gases are active allergens. In the exhaust gases of diesel engines, the
main harmful components are soot and nitrogen oxides.
The maximum amount of carbon monoxide is formed at idle and full load,
hydrocarbons - at idlecourse, and nitrogen oxides and aldehydes - under active
load modes. The toxicity of the exhaust gases of carburetor engines is higher
toxicity of exhaust gases of diesel engines, however, the latter have a strong irritant
effect on the mucous membranes of the respiratory tract and eyes, associated with
the presence in their composition of a significant amount of sulfur dioxide,
aldehydes and smoke particles. The clinical picture of exhaust gas poisoning
depends on their concentration, time of action and chemical composition. With
prolonged inhalation of air containing a small amount of exhaust gases from
carburetor engines (when working in workshops, on the march in a convoy of
moving vehicles at close distances, etc.), the symptoms of poisoning are similar to
those under the action of carbon monoxide - tinnitus, general weakness, headache
pain, dizziness, nausea, sometimes vomiting. The exhaust gases of a diesel engine
during its operation in a closed room cause a sharp irritation of the mucous
membranes within a few minutes - scratching, up to painful sensations in the
nasopharynx, larynx and behind the sternum, irritation of the mucous eyes with
profuse lacrimation, which makes it impossible to stay in these conditions for a
long time. When entering clean air, all these phenomena disappear rather quickly.
Reducing the air pollution of the working area with exhaust gases can be
achieved by improving engines, the quality of fuel and additives, creating
neutralizers, filters, timely repairing engines, adjusting the carburetor, sealing flange
joints and slots to prevent exhaust gases from entering the cabins of cars, providing
boxes and other rooms for equipment with sufficient supply and exhaust
ventilation, etc.
The MPC for exhaust gases is set for carbon monoxide. Since the action of
the exhaust gases, as a rule, is long-term, the MPC values ​are taken the same as for
3
industrial enterprises: 20 mg / m - during the action during the working day, 50 mg
3 3 3
/ m - within an hour, 100 mg / m – inwithin 30 minutes, 200 mg / m - within 15
minutes. Repetitive work at these concentrations is allowed with interruptions of at
least two hours.
Battery gases. Personnel engaged in charging and operating batteries are
exposed to battery gases.
When working with lead (acid) batteries accepted for supply, the main
components of gases are oxygen, hydrogen, sulfuric acid aerosol, sulfur dioxide
and antimony hydrogen. The smallest droplets of sulfuric acid are captured by
hydrogen bubbles released during electrolysis, and antimony hydrogen appears due
to the reduction of antimony added to lead plates to improve their operational
properties.
In battery gases, 33-47% is oxygen, 52-67% is hydrogen, but they do not have
a toxic effect. When storage batteries are stored for a long time in closed,
unventilated spaces, the hydrogen content in the air can rise to explosive levels
(4%).
3
An aerosol of sulfuric acid at concentrations of 3.5-5.0 mg / m has a
pronounced irritating and cauterizing effect. When inhaled, it causes sore throat,
runny nose, sneezing, coughing, burning eyes, lacrimation, and later - inflammatory
diseases of the upper respiratory tract and eyes, less often - diseases of the
gastrointestinal tract, liver and pancreas. Maximum concentration limit for sulfuric
3
acid and sulfuricanhydride in the air of working rooms is 1 mg / m , sulfur dioxide
3
- 10 mg / m .
The clinical picture of acute poisoning with antimony hydrogen develops after
a latent period lasting from 0.5 to 24 hours. The more severe the poisoning, the
shorter the latent period, and sometimes it can evenPoisoning is manifested by
malaise, nausea,salivation, muscle pain, eosinophilia is noted in the blood. MPC for
3
antimony hydrogen in the air of the working area is 0.3 mg / m .
Measures to prevent injuries from battery gases include compliance with
hygienic standards during the construction and equipment of battery ventilation,
including local, sufficient power, provision of personnel with special clothing,
compliance with safety and personal hygiene rules
Synthetic building and finishing materials. The amount of synthetic
materials in HVHT has been increasing extremely rapidly in recent years. Low
specific gravity, strength, hydro-, vibration-, thermal- and anticorrosive resistance
make it possible to use plastics and other types of synthetic products as structural,
heat-, sound- and electrical insulating, decorative-finishing and other materials. At
the same time, synthetic varnishes, paints and adhesives are of great
importance. Most materials are based on numerous high-molecular compounds:
polyurethanes, polyamides, polyacrylates; epoxy, phenol-formaldehyde and
polyester resins, etc.
The danger of these materials is due to the fact that the release of volatile
chemicals from synthetics begins immediately after their manufacture.
Continues constantly, increasing when exposed to high temperature,
mechanical factors and ionizing radiation.
Gaseous products of combustion (thermal destruction) of polymeric materials
in an emergency such as fire are extremely dangerous due to the formation of
highly toxic substances: hydrocyanic acid,phosgene, carbon monoxide, hydrogen
fluoride, aldehydes, etc.
Some gaseous substances emitted from plastics are sensitizing. The noted fact
should be taken into account when analyzing the occupational morbidity of military
specialists.
Aerosols. Until recently, insufficient attention was paid to aerosols in military
hygiene. However, impurities such as dust and smoke continually pollute the air of
mobile and stationary military installations. The greatest
lead dust in the form of lead compounds is important. Red lead can enter the
body through the respiratory tract and orally. Lead and its compounds affect the
nervous system, blood vessels and hematopoietic system, block sulfhydryl
groups. As a result of intoxication,asthenic-vegetative syndrome (sleep disturbance,
general weakness, dizziness, memory loss, bradycardia, tremor, etc.), hypertension
and lead colic. Lead is a highly toxic substance, its maximum permissible
3
concentration for the working area of ​industrial premises is 0.01 mg / m .
The smoke generated during the combustion of various fuels, natural
 synthetic materials, is capable of absorbing various active toxic chemical
compounds on soot particles. In particular, the smoke in the exhaust gases contains
carcinogenic substances of the type 3-4-benzopyrene, and the smoke of burning
powder or rocket fuels - hydrogen chloride and fluoride and a complex of
undeoxidized products.
Anthropotoxins are volatile human waste products. They accumulate in
significant quantities during a long stay of a person sealed or insufficiently
ventilated rooms. By their origin, they are divided into endogenous and secondary
waste products.
Endogenous products are formed in the body and are excreted with exhaled
air due to cutaneous respiration, with the excretion of sweat and sebaceous glands,
intestinal gases and in the form of a volatile phase of feces and urine.
Secondary products are formed outside the body as a result of the
decomposition of urine, feces and skin secretions. Sources of contamination in this
case are contaminated linen, waste and waste systems, contaminated surfaces.
Anthropotoxins contain over 400 chemical compounds and their release
increases under extreme conditions. The exhaled air contains nitrogen, oxygen,
carbon dioxide, inert gases; metabolic products excreted through the
lungs; substances formed in the oral cavity;
hydrocarbons, ketones, ammonia, acetaldehyde, fatty acids, ethanol and other
substances. Ammonia, amines, acetone, phenols, alcohols, organic acids,
acetaldehyde, isoprene and other compounds are excreted from urine. Feces -
hydrogen sulfide, mercaptans, ammonia, amines, indole, skatole, phenol, organic
acids, carbon monoxide. Intestinal gases include: carbon dioxide, nitrogen,
hydrogen, methane, hydrogen sulfide, mercaptans, acetaldehyde, etc. The methane
formed and released by the body can create significant concentrations during
prolonged sealing. From volatile substances in the composition of sweat, acetone,
acetic acid, ammonia, propionic and butyric acids, alcohols, formic acid and other
substances were found that determine the specific smell of sweat.
5.3.2. Physical factors
The increase in the technical equipment of military units and formations, the ever
wider use of various military equipment and weapons in the course of combat
training activities lead to a steady increase in the number and intensity of physical
factors generated by them, which have a negative effect on the health of service
personnel and persons in their sphere of action. ... These include noise, vibration,
microclimate, electromagnetic radiation, etc.
Noise. A significant number of personnel are exposed to this physical factor,
for whom this occupational hazard is systematic and long-term. In addition, in
military conditions, sources of such noise levels are widespread, which, even with a
single exposure, can cause irreversible changes in the auditory analyzer and even
acute acoustic trauma from a physical point of view, noise is a complex sound
phenomenon consisting of irregular, aperiodic oscillations of various amplitudes
and frequencies, randomly varying in time, therefore, unlike musical sounds, it does
not have the correct numerical connection betweenfluctuations of individual tones.
hygienic positions, noise, in the broad sense of the word, should be
considered any undesirable, not corresponding to the time, place,the needs of
people and thus interfering with work and rest sound. The physical characteristics
of noise that determine its effect onthe human body are the intensity and frequency
composition. The intensity (strength) of sound is characterized by the amount of
soundenergy passing per unit of time through a unit of area perpendicular to the
direction of propagation of the sound wave. The unit of sound intensity is a
2
measure of watts per square meter (W / m ).
In practice, the physical effect of noise on the organ of hearing is
often characterized not by the strength of sound, but by the sound pressure,
2
expressed in newtons per square meter (N / m ).
The minimum amount of sound energy that can cause a feeling of audible
sound, called n on p o r o m a l s and w s t m and about and is for tone 2000 Hz of
2 -5 2
10-12 W / m . For sound pressure, this value is 2 ∙ 10 N / m .
The upper limit of perception, corresponding to such values ​of sound
pressure that cause pain in the organ of hearing, is called the threshold of pain . It
 2 2 -2
corresponds to a sound power of 10 W / m or a sound pressure of 2 ∙ 10 N /
2
m .
The total sound energy emitted by a noise source into the surrounding area per
unit of time is called sound acoustic power and is expressed in watts (W).

The frequency composition of noise is characterized by its spectrum, that

is, by a set of frequencies included in it. Sound vibrations are perceived by the
human hearing organ if their frequency is in the range from 16-20 to
18,000-20,000 Hz. The ear is most sensitive to sounds with a vibration frequency
of 1000 to 4000 Hz. Its sensitivity is constantly decreasing with a change in the
frequency of the named interval, both in the direction of decreasing and in the
directionincrease.
Inaudible sounds below 16 Hz and above 20,000 Hz are called infra- and
ultrasounds, respectively. The boundaries of the frequency range of audible sounds
are not the same for different people and depend on age, work experience in
conditions of noise exposure and other reasons.
By the nature of the spectrum, noise is divided into broadband, with a
continuous spectrum more than one octave wide, and tonal, in the spectrum of
which there are pronounced discrete tones.
An octave band is a frequency interval in which the upper cutoff frequency is
2 times higher than the lower one. The entire range of audible sounds contains 9
octaves, but in practice the most important are 8 octave bands, covering the sound
range from 45 to 11,000 Hz.
Time characteristics distinguish between constant noise, the sound level of
which during a working day (shift) changes in time by no more than 5 dB, and
non-constant if this change exceeds 5 dB.
Intermittent noise, in turn, is subdivided into time-varying noise if the sound
level changes continuously over time; intermittent, the sound level of which changes
stepwise, and the duration of the intervals during which the level remains constant
is 1 s or more; pulse, consisting of one or more sound signals, each with a duration
of less than 1 s.
Low-frequency noise is distinguished by the prevailing frequency
composition up to 300-400 Hz; mid-frequency - from 400 to 1000
Hz; high-frequency – higher1000 Hz.
According to the duration of exposure, one distinguishes between long-term
noise, with a total duration of 4 hours or more, and short-term, with a duration of
less than 4 hours per shift; extended solids.
The sensitivity of the human ear to sounds of different frequencies, as noted
above, is different, and therefore the perception of loudness caused by sounds of
equal intensity, but different in frequency, is not the same.
Loudness is a physiological concept that characterizes the strength
(magnitude) of the subjective sensation experienced by a person as a result of the
effect on his hearing organ of a particular sound or noise. The level of sound or
noise intensity expressed in decibels does not allow judging the physiological
sensation of its loudness, therefore, by analogy with the concept of the level of
sound (noise) intensity, the concept of loudness level was introduced, the unit of
measurement of which is called background.
The loudness level is set subjectively, by comparing with the loudness of a
sound with a frequency of 1000 Hz, for which the level of intensity (sound
pressure) in decibels is conventionally taken as the loudness level in
backgrounds. Thus, the loudness level of any noise in the backgrounds will be
equal to the intensity level of the same loud noise with a frequency of 1000 Hz.
Continuous noise levels in workplaces are characterized by
sound pressure measured in octave bands with geometric mean frequencies of
63, 125, 250, 500, 1000, 2000, 4000 and 8000 Hz. It is allowed to take sound
levels in dBA, measured on the A-scale of the sound level meter, as a characteristic
of constant broadband noise at workplaces with a rough estimate.
The specific physical parameters of intermittent noise, along withintensity and
spectral composition, are the temporal characteristics, the duration of the action of
individual pulses, the shape of the pulse (the time of the rise of its leading and
falling of the trailing edge) and the frequency of pulse repetition.
Given the many characteristics of intermittent noise, it is currently measured
and assessed, according to the energy concept, by the equivalent (energy) level, in
particular, by the equivalent and maximum sound levels, expressed in dBA and
calculated froma special formula or determined from tables. Equivalent levels of
intermittent noise have the same effect on humans as constant noise at the same
levels.
Recently, noise assessment has become widespread. The noise dose is
estimated both as the impact of noise, taking into account its duration and
magnitude, and as the product of the equivalent level by the time of its action, and
as the average energy level during the action, expressed as a percentage over the
permissible noise standard. A dose-based approach to noise assessment is very
promising, since individual dosimetry of noise makes it easier and easier to control
its level, assess the cumulation of noise exposure during work, and distribute the
acoustic load during the working day. Modern individual noise dosimeters make it
possible to simultaneously determine the averaged (equivalent level) and cumulative
(noise dose) indicators of acoustic load.

Noise has a negative effect on the hearing organ, the central nervous system
and the entire body as a whole. Under the influence of intense noise, both reversible
functional changes in the organ of hearing and irreversible morUological changes
can develop.
The initial stage is adaptation to the effects of noise. It is a reflex protective
and adaptive reaction,expressed in an increase or decrease in the hearing threshold
within 15 dB for frequency es below 1000 Hz and 10 dB for frequencies of 2000
Hz and above, with a recovery period within the first 3 minutes after sound
exposure.
Systematic exposure to noise leads to a greater shift in the threshold of
auditory sensitivity, a longer recovery time, up to hearing loss and deafness.
Occupational hearing loss and deafness are characterized by progressive
weakening of hearing in whispering, slowly developing hearing loss in speaking,
increasing thresholdsauditory sensitivity to high tones in both air and bone
conduction.
The effects of noise are not limited to the auditory analyzer. Intense noise has
a negative effect on the function of the visual, motor, vestibular analyzers, leads to a
decrease in working capacity, a decrease in labor productivity and the quality of
work performed, a drop in the pace and rhythm of work, a decrease in
concentration of attention, its distribution and switching, contributes to an increase
in injuries.
Based on the constancy and originality of the symptoms of disorders of the
functions of various organs and systems of the body in people working in
conditions of intense noise, Professor E.Ts. Andreeva-Galanina (1957) identified
noise sickness as an independent nosological form of occupational pathology,
which has 4 main syndromes: vegetative-vascular dysfunction, astheno-vegetative,
hypothalamic and dyscirculatory encephalopathy.
Impulse noise has a more adverse effect on the body than constant noise of
the same level and spectral composition. This is reflected in a higher level of general
morbidity in the corresponding professional groups of workers, in a higher
frequency of disorders of the nervous and cardiovascular systems.
Infrared and ultrasound have the same physical characteristics as noise.
Infrasound can be of natural or artificial origin. In the first case, it occurs
during sea storms, earthquakes, volcanic eruptions. Sources of artificial infrasound
are turbines, diesel engines, fans, compressors, jet, automobile, tank and other
engines.
The biological effect of infrasound on the human body is manifested by
neuro-vegetative disorders and mental disorders. In people,located near the source
of infrasound, fainting, increased blood pressure, feelings of anxiety and
unconscious fear, sensations of vibrations of internal organs, nausea may occur. In
this case, the internal organs of a person exhibit unequal sensitivity to the frequency
range of infrasound. So, the frequency from 1 to 3 Hz selectively affects mainly
the respiratory organs, from 5 to 9 Hz - on the organs of the chest and abdomen
(up to cardiac arrest), from 8 to 12 Hz - on the spine. This is associated with the
phenomena of resonance of internal organs.
Ultrasound accompanies the same processes that are sources of noise,
vibration and infrasound. It has a pronounced effect on the central nervous system,
cardiovascular and endocrine systems, and therefore its positive effect has long
been used with benefit in medicine with therapeutic diagnostic purpose. The
adverse effect of ultrasound is manifested in the form of headaches in people, a
feeling of pressure in the ears and dizziness, which intensifies towards the end of
the working day. In addition to the general effects, vegetative polyneuritis, paresis
of the fingers,hands, forearms.
Vibration - mechanical non-damping (periodic) oscillatory movements of
elastic solids, in which the entire oscillating material body or its individual particles
periodically, at certain intervals, pass the same position of stable equilibrium,
deviating from it in one direction or another. Vibrating bodies are, as a rule, sources
of airborne noise, and when in direct contact with the human body, they transmit
vibrations and cause harmful consequences.
The physical characteristics of vibration are frequency and amplitude, as well
as their derivatives - vibration velocity and vibration acceleration.
Vibration acceleration is characterized by an increase in the vibrational
2
speed per unit time and is expressed in cm per 1 s or in fractions of the
2
acceleration of gravity equal to 9.81 m / s . The amount of vibrational energy
transmittedunder the action of vibration on the human body, in proportion to the
square of the vibrational speed. This is the basis for the measurement and
standardization of vibrations, which is carried out according to the rms values ​of​
vibrational velocities with geometric mean values ​of frequencies in octave
bands. To characterize impulse vibrations, the maximum (peak) values ​of the
vibrational velocities are also measured and normalized.
Since the values ​of the vibrational velocities can vary over a wide range, a
logarithmic scale of the vibrational velocity levels in dB is used to reduce the linear
measurement scale. Oscillating velocity, acceleration or displacement values ​can be
converted to dB. The threshold level of the vibrational speed is taken as a value of
-6
5 ∙ 10 cm / s, which corresponds to the value of the root-mean-square vibrational
-5 2
speed at the standard threshold of sound pressure (2 ∙ 10 N / m ) . Accordingly,
2 2 is
the value of 3 ∙ 10 cm / s taken as the threshold level of the vibrational
acceleration . The hygienic characteristic of vibration is the root-mean-square value
of the vibration velocity or its levels in octave frequency bands.
As with noise assessment, approaches to vibration dose assessment are being
developed.
By the method of transmission, general and local vibrations are distinguished,
by the direction of action - longitudinal, transverse, mixed, in accordance with the
adopted coordinate system, by the source of occurrence - transport,
transport-technological and technological.
Vibration has an adverse effect on human health. Local action is manifested in
the form of peripheral disorders of sensitivity, function, etc. Long-term general
exposure to vibration leads to the development of a symptom complex known as
vibration disease.
The problem of preventing the adverse effect of noise and vibration on the
human body requires the joint efforts of design engineers,acoustics, architects,
builders, doctors and other professionals. Measures of a technical, organizational
and medical nature are being developed and carried out.
Measures of a technical nature provide for the reduction of noise and vibration
in the source of formation and the closure of their propagation paths by
technological, design and operational measures.
When the attenuation of noise at the source of its formation is impossible,
various kinds of local sound and vibration isolation devices are used, installed on
noisy units of the units. General sound insulation of rooms or boxes with the most
noisy equipment is achieved by monolithic, thick enclosing structures made of
heavy dense materials that have a high soundproofing ability, or by the device of
multilayer fences, walls, ceilings, floors, separated by air gaps or spaces filled with
sound-absorbing material. Such enclosing structures with the same mass of a unit
of surface have a higher sound insulation than homogeneous ones.
Vibration isolation is provided by the use of various types of shock
absorbers, which are placed between vibration sources and supporting structures.
To weaken the transmission of vibrations through the building during its
design and construction, elastic gaskets are provided at the joints, under the
floors. Structure-borne noise propagating through metal pipelines is attenuated by
the device of ruptures in separate sections of the network with the inclusion of
elastic couplings and hoses in these places.
For decrease hesitation corps moving objects of equipment,
caused by road irregularities, suspension and shock-absorbing devices are
used in the seat structure.
As an aid to combat, especially with reflected noise, various porous materials
are used for wall cladding andspecial designs of sound absorbers in the form of
perforated sheets, slabs, mats, cones and pyramids suspended over noisy
equipment in places where sounds reflected from the surfaces of the room are
concentrated. For damping aerodynamic noise generated by compressors,Silencers
are installed with internal combustion engines, ventilation units at the points of
intake and discharge of air streams into the atmosphere or in the air duct network.
Rational placement of objects and layout of premises contributes to the
attenuation of noise.
Organizational measures provide for short breaks during work, the
organization of rest and sleep rooms, the exclusion of overtime work, etc.
The dynamic medical control system allows timelydetect the initial signs of
occupational diseases caused by noise and vibration, and determine the nature of
the necessary measures to prevent them.
To improve working conditions, an important place is occupied by the
legislative limitation of noise and vibration levels acting on a person.
It is not always possible to reduce noise and vibration to a safe level,
especially in the army. In these cases, personal protective equipment is used -
anti-noise. Their use is based on the isolation of the tympanic membrane with
sound-absorbing materials by obturation of the auditory canals or isolation from
external noise of the auricles with adjacent skin areas or the entire head.
According to the method of fixation, they distinguish between internal noise
(anti-noise bushings, tampons, liners, half-sleeves) and external (anti-noise
headphones, noise-protective helmets) type.
Personal vibration protection equipment is made of materials that can damp
(damp) mechanical vibrations. Local vibration is attenuated by vibration protection
gloves, mittens, knee pads with padding made of damping materials, spring shock
absorbers, etc. To protect against general vibration, shoes with vibration-damping
soles, shock-absorbing seats, mats and platforms made of vibration-damping
materials are used.

All organizational, technical and medical measures aimed at reducing the

harmful effects of noise and vibration are at the same time effective in relation to
infra- and ultrasound.
Microclimate is a complex of physical environmental factors in a confined
space that affects heat exchange and the thermal state of the body. It is determined
by - temperature, humidity and air speed, the temperature of the surrounding
surfaces and their thermal radiation. Atmospheric pressure is essential only in
special conditions of human activity (aviation, caisson work, etc.).
The parameters of the microclimate of working rooms, differing in great
dynamism, depend on the thermophysical characteristics of the technological
process, climate, season of the year, heating and ventilation conditions. The impact
on the body of each of the microclimate parameters separately and (or) in
combination affects primarily the heat exchange process.
Under heat exchange realize exchange of thermal energy between the body
and the environment, the relationship between the formation of heat in the body as a
result of ability to live and return (yield) of heat.
Preservation of temperature homeostasis, which is an indispensable condition
for normal life and high human performance, is ensured by thermoregulation - the
coordination of heat production and heat transfer processes. Distinguish between
chemical, physical and behavioral thermoregulation.
Regulatory mechanism, allowing increase heat production inas a result of
changes in metabolic processes in the body, it is called chemical
thermoregulation. Heat generation in the body occurs due to the mechanical work
of skeletal muscles and smooth muscles of internal organs, continuous biochemical
synthesis of proteins and other organic compounds, osmotic processes (ion
transfer), etc. When performing physical work, with a pronounced cooling of the
body (cold shiver), the share of heat generation in skeletal muscles significantly
increases. The daily value of heat production varies widely and depends on the
conditions and nature of the load.
Physiological mechanisms regulating the intensity of heat transfer body
surfaces into the environment by convection, conduction, radiation and evaporation
are referred to as physical thermoregulation.
The state of heat exchange between the body and the environment in a heating
or cooling microclimate in general can be judged by the heat balance equation.
Thermoregulation, which consists in the adaptive actions of a person aimed at
creating an optimal microclimate and using clothes, is called behavioral.
With an imbalance in the mechanisms of thermoregulation in the body, there
is an accumulation or loss of heat. The functional state of the body, due to thermal
stress and characterized by the content and distribution of heat in it, is called the
thermal state of a person.
In the body, distinguish between "core" (deep layers of the human body) and
"shell" (surface layers of the body 2.5 cm thick). The thermal state of a person is
judged by his heat sensation and objective indicators.
objective are body temperature, skin temperature, the amount of sweating
(moisture loss), heat content in the body and its change
(deficit or accumulation), cardiorespiratory indicators - heart rate, blood
pressure, pulse pressure,minute blood volume, value of pulmonary ventilation,
respiratory rate, etc., also energy exchange, water-electrolyte metabolism, mental
and physical performance.
The temperature of the skin of a person, even in a state of thermal comfort,
differs significantly in different parts of the body surface depending on the
characteristics of the circulatory system, the type and intensity of physical activity,
temperature conditions of the environment, etc. For its generalized characteristics,
the weighted average skin temperature (WTC) is used .
It is calculated in accordance with the temperature of the skin in individual
areas and the proportion of the area of ​these areas in relation to the entire surface of
0
the body. A person feels a comfortable state with SVTK in the range of 31-34 C.
Under body temperature (temperature of the "core") means the temperature
of internal organs and tissues - liver, brain, stomach, lung, rectum. Its indirect
indicator is the temperature of the oral cavity (under the tongue), armpit, distal
rectum, esophagus, auditory canal (near the tympanic membrane). Under normal
environmental conditions and with an established equilibrium of thermoregulation
0
processes, body temperature is maintained at 37.0 ± 0.5 C.
Average body temperature (CTT) takes into account the body temperature
("core") and AMT ("shell"), taking into account the mixing coefficients.
According to the degree of stress of thermoregulation, the optimal,
permissible and limiting thermal state are distinguished.
The optimal thermal state of the body is characterized by comfortable
sensations of heat, the absence of physiological stress.
mechanisms of thermoregulation, maintaining a high level of performance and
health.
The permissible thermal state is associated with a moderate tension of the
physiological mechanisms of thermoregulation, the appearance of discomfortable
sensations of heat, a possible decrease in working capacity, and the absence of
health disorders.
The limiting thermal state is manifested in a sharp tension in the mechanisms of
thermoregulation, which, however, does not provide stabilization of the thermal
balance of the body. As a result, there is a continuous increase (decrease) in its heat
content and a sharp decrease in performance.
The microclimate in the working rooms of the OVHT should correspond to
the nature of military work and ensure the thermal equilibrium of the body with the
environment, without causing a pronounced feeling of discomfort and excessive
tension of the thermoregulatory apparatus; have minimal temperature gradients of
air and surrounding objects both vertically and horizontally and promote uniform
heat transfer from the entire surface of the human body; be relatively constant in
time.
According to the effect on the human body, a heating and cooling
microclimate is distinguished.
To assess the microclimate in working rooms and in an open area, in addition
to the parameters already mentioned above, integral indicators are used that
characterize the combined effect of thermal radiation, temperature, movement
speed and air humidity (effective and resulting temperature) on human heat
exchange.
The norms of individual parameters of the microclimate, taking into account
heat production, the severity of physical labor and the season of the year, are
regulated by sanitary norms and rules, as well as by departmental regulations. The
latter also contain standards for complex indicators of the thermal state of the
environment, which make it possible to assess the total thermal effect of individual
parameters of the microclimate in various combinations.
Prevention of heat lesions. Large physical and neuropsychic stress during
training and combat activities of personnel in conditions of high air temperatures,
intense solar radiation, high air humidity and calmness, difficulties in metabolic
recoveryheat into the environment, unbalanced nutrition and limited water
consumption place increased demands on the adaptive capabilities of the human
body, and in particular on its thermoregulatory apparatus.
There are the following forms of heat damage: heat (sun) stroke, heat fainting,
heat cramps, heat exhaustion, heat fatigue, heat edema and other manifestations of
heat exposure.
Heat (sunstroke) occurs when performing heavy physical exertion in
conditions of high ambient temperatures due to acute insufficiency of
thermoregulation of the body, which leads to hyperthermia, disturbances in the
activity of the central nervous system, cardiovascular system and water-electrolyte
homeostasis of the human body. It is characterized by a sharp increase in body
0
temperature, reaching in some cases 41 C and above, loss of consciousness,
motor excitement, delirium, hallucinations, tonic and clonic seizures, a sharp drop
in blood pressure, rapid, small and threadlike pulse. This form of heat injury is
dangerous with high mortality (from 17 to 70%).
Thermal fainting is caused by the expansion of the peripheral vascular bed, a
drop in arterial tone and venous congestion with difficulty in the return of
metabolic heat under high ambient temperatures. Clinically characterized by
dizziness or loss of consciousness, profuse sweating, an increase in heart rate, and
0
a drop in blood pressure. The body temperature rises to 37.0 - 38.5 С.
Heat cramps occur during hard physical work, increased sweating, copious
and indiscriminate drinking of water. They are a consequence of extracellular
dehydration with intracellular hyperhydration, alkalosis and are manifested by
involuntary periodicspasms of the muscles of the abdomen and limbs. The body
temperature is usually normal.
Heat exhaustion (heat exhaustion) can be of two types:
a) heat exhaustion due to dehydration of the body, which, according to the
pathogenetic mechanism, is intracellular dehydration. The leading symptom is
unquenchable thirst. With severe dehydration, neuropsychiatric disorders,
drowsiness, anxiety, agitation, hallucinations are observed. Body temperature
0
rises to 38 C. Body weight decreases sharply. Diuresis is reduced up to anuria;
b) heat exhaustion due to a decrease in the salt content in the body with
profuse sweating, which is extracellular dehydration. The defeat develops
gradually. Disturbed by headache, dizziness, vomiting. There is no thirst. Facial
features are sharpened. The patient often yawns. The pulse pressure drops to
 20-30 mm Hg. Art. due to a drop in systolic pressure. The content of sodium
and chlorides decreases up to their complete absence in the urine.
Heat fatigue (transient) is characterized by the appearance of an asthenic
reaction under the influence of a hot climate, which is based on neuropsychic
exhaustion. It is manifested by slowness at work, irritability, decreased attention
and memory, rapid fatigue, lethargy, reactive depression and loss of strength.
Heat edema occurs most often in the shins and feet. They are associated
with moderately pronounced, but long-term disorders of water-salt metabolism.
Heat dermatitis occurs with prolonged and ineffective sweating, most often
with high humidity. It manifests itself as an erythemal papulo-vesicular rash on the
skin, accompanied by a burning sensation and tingling sensation.

Thermogenic anhidrosis arises at people for a long time

staying in high temperature conditions. It is characterized by the appearance of
numerous vesicular rashes on the skin of the trunk and proximal parts of the
extremities and the cessation of perspiration in the places of the rash.
Helping victims of thermal injuries is effective only with quick and energetic
actions of commanders and medical workers.
The prevention of thermal injuries is achieved by carrying out a set of
measures along the command and medical lines aimed at reducing the external
thermal load on the personnel, reducing metabolic heat production and increasing
heat transfer, organizing a rational daily routine, drinking regime and diet, increasing
the thermal stability of the body (preliminary and accelerated adaptation ) and
control over the thermal and functional state of the body of military personnel in the
process of their training and combat activities.
Prevention of cold injuries. In military practice, as evidenced by the history
of past wars and local military conflicts, the harmful effect of cold not only
increases the non-combat losses of troops, but also reduces the effectiveness of
the use of weapons and military equipment.
Cold injuries are caused by low temperatures of air and fences, especially
metal ones, air speed, precipitation, soil and ground moisture, significant
fluctuations in the thermal state of the environment. They are promoted by
insufficient thermal and windproof properties of clothing, damp and tight shoes,
low physical activity of personnel, weakening of the body due to fatigue, previous
illnesses, poor nutrition, and intoxication. A known role in their occurrence is
played by the lack of training and preliminary adaptation and acclimatization to the
cold.
Cold lesions are divided into general (chills, accidental hypothermia) and
mainly with local manifestations - local cold injury with freezing (frostbite of the
face, hands, feet and other parts of the body) and without tissue freezing ("trench
foot", "immersionfoot").
The general acute effect of cold on the body is divided into 4 stages. The first
stage is a physiological adaptation, when, due to intense physical and chemical
thermoregulation, the body satisfactorily copes with cooling and maintains the body
0
temperature at a normal level (37 С).
At the second stage, there is a relative lack of thermoregulation: there is an
unpleasant feeling of chills, tremors, increased heart function, increased blood
pressure, increased breathing (up to 24 or more per minute), increased excretion of
0
water through the kidneys. The body temperature decreases by 1-2 C.
The third stage (decompensation) is characterized by a decrease in heat
production due to the depletion of nutrient reserves(glycogen, etc.), as well as
depletion of thyroid and adrenal hormones, weakening of cardiac activity,
bradycardia (up to 60-40 beats per minute), then arrhythmia, decrease in stroke and
minute blood volume. Breathing becomes infrequent and irregular. The tremors are
replaced by muscle stiffness, fatigue and a tendency to sleep increase. The body
0
temperature drops to 30-28 С.
The fourth stage (pathological) is accompanied by complete loss of sensitivity
(anesthesia from cold) and deep fainting, barely noticeable breathing, cardiac
0
fibrillation. Body temperature drops to 25-26 С, belowwhich is fatal.
Chills occurs with prolonged and strong cooling of superficially located
tissues: the skin and mucous membranes become cyanotic, edematous, sometimes
cracking with the formation of poorly healing weeping ulcerations.
Random hypothermia is itself an unintentional decline
0
deep temperature body (temperature "core") below 35 C.
0
Distinguish o s t r u y (temperature "kernels" below 30 C) n o n a s t y p
0
w (deep temperature above 30 С) and chronic accidental hypothermia. In acute
hypothermia, rapid heat loss occurs with deep hypothermia for 6 hours or
less. Subacute hypothermia develops more slowly (within 6-24 hours) due to high
heat transfer depleting the body. Chronic accidental hypothermia occurs as a
consequence of a prolonged vascular reaction to cold.
Local cold injury is closely related to the general effect of cold, since there is a
commonality of the main cause (excessive heat transfer), pathogenesis (vascular
changes in the form of spasm of arterial vessels, expansion and thrombosis of
veins and tissue hypoxia of varying severity), as well as frostbite of peripheral parts
0
of the body usually occurring at air temperatures below -15 С.
Frostbite is a cold injury that poses the greatest danger to personnel during
training and combat activities in the field at low temperatures. With frostbite, the
actual freezing of tissues occurs with the formation of ice crystals in them.

According to the severity of frostbite, they are divided into 4 degrees. The
first degree of frostbite is characterized by redness, soreness, swelling, impaired
sensitivity; the second - superficial damage to the epithelium with the formation of
blisters filled with serous or bloody fluid; the third - necrosis (necrosis) of the skin
and deep tissues throughout their thickness; the fourth - damage to all tissues of the
limb (hand, foot), including muscles, tendons and bone tissue.
Cold lesions without freezing tissues occur in a humid environment air
0
temperature close to 0 C. A variation of such lesions is the "trench foot"
syndrome. It is observed in the military,for a long time in damp shoes at low air and
soil temperatures. The victims develop swelling, soreness in the soles of the feet,
after 48 hours paresthesia and sluggishness of the peripheral circulation may
occur. During the defeat, there are severalphases - expositional,
prehyperemic, hyperemic and posthyperemic. The latter is characterized by
increased sensitivity to cold and hyperhidrosis, which can persist for several years.
Swelling of the foot leads to the fact that the shoes become tight and further
disrupts the local blood circulation. As a result, a serious protracted disease of the
feet develops from a relatively small lesion with petechial hemorrhage into the skin
to severe trauma resulting in necrosis and wet gangrene with a general infection of
the body.
This type of defeat is also found in accidents, rescuing drowning people.
other situations when military personnel are forced to stay in cold water for a
long time. In these cases, the lesion is called"immersion (immersion) foot".
The prevention of cold injuries is achieved by a system of measures, which
include providing servicemen with clothing and footwear in accordance with
weather conditions, with the provision of drying them; regular and nutritious meals
with the provision of hot food and drink; periodic heating; active muscular
activity; preliminary thermal adaptation and acclimatization to the cold.
The quality and size of the footwear is critical to preventing local cold lesions
of the feet. Boots (boots) must reliably protect the feet from getting wet, and also
be spacious enough to make it possible to easily use internal insulation in the form
of felt insoles, greatcoat cloth, etc. and several pairs of socks (footcloths).
However, the shoes should remain free so as not to restrict the blood
circulation of the foot.
To combat the cold, early and competent hardening, strengthening of
physical development, the correct organization of work in the open air (instructing
servicemen about the possibility of cold injury, factors,accompanying, and
protective equipment, regular change of servicemen on duty shifts, the provision of
good rest, weakening or prevention of sweating of the legs.
Non-ionizing radiation. Non-ionizing radiation is part of the spectrum of
electromagnetic waves, which covers the wavelength range from 1000 km to 0.001
-3 21
μm or less, and in frequency - over 20 orders of magnitude from 5 ∙ 10 to 10
Hz. Most of the spectrum of non-ionizing radiation is radio frequency radiation -
low, high, very high, ultrahigh and ultrahigh electromagnetic radiation (EMP).
From a physical point of view, electric and magnetic fields do not represent
radiation; they are classified as non-ionizing radiation for practical reasons.
An electromagnetic field (EMF) is a combination of alternating electric and
magnetic fields. The mutual transformation of the electric and magnetic
components of the field determines its propagation in the medium. Together, the
variables of the electrical andmagnetic fields propagating in a medium are called
electromagnetic waves.
The characteristics of the EMF are the frequency of its oscillation, the unit of
which is hertz (Hz), and the wavelength (meter, multiples of it and sub-multiples).
Three zones are defined around any source of EMF radiation: near (induction
zone), intermediate (interaction zone) and far (wave zone).
In the frequency range 30 kHz-300 MHz, EMF is estimated by the
magnitude of the field strength from the electric and magnetic components and is
expressed, respectively, in volts per meter (V / m) and amperes per meter (A /
m). In the frequency range 300 MHz-300 GHz, EMF is estimated by the value of
the surface radiation energy flux density and the energy load generated by it and is
2 2
expressed, respectively, in μW / cm andμW ∙ h / cm .
EMP of radio frequencies, along with widespread use in radio communication
and radio broadcasting, radar and radio astronomy, television and medicine, have
been used in various technological processes - in the heat treatment of metals,
plastics, wood, food products, etc.
The most pronounced effect on the human body is exerted by the EMR of the
microwave range. It depends on the wavelength, intensity, duration and modes of
radiation, the size and anatomical structure of the organ being irradiated, the
structure of the irradiated tissue or organ. The effect of the biological action is the
more pronounced, the greater the radiation intensity, the longer the irradiation time
and the larger the irradiated surface. EMP in the millimeter range is absorbed by the
surface layers of the skin, in the centimeter range - by the skin and adjacent tissues,
decimeter ones penetrate to a depth of 10-15 cm. For longer wavelengths, human
body tissues are a well-conducting medium.
Depending on the intensity of the radiation, a distinction is made between
thermal (thermal) and non-thermal effects. The boundary of this section is the
2
energy flux density (PES), equal to 10 mW / cm : at high energies, a thermal effect
is manifested, at lower energies, a non-thermal one.
The thermal effect consists in heating the irradiated tissues and increasing their
temperature, which determines the emerging pathology. Different tissues absorb
EMP energy in different ways. Most strongly absorb energy and heat up tissues
and organs that contain a lot of water - the lens and vitreous body of the eye,
hollow organs (urinary and gall bladders, stomach, intestines), gonads,
parenchymal organs. Organs and tissues with poor thermoregulation are the most
sensitive to local selective heating - the lens and vitreous body of the eye. The
changes occurring in the tissues are associated with protein denaturation and
changes in the course of biochemicalreactions (cataracts, necrospermia and
atrophy of the spermatogenic epithelium, gastric bleeding, etc.). The thermal effect
of microwave radiation is the result of accidents, emergencies and gross violations
of safety rules. Much more often in military practice, the specific, non-thermal
effect of EMP is noted.
M icrowave radiation is manifested only indirectly. Mainly, these are functional
changes and biological effects that occur in the body in the absence of temperature
shifts in tissues and special thermoregulatory reactions at microwave radiation
intensities that are less than the threshold level of thermal action.
The specific action of radio waves causes various changes in the body -
reversible or irreversible, moruological or functional.
MorUological changes are more often observed in the tissues of the peripheral
and central nervous systems. Their nature depends on the frequency of radiation
(wavelength): under the action of millimeter waves, the changes are local, in the
form of foci, under the action of centimeter waves, they are concentrated around
the vessels of the brain. In terms of the total effect on the nervous system,
decimeter waves have the greatest effect. MorUological changes are also observed
in other tissues and organs (eyes, blood, etc.).
Functional changes are expressed in a violation of the nature and intensity of
physiological and biochemical processes in the body, functions of various parts of
the nervous system, nervous regulation of the cardiovascular system, etc.
Clinical manifestations of the action of microwave radiation are observed
mainly from the nervous and cardiovascular systems. Asthenic syndrome is
characterized by complaints of increased fatigue, weakness, weakness, decreased
performance, sleep disturbance, headache, dizziness, irritability, irascibility,
increased sweating, less often - memory loss, anxiety,sexual weakness, etc.
Objectively, there is an increase in tendon reflexes, tremors of the hands and
eyelids, acrocyanosis, local and general hyperhidrosis, changes in dermographism,
pilomotor reflex, etc. In some cases, changes in the functions of the nervous
system indicate diencephalic disorders. The changes observed in people with
chronic exposure to the microwave field are of a polymeric character and are
unstable. They are caused by disorders of neuro-humoral regulation, appear
gradually and show a clear connection with work experience.
Dysfunctions of the cardiovascular system proceed as neurocirculatory
dystonia with complaints of pain in the heart, palpitations, shortness of
breath. Hypotension, bradycardia and slowing of intraventricular conduction are
objectively observed.
Changes in the blood are often unstable, but with prolongedleukopenia with
neutrophilopenia and thrombocytopenia are observed.
In the gastrointestinal tract, there are violations of the secretory and evacuation
functions.
In addition, the specific effect of microwave radiation is manifested in changes
in gas exchange, the activity of the urinary system, metabolism (protein,
carbohydrate, fat, mineral, etc.), the activity of the endocrine glands, enzymatic
processes, the exchange of nucleic acids, etc. It causes dysfunctions adaptation
mechanisms that regulate the body's adaptive responses to changes in
environmental conditions. It has a maladaptive effect in relation to heat, cold, noise,
psychological trauma, etc.
Hygienic standardization of EMP is aimed at preventing the thermal effect of
EMP during short-term exposure and limiting the possibility of the occurrence of
non-thermal effects during long-term operation with sources of EMF.
The operating standards establish Remote control radio wavesimpacts for
people professionally and non-professionally associated with exposure to radio
frequency EMR, and for the population.
Medical measures to prevent the adverse effects of EMR provide for the
development of PDUs and control over their observance, justification of the work
and rest regime of people associated with exposure to EMR, hygienic assessment
of projects for the construction of new and reconstruction of existing facilities,
equipment, technological process, means of protection against EMR, preliminary
and periodic medical examinations of workers.
5.4. Hygienic features of the service in individualbranches of the armed
forces
Motorized rifle troops are one of the main branches of the Ground
Forces. Their technical equipment is steadily increasing.The presence of infantry
fighting vehicles (BMP), armored personnel carriers and other vehicles made
motorized rifle units a mobile and maneuverable combat arm, significantly increased
the protection of personnel from the damaging effects of all types of weapons,
including nuclear ones.
Operating on high-speed armored vehicles of high cross-country ability,
motorized rifle troops are capable of marches over long distances, flexibly and
quickly maneuver on the battlefield. Using almost all types of weapons and
equipment (tanks, rocket launchers, artillery, etc.), motorized rifle troops,
interacting with other types of troops, are able to quickly switch from one type of
battle to another: successfully break through the enemy's defenses on the move,
inflict short-term defeat in a meeting engagement, relentlessly pursue it to great
depths, cross water obstacles on the move and firmly hold captured lines and
objects.
The increased technical equipment and the variety of complex combat
missions solved by motorized rifle troops led to a significant increase in the number
and intensity of actions adverse to health andcombat readiness of personnel of
environmental factors. However, it is currently impossible to single out these
factors as characteristic only of motorized rifle troops.
In fact, the nature of the military labor of tankers who are part of the
motorized rifle forces does not differ from that of the tank forces; the personnel of
missile subunits encounter the same harmful factors,that the personnel of the missile
forces; the military labor of artillerymen as part of motorized rifle troops has the
same features as in artillery units and formations, etc. In this regard, these features
are considered in the corresponding sections of the textbook. The most specific
features of the work of motorized riflemen include: infantry vehicles, armored
personnel carriers and vehicles; normal and forced movement on foot (chapter
VI); firing from conventional small arms, including from confined spaces, which are
the amphibious compartments of infantry fighting vehicles; long stay in trenches
and other fortifications during defensive battles, etc.
Tank forces. The tank is a combat vehicle with a powerful powerful engine
and armament, protected by strong armor and high maneuverability. The main parts
of the tank are: armored body, weapons, engine, transmission mechanisms and
chassis.
The main activities of tankers, in addition to the usual army (drill and fire
training, orders, duty, etc.), are maintenance of vehicles, repair work, and during the
war - battle and special treatment of vehicles (degassing, decontamination and
disinfection).
The conditions for the activity of tankers are characterized by specific features
that complicate and complicate work, adversely affect the combat effectiveness
and even health: the small size of workplaces and the presence of metal fences and
objects; limiting the view andlow illumination of workplaces, the possibility of high
and low temperatures; changed chemical composition of the air and its large
dustiness; contact with fuels and lubricants; noise, vibration and shock; great
physical and neuropsychic stress, etc.
3
compartment of the tank does not exceed 4 m , but in fact it is even less,
since part of the space is occupied by the breech of the gun and other
equipment. Height - below the height of the average person. This restricts the
freedom of movement of the crew members, makes it difficult to use devices and
mechanisms, and forces them to work in a forced position. The main trend of
modern tank building is a further decrease in the height of combat vehicles, which
leads to an even greater decrease in the volume of manned compartments, makes it
necessary to reduce the number of crews to three people (tank commander, gunner
and driver mechanic) and further worsens their working conditions (driver is
located in a semi-recumbent position).
The presence of metal fences and objects with many protrusions sharp
corners require constant attention and high coordination of movements in order to
avoid injuries to the body and damage to the skin of tankers, especially when the
tank moves over rough terrain.
Limited vision and light fluctuations. Observation conditions, especially from a
moving tank, are extremely unfavorable due to the limited field of view and require
a lot of attention, good vision and systematic training in conditions as close as
possible to a combat situation. It is especially difficult to observe the area at night,
when all objects become gray, their contours blur, deep vision deteriorates, spatial
representations are disturbed, objects seem closer than in reality, their sizes
increase, and the movement of luminous objects seems to be faster than in reality.
Observation conditions also depend on the lighting inside the tank. During the
day, when the hatches are open, the illumination ranges from 30 to 250 lux, when
closed, it drops to 10, even 2 lux or less. Such a low illumination of the inner
surfaces of the tank makes it difficult for the eyes to adapt when looking from
brightly lit external objects to internal ones. At night, observation of poorly lit
terrain, especially when the headlights are off, is difficult if there is excessive
illumination inside the tank or the instrument scales are brightly lit. In this regard,
artificial lighting should be constructed with the expectation of maximizing the
facilitation of the adaptation of the eye. It should provide free work with control
devices, map reading, record keeping, etc .; at the same time, it should make it as
easy as possible to adapt to low light inside the tank during the day and outside it at
night.
Currently, tanks are widely used night vision devices that transform thermal
radiation into visible light emitted by special screens. The use of these devices
significantly improves the observation conditions from the tank at night and
increases the effectiveness of firing.
Vibration, shock and noise. Vibrations and shocks in the tank are the result of
engine operation and driving on roads and terrain with an uneven profile. Vibrations
in a tank that occur during engine operation are of a rhythmic nature, their
amplitude is usually small, they act on the body of tankers in isolation only when
the engine is idling.
Arrhythmic, jerky vibrations when the tank moves are much more
unfavorable. Oscillations of a tank are complex and can have different directions:
horizontal, vertical, angular, etc. The number and strength of vibrations largely
depend on the terrain profile and the driver's qualifications. Amplitude and
acceleration during shocks and concussions often reach such magnitudes that
tankers can get bruised and injured. They also cause member fatigue.
Of the crew, who are forced to exert muscle efforts all the time to maintain
balance, significantly complicate the working conditions of the crew, interfering
with aimed fire on the move, interfering with observing the battlefield and using
optical devices, and can cause motion sickness.
It is possible to reduce shaking and vibrations in the tank (up to the standard
parameters of smoothness of movement) by improving the suspension system,
shock absorbers and seats. Special and general physical training of personnel is
also important, as well as professional training of the crew, especially the gunner
and driver, in order to develop skills in driving and shooting from a moving tank.
The main source of noise in the tank is the propulsion unit, that is, the
chassis. Added to this is the noise of the engine and weapons (cannon and machine
gun) during firing, from the impact of bullets and shrapnel on armor, etc. The noise
level in a moving tank can reach 130 dB, which is much higher than the adaptation
limit. Voice communication becomes difficult. With prolonged exposure to noise,
hearing sensitivity is significantly reduced.
For individual protection against noise and improvement of speech
communication, summer and winter tank helmet-mounted helmets are used, which
significantly reduce the level of noise intensity (up to 45 dB), telephone earphones
and laryngophones. On the frontal and parietal parts inside the headset there are
ribbed rollers made of spongy rubber or foam rubber, which protect the tanker's
head from accidental blows when the tank moves. The winter helmet also protects
the head from the cold. However, long-term use of headsets is hampered by the
fact that the built-in their antinoises exert significant pressure (about 5 kg around
the perimeter) on the underlying tissues of the head.
0
Microclimatic conditions. Air temperature inside the tank in winter4-8 higher
than the outside temperature. The cooling of the crew members is facilitated by
high air velocities and negative radiation on the fences. Contact with cold metal
surfaces of the handlescontrol levers, pedals, floor, as well as the lack of mobility
of tankers, in turn, increase the likelihood of cooling.
Prevention of general hypothermia and frostbite is achieved by installing the
heating system due to the heat of the exhaust gases, covering the inner surface of
the floor, seats, levers, pedals and other items with heat-insulating
(non-combustible) material, using appropriate clothing and footwear. Measures are
taken to heat people during stops and rests due to active movements, and at the
slightest opportunity - in warm rooms.
0 0
In summer, the air temperature inside the tank can reach 40 - 50 C.
Overheating is facilitated by the high radiation temperature, since individual sections
of the armor are heated to 65-70 °. Under these conditions, the movement of air
has a beneficial effect on the heat exchange of tankers, increasing heat transfer,
mainly due to evaporation. Prevention of overheating is facilitated by: the use of air
conditioners, forced ventilation of the sub-suit space, strengthening of general
ventilation by opening hatches, switching on artificial means of air supply (fans,
blower separator, filter and ventilation unit, etc.), reducing physical activity in hot
weather, provision of good-quality chilled drinking water, halts with a choice of
parking in the shade and people getting out of cars.
Dustiness of the air. When tanks move on dirt roads or off-road in dry
seasons, a huge amount of dust penetrates into the manned compartment of the
tank through hatches and viewing slots, which covers surfaces and glasses of
viewing devices, reducing visibility and impairing observation conditions.
Dust contributes to the development of conjunctivitis and blepharitis in the
crew members, catarrhal inflammation of the respiratory tract, pustular diseases,
reduces the air and vapor permeability of their clothes.
Together with the dust in the manned compartment of the
tank can fall fighting
poisonous and radioactive substances, as well as bacterial agents.
To reduce the ingress of dust into the tank, it is necessary to maintain a
distance between the vehicles (approximately 50 m) when moving in a column and
periodically change vehicles traveling at the head and tail of the column. In the case
of a march through extremely dusty terrain, it is advisable to seal the tank with air
supply through a blower separator. To protect the eyes and respiratory system, use
goggles, respirators and gas masks.
Chemical hazardous substances. In the course of combat activities, tankers
come into contact with powder and exhaust gases, products of flame-extinguishing
mixtures, fuels and lubricants and their pyrolysis products, with various kinds of
solvents used in engine repairs, etc.
Powder gases. Air pollution in the tank occurs when firing from a cannon and
machine guns due to the ingress of powder gases from the bore when opening the
bolt, as well as from spent cartridges.
The amount and concentration of powder gases in the air of tanks depend on
the caliber of the gun and its design features, the composition of the powder
charge, the rate and duration of firing, the type and efficiency of ventilation, the
degree of tank sealing, etc.
A decrease in the concentration of powder gases is ensured by natural
ventilation, operation of supply and exhaust fans, a blower separator and a filter
and ventilation unit. In addition, to limit the ingress of powder gases into the
fighting compartment, an ejection device is installed in the structure of the front
third of the barrel in the form of an annular chamber around the barrel, from which,
after the projectile is released under high pressure, gases flow out in the direction of
the muzzle, entraining the powder gases not only from the channel trunk, but also
from the fighting compartment of the tank.
Exhaust gases can get inside the tank from a vehicle in front or from its own
engine with a tailwind and at stops, andalso when the engine is running indoors
(tank boxes, workshops). The exhaust gases of modern tank engines contain
relatively little carbon monoxide, but they have an unpleasant odor and are highly
irritating to mucous membranes due to aldehydes and sulfur dioxide formed during
the combustion of heavy fuels.
Fuels and lubricants. Diesel fuel is used as fuel (fuel) for tanks, and lubricants
are used as lubricants. Getting on the heated surfaces of the engine and armor, they
can evaporate and decompose with the formation of aldehydes, unsaturated
hydrocarbons and their sublimation products, which have a sharp irritating effect. A
noticeable amount of pyrolysis products can accumulate in the fighting
compartment immediately after stopping the engine.
Contamination of clothing and skin with fuels and lubricants can cause
pyoderma and furunculosis. To prevent them, it is necessary to provide the tank
crew with oil and petrol-proof clothing, the tank crew must comply with the rules of
personal hygiene and safety measures, as well as good nutrition, which increases
the overall resistance of the body.
When using multi-fuel engines, tankers can also be exposed to leaded gasoline
and ethyl liquid containing more than 50% tetraethyl lead, therefore tankers must
know the rules for working with these substances and take measures to prevent
poisoning
It is very important to keep the container in good condition, to use only closed
mechanical methods for overflowing fuel. The personnel serving the equipment is
obliged to use protective clothing. It is forbidden to use gasoline or kerosene for
washing hands, and even more so to suck fuel into the hose by mouth. Strict
adherence to the rules of personal hygiene also has a significant effect in preventing
the harmful effects of fuels and lubricants.
Physical and neuropsychic stress. Driving cars and especially marches are
associated with great neuropsychic and physical stress, especially the
driver. However, the rest of the crew, especially after long (many-day) marches,
due to the action of a number of unfavorable factors and static stress, experience
significant physical and neuropsychic fatigue, accompanied by a decrease in
working capacity. Even after a daily march of 250-300 km, a weakening of
attention, a decrease in memory, a decrease in muscle tone, an increase in the
hearing threshold, a deterioration in the accuracy of aiming and firing results, an
increase in the number of driving errors, etc. were noted. execution of fire missions,
and during war - battle.
Underwater tank driving. Modern tanks can cross water lines along the
bottom of reservoirs. To do this, they are equipped with equipment, the technical
perfection of which allows the crew to carry out such a combat mission without
risk to health. However, violations of operating rules and safety regulations can lead
to serious consequences. So, if, during underwater driving, a vacuum is created in
the tank and exhaust gases are sucked in together with the air through the air supply
pipe, poisoning by them is possible. Improper use of a self-contained gas mask
can lead to barotrauma.
Prevention of possible adverse consequences of underwater driving of a tank
is of great importance to trainings conducted in the course of combat training and
competent medical support for light diving training of tankers.
Airborne Forces (Airborne Forces). The main features of service in the
Airborne Forces are constant readiness for long-distance flights, for parachute
jumps in various weather and climatic conditions, at any time of the year or day,
readiness for decisive combat operations after landing, as well as for quick and
covertmaneuvering in unfamiliar terrain. All this requires physical endurance,
emotional stability, willpower, technical and other knowledge and skills from the
paratroopers. Such qualities are formed in the process of long-term physical and
special training.
In the course of physical training, strength, endurance, speed of reaction,
methods of individual struggle, stability of the vestibular apparatus, the ability to
control one's body, navigate in space and other qualities are developed. The
training is carried out on special and ordinary sports equipment, as well as with
specialist instructors.
Airborne training consists in acquiring reliable skills in fitting, packing and
donning parachutes, correctly distributing and securing the layout (weapons,
knapsack, special equipment), self-control and mutual control. Training includes
practicing techniques for quickly boarding an aircraft and correctly placing it in it,
separating from the aircraft on command, deploying a parachute, acting in the air
when descending on the main canopy and using a reserve parachute, mastering the
technique of landing and extinguishing the canopy, methods of quickly releasing
from the harness ... These skills are acquired in the course of many hours of
training on mock-ups of military transport aircraft, suspension systems, cable
slides, etc.
During flights, the personnel can be affected by changes in atmospheric
pressure, lack of oxygen, noise and vibration, low temperatures, and when landing
at intermediate airfields, sudden changes in temperature, motion sickness and other
unfavorable factors.
Differences in barometric pressure are observed in unpressurized landing
cabins, during the ascent and descent of the aircraft, as well as during the descent
by parachute. It is known that even with relatively small differences, the pressure
inside the cavities of the human body lags behind the changes in external
pressure. This is perceived as "bursting", pressure on the eardrums, "stuffing" of
the ears,soreness in the area of ​the sinuses, etc. In these cases, it is often enough to
make a swallowing movement to equalize the pressure in the middle ear. When
flying in sealed landing cabins, a sharp depressurization at altitudes of more than 8
km or leaving the cockpit for a parachute jump can cause decompression
phenomena with sharp pains in muscles and joints, cardiovascular disorders and
dysfunction of the central nervous system, up to paresis and paralysis.
At altitudes of more than 4-5 km, the lack of oxygen begins to affect. First,
there is an increase in breathing, pulse, euphoria; in the future, the picture of the
so-called "high-altitude" illness develops. At the same time, headache, weakness,
increased fatigue are felt, euphoria is replaced by depression and apathy. Precision
and coordinationmovements are disturbed, an uncritical attitude towards reality
appears. To prevent hypoxia, an on-board system is used that supplies oxygen to
oxygen masks to each paratrooper seat. A sudden disconnection from the onboard
oxygen-respiratory system at an altitude of 8-9 km can lead to the development of
acute oxygen deficiency and loss of consciousness within 1.5-2 minutes.
The intensity of the noise generated by the aircraft engines in the airborne
cargo cabin reaches 100-120 dB. Its energy maximum is located in the region of
low and medium frequencies (200-500 Hz). When flying at high altitudes, the energy
maximum shifts to the high frequency region of the order of 4-5 kHz. Prolonged
exposure to noise causes hearing loss among paratroopers, which is most
pronounced in the frequency range from 2000 to 8000 Hz, and a slowdown in
speech. After four to five hours of flight, full recovery of hearing and articulation is
observed only as a result of a 24-hour rest.
Temperature changes are most significant in summer when flying at high
0
altitudes, where the air has subzero temperatures (-30 С at an altitude of 7 km),
0
while daytime temperatures at airfields can reach 30-40 С heat. Therefore, the
danger of diseases caused by rapid cooling when climbing to a height in summer is
especially great. The negative effect of such large temperature differences in an
unpressurized airborne cargo compartment can be weakened by expedient
equipment of the paratroopers. These circumstances must be taken into account
when planning hygiene measures.
The state of motion sickness occurs during flights in bad weather conditions,
in the clouds, etc. and manifests itself, first of all, in persons with insufficient
functional stability of the vestibular apparatus. Their general condition worsens,
pallor of the skin, nausea, vomiting, discoordination of movements and a sharp
decrease in efficiency appear. In order to prevent motion sickness, training on a
swing, loping, gymnastic wheel, cable slide, jumping from trampolines, etc. is
recommended.
Parachute jump is the most difficult and most responsible way of landing. This
specific type of military labor requires high concentration and willpower, causes
great emotional stress, which is a natural adaptive response of the body, maximum
mobilization of internal reserves for the successful completion of the jump. For the
majority of skydivers, emotional stress reaches its maximum, by the time of the
command "went". Usually, after a jump, the tension disappears, and after a day the
state of the body is practically normalized. Prolonged emotional stress with
unexpected delays, the postponement of the start moment can be replaced by
fatigue and depression.
A parachute jump makes high demands on the physiological systems that
provide the spatial orientation of the paratrooper, primarily to the vestibular
apparatus.
After separating from the plane, the parachutist falls freely for some time. The
free fall usually takes a few seconds, ending withopening of the canopy of the
stabilizing parachute, and if the jump is made without stabilization, then with the
opening of the canopy of the main parachute. At the moment the parachute is
deployed, the paratrooper experiences a significant dynamic impact caused by a
sharp change in speed. The force of the impact is directly proportional to the speed
gradient and weight of the skydiver and inversely proportional to the deceleration
time. Since the dynamic strike is sufficiently extended in time (about two seconds),
the parachutist is not exposed to serious danger if his equipment is well fitted, and
the weapons and cargo are correctly and carefully secured. The danger of a
dynamic impact increases markedly when landing at high speed, therefore, by the
time the parachutists are thrown, the flight speed must be reduced.
The descent stage with the canopy open is the safest for the paratrooper. In
the conditions of a training jump during this period, he must orient himself, turn
around in the wind and prepare to meet the ground.
The moment of landing, the parachutist experiences a blow, the force of which
is directly proportional to the parachutist's mass (with a load), the speed of
descent and the wind speed. It accounts for 67.7% to 95% of all skydiving injuries.
After landing, the landing party proceeds to active actions, accompanied by
significant risk and high expenditure of energy, that is, emotional and physical
stress. Consequently, for many hours and days, the landing personnel work in
extremely difficult conditions. Suffice it to say that after landing, individual units
have to make quick marches for tens of kilometers, following with a load of up to
40-50 kg in unfamiliar terrain, often without roads and in the dark. Energy
consumption can reach 10 kcal / min and more. At the same time, only physically
developed and well-trained people retain a sufficiently high degree of combat
capability.
Airborne units raised on alert must be ready for action in any climatic and
weather conditions. Give out different kitsclothing and footwear or to create a
stock for changing them during hostilities is impossible, therefore, clothing and
footwear of the airborne forces must be versatile, protect well from cold,
precipitation, wind, harmful factors of a combat situation and at the same time
easily transform, changing significantly degree of its heat and windproof, as well as
other properties. In addition, it should be lightweight, not difficult to carry
equipment, waterproof, non-flammable and possessing many special
qualities. Shoes should be comfortable, cushion the impact at the moment of
landing, as well as soft, light, warm enough (if necessary), waterproof.
Modern paratrooper clothing and footwear is not free from flaws. The weight
of a set of uniforms with a raincoat and shoes is 5.5-6 kg, and for a winter one is
10-13.5 kg. Waterproof and some other properties of clothing, also its ability to
transform (in accordance with changes in weather and climatic conditions, the
nature of physical activity andfeatures of combat activity) need further
improvement.
The mass of paratrooper soldiers (machine gunners, machine gunners,
reconnaissance chemists, radio operators, etc.) consists of a mass of clothes,
shoes and equipment, weapons with ammunition, a wearable food supply, a mass
of engineering, anti-chemical and other equipment necessary for a soldier, and also
special equipment and packing (radio stations, chemical and radiation
reconnaissance devices, night vision devices, medical bags, etc.).
The weapons and ammunition of the submachine gunner weigh 6.5-8 kg, the
machine gunner or grenade launcher - up to 12-15 kg. A supply of food, a
protective kit, a gas mask, a shovel, a flask of water and other property (chemical,
engineering, medical, etc.) weigh up to 17-19 kg. Thus, the total mass of the
submachine gunner's load reaches 37-38 kg, the machine gunner, the grenade
launcher - 45 kg or more. The mass of the calculation for specialists is usually more
than that of submachine gunners. In addition, at the airfield and on the plane, each
paratrooper hason itself two parachutes (main and reserve) with a harness with a
total weight of up to 18-20 kg.
It is accepted to consider admissible the mass of the calculation, which does
not exceed 1/3 of the soldier's body weight. With an average body weight of 65 kg,
the display should not be heavier than 22 kg. For soldiers of parachute units, body
weight, as a rule, reaches 70-72 kg. In this case, the mass of the display can be
increased to 24-25 kg. A load of 37-40 kg or more is excessive from a hygienic
point of view. Therefore, in order to preserve the combat effectiveness of the
airborne soldiers, it is necessary to improve the design and lightening of clothing,
reduce the mass of the display, rationalize the shape of the wearable items and their
mutual arrangement.
The hygienic features of the work of motorists, self-propelled gunners,
artillerymen and other specialists, along with those common to all airborne forces,
also have specific features due to the need to work with special equipment. This
specificity is described in sufficient detail in the sections of the textbook devoted to
occupational health in artillery, armored, engineering and other troops.
Artillery. The variety and difference in the tasks facing the artillery determines
the presence of a variety of artillery weapons, including artillery pieces, mortars,
rocket systems, ammunition and artillery devices. The rapid development of
rocketry resulted in the equipping of artillery formations and units with various
missiles (operational-tactical, anti-aircraft, etc.).
In the process of combat training and combat activities, artillerymen encounter
many factors that have a negative effect on the body. The peculiarities of the
artillerymen's work include heavy physical activity, the possibility of injury, the
action of an air shock wave,blast wave, impulse noise, flame jet and powder gases,
frostbite of the hands in winter.
Maintenance and repair of mechanisms, carrying heavy weights (shells,
carriage frames, etc.) require significant muscular work .
Suffice it to say that the mass of one projectile in large-caliber artillery systems
reaches 30-40 kg. When installing the implement in position at the moment of
removal from position, the artillerymen have to lift massive beds with coulter
supports. The result of such tension, with an appropriate predisposition, can be
hernias, discosis,sprains, even tears of muscles and tendons, and various kinds of
traumatic injuries (bruises, fractures, etc.). A significant amount of work associated
with great physical stress is carried out by personnel also when equipping fire,
reserve and false artillery positions in engineering terms.
Injuries in artillery are also caused by the contact of people with various heavy
metal mechanisms and tools and the significant inconvenience of working with
them in mittens, especially at negative ambient temperatures. Bare hand
contact metal surfaces that are chilled in winter can cause frostbite on the
hands. Reducing traumatic injuries in artillery is facilitated by high level of training,
coordination of actions of all numbers of artillery crew, as well as providing them
with comfortable mittens for work in winter.
An air blast wave is generated when firing and bursting projectiles,
mines, etc. It can be muzzle, ballistic and explosive.
The muzzle wave occurs as a result of the ejection from the bore under high
(3000 atmospheres or more) pressure of powder gases. They compress the
surrounding air at the muzzle, creating a positive phase of the wave lasting several
tens of milliseconds. The resulting compression is transmitted to more and more
distant layers of air, which spreads over a considerable distance. Then the positive
phase changes to negative when the pressure drops below atmospheric.

The use of brakes attached to the muzzle of the barrel to reduce the recoil
energy of the gun leads to the fact that the energy of the muzzlewaves propagate to
the sides, up, down and back and increases the possibility of hitting artillery crews,
especially when the wave is reflected from surrounding objects (various buildings,
trees, etc.). The larger the caliber of the gun, the higher the overpressure value in the
positive phase.
The appearance of a muzzle wave is accompanied by the formation of
high-intensity sound waves, with low-frequency sounds mainly occurring in
large-caliber guns, and high-frequency sounds in small-caliber guns.
A ballistic wave is generated by the oscillation of air particles caused by a
projectile. Its energy is usually low, therefore its damaging effect affects only at
close range (about 1m).
The blast wave is formed at the moment of the rupture of a projectile (mines,
bombs, etc.) as a result of an extremely fast (explosive) chemical transformation of
solids into gaseous substances with the release of heat and the formation of
heated,gases compressed to several thousand atmospheres, expanding the
compression front at a speed of up to 5-25 km / s.
The blast wave, like the muzzle wave, is characterized by a two-phase action
(a phase of compression and a phase of rarefaction of air). As it propagates, its
pressure and speed decrease, and, ultimately, it turns into an ordinary sound wave
with a predominance of infra- and ultrasonic frequencies in its spectrum.
The damaging effect of the front of all types of air shock waves is the
stronger, the larger the area of ​the body. The impact of a layer of compressed air
causes a short-term deformation of the human body and the associated trauma to
organs and tissues, which in mild cases is reduced to damage to the eardrum, and
in severe cases it causes a closed craniocerebral injury and numerous injuries of
internal organs.
Thus, during firing from guns, pressure drops, infra- and ultrasonic vibrations
and super-strong impulse noise (140-170 dB) affect the artillerymen; steeply rising
sound pressure, short duration of action, and a relatively slow decay.
The gas-flame jet that occurs when the rockets are launched, like the shock
wave, causes an instantaneous increase in pressure on the body surface and
multiple injuries such as closed injuries. However, due to the longer duration of
action (tenths of a second or second), the gas-dynamic pressure causes much more
severe damage in the body, often incompatible with life, in addition, burns of
varying degrees from the action of highly heated gas streams, as well as bruises

damage to various parts of the body as a result of the throwback effect.

Powder gases escaping from the muzzle brake of artillery systems( especially
recoilless guns) to the sides and back, create an additional danger of destruction of
artillery crews and their troops when placing guns in engineering structures
(trenches, pillboxes, bunkers).
The number of unfavorable factors should also include the contamination of
clothing and leather with fuels and lubricants, both during the operation of mobile
objects of artillery equipment (artillery tractors, etc.), and during disassembly and
cleaning of the material part of the guns.
Troops radiation, chemical and bacteriological protection
(RHBZ) are designed to carry out measures to protect troops in the event that
the enemy uses weapons of mass destruction. To solve this problem, they have
intelligence units, special processing and degassing of uniforms and equipment,
degassing of the area and others.
Intelligence subdivisions carry out studies of air, terrain, water sources and
other objects for contamination with radioactive, toxic substances and
bacteriological agents, establish the type and degree of contamination, denote the
boundaries of zones of radioactive and chemical contamination, determine ways to
bypass them, monitor the contamination of personnel, weapons, equipment and
stocks of material resources of radioactive and toxic substances, keep records
radiation exposure of soldiers and officers and observe the meteorological
conditions.
Subdivisions of special treatment carry out washing of people infected with
radioactive and toxic substances, decontamination, degassing and disinfection of
weapons, equipment and supplies, equip degassing kits and devices, and take part
in rescue operations.
Degassing units of the area carry out the appropriate treatment of
contaminated sections of roads, passages, control points, medical centers and
other facilities. Working conditions in them are the same as in other departments.
In addition to the above works, in the units and subdivisions of the RChBZ,
both in peacetime and in wartime, repair and calibration of radiometric equipment
are carried out
Thus, the working conditions of the military personnel of the RChBZ troops
are characterized by the following main features: a significant amount of work on
the terrain contaminated with radioactive and toxic substances; staying and working
in protective clothing and gas masks, which can contribute to
overheating; exposure to a complex of harmful factors while in special
machines; contact with harmful chemicals used for special treatment, work with
sources of ionizing radiation during the repair and calibration of dosimetry devices.
Engineering troops. The main task of the engineering troops is the
construction of field defensive structures, the construction and overcoming of
obstacles, demolition work, the construction of roads and column routes, the
construction of crossings over water barriers, the provision of troops with water,
etc.during the construction of foundation pits and underground structures,
mechanical and electrical injuries, poisoning with explosive gases are possible.
Injuries increase due to deficiencies in organization and sanitarytechnical support of
workplaces (cluttering workings, poor lighting and ventilation, lack of protective
equipment, irrational overalls and footwear, etc.), as well as as a result of fatigue of
personnel.
Work on the installation and overcoming of mine, wire and other obstacles
and rubble, the opening of anti-tank ditches, etc. is associated with great physical
exertion, the need to use personal protective equipment, the possibility of injury,
and some (mining and demining) - and with a danger to life.
Blasting operations are associated with the risk of injury and explosive gas
poisoning.
The construction of roads and column tracks is carried out using a variety of
road equipment (tractors, excavators, scrapers, bulldozers, snow plows, etc.),
however, in combat conditions, the possibility of widespread use of manual labor is
not excluded. Harmful factors affecting drivers of road vehicles and road builders
can be uncomfortable meteorological conditions, dust, substances polluting the
cabin air (engine exhaust gases, oil vapors), noise and vibration, forced position of
the body during work, as well as overvoltage of certain organs. and body systems.
The construction of crossings over water obstacles is associated with the
work of carrying bulky and heavy parts (flooring, beams, half pontoons, anchors
etc.). Some works do not require significant efforts, but must be done
quickly (laying and securing the bridge deck, installing railings, equipping
pontoons). Large energy expenditures take place when managing floating equipment
on the river (rowing, putting a pontoon into the bridge line,anchoring, steering aft
oar). All bridge building work is done at a high pace. Crossing guidance, as a rule,
takes place at night and under any meteorological conditions.
In the autumn, during the spring and winter months people employed at
the crossings, exposed to cold and moisture, which can lead to colds and frostbite.
Radio-technical troops. The name is relatively arbitrary, since there is no
such type of troops in the modern army. But the use of radio technical objects
(RTO) literally in every service and branch of the military, in military districts and
fleets, both in peacetime and, in particular, in a special period, determines the need
to consider the features of the activities of RTO specialists separately.
At present, electronic equipment has reached a high level of perfection
and has found wide application in many fields of science and technology, including
in the army. Now it is almost impossible to name a branch of the armed forces
where radio-technical systems and installations would not be used.
Along with radar stations (radar), radio technical objects are widely used in
military communications (radio and radio relay stations, repeaters, means of
long-range and space communications, etc.) and in the conduct of electronic
warfare (active jamming systems). The circle of persons exposed to radio waves of
the ultrahigh frequency (microwave) range has expanded. In this case, the influence
of the specified physical factor can be exposed not only to specialists engaged in
servicing microwave field generators, but also to persons who are not directly
related to these technical means.
In addition to microwave radiation, a number of other unfavorable
(nonspecific) factors characterizing the working conditions and the work itself act
on the personnel serving the RTS. These include unfavorable microclimatic
conditions, noise and vibration, high voltage electric current, changed gas
composition and dustiness of the air premises, soft X-ray radiation, irrational
lighting of rooms and workplaces, irrational work regime, heavy load on the central
nervous system and visual analyzer, etc.
Necessary Mark, what the whole complex listed
As a rule, unfavorable environmental factors are not found on the
radar. However, a greater or lesser combination of these factors is common,
especially when hygiene recommendations are violated.
The working conditions of specialists of radio engineering objects, primarily
radars, are largely determined by the option of their deployment. The most
favorable conditions can be provided at stationary facilities that have a sufficient
number of premises for isolated placement at the required distance from all sources
of harm and sufficientengineering and sanitary equipment. The most unfavorable
conditions are created on mobile radio-technical objects mounted on the chassis of
one car. In this case, the following are observed: the least favorable microclimate,
the highest levels of microwave and X-ray radiation, noise and vibration, air
pollution with harmful chemicals, etc.
The electromagnetic radiation generated by the RTO is divided into used and
parasitic. Antenna radiation is called used, and radiation from generators and feeder
paths (waveguides, cables) is called parasitic.
Among the personnel engaged in direct maintenance of modern radio
engineering systems, the following groups of specialists stand out:
heads of PTC, the chiefs of shifts, engineers and technology, providing
combat operation of the stations and performing repairs, adjustment and preventive
maintenance of equipment;
operators working behind indicator screens;
diesel operators servicing power units;
tablet players working at command posts;
personnel of radio engineering workshops.
Specialists of these groups may be exposed to radiation to varying degrees,
however, the work they do makes it possible to assign them in advance definitely
irradiated or conventionally irradiated categories of persons. Undoubtedly, the first
and last groups of specialists should be classified as irradiated, that is, the
engineering and technical staff of the stations and the personnel of radio engineering
workshops, who, as a rule, work in the premises where the receiving and
transmitting equipment is installed, subject to repair and adjustment. They often
work with equipment with broken shielding and are often not time-regulated
The rest of the groups of specialists make up the conditionally irradiated
contingent. Most of the working time they are in rooms shielded from external
radiation and only in the open area of ​positions in the range of radiating antennas
can they be exposed to some extent to microwave irradiation. The conditionally
irradiated personnel should also include those personnel who do not serve the
RTS, but are exposed to the action of fields on the territory of the facilities.
Due to the peculiarities of their work, the group of operators stands somewhat
closer to the irradiated contingent. Indicator screens on some radars are installed in
working rooms along with generating equipment,therefore, operators can be
exposed to internal fields.
This division of specialists into groups makes it possible to roughly establish
which of them in the course of their work is exposed to the microwave field. A
specific characteristic of the level of exposure can be given only on the basis of
objective data based on the results of measuring the PES, the timing of the work of
a specialist and the work of the station for radiation.
The level of radiation exposure of personnel in the open area of ​the RTS
position depends primarily on the intensity of EMF. For modern RTS, the range of
radiation intensities can be from negligible values ​to several watts per square
centimeter.
The levels of intensity of spurious radiation can also be different, and although
they are significantly lower than the PES of the radiation used, nevertheless, they
can reach values ​that significantly exceed the permissible ones.
Even insignificant gaps in loosely closed cabinet doors can cause radiation in
2
the cabins with an intensity of up to 30-50 µW / cm . Radiation generated as a
result of energy leakage through the cathode leads of magnetrons can penetrate
through slots and ventilation openings, near which the PES reaches 1000 μW / cm
2
. In the case of an unshielded unit, the radiation intensity can reach 1000-2000 μ W
2 2
/ cm , and for generator lamps it is 3000-4000 μW / cm .
The system for preventing the adverse effect of microwave radiation on the
human body provides for monitoring the design of the RTO, as well as engineering
and technical measures to protect against microwave radiation. Microwave
emission limits are strict. The prevention system also includes medical selection of
persons to work with microwave generators and constant dispensary supervision of
specialists.
Protection in rooms from microwave radiation is achieved by rational
placement of emitting devices, shielding of workplacesmetal sheets or nets, the use
of personal protective equipment - protective suits and goggles, limiting the
duration of the device's operation for radiation, reducing the working time of
specialists.
In open areas, protection against microwave radiation is achieved by
designating zones of normalized radiation, rational placement of radio technical
devices, using the terrain when choosing a site for objects in which people should
be, and observing the necessary distances between emitters and living quarters. To
protect people in rooms located close to radar antennas, windows and walls facing
the radiator are shielded. Trees are planted around residential buildings.
Microwave shields are made of materials that can reflect or absorb radio
waves. Protect well againstmicrowave radio waves conductors of electricity. Solid
sheet metal fully reflects the electromagnetic wave at any polarization. The metal
mesh also attenuates microwave fields. The degree of attenuation depends on the
diameter of the wire, the size and shape of the mesh. The thicker the conductor and
the smaller the mesh, the higher the protection effect. In a protective overalls made
of metallized fabric, in order for the fabric to reflect an electromagnetic wave of any
polarization, metallized threads are included in both the weft and the warp.
Taking into account the variety of RTO types, deployment options, modes of
their operation and location in all climatic zones, the microclimate of the premises
varies within wide limits, therefore, it is not possible to talk about any general or
typical parameters of the thermal state of their environment for most stations.
Air conditioners are the best way to keep the microclimate at an optimal
level. Powerful and properly equipped supply and exhaust ventilation at an air
speed of 0.4-0.5 m / s is very effective, which ensures the removal of heated and
polluted air directly from the places of its formation. The shielding of the heating
surfaces of the equipment and the thermal insulation of the cab help to maintain the
radiation temperature at an optimal level. Thermal insulation is especially needed in
the northern and southern regions. In the prevention of overheating and
hypothermia, rational clothing occupies an important place.
Sources of acoustic noise in the RTO rooms, where the EMP generators are
located and the maintenance personnel are located, can be special technical
equipment and ventilation systems (technological and general exchange). Noise can
also penetrate from neighboring rooms (diesel, unit), ventilation chambers, turbo
blowers, etc. The levels of acoustic noise in indicator rooms can reach 90-95 dB, in
generator rooms - 95 dB, and in aggregate and dieselindoors - 115-120 dB, mainly
in the low and mid-frequency range (up to 800-1000 Hz).
Noise distracts the personal composition of the performance of the
combat operation, do not give focus on it, reduces mental and physical
performance, causes premature and more significant fatigue, and under certain
conditions can cause painful changes in the body. Work in many radar rooms
should be equated with a quiet production room, that is, noise levels of 60 dBA
should be considered acceptable for them, and up to dBA.
Radar noise is usually accompanied by vibration from motors and fans that
cool electronic equipment. Not only units or their individual parts can vibrate, but
also the floor, walls, windows, doors - that is, everything that is in the range of the
operating units. More often, vibration lies within the tolerable values, and only a few
individuals who are sensitive to it develop fatigue and drowsiness.
To reduce the level of noise and vibration on the radar, it is necessary to
mount the fans on shock absorbers, or to take them out of the station by
connecting housing with the help of soft air ducts, if possible, replace fast-rotating
fans with slow-rotating ones, close the cab doors tightly.
Radar X-rays are unused. It is generated by indicators and electric vacuum
devices (kenotrons,thyratrons, magnetrons, klystrons, spark gaps) operating at
voltages exceeding 10-15 kW. More often this is the so-called soft X-ray radiation,
which has a relatively low penetrating and ionizing ability. When assessing the risk
of exposure to X-ray radiation on the radar, the significance of this harmful factor
should not be exaggerated, however, it should not be underestimated.
Cathode ray tubes (indicators) are less dangerous than radio tubes, since they
have thickened leaded glass walls, and powerful tubes are mounted in a box with
lead shielding.
 During normal operation of the radar, personnel are practically not exposed
to X-ray radiation, since protection from it is provided for in the manufacture of
these devices. X-rays can enter the work area through unprotected viewing
windows,ventilation openings, leaks in the shielding, as well as during adjustment
and repair work due to violation of the shielding.
Harmful impurities to the air of the working premises of the radar are formed
during the operation of power units and equipment, as well as as a result of human
activity. These are carbon monoxide, nitrogen oxides, ozone, decomposition
products of fuels and oils, hydrocarbon vapors, fluorine, formaldehyde, carbon
dioxide, and anthropotoxins.
The tension of a number of mental functions - attention, the speed of the
memorization reaction and, in particular, the function of the visual analyzer is
characteristic of the activity of operators. While observing the screen, a prolonged
tension of mental functions occurs with a motionless or sedentary working posture
in a quiet, monotonous environment, when extraneous stimuli are almost completely
absent. This phenomenon, called by experts "sensory hunger", leads to the
development of fatigue.
In addition, lighting is of great importance in the activities of
operators. Significant load on the organ of vision in case of incorrect operation
behind the indicator, different brightness of screens, adaptive lighting
luminous instrument scales - all this can lead to visual fatigue Prevention of
visual fatigue includes the regulation of work and rest, rational lighting equipment,
training operators in the hygienic rules of visual work, in particular the rules for
working behind the screen, control over the content in the dietvitamins and
replenishment of their deficiency. Operators are rarely exposed to microwave
radiation.
The work of diesel operators associated with the maintenance of power units
can take place in conditions of short-term exposure to strong noise and exhaust
gases, as well as contact with fuels and lubricants.
Features of labor in parks of equipment and weapons.
The equipment and weapons park (TV park) of the military unit is one of the places
where personnel are at increased risk of traumatic injuries, colds and skin
diseases. Maintenance and repair of weapons and military equipment in TV parks is
accompanied by a number of unfavorable factors for health, associated both with
the peculiarities of the technological process and with possible shortcomings in
ensuring healthy and safe working conditions for personnel.
The most important work is carried out at the point of maintenance and
repair (PTOR) . All types of complex technical maintenance and current repair of
weapons and military equipment of the unit are carried out here . PTOR has areas
for tracked and wheeled vehicles, missile and artillery weapons, auxiliary and
sanitary facilities. As a rule, specialized sections (posts) are created - for technical
diagnostics of weapons and military equipment, routine repair of machine units,
metalwork and mechanical work, electric and gas welding, forging copper and tin
works, maintenance and repair of electric special equipment and fuel equipment, tire
fitting and vulcanization works, repair of bodies, seats, stands, painting works, etc.
For the prevention of injuries and other injuries personal composition
technological equipment in production facilities is installed in such a way that at
least 1 m is free access to machines and machines from the side of the working
area, from the side of the non-working area -0.5 m. The width of the main aisles
inside the premises should be at least 1.5 m. In the areas where the dismantling or
movement of heavy units or parts is carried out, lifting equipment (cranes, hoists,
etc.) are provided.
To prevent injury to personnel, it is very important that all operating equipment
and tools used are in good condition. The machines are provided with devices that
reliably protect the workers themselves and others from flying chips, sparks,
etc. The surfaces of workbenches, tables and shelves must be smooth, free from
dents, burrs, cracks and other defects. Hammers, chisels, cores, sledgehammers,
anvils, screwdrivers, etc., which have cracks, chips, burrs, work hardening,
knocked down surfaces, are not allowed to be used. Files, hacksaws, chisels can
only be used with handles. Wrenches, pliers, etc. also should not have cracks,
nicks, their lips should be parallel and not worn out. Do not use oily
tools. Defective tools should be removed and stored separately for disposal or
repair.
To sweep away chips and dust from machines and equipment, brushes or
brooms (metal and hair) should be used. For cleaning machines, workbenches,
etc. rags are used. For the used cleaning material, metal boxes with lids are
installed. At the end of the work, all industrial waste and garbage accumulated
during the day should be taken out of the work premises to specially designated
places in the park.
In order to prevent electric shocks in the park, electrical safety requirements
must be observed. Under the switchgear (switchboard), the floor must be insulated
with rubber mats. The presence of bare electrical wires, their uninsulated ends,
broken sockets is not allowed. To protect personnel from electric shock leakage
when touching non-conductivethe metal parts of electrical installations must be
grounded. In the inspection ditches of the PTOR, electric lighting is allowed from
the network with a voltage of not higher than 42 V.
At the points of the highest emission of harmful gases, vapors and dust into
the air of the working area, local exhaust ventilation with mechanical induction is
arranged. Local suction units are installed:
in battery (from cabinets for charging rechargeable batteries,
places for electrolyte preparation, a table for disassembling batteries, places
for melting lead, alkalization baths);
at the site of forge and copper-tin works (from furnaces for hardening and
annealing of parts, hardening baths, muffle furnaces, forge forges);
at the welding site (from the table or rotary-tilting device);
on the painting site (from painting chambers);
at the workplace for the repair of fuel equipment;
at the site of tire fitting and vulcanization works (from the apparatus for
vulcanizing chambers, from grinding machines, workbenches for spreading
adhesives, etc.).
Among the objects of the park, accumulator batteries stand out as a place of
possible occurrence of chemical injuries to personnel. Rechargeable (acid and
alkaline) TV parks are designed for storage, maintenance and repair of batteries,
charging them and carrying out control and training cycles, as well as for preparing
and storing the necessary electrolyte reserves. Not only accumulators, but also a
wider circle of military personnel (members of the crews of military vehicles) are
exposed to the danger of being hit by corrosive liquids here. Such injuries are most
likely when actions are taken to urgently (on alarm) bring the stored storage
batteries into working condition and give them out on a massive scale.
The dimensions of the production areas of accumulator batteries are
determined depending on the needs of the military unit in daily charging.
used rechargeable batteries, as well as the storage conditions and putting into
working condition of dry-charged batteries. Never charge acid and alkaline batteries
in the same room.
It is unacceptable to place accumulator batteries over rooms with working
personnel. The walls of the storage batteries are sealed in such a way as to prevent
the penetration of storage gases into adjacent rooms.
In rooms with acid battery floors are lined with ceramic tiles or other
acid-resistant materials, and in alkaline ones - with alkali-resistant materials. Walls,
ceilings, doors and window frames, metal structures and ventilation ducts should
be painted with acid and alkali resistant paints.
in order to ensure electrical and explosion safety, the starting devices of
ventilation units, switches, plug sockets, electrical network protection equipment
are located outside the working rooms of the accumulator rooms (in the corridor,
vestibule). Floor areas near chargers should be covered with insulating material
(rubber mats).
All battery rooms are provided with natural and artificial lighting. Artificial
lighting is provided by explosion-proof luminaires, while the illumination of the
premises at the floor level must be at least 20 lux.
The evolved battery gases and electrolyte aerosols are removed from the
battery rooms using ventilation. In the rooms for charging and storing batteries,
general exchange insulated supply and exhaust ventilation with mechanical induction
in explosion-proof design is equipped, providing 8-10 times air exchange per
hour. Its device should exclude the presence of stagnant areas under the floors of
the building. Do not combine acid and alkaline battery exhaust ventilation
lines. Umbrellas and duct boxes for exhaust ventilation must be made of acid
resistant materials.
Racks, battery repair stations and electrolyte preparation stations are equipped
with local forced exhaust ventilation in explosion-proof design. When combining
workplaces in the case of combining the reception, repair and charging of batteries,
the latter should be carried out fume hood.
Rooms for charging and storing batteries, exceptforced supply and exhaust
ventilation, natural exhaust ventilation is provided from the upper zone of the
room. A mechanical exhaust system must have two fans (operating and standby)
with automatic activation of the standby when the operating fan stops.
The polluted air removed from the battery rooms is discharged into the
atmosphere above the roof of the building so that the exhaust shaft rises above its
ridge by at least 1.5 m. Filters are installed to clean the supply air.
The personnel working in the battery room (regular accumulators and military
personnel arriving to bring dry-charged batteries into working condition) are
provided with suits made of cotton fabric with acid-resistant impregnation, rubber
aprons, rubber and cloth gloves (mittens), rubber boots (galoshes), goggles with
shatterproof glasses, respirators. At the battery reception post, two or three sets of
special clothing are additionally provided for personnel who donate batteries for
charging and repair.
To avoid chemical burns to the skin and eyes, poisoning with aggressive
vapors, and electric shock, you must:
store acid, liquid alkali, electrolyte in glass bottles with ground-in stoppers or
plastic bottles and canisters with tight-fitting lids;
carry bottles with acid, alkali, electrolyte only together inbaskets or in wooden
crates; to use special dispensers (tilters) for filling the contents of bottles;
prepare electrolyte only in special baths resistant to acid (alkali) action; when
preparing the electrolyte, always pour acid or alkali into the water in a thin stream
with continuous stirring with a glass or ebonite stick;
for inspection, maintenance and repair of chargers, disconnect them from the
mains.
In all working rooms of the battery room with the presence of acids,
alkalis electrolyte, you must have in readiness for immediate use a supply of means
for neutralizing spills: 10% soda ash solution (for acid battery), 10% boric acid
solution (for alkaline battery), cold water in an amount of at least 10 liters. One of
the rooms should contain a first-aid kit. Personnel,working in a battery room, must
know the procedure for eliminating emergency spills of acids and alkalis, as well as
the rules for providing first aid (in the order of self-help and mutual assistance) in
case of electric shock, when acid or alkali gets on the skin and eyes.
In connection with the widespread use of toxic technical fluids (YATZH) in
the operation of military equipment, unremitting attention should be paid to the
prevention of poisoning , for which:
storage, accounting and use of YATZ shall be carried out in strict accordance
with the established requirements;
keep all technical equipment in good working order , intended for
transportation, reception, storage and delivery of YATZh;
store YATZh only in closed metal containers, do not allow them to spill. It is
strictly forbidden to store YATZh in any quantities outside of special storage
facilities, in barracks, production facilities of the park and on cars. The received
YTZh should be immediately used for its intended purpose, and the merged ones
should be handed over to the warehouse.
Permanent TV parks must have an established set of sanitary facilities. It
includes dressing rooms for all personnel of repair units, rooms for rest and heating
of personnel, showers, storerooms for storing clean and dirty work clothes, and
toilets. In the buildings of the control and technical point, the filling station, the
PTOR, the warehouses of military-technical property, the accumulator rooms and,
if necessary, in other rooms, washbasins with hot and cold water supply are
installed. In the absence of hot water supply networks on the territory of the TV
park, equipment for local heating of water should be installed.
For work in the park, both military personnel and civilian personnel are
provided with special clothing and protective equipment according to established
standards.
During the cold season, personnel working in the park outdoors or in unheated
rooms must be provided with warm overalls. If it is necessary to access the
low-lying parts of the machine from the position of the repairman lying down, it is
imperative to use loungers made of heat-insulating materials.
To protect the eyes and face, electric welders are provided with special
shields with replaceable glasses, selected depending on the strength of the welding
current. Gas welders, turners and other metalworkers must wear safety
glasses. Respirators must be used to protect the respiratory system from harmful
aerosols when painting.
For the prevention of pustular diseases of the skin and subcutaneous tissue, it
is recommended to use protective ointments and pastes (the so-called "biological
gloves"). In areas where soldering is carried out using lead-containing solder, a
washstand filled with a 1% solution of acetic acid should be installed to handle the
hands at the end of the work.
Soap for military personnel for hygienic needs is dispensed to public places
(washbasins, showers) at the rate of 100 g per month per one person of
staff. Civilian personnel in contact with hazardous chemicals (battery operators,
electric gas welders, etc.) are entitled to free milk and soap delivery.
5.5. Prevention of occupational pathology in military personnel
All activities aimed at preventing occupational pathology are aimed at solving
three problems:
improving the environment in the workplace and optimizing the work itself;
strengthening the physical condition of workers;
increasing the level of their sanitary culture.
The implementation of these measures is carried out in the following main
areas: ensuring safe and harmless working conditions; regulation of the level and
duration of exposure to a harmful factor; professional selection of
specialists; medical control over the health of workers with occupational
hazards; strengthening the physical condition and increasing the nonspecific
resistance (resistance) of workers; hygienic education of workers.
Ensuring safe and harmless working conditions is achieved by a complex
of diverse measures, the most important of which are engineering, architectural,
planning, sanitary, administrative and organizational, safety measures, protective
and providing conditions for observing personal hygiene rules.
Engineering and technical measures are aimed at eliminating or reducing
the corresponding occupational hazard at the source of its formation, preventing
this hazard from entering the environment and its impact on people. The most
radical of these measures isreplacement of harmful and hazardous technology or
equipment with less harmful and hazardous ones.
Architectural and planning measures are aimed at maximum separation
and distance from each other of sources of harm and people: zoning of the territory
of a military camp or a military production facility, taking into account the wind
rose and sanitary gaps between them, the appropriate layout of the technical area,
individual buildings and premises, the allocation of clean and dirty areas, serviced,
semi-serviced and unattended premises, rational placement of equipment in
premises, etc.
Sanitary measures provide for the optimization of working conditions. They
include equipment with sufficient capacity for ventilation, heating, water supply,
lighting and sewerage of work premises.
Administrative and organizational measures consist in the rational
organization of work as a whole, the development of an optimal working regime,
the organization of the workplace, etc.
Safety measures when working with moving parts of machines and
mechanisms or parts, when working with electric current, fire and explosive
substances and objects, compressed and liquefied gases, poisonous technical
fluids, etc. are aimed at preventing injuries, burns and injuries by aggressive or
poisonous liquids.
Protective measures include the protection of workers with personal
protective equipment for the respiratory tract, skin, eyes, hearing organ, etc., the
use of protective ointments and pastes.
Measures to ensure conditions for observing the rules of personal hygiene
include: equipping sanitary passages, showers and washbasins, providing cold and
hot water, providing overalls, detergents, towels or electric dryers, etc.
They must ensure the ability to meet hygienic requirements when working with
chemicals, biological and radioactive materials, as well as in dusty production
environments, and thereby reduce the possible adverse effects of these works.
Regulation of the level and duration of exposure to harmful factors includes:
scientific substantiation of restrictions on the level and duration of exposure to
harmful factors, real provision and control over compliance with standards.
The professional selection of specialists is primarily aimed at preventing
persons from working with hazardous and harmful production factors, whose
individual characteristics make them the most sensitive to the action of this harmful
factor and who have contraindications for working with it, as well as the selection
of servicemen for specific military specialties, who, according to their constitutional
characteristics and psychophysiological capabilities are best suited to work in these
specific conditions. In this case, the fulfillment of official duties by servicemen will
require from them the least expenditure of physical forces and neuropsychiatric
stress and, therefore, will have an adverse effect on their health to a lesser extent.
Medical control over the health of workers is carried out in stages and
includes preliminary (when called up for military service or joining), periodic and
extraordinary medical examinations and examinations. In addition, in the process of
combat training and in everyday life, daily medical supervision is carried out, and
dispensary dynamic observation is established for servicemen exposed to
occupationally harmful factors of military service. The purpose of these measures
is to establish contraindications for working with hazardous harmful factors and
possibly earlier detection of disorders starting in the body or already existing
diseases, solving the issue of professional suitability of the worker, admission to
work with harmfulfactors.
Strengthening the physical condition and increasing the nonspecific
resistance of workers is achieved by improving their living conditions, rational
organization of nutrition, including therapeutic and prophylactic, systematic
physical education, measures to temper the body, good rest and sanatorium
treatment. An increase in nonspecific resistance contributes to an increase in the
resistance of workers to the action of occupational hazards.
Hygienic education is aimed at explaining the danger or harmfulness of
production factors, the nature of their influence on health and possible
consequences; formation of a conscious attitude among workers to the
implementation of preventive recommendations and the use of personal protective
equipment; development of a habit and internal need for compliance with the rules
of personal hygiene; development of a hygienic way of thinking and behavior,
including at least giving up bad habits - smoking, drinking alcohol, etc.
The above measures are far from being equivalent in terms of their impact on
the prevention of occupational diseases. Leading here are measures to ensure a real
safe and harmless working conditions.
5.6. Medical supervision of the military professionalactivities of
military personnel
Medical control over the military professional activities of military personnel
is the activity of officials of the military medical service of the Armed Forces of the
Republic of Uzbekistan to monitor the implementation of hygiene standards and
requirements the process of military training activities of troops, physical training,
performance of official (in their military specialty) and others, due to service needs
(construction,economic, etc.), duties and works. It aims to warn military personnel
of occupational and other diseases, injuries, injuries and fatigue.
Medical control over the military professional activities of military personnel is
carried out in order to maintain a high combat readiness of military units and
formations through the preservation and strengthening of the health of military
personnel, and an increase in their efficiency (combat capability).
The objects of control are: the health of a serviceman (military collective) and
the conditions of military professional activity.
Medical control over the training and combat activities of military personnel
includes:
observation, assessment and forecasting of the health status of troop
personnel in connection with the specifics of their training and combat activities;
establishment of cause-and-effect relationships between the characteristics of
combat training activities, morbidity and other indicators of the health of military
personnel;
registration of infectious and non-infectious diseases caused by the harmful
effects of factors associated with the training and combat activities of the troops;
participation in the development of plans for combat training in order to fully
implement the hygienic requirements for ensuring the regime of military service, the
magnitude and intensity of physical activity, the alternation of various activities;
checking the equipment of military personnel during training in the open air
and meeting the requirements for the prevention of hypothermia or overheating;
checking and assessing the sanitary condition of the places where classes are
held;
checking the implementation of measures to prevent injuriespoisoning of
servicemen by poisonous technical fluids, powder and exhaust gases during firing
and operationmilitary equipment;
verification of the implementation of measures to prevent the impact of
unfavorable meteorological factors (high or low ambient temperatures, etc.),
overwork of personnel during long marches;
assessment of the correspondence of the magnitude and intensity of physical
activity to the physical development of military personnel.
 Medical control at performance by military personnel official and others,
conditioned business need, duties and work includes checking:
compliance of the placement, equipment and equipping of the premises of the
military unit with the sanitary rules;
the availability of instructions on the rules for the safe conduct of work,
accounting for the briefing of personnel;
compliance of microclimate parameters, illumination, etc. sanitary
epidemiological rules and regulations by carrying out instrumental
measurements and based on the results of laboratory tests carried out by specialists
of sanitary and epidemiological institutions (divisions);
the correctness of accounting, storage and consumption of toxic technical
liquids, radioactive substances and other sources of ionizing radiation;
provision of personnel with overalls and personal protective equipment for
the respiratory system, vision, skin;
conditions for washing personnel after work;
availability of tents (points) for periodic heating of personnel, performing
work in cold weather outdoors;
availability and completeness of first aid kits,the ability of servicemen to use
them;
- timeliness and completeness medical examinations andexaminations of
persons working under conditions of exposure to occupational hazards;
organization of therapeutic and prophylactic nutrition.
5.7. Hygienic requirements for military clothing,shoes and equipment
Rational individual equipment ensures high physical activity and efficiency of
servicemen. A set of equipment consists of combat (uniforms, equipment,
weapons and ammunition required to complete a combat mission) and economic
(items required for organizing everyday life in the field) parts.
Cloth. The direct or indirect effect of clothing on the human body is exerted
by its mechanical, physical and chemical properties.
Mechanical properties of clothing are subdivided into general and structural
and mechanical properties. The general includes a lot of individual items.
sets, thickness of clothing materials and bags, ply, friction, density and
porosity. Structural and mechanical properties determine the correspondence of the
design of clothing to the anthropometric data of a person and his motor abilities,
as well as to the conditions of use of clothing. These properties characterize the
convenience of clothing in the process of performing combat training activities by
military personnel.
TO physical properties clothes include thermal insulation
(breathability, ventilation, vapor permeability,hygroscopicity, moisture permeability,
thermal conductivity, radiation absorption), dust holding capacity and
electrification.
The chemical properties of clothing determine the chemical resistance of
materials, the ability to absorb chemicals and desorb them into the environment.
Effective functioning of the system "person - clothes - environment" is
possible only if the clothescorresponds to the anthropometric data of a person, his
motor and functional capabilities and is adequate to the changing parameters of the
environment.
To assess the conformity of clothes to the anthropometric data of a person,
size and height characteristics, the time of putting on and taking off clothes, the
efforts applied when putting them on and off, as well as the subjective feelings of a
person are used. The conformity of the design of clothing to the motor capabilities
of a person is determined by the maximum amplitudes of active movements in the
large joints of the upper and lower extremities of a dressed person, efforts to
overcome the resistance of clothing when performing movements, the level of
pressure of clothing on the body in dynamics, as well as by the accuracy, speed
and pace of working movements.
The thermal state of a person can be judged by the temperature of the "core"
and "shell" of the body, extrarenal loss of water, the functional state of the
cardiorespiratory and other systems of the body.
Hygienic requirements for clothing are aimed at protecting a person from
adverse environmental factors, ensuring his performance (combat capability) and
maintaining health. They apply to all the hygienic properties of clothing, are
differentiated depending on the climatic zones for which the clothing is intended, as
well as on the living conditions and labor (combat training) activities of a person
and are divided into general and private. General requirements apply to all types of
clothing, regardless of who, when and in what conditions it will be used. Particular
requirements include those that apply to clothing designed for specific conditions
of use.
In accordance with general hygienic requirements, the design and size and
height characteristics of military clothing must correspond to anthropometric data
and the necessary volumes of working movements of military specialists, geometric
sizes and volumes of jobs,the dimensions of the entrance and exit hatches of
military equipment. Clothing should be easy to put on and take off, not impede
movement, breathing, blood, lymph circulation and the discharge of natural
physiological needs, not significantly narrow the field of vision and not reduce
visual acuity and hearing, in any conditions not interfere with the performance of
professional duties and the provision of first aid to the wounded and amazed.
Clothing items should be well combined in terms of basic size and height
parameters with each other, with shoes, overalls, equipment and personal
weapons. On the surface of the clothing there should be no protruding parts and
elements clinging to the equipment and parts of the equipment used.
According to its structural and mechanical properties, clothing should provide
freedom of active movement in the joints of the upper and lower extremities of a
dressed person with amplitudes for which standard values ​have been developed.
Clothing should protect the skin from possible mechanical traumatic factors,
blood-sucking ectoparasites, poisonous animals, thorny and stinging plants,
excessive solar radiation, as well as contamination with dust, dirt, fuels and
lubricants and other substances.
The mass of individual items and sets of clothing as a whole should be
minimal for its given thermal insulation properties and should be evenly distributed
in the package of products.
In terms of its thermal insulation properties, clothing should correspond to
climatic and weather conditions, the nature and intensity of labor, the availability of
opportunities for heating and resting people, as well as the energy cost of their daily
food rations. In all cases, it should ensure the preservation of the optimal,
permissible or maximum permissible thermal state of the body during a given
(required) time.
Clothing during its use should not emit chemical substances that smell and are
harmful to the body and have an irritating, general toxic, allergenic and other
harmful effect on the human body. It should be non-marking, easily cleaned of dirt
and dust, not lose operational and hygienic properties after washing, mechanical
and dry cleaning, withstand all types of disinfection, disinsection, degassing and
decontamination.
Shoes. Shoes are designed to protect feet and legs from external mechanical
and thermal influences, moisture, pollution, insect and animal bites. The most
common types of footwear for military personnel are boots and boots with
extended ankle boots.
The properties of footwear, including military footwear, are subject to
complex and contradictory hygienic requirements, which largely coincide with the
requirements for clothing. She must rationally combine hygiene,operational and
aesthetic properties with the physiological functions of the lower limbs of a person
and comfort for the foot.
The hygienic characteristics of footwear include the weight and flexibility of
the footwear, the cushioning and frictional properties of the bottom, the shape and
internal dimensions of the product, the speed of molding to the foot, and thermal
insulation properties.
The insulating properties of footwear are of particular importance, since in the
structure of frostbite, especially in wartime, lesions of the feet predominate.
Protective properties from external moisture are determined by wetness,
moisture resistance and water absorption - qualities that depend on the properties
of the material and the construction of the shoe.
The hygienic characteristics of shoes affect the biomechanics of movements,
functional state and physical performance, provide the necessary relative comfort
to the shod foot and largely determine the general well-being and mobility of
servicemen duringperforming combat training activities by him.
Shoes must be highly durable, retain their original shape, size and flexibility
after moistening, drying, special processing and during long-term storage. By its
design and cut, it must fit into the general ensemble of equipment, be combined
with clothing, equipment and additional personal protective equipment.
Equipment. The individual equipment of soldiers and sergeants of motorized
rifle units consists of a waist belt, a shoulder strap, a bag for magazines for a
machine gun, a grenade bag, covers for a flask and a small sapper shovel, a duffel
bag (backpack) and a cover for protective stockings and gloves. The duffel bag
(backpack) contains a raincoat-tent, spare linen and footcloths, a bowler hat, a
mug, a combat food ration or dry rations. Toiletries, a towel, a spoon, and
household items fit into the pocket of the duffel bag.
In addition, the equipment includes a protective helmet and anti-splinter body
armor. In real conditions of training and combat activities, a soldier must also have
an assault rifle, 4 ammunition of cartridges, 4 magazines, a small sapper shovel, a
gas mask, 2 flasks with drinking water and an OZK, and in cold periods of the year
- a sleeping bag.
The limiting, from a hygienic point of view, the properties of the equipment of
military personnel are its mass and the distribution of individual objects on the
human body, since they significantly affect the stability of the body when standing
and the energy consumption of a person. Improperly positioned equipment
constricts chest excursions, impedes blood circulation and causes premature
fatigue of muscle groups. In addition, items of equipment, covering about 70% of
the body surface, impede heat transfer and evaporation of sweat from the body
surface.
The recommended permissible value of the total mass of equipment worn by
military personnel (including clothing and footwear) is 40 kg, and the mass of a
backpack with property is 24 kg. The mass of items placed in front andbehind, as
well as on the right and left surfaces of the body, should be balanced. Relatively
less static muscle tension and restriction of respiratory excursion of the chest
occurs if the load in the back and lumbar region exceeds the load in the front by no
more than 2-3 times.
The equipment must be adjusted in such a way that it does not impede
breathing and blood circulation, and also does not cause abrasions of the skin on
the body and limbs.
Clothing security military personnel includes supplyuniforms, footwear,
underwear, bedding, warm clothes, overalls, sanitary and household items,
materials for sewing and repairing clothing items, technical means for dry cleaning,
repair, etc .; organization, repair and dry cleaning of clothing. According to official
documents, it is assigned to the clothing service.
The medical service oversees the organization and adjustment of clothing and
footwear; the timely provision of servicemen with all required types of clothing
allowance; the compliance of worn clothes and footwear with the temperature
conditions of the environment and the nature of military training and combat
activities; compliance with the established rules for the operation of clothing,
footwear and equipment; the sanitary condition and serviceability of clothes, shoes
and equipment, the timeliness of their drying, washing and cleaning.
Control questions
1.Hygiene of military labor: definition of definition, essence and tasks.
2.Modern classification of factors of the labor process.
3.Principles of modern classification of working conditions.
4.Characteristics of chemical factors in the hygiene of military labor.
5.Hygienic characteristics of physical factors of labor process.
6.Hygienic features of work in tank troops.
7.Hygienic features of work of personnel of radar stations.
8.The problem of habitability in the hygiene of military labor.
9.Heat lesions and measures for their prevention.
10.Ways of preventing occupational pathology in military personnel.
Test questions on the topic
1. Teaches military hygiene
a) the nature and impact of the state of combat readiness on servicemen
b) the impact of the military production environment on the body of
servicemen for the development of preventive measures
c) the impact of the environment on the bodies of servicemen
d) basic patterns of change in the state of health and combat effectiveness of
troops
2. Place of residence - includes the concept
a) environmental factors
b) a combination of the same group of factors
c) a complex of physical, chemical and psychophysiological factors that
affect the body when interacting with military equipment and weapons
d) the nature of the training and combat situation
3. The main factors of residence
a) physical, chemical, psychophysiological
b) chemical, biological, production
c) production, transport
d) physical, biological
4. Includes physical factors of residence
a) light, humidity, area of ​the room
b) dust, air velocity
c) noise and vibration, microclimate, electromagnetic radiation
d) psychophysiological stress, components of rocket fuel.
5. Fundamentals of the theory of military hygiene methodology
a) hygienic regulation and biological research
b) use of hygiene norms, sanitary characteristics and statistics, as well as
biochemical, physiological and hygienic research
c) evaluation of facility design systems and development of preventive
measures
d) primary prevention
6. A building for the permanent location of a military unit in a certain area
a) barracks
b) training center
c) military school
d) military town
7. Staff of medical staff of the sanitary-epidemiological laboratory (flood)
a) doctor-toxicologist, doctor-laboratory assistant
b) hygienist, toxicologist, epidemiologist, radiologist
c) general practitioner, infectious disease physician
d) surgeon, general practitioner, epidemiologist
8. Specific factors of military labor
a) engineering-psychological, psychological, socio-psychological
b) abiotic
v) biotic
d) physical
9. Harmful factors affecting the personnel of motorized infantry while driving
a) the effect of ultraviolet radiation;
b) the effect of ionizing radiation;
c) vibration, shock and impact, noise, dust, adverse meteorological factors,
dust and exhaust gases
10. Prevention of overheating of motorcyclists during the march
a) decrease in heat transfer, increase in body heat production, restriction of
drinking;
b) use of layered clothing;
c) a decrease in the thermal effects of the environment, an increase in heat
transfer, a decrease in the body's heat production, the organization of a rational diet
and drinking regime.
11. Harmful factors affecting tankers when the crew is in the tank
a) electromagnetic and ionizing radiation;
b) dispersed components of nuclear charge;
c) adverse temperature conditions, exhaust gases, dusty air, noise and
vibration, forced state, dust and explosive gases.
12. Includes harmful and dangerous factors of military labor
a) mechanical and physical
b) chemical and biological
c) mechanical, physical, chemical, biological, informational,
socio-psychological factors of social process
g) physical and chemical
13. All measures aimed at preventing occupational pathology of servicemen
a) improving the external environment in the workplace
b) strengthening the physical condition of workers
c) raising the level of sanitary culture
g) improving the external environment in the workplace and optimizing the
work itself,
strengthening the physical condition of workers, improving the level of
sanitation
culture
14. Personal equipment includes:
a) portable water purifier "Rodnik"
b) "Tourist-2M" device
v) carbon cloth filters
g) military filter station
15. Military occupational hygiene is one of the departments of military hygiene
a) all factors of the labor process are studied
b) all factors of the labor process, their military personnel
CHAPTER 6. HYGIENE OF TROOPS MOVEMENT
6.1. Sanitary and anti-epidemic (preventive) measures during the
transport of troops by rail, water and air transport
Transportation by rail and water transport in wartime hinterland areas are
the most common. At the same time, military echelons are formed, which are
understood as a military unit or its subdivision organized for transportation in one
train or on one ship.
The railway military echelon provides for wagons for personnel, an isolator, a
kitchen, a wagon for food (in summerisothermal car). The railway carriages,
prepared in a sanitary sense, cleared of debris, washed with hot water and
disinfected, provided with removable military equipment, are provided by the
railway. If necessary, dosimetric control and decontamination are performed. The
prepared wagons are checked by the commission and sealed. The composition of
the commission for the acceptance of a military echelon ina representative of the
sanitary and epidemiological supervision bodies of the Ministry of Defense of the
Republic of Uzbekistan, or a doctor of the unit for which this echelon is dressed
up, must be included.
Removable military equipment of railway cars intended for the transport of
personnel includes boards (including for the device of bunks), lanterns, buckets,
ladders, window frames, brooms, and during the heating season - stoves with the
necessary equipment.
The task of the military medical service and representatives of
sanitary-epidemiological institutions and subunits is to identify circumstances that
may adversely affect the health and combat effectiveness of soldiers and officers,
and take measures to eliminate them, through constant monitoring of personnel and
transport conditions.
The head of the medical service of a military unit, when planning measures for
the medical control of railway transportation, first examines the order of the unit
commander to organize transportation and assesses the situation. He asks for the
necessary additional information from the relevant officials and, above all, from his
specialty supervisor. He turns to him with an application for the missing forces and
means.
The planned measures are divided by the head of the medical service into 3
groups: measures of the preparatory period, the period of the echelon along the
railway and measures in the unloading area.
Having made a decision on the procedure for providing medical support to
the train, the head of the medical service assigns a doctor (or paramedic) to the
train and assigns him a task.
For the organization and implementation of sanitary and anti-epidemic
(preventive) measures in the echelon, the following are responsible: the chief of the
echelon and his deputies, the deputy for logistics (supply), the doctor (paramedic)
of the echelon, unit commanders, the head of the RChBZ service team and the
elders for the cars.
The head of the carriage is obliged to allocate soldiers for receiving food,
bringing water and working in the kitchen. He must immediately report all cases to
the echelon duty officer and the subunit commander, and after unloading, ensure
the wagon is cleaned.
The doctor (paramedic) of the train during preparation for transportation is
obliged to understand the radiation, chemical and epidemic situation in the loading
area and on the route, check if washing with a change of linen and medical
examination of personnel has been carried out, check the good quality of food
received on the route, organize medical examination and extraordinary
bacteriological examination of the chefs and arrange interviews with the
personnel. Facilities, the necessary for holding sanitary and anti-epidemic
(preventive) measures, he receives from the head of the medical service of the
military unit.
the path a doctor (paramedic) bypasses the carriages every day, checking their
sanitary condition and monitoring the observance of the rules of personal hygiene;
checks the storage conditions and the good quality of food products issued
for allowance, conducts medical control over the preparation and distribution of
food, the supply of boiled water; supervises the sanitary treatment of
personnel; together with the head of the RChBZ service team, conducts
bacteriological reconnaissance, and in case of infection of the echelon with bacterial
agents, organizes sampling and transferring them for analysis to the sanitary control
points nearest along the route; conducts hygienic education of personnel according
to the rules of safe behavior when moving in the train. All patients identified during
the examination of the echelon are placed in an isolation ward and hospitalized at
the nearest stop in the hospitals of the Ministry of Health of the Republic of
Uzbekistan or in the garrison hospital, about which the doctor (paramedic) of the
echelon through the commander of the echelon reports on command.
If in a military echelon 2% of personnel fall ill with homogeneous or 5% with
heterogeneous infectious diseases, as well as if at least one patient with especially
dangerous infections (plague, cholera, etc.) is detected, the military echelon is sent
to the observation paragraph. If at least one case of typhus is detected or if the
disease is suspected, the patient is isolated, the personnel of the carriage at the
nearest junction station are completely sanitized, and the carriage must be
disinfected or replaced.
Sanitary and epidemiological supervision over the organization and
implementation of the movement (redeployment) of troops is assigned to specialists
from the sanitary and epidemiological institutions of the Ministry of Defense of the
Republic of Uzbekistan and the Ministry of Railways. Compliance with their
requirements, aimed at preventing the emergence and spread of infectious and mass
non-infectious diseases (poisoning) during the movement of troops, is mandatory
for the commanders of the echelons.
The route of the train is supplied with cold and hot water by the railway
administration at the rate of at least 6-10 liters per day per person. The train should
have a supply of drinking water - in boilers,drinking water tanks and flasks.
The route of the personnel is strictly forbidden to use food products received
or purchased from the population.
Control over the implementation of this requirement is entrusted to the
commandant service of the echelon.
Hot food is prepared at least 2 times a day. If there are no kitchens in the
echelon, then at least once a day food is provided at military food points, where
servicemen can receive up to 50% of the daily food requirement. The rest of the
standard allowance is provided by dry rations. It is advisable to give out the daily
ration of bread and sugar in parts along with hot food.
At military food points, food should be prepared no earlier than 30-40 minutes
before the arrival of the train. The personnel can receive hot food in their pots. In
this case, it should be possible to wash individual dishes with hot water - pots,
mugs and spoons.
Before loading onto the train, all personnel are washed in a bath, if necessary,
disinfection, disinsection (impregnation) of linen, uniforms and personal belongings
are carried out. Washing (sanitization) along the route are carried out after 7-8 days
in station sanitary checkpoints, bath and laundry trains and garrison baths.
For the movement (redeployment) of troops by water transport ,
self-propelled and non-self-propelled (transport and cargo) ships are used, which
have rooms and decks suitable for accommodating personnel. The area per person
in the cargo spaces of the ship, not equipped with bunks, is determined at the rate
2
of 0.5-1.3 m . When installing bunk bunks, it is reduced by 1.1-1.4 times, and
when installingfor three-tiered bunks - 1.6-2 times, which leads to an even greater
overcrowding of personnel than when transported in railway wagons.
Since the ships can accommodate significant military contingents, the
command of military units and representatives of the shipping company draw up a
plan for adapting transport for the transport of personnel and equipment. The
necessary re-equipment and equipment of the vessel is carried out by the shipping
company.
The use of water transport for the transport of troops has the following
hygienic features: placement of personnel of subunits on one ship, and on river
transport - in one room; susceptibility to motion sickness in most people; the need
to create large reserves of water and carry out deratization measures.
Placing large groups of people in one room is fraught with the danger of the
spread of epidemic diseases, deterioration of the microclimate, and air pollution
with human waste products. A decrease in ventilation volume more often occurs at
night, in parking lots, during a storm and in cold weather due to the battening down
of hatches and windows. Therefore, when considering a plan for adapting a vessel
for the transport of military personnel, the medical service draws the attention of the
command to the need for additional ventilation equipment (windzails, wind chutes,
portable fans) and the use of skylights and similar hatches, elevator shafts and
chimney casings for ventilation of living quarters.
Most people are susceptible to motion sickness (or "seasickness"). One of
the preventive measures used on ships is the organization of vigorous activity of
personnel.
Units are supplied with fresh water for transportation by sea in ports for the
entire route at the rate of at least 10 liters per day per person. In the maritime
transport, significant reserves of drinking water are created, which must be
preserved for a long time.
In such cases, during the preparation period, ballast tanks are cleaned,
cemented and disinfected, filled with good-quality water and preserved with
chlorine-containing preparations or ionized silver in special installations located on
large modern ships.
For drinking use only disinfected water (boiling, chlorination). Outboard
water is used for household needs. The quality of the water is subject to strict
medical control. Hot food is prepared in ship galleys and field kitchens of
transported units.
Deratization is a mandatory measure when preparing a vessel for transporting
troops. It is being carried out by the shipping company.
For urgent transfer of military units and the evacuation of the wounded to the
long distance to the resort and and a tio n O N m traffic. For this,
propeller-driven and jet aircraft and helicopters are used. Providing a military unit
transported by air transport with everything necessary along the route is the
responsibility of the commanders of the corresponding aviation and airfield
units. Checking the presence of fixation belts for personnel, the reliability of cargo
fastening, the condition of the onboard oxygen breathing apparatus (KDA) is
carried out in the presence of a representative of the military transport aviation.
The peculiarities of medical control during air transportation are associated
with the effect on the body of military personnel of a low atmospheric partial
pressure of oxygen, which can cause aerosinusitis, aerootitis, high-altitude
flatulence, and hypoxia. Under the influence of small overloads of the changing
direction, 1-2% of the personnel experience motion sickness ("air sickness").
The main measures to prevent the action of unfavorable factors during air
transportation include a medical examination of personnel before the flight, an
inspection of the on-boardequipment, the maximum reduction in waiting time for
boarding and departure, eating no later than 2 hours before departure and providing
hot meals at the landing site; provision of good-quality water while waiting for
boarding and along the route.
6.2. Sanitary and anti-epidemic (prophylactic)measures for the
transport of troops by road
The most common way of movement of units in the military and army areas is
to march in cars, armored personnel carriers or combat vehicles.
An automobile unit or a group of vehicles following the same route under a
single command and performing a common task constitutes an automobile convoy.
The time of the march is determined depending on the real situation. Night
marches provide greater secrecy and less probability of combat losses, but they
also cause greater fatigue of personnel, are carried out at a lower pace, require a
high degree of driver training, careful preparation of vehicles and roads. The
average speed of movement of convoys on the march can be 25-30 km / h at night,
30-40 km / h in the daytime, the average daily mileage of a car convoy with one
driver in a car can be up to 150-350 km. The time of day is distributed as follows:
movement - 10-12 hours, loading (unloading) - 3-4 hours, maintenance - 1-2 hours,
rest of personnel - 7-8 hours.
For the rest of the personnel and checking the condition of the vehicles, they
make small and large halts, as well as arrange day (night) rest. Small breaks lasting
20-30 minutes are prescribed every 2-3 hours of movement for warm-up, food and
water intake. It is advisable to arrange the first small halt 1-2 hours after the start of
the movement. At the beginning of the second half of the daily transition - after 6-8
hours of being on the way - a large halt is made for 2-4 hours for rest, taking hot
food and inspecting the material part of the equipment.
For the transportation of personnel, only serviceable, clean, and, if
necessary, disinfected vehicles equipped with benches and an awning are
used. The head of the automobile service is responsible for the preparation of
2 of the
vehicles. When calculating the landing rates, they proceed from 0.27 m body
floor per person. A modern truck can accommodate 21-35 people.
During road transport, the body of military personnel can be adversely
affected by the combined effect of a number of environmental factors (Table 6.1),
the total effect of which can be the premature development of fatigue and a
decrease in combat effectiveness. Particular attention should be paid to the
prevention of poisoning by exhaust gases, the negative effect of which is observed
when the distance between cars is violated, at a slow pace of movement, frequent
stops without turning off the engines, when the column moves along forest roads,
in gorges and valleys, in tunnels, when there is no wind or tailwind, as well as
when moving with tanks.
Table 6.1.
Unfavorable environmental factors during transportation by road
 transport and body reaction

Environmental factor. Possible body reaction a person on the impact of a factor

environment.
Sunny Overheating,

radiation, blows,photophthalmia.
high
temperature
air,
high
humidity.
Low Cooling,
temperature
air, highabsolute colds
humidity,
wind speed, snow, (precipitation, in pneumonia, bronchitis, exacerbation diseases musculoskeletal
the form systems, myalgia, radiculitis.
rain, snow, hail).
Intensive Conjunctivitis, blepharitis, microtrauma
eyes air
movement at
traffic, dust.
Exhaus gases at Headache, dizziness, noise in
ears, weakness and weakness. movement
technology.
Noise, vibration, shock. Deterioration

sharpness

bluntingattention, tinnitus, fatigue. Static

individualmuscle groups (due to the need

 preservation

normal

distribution(ischemic pain), chest compression

cells and individual nerves, displacementinternal organs
Small overloads of the changing Motion sickness-dizziness violation of stability, balance,
directions. nausea, vomiting
Poisoning with technical fluids most often occurs when their vapors are
inhaled, as well as when they come into contact with open parts of the body and
mucous membranes.
Acute poisoning with fuel vapors can cause prolonged loss of
consciousness, and untimely assistance to the victim - death. In all cases of acute
poisoning, the victim must be immediately removed from the danger zone.
If antifreeze or brake fluid is swallowed, induce vomiting and immediately
take the victim to a medical center. In case of carbon monoxide poisoning,
remove the victim to fresh air,give a smell of ammonia. If vomiting occurs, deliver
to a medical center, taking measures to prevent asphyxia.
On the route of the convoy, there may be areas contaminated with weapons
of mass destruction (WMD). In this case, factors specific to one or another type
of WMD may join the factors indicated in the table.
On the way, the personnel prepares food from canned food and
concentrates, uses an individual diet (IRP-1). When transporting along military
highways, food can be carried out at military food points. Before the performance
for 1-1.5 hours, hot food is not abundant.
During the reconnaissance of the route of movement, the medical service
conducts a sanitary and epidemiological assessment of the route, places of stops
and rest stops, as well as water sources and settlements through which the convoy
travels; identifies locations for the deployment of field water and food points
(FFS). All contaminated and unsafe areas in sanitary and epidemiological terms are
provided with clearly visible signs along the route. Water sources intended for use
by units are taken under protection. In accordance with the assigned combat
mission and intelligence data, the commander of the military unit, according to the
report of the head of the medical service and other officials, in his order or at a
service meeting, determines the preventive measures carried out in the preparatory
period and during the movement of the convoy.
The mode of movement is set: the distance between the cars is indicated (25-30
m), the duration of movement and rest. Determine the measures carried out at the
halts to maintain combat effectiveness; exercise, personal hygiene measures -
washing, washing feet, bathing, cleaning clothes from dust.
Troops marching under conditions of the use of weapons of mass destruction
by the enemy can find themselves in a nuclear explosion zone, cross the trail of a
radioactive cloud or a hotbed of chemical or bacteriological contamination. Troops
overcome areas of contamination with radioactive substances (RW), toxic
substances (OM), bacterial agents (BS) in personal protective equipment - in gas
masks, protective capes, protective stockings, gloves. Cars should move at such
distances, at which mutual dusting will be the least. For movement, whenever
possible, use areas of the terrain with a lower level of infection. Such areas are
designated by exploration warning signs.
The doctor needs to know the data of chemical intelligence and dosimetry
control and check the thoroughness of the decontamination, neutralization and
disinfection.
6.3. Sanitary and anti-epidemic (preventive) measures to ensure the
march on foot
Troops, as a rule, make a march on foot in the mountains, wooded-swampy
and other inaccessible areas.
A march on foot, depending on the mode of movement, the distance of the
transition and the degree of stress, is divided into a normal march, forced march
. With a normal march, the length of the daily passage is on average 25-30
km. Travel speed - 4-5 km / h, on skis - 5-7 km / h. With a forced march, the daily
crossing is 40-45 km. During the march
Throwing troops move, alternating an accelerated step with a run. In this case, it
is most advisable to move a quarter of the distance of the transition by running, the
rest - at an accelerated step. The average speed during the forward march is about
8-9 km / h, and the covered distance is 5-15 km. The throw-march can be either an
independent form of movement if the unit is located near the front line, or other
types of march end with it.
The assigned combat mission and the specific conditions in which the march
takes place determine the distance of the daily transition, the type, duration and
number of halts. The first small halt for 10-15 minutes is done after 1 hour of
movement, then for 20-30 minutes every 2-3 hours of movement. In the second for
half of the daily transition, a large halt is arranged, lasting 2-4 hours, and after
several days of movement, a rest during the day (daytime) is arranged.
The unit bypasses the infected areas, and if it is impossible, overcomes at
maximum speed in the shortest direction, providing the lowest degree of radiation
(infection), using personal protective equipment. Partial special treatmentit is carried
out after leaving the infected areas, and the full one - on large halts or in the
recreation area.
A march on foot is hard physical labor, which consumes 4000 kcal or more
per day. Under its influence, the functions of the cardiovascular and central nervous
system, respiratory and digestive organs change, the heat production of the body
increases sharply, as a result of which heat exchange can be disrupted.
Changes in the function of the cardiovascular system are manifested in an
increase in heart rate and an increase in the minute blood volume. In trained
servicemen, an increase in the minute blood volume is due to an increase in the
pulse and systolic volume with a relatively small increase in the pulse rate - up to
100-120 beats per minute. In untrained, the pulse becomes more frequent up to 160
beats per minute with a slight increase in systolic volume.
Pulmonary ventilation increases from 7-8 liters at rest to 20 and even 50 liters
per hour during the march. The respiratory rate reaches 30-40 breaths per minute.
A march on foot, like any other hard physical work, is accompanied by the release
of a large amount of heat, an effective way of dissipating which is the evaporation
of moisture (sweat) from the surface of the skin. The loss of water when marching
on foot reaches 5-6 l / day, and mineral salts - about 25 g / day.
When planning medical measures to support the march, the head of the
medical service is guided by the general scheme for organizing the march, in which
2 periods are distinguished: the preparatory period and the period of the march.

The content of preventive measures is determined, in addition to a number of

other factors, by the degree of marching training of servicemen. Marching training
is an integral part of the combat training of troops. Its purpose is to develop
endurance among military personnel to intense physical exertion and the action of
unfavorable environmental factors during the march.
Diet: 40-60 minutes before the performance, a hearty meat breakfast is
served. When speaking before 4-5 am, breakfast is served at the first or second
small rest. At a big break after a short rest, a second breakfast is served in the form
of a second course and tea or canned food (sausages) with bread and tea. Lunch
is appointed after the end of the march or at the place of the overnight stay. Meals
are provided at the PPP.
Preparing for the march, each soldier must inspect in advance, fix and adjust
his shoes, wash and dry well socks or footcloths, wash their feet, cut their nails and
properly wind the footcloths. Shoes should not be too loose or tight. From tight or
loose shoes, there are scuffs. During the hike, you need to move with a measured
step, at a set pace, in order to consume less strength. Breathe deeply and through
your nose as you walk.
The health worker talks about the meaning of restrictive measures, drinking
regimen and rational rest at the halts.
The night march is one of the common modes of troop movement. The
speed of movement during the night march is reduced by about one third. Big
stops are not assigned.
On the march at night, the load on the central nervous system and especially on the
visual analyzer increases. This is facilitated by the difficulty of observing the
environment due to a decrease in visual acuity, changes in the spatial perception of
objects (they seem closer and larger in size) and the loss of the ability to distinguish
colors at night; incorrect assessment of the speed of movement of objects; change
in the habitual regime of work and rest, as well as high emotional stress. A night
march is more tiring than a day march.
Along with other sanitary and anti-epidemic (preventive) measures to ensure
the night marchthe unit's doctor identifies soldiers suffering from hemeralopia and
other visual impairments; makes sure that before the march the personnel are
provided with 7-8 for rest. Conditions similar to a night march are observed with
limited visibility during snowfall, blizzard, rain and fog.
A march in a mountainous area is associated with ups and downs, driving
along narrow paths, scree, glacial moraines and snow. Many difficulties arise due to
the poorly populated mountainous terrain, lack of fuel and a limited amount of
materials at hand. A march in a mountainous area is complicated by large
fluctuations in air temperature during the day, fogs, cold winds, intense direct and
reflected solar radiation. Among the many natural factors in the mountains, the most
pronounced adverse effect on the health of personnel can be exerted by the
absolute height of the terrain, the ruggedness of the mountain relief and the
climate. The threat to life and health is growing due to the possibility of rockfalls,
avalanches, avalanches, mudflows, blockages, flooding of mountain river valleys,
as well as earthquakes.
Special attention on the part of the medical service should be paid to the
organization of the march in the highlands. Difficult terrain, lack of oxygen, low
cross-country ability limit the speed of movement in the mountains and the duration
of the transitions. In order to prevent rapid and premature fatigue of servicemen, it
is necessary to recommend the command to plan the following movement speeds:
o, the
with a steepness of rise from 5 to 15 speed of movement should not
exceed 3-4 km / h;
 to
at the steepness rise up to 25 be shortened pitch distance and movement speed
reduced to 1.5-2 km / h with a walking tempo of 60-70 steps per minute;
o, the
on slopes with a steepness of 25-30 speed of movement should not
exceed 1-1.5 km / h at a walking pace of 30-40 steps per minute;
on glaciers, the speed of movement on foot will not exceed 1km / h. It is
advisable to make small ten-minute stops every 45-60 minutes of the transition.
The range of the daily passage depends on the altitude of the terrain and the
level of training of the subunit personnel. At altitudes of 2500-3500 m above sea
level, for trained personnel, the distance of the daily crossing can be planned up to
18-20 km per day. In high altitude conditions, the daily transition distance should be
limited, depending on the assigned combat mission, to 10-15 km per day.
According to existing data, the average energy consumption when climbing
in the mountains for a person of average height weighing 65-70 kg is from 3.3 to
16.0 kcal / min or from 200 to 960 kcal / hour. For servicemen of motorized rifle
units, when marching at an altitude of 2500-3000 m in summer, energy
consumption is from 4000 to 4144 kcal / day.

Along with other factors, the mass of the carried load, taking into account
equipment, affects the development of fatigue in military personnel and thereby a
decrease in working capacity when performing a march in mountain
conditions. The optimal weight of equipment worn by a soldier in conditions of a
foot march in the mountains is considered to be equal to 1/3 of the body weight of
a soldier, which is approximately 24-36 kg. When planning and carrying out a
march in mountain conditions, the head of the medical service is obliged, together
with the command, to establish and check the weight of the carried cargo for each
serviceman and take measures for its even redistribution in order to prevent
overwork and reduce efficiency. The equipment and fit of shoes and uniforms will
also be checked.
The head of the medical service, on the eve of the march, is obliged to
conduct a medical examination of the personnel in order to identify the weakened
and sick in the unit.
However, the most serious difficulties are associated with oxygen deficiency
(mountain sickness), which can occur already at an altitude of 2500-3000 m.
Mountain sickness is accompanied by headache, dizziness, tinnitus, palpitations,
shortness of breath, blue discoloration or pale skin. In severe cases, nausea,
vomiting, and fainting are observed. Prevention of altitude sickness is achieved by
training in mountain hikes with constant ascents to great heights, a correct mode of
movement with additional stops for rest.
The most reliable method of preventing the development of altitude sickness in
personnel and a decrease in work and combat capability is advance stepwise
high-altitude acclimatization, adherence to the work and rest regime during the
ascent. When registering altitude sickness, oxygen therapy is required, and in its
severe form, descent to the plain and hospitalization.
The prevention of cases of photophthalmia is to provide all personnel with
protective glasses with tinted glasses, the provision of which is the responsibility of
the clothing service of the military unit. The medical service should ensure control
over the completeness of providing servicemen with glasses when preparing to go
to the mountains.
It is especially necessary to note the difficulties of cooking in the mountains
associated with the lack of fuel and the lengthening of the cooking time for
vegetables and meat in conditions of reduced pressure.
When making a march in a mountainous area, under the influence of a number
of factors and hard physical work, there is a decrease in the secretion of the
gastrointestinal tract. Therefore, the personnel are reluctant to use crumbly and
viscous cereals, as well as prepared food of other types, containing little water. In
the mountains, it is advisable to switch to food with concentrates and canned food,
increase the carbohydrate content, use spices, cooksemi-liquid meals and provide
personnel with sufficient water, tea or drinks.
Moving in low temperatures. Troops are exposed to low air temperatures
when moving in winter, as well as in the Far North and highlands. Difficulties in
movement in these conditions are associated with the impact of low air temperature,
cold winds, blizzards and snowfalls, with the presence of snow cover and poor
passability of roads or off-road conditions, with the cumbersomeness of uniforms
and difficulties in organizing recreation at low temperatures.
The speed of movement on foot with a snow depth of 0.3-0.5 m is 2 km / h,
and with a depth of more than 0.75 m - 0.5 km / h. Well-trained skiers cover 80-100
km per day, medium-trained skiers - no more than 40-50 km.
In the absence of the necessary preparation for the winter march, fatigue
develops rapidly due to very high energy costs - for skiers, they reach 5000 kcal.
One of the main tasks when organizing a march in winter is to protect soldiers
from the cold, both during movement and on vacation. The solution to this
problem is ensured by the issuance of a complete set of warm clothes and shoes to
the personnel, which must be properly fitted and dry. The crossing distance for a
winter march is shorter, and the pace of movement is lower than for a summer
march. The pace of movement should be such as not to cause overheating of the
soldiers. The change of the head units is carried out after 20-30 minutes, when
moving on skis - after 1 hour. Halts are prescribed for 5-10 minutes, and in severe
frosts they are limited to a periodic decrease in the rate of movement. During rest
periods, servicemen are not allowed to sit down or lie down on the snow.
If it is impossible to stay overnight in the village, the troops set up a winter
camp. The basic requirements for it are the same as for the summer camp.
increasing the endurance of soldiers during the winter march, the organization
of heating stations and the timely provision of hot food are of great importance.
All military personnel are required to know the signs of frostbite. On the way,
they must watch each other and warn in time about the pale skin of the face (nose,
cheeks, ears) in order to take protective measures, self-help mutual assistance. If
signs of frostbite are found, you must immediately notify the sanitary instructor or
paramedic. If it is not in the column, it is necessary to warm the frostbitten skin area
by rubbing(massaging) him with clean hands. Frostbite of the feet is prevented by
supplying personnel with warm footwear (felt boots), inserting additional insoles
into leather shoes and wrapping the feet with a pair of warm footcloths. One of the
reasons leading to frostbite of the feet is their sweating. Therefore, you need to
keep your feet clean, and be sure to wash them before the hike.
In winter, when driving in cars, preventive measures against frostbite are as
follows. The bottom of the car body is covered with hay, straw, coniferous
branches or other materials. When driving in an open car, all soldiers, except for
the observers, sit with their backs in the direction of the movement and cover
themselves with raincoats. At the halts, you should definitely do warm-ups.
Small halts when following units on armored personnel carriers (cars) are
assigned after 1-1.5 hours of movement.
During the march, the doctor carries out medical control over the established
order of movement, measures to prevent frostbite, controls the physical condition
of the personnel and especially those who have been taken under supervision
(calculating heart rate andrespiration rate, observation of the general condition and
behavior). He pays special attention to monitoring the organization of
accommodation: providing an opportunity to warm up, dry clothes and shoes, get
hot food.
March in a desert, semi-desert, steppe area. Troops marching in the desert,
semi-desert, steppe area can meet with difficult climatic conditions, lack of water,
impassable roads and unfavorable conditions for accommodation and recreation,
the presence of active and permanent natural foci of plague, tularemia, leptospirosis
and other foci of zooanthroponous diseases. In deserts, there are sharp daily
fluctuations in air temperature, sandstorms. Intense solar radiation leads to heating
of the surface of objects up to 40-70 ° C and, together with hot air, contributes to
overheating of the body.
Muscle activity during a hot period increases metabolism and the accumulation
of endogenous heat, which is fraught with the danger of heatstroke. Ignoring this
fact and an arbitrary decrease in the amount of drinking water consumed under
these conditions can lead to disruptions in the performance of a combat mission as
a result of massive heat damage and dehydration.
In accordance with this, when planning preventive measures, measures are
provided to prevent heat lesions, nosebleeds, and dust conjunctivitis.
To prevent sun and heat strokes and to save energy, it is necessary to provide
the personnel with sufficient rest before the performance and on large halts, use the
cool time of the day for movement, schedule halts in a timely manner, use clothes
correctly, have sufficient water and observe a drinking regime. Halts should be
appointed, if possible, in shady places, near rivers and water bodies. Areas with
stagnant incandescentair should be avoided. The number of halts is increased, and
the time for large halts is lengthened.
Water supply is of particular importance when marching in the desert and in
the steppes. For the period of the march, a plan is drawn up for providing the units
with water, taking into account the distance to the nearest water source or water
supply point. To restore the water-salt balance in the body and maintain its normal
life, full satisfaction of the need for water, salts and trace elements is required,
which is often difficult in semi-desert and steppe zones, since most shallow
watercourses dry up in summer, and in lakes the water is usually highly mineralized
or salty. rarely suitable for internal use.
Medical control over the provision of personnel with a sufficient amount of
good-quality water is one of the main tasks of the medical service when troops are
stationed in areas with an arid climate during the hot season of the year. All
transport and military equipment must have a supply of clean drinking water, in the
subdivisions - special containers for water, means for transporting and storing
drinking water, in engineering subdivisions - means for its extraction and
desalination.
To feed the personnel, they select products that do not cause thirst, do not
deteriorate from the heat and do not require a large amount of water for preliminary
processing.
It is rational to transfer the intake of the main amount of food products of the
daily diet to the coolest time: plan mainly carbohydrate foods for lunch, and the
main amount of proteins and fats of the daily diet - for breakfast and dinner. The
energy value of the daily ration should be distributed as follows: 1st breakfast -
30%, 2nd breakfast - 15%, lunch - 25%, dinner - 30%. When carrying out medical
control, the medical service pays special attention to the observance of the rules of
storage and preparation of food. Storing food and finishedfood in conditions of
high external temperatures, washing dishes at low water supply rates can cause an
outbreak of foodborne toxicity. Protecting food from sand and dust is well
provided by modern outdoor kitchens.
For protection eye from high insolation, sand and dust of all military personnel
must be provided with protective goggles with tintedglasses.
To protect military personnel from attacks by blood-sucking insects and
ticks necessary use collective and individual mechanical (mosquito nets, mosquito
nets, canopies, shelters)and chemical (repellents) remedies.
It is necessary to conduct hygienic education of military personnel, aimed at
preventing overheating, dehydration, solarskin burns, conjunctivitis, infectious and
parasitic vector-borne diseases.
Control questions:
1.Reasons causing overfatigue in servicemen during transportation and
preventive measures.
2Water consumption rates for the transport of troops by rail.
3.Features of the nutrition of servicemen when performing a march in the
mountains.
4.Measures carried out by the command and the medical service to maintain
the combat effectiveness of personnel when performing a march in mountain
conditions.
5.Environmental factors that adversely affect the health of servicemen when
performing a march in the cold season and measures to prevent frostbite.
6.Movement in the mountains and its rationale.
7.The diet of servicemen during the march in a desert area.
8.Measures aimed at the prevention of overheating in the course march.
Chapter 7. Dangerous and harmful factors of the environment and their
 impact on human life. Seminar
Purpose of the lesson: Studying the state of the natural and industrial
environment, human health (population), establishing the relationship between the
state of the environment and human health, acquaintance with the maximum
permissible levels of exposure to harmful and dangerous factors on the human
body.
The task:
1. To get acquainted with the main (dangerous and harmful) chemical factors
of the working environment of military specialists.
2. Get acquainted with the main (dangerous and harmful) physical factors of
the working environment of military specialists
3. To study the permissible effects of harmful chemical and physical factors
on the human body.
4. To study the negative consequences of exposure to harmful and dangerous
factors on the human body.
5. Listen to abstract messages on the topic of the lesson.

7.1. Hygienic characteristics of the main chemical factors of the

working environment of military specialists
Chemical factors. Technological progress, accompanied by a significant
increase in the chemicalization of all branches of human activity, has led to an
increase in the role of the chemical factor in military affairs. Accordingly, the
number of military specialists who, in the performance of their duties, encounter
certain abiotic substances has increased. Most often they are exposed to toxic
industrial fluids and compounds that pollute the air in the workplace.
Poisonous technical liquids . The operation and maintenance of modern
military equipment and weapons necessitate the use of a wide range of technical
fluids and oils with additives - substances added in certain quantities to improve
their performance properties. Many of them are poisonous and even aggressive,
which is why they are collectively referred to as toxic technical fluids (YATL). Of
these, military personnel most often come into contact with fuels and lubricants,
antiknock agents and antifreezes.
Fuels and lubricants consist of substances that can have a toxic effect on
humans. According to the boiling point and composition, mainly in the distillation
of oil, light fuel with a low molecular weight and heavy fuel with a relatively large
molecular weight are distinguished. Light fuel (gasoline, naphtha) is used for
carburetor engines, heavy fuel (kerosene, diesel oil, gas oil or their mixture - diesel
fuel) - for diesel engines. In terms of composition, fuels and lubricants (fuels and
lubricants) can only consist of fatty hydrocarbons or contain a certain part of
aromatic hydrocarbons.
In contact with the skin and mucous membranes, fuels and lubricants can have a
local effect, and when the vapors of these substances are inhaled or enter the
gastrointestinal tract, it can have a general effect on the human body.
Light fuel, especially gasolines with a high content of aromatic hydrocarbons,
upon local action causes changes in the surface layers of the skin - defatting,
irritation, cracking, and inflammatory diseases. With the local action of heavy fuel
and lubricating oils, pathological changes appear in the deeper layers of the skin:
inflammatory diseases of the hair follicles and sebaceous glands (folliculitis, boils)
occur, acne is formed, sometimes hyperkeratosis develops.
The ingress of fuel inside most often occurs with a gross violation of safety
measures - when it is sucked through a hose through the mouth to obtain a siphon
effect. This causes gastroenteritis, which is accompanied by damage to the central
nervous system, and in severe cases, paralysis may develop. By inhalation, fuels
and lubricants enter the body in the form of vapors. The accumulation of vapors in
the air of the working area is promoted by high temperatures, large evaporation
areas and insufficient air exchange in the premises.
The severity of poisoning with fuels and lubricants vapors depends mainly on
their chemical composition, content in the air and duration of action on humans.
The most toxic are fuels and lubricants containing many aromatik hydrocarbons.
The severity of the lesion also depends on the general condition of the body,
individual sensitivity, the amount of physical activity, air temperature and other
factors.
The toxicity of fuels and lubricants vapors is relatively low, but their
prolonged exposure can cause chronic poisoning of people, which is characterized
by headache attacks, drowsiness, itching, loss of appetite, decreased performance
and other nonspecific symptoms. MPC of vapors of gasoline, kerosene, naphtha
and mineral oil in the air of the working area - 300 mg / m3.
Measures to prevent the harmful effects of fuels and lubricants on the human
body includecompliancewith hygiene standards during the construction of parks,
workshops, garages and fuel depots; maintenance and storage of fuels and
lubricants in a tightly closed container; mechanized filling of equipment in a closed
way; equipping premises for work with a high content of fuel vapors with artificial
ventilation of sufficient power; provision of personnel with overalls and their timely
change,compliancewith the rules of personal hygiene.
Antiknock agents are added to motor fuel to prevent the simultaneous
explosion of the entire mass of the combustible mixture in the combustion
chamber, which disrupts normal operation, reduces efficiency and accelerates
engine wear.
The most widely used antiknock agent is tetraethyl lead (TPP), more precisely
ethyl liquid containing 50-60% TPP and added to gasoline in an amount of 1.5-4
mg / l.
Leaded gasoline is less toxic than thermal power plants or ethyl liquid,
however, if sanitary rules are violated, it can cause both acute and chronic
poisoning.
Acute poisoning is possible when TPP or ethyl liquid is ingested through the
mouth, through the respiratory tract and intact skin (when used for washing hands
and washing uniforms, as well as as a solvent during the repair and maintenance of
equipment).
Serious consequences are possible when eating food contaminated during
transportation with ethyl liquid and when it is mistakenly ingested. TPP has
cumulative properties. At the moment of contact with EFT, irritation symptoms are
not observed. The clinical picture of acute TPP poisoning develops after a latent
period - from several hours to 3-5 days. In mild cases of acute poisoning,
headache, dizziness, nausea, vomiting, general weakness, metallic taste in the
mouth, restless sleep with nightmares, decreased performance appear. A triad of
symptoms is characteristic: bradycardia, a decrease in blood pressure, a decrease
in body temperature. In severe cases, the poisoning is accompanied by severe
psychomotor agitation, confusion, delusions of persecution, visual and auditory
hallucinations, mental disorder of a manic-delirious nature. These disorders are
joined by damage to the kidneys, liver and motor nerve palsy. At the height of
nervous excitement, the body temperature rises to 39–40 ° C. Overexcitation is
followed by depression of the central nervous system, respiratory failure,
weakening of cardiac activity and a drop in vascular tone.
In chronic poisoning, psychosis does not develop. There is a pronounced
asthenization, sleep is disturbed, in some cases the above-described triad of
symptoms is observed. This is accompanied by dysfunctions of the autonomic
nervous system - hyperhidrosis, hypersalivation, acrocyanosis, tremor of the
fingers. The content of lead in urine more than 0.07 mg / l is an additional
confirmation of TPP intoxication.
In the prevention of poisoning at thermal power plants, the leading role
belongs to organizational measures. The personnel must strictly comply with the
requirements of the instructions for handling YATZh. The preparation of leaded
gasoline is permissible only at specially equipped ethyl mixing stations, provided
with sufficient ventilation, and in the field - under a canopy away from residential
and work premises.
The personnel are allowed to work after preliminary instruction, provided, in
addition to uniforms and overalls, rubber suits, boots, gloves and filtering gas
masks. Ethyl fluid and leaded gasoline should be stored and transported in tightly
closed containers with clear warning labels. MPC of TPP in the air of the working
area - 0.005 mg / m3.
Antifreezes are aqueous solutions of certain substances (glycols, glycerin, etc.)
that do not freeze at low temperatures and are used in engine cooling systems at
temperatures below 0 ° C. Most often, antifreezes containing ethylene glycol are
used, depending on the brand, in the amount of 30-60% of the total volume.
Ethylene glycol is the main toxic agent in glycol-based antifreezes.
Poisoning is possible only when these YATF enter the body. Inhalation
poisoning is unlikely, since the volatility of ethylene glycol at normal temperatures is
insufficient to create toxic concentrations in the air. Mistaken ingestion of
glycol-based YATZh due to the similarity of smell and taste with ethyl alcohol is the
most comon cause of acute fatal poisoning.
The toxicity of antifreeze is due to the presence of denatured alcohol and
glycols. They have a narcotic and paralytic effect, affecting mainly the central
nervous system, liver and kidneys.
When you take 100 ml of antifreeze, moderate poisoning occurs, manifested
first by excitement, and then by lethargy, drowsiness, vomiting and weakening of
consciousness. Subsequently, from the 4th to 5th day, the phenomena either
gradually fade away and recovery occurs, or the temperature rises, symptoms of
nephritis and pyelonephritis appear with the development of anuria and uremic
cTSa. Atypical crystals of calcium oxalate (oxalates) are found in urine.
A dose of 150-200 ml of antifreeze causes severe poisoning, characterized by
a rapid onset of unconsciousness with pronounced symptoms of CNS damage.
Mortality reaches 50%, the outcome often occurs in the first 2 days. Taking 400 ml
of antifreeze or more causes fatal poisoning, in which the arousal phase may be
absent, unconsciousness, coma and death quickly occur.
The main measure to prevent poisoning with antifreezes is to educate the
personnel about the toxicity of ethylene glycol, the danger of accidentally
swallowing it or using it as a surrogate for alcohol, and thoroughly instructing
persons working with antifreeze about the rules for handling them, the procedure
for storing and refueling vehicles.
To exclude the possibility of using antifreeze for an off-label purpose, the
container in which it is transported or stored is supplied with warning inscriptions
"Poison", "You cannot drink", etc., and the antifreeze itself is tinted or added to it
with substances that give an extremely unpleasant taste and smell.
Substances that pollute the air. The chemical composition of the air is one of
the main characteristics of the working conditions of military personnel, especially
in sealed samples of weapons and military equipment. Its formation depends on
changes in the natural composition of the air and on the entry into the atmosphere
of various harmful impurities released during the operation of weapons,
mechanisms, systems, devices and materials.
The natural chemical composition of the air environment and the dynamics of
the concentrations of toxic impurities are influenced by the design features of the
object and its technical means: the volume of romes and their mutual arrangement,
the type of power plant, the type and number of standard weapons and methods of
its use, saturation with devices, mechanisms, synthetic materials, temperature air ,
humidity, atmospheric pressure, efficiency of life support. The number and
conditions of combat activity of personnel are also of great importance.
The substances that most frequently pollute the air of inhabited HHVT
compartments include powder, exhaust and battery gases, emissions from building
and finishing materials, aerosols, anthropotoxins, etc.
Powder gases are a mixture of gaseous, vaporous and solid substances
formed at the time of a shot in the bore of a firearm. Their composition depends
on the composition of the propellants and the conditions for the decomposition of
the charge when fired (temperature, pressure at which the propellant burns, etc.).
The concentration of powder gases depends on the caliber and number of
weapons, the power of the charges, the rate of fire, the performance of the
ventilation means, the volume of the manned compartment, etc.
The tendency currently observed in most armies to increase the calibers of
artillery systems and their rate of fire creates a real danger of lethal concentrations
of powder gases in the air of pressurized combat vehicles and closed artillery
systems.
The main components of propellant gases that have a toxic effect are carbon
monoxide, nitrogen oxides, carbon dioxide. In a normal shot, the propellant gases
contain almost no nitrogen oxides and have a minimum amount of carbon
monoxide for a given propellant. In the case of combustion of gunpowder at low
(below 50 atmospheres) pressure, more carbon monoxide and a significant amount
of nitrogen oxides are formed. This takes place when the remnants of the charge in
the casings are burned out, when training (blank) charges are fired, and at low
charging densities (incomplete charges). Poisoning with powder gases is possible
when their high concentration is reached in weakly ventilated structures (romes)
during firing.
The clinical picture of powder gas poisoning is mainly caused by carbon
monoxide. In the case of a predTSinance of nitrogen oxides in the powder gases,
respiratory dysfunctions develop - from symptoms of irritation of the mucous
membranes to pulmonary edema.
The prevention of powder gas poisoning involves the use of special technical
means that ensure the rapid removal of gases from the working area or a decrease
in their concentration (the use of ejection devices to remove powder gases from the
barrel bore, devices for ejecting cartridges after a shot from the habitable
compartments, the use of burning cartridges, etc. .).
The maximum permissible concentration of powder gases is set for carbon
monoxide differentially, depending on the exposure and conditions of their action
on people. For the first time, MPCs for powder gases for objects of armored
vehicles were developed by Professor of the Department of General and Military
Hygiene of the Military Medical Academy N.F. Koshelev in 1951: 0.25 mg / l - for
no more than 25 minutes, 0.5 mg / l - no more than 10 minutes, 0.6-0.7 mg / l - no
more than 5-6 minutes, 1.5 mg / l (maximum concentration) - no more than 5–6 s.
The currently valid official documents provide for standards that do not
fundamentally differ from those listed above.

Radiation intelligence and control equipment

Exhaust gases (formerly known as exhaust gases) are a complex mixture of

gaseous, vaporous substances and aerodispersions formed when fuel is burned in
internal cTSbustion engines.
The reasons for the flow of exhaust gases into the inhabited compartments of
the OVHT are leaks in the engine partitions, the irrational position of the air intake
openings of the filtering units (FVU) when cars move in columns or in the direction
of the wind, "reverse" diesel engines, heater malfunctions, etc.
The composition of the exhaust gases varies greatly and depends on the type
of engine, its mode of operation and load, technical condition, type and quality of
fuel, qualifications and experience of the driver, and other factors. The main
harmful products in the emissions of carburetor engines are carbon monoxide,
hydrocarbons and nitrogen oxides. When a TPP antiknock agent is added to the
fuel, inorganic lead compounds are found in the exhaust gases. Some components
of the exhaust gases are active allergens. In the exhaust gases of diesel engines, the
main harmful components are soot and nitrogen oxides. The maximum amount of
carbon monoxide is formed during idle and full load, hydrocarbons - during idle,
and nitrogen oxides and aldehydes - during active load modes.
The toxicity of exhaust gases from carburetor engines is higher than the
toxicity of exhaust gases from diesel engines, however, the latter have a
pronounced irritating effect on the mucous membranes of the respiratory tract and
eyes, which is associated with the presence in their composition of a significant
amount of sulfur dioxide, aldehydes and smoke particles. The clinical picture of
exhaust gas poisoning depends on their concentration, time of action and chemical
composition. With prolonged inhalation of air containing a small amount of
exhaust gases from carburetor engines (when working in workshops, during a
march in a convoy of cars moving at close distances, etc.), the symptoms of
poisoning are similar to those under the action of carbon monoxide: tinnitus,
general weakness , headache, dizziness, nausea, sometimes vomiting. The exhaust
gases of a diesel engine, when it is operating in a closed rome, within a few minutes
cause a sharp irritation of the mucous membranes in the nasopharynx, larynx,
behind the sternum, eye membranes with profuse lacrimation, which makes it
impossible to stay in these conditions for a long time. When entering clean air, all
these phenomena disappear rather quickly.
It is possible to reduce the air pollution of the working area with exhaust
gases by improving engines, the quality of fuel and additives, creating neutralizers,
filters, timely repairing engines, adjusting the carburetor, sealing flange joints and
slots to prevent exhaust gases from entering the cabins of cars, providing boxes
and other romes for equipment sufficient supply and exhaust ventilation, etc.
Exhaust gas maximum permissible concentration is set for carbon monoxide.
Since the action of exhaust gases, as a rule, is long-term, the MPC values ​are taken
the same as for industrial enterprises: 20 mg / m3 - during the action during the
working day, 50 mg / m3 - within an hour, 100 mg / m3 - in within 30 minutes, 200
mg / m3 - within 15 minutes. Repetitive work at these concentrations is allowed
with interruptions of at least 2 hours.

Anthropotoxins are volatile human waste products. They accumulate in

significant quantities during a long stay of a person in sealed or insufficiently
ventilated romes. By their origin, they are divided into endogenous and secondary
waste products.
Endogenous products are formed in the body and are excreted with exhaled
air due to cutaneous respiration, with the excretion of sweat and sebaceous glands,
intestinal gases and in the form of a volatile phase of feces and urine.

Secondary products are formed outside the body as a result of the

decomposition of urine, feces and skin secretions. Sources of contamination in
this case are contaminated laundry, waste and waste systems, contaminated
surfaces.

Anthropotoxins contain more than 400 chemical compounds, the release of

which increases under extreme conditions. The exhaled air contains nitrogen,
oxygen, carbon dioxide, inert gases; metabolic products excreted through the
lungs; substances formed in the oral cavity; hydrocarbons, ketones, ammonia,
acetaldehyde, fatty acids, ethanol and other substances. Ammonia, amines,
acetone are excreted from urine! phenols, alcohols, organic acids, acetaldehyde,
isoprene and other compounds. Feces - hydrogen sulfide, mercaptans, ammonia,
amines, indole, skatole, phenol, organic acids, carbon monoxide. Intestinal gases
include carbon dioxide, nitrogen, hydrogen, methane, hydrogen sulfide,
mercaptans, acetaldehyde, etc. The methane formed and released by the body can
create significant concentrations during long-term sealing. From volatile substances
in the composition of sweat, acetone, acetic acid, ammonia, propionic and butyric
acids, alcohols, formic acid and other substances were found that determine the
specific smell of sweat.

7.2. Hygienic characteristics of the main physical factors of the working

environment of military specialists
Physical factors. The increase in the technical equipment of military units
and formations, the ever wider use of various military equipment and weapons in
the course of combat training activities lead to a steady increase in the number and
intensity of the physical factors generated by them, which have a negative effect on
the health of service personnel and persons in their sphere of action. ... These
include noise, vibration, microclimate, elektromagnetik radiation, etc.
Noise . A significant number of personnel are exposed to this physical factor,
for which this occupational hazard is systematic and long-term. In addition, in
military conditions, sources of such noise levels are widespread that, even with a
single exposure, can cause irreversible changes in the auditory analyzer and even
acute acoustic injury.
From a physical point of view, noise is a complex sound phenTSenon
consisting of irregular, aperiodic oscillations of various amplitudes and frequencies,
randomly varying in time, therefore, unlike musical sounds, it does not have a
correct numerical connection between the oscillations of individual tones.
From a hygienic point of view, noise should be considered any unwanted
sound that does not correspond to the time, place, needs of people and thereby
interferes with work and rest.
The physical characteristics of noise that determine its effect on the human
body are the intensity and frequency composition.
The intensity (strength) of sound is characterized by the amount of sound
energy passing per unit time through a unit of area perpendicular to the direction of
propagation of the sound wave. The unit for measuring sound intensity is watts per
square meter (W / m2).
In practice, the physical effect of noise on the organ of hearing is often
characterized not by sound intensity, but by sound pressure, expressed in newtons
per square meter (N / m2).
The minimum amount of sound energy that can cause the sensation of audible
sound is called the audible threshold and is 1012 W / m2 for a tone with a
frequency of 2000 Hz. For sound pressure, this value is equal to 2 • 10 ~ 5 N / m2.
The upper limit of perception, corresponding to such values ​of sound pressure
that cause pain in the organ of hearing, is called the threshold of pain. It
corresponds to a sound power of 102 W / m2 or a sound pressure of 2 • 10 ~ 2 N
/ m2.
The total sound energy emitted by a noise source into the surrounding space
per unit time is called sound acoustic power and is expressed in watts (W).
The frequency composition of noise is characterized by its spectrum, i.e. a
set of frequencies included in it. Sound vibrations are perceived by the human
hearing organ if their frequency is in the range from 16–20 to 18,000–20,000 Hz.
The ear is most sensitive to sounds with a vibration frequency of 1000 to 4000 Hz.
Its sensitivity is constantly decreasing with a change in the frequency of the said
interval, both in the direction of decreasing and in the direction of increasing.
Inaudible sounds at frequencies below 16 Hz and above 20,000 Hz are called
infra- and ultrasounds, respectively. The boundaries of the frequency range of
audible sounds are not the same for different people and depend on age, work
experience in conditions of exposure to noise and other reasons.
By the nature of the spectrum, noise is divided into broadband with a
continuous spectrum more than one octave wide and tonal, in the spectrum of
which there are pronounced discrete tones.
An octave band is a frequency interval in which the upper cutoff frequency is
2 times higher than the lower one. The entire range of audible sounds contains 9
octaves, but in practice the most important are 8 octave bands, covering the sound
range from 45 to 11,000 Hz.
Time characteristics distinguish between constant noise, the sound level of
which during a working day (shift) changes in time by no more than 5 dB, and
non-constant if this change exceeds 5 dB.
Intermittent noise, in turn, is subdivided into time-varying noise if the sound
level changes continuously over time; intermittent, the sound level of which
changes stepwise, and the duration of the intervals during which the level remains
constant is 1 s or more; pulse, consisting of one or more sound signals, each with
a duration of less than 1 s.
Low-frequency noise is distinguished by the prevailing frequency
composition - up to 300-400 Hz; mid-frequency - from 400 to 1000 Hz; high
frequency - above 1000 Hz.
Depending on the duration of exposure, there are long-term noise with a total
duration of 4 hours or more and short-term noise with a duration of less than 4
hours per shift, and taking into account the transmission paths, air noise, when
sound vibrations propagate in the air, and structural (body), in which sound
vibrations propagate in sufficiently extended solids.
The sensitivity of the human ear to sounds of different frequencies, as noted
above, is different, therefore, the perception of loudness caused by sounds of
equal intensity, but different in frequency, is not the same.
Loudness is a physiological concept that characterizes the strength
(magnitude) of the subjective sensation experienced by a person as a result of the
effect on his hearing organ of a particular sound or noise. The level of sound or
noise intensity expressed in decibels does not allow judging the physiological
sensation of its loudness, therefore, by analogy with the concept of the level of
sound (noise) intensity, the concept of loudness level was introduced, the unit of
which is called background.
The loudness level is set subjectively by comparison with the loudness of a
sound with a frequency of 1000 Hz, for which the level of intensity (sound
pressure) in decibels is conventionally taken as the loudness level in backgrounds.
Thus, the loudness level of any noise in the backgrounds will be equal to the
intensity level of the same loud noise with a frequency of 1000 Hz.
Continuous noise in workplaces is characterized by sound pressure levels
measured in octave bands with geometric mean frequencies of 63, 125, 250, 500,
1000, 2000, 4000 and 8000 Hz. As a characteristic of constant broadband noise at
workplaces, in a rough estimate, it is allowed to take sound levels in dBA,
measured on the A scale of the sound level meter.
Specific physical parameters of non-constant noise, along with the intensity
and spectral composition, are the temporal characteristics, the duration of the
action of individual pulses, the shape of the pulse (the rise time of its leading and
falling edges), and the pulse repetition rate.
Noise has a negative effect on the hearing organ, the central nervous system
and the entire body as a whole. Under the influence of intense noise, both
reversible functional changes in the organ of hearing and irreversible morphological
changes can develop.
At the initial stage, there is an adaptation to the effects of noise. It is a reflex
protective-adaptive reaction, expressed in an increase or decrease in the hearing
threshold within 15 dB for frequencies below 1000 Hz and 10 dB for frequencies of
2000 Hz and above with a recovery period during the first 3 minutes after sound
exposure.
Systematic exposure to noise leads to a greater shift in the threshold of
auditory sensitivity, lengthening the time of its recovery up to hearing loss and
deafness.
Occupational hearing loss and deafness are characterized by progressive
weakening of hearing in whisper speech, slowly developing hearing loss in spoken
speech, and an increase in the thresholds of auditory sensitivity to high tones in
both air and bone conduction.
The effects of noise are not limited to the auditory analyzer. Intense noise has
a negative effect on the function of the visual, motor, vestibular analyzers, leads to
a decrease in working capacity, a decrease in labor productivity and the quality of
work performed, a drop in the pace and rhythm of work, a decrease in
concentration of attention, its distribution and switching, contributes to an increase
in injuries.
Infrared and ultrasound have the same physical characteristics as noise.
Infrasound can be of natural or artificial origin. In the first case, it occurs during
sea storms, earthquakes, volcanic eruptions. Sources of artificial infrasound are
turbines, diesel engines, fans, compressors, jet, automobile, tank and other engines.
The biological effect of infrasound on the human body is manifested by
neurovegetative disorders and mental disorders. People who are near the source of
infrasound may experience fainting, increased blood pressure, anxiety and
unconscious fear, sensations of vibrations of internal organs, and nausea. At the
same time, the internal organs of a person have unequal sensitivity to the frequency
range of infrasound. So, the frequency from 1 to 3 Hz selectively affects mainly
the respiratory organs, from 5 to 9 Hz - on the organs of the chest and abdomen
(up to cardiac arrest), from 8 to 12 Hz - on the spine. This is associated with the
phenomena of resonance of internal organs.
Ultrasound accompanies the same processes that are sources of noise,
vibration and infrasound. It has a pronounced effect on the central nervous
system, cardiovascular and endocrine systems, and therefore its positive effect has
long been used with benefit in medicine for therapeutic and diagnostic purposes.
The adverse effect of ultrasound manifests itself in the form of headaches, a feeling
of pressure in the ears and dizziness in people, which intensify towards the end of
the working day. In addition to the general effects, vegetative polyneuritis, paresis
of the fingers, hands, and forearms can occur.
Vibration - mechanical vibrational movements of elastic solids, in which the
whole body or its individual particles periodically, at certain intervals, pass the same
position of stable equilibrium, deviating from it in one direction or another. The
physical characteristics of vibration are frequency and amplitude, as well as their
derivatives - vibration velocity and vibration acceleration.
Vibration acceleration is characterized by an increase in vibrational speed
per unit time and is expressed in centimeters per 1 s2 or in fractions of the
acceleration of gravity equal to 9.81 m / s2.
By the method of transmission, general and local vibrations are distinguished,
by the direction of action - longitudinal, transverse, mixed in accordance with the
adopted coordinate system, by the source of occurrence - transport,
transport-technological and technological.
Vibration has an adverse effect on human health. Local action manifests itself
in the form of peripheral disorders of sensitivity, function, etc. Long-term general
exposure to vibration leads to the development of a symptom complex known as
vibration disease.
The problem of preventing the adverse effects of noise and vibration on the
human body requires joint efforts of design engineers, acoustics, architects,
builders, doctors and other specialists. Technical, organizational and medical
measures are being developed and carried out.
Measures of a technical nature provide for the reduction of noise and
vibration in the source of formation and the closure of their propagation paths by
technological, design and operational measures.
When the attenuation of noise at the source of its formation is impossible,
various kinds of local sound and vibration isolation devices are used, installed on
noisy units of the units. General sound insulation of romes or boxes with the most
noisy equipment is achieved by monolithic, thick enclosing structures made of
heavy dense materials that have a high soundproofing ability, or by the device of
multilayer fences, walls, ceilings, floors, separated by air or sound-absorbing gaps.
Vibration isolation is ensured by the use of various types of shock absorbers,
which are placed between the vibration sources and the supporting structures.
To weaken the transmission of vibrations through the building during its
design and construction, elastic pads are provided at the joints, under the floors.
Structure-borne noise propagating through metal pipelines is attenuated by the
device of ruptures in separate sections of the network with the inclusion of elastic
couplings and hoses in these places.
To reduce the vibration of the body of moving objects of equipment caused
by road irregularities, suspension and shock-absorbing devices are used in the seat
structure.
As an aid to combat, especially with reflected noise, various porous materials
are used for wall cladding and special designs of sound absorbers in the form of
perforated sheets, slabs, mats, cones and pyramids suspended above noisy
equipment and in places where sounds reflected from the surfaces of the rome are
concentrated.
To muffle aerodynamic noise generated by compressors, internal combustion
engines, ventilation units, mufflers are installed at the points of air intake and
discharge into the atmosphere or in the air duct network.
Organizational activities provide for short breaks during work, the
organization of rest and sleep romes, the exclusion of overtime work, etc.
The dynamic medical control system allows to timely detect the initial signs of
occupational diseases caused by noise and vibration, and to determine the nature
of the necessary measures to prevent them.
In improving working conditions, an important place is occupied by the
legislative limitation of noise and vibration levels acting on a person.
It is not always possible to reduce noise and vibration to a safe level, especially in
the military. In these cases, use personal protective equipment - anti-noise. Their
use is based on the isolation of the tympanic membrane with sound-absorbing
materials by obturation of the ear canals or isolation from external noise of the
auricles with adjacent skin areas or the entire head.
According to the method of fixation, there are internal (anti-noise bushings,
tampons, liners, half-sleeves) and external (anti-noise headphones, noise-protective
helmets) type anti-noise.
Personal vibration protection equipment is prepared from materials capable of
damping (damping) mechanical vibrations. The effect of local vibration is
weakened by vibration-proof gloves, mittens, knee pads with pads made of
damping materials, spring shock absorbers, etc. To protect against general
vibration, shoes with vibration-damping soles, shock-absorbing seats, mats and
platforms made of vibration-damping materials are used.
All organizational, technical and medical measures aimed at reducing the
harmful effects of noise and vibration are at the same time effective in relation to
infra- and ultrasound.
Microclimate is a complex of physical environmental factors in a confined
space that affects heat exchange and the thermal state of the body. It is determined
by temperature, humidity and air velocity, the temperature of the surrounding
surfaces and their thermal radiation.
The parameters of the microclimate of working romes, differing in great
dynamism, depend on the thermophysical characteristics of the technological
process, climate, season of the year, heating and ventilation conditions. The impact
on the body of each of the microclimate parameters separately and (or) in
combinations affects primarily the heat exchange process.
Heat exchange is understood as the exchange of heat energy between the
body and the environment, the relationship between the formation of heat in the
body as a result of its vital activity and the return (receipt) of heat.
Preservation of temperature homeostasis, which is an indispensable condition
for normal life and high human performance, is ensured by thermoregulation - the
coordination of heat production and heat transfer processes. Distinguish between
chemical, physical and behavioral thermoregulation.
The regulatory mechanism that allows you to increase heat production as a
result of changes in metabolic processes in the body is called chemical
thermoregulation. Heat generation in the body occurs due to the mechanical work
of skeletal muscles and smooth muscles of internal organs, continuous biochemical
synthesis of proteins and other organic compounds, osmotic processes (ion
transfer), etc. When performing physical work, with a pronounced cooling of the
body (cold shiver), the proportion of heat generation in skeletal muscles
significantly increases. The daily value of heat production varies widely and
depends on the conditions and nature of the load.
Physiological mechanisms regulating the intensity of heat transfer from the
body surface to the environment by convection, conduction, radiation and
evaporation are referred to as physical thermoregulation.
The microclimate in the working romes of the TSHT should correspond to
the nature of military work and ensure thermal equilibrium of the body with the
environment, without causing a pronounced feeling of discomfort and excessive
tension of the thermoregulatory apparatus; have minimal temperature gradients of
air and surrounding objects both vertically and horizontally and promote uniform
heat transfer from the entire surface of the human body; be relatively constant over
time.
According to the effect on the human body, the microclimate is distinguished
between heating and cooling.
To assess the microclimate in working romes and in an open area, in addition
to the above parameters, integral indicators are used that characterize the combined
effect of thermal radiation, temperature, speed of movement and air humidity
(effective and resulting temperatures, heat load index) on human heat exchange.
The norms of individual parameters of the microclimate, taking into account
heat production, the severity of physical labor and the season of the year, are
regulated by sanitary norms and rules, as well as by departmental regulations, which
also contain standards for complex indicators of the thermal state of the
environment, which make it possible to assess the total thermal effect of individual
parameters of the microclimate in various combinations.
Non-ionizing radiation is part of the spectrum of elektromagnetik waves,
which covers the wavelength range from 1000 km to 0.001 μm or less, and in
frequency - over 20 orders of magnitude - from 5 (10 ~ 3 to 1021 Hz. Most of the
spectrum of non-ionizing radiation is made up of radio frequency radiation - low,
high, very high, ultrahigh and ultrahigh elektromagnetik radiation (EMR) Electric and
magnetic fields from a physical point of view do not represent radiation: they are
classified as non-ionizing radiation for practical reasons.
An elektromagnetik field (EMF) is a combination of alternating electric and
magnetic fields. The mutual transformation of the electric and magnetic
components of the field determines its propagation in the medium. Collectively, the
alternating electric and magnetic fields propagating in the medium are called
elektromagnetik waves.
The characteristics of the EMF are the frequency of its oscillation, the unit of
which is hertz (Hz), and the wavelength (meter, multiples of it and sub-multiples).
Three zones are defined around any EMF radiation source: near (induction
zone), intermediate (interference zone) and far (wave zone).
In the frequency range 30 kHz – 300 MHz, EMF is estimated by the value of the
field strength from the electric and magnetic components and is expressed in volts
per meter (V / m) and amperes per meter (A / m), respectively. In the frequency
range 300 MHz - 300 GHz, EMF is estimated by the surface radiation energy flux
density and the generated energy load and is expressed in μW / cm2 and μW h /
cm2, respectively. EMP of radio frequencies, along with widespread use in radio
communication and radio broadcasting, radar and radio astronomy, television and
medicine, have been used in various technological processes - in the heat treatment
of metals, plastics, wood, food products, etc.
The most pronounced effect on the human body is exerted by the EMR of
the microwave range. It depends on the wavelength, intensity, duration and modes
of radiation, the size and anatomical structure of the organ being irradiated, the
structure of the irradiated tissue or organ. The effect of biological action is the
more pronounced, the greater the radiation intensity, the longer the irradiation time
and the larger the irradiated surface. Millimeter-wave EMR is absorbed by the
surface layers of the skin, centimeter-wave - by the skin and adjacent tissues,
decimeter ones penetrate to a depth of 10-15 cm. For longer wavelengths, human
body tissues are a well-conductive medium.
Depending on the intensity of the radiation, a distinction is made between
thermal (thermal) and non-thermal effects. The boundary of this section is the
energy flux density (PES) equal to 10 mW / cm2; at high energies, thermal action is
manifested, at lower energies, non-thermal.
The thermal effect consists in heating the irradiated tissues and increasing
their temperature, which determines the emerging pathology. Different tissues
absorb EMP energy in different ways. Most strongly absorb energy and heat up
tissues and organs that contain a lot of water - the lens and vitreous body of the
eye, hollow organs (urinary and gall bladders, stomach, intestines), gonads,
parenchymal organs. Organs and tissues with poor thermoregulation are the most
sensitive to local selective heating - the lens and vitreous body of the eye. The
changes occurring in tissues are associated with protein denaturation and changes
in the course of biochemical reactions (cataracts, necrospermia and atrophy of the
spermatogenic epithelium, gastric bleeding, etc.). The thermal effect of microwave
radiation is a consequence of accidents, emergencies and gross violations of safety
rules. Much more often in military practice, a specific, non-thermal effect of EMP
is noted.
The non-thermal effect of microwave radiation is manifested only indirectly.
These are mainly functional changes and biological effects that occur in the body in
the absence of temperature shifts in tissues and special thermoregulatory reactions
at microwave radiation intensities less than the threshold level of thermal action.
The specific action of radio waves causes various changes in the body -
reversible or irreversible, of a morphological or functional nature.
Morphological changes are more often observed in tissues of both the
peripheral and central nervous systems. Their nature depends on the frequency of
radiation (wavelength): under the action of millimeter waves, the changes are local,
in the form of foci, under the action of centimeter waves, they are concentrated
around the vessels of the brain. In terms of the total effect on the nervous system,
decimeter waves have the greatest effect. Morphological changes are also
observed in other tissues and organs (eyes, blood, etc.).
Functional changes are expressed in a violation of the nature and intensity of
physiological and biochemical processes in the body, functions of various parts of
the nervous system, nervous regulation of the cardiovascular system, etc.
Clinical manifestations of the action of microwave radiation are observed
mainly from the nervous and cardiovascular systems. Asthenic syndrome is
characterized by complaints of increased fatigue, weakness, weakness, decreased
performance, sleep disturbance, headache, dizziness, irritability, short temper,
increased sweating, less often - memory loss, anxiety, sexual weakness, etc.
Objectively, there is an increase in tendon reflexes, tremor of the hands and
eyelids, acrocyanosis, local and general hyperhidrosis, changes in dermographism,
pilomotor reflex, etc. In some cases, changes in the functions of the nervous
system indicate diencephalic disturbances. Changes observed in humans under
chronic exposure to microwave fields are polymorphic and unstable. They are
caused by disorders of the neuro-humoral regulation, appear gradually and reveal a
clear connection with the length of service.
Dysfunctions of the cardiovascular system proceed as a neurocirculatory
dystonia with complaints of pain in the heart, palpitations, shortness of breath.
Hypotension, bradycardia and slowing of intraventricular conduction are
objectively observed.
Changes in the blood are often unstable, but with prolonged exposure,
leukopenia with neutrophilopenia and thrombocytopenia are observed.
In the gastrointestinal tract, there are violations of the secretory and
evacuation functions.
In addition, the specific effect of microwave radiation is manifested in
changes in gas exchange, the activity of the urinary system, metabolism (protein,
carbohydrate, fat, mineral, etc.), the activity of the endocrine glands, enzymatic
processes, the exchange of nucleic acids, etc. It causes dysfunction adaptation
mechanisms that regulate the body's adaptive responses to changes in
environmental conditions, has a maladaptive effect in relation to heat, cold, noise,
psychological trauma, etc.
Hygienic standardization of EMP is aimed at preventing the thermal effect of
EMP during short-term exposure and limiting the possibility of non-thermal effects
during prolonged operation with sources of EMF.
The current standards establish a remote control for radio wave exposure for
people professionally and non-professionally associated with exposure to radio
frequency EMR, and for the population.
Medical measures to prevent the adverse effects of EMR provide for the
development of PDUs and control over their observance, justification of the work
and rest regime of people associated with exposure to EMR, hygienic assessment
of projects for the construction of new and reconstruction of existing facilities,
equipment, technological process, means of protection against EMR, preliminary
and periodic medical examinations.

Control questions
1. Characteristics of the main hazardous and harmful chemical factors in the
working environment of military specialists.
2. Hygienic characteristics of toxic chemical liquids, fuels and lubricants and
antifreezes.
3. Hygienic characteristics of chemicals polluting the air (powder and waste
gases, anthropotoxins).
4. Characteristics of the main dangerous and harmful physical factors of the
working environment of military specialists.
5. Hygienic characteristics of noise, infra- and ultrasound.
6. Hygienic vibration characteristics.
7. Hygienic characteristics of microclimatic factors.
8. Hygienic characteristics of non-ionizing radiation.
Test questions on the topic
1. Permissible concentration of CO2 in the shelter of the sick and wounded
a) 0.1%
b) 0.5%
c) 1%
d) 1.2%
2. "uses" microwave radiation in radar stations
a) antennas
b) generators
c) waveguides
d) cables
3. Units for measuring the intensity of microwave radiation
a) volt;
b) amperes;
v) watts;
g) power flux density
4. The biological effect of microwave radiation on the body depends
a) about the temperature regime inside the vessel;
b) the radiation mode of the antenna;
c) radiation intensity, exposure time, wavelength, size of the irradiated surface,
blood supply to the body
5. The essence of the microwave effect on the body is reduced as follows:
a) changes in osmotic pressure in cells;
b) measurement of cellular content of blood;
c) transfer of energy to molecules
6. The effect of heat occurs
a) when the microwave radiation PPM is higher than 1 mW / cm 2;
b) at PPM of microwave radiation from 1 to 5 mW / cm 2;
c) At PPM of microwave radiation above 10 mW / cm 2
7. Principles of protection against false electromagnetic radiation
a) remote protection;
b) protection by placing the radar in positions;
c) screen protection, time protection.
8. Something that is part of YaPM
a) flux of neutrons and protons;
b) gamma radiation;
c) alpha and beta radiation;
g) the unreacted part of the nuclear charge, the fission of the nuclear charge,
the induced radioactivity.
9. Indicate the distance between vehicles when transporting vehicles
a) 3m
b) 5m
v) 10-15 m
g) 25-30m
d) 50m
10. Medical radiometric laboratory in the complex (mrlu)
a) carrying out sanitary-hygienic works according to the full scheme
b) assessment of water and food quality for the presence of OM
c) qualitative and quantitative assessment of the content of radioactive
substances in water and products
d) monitoring of food and water for the presence of pathogenic
microorganisms
11. Troops can be involved
a) barracks
b) area
c) stationary
g) barracks (stationary) or temporary (field)
12. Designed for LG-2
a) abbreviated scheme
Sanitary and hygienic research of water and food products
b) carrying out sanitary-hygienic researches of water and food products
according to the full scheme
c) Assess water quality for the presence of OM and RS and subsequent
treatment
d) Assess the presence of OM and RS and the quality of the food for
subsequent cleaning
13. A table tool used to purify water during war
a) LG-2
b) RMS "HYGIENA-10"
c) MRLU
d) PCR
14. Lighting standards for barracks preparation rooms with fluorescent
lamps, when the training room is illuminated
a) 500 lux
b) 300 lx
v) 150 lx
g) 75 lux
15. Employees can be accommodated in this area
a) in training centers and camps
b) two-storey and multi-storey houses
c) in training centers and camps, bivak, apartment and mixed (apartment)
bivuak)
g) mixed (apartment and bivouac)

Chapter 8. Expertise of water and food for contamination of substances

and radioactive substances in sanitary and epidemiological institutions
The purpose of the lesson:
Consider the methodology for conducting a hygienic examination of water
and food contaminated with TS or RS. To acquaint students with the procedure
for drawing up an expert opinion and ways of selling water and food that have
been exposed to weapons of mass destruction (WMD).
Tasks:
1. To study the sanitary and anti-epidemic measures for the control and
protection of food products, food raw materials, water and the organization of
their sanitary examination in emergency situations.
2. To master the method of sampling water and food for research on
 contamination with toxic or radioactive substances.
3. To get acquainted with the main methods for determining the RS and TS
in water and food.
4. To get acquainted with the main standard means of determining RV and
TS in water and food.
5. To study the procedure for the examination of water and food
contaminated with radioactive substances and substances. Safety measures during
the indication of RS and TS.
6. Learn to make a decision about the possibility of further use of water and
food, which were affected by weapons of mass destruction.
8.1. Organization of sanitary and anti-epidemic measures for the
control and protection of food products, food raw materials, water and the
organization of their sanitary examination in emergency situations
It is possible to prevent contamination (contamination) of food, water, food
raw materials and medical property by taking protective measures even during the
period when the threat of radioactive substances and TS contamination and BS
infection occurs. Protecting food (various types of food and water) is difficult, and
yet preventing contamination (contamination) is easier than neutralizing. Protection
of food and water is understood as a set of measures aimed at protecting them
from contamination with radioactive substances, TS and infection with BS.The
main source of radioactive contamination is radioactive substances falling out of a
radioactive cloud in the form of dust. Induced radioactivity for food and water
does not pose a great danger.

· Fallout of radioactive fallout (as well as TS and BS) entails contamination

(pollution) of open water bodies, water sources, unprotected reservoirs,
pastures, agricultural crops and food supplies. The degree of food
contamination with radioactive substances, organic substances or BS
contamination depends on the type of food product, type of medical property,
degree of sealing, type of packaging, quality of packaging, exposure time and
resistance of the influencing agent.

Densely consistency and loose food products, medicines in packaging and

containers are contaminated (contaminated) mainly superficially, and liquid -
throughout the volume. The penetration depth of radioactive dust into various
types of unprotected food can vary widely. So, PB can penetrate into a grain
embankment to a depth of 30 mm, into flour - up to 15 mm, into millet and
 buckwheat - up to 20 mm, into bakery products - up to 10 mm. Unprotected liquid
food (milk, vegetable oil) and drinking water are polluted to their full depth. The
duration of contamination depends on the rate of decay of the isotopes.

TS can enter the environment in the form of steam, gas, fog, smoke or
droplets. Some of them lose their toxic properties under the influence of light,
moisture and other natural factors, while others remain toxic for a very long time.
The possibility of contamination of drinking water and food supplies by sabotage is
not excluded. TS are well sorbed by food products and can be stored in them for
a long time in dangerous concentrations.

The depth of penetration and the degree of contamination depend on the type of
TS, concentration, duration of exposure, size of droplets, chemical composition
of the product itself and the nature of its packaging. For example,
organophosphate toxic substances (OPT) penetrate in the form of vapors into
bread, potato tubers to a depth of 20 mm, into meat - up to 70 mm, into solid fats -
by 80-100 mm, into cereals and sugar - up to 80 mm, into pasta - up to 140-160
mm. Liquid products can be contaminated throughout the entire depth of the
container.

The degree of contamination of drinking water with TS depends on a

number of reasons, the main of which are: the type of substance, its physical state,
the ability to hydrolysis, the amount of the substance and the nature of the water
supply.

Infection of food products and drinking water with BS can occur when
aerosols with microbial formulations settle on them, contact with infected insects,
rodents, and sick people. The vast majority of food products are a good breeding
ground for the development and accumulation of pathogenic microorganisms.
Many microorganisms are able to maintain vital activity in water for quite a long
time. For example, the plague pathogen remains in food for up to 3 months, in
water - 2-3 peds; the causative agent of Asian cholera is stored in oil for up to 30
days, in black bread - up to 4, in white bread - up to 26, on vegetables and fruits - 8
days, in water - up to several months; the causative agent of brucellosis lives in
water for up to 2 months; the causative agent of tularemia - up to 3 months; the
dysentery microbe lives in the soil up to 62 days, in water - up to 92 days, on bread
- up to 20 days, on fresh vegetables and fruits - up to 6 days. Spores of anthrax
and botulinum bacillus are highly resistant.

Chemical contamination of water sources is possible with the help of chemical

means of attack (bombs, shells, missiles, etc.), by sabotage, as well as due to the
ingress of water flowing from the contaminated territory into them. It is not
excluded that the enemy uses so-called denaturing substances for moral influence,
which in effective doses are not poisonous, but can make water unfit for drinking,
giving it an unpleasant taste and smell (substances like chlorophenol, many
water-soluble dyes).

The degree of water contamination depends on a number of factors, the main

of which are the chemical nature and physical state of the HHWS, hydrolytic
stability, the amount of poison that has entered the reservoir, and the nature of the
water supply.

Infection of open water bodies with poisonous and highly toxic substances is
possible when they are used in a drop-liquid and aerosol state. Chemical
contamination occurs with direct ingress of HHTS into the water source, as well as
with rain and melt water. Small stagnant water bodies (lakes, ponds, especially
wells) can be contaminated with HHTV for a period of weeks and months, and
contamination of large and fast-flowing rivers with hazardous concentrations of
these substances is practically impossible. Water in tubular and well-closed mine
wells with a depth of at least 5-6 m remains practically uncontaminated, however,
with significant density of contamination of the area by FOB, as well as suspicion
of sabotage, these water sources are subject to contamination control.

Chemicals, hydrolysis of which proceeds with the formation of non-toxic

products (phosgene, diphosgene), practically do not cause water contamination.
Difficult hydrolysable organic substances, for example, substances of the VX type,
give a stable and long-term infection. STSan and sarin dissolve quickly and
completely in water, remaining, like VX, in aqueous solutions in summer, spring
and autumn for weeks, and in winter for months. Sulfur mustard remains in water
for about 1 hour in summer, 4–6 hours in spring and autumn, and 14–16 hours in
winter. Nitrogen mustard gas and its salts can remain in water for a longer time.

Food contamination depends on the physical and chemical properties, the

state of aggregation of the TS at the moment of contact with the food product, the
nature of the packaging, the duration of exposure to the toxicant and the properties
of a particular product.

Poisonous and highly toxic substances can contaminate food products in

droplet liquid, aerosol and vapor state. Droplet-liquid contamination of food is
possible when a chemical munition explodes near the storage site of food, as well
as when TS is sprayed with the help of aviation equipment. Contamination of food
products with vapors and aerosols of TS is possible when stored in warehouses
and packages permeable to aerosols and vapors of toxic substances, both near the
rupture of a chemical weapon, and at a considerable distance due to the movement of
the cloud in the direction of the wind. The possibility of contamination of food
supplies by sabotage is not excluded.

Poisonous and highly toxic substances are well sorbed by food products and
remain in them for a long time. Persistent agents (VG, soman, mustard gas), which
can cause dangerous food contamination for several days, weeks, and even
months, are especially dangerous. Unstable TS such as phosgene, due to their
volatility, remain in food for a short time, but such products may not be suitable for
immediate use. Foodstuffs contaminated with liquid hydrocyanic acid are of great
danger due to the formation of non-volatile hydrocyanic acid salts.
Chloroacetophenone, brTSobenzyl cyanide and other irritating substances,
including arsenic ones, when exposed to food, leave their unpleasant odor in them
for a long time, but do not cause dangerous infection. Sulfur mustard gas in
vaporous, foggy and drip-liquid form causes a very persistent contamination of
food products, especially fat-containing ones. Vapors of mustard gas penetrate
into grain and cereals to a depth of 10 cm, into flour - up to 6 cm, into solid
products (meat, fish, bread) - by 1–2 cm. In fats and oils, drop-liquid mustard gas,
as well as its aerosols due to their lipidophilicity, they dissolve very quickly,
gradually spreading throughout the mass.

Glass and metal containers completely protect the products stored in them
(cans, barrels, cans) from TS, as well as in hermetically sealed containers
(thermoses, cans). Packaging made of cardboard and paper, plastic bags, wooden
and plywood boxes do not protect products from organic matter. In unprotected
bulk food products (cereals, flour, grain, etc.), OVTV, depending on the state of
aggregation, penetrate to a depth of 1–7 cm, into the thickness of meat - by 2–5
cm, into vegetables - by 0.5–2 cm, and in fat-containing products they dissolve
very quickly and infect their entire mass. In the early periods after exposure to TS
on bulk food and products, the surface layers are most contaminated. Over time,
the contamination of these layers decreases, and deeper ones increases, and
therefore it is necessary to avoid mixing of the surface layers with the deep ones, as
this worsens the conditions for the desorption of the toxic substance and increases
the time it remains in the product.

Contamination of water and food with radioactive substances is possible

during the fallout of radioactive fallout from a nuclear explosion and during
actions on radioactively contaminated areas, as well as during sabotage or terrorist
acts. The most dangerous is the contamination of open water bodies and loose
food. In water and liquid food products, radioactive substances issolve, infecting
them to their entire depth, and in solid and bulk food products, only the surface
 layers are most often infected.

8.2. Methodology for sampling water and food for testing for
contamination with toxic or radioactive substances
When sampling water and food in the area of ​contamination with toxic, highly
toxic or radioactive substances, it is necessary to observe precautions with the use
of personal protective equipment. Sampling for examination is carried out with
strict consideration of chemical reconnaissance data: where, when and with what
agent the chemical attack was delivered to the enemy.
When taking samples from water sources and food objects, the surrounding
area is carefully examined in order to identify signs of TS contamination. All
suspicious areas of soil, vegetation, containers with signs of infection with
droplet-liquid or powder formulations of unknown substances are subject to
investigation. The soil is selected with a shovel, vegetation is cut with scissors or a
knife. The selected samples are transferred with tweezers into jars or plastic bags.
In the first hours after water contamination, as well as if the timing of
contamination is unknown, samples are taken in the upper layer on the leeward side
directly from the surface, at a depth of 20–30 cm from the water surface and in the
lower layer (20–30 cm from the bottom). At later periods of infection, samples are
taken from the middle layer of the reservoir and from the bottom. In each layer of
water, samples are taken from two or more different places and mixed into a total
sample.
When taking a sample from the upper layers, scoop up the water with a jar or
any other clean vessel. To take a water sample from the bottom layer, use a
bathTSeter (service or adapted). Water samples from rivers and lakes are taken
with a bucket or jar from the surface near the shore, especially in places with visible
oily spots and deposits.
From an artesian well or a water supply system, water is preliminarily
discharged for 10 minutes, and then the bottle is filled. Each water sample (from
different layers of a water source, from a well or a water supply system) in volume
must be at least 1.5–2 liters.
If a water sample is delivered for analysis later than 2 hours from the moment
it was taken, the TS are extracted with an adsorbent or organic solvent using a
special procedure. Therefore, 2 liters of water and a test tube with dried coal are
sent to the sanitary-epidemiological institution, after filtration through it using a
sorption column of 1.5–2 liters of water.
For sampling food products, it is necessary to equip a special metal box with
cells. It should contain: a soil sampler, a probe for sampling bulk products, a
measuring tank or spring balance for measuring the volume or mass of a sample,
500 ml jars with lids and labels for samples of liquid products, plastic bags for
samples of dry products, tweezers, a knife , scissors, scoop, insect net and jar
with test tubes for sampling for biological research.
Food products stored openly or in insufficiently sealed containers
(polyethylene, burlap, cardboard, plywood, parchment, polyethylene-coated paper)
are subjected to preliminary laboratory control. Samples of such food products
are sent for laboratory control together with samples of container material. Food
products stored in glass and metal containers, after degassing the outer surface of
the container, are suitable for use without examination.
A sample of bulk food products in a bag container is taken using a metal
probe or a spatula from the most suspicious areas of contamination. To do this,
make a U-shaped cut of burlap on an area of ​10x15 cm, after which a sample is
taken to a depth of 1.0–1.5 cm. In bags with cereals, granulated sugar or flour, a
sample is taken to a depth of 3 cm.
A sample of crackers, biscuits, biscuits, dry vegetables, food concentrates,
lump sugar is taken to a depth of 10 cm from the surface adjacent to the areas of
the container with the greatest contamination.
Samples of meat, fish, bread and solid fats are taken with a scalpel and
tweezers, cutting off a layer 0.5–1.0 cm thick from the places of greatest infection
or those individual areas where traces of TSHT are visible (drops, spots, smears).
Small fish, fresh fruits and vegetables are taken whole.
A sample of liquid products (vegetable oil, liquid food, etc.) is taken after
thorough mixing of the entire mass in the container (bottle, jar, can, etc.); scoop up
the surface layer up to 5 cm.
The mass of the food product sent for analysis must be at least 150-200 g.
Liquid food products, fresh vegetables are sent for examination in 500 g each, solid
and bulk products - 150-200 g each, packaged and piece products weighing less
than 500 g - by the piece.
If food products contain a significant amount of moisture, it is necessary to
duplicate samples by extracting the HHTV from the product with an organic
solvent using a special method.
When sampling, it is necessary to number them, indicate the place of
sampling, the time of infection and sampling, the name of the person who took the
sample. Selected samples should be tightly sealed and placed in a special box
along with accompanying forms. The box is sealed and sent to a
sanitary-epidemiological institution with a special transport on a separate transport.
The subdivisions and units deliver samples to the chemical laboratory of the
medical service on their own. The conditions for packaging and transportation of
the taken samples of water and food must ensure the safety of others and the safety
of TS in the delivered material.
The accompanying sample report is completed and signed by the medical
officer responsible for sampling. It indicates:
- the address to which the sample is sent;
- the purpose of the study (determination of the degree of contamination or the
completeness of degassing, indicating the type of degassing);
- the location of the object where the sample was taken;
- number and time of sampling;
- name, weight (volume) and sampling conditions;
- results of preliminary control and presumably the nature of sample
contamination;
- time of departure of the sample;
- the address to which the analysis results should be sent;
- position, military rank and surname of the person who sent the sample.
Samples of water and food arriving at the sanitary-epidemiological institution,
suspicious of contamination with toxic, highly toxic and radioactive substances, are
subjected to primary treatment in a separate rome (separate tent, rome). Primary
treatment is carried out under conditions of supply and exhaust ventilation, which
excludes the ingress of TS into the respiratory system, on the skin, for which a
fume hood, a protective apron, armbands, gloves are used in laboratory conditions,
and in the field the tent curtain is raised, a gas mask and a protective suit are used.
Part of the sample received for primary processing is subject to chemical and
toxicological studies, the second part, after the TSHT is deactivated in it, is
transferred for radiometric study. Neutralization of samples directed for
radiometric studies is carried out by evaporation, aeration or treatment with
degassing solutions..

8.3. Basic methods for determination of radioactive substances and

organic substances in water and food
Historically, the first, when there were no instruments for detecting chemicals,
was the organoleptic method of indicating TS.
The organoleptic method is based on the use of human visual, auditory or
olfactory analyzers. For example, you can hear the dull sound of a chemical bomb
exploding, see a cloud at the site of its explosion, detect a change in the color of
vegetation, dead animals and fish, on the ground - drops or smears of a liquid
similar to TS, feel a suspicious smell. This method can be used by chemical
observation posts, but only as an auxiliary one, since it is unreliable and subjective.
Physical and physicochemical methods of indication are based on the
determination of some physical properties of TS (for example, the boiling or
melting point, solubility, specific gravity, etc.) or on the registration of changes in
the physicochemical properties of the contaminated environment arising under the
influence of TS (change in electrical conductivity, refraction Sveta). The physical
method can be used only when determining the constants of a chemically pure
substance. The physical and chemical method is the basis for the operation of
automatic gas detectors and gas detectors. These devices allow you to constantly
monitor the air and quickly signal about the contamination of TS.
At present, the main methods for indicating TS are chemical and biochemical
methods. They form the basis for the work of chemical reconnaissance
instruments, field and base laboratories.
The chemical method is based on the ability of TS to produce sedimentary or
color reactions when interacting with a certain reagent. These reactions should
ensure the detection of TS in concentrations that are not hazardous to human
health, i.e. should be highly sensitive and, if possible, specific.
The need to detect small amounts of TS in air and water is achieved by using
adsorbents and organic solvents, with the help of which TS is extracted from the
analyzed sample, and then is concentrated.
The specificity of the reaction is determined by the ability of the reagent to
interact with only one specific TS or a specific group of substances similar in
chemical structure and properties. In the first case, these are specific reagents, in
the second, group ones. Most of the known reagents are group reagents; they are
used to determine the presence of TS and the degree of their contamination of the
environment.
Chemical indication of TS is carried out by reaction on paper (indicator
papers), adsorbent or in solutions. When performing a reaction on paper, reagents
are used that, when interacting with an organic matter, cause a change in the color
of the indicator paper. When contaminated air is sucked in through the indicator
tube, the TS is absorbed by the adsorbent, concentrated in it, and then reacts with
the reagent to form colored compounds. This makes it possible to determine by
means of indicator tubes such concentrations of TS that cannot be detected by
other methods.
When performing an indication in solutions, the TS is preliminarily extracted
from the contaminated material, and then transferred to a solvent, in which the TS
interacts with a specific reagent. Depending on the test material, type of TS and
reagent, water or organic compounds are used as a solvent, most often ethyl
alcohol or petroleum ether.
The biochemical indication method is based on the ability of certain TS to
disrupt the activity of a number of enzymes. The cholinesterase reaction is of
practical importance for the determination of organophosphorus compounds (OP).
FOS inhibit the activity of cholinesterase, an enzyme that hydrolyzes
acetylcholine. This property of FOS is used for indication. The standard
preparation of cholinesterase is exposed to the substance from the test object, and
then, according to the change in the color of the indicator, the time of hydrolysis by
the enzyme of a certain amount of acetylcholine in the experiment and control is
compared. The main advantage of the biochemical indication method is its high
sensitivity. For example, in air, FOS are determined at a concentration of
0.0000005 mg / l.
The biological indication method is based on monitoring the development
of pathophysiological and pathological changes in laboratory animals infected with
OS. This method forms the basis of toxicological control and is of great
importance for the indication of new substances or toxic substances that cannot be
determined using standard indicator chemical devices. Indication by the biological
method is carried out for a rather long time and requires special training of
personnel and the presence of laboratory animals, and therefore it is used mainly in
sanitary and epidemiological institutions.
The photometric method is based on the determination of the optical
density of various chemicals, by changing which the concentration of TS is
determined. To measure light absorption, photometers and spectrophotometers are
used, which are based on the law of light absorption by colored solutions
(Lambert-Beer law).
Usually, for photometry, an area is used in which the greatest light absorption
occurs. Moreover, for analytical purposes, only those color reactions are suitable,
during which a color develops proportional to the concentration of the investigated
substance. For example, these methods can determine the concentration of
carboxyhemoglobin in the blood.
The chromatographic method is based on dividing substances into zones
of their maximum concentration and determining their amount in various fractions.
In practice, various types of chromatography have found application: paper,
thin-layer, liquid, gas-liquid, etc. These methods are very promising, since they
allow you to determine the content of various chemicals in the objects under study
in the smallest quantities.

8.4. Standard means for determining RS and TS in water and food

For the implementation of measures for the indication of TS on the equipment
of units, units and institutions of the medical service, there are means of continuous
and periodic monitoring.
The means of continuous monitoring include indicator elements, automatic
gas alarms and gas detectors, and the means of periodic monitoring are a military
chemical reconnaissance device (VPHR), a chemical reconnaissance device
for medical and veterinary services (PKhR-MV), a medical chemical
reconnaissance device (MPHR) and a medical field chemical laboratory
(MPHL).
Indicator elements are represented by the KHK-2 set, which allows detecting
droplets and settling aerosol VX, soman and mustard gas with a dispersion of
80-400 microns in 30-80 s and indicator films AP-7, intended for determining VX
aerosols. AP-1 film is a yellow tape that is attached to uniforms, most often to the
sleeve on the forearm. A sign of a dangerous VX infection is the appearance of
blue-green spots on the film.
The military automatic gas detector GSA-2 allows detecting
organophosphorus toxic substances in the air at a concentration of 5-8x10-5 mg / l
for 2 s.
The automatic gas detector GSP-11 is designed for continuous monitoring
of air in order to determine the presence of organophosphate vapors in it, upon
detection of which the device gives light and sound signals. The device is
operational in the temperature range from –40 to + 40 ° C, the duration of the
device is from 1 to 6 hours, depending on the ambient temperature.
The automatic gas detector GSP-12 is designed for the same purposes. It is
also equipped with sound and light alarms, which are triggered no later than 4-5
minutes after the detection of organophosphates. The device operates in one of
two modes with updating of information on the presence of FOV: continuous -
after 2 minutes, in cyclic - after 16 minutes. Time of continuous operation with one
charge of indicator means in continuous mode is 8 hours, in cyclic mode - 24
hours.
Gas detector PGO-11 has a set of indicator tubes, which allows for 1-6 min
to determine OPV, mustard gas, hydrocyanic acid, cyanogen chloride and
phosgene in the air.
The device for chemical reconnaissance of medical and veterinary services
(PCR-MV) is used to take samples of water, food and bulk materials and determine
the TSHT in them. The stock of reagents allows performing 10-15 qualitative
analyzes of water and food samples.
The military chemical reconnaissance device (VPHR) is designed to
determine in the air, on the ground, on the surface of weapons and military
equipment sarin, sTSan, mustard gas, phosgene, diphosgene, hydrocyanic acid,
cyanogen chloride, as well as VG and BS vapors. The VPChR is a standard
chemical reconnaissance device and is staffed at any stage of medical evacuation.
For the same purposes, a medical chemical reconnaissance device (MPHR)
and a medical field chemical laboratory (MPHL) can be used.
The medical device for chemical reconnaissance (MPHR) is designed to
detect contamination of water sources, forage and bulk foodstuffs with toxic
substances. The means and methods of indication of the main TSHT provided in
the MPHR make it possible to determine the TS of the VG type, sarin, sTSan,
mustard gas and the TS of the BS type on the ground and on various objects. In
addition, the device is designed to take samples suspected of contamination with
bacterial agents. Departments and institutions of medical and veterinary services
are equipped with the device.
The device provides detection of the following TS groups:
- in water: sarin, soman, VG, mustard gas, BS, arsenic compounds,
hydrocyanic acid and its salts, organophosphorus pesticides, alkaloids and heavy
metal salts;
- in bulk food and feed: sarin, soman, VG, mustard gas;
- in the air, on the ground and on various objects: sarin, soman, VG, mustard
gas, BS, phosgene, diphosgene.
- The stock of reagents is designed for 100-120 analyzes and allows for 20
high-quality analyzes of water or food products in 10 hours.
- A medical field chemical laboratory (MPHL) is used to equip
sanitary-epidemiological institutions.
It is intended for the qualitative and quantitative determination of TSHT in
samples of water, food, fodder, medicines, dressings and on items of medical and
sanitary equipment. In particular, the capabilities of MPHL make it possible to
carry out:
- qualitative detection of organic matter, alkaloids and salts of heavy metals in
water and food;
- quantitative determination of FOS, mustard gas and arsenic-containing
substances in water;
- determine the completeness of the degassing of water, food, fodder,
medicines, dressings and care items;
- to establish the contamination of water, food and fodder with unknown TS
by conducting biological samples.
The stock of reagents, solvents and materials provides the laboratory for at
least 120 analyzes. MPHL is adapted for transportation by any means of transport,
is serviced by one laboratory assistant, its performance is 1012 samples per 10
hours of operation.
The main requirement for the indication of TS is the reliability of its results
and the safety of work. In this regard, the determination of TS should be carried
out in strict accordance with the instructions or guidelines, since they provide
optimal conditions for the study. In addition, the indication of TS should be
carried out by persons who have undergone the necessary training in the amount of
manuals or instructions for the used indicating devices, who know the properties of
the TS and safety measures when working with them. In particular, when working
in the field, it is necessary to use technical means of individual protection (gas
mask, protective clothing, rubber gloves and boots), and in the process of
performing work it is necessary to be on the leeward side of the infected area.
8.5. The procedure for the examination of water and food for
contamination with toxic, highly toxic and radioactive substances
When there is a danger of exposure to toxic, highly toxic or radioactive
substances in subdivisions, units and institutions of the medical service, military
control of the chemical and radiation contamination of water and food is carried
out. Military chemical and radiation monitoring of water and food is the
establishment of their contamination with toxic, highly toxic or radioactive
substances using chemical and radiation reconnaissance devices in order to resolve
the issue of the possibility of their intended use, the need for special treatment of
water and food or their further research in the course of sanitary -toxicological and
sanitary-radiological expertise. It is conducted under the guidance of unit
commanders by paramedics or sanitary instructors specially trained for
radiation-chemical reconnaissance. In cases where the medical staff cannot make a
final conclusion on the spot, water and food samples are taken to send them to
sanitary and epidemiological institutions for sanitary-toxicological or
sanitary-radiological expertise.
Military control and examination of water for drinking and sanitary needs in
case of suspicion of chemical or radioactive contamination is carried out without
fail. Food control and examination is carried out if the food was in areas where the
enemy was using weapons of mass destruction, in the areas of accidents
(destruction) of radiation and chemically hazardous facilities, if trophy food is
received or there is a suspicion of food contamination by sabotage, as well as, if
necessary, to assess residual contamination after special processing of food.
Chemical control and examination of water and food products in subdivisions
and units of the medical service (regiment medical station, separate medical
battalion) is carried out using the MPKhR device (PKhR-MV), and in sanitary and
epidemiological institutions - using the MPHL field laboratory. Radiation control is
carried out using the DP-5V device, which is equipped with all units and units of
the Armed Forces (including medical ones), and sanitary and radiological
examination is carried out using the IMD-12 device. In the event that there is no
information about the time and type of the TS used by the enemy in the area of ​the​
object being examined, or when new, unknown TS are used by them, a complete
(or systematic) analysis of water and food samples is carried out. In addition,
samples of trophy food, as well as water samples from sources previously located
on enemy territory, are systematically analyzed for TS contamination. If there is
information about the nature of the substance used, the analysis of samples can be
carried out in a certain volume, i.e., for contamination with specific TS.
Systematic analysis of water samples provides for direct determination of
water contamination, extraction of TS from water with birch activated carbon,
organic solvents, and biosamples. For a systematic analysis of food, a part of the
product is placed in the cylinder of the air extraction device and subjected to a
preliminary study for TS contamination by means of indicator tubes provided in the
MPHL set. After that, the rest of the sample is analyzed in solutions of petroleum
ether, alcohol and water. The analysis of the food sample ends with the setting of
bioassays on animals.
Toxicological (biological) control is carried out to establish the fact of
contamination of food, water and other objects of the external environment by TS,
when toxicants are not recognized by chemical and biochemical methods. The
obtained results of toxicological control can be used to solve expert questions
related to the organization and implementation of preventive and therapeutic
measures.
Based on the results of the examination of water and food, the following
decisions can be made:
- food or water is suitable for its intended use without restriction;
- food or water is suitable for use with a limited period of consumption (if
their contamination does not exceed the corresponding maximum permissible
concentrations);
- food is ready for consumption after the recommended cooking;
- food and water are not suitable for consumption and are subject to
degassing with subsequent re-examination with the solution of issues of possible
use for its intended purpose;
- food is not suitable for use by personnel and is subject to destruction;
- the water is suitable for drinking and household needs after it has been
purified by technical means of the engineering troops.
In accordance with the recommendations received, the unit commander
announces a decision on the further use of water and food.

Food and water contaminated with toxic, highly toxic or radioactive

substances above the maximum permissible concentrations are degassed or
decontaminated. In this case, the medical service is responsible for re-indication of
TS in water and food that have undergone degassing, re-assessment of the level of
their radioactive contamination, determination of the good quality of water and food
and an examination to decide on their suitability for use.

Control questions
1. Ways and methods of contaminating water and food with weapons of
mass destruction (TS, RS and BS).

2. Tasks of the hygienic examination. Specialists who conduct it.

3. Stages of the hygienic examination.

4. Methods for conducting a hygienic examination. Technical tools used for
examination.

5. Methodology for sampling water and food. Features of sampling

depending on the type and degree of contamination of TS and RS.

6. Rules for drawing up an expert opinion.

7. Ways of selling water and food contaminated with weapons of mass

destruction.
Test questions on the topic
1. electrical equipment for the application of hygienic control of food and
water quality
a) DP-5, PKhR-MV, LG-1
b) MRLU, MAFS
c) TUF-200, LG-2
d) MAFS-2.5, DP-5B, RV
2. District sanitary-epidemiological department
a) biochemical, physiological
b) medical, chemical, biological
c) epidemiological, physiological
d) disinfection, especially dangerous infections, anti-epidemic, bacteriological,
hygienic radiometric laboratory
3. The set "laboratory hygienic-1" (lg-1) is designed
a) sanitary and hygienic inspection of water and food products according to
the abbreviated scheme
b) Assess water quality for the presence of OM and RS and then purify
c) Assess food quality for OM and RS availability and subsequent cleaning
4. Designed for LG-2 (mrlu)
a) carrying out sanitary-hygienic works according to the full scheme
b) for a complete assessment of water and food quality
c) qualitative and quantitative assessment of the content of radioactive
substances in water and products
g) monitoring of food and water for the presence of pathogenic
microorganisms
5. Decade-counting radiometer (DP-100M) is designed
a) to determine the radioactivity of water, food and air
b) to disinfect water and products
c) to determine the distance from the object of disinfection ionizing radiation
6. Basic rules of water purification according to the table
a) oxidizing
b) oxidative-sorption
c) oxidation -vosstanovitelny
d) rehabilitation
7. Medical examination of water and food
a) Cleaning with TUF-200 and MAFS
b) installation of equipment, followed by disinfection and decontamination of
water and food;
c) sanitary treatment of water and food
d) analysis of radiation, chemical and bacteriological condition, site
inspection, packaging and food, water supply, food sorting, sampling and
laboratory studies and expert opinions
8. The nature of the nutrition of military service in peacetime
a) individual, dietary
b) decentralized, regulated
c) characterized by superior use of dry ration,
d) mass, centralized, stratified
9. Duties of the medical worker on the organization of food in peacetime.
a) monitoring the health of food workers, providing staff with disinfectants;
b) inspection of products for chemicals and radioactive substances,
decontamination of products and containers
c) quality control of food products, control of sanitary condition of food
products, menu ordering
d) establishment of a battalion feeding point
10. The size of the area for the battalion's food point
a) 50 × 100 m²
b) 80 × 100 m²
c) 100 × 110 m²
d) 150 × 100 m²
11. Features of nutrition of servicemen during the war
a) strict adherence to the diet
b) the centralized nature of nutrition
c) an increase in vitamins and mineral salts in the diet and an increase in the
taste of food
d) decrease in taste, nutritional properties of foods and decrease in vitamin
value of food
12. BOP kitchens are located at the following distances
a) at a distance of 30 m
b) 40 m
c) 45 m
d) 50 m
13. Energy value of common food (kcal)
a) 3500
b) 4374
c) 5000
d) 4800
14. The amount of vitamin A (d) in the diet
a) 0.2
b) 0.4
c) 0.3
d) 1.0
15. Food organization service for military personnel
a) front rear service
b) food
c) medical
d) chemical

PART TWO
MILITARY EPIDEMIOLOGY
Chapter 9. Military epidemiology. Features of the development of the
epidemic process among the personnel of the troops and the civilian
population in wartime and emergency situations
9.1. Definition and objectives of military epidemiology/ Military
epidemiology
It is a discipline that studies the causes and conditions for the development of
the epidemic process in military contingents and substantiates measures to prevent
the introduction of infections into the troops (fleet), and in the event of their
occurrence and spread, measures to eliminate epidemic foci and prevent the spread
of infection beyond its borders. Military epidemiology as a theory and practice of
anti-epidemic support of troops was formed at the junction of epidemiology and
military medicine. The system of anti-epidemic protection of troops that has
developed in the Armed Forces is focused on preventing the introduction of
pathogens into military collectives and the emergence of diseases when the internal
reservoirs of infections are activated in units (on ships), to prevent the spread of
diseases due to the action of predisposing social and natural conditions, to localize
and eliminate epidemic foci that have arisen , to eliminate the possibility of carrying
infections outside the units (garrisons) and bringing them into other units (garrisons)
and settlements in the areas where units are deployed and combat operations. Such
an integrated approach is due to the fact that none of these areas individually
guarantees high efficiency due to objective reasons due to the continuity of the
epidemic (epizootic) process, the easily realized introduction of infections into the
troops, social and natural conditions that are not amenable to or poorly amenable to
correction, the complexity of the medical service in wartime and in the elimination
of the consequences of emergency situations, tasks and other factors. Difficulties in
the rational organization of anti-epidemic measures are also associated with the fact
that some of them are implemented by non-medical forces and means, and issues
of interaction in related areas are often more difficult to solve than their own
problems. Much depends on the supply capabilities, organizational and staffing
structure of the medical service and logistics services, as well as on the
socio-economic and political situation. Without a rational solution to these difficult
issues, even a complex impact on the epidemic process is not always able to ensure
the stable sanitary and epidemiological well-being of the Armed Forces in relation
to urgent infectious diseases in a peaceful environment and in wartime. Therefore,
the choice of the main direction of influence on the cause and conditions of the
development of the epidemic process and the rational use of potentially effective
anti-epidemic agents based on the results of sanitary and epidemiological
surveillance remains the main strategy for combating infectious diseases in the
troops at this stage. Military epidemiology includes the military medical aspect of
the theory of the epidemic process, a set of theoretical, methodological and
organizational principles for the justification and implementation of sanitary and
anti-epidemic measures in the troops on the basis of epidemiological diagnostics,
sanitary and anti-epidemic measures proper, means and methods of their
implementation, private epidemiology of infections, relevant for troops and the
population in wartime, as well as a system of knowledge about the damaging
properties of biological weapons (BW) and biological defense of troops (BZ). On
the basis of this knowledge, skills and abilities, in order to achieve the goals of
anti-epidemic and biological protection of troops in the practical activities of the
medical service, the following tasks are consistently solved:

- dynamic assessment of the epidemiological (biological) situation in the

troops and areas of their deployment (actions) and its forecasting using modern
methods of epidemiological diagnostics;

- selection of sanitary and anti-epidemic measures (biological protection

measures) corresponding to the epidemiological (biological) situation and the real
capabilities of the medical service, taking into account their potential and actual
effectiveness;

- carrying out measures justified by the situation and the availability of the
necessary forces and means on the basis of the organizational principles of military
epidemiology and a functional approach to the distribution of duties of officials;

- dynamic assessment of the effectiveness of measures and the quality

(efficiency) of the work of officials and organizational structures of the
anti-epidemic system and adjustment of methods for solving further problems of
anti-epidemic (biological) protection of troops.

At this stage in the development of preventive medicine, the epidemiological

consequences of emergencies (catastrophes, accidents, natural disasters) should be
considered in the relevant sections of military epidemiology. This is justified by the
similarity of the patterns of the epidemic process and its manifestations, as well as
the strategy and tactics of conducting epidemiological surveillance and organizing
sanitary and anti-epidemic (preventive) measures in wartime and in conditions of
emergencies, as well as during the elimination of their consequences. At the same
time, it should be borne in mind that emergency situations can manifest themselves
both in peacetime and in wartime, and the conditions that develop during the period
of hostilities further complicate the epidemiological situation among the population
and among the troops.

9.2. The purpose and objectives of training students in military

epidemiology (guidelines)

The purpose of training students is to prepare them in theoretical and practical

issues of military epidemiology to the extent necessary for the performance of their
duties in accordance with their mission in wartime and in peacetime emergency
situations. As a result of studying the discipline, the student must know: - the
mechanism of development and manifestation of the epidemic process in wartime,
its features in emergency situations and in conditions of the enemy's use of
weapons of mass destruction; - methods for assessing the sanitary-epidemic state
of troops and the area of ​their operations;

- characteristics of biological damaging agents and methods of their use;

- measures taken for anti-epidemic and biological protection of personnel and

stages of medical evacuation, forces and means involved in their implementation;

- basic principles of transferring the stage of medical evacuation to a strict

anti-epidemic mode of operation;

- measures of the medical service to identify and isolate patients with

especially dangerous infections;

-organization of the work of the main divisions of sanitary and

epidemiological institutions in wartime and in emergency conditions;

As a result, the followings can be achieved:

- to assess the sanitary-epidemic state of the unit (area of ​its operations) and,
in accordance with the assessment, to determine the list of measures for
anti-epidemic and biological protection;

- to conduct an epidemiological survey of foci and sanitary and

epidemiological reconnaissance and surveillance in areas of hostilities;
- to determine the indications for sanitization in the hearth;

- master the basics of laboratory research and indication of biological agents

in the amount provided for the sanitary-epidemiological laboratory of the
compound (medical institution).

Be aware of:

- with the peculiarities of the etiological structure of infectious morbidity in the

troops and among the population in wartime and in emergency situations;

- with the organizational and staff structure of the SEA associations. In the
course of practical exercises, the main attention should be paid to the analysis of
specific issues of organizing and carrying out measures for anti-epidemic and
biological protection of troops using situational tasks. Independent work is carried
out by studying the recommended literature and lecture material. The study of
military epidemiology begins after students have completed general epidemiology
and the basic course in the organization and tactics of medical service and military
hygiene.

9.3. Formation and development of military epidemiology

The source of the formation of domestic military epidemiology was both

military medicine, on the one hand, and the epidemiology of infectious diseases, on
the other. In the 19th century, military doctors began to strive for separate services
for infectious patients and military personnel with other pathologies, and use mobile
quarantines more widely. It should be noted the outstanding role in the
development of the preventive direction in military medicine of the great Russian
scientists - therapist M.Ya. Mudrov and surgeon N.I.Pirogov. It was N.I. Pirogov
defined the war as a "traumatic epidemic" combined with epidemics of infectious
diseases and hunger. During the Russian-Turkish war of 1877-1878, the first
non-standard sanitary and epidemiological institutions appeared. Bacteriological
discoveries contributed to the further improvement of anti-epidemic support for
troops and medical and evacuation services for infectious patients. Thus, in the
Russo-Japanese War, a system of anti-epidemic barriers began to take shape on the
routes of movement of troops and railway echelons (sanitary observation posts,
railway disinfection units and baths, flying units - the prototype of mobile
epidemiological groups). It was then that the first full-time sanitary and
epidemiological institutions arose. In World War I, isolation checkpoints and
observation points, regular sanitary and epidemiological detachments in corps and
disinfection detachments in divisions were formed. Vaccination and disinfection
began to be widely used. On the basis of two years of war experience, the assistant
professor of the Military Medical Academy K.V. Karaffa-Korbut formulated the
organizational principles of military epidemiology and anti-epidemic support of
troops in different periods of hostilities. This, in particular, is the need for special
forces and means to carry out sanitary and anti-epidemic measures (sanitary and
epidemiological institutions); the obligation to carry out measures in the area of
​hostilities, extending not only to the army, but also to the civilian population; the
expediency of anti-epidemic barriers (filters) to prevent the introduction of
infections from one stage of the evacuation of the wounded and sick to others and
to the rear, as well as from the interior regions of the country to the active army;
implementation of the principle of treating infectious patients on the spot (in the
front-line area) without evacuating them to the rear of the country; the importance
of training epidemiologists as specialists to manage the anti-epidemic activities of
the medical service, other army and health services. Basically, they are still
effective. In a difficult epidemic situation during the civil war and foreign
intervention, the country's military-sanitary service is being created practically from
scratch. At this time, a preventive direction was developing in health care and
military medicine. The organizational and staff structure of the sanitary and
epidemiological institutions of regiments, divisions and armies created in these
years is constantly being improved. Their material and technical equipment and
working methods are improving. In 1932, domestic samples of field washing and
disinfection equipment and auto laboratories appeared on the supply of the troops.
In 1935, a medical-sanitary battalion with a sanitary platoon in its composition was
introduced into the division, the staff of the army and front-line
sanitary-epidemiological detachments was strengthened. The most important stage
in the development of organizational forms and methods of anti-epidemic support
of troops was the Great Patriotic War. In the course of it, the formation of a
system of anti-epidemic barriers on the routes of movement of troops and
replenishment, as well as the evacuation of the wounded and sick, was finally
completed. This took place against the backdrop of a difficult epidemic situation in
the theater of operations that developed in the first two years of the war. In the
conditions of the offensive period of the war, methods of sanitary and
epidemiological reconnaissance were improved, the organization of anti-epidemic
measures in the places of deployment and operation of troops, at the stages of
medical evacuation, as well as among prisoners of war and repatriates. The
experience of world wars made it possible to develop the fundamentals of
anti-epidemic protection of troops in the theater of operations (theater of
operations), which, with some clarifications, are still effective today. In general
terms, they are reduced to the peculiarities of the use of sanitary and
epidemiological institutions in combat operations, including: layered formation and
use of sanitary and epidemiological institutions in the theater of operations ; the
approach of anti-epidemic forces and means to the troops provided, taking into
account the situation and the need for measures in the rear; rendering assistance to
the lower level of the medical service and interchangeability, if necessary, at the
expense of higher forces and means; continuity of sanitary and anti-epidemic
measures in the process of moving anti-epidemic forces and means; determination
of the effective amount of sanitary and anti-epidemic measures, depending on the
specific situation, the availability and capabilities of the available forces and means;
constant readiness of subdivisions of sanitary and epidemiological institutions to
move to epidemic foci due to timely and rational maneuver and creation of a
reserve; carrying out activities throughout the territory occupied by the troops,
including the population and natural (anthropurgic) foci of infections; the allocation
of functional (working) groups from the composition of sanitary and
epidemiological institutions for solving problems arising from the situation. In
peacetime conditions, the system of anti-epidemic support and biological
protection of the Armed Forces of the RUZ continues to improve. Parallel to this,
military epidemiology is developing as a branch of medicine and epidemiology.
This contributes to the rationalization of the organizational and staff structure and
the expansion of the functions of sanitary and epidemiological institutions, the
introduction into practice of advanced methods of epidemiological diagnostics and
a functional approach in the management activities of the anti-epidemic service. The
functional directions in the control system of anti-epidemic forces and means are:
epidemiological - diagnostic (justification of management decisions, the choice of
measures and means); organizational (registration of the adopted decision and
bringing it to the attention of the executors); methodical (preparation of performers
for high-quality events); executive (direct implementation of the event in accordance
with the requirements); control (checking the timeliness and quality of the
execution of the event). A clear delineation of the functions of organizers and
executors of sanitary and anti-epidemic measures is especially important for
coordinating the efforts of the medical service, other services, command and
personnel, as well as for interaction with other structures (local government and
health authorities, the formation of the Ministry of Emergency Situations, Ministry
of Railways, etc.) to achieve and the preservation of epidemiological well-being in
the troops and among the population. It is enshrined in the general military
regulations and other guiding documents of the Ministry of Defense of the RUZ
and the Main Military Medical Directorate of the Ministry of Defense, which
regulate the activities of officials in the interests of anti-epidemic support of
personnel of the troops. Scientific research by military epidemiologists is aimed at
finding and testing new means of immuno- and emergency prophylaxis,
disinfection, laboratory diagnostics, and indication of biological weapons. The
valuable experience of anti-epidemic work during local wars and armed conflicts, as
well as during the elimination of accidents, the consequences of natural disasters
and other emergencies, is summarized. Rational practical approaches developed by
military epidemiologists in the unique conditions of local wars and conflicts, as
well as in eliminating the consequences of disasters, are successfully used not only
in our country, but also when providing assistance to the population of other
countries in emergency situations. Currently, on a new scientific basis - the theory
of self-regulation of parasitic systems - a modern system of epidemiological
surveillance of infectious diseases of the personnel of the Armed Forces of the
Republic of Uzbekistan and new approaches to organizing anti-epidemic measures
in the troops (in the navy) are being introduced. The reform of the Armed Forces
of the Republic of Uzbekistan medical service in modern conditions poses new
complex tasks for military preventive measures, the solution of which should bring
military epidemiology as a science, as well as the system of anti-epidemic support
of troops (navy) as an essential part of the preventive direction of military medicine
to a qualitatively new level of development.

9.4. Ways of introducing infection into troops and factors (conditions)

affecting the development and manifestations of the epidemic process in
emergency situations and in wartime

In wartime, the role of the main ways of introducing pathogens into the troops,
characteristic of peacetime, generally remains, but the importance of some of them
may increase. So, if the introduction of infections by the arriving replenishment will
be carried out not in strictly defined terms, as in peacetime, but sporadically, then
this path will be followed by import from the local population (when using housing
stock, water, food, property purchased or requisitioned from the population, at the
expense of other contacts). A particular danger here is represented by lice, parasitic
typhus, typhoid paratyphoid diseases, viral hepatitis. Under the action of personnel
in natural foci, the risk of infection with pathogens of the corresponding infections
will be associated with trench work, with the use of natural bedding material, water
for household and drinking needs from open or untested water sources, with
arthropod bites and contacts with rodents, as well as with the availability of
facilities water supply and food storage points for the latter. Other pathways for the
introduction of infections will be of lesser importance, but some that are not
characteristic of peacetime may in some cases advance to leading positions. We are
talking about the introduction of pathogens with prisoners of war, refugees,
"displaced" persons, repatriates and other non-military contingents. The experience
of world and local wars testifies to this, especially the episodes of abandonment of
concentration camps with Soviet prisoners of war during the retreat by fascist
German troops, among whom outbreaks of infectious diseases raged. The role of
skid routes will be ambiguous in different types of combat operations, as well as in
relation to the peculiarities of the separation of troops and the rear, and this will
largely depend on the natural and social conditions in the theater of operations. So,
in the forward units, military personnel will become infected to a greater extent from
the local population, prisoners of war, as well as when operating in natural and
anthropurgic foci of zoonoses (sapronoses), and for the rear units, the introduction
of infections with replenishment will be significant. Other ways of introducing
pathogens will also become more active, including those associated with refugees
and other non-military contingents. In wartime, contamination of wound surfaces
with earth (dust) and infection with anaerobic pathogens (tetanus, gas gangrene,
etc.) are of particular importance. Since war is a "traumatic epidemic", it is
necessary to pay great attention to the specific prevention of wound infections even
in peacetime, creating grund-immunity in military personnel against tetanus,
botulism, gas gangrene, and in the future, possibly against other wound infections
(staphylococcal, Pseudomonas aeruginosa, etc.). During the period of mobilization,
mandatory revaccination is provided, and emergency prevention of these infections
is carried out in the future according to epidemic indications (in case of injuries).
Only compliance with these requirements can explain the irrelevance of these
infections in local conflicts of recent decades (Vietnam, Afghanistan, etc.).
However, the causative agents of other infections, including purulent-septic ones,
will have many opportunities to penetrate the medical institutions of hospital bases
and take root in them. It will be extremely dangerous to use infected donor blood,
the need for which sharply increases in wartime (blood-borne viral hepatitis, HIV
infection, malaria, etc.). The long-term consequences of "delayed" morbidity will
be very serious. This is an important problem in peacetime, associated with the
selection of donors, laboratory control of the safety of blood and its derivatives, as
well as with the observance of the anti-epidemic regime in medical institutions. It
should also be said about the possibility of the enemy using a special way of
introducing pathogens into the opposing troops - the use of biological means of
attack. However, in view of the retroactive action, it is likely that, as a rule, only
fast-acting non-contagious pathogens will be used against defending units in the
military and army area. The use of contagious agents in the rear of the front and the
country, including in a sabotage way, is not excluded. The latter can be used by the
enemy during his retreat from the occupied territory. In this case, the
contamination of the territory can reach significant proportions. To neutralize the
pathways of the introduction of pathogens associated with the use of mainly
aerosols, the implementation of measures of a complex of biological protection is
provided. In addition to the introduction of infections into the troops, in many
situations the previously formed (including in peacetime) internal reservoirs of
pathogens will be active, however, their relatively autonomous circulation will be
manifested to a greater extent in the rear units, where combat losses will be less,
and the conditions more stable (hospital bases, special units, ships and units of the
Navy, formations of the Air Force and Airborne Forces, training centers, etc.).
During the period of hostilities, the role of pathways for the removal of infection
from units increases sharply due to the possibility of introducing pathogens from
the advanced stages of medical evacuation to subsequent stages and the spread of
diseases both in hospital bases and in the rear. This will be facilitated by massive
flows of the wounded and sick, overloading stages, especially due to the use of
weapons of mass destruction by the enemy, lack of transport for evacuation, etc.
The experience of the wars of the 20th century has convincingly proved this. As a
result of its analysis, domestic scientists proposed the principle of treating
infectious patients on the spot (in the front-line area) and a fairly harmonious and
effective system of anti-epidemic barriers, providing for special measures in relation
to infectious patients and those suspected of having a disease at each stage of
medical evacuation. At the same time, regular formations of the medical 346 service
and non-standard forces are used to implement barrier functions. These measures
are especially important in conditions of the use of BW by the enemy, as well as
when especially dangerous and other severe highly contagious infections appear in
the troops. The same anti-epidemic barriers provide at the same time the prevention
of the introduction of pathogens into the troops with replenishment, food, and
other material resources coming from the rear areas. Under conditions of peacetime
emergencies, the introduction of pathogens of zoonoses and sapronoses from the
nearby territory into the contingents of the affected population is of paramount
importance, since natural disasters and catastrophes are often accompanied by
spontaneous migration of wild and synanthropic animals, as well as arthropods,
death of domestic and farm animals. When fecal contamination of the territory,
reservoirs, water sources due to large-scale destruction of residential and industrial
facilities, sewage, water supply, pathogens of intestinal anthroponosis are
introduced. Subsequently, in the course of liquidation of the consequences of
disasters, the introduction of pathogens of other anthroponotic infections can be
carried out in the usual ways, including with rescuers arriving in the disaster areas,
food, water and other means of humanitarian aid. It is also necessary to take into
account the possibility of contamination of the population in disaster zones during
accidents and destruction of facilities of medical institutions, enterprises producing
biological preparations for various purposes, as well as special research centers.
Massive emissions and leaks of biological aerosols into the atmosphere are of
particular concern. During the period of hostilities, the most important factors
(conditions) that determine the characteristics of the epidemic process will be: the
nature of combat missions, life support conditions for personnel, and the sanitary
and epidemiological state of combat areas. So, in the combat formations of troops
during the offensive period, contacts with the local population (purchasing food,
using housing stock, using water from unverified water sources - in relation to OCI,
zoonoses) will be of greatest importance for the introduction of pathogens. In
defense, the features of nutrition, water supply, placement in the field are important,
especially when water pipelines, treatment facilities, sewage systems, housing stock
(OKI, sapronoses) are destroyed, and when acting in natural foci, these conditions
become of leading importance, but already in connection with the degree of
activity of rodents and arthropod carriers of pathogens. Some of these conditions
are well modeled on the experience of the epidemiological consequences of natural
disasters, especially earthquakes (Ashgabat, Tashkent, Spitak, etc.). The role of
replenishment in the introduction of pathogens with a constant, but irregular in time
and unstable in terms of volume of personnel renewal of military units will not be as
significant as in peacetime. Due to the large loss of wounded and dead, elements
of self-regulation of the epidemic process are likely to remain only in the rear units
and hospitals. Therefore, the incidence of airborne and other infections will be
significantly higher in the rear zone of active forces than in the forward area. In the
rear area, where the living conditions of servicemen will not be as difficult as in the
forward area, the peculiarities of catering, water supply, cleaning the territory, bath
and laundry services, and placement will have a greater impact on the regulation of
the epidemic process. So, the summer seasonality for intestinal infections will
remain, which was usually rightly associated with the pollution of the territory with
sewage and the mass emergence of flies during the wars, and viral hepatitis A and E
will manifest itself in the fall or winter in the form of "shifted to the right"
morbidity. The "mixing factor" (renewal of contingents) will more actively affect the
epidemic process in reserve units and formations, Special Forces, and hospital
base institutions. Therefore, in the rear areas, there will be smoothed forms of
seasonality of airborne infections In this situation, the conditions of
accommodation, bath and laundry services, as well as compliance with the rules of
the sanitary and anti-epidemic regime, primarily sterilization and disinfection,
especially in hospitals for the wounded and burned, will acquire great importance.
The dynamics of the incidence of zoonoses and sapronoses will depend on the
specific conditions of combat activities of personnel in the natural and anthropurgic
foci of these infections, the activity of reservoir animals and arthropod vectors of
pathogens. Annual dynamics of the incidence of infections with the fecal-oral
transmission mechanism in the 40th Army in 1980 – 1988 (average monthly levels,
absolute number, Ogarkov P.I., 1996, Sinopalnikov I.V., 2000). In the case of the
enemy's use of nuclear weapons with a decrease in the immune resistance of the
wounded and sick in hospitals, the carriage of pathogens of meningococcal and
diphtheria infections is activated, Viral hepatitis A Typhoid fever and paratyphoid
fever Acute dysentery and acute enterocolitis morbidity of bacteria and viruses of
the intestinal group, which can lead to outbreaks of disease. The legitimacy of such
conclusions is confirmed not only by experimental data, but also by the
consequences of the nuclear bombing of Japanese cities, accidents at nuclear
submarines and power plants, especially the Chernobyl tragedy. All this is
especially important in view of the new defensive doctrine of the Republic of
Uzbekistan. When the enemy uses biological weapons, the manifestations of the
epidemic process will be determined by the timeliness of notification of an attack,
the use of protective equipment by the troops, the organization of restrictive and
other special measures, including those taken in advance (vaccination). In some
cases, in suitable conditions, secondary natural foci can form, requiring long and
complex work of various specialists and services for their elimination. Thus,
hostilities and emergencies, as a rule, are accompanied by an increase in the number
of infectious agents, activation of almost all mechanisms of transmission of
pathogens and a decrease in human immunity, which leads to more significant
epidemiological consequences than in peacetime.

9.5. Features of the etiological structure of infectious morbidity in wartime

and during natural disasters

The special epidemiological significance of infectious diseases in wartime is due to

the possibility of significant non-combat irrecoverable losses due to those
dismissed or died as a result of diseases. In addition, significant sanitary losses
associated with the loss of servicemen due to illness seriously affect the combat
effectiveness of personnel, and in general, units and formations, sometimes even
making it impossible to perform combat missions. It is well known that wars were
always accompanied by epidemics of highly contagious diseases, and up to World
War I, the irrecoverable losses from diseases were many times higher than those
from weapons. The colonial wars were especially demonstrative in this respect. In
armed conflicts of the 18-19 centuries, as in the wars of Antiquity and the Middle
Ages, especially dangerous infections (cholera, plague, smallpox) and other highly
contagious severe infections (parasitic typhus, Shiga dysentery, typhoid fever,
malaria, naturally focal zoonoses). Subsequently, the situation changed for the
better, but, with a significant reduction in irrecoverable losses from infections,
sanitary losses continued to remain high in the wars of the 20th century.

In particular, in World War I, they were still 2-3 times higher than those from
wounds in all belligerent countries, and in World War II in some armies or in certain
periods of hostilities, depending on the regions where they were fought, the ratio
was in favor of infectious morbidity, although overall these proportions have
improved (Table 7.1.). This was the case during the operations of the belligerents in
Africa, the Balkans and especially in Southeast Asia.

For example, the number of labor losses from infectious diseases associated
with hospitalization of US Army and Navy personnel in hostilities against Japan was
4 times higher than those for the wounded.

Table 7.1.

Losses in past wars from weapons and disease

The ratio of the number of killed

and the number of deaths from
Wars Armies wounds deaths from disease

Russian-Turkish Russian 100: 550

1828-1829
Crimean Russian 100: 219
 1854-1856 French 100: 373
British 100: 382
Russian-Turkish Russian (Danube) 100: 208
1877-1878 Russian (Caucasian) 100: 643
Russian-Japanese Russian 100: 41
1904-1905 Japanese 100: 46
1st world war Germanic 100: 13
1914-1917 French 100: 28

A retrospective analysis of indicators of the integral significance of various

nosological forms recorded during the world wars indicates, in general, the leading
role in the pathology of military personnel of fecal-oral anthroponosis (typhoid
paratyphoid diseases, viral hepatitis, dysentery). They are followed by typhus and
relapsing fever, followed by zoonotic, mainly natural focal infections, closely
related to the climatic and geographical characteristics of the theater, and only then
- aerosol anthroponoses and other diseases. In certain periods of wars in some
armies, especially dangerous infections (cholera, smallpox, and to a lesser extent
plague), as well as influenza (the Spanish flu pandemic in World War I), parasitic
typhus during the civil war and the intervention in Russia, acquired great
importance. Malaria, some natural focal infections and parasitoses were also
spread. So, in 1943, on the Western Front, in the areas of operations of Soviet and
German troops in the belligerent armies, outbreaks of tularemia arose, and in
Belarus in 1944, against the background of an epidemic in German troops, typhus
was introduced into our units with the Soviet liberated from captivity. Prisoners of
war, suffered from "sypniak". World wars have always been accompanied by large
epidemics of diphtheria, meningitis, and even non-influenza acute respiratory
infections among the civilian population and military personnel, concentrating in the
rear areas during the mobilization of troops.

Statistical materials of the past decades do not give grounds to exclude other
possible episodes associated with epidemics of typhus, cholera, hemorrhagic
fevers, leptospirosis and other severe infections in the first years of the war among
the population, as well as in units of our army in 1941-1943. It should also be noted
the importance in wartime of anaerobic infections (tetanus, gas gangrene) and
septic complications of gunshot wounds. If already in World War II the problem of
tetanus almost ceased to be relevant due to the effectiveness of vaccination, then
other infections remain the "scourge" of surgical hospitals even now. The role of
staphylococcal and anaerobic complications has increased, which are especially
difficult to deal with in the field.

Epidemics have always accompanied local wars and major military conflicts,
not excluding those that were fought after World War II. In the course of their
conduct, sanitary losses usually exceeded combat losses, and the share of
irrecoverable non-combat losses was significant. The experience of anti-epidemic
support of the US troops in South Vietnam and the contingent of the USSR Armed
Forces in Afghanistan is especially demonstrative (Table 7.2).

Table 7.2.
The ratio of combat and non-combat sanitary losses of the
Armed Forces of the USSR and the Republic of Uzbekistan in
some wars, hostilities and military conflicts
Wars, fighting and military
conflicts Ratio
Combat Non-combat
combat and
sanitary sanitary
non-combat
losses, losses,
sanitary
% %
losses
Civil War (May 1918 7.6 87.5 1: 11.4
- October 1922)
The battle on the r. Khalkhin-Gol 60.7 8.7 6.8: 1
(June - September 1939)
 Soviet-Finnish war 50.5 20.4 2.4: 1
(November 1939 - March 1940)
The Great Patriotic War 46.3 23.6 1.9: 1
(June 1941 - May 1945 and 9
August - September 2, 1945)
Local war in 11.2 86.2 1: 7.8
Afghanistan (December 1979.
- February 1989)
Ossetian-Ingush conflict 62.2 37.8 1.6: 1
(October 1992 - December 1994
G.)
Armed conflict in 52.7 47.3 1.1: 1
Chechnya (December 1994 -
November 1996)

The structure of the infectious pathology of the American military very well
reflects its direct connection with the natural conditions of the region, as well as
with the morbidity of the population and personnel of the South Vietnamese troops.
Significant infections were various natural focal diseases (hemorrhagic fevers,
Japanese encephalitis, tsutsugamushi and other rickettsioses, including typhus, as
well as melioidosis, tularemia and other fevers, including of unknown etiology),
fecal-oral anthroponoses and dysentery (dysentery typhoid paratyphoid infections,
viral hepatitis, helminthiases, protozoses and even cholera). Up to 50% of the
personnel were ill with malaria alone. Skin infectious diseases and venereal diseases
were very common. In general, the non-combat losses of the US troops were 5
times higher than the combat losses (Table 7.3.).

Table 7.3.

Incidence rates per 1000 American military personnel in South Vietnam

and the United States for 1967 (Greenberg D.K., 1970)
Morbidity troops on US
Disease Troops in South Vietnam territory
 ARI, including influenza 33.3 124.6

Gastrointestinal diseases 48.4 14.9

Skin diseases 28.2 7,7

Fever of unknown origin 75.3 14.6

Malaria 30.6 3.8

During the action of the troops of the 40th Army (a limited contingent of the
USSR Armed Forces) in the conditions of Afghanistan, most of the class I
diseases were intestinal anthroponoses, and the most relevant were during the
entire period of hostilities (1980-1989) viral hepatitis and typhoid paratyphoid
infections, causing a high incidence ( they had at least 5-10% of the personnel
annually), most
labor losses, as well as hundreds of layoffs and dozens of deaths of military
personnel as a result of severe disease outcomes. Only then dysentery (primarily
amoebic) and other AEIs, malaria, fevers of unknown etiology, which probably
included various rickettsioses, spirochetoses, arbovirus infections, and others,
followed in importance. There were many severe mixed infections that were
consistently manifested in patients in accordance with the duration of the incubation
periods. Airborne infections were less significant against this aggravated
background, but measles, meningococcal and diphtheria infections were still
distinguished from them. Infectious skin pathology and head lice, which in the early
years affected quite a lot of military personnel, were also relevant(Table 7.4.).

Table 7.4.
 Structure of sanitary losses from infectious diseases 40th Army in
1980-1988 (Ogarkov P.I., 1996)

Years
Nosological
form
1980 1981 1982 1983 1984 1985 1986 1987 1988

sanitary
losses from 16912 27757 23421 32478 39253 40089 42077 34391 25244
infectious
diseases
(absolute
number)

acute viral 46.1 50.1 40.9 47.4 34.8 28.2 42.5 36 50.5
hepatitis

typhoid-paratyp
hoi 1.8 2,3 5.9 13.5 18.5 16.9 7.8 7.5 10.6
infections
shigellozy and
other oki 11.4 6.1 13.1 14.1 20.8 21.1 15.3 13.7 12.9

nedizenter. etiol
og
amebiasis - - - 0.1 1.3 3.1 6.5 10.2 6.1

flu and other

ari 30.6 30.2 29 18 14.3 16.2 14.5 14 10.9

angina 4.9 4.1 5.2 2.6 2.6 4 6.1 3.7 3.2

malaria 0.8 0.9 2.7 3.2 4.2 6.6 4.7 4.2 2.7
 other
infectious and 4.4 6.3 3.2 1.1 3.5 3.9 2.6 10.7 3.1
parasitic
diseases

share of
infectious 53.3 68.4 62.9 68.7 68 63 61.6 67.6 67.8
diseases in
the structure
general
incidence,%

According to official data, the share of infectious diseases in the 40,355 army
was more than 60% of the total number of sanitary losses and more than 70% of
the number of losses caused by patients. At the same time, in the structure of
infectious morbidity, up to 70% accounted for fecal-oral anthropnosis, among
which viral hepatitis dominated (more than 40%). About 7,800 people have been ill
with malaria alone. In 1985, an outbreak of cholera was even recorded, affecting
137 military personnel. A basically similar picture was observed during the
Arab-Israeli conflicts in the UN forces in the Middle East (Kluge, 1982), while
during the Falklands crisis one of the main problems for the medical service of the
conflicting parties was the prevention of airborne infections, including
meningococcal and diphtheria. In these situations (to a lesser extent in the latter
case), sanitary losses from infectious diseases still significantly exceeded losses
from weapons, there were also irrecoverable losses. This created a great deal of
stress in the activities of the medical service and ultimately led to huge economic
costs and moral damage. At the same time, the actions of US troops in Operation
Desert Storm and during the occupation of Iraq, as well as of NATO and UN
contingents in Yugoslavia, were not accompanied by a high incidence of illness, as
targeted and effective preventive measures were taken based on the experience
gained. First of all, this concerned the organization of water supply, food and
cleaning of the territory from sewage. There is no reason to believe that in the event
of a global world war, the structure and significance of the infectious morbidity of
the belligerents will be very different from the above. Of course, many of its
features will depend on the specific climatic and geographical conditions of the
theater of operations, as well as on the preventive activities of the medical service.
The epidemiological situation can change significantly only when the belligerents
use biological weapons. In this case, there will appear and, probably, will take a
leading place in the pathology of the personnel of the disease, the causative agents
of which are in the arsenal of potential opponents. Among them, there may be
causative agents of especially dangerous infections (smallpox, plague, hemorrhagic
fevers Lassa, Ebola, etc.), severe viral infections that are not contagious (yellow
fever, encephalon mellitus, hemorrhagic fevers), and anthrax, Q fever, tularemia,
brucellosis, etc. This will require priority anti-epidemic measures on the part of the
medical service, as well as close interaction with logistics services, the Ministry of
Health and the Ministry of Emergency Situations. Of course, in the current political
situation, the likelihood of such a global socio-ecological catastrophe is small.
Local conflicts, including those involving the use of sabotage elements of weapons
of mass destruction (WMD), are quite likely. Therefore, it is necessary to deeply
analyze the past experience and rationally use it to ensure the epidemiological
well-being of troops, and especially contingents performing combat and other tasks
in a difficult situation. In peacetime, as in wartime, there is always the likelihood of
certain emergencies that require extraordinary measures to eliminate their medical
and sanitary (including epidemiological) consequences. Therefore, within the
framework of military epidemiology, the main aspects of the epidemiology of
disasters are also studied, which do not include situations characteristic of military
contingents conducting conventional combat operations. Accidents, catastrophes
and natural disasters are often accompanied by one or another sanitary loss and
epidemiological consequences, including the occurrence of infectious diseases
among people in emergency situations. Epidemiological consequences of
accidents, natural disasters and catastrophes depend on the scale and nature of
destruction and their impact on people and life support facilities, the timeliness and
quality of rescue, recovery and preventive measures, as well as the influence of
associated harmful factors (radiation, hypothermia, etc.) In addition to those killed
as a result of natural or man-made disasters, there are always a significant number
of injured and sick people in emergency zones. Among the latter, significant
proportions, sometimes very large, are infectious patients. In the spread of
infectious diseases, an important role is played primarily by the water factor (OCI,
viral hepatitis A and E, typhus and paratyphoid fever, cholera, leptospirosis, etc.).
Under the action of other social and natural factors, outbreaks and even epidemics
of zoonotic and sapronous diseases (plague, tularemia, rabies, wound infections,
anthrax, etc.), as well as severe anthroponous infections (diphtheria, meningococcal
infection, pneumonia) may occur. There may be long-term consequences of
human infections (malaria, leishmaniasis). All of these consequences pose a threat
not only to the affected local population, but also to the contingents of rescuers,
the Ministry of Emergency Situations, the Ministry of Defense, the Ministry of
Health, veterinary and other services arriving in the disaster areas to eliminate their
consequences. The etiological structure of infectious morbidity in emergency zones
will significantly depend on the social and natural conditions of the territory,
contributing to the spread of infections typical for a given area and population, the
causative agents of which naturally circulate among people and animals. Thus,
knowledge of the main pathways for the introduction of infectious agents, the
conditions (factors) that contribute to the emergence and spread of infectious
diseases among the personnel of the troops and the population, the probable
structure and dynamics of the incidence of infections relevant to the theater of
operations (emergency zones) is necessary to predict the epidemiological situation,
justify and the choice of rational sanitary and anti-epidemic measures.

Control questions:
1. Give a definition of military epidemiology as a preventive discipline of military
medicine.

2. List the main directions of the modern system of anti-epidemic protection of

troops.

3. Name the main stages in the formation and development of military epidemiology
and indicate the contribution of domestic scientists to improving the system of
anti-epidemic protection of troops.

4. List the main ways of bringing infections into the troops in the theater of
operations with examples of the most relevant nosological forms in terms of the
damage caused.

5. How is the relative autonomy of the epidemic process in the troops manifested in
wartime conditions, what are its main reasons? 6. List the main conditions (factors)
of wartime, influencing the level, structure and dynamics of infectious diseases in
active forces.

7. What are the features of the structure of infectious morbidity of military

personnel when operating in different regions of the world (regions of Central
Europe, Southeast and Central Asia, North Africa)?

10. Sanitary and epidemiological institutions (subdivisions) of the

Ministry of Defense of the Republic of Uzbekistan in wartime. Organization of
their work in extreme conditions and in wartime

The anti-epidemic protection of troops, being a subsystem of the medical

support system, is designed to maintain sustainable sanitary and epidemiological
well-being in military formations by involving various medical and non-medical
forces and means in carrying out preventive and anti-epidemic measures. Forces
and means involved in carrying out measures for the anti-epidemic protection of
troops The basis of the anti-epidemic protection of the personnel of the Armed
Forces of the Republic of Uzbekistan is made up of sanitary and epidemiological
units and institutions. They are designed to carry out medical control and sanitary
and epidemiological surveillance in the troops, as well as to provide methodological
and practical assistance to the command and medical service of units and
formations in carrying out sanitary and anti-epidemic (preventive) measures. Forces
and means involved in the implementation of measures for anti-epidemic protection
of troops

Forces and means of the medical service

Forces and means of the non-medical service medical service of units

sanitary-epidemiological units, institutions and management bodies, medical
institutions command and party-political apparatus of the logistics service,
chemical, engineering and other service personnel. Sanitary and Epidemiological
Units of Formations The sanitary and epidemiological units carrying out medical
control and sanitary and anti-epidemic (preventive) measures in units and
subdivisions of formations, as well as organizational and methodological guidance
in planning and carrying out these measures, include the sanitary and
epidemiological platoon (SEV) of a separate the medical company of the brigade
and the sanitary-epidemiological laboratory (SEL) of the division.

They are entrusted with the following tasks:

- continuous study of the sanitary and epidemiological situation by conducting

sanitary and epidemiological reconnaissance and observation in the areas of
deployment (combat operations) of the unit;

- implementation of medical control over the fulfillment of sanitary

requirements for accommodation, food, water supply, bath and laundry services,
as well as the conditions of military labor of the unit's personnel;

- participation in biological prospecting;

- conducting an epidemiological survey of epidemic foci, providing

methodological and practical assistance, as well as monitoring the organization and
implementation of sanitary and anti-epidemic (preventive) measures carried out by
the forces and means of the medical service of units and other services;

-conducting microbiological, hygienic, toxicological and radiometric studies in

the prescribed volume;

- organization and conduct of hygienic training and education of the personnel

of the unit.

The sanitary and epidemiological platoon of a separate medical company of

the brigade is a functional unit designed to carry out medical control and
anti-epidemic measures in the brigade's units. The head of the
sanitary-epidemiological platoon is a doctor-epidemiologist. In addition to him, the
SEV staff includes a laboratory assistant, a sanitary
instructor-disinfector-dosimeters and a driver. The sanitary-epidemiological platoon
is equipped with a military field medical laboratory (LMP-V) and a disinfection and
shower unit on a trailer (DDP-2). Field medical laboratory LMP-V The sanitary
and epidemiological platoon performs the tasks assigned to it at the point of
permanent deployment, and in wartime - in the areas of deployment (actions) of
brigade units and on traffic routes, located, as a rule, at the rear control point
(TPU) or not far from a deployed separate medical company. The sanitary and
epidemiological laboratory is a specialized subdivision of the medical service of the
division and is designed to carry out medical control and conduct sanitary and
anti-epidemic (preventive) measures. The head of the SEL is a
doctor-epidemiologist, at the same time he is the deputy head of the division's
medical service. The division's epidemiologist conducts an epidemiological analysis
of the morbidity in the division's units and, based on its results, assists the unit
doctors in organizing and carrying out measures for the prevention and control of
infectious diseases. The SEL staff also includes: 3 senior medical specialists
(bacteriologist, hygienist, toxicologist-radiologist), a laboratory assistant, 2 sanitary
instructors (disinfector, dosimetrist) and 2 drivers. The SEL is equipped with an
UAZ-452A, LMP-V and DDP-2 ambulance. The procedure for the use of sanitary
and epidemiological units is determined by the medical support plan, the nature of
the activities of the units (formation) and the specifics of the emerging operational,
rear, medical and sanitary and epidemiological situation. The transfer of the SEL to
a new location is carried out, as a rule, together with a separate medical battalion of
the division (medb) or TPU unit. In peacetime, stationary premises are usually used
to carry out the list of mandatory microbiological, sanitary-hygienic and other
types of research defined by the directive. Depending on the specifics of the
location and use of the division in an emergency situation, the presence of other
sanitary and epidemiological institutions on this territory, by order of the higher
head of the medical service, individual SEL specialists may be temporarily sent
(especially for laboratory research) to these institutions. A military field medical
laboratory (LMP-V) should always be in constant readiness to travel to supervised
objects and conduct laboratory research directly in the LMP-V body, in a tent, or
in another adapted room. In wartime, when establishing the fact of the use of BW
by the enemy, as well as in emergency situations when patients or those suspicious
of dangerous infectious diseases appear, microbiological studies are carried out on
the basis of LMP-V. SEL specialists mainly carry out sanitary and epidemiological
reconnaissance and sampling of the external environment with their subsequent
delivery to the army sanitary and epidemiological institution. Sampling is carried out
using a microbiological sampling kit (KOPM-2). Sampling is carried out by
personnel with at least secondary medical education. At the same time, the
bacteriologist or laboratory assistant takes samples only in official anti-plague
clothing (PChO set), which is worn and removed outside the laboratory.
Disinfection measures are carried out using sets B-5 ("Disinfection") and CO
("Special treatment"). Hygienic, radiometric, toxicological studies should be carried
out in a tent deployed next to the car or in another adapted room, using their
service equipment (MPHL, DP5, and LG-1). The divisional epidemiologist, as the
deputy chief of the unit's medical service, works part of the time together with his
chief (especially during the planning period). In addition, the epidemiologist can be
involved in the group at the reserve command post. But most of the time the
epidemiologist should devote to conducting sanitary and epidemiological
reconnaissance, using for this a standard vehicle UAZ-452A, KOPM-2, involving a
doctor in this work. Microbiological sampling kit KOPM-2, assembled.
Microbiological sampling kits KOPM-2 in open packaging for hygienist, sanitary
instructor and laboratory assistant have been there. The location of the LMP-V
deployment is determined by the head of the medical service. One of the options
could be the deployment of an SEL in the area where a separate medical battalion
or TPU division is based.

Disinfection and shower unit (DDP-2) on a trailer is used to solve various

tasks:

- carrying out a complete sanitization of a small number of personnel for

epidemic indications, including head lice; - as a reinforcement of the division's
medical department when transferring it to a strict anti-epidemic mode of operation;

- for sanitizing personnel of the SEL itself

- chamber treatment of anti-plague clothing sets and hygienic washing of

personnel.

Doctor-toxicologist-radiologist, in addition to carrying out toxicological and

radiometric studies in case of admission of the wounded and sick from the centers
of chemical contamination and from the centers of the use of nuclear weapons,
provides advice in organizing the reception of those affected by poisonous or
radioactive substances, in carrying out special and sanitary treatment at the special
treatment site division meds. During 10-12 hours of daylight time, SEL specialists
can conduct sanitary and epidemiological reconnaissance of one or two objects
(for example, settlements with a population of 10-12 thousand people) or 2-3
districts of deployment of a command post, TPU, logistics battalion. The survey of
the proposed deployment area of ​the water supply point on the basis of an open
water source takes 2-3 hours. For a full-fledged epidemiological examination of an
outbreak of acute intestinal infections, food poisoning with the necessary laboratory
tests, at least 2-3 days are required with the participation of all SEL specialists.
With other infectious diseases, the time for conducting an epidemiological
examination of a focus with multiple diseases can increase to 4-5 days or more. For
a working day of 10-12 hours, a toxicologist-radiologist with a laboratory assistant
and a hygienist with a sanitary instructor can conduct an examination of 10-12
samples for contamination with toxic substances, including 3-4 studies with an
unknown agent, and the rest - with targeted analysis, or up to 120 samples for
contamination with radioactive substances, subject to their delivery to the
laboratory, and up to 30 samples, if they are taken on their own on site.

Pic. 8.1. Medical field military laboratory LMP-V

Picture 8.2. Disinfection and shower unit DDP-2
 Pic. 8.3. Microbiological sampling kit KOPM-2 , assembled

Pic. 8.4. Microbiological sampling kit KOPM-2 in an open package

10.2. Sanitary and epidemiological institutions of operational
associations.

A separate sanitary and epidemiological detachment of the army medical

brigade (OSEO AMEDBR) is designed to organize and conduct sanitary and
epidemiological surveillance and sanitary anti-epidemic (preventive) measures in the
troops and the army's zone of action. The detachment has the following main tasks:

- Conducting sanitary and epidemiological reconnaissance and surveillance in

the troops and areas of their location (actions);

- sanitary and epidemiological supervision over accommodation conditions,

catering, water supply and bath and laundry services for troop personnel;

- epidemiological examination of foci of infectious diseases in the troops with

the organization of measures for their localization;

- participation in the organization and conduct of biological prospecting with

a specific indication of biological agents;

-conducting an examination of water and food for contamination with

radioactive, poisonous and potent toxic substances (SDYAV);

- participation in the organization of observational and isolation-quarantine

measures in the centers of especially dangerous infections;

- establishing the presence and activity of natural foci of infections with the
development of measures for their prevention in the troops;

- carrying out microbiological, sanitary and hygienic, toxicological and

radiometric studies;

- carrying out disinfection, disinsection, deratization at facilities, as well as

sanitizing personnel for epidemic indications. In addition, the specialists of the
OSEO Amedbr can be involved in carrying out preventive vaccinations for military
personnel, organizing emergency prevention; in addition, standard equipment can
be used to strengthen the medical service of the compounds with washing and
disinfection equipment and other forces and means. The structure of the OSEO
AMEDBR includes: management, main divisions (sanitary and epidemiological
department with laboratories, two mobile laboratories, isolation and quarantine
department, sanitary treatment platoon, medium cooking department) and support
units (liaison office, power plant, vivarium). The head of the
sanitary-epidemiological detachment is subordinate to the commander of the army
(corps) medical brigade, and on special issues he is guided by the instructions of
the leading epidemiologist of the army (corps). He is responsible for the constant
readiness of the detachment to fulfill the assigned tasks, the organization and
implementation of anti-epidemic protection measures in the troops and the zone of
operations of the army (corps). The most important objects under the close
supervision of the OSEO AMEDBR specialists are the areas where the army
command posts and supply bases are located, military highways, field bakeries,
stages of medical evacuation, and an army reception center for prisoners of war. In
the period of preparation for the conduct of hostilities, the main attention is paid to
planning anti-epidemic measures carried out by various links of the medical service,
conducting anti-epidemic measures among the arriving reinforcements, sanitary and
epidemiological reconnaissance on the main routes for the supply of materiel and
the evacuation of the wounded and sick, assistance in sanitizing personal the
composition of the troops, control of the anti-epidemic regime at the stages of
medical evacuation, as well as other sections of work determined by the specific
situation. Medical field laboratories (LMP), disinfection vehicles (DA, mobile
disinfection and shower complexes (DDC-01)) are equipped with the OSEO
amedbr.

Medical field laboratory LMP . Disinfection vehicle YES Disinfection and

shower complex mobile DDK-01 The base laboratory of the OSEO is usually
located in the area of ​T PU deployment, and mobile laboratories move forward to
the main evacuation directions, or act in the interests of army (corps) formations
operating in certain directions. In the course of an offensive, the main function of
the AEDBR OSEO is to conduct sanitary and epidemiological reconnaissance in
the zone of advance of troops and localize the identified epidemic foci, as well as
control anti-epidemic barriers (stages of medical evacuation, a prisoner of war
reception center, etc.). In the transition to defense, the efforts of the SEO
specialists switch to the organization and direct implementation of measures to
eliminate foci of infectious diseases in the troops, as well as among the civilian
population, to conduct sanitary and epidemiological reconnaissance and
surveillance in the area of ​deployment of units and formations. The front has a
sanitary and epidemiological detachment of the front, which is a specialized medical
institution (unit), designed to organize and conduct sanitary and epidemiological
surveillance and sanitary and anti-epidemic (preventive) measures in the troops
(forces) and areas of their location, and the implementation of medical protection
against weapons mass destruction of troops in the zone (area) of the front, as well
as control over the activities of the military medical service and sanitary and
epidemiological institutions and to provide them with practical assistance in
maintaining sanitary and epidemiological well-being. Thus, the sanitary and
epidemiological units and institutions available in the Armed Forces make it
possible to effectively organize and carry out medical control and sanitary and
epidemiological supervision over all aspects of the activities of troops (naval
forces) in various conditions of their daily and combat activities. It should be
remembered that anti-epidemic protection of active forces in extreme conditions
and in wartime is the responsibility of the entire medical service and is impossible
without close interaction with the command, with the direct participation of the rear
services, engineering service and all personnel.

Control questions:

1. What forces and means of anti-epidemic protection of troops exist in the

Armed Forces of the RUZ.

2. What are the basic principles of anti-epidemic protection of troops.

3. Name the main tasks of the sanitary and epidemiological units of the Armed
Forces of the RUZ.

4. Sanitary and epidemiological platoon of a separate medical company.

Purpose. Organizational and staff structure.

5. Sanitary and epidemiological laboratory of the division. Purpose.

Organizational and staff structure.

6. Name the capabilities of the division's sanitary and epidemiological

laboratory to conduct sanitary and epidemiological reconnaissance, laboratory
research.

7. A separate sanitary and epidemiological detachment of the army medical

brigade. Purpose. Tasks. Organizational and staff structure.

11. Organization of sanitary and epidemiological reconnaissance in the

troops. Criteria for assessing the sanitary and epidemic state of troops and
their area of ​operations

11.1. Sanitary and Epidemiological Intelligence

Sanitary and epidemiological reconnaissance is an event of the medical

service aimed at the advance study of the sanitary and epidemiological situation in
the area of ​operations (location) of troops, along the routes of movement, as well
as clarifying this situation from neighbors and enemy troops. It is an integral part of
medical intelligence. Sanitary and epidemiological reconnaissance is carried out in
order to identify conditions affecting the sanitary and epidemiological state of the
troops, and to establish ways of the possible introduction of infectious diseases
into the served contingents. Its tasks include:

- identification of the presence, nature and spread of infectious diseases

among various contingents in the areas of deployment of troops and the local
population;

- detection of epizootics among wild and domestic animals, as well as the

presence and activity of natural foci of infections in these areas;

- determination of the sanitary and epidemic state of the territory, settlements

and water sources;

- assessment of the forces and means of local health authorities in the interests
of carrying out sanitary and anti-epidemic measures;

- study of data from headquarters (intelligence agencies) on infectious diseases

in enemy troops and the sanitary and hygienic state of the territory they occupy.
 The following basic requirements are imposed on sanitary and
epidemiological intelligence: continuity (constant awareness in a changing
environment), reliability (information coming from various sources is compared),
timeliness (the necessary measures must be taken on time), continuity (higher levels
of the medical service use the information obtained lower echelons),
purposefulness (obtaining, expanding and deepening information in accordance
with the results of the analysis of the sanitary-epidemic situation and with the
peculiarities of the operational-tactical situation, primarily of the main groupings of
troops), echelon (should organizationally consist of military, army and frontline).

Table 9.1.

Types of sanitary and epidemiological reconnaissance

Types of
ERM Troop I Army II Frontline III
echelon echelon echelon
The main Revealing Identification of foci Identification of foci
tasks foci infectious infectious
infectious diseases, their diseases,
diseases, localization, localization and
their designation, Information about eliminating them
Information about the results of the
the results of the
The most important The most important
The main Areas objects objects
objects placement and for troops in the strip for troops in the strip
action parts army action army actions and
and connections back lane
front
Who Bosses Bosses Bosses
organizes medical medical medical
service parts and army services front services
 connections
Who conducts Doctors, Sanitary Sanitary
paramedic, epidemiological epidemiological
sanitary instructors army institutions front institutions
medical
service parts and
connections
In the implementation of sanitary and epidemiological reconnaissance, the
medical staff takes part in all levels of the medical service(Table 9.1).

Military sanitary and epidemiological reconnaissance is organized by the chiefs

of the medical service of units (ships) and formations and is carried out by forces
subordinate to them (from a company sanitary instructor to specialists) and means
in the zone (in the sector) of operations of troops (fleet).

Army sanitary and epidemiological reconnaissance is carried out by the forces

and means of army sanitary and epidemiological institutions with the main task of
identifying foci of infectious diseases and taking measures to localize them. From
the composition of these institutions, medical workers or groups of specialists are
allocated for targeted sanitary and epidemiological reconnaissance.They are
supplied with transport and equipment necessary for certain laboratory tests and
some anti-epidemic measures.

The main task of the front-line sanitary and epidemiological reconnaissance,

which is carried out by the forces of front-line sanitary and epidemiological
institutions, is not only the identification and localization of epidemic foci, but also
their elimination.

The main method of work of medical workers is interviewing and visual

examination, supplemented by the collection of individual samples for their transfer
to the laboratory. Specialists of sanitary and epidemiological units, performing the
most important tasks, are supplied with specially designed mobile installations (auto
laboratories) and equipment (disinfection and shower installations, etc.) necessary
for conducting certain laboratory studies during sanitary and epidemiological
reconnaissance, and in some cases, some sanitary anti-epidemic (preventive)
measures in the identified epidemic (epizootic) foci.

The preparatory period for sanitary and epidemiological reconnaissance,

when receiving information from the command about upcoming changes in the
conditions of combat activity of troops, the sanitary and epidemiological situation
is studied according to the data of medical and geographical descriptions, sanitary
and epidemic reports, reviews and other materials. This information is
supplemented by information received from the senior medical director, civil health
authorities. At the headquarters, the necessary operational and tactical situation is
being clarified (clarification of routes for the advancement of troops, the places of
proposed stops and parking, areas of the upcoming deployment combat
operations). It turns out what additional information is needed to organize
anti-epidemic protection of troops. If the need arises, a decision is made on a direct
survey of individual areas and objects.
When planning the main measures to ensure sanitary epidemiological
reconnaissance determines its specific tasks, areas and objects, the composition
and equipment of reconnaissance groups, their routes, the timing of
reconnaissance, the type of communication, the procedure and form of reporting
the results.
Carrying out sanitary and epidemiological intelligence provides for:
the study of medical and geographical descriptions of the areas of upcoming
military operations;
obtaining and using information from headquarters, intelligence agencies;
study of documents seized from the enemy, and information, received from
prisoners of war;
direct examination of areas, settlements and individual objects, assessment of
their sanitary and hygienic state and possible impact on the health of personnel and
the epidemiological situation in the troops (naval forces);
collection and refinement of data held by local health authorities, institutions of
sanitary-epidemiological, veterinary and other services, authorities;
selection for laboratory research of materials from people, animals objects of
the external environment;
detailed study of the identified epidemic (epizootic) centers, the organization
of primary activities in them;
determination of indications for the conditions of the deployment
of troops, command, rear and other command posts and medical institutions.
At the final stage , material is prepared on the results of sanitary and
epidemiological reconnaissance with conclusions and proposals.
Presented to the chief who organized intelligence in the form of an oral report,
a written report, a report card or an epidemiological map (topographic map with a
marked epidemiological situation).
Sanitary and epidemiological reconnaissance provides for its maximum
coverage of the territory and settlements in the zone of operation of the troops
(table
9.1). The medical service of units and formations conducts sanitary and
epidemiological reconnaissance within the boundaries of the demarcation lines, the
medical service of the rear units and subunits - in the deployment area. For
treatment-and-prophylactic institutions, a radius is determined within 3-5
km. Sanitary-epidemiological units receive objects or routes of reconnaissance.
Military sanitary and epidemiological reconnaissance is carried out throughout
the entire territory from the front edge to the rear of formations by all medical
personnel of subunits, units and formations. Sanitary and epidemiological units
carry out reconnaissance of rear services and the most important objects in the
epidemiological and operational-tactical terms (in the direction of the main attack,
routes for the supply and evacuation of the wounded, command posts), re-examine
the foci identified by the medical service parts. Anti-epidemic measures are often
limited to the designation of identified foci in the course of sanitary-epidemiological
reconnaissance and the orientation of troops to limit contact with them. At the
capabilities of the sanitary and epidemiological units can carry out primary
measures to localize the focus.
The volume and tasks of each type of sanitary and epidemiological
reconnaissance can change dramatically under the influence of the nature of the
combat activities of the troops. During the preparatory period of sanitary and
epidemiological reconnaissance, upon receipt of information from the command
about the upcoming changes in the conditions of combat activity of troops, the
sanitary and epidemiological situation is studied according to the data of medical
and geographical descriptions, sanitary and epidemiological reports, reviews and
other materials. This information is complemented by information received from the
senior medical officer, civil health authorities. At the headquarters, the necessary
operational and tactical situation is being clarified (clarification of routes for the
advancement of troops, places of supposed stops and parking, areas of upcoming
deployment and hostilities). It turns out what additional information is needed to
organize anti-epidemic protection of troops. If the need arises, a decision is made
on a direct survey of individual areas and objects. When planning the main
measures to ensure sanitary and epidemiological reconnaissance, its specific tasks,
areas and objects, the composition and equipment of reconnaissance groups,
routes of their movement, the timing of reconnaissance, the type of communication,
the procedure and form of reporting the results are determined.

Conducting sanitary and epidemiological reconnaissance involves: - studying

the medical and geographical descriptions of the areas of upcoming hostilities;

- obtaining and using information from headquarters, intelligence agencies; -

study of documents seized from the enemy, and information received from
prisoners of war;

- direct examination of areas, settlements and individual objects, assessment

of their sanitary and hygienic condition and possible impact on the health of
personnel and the epidemiological situation in the troops (naval forces);
- collection and refinement of data held by local health authorities, institutions of
sanitary-epidemiological, veterinary and other services, authorities;

- selection for laboratory research of materials from people, animals and

objects of the external environment;

- a detailed study of the identified epidemic (epizootic) foci, the organization

of primary measures in them; - determination of indications for the conditions of
the deployment of troops, command, rear and other command posts and medical
institutions. At the final stage, material is prepared on the results of sanitary and
epidemiological reconnaissance with conclusions and proposals and is presented to
the chief who organized the reconnaissance in the form of an oral report, a written
report, a report card or an epidemiological map (topographic map with a marked
epidemiological situation). Sanitary and epidemiological reconnaissance provides
for the maximum coverage of the territory and settlements in the zone of operation
of the troops. The medical service of units and formations conducts sanitary and
epidemiological reconnaissance within the boundary lines, the medical service of
rear units and subunits - in the deployment area. For treatment-and-prophylactic
institutions, a radius is determined within 3-5 km. Sanitary-epidemiological units
receive objects or routes for reconnaissance. Military sanitary and epidemiological
reconnaissance is carried out throughout the entire territory from the front edge to
the rear of formations by all medical personnel of subunits, units and formations.
The sanitary and epidemiological divisions carry out reconnaissance of the rear and
the most important objects in the epidemiological and operational-tactical terms (in
the direction of the main attack, the ways of transporting and evacuating the
wounded, command posts), re-examine the foci identified by the medical service of
the units. Anti-epidemic measures are often limited to the designation of identified
foci in the course of sanitary-epidemiological reconnaissance and the orientation of
troops to limit contact with them. If possible, sanitary and epidemiological units can
carry out primary measures to localize the outbreak. The volume and tasks of each
type of sanitary and epidemiological reconnaissance can change dramatically under
the influence of the nature of the combat activities of the troops. During the
preparatory period and in the process of regrouping the troops, the main attention
is paid to the routes of the troops and the areas of their deployment, the highways
at the points of supply and evacuation. In an offensive, it is carried out only along
the lines and main directions of the advance of troops, at points of new
deployments of rear and medical units and command posts. Under defensive
conditions, the reconnaissance area expands significantly, encompassing, in
addition to roads and points of new deployment of troops, also the surrounding
settlements within a radius of 5 to 10 km. In defense, sanitary and epidemiological
reconnaissance very often develops into sanitary and epidemiological surveillance,
i.e. repeated exploration in a previously surveyed area.

11.2. Assessment of the sanitary-epidemic state of the unit (area of ​i ts​

operation)

Assessment of the sanitary and epidemic state is a briefly formulated

quantitative and qualitative characteristic of the epidemic process both among the
personnel of the troops and among the population or personnel of other units
(formations) located in the area of ​their operations (location), as well as the intensity
of the epizootic process, taking into account conditions for the introduction and
spread of infectious diseases among the troops. The sanitary-epidemic state is
assessed regularly - daily, periodically - when planning activities for a certain
calendar period or at certain stages of combat activity, as well as immediately -
when the epidemic situation changes both in the troops and in the area of ​their​
operations (location).

According to the totality of signs identified in the process of epidemiological

diagnostics, the sanitary-epidemic state of the troops and the area of ​their​
operations (location) can be favorable, unstable, unfavorable and emergency.

The assessment of the sanitary-epidemic state is given separately for the

troops and the area of ​their operations (location) and is specified in relation to
individual infectious diseases.

The sanitary-epidemic state of the troops is assessed taking into

account: the presence, level, structure and dynamics of infectious diseases among
personnel; the likelihood of the introduction of infection (determined by the sanitary
and epidemic state of the area of ​military operations (deployment) of troops; the
presence or absence of conditions for the spread of infectious diseases; the fact of
the use of biological weapons by the enemy.

- infectious diseases do not occur among the personnel, with the exception of
sporadic morbidity characteristic of certain infectious forms;

- the sanitary-epidemic condition of the area of ​operations (disposition) of

troops is safe;

- satisfactory sanitary and hygienic condition of the unit (connection);

- there is no data on the use of BO by the enemy.

The sanitary-epidemic state of the troops is considered unstable under any of

the following options:

- there are isolated, not previously observed infectious diseases;

- with a slight increase in the sporadic level of infectious diseases or the

occurrence of individual group diseases without a tendency to further spread;

- the sanitary-epidemic state of the area of ​operations (location) of troops is

unstable or unfavorable;

- the sanitary and hygienic condition of the part (connection) is unsatisfactory.

The sanitary-epidemic state of the troops is considered unfavorable if:

- group infectious diseases have appeared among the personnel and there are
conditions for their further spread (unsatisfactory sanitary and hygienic condition of
the area);

- there are isolated cases of diseases among the personnel of especially

dangerous infections (smallpox, plague, cholera);

- during the conduct of combat operations (deployment) of troops in an area

of ​extreme sanitary and epidemiological significance;

- the enemy used BO (before establishing the type of biological agent or using
pathogens of non-contagious infections).

The sanitary-epidemic condition of troops is considered to be extraordinary if:

- the number of infectious patients among the personnel is growing in a short

time, which leads to the loss of the combat capability of the troops;

- repeated cases of diseases with especially dangerous infections are

registered;

- the fact of the use by the enemy of the BO troops in the form of
formulations of pathogens of especially dangerous infections was established.
Simultaneously with the assessment of the sanitary and epidemic state of the
troops, the sanitary and epidemic state of the area of ​military operations
(deployment) of troops is assessed, since the assessment of the sanitary and
epidemic condition of troops largely depends on the assessment of the sanitary and
epidemic condition of the area of ​combat operations (deployment) of troops. In a
number of cases (during the redeployment of troops), the sequence of assessment
may be different, and the sanitary-epidemic state of the area is first assessed, and
then of the troops.

The sanitary-epidemic condition of the district is assessed taking into

account:

-level, structure and dynamics of infectious morbidity of the population, as

well as other troops located in the area;

- data characterizing the intensity of the epizootic process;

- the presence (absence) of conditions for the spread of infectious diseases (the
sanitary condition of the territory, water supply facilities, the degree of communal
improvement, etc.).

The results of sanitary-epidemiological and biological reconnaissance are used

as the initial data for assessing the sanitary-epidemiological state of the territory.
The sanitary-epidemic condition of the area is considered safe if at the same time:

- there are no infectious diseases among the population or personnel of

neighboring troops, with the exception of sporadic ones characteristic of certain
infectious forms;

- the epizootic situation does not pose an immediate danger to the troops;

- there are no conditions for the wide spread of infectious diseases

(satisfactory sanitary and hygienic condition of the territory, water supply facilities,
communal amenities);

- the enemy did not use BO troops in the area of ​operation (location). The
sanitary-epidemic state of the area is considered unstable if:

- among the population or personnel of neighboring troops, there are separate

infectious diseases that were not previously registered; there is a slight increase in
the sporadic level of infectious diseases or there are separate group diseases
without a tendency to further spread with a satisfactory sanitary and hygienic
condition of the area;

- there is no infectious morbidity, with the exception of sporadic ones, but the
region has conditions for the spread of infectious diseases (unsatisfactory sanitary
and hygienic condition of the region);

- there are epizootic (enzootic) foci of zoonotic infections that pose a threat to
the troops; troops are stationed near large epidemic foci or a foci of bacterial
infection.

The sanitary-epidemic state of the district is considered unfavorable if:

- number of infectious diseases (epidemic outbreak) among the local population is
growing and there are conditions for their further spread (unsatisfactory sanitary
and hygienic condition of the district);

- found isolated diseases with especially dangerous infections;

- enemy used a BO that did not include OOI pathogens. The

sanitary-epidemic condition of the area is considered to be extraordinary if one of
the following conditions is met:

- among the local population there are repeated or group diseases of especially
dangerous infections or other infectious diseases dangerous for the troops are
widespread (epidemic);

- the natural foci of plague became more active and diseases of this infection
appeared among the population;

- pathogens of especially dangerous infections were used as BW in the area of

​​​operations (location) of troops.

In accordance with the principles outlined above, the Department of General

and Military Epidemiology of the Military Medical Academy has developed the first
stage of an automated system for epidemiological surveillance of infectious
diseases, which implements algorithms for operational 382 epidemiological
diagnostics and assessment of the sanitary and epidemiological state of military
formations in wartime. Taking into account the results of the assessment of the
sanitary-epidemic state, sanitary-anti-epidemic (preventive) measures are organized
and carried out in the troops (unit, formation). With a safe sanitary and epidemic
condition of troops (units, formations) and the area of ​their operation
(deployment), planned sanitary and anti-epidemic (preventive) measures are taken
by the forces of the medical service (unit, formations). The head of the medical
service (unit, formation) reports to the commander, the superior head of the
medical service on the unstable sanitary-epidemic state of troops (unit, formation)
and the area of ​their operation (deployment), and at the same time submits
proposals on the necessary additional measures, organizes and participates in their
implementation and exercises control. In case of an unfavorable sanitary and
epidemic condition of troops (unit, formation) or region, sanitary and anti-epidemic
(preventive) measures are organized by the head of the medical service of the
operational association with the involvement of sanitary and epidemiological
institutions (subdivisions). According to the report of the head of the medical
service, observation is introduced in these units by the order of the commander of
the operational formation (the commander of the formation). The emergency
sanitary and epidemic condition of troops (units, formations) is declared by order
of the commander of the operational formation (the commander of the formation).
The troops are being quarantined. The conduct of sanitary and anti-epidemic
(preventive) measures is organized by the head of the medical service of the
operational association with the involvement of sanitary and epidemiological
institutions. Areas with an emergency sanitary and epidemic state for the
deployment of troops, as a rule, are not used. In the event of the forced use of
such areas by troops under the conditions of a combat situation, personnel are
stationed outside the settlements. Sanitary and anti-epidemic (preventive) measures
in the area of ​the deployment of troops are carried out by the
sanitary-epidemiological institutions of the associations in cooperation with the
local authorities of the sanitary-epidemiological service and health care. Thus,
sanitary and epidemiological reconnaissance is one of the important epidemiological
and diagnostic methods that allow the military medical service to receive
information in advance about possible sources of infection in the troops from the
civilian population and other non-military contingents, from natural foci or enemy
troops, as well as advance elucidation of the conditions for the possible spread of
infectious diseases among the personnel of the troops at the expense of not only
the external, but also their own reservoir of infection. The information obtained in
the course of its implementation makes it possible to concretize the assessment of
the sanitary and epidemic state of the troops and the areas of their deployment, as
well as the list of necessary sanitary and anti-epidemic measures.
Control questions:

1. Outline the main tasks of sanitary and epidemiological intelligence.

2. List the requirements for sanitary and epidemiological reconnaissance.

3. Name the main objects of the military and army level, in respect of which
sanitary and epidemiological reconnaissance should be carried out

4. In what form are the results of sanitary and epidemiological reconnaissance

formalized? 5. List the possible assessments of the sanitary-epidemic state of the
troops and their criteria.

6. List the possible assessments of the sanitary-epidemic state of the troop

deployment areas and their criteria.

12. The content and organization of sanitary anti-epidemic (preventive)

measures in the troops in wartime and in emergency situations

The purpose of the anti-epidemic protection of troops is to create and

maintain (preserve) the epidemic well-being of the troops. In general, the
achievement of this goal is solved by solving three problems:

-prevention of the introduction of infection into military collectives (with

replenishment, from neighboring units, from the local population, from livestock
farms and natural foci, as well as from enemy troops);

-Prevention of the emergence and spread of infectious diseases in military

collectives due to the internal reservoir of infection;

- localization and elimination of foci of infectious diseases in military

collectives in cases of their occurrence and prevention of uncontrolled transfer of
infection outside the focus.

In the specific conditions of troop activities, the tasks of the medical service
for the anti-epidemic protection of troops are clarified on the basis of a study and a
thorough assessment of the sanitary-epidemic, epizootological,
operational-logistical and environmental situation, due to the nature and scale of
anthropogenic or natural disasters. To solve each individual problem, the medical
service determines targeted sanitary and anti-epidemic (preventive) measures, the
implementation of which, together with the command, rear services and other
performers, makes it possible to achieve the formulated goal of anti-epidemic
protection of troops. According to the doctrine of the epidemic process, sanitary
and anti-epidemic (preventive) measures are aimed at neutralizing sources of
infection, breaking (weakening) the transmission mechanism of pathogens of
infectious diseases and increasing the immunity of the human body to infectious
diseases.

Measures aimed at neutralizing sources of infection include:

- identification, isolation, hospitalization and treatment of infectious patients;

- carrying out in military collectives (institutions) enhanced medical

supervision, observational, and in emergency conditions - and quarantine measures;

- sanitary, veterinary and deratization measures. Measures aimed at breaking

(weakening) the transmission mechanism of pathogens of infectious diseases
include:

- anti-epidemic sanitary and hygienic measures;

- disinfection and disinsection measures, including sanitization of military

personnel for epidemic indications.

Measures to reduce the susceptibility of the organism of troops to

infectious diseases include : - immunization; - emergency prevention; -
immunocorrection. Improving the quality of the above measures is achieved by
using laboratory research methods and conducting hygienic education and training
of personnel.

12.1. Measures to neutralize sources of infection.

 Detection, isolation, provision of medical care and evacuation of infectious
patients (suspected of infectious diseases) in military units (on ships) and medical
centers, including among the wounded and sick, are organized by the chiefs of the
medical service of units (ships, institutions), and in the medb - Commander of a
separate medical battalion. Infectious patients (and those suspected of having a
disease) are identified through medical supervision, interviews, medical
examinations and thermometry, especially among those at risk of infection. In the
presence of conditions in the identified patients, material is selected for laboratory
research. At the stages of medical evacuation of units and formations during triage,
suspicious for infectious diseases are differentiated into groups: - with
predominantly general toxic symptoms; - with predominantly signs of damage to
the respiratory system; - with predominantly signs of damage to the digestive
system; - with predominantly signs of damage to the central nervous system. The
most dangerous for others are infectious patients with signs of damage to the
respiratory organs and mucous membranes of the oropharynx, as well as patients
with diarrhea and vomiting. The identified patients are immediately isolated in
isolation wards of medical centers and medical departments (pending permission to
evacuate them) to provide medical care and establish a diagnosis. Isolators of the
stages of medical evacuation are deployed, as a rule, for the temporary
accommodation of patients with two groups of infections and are equipped with
bedding vessels, urinals, heating pads, drinking cups, disinfectants, containers for
disinfecting the secretions of patients and other patient care items, as well as for
wet disinfection in the room insulators.

The evacuation of infectious patients is carried out in the accompaniment

of medical workers by ambulance transport of infectious hospitals, as well as a
specially designated road or other transport separately from other wounded and
sick. Patients with homogeneous infectious diseases can be transported in one
ambulance.

The sanitary transport, intended for the evacuation of infectious patients, is

equipped with bed vessels, urinals, disinfectants and medicines to provide
assistance to the transported patients.

If a patient (patients) with especially dangerous infections is identified in a

medical station of a regiment (ship), the corresponding stage of medical evacuation
is transferred to work in a strict anti-epidemic mode. Evacuation of identified
patients and other anti-epidemic measures are carried out in agreement with the
higher head of the medical service. In the medical documents of the evacuees,
notes are made about the medical and preventive and sanitary and anti-epidemic
measures taken. Sick and wounded who died at this stage of medical evacuation are
buried in compliance with special rules.

The prevention of the introduction of infection with replenishment is

achieved by carrying out sanitary and anti-epidemic (preventive) measures at
assembly points, a reception point for personnel of units, formations and in spare
parts (naval crews).

At assembly points by the forces and means of military commissariats and

health authorities, and at points of reception of personnel in units and formations -
by the forces of the medical service:

- early and active detection of infectious patients (suspicious), their isolation

and hospitalization;

- medical control over the accommodation, food, water supply of arriving

contingents and the sanitary condition of the territory of assembly points and
military units;

- identification and registration of persons with chronic forms of infectious

diseases (bacteria carriers) and their reorganization;

- identification of persons at risk of infection, organization of medical

supervision over them;

- sanitization (including for epidemic indications);

- disinfection, disinsection and deratization (according to epidemic indications);

- preventive vaccinations, emergency prevention (according to epidemic

indications);

- Observational and quarantine measures (according to epidemic indications);

- Hygienic education and training in the prevention of infectious diseases.

The prevention of the introduction of infection into the troops from the
population is achieved by:

- ​conducting sanitary and epidemiological reconnaissance of settlements and,

subsequently, sanitary and epidemiological surveillance; - restrictions (prohibitions)
of contact of personnel with the population; - placement of units, formations
outside populated areas, unfavorable in an epidemic sense; - participation of the
medical service of the troops in the localization and elimination of epidemic foci
among the population.

To prevent the introduction of infectious diseases into units and formations,

contact of personnel with prisoners of war is limited (prohibited). Disinfection and
other necessary sanitary and anti-epidemic (preventive) measures in places of their
temporary detention are carried out by the military personnel themselves.

Prevention of the introduction of infection into troops from natural foci

of infectious diseases is ensured by:

- ​conducting sanitary and epidemiological reconnaissance and monitoring the

activity of natural foci; - the participation of the medical service in the choice of
places for the accommodation of personnel, excluding infection or less dangerous
for infection; - providing personnel with protective equipment against
blood-sucking arthropods (protective nets, repellents for application to the skin and
uniforms, linen and uniforms, impregnated with insecticides); - carrying out
periodic (after 1-2 hours) self- and mutual examinations and bodily (morning, lunch
and evening) examinations with the removal (destruction) of arthropods; - carrying
out disinfestation and deratization; - carrying out (according to epidemic
indications) preventive vaccinations and emergency prophylaxis for personnel; -
conducting hygienic training and education of military personnel on the prevention
of natural focal diseases and the rules of behavior of personnel in natural foci; -
prohibiting the use of hay and straw as bedding material in the cold season.

To prevent the introduction of infection in units of prisoners of war,

contact of personnel with prisoners of war (except for a specially designated escort
group) is prohibited until they are sent to army reception centers or to front-line
prisoner of war camps. Disinfection and other necessary sanitary and anti-epidemic
(preventive) measures in places of their temporary detention are carried out by the
forces of the prisoners of war themselves in accordance with the instructions of the
senior medical commanders.

12.2. Measures aimed at breaking the mechanism of transmission of

infection and preventing mass non-infectious diseases and poisoning
(damage) of military personnel

In order to prevent the spread of infectious diseases, poisoning (injuries)

among the personnel as a result of exposure to potent physical and chemical
agents, as well as other mass non-infectious diseases, medical control is carried out
over accommodation, food, water supply, bath and laundry services, compliance
with personal hygiene rules, conditions military labor, clearing battlefields and
burial of the fallen (dead). Medical control over the fulfillment of sanitary and
epidemiological requirements for placement conditions includes: - participation of
representatives of the medical service in the selection of locations for
deployment of troops in the field and in settlements, as well as sites for the
construction of temporary military camps; - verification of compliance with sanitary
rules, norms and hygienic requirements during the construction of engineering
(fortification) structures; - checking the fulfillment of sanitary and hygienic
requirements for the equipment and maintenance of engineering structures, heating
points, field dwellings and shelters outside settlements that provide satisfactory
conditions (tents, dugouts, dugouts) or living conditions at the level of survival
(barriers, canopies, shelters, snow and snow-ice structures, simplified ground
buildings); - quality control of cleaning the territory. The participation of
representatives of the medical service in the selection of sites (areas) for the
deployment of troops is carried out during the conduct of sanitary and
epidemiological reconnaissance as part of a reconnaissance group of a military unit
(formation) and includes: and settlements as a whole), conditions of
accommodation and recreation of personnel in them; - identification of water
sources and their hygienic assessment; - collection of information from local health
authorities and the population on the presence and extent of the spread of
infectious diseases; - assessment of the sanitary condition of the area (site) location
and making proposals to the commander of the military unit (formation) on the
implementation of measures to improve it; Skin diseases Fever of unknown origin,
Malaria - identification of infected and contaminated products of a nuclear
explosion, toxic substances, biological agents, sewage and waste of terrain,
buildings and structures. The placement of servicemen in settlements that are
unsatisfactory in sanitary and epidemiological terms is prohibited.

Medical control over the fulfillment of sanitary and epidemiological

requirements for cleaning the territory provides for: - checking the correctness,
timeliness and completeness of collection, removal and disinfection of sewage and
waste; - constant monitoring of the area of ​location (actions) of a military unit
(subunit), formation and timely identification of factors that negatively affect the
sanitary and hygienic state of troops (naval forces), the development and
submission of proposals to the command for their elimination (limitation). Cleaning
of the territory of the location area from sewage and wastes is carried out by forces
and means of subdivisions and units. Medical control over the fulfillment of
sanitary and epidemiological requirements for catering includes: - visual and
organoleptic assessment of the good quality of food raw materials, food products
and their suitability for consumption (appearance, color, smell, texture, taste); -
checking the sanitary condition of field bakeries, food warehouses, food points,
their territory, equipment, compliance with the rules for food processing, shelf life
of ready-made food, washing equipment, dishes and personal bowlers of military
personnel; - systematic verification of compliance with sanitary and hygienic
standards when receiving and transporting food products, as well as the conditions
of their storage at all food facilities with selective control of the quality of products
by external signs, shelf life and condition of containers, with laboratory examination
of food samples in the sanitary -the epidemiological laboratory of the formation or
army; - medical monitoring of the health status of the food service personnel and
their compliance with the rules of personal hygiene; - investigation of the causes of
food poisoning and other mass diseases of alimentary origin and the organization of
measures to prevent them; - carrying out a hygienic (laboratory) examination and
determining the suitability of food according to indications, including suspicion of
contamination of food products with radioactive substances, OM and BS in
sanitary and epidemiological institutions (subdivisions) of the division and the army;
- making proposals to the command to change and improve the organization of
food for personnel.

Trophy food for military personnel can only be used after a

sanitary-epidemiological and veterinary-sanitary examination. The provision of
water to the troops for drinking and household needs is carried out through water
supply points deployed by units of the engineering service of regiments and
formations.

Medical control over the fulfillment of sanitary and epidemiological

requirements for the water supply of troops includes: - participation of
representatives of the medical service of the unit (formation), together with
specialists of the radiation, chemical and biological protection troops (RHBZ) in
the reconnaissance of water sources, organized by units of the engineering service,
determining their suitability for water supply troops, as well as the size of the
sanitary protection zones of water supply points; - assessment of the observance of
quantitative norms of water consumption and participation in the development of
temporary norms of water consumption with limited opportunities for the extraction
and supply of water; - systematic inspection of water quality and compliance with
sanitary rules and hygienic requirements during its extraction, processing, storage,
transportation and distribution at water supply points and water points; - medical
monitoring of the health of servicemen involved in the extraction, purification,
storage, transportation and distribution of water; - training of troop personnel in the
rules for the use of individual and collective means of water disinfection and
control over the correctness of their use; - assessing the quality of disinfection,
degassing and decontamination of water and checking the sanitary condition of
water supply points and water points, the regularity of disinfection of containers for
the supply and storage of water; - hygienic examination of water in the sanitary and
epidemiological divisions of the compound and the army; - hygienic examination
of water contaminated with products of a nuclear explosion (RW), OM and BS; -
development of proposals to the command to improve the water supply to the
troops.

The reconnaissance of water sources by units of the engineering service with

the participation of representatives of the RChBZ troops and the medical service
provides for: - obtaining and studying information from the higher headquarters
about the conditions for water supply to the troops; - collection of
sanitary-topographic, sanitary-technical data in places of possible deployment of
water supply points and information of a sanitary-epidemiological nature (on the
quality of drinking water used by the population; the incidence of intestinal
infections, etc.). Organization of bath and laundry services for troops in
wartime is the responsibility of the deputy commander of a military unit
(formation) for the rear. Bath and laundry services for the wounded, injured and
sick who are being treated in the division's medical department (brigade's medical
brigade) is entrusted to the deputy commander (chief) of this institution for material
and technical support.
Bath and laundry service for the personnel of the troops is provided by: -
​washing, disinfection and laundry equipment of field bath and laundry and
disinfection units and institutions; - stationary bath and laundry disinfection facilities
located in the area of ​the location (of combat operations) of the troops; - isolation
checkpoints on railways and highways. Medical control over the fulfillment of
sanitary and epidemiological requirements for bath and laundry services for troops
includes: - checking the organization of washing of personnel and their regularity (at
least once a week); - checking the observance of the temperature regime in the
premises of field baths for undressing, washing and dressing, delimiting the flows
of dirty and clean linen, cleaning and disinfecting rooms, equipment and washcloths
between washing shifts, etc .; - checking the provision of personnel with soap,
washcloths, clean linen, footcloths (socks); - Carrying out physical examinations of
personnel on bathing days to identify skin lesions and head lice, the sequence of
washing and the need for complete sanitization; - checking the quality of washing,
disinfection, disinsection of underwear and bed linen, disinfection and dry cleaning
of uniforms; - checking the quality of impregnation of uniforms with special
antiparasitic, fire retardant, water-repellent and repellent compounds; - medical
monitoring of the state of health of personnel serving field and stationary baths and
laundries; - verification of compliance with the rules for the safe operation of
disinfection and shower installations and mobile dry cleaning workshops for
uniforms; - verification of the implementation of measures to prevent pollution of
water supply sources by sewage baths of military units (formations) and points of
special treatment; - participation of the medical service of the military unit
(formation) in planning the time and sequence of washing the personnel of the unit
(subdivisions). Disinfection and disinsection of linen and uniforms for epidemic
indications is carried out by the forces and means of the medical service of the
formations and means of the clothing service.

12.3. Sanitary treatment for epidemic indications

Indications for sanitizing are the occurrence among the personnel of cases of
OOI, diseases of parasitic typhus, scabies, as well as the identification of head lice.

Full sanitization includes hygienic washing of personnel with a change

(disinfection, disinsection) of linen, uniforms, bedding and disinfection of living
quarters (tents, dugouts, dugouts, etc.). It is organized by the heads of the medical
service of the units and is carried out by the forces and means of the clothing
service (DDC-01) using the washing and disinfection equipment of the
sanitary-epidemiological units (DDP-2) at the direction of the head of the medical
service of the compound. Full sanitization can be carried out in stationary sanitary
passages or in specially deployed tents using disinfection and shower installations.
In the sanitary checkpoint, the oncoming movement of people heading for
processing is completely excluded, and the linen and uniforms removed from them
with the flow of persons who have been washed and received disinfected property.
A special team of 5-7 people is allocated to service the sanitary checkpoint.

In the field, tents are set up for undressing, washing and dressing personnel.

A disinfection and shower unit is installed between the dirty and clean halves
of the sanitary pass.

For sanitation, servicemen arrive in groups (units) of 12-36 people (depending

on the throughput of disinfection and shower installations); bedridden wounded
and sick are delivered by porters. Uniforms and underwear are removed in the
locker room, as well as documents are handed over. The personnel are examined.
In the process of sanitization, 30-40 g of soap and 40-50 liters of water are
consumed per person at a temperature of the latter within 40 ˚С. To wash one shift,
30 minutes are allotted, of which 5 minutes are spent on undressing, 15 minutes on
washing, 10 minutes on dressing. Within one hour, 4 shifts take place, provided
that the next shift undresses while the previous one is washing, and the previous
one is in the dressing room.

The number of washcloths used simultaneously in the sanitary checkpoint

should not be less than the number of people in three groups of washable. At the
same time, two batches of personnel (washing and preparing for washing) have
washcloths on their hands, and for the third batch they are disinfected in a
disinfectant solution.

When sanitizing personnel for epidemic indications, as well as for disinfection

and disinsection of uniforms, protective equipment, bedding and underwear,
movable disinfection and shower installations (DA, DDK-01) are used.

The preschool educational institutions of the medical service are used at the
stages of medical evacuation and in the foci of infectious diseases (parasitic typhus,
anthrax, plague, tuberculosis, etc.).

At present, the equipment of the medical service of the Ministry of Defense of

the Republic of Uzbekistan may be equipped with disinfection and shower
installations previously accepted for supply: DDC-01 ");

2. Combined disinfection and shower unit on a ZIL-130 ("DDA-2") vehicle;

3. Combined disinfection and shower unit on a GAZ-66 ("DDA-66") vehicle;

4. Combined disinfection and shower installation on a car trailer ("ДДП -2").

Currently, in the Armed Forces of RUZ, a disinfection and shower complex

(DDC-01) on the chassis of a car KAMAZ with a capacity for hygienic washing or
disinfection of uniforms for vegetative forms of microorganisms 160 people per
hour. In addition, a disinfection vehicle (DA) was adopted for the supply of the
medical service, designed for mechanized disinfection, disinsection and deratization
at the stages of medical evacuation, during the elimination of foci of infectious
diseases.

All types of combined disinfection and shower installations have fundamental

similarities and differ in some technical and operational indicators.

Their equipment consists of three main units: one or two steam boilers, one to
three showers and one or two disinfection chambers.
The steam boiler is designed to generate steam, with the help of which disinfection,
disinsection and heating of water supplied to shower devices for washing people
are carried out.

In the disinfection chambers of mobile disinfection and shower installations, it

is possible to carry out steam-air disinfection and disinsection of cotton and
woolen products, protective equipment, disinsection of leather and fur items and
steam-formalin disinfection of leather and fur products.

Special treatment of personnel of units and formations that find themselves

in foci of biological contamination is subdivided into partial and complete special
treatment. Partial sanitization, as an integral part of partial special treatment, is
carried out by personnel in the order of self and mutual assistance in order to
remove pathogenic microorganisms from the surface of uniforms, gas masks and
individual parts of the body. It includes the processing of uniforms, shoes, a gas
mask and equipment by sweeping with a broom or wiping with a rag, as well as
careful processing of exposed areas of the body (hands, neck, face) with the
contents of an individual chemical protection bag or with soap and water using a
bandage, napkin or rag.

Full sanitary treatment, as part of the full special treatment of troops, is carried
out by order of the command in the sanitary checkpoints of special treatment
points. Before washing, those undergoing complete sanitization wipe open parts of
the body with tampons or napkins moistened with a 2% solution of chloramine or
0.5% solution of sodium salt of dichloroisocyanuric acid (HC DCCC) when
infected with non-spore-forming microorganisms or a 5% aqueous solution of HC
DCC when contaminated with bacilli spores.

After undergoing sanitization, the wounded and sick are sent (transferred) to
the appropriate departments of the stages of medical evacuation, and healthy
personnel are sent to the collection points to go to their units. At the site of
sanitization, it is advisable to carry out cleaning and disinfection every 1-2 hours of
work. The dirty half of the sanitary checkpoint and the water collection points from
the washing department are especially carefully treated.

12.4. Disinfection

Disinfection measures are carried out by mechanical, physical and chemical

methods.

Mechanical methods of disinfection include: cleaning, shaking out, knocking

out, ventilating the premises, washing and washing infected objects and washing
personnel.

The mechanical method of disinfection, without ensuring the destruction of

microorganisms, leads to a decrease in their number on the surface of objects,
often to a safe level.

Physical methods of disinfection include exposure of disinfected objects to

fire, dry hot air, steam, hot water (boiling), ultraviolet radiation, as well as natural
factors that have a detrimental effect on microorganisms (drying and solar
radiation).

Low-value items are incinerated: used bandages and dressings, deteriorated

anti-chemical protective equipment, uniforms, shoes, waste and animal corpses.
Boiling water kills vegetative microorganisms and microbial spores. The
effectiveness of disinfection increases significantly when 1-2% of soda or
detergents are added to boiling water. 400 Ultraviolet rays are used during the
stages of medical evacuation to decontaminate operating rooms, dressing rooms
and resuscitation rooms.

The chemical method of disinfection is based on the use of chemicals

(disinfectants) that have a destructive effect on microorganisms. According to their
composition, disinfectants are subdivided into:

- halogen-containing (chlorine-containing, bromine-containing,

iodine-containing) preparations;
- oxygen-containing drugs (hydrogen peroxide, peroxide compounds, peracids);

- Quaternary ammonium compounds; - derivatives of guanidine;

- aldehydes (formaldehyde, glutaraldehyde);

- derivatives of phenol; - alcohols; - derivatives of lactones;

- alkalis;

- acids.

In the army, chlorine-containing disinfectants are most widely used: bleach,

dibasic calcium hypochlorite salt (DTS GK), neutral calcium hypochlorite (NGC),
chloramine, sodium salt of dichloroisocyanuric acid (HC DCC), as well as
hydrogen peroxide and formalin.

The wet method of disinfection is based on the use of aqueous solutions of

chemical disinfectants (less often emulsions or suspensions), which are used to
immerse disinfected objects in them, wipe or irrigate objects and surfaces with
these solutions.

The immersion of an object in a disinfectant solution is used to decontaminate

dishes, patient care items, medical instruments, as well as underwear and bed linen,
clothing, etc.

Wiping with a rag soaked in a disinfectant solution is used in medical

institutions, in rooms with highly sensitive equipment, as well as in the disinfection
of ship premises, aircraft, ambulance saloons.

The method of disinfection by irrigation using special equipment and technical

means is highly efficient and effective.

Large-drop irrigation is achieved with the help of standard liquid sprays such
as Avtomax, Disinfal and a hydraulic control unit. Coarse-droplet irrigation
disinfects premises with equipment located in them, sanitary vehicles, railway cars,
stretchers, cesspool toilets, garbage bins, etc.
For the treatment of premises, an aerosol disinfection method is preferable.

There are two types of disinfection - prophylactic and focal. Preventive

disinfection is carried out systematically in places of possible accumulation of
pathogens of infectious diseases (toilets, food facilities, living quarters). Focal
disinfection (current and final) in the foci of infectious diseases occurs. The
current disinfection is carried out constantly in the isolation ward and other places
where infectious patients are accommodated, and the final disinfection is carried
out no later than three hours after the evacuation of the patient or suspected of an
infectious disease.

Ambulance transport at the stages of medical evacuation is processed on a

specially designated site with the help of disinfectants by specially trained personnel
or by the drivers themselves.

After the end of the exposure, the transport is washed and wiped with a dry
cloth.

Disinfection of uniforms is carried out at the sanitization site during the period
of washing the personnel undergoing complete sanitization by a special service
team that accepts property from the personnel and sorts them out, highlighting the
following groups: cotton uniforms and cloth products are disinfected according to
the steam-air regime; leather and fur products (short fur coats, hats, boots and
boots) are disinfected according to the steam-formalin regime.

Cotton uniforms and linen can be disinfected by boiling, as well as (soaking)

immersion in disinfectant solutions.

At the stages of medical evacuation, water is disinfected, if necessary, on the

spot by boiling in boilers, field kitchens or other containers for 30 minutes, or by
chlorination. The required amount of chlorine-containing disinfectant is determined
by calculation, taking into account the experimental chlorination. Usually 25-30 mg
of active chlorine is used per 1 liter of water.
For disinfection of individual supplies of drinking water, chemical tablets
"Akvasept", "Neoaquasept", as well as portable water purifiers "Rodnik" and
"Tourist-2M" are used. Water contaminated with bacillus spores cannot be
disinfected.

Disinfection at low temperatures is associated with significant difficulties.

Pathogenic microbes are more viable under such conditions, the activity of
disinfectants decreases, aqueous solutions of many drugs freeze, deterioration of
the detergent properties of solutions. Therefore, special methods are used for
disinfection at low temperatures: treatment with hot solutions of disinfectants; the
use of solutions prepared in non-freezing liquids (dichloroethane, etc.); adding
substances to disinfectant solutions that lower the freezing point (fused calcium
chloride, sodium chloride, ethylene glycol, etc.).

Such solutions can be corrosive to metals. To prevent this, after processing

the object, it is necessary to wipe the metal surfaces with a rag moistened with
kerosene (diesel fuel). Objects that cannot be treated with corrosive solutions
should be disinfected in warm rooms.

12.5. Disinsection.

Disinsection is a set of measures to destroy or reduce the number (to a safe

level) of carriers of infectious disease pathogens, as well as protect people from the
bites of blood-sucking arthropods.

The greatest danger to the troops is posed by:

fleas - as specific carriers of plague, rat typhus;

ixodid ticks - tick-borne encephalitis, tick-borne rickettsioses, tularemia,

borreliosis and other fevers;

argas mites - tick-borne relapsing fever;

red-bodied - tsutsugamushi fevers;

mosquitoes - malaria, Japanese encephalitis, fevers (Dengue, etc.);

lice - typhus and relapsing fever, trench fever.

Vector control activities are subdivided into prophylactic and extermination.

Preventive measures, in turn, are subdivided into sanitary and hygienic and
protective ones.

The sanitary and hygienic measures include:

- strict observance by the military personnel of the rules of personal hygiene;

- conducting periodic examinations of personnel in order to identify insects or

remove ticks from the body;

- maintaining the proper sanitary condition in residential and office premises

(tents), at food facilities, in public places;

- timely disposal of food waste and garbage in the places of deployment of

troops;

- clearing the territory where troops are located from dead wood and
vegetation, eliminating shallow water bodies and other breeding grounds for insects.

Protection of personnel from attacks by blood-sucking arthropods is achieved

by a mechanical, chemical or combined method.

The mechanical method includes wearing a special protective suit, a net or a

mosquito net, using canopies, and when protecting groups of people, covering
window and door openings, ventilation and other openings, which prevents
arthropods from accessing the human body or their penetration into inhabited
mobile and stationary objects.

The chemical method is based on the use of various chemical compounds

(repellents) that have a deterrent effect on blood-sucking arthropods.

The combined method involves the use of mechanical protective equipment

treated with deterrent agents.

On the basis of a number of repellents (dimethyl phthalate, diethyltoluamide

and some others, such as benzoylpiperidine and osamate), formulations have been
developed that have a pronounced deterrent effect.

To apply repellents to the skin of open areas of the body (hands, neck and
face), special emulsions, creams, foams, aerosols, individual wipes, etc. are
produced. in the form of aerosol cans (for application on the outer surface of
uniforms without soaking through).

The most complete protection of military personnel from blood-sucking

arthropods is provided by insecticidal-repellent mixtures (oxazole, etc.) containing
repellents (a mixture of repellents) and acute insecticides, low-toxic to humans
(neopamine, permethrin, etc.). They are designed for processing uniforms in order
to protect personnel from attacks by ixodid ticks, fleas and other blood-sucking
arthropods, as well as tents and curtains. They have both a deterrent and a
paralyzing effect on uniforms when worn daily for 7-14 days.

Extermination activities include the use of mechanical, physical and

chemical methods to kill insects and ticks in their natural habitat and distribution.

The mechanical method is auxiliary - with its help it is impossible to ensure

the complete destruction of arthropod vectors. Means of the mechanical method of
extermination include: cleaning, cleaning of premises and territories; shaking out
and knocking out clothes, bedding; catch on sticky paper (tape) of flies, fleas,
mosquitoes, etc.

From physical means of influencing arthropods in order to exterminate

them, fire is used (burning garbage, dead wood, weeds, dead wood, low-value
things infected with ticks, fleas, lice), hot and boiling water (washing clothes,
boiling and sanitizing personnel) , hot water vapor and air (disinsection of linen,
uniforms and other things infected with lice in stationary and mobile steam and
steam-formalin disinfection chambers).
The chemical method of disinsection involves the use of chemicals (insecticides)
that cause the death of all stages of arthropod development. In terms of chemical
structure, insecticides are divided into chlorinated hydrocarbons,
organophosphorus compounds, carbamates, plant pyrethrins and synthetic
pyrethroids, and other compounds. The greatest use in the troops is found in
preparations of the group of organophosphorus compounds, synthetic pyrethroids
and their mixtures.

Depending on the pathways of entry into the body of arthropods, insecticides

are divided into contact, penetrating through the integument of the body, intestinal,
penetrating through the digestive system, and fumigants penetrating through the
respiratory system. The group of intestinal poisons also includes systemic
insecticides that enter the body of arthropods when they feed on the blood of an
animal or a person who has previously been injected with a special drug, for
example, butadion. Some insecticides are complex. According to their intended
purpose, insecticides can be subdivided into acaricides (preparations for the
destruction of ticks), actually insecticides (for insects), pediculicides (for lice), as
well as ecocides, parricides and imagocides, depending on the effect on certain
stages of arthropod development.

Insecticides are produced by the industry in the form of dusts (powders),

wettable powders, emulsifiable concentrates, granules, food and dry baits,
thermo-sublimation sticks, aerosol cans, etc. The specific forms of pediculicide use
include soaps, shampoos and lotions.

Disinsection measures are carried out taking into account the

operational-tactical situation, biological and ecological characteristics of arthropods
against which these measures are directed (places of accumulation and breeding,
routes and possible distance of their migration, timing and dynamics of
reproduction, life expectancy).

Disinsection, carried out at the stages of medical evacuation, is aimed at

preventing the transmission of infectious diseases to the wounded and sick, medical
and service personnel and the removal of infected arthropods to the troops and the
rear of the country.

Indications for disinsection measures at the stages of medical evacuation

are:

- detection of fleas, ticks or other blood-sucking arthropods on uniforms,

underwear or the body of the wounded and injured and medical personnel;

- detection of fleas, ticks, mosquitoes, flies and other arthropods - carriers of

infectious diseases in the territory of the medical evacuation stage.

If lice are found in the wounded and sick, the following anti-pediculosis
measures are taken:

- partial disinsection of uniforms by irrigating or dusting the uniforms directly

on people at the special treatment site in order to prevent the dispersal of
arthropods;

- Grooming and shaving of hairy parts of the body and treatment with
pediculocides during full sanitization before washing persons infected with body
lice and head lice.

The contaminated linen is subject to disinfestation in a preschool or training

facility, and then sent to the wash; - disinsection of vehicles and stretchers, on
which the wounded and sick with head lice were delivered; - disinsection of tents,
reception and sorting rooms, isolation and other rooms in which there were lousy
persons; - systematic examination of those admitted to pediculosis during their stay
at the stage of medical evacuation. If even single lice are found on the body or
linen, a complete sanitization of the admitted is carried out with a change of
underwear and bed linen. All persons who have been in contact with the licked
wounded and sick, including medical and service personnel also undergo
sanitization.
 12.6. Deratization

Deratization is a set of measures to combat rodents - sources and mechanical

carriers of infectious disease pathogens.

Preventive measures are aimed at preventing rodents from entering objects,

depriving them of their food supply and places of shelter with the help of
sanitary-hygienic and sanitary-technical measures.

Sanitary and hygienic measures include clearing the area where the unit is
located and the stages of medical evacuation from bushes, garbage, mowing grass,
burning dead wood, brushwood, equipping places for collecting waste and
garbage, keeping the area clean.

Sanitary-technical measures provide for the creation of obstacles to the

access of rodents to tents and temporary structures by ditching them with grooves
and equipping trapping pits. During field deployment of troops, stages of medical
evacuation, after clearing the occupied territory, the tents are dug in with protective
grooves with trapping pits.

Activities for the extermination of rodents are carried out according to

epidemic indications by specially created teams from among the personnel of units,
subdivisions and stages of medical evacuation. The medical service provides
methodological guidance for the work of deratization teams. In special cases,
extermination measures are carried out by regular disinfection units of sanitary and
epidemiological institutions.

Exterminatory deratization is carried out by mechanical and chemical

methods. The mechanical method is used mainly in rooms (tents) with a low level
of rodent numbers and consists in their destruction with the help of service or
homemade fishing gear (spring or arc traps, apexes, live traps of various designs).
Bread moistened with vegetable oil is used as bait. Traps are placed in the evening
in all rooms where rodents are expected, along the walls at the rate of 1-5 traps per
30 m2. In the morning, traps are checked and captured rodents are collected. The
vertices are placed in the same way. If the rodents are not caught, then the trap or
top is left uncharged for 3-5 days. After the rodents get used to the traps and begin
to eat the bait, the traps are charged. In the field and in the foci of infectious
diseases, where it is necessary to obtain a quick effect, a chemical method of
deratization is used, based on the use of chemicals (raticides) that have a
detrimental effect on rodents.

Among the raticides, the troops traditionally use zinc phosphide - an acute
poison and coumarin anticoagulants - zoocoumarin and ratindan. In addition,
modern drugs can find application: glyfluorine, monofluorin, fluoroacetamide,
ethylphenacin, etc.

For the extermination of rodents, chemical deratization agents are used in solid
and liquid state in food baits, applied to the surface of the water, and also used for
dusting holes or spraying fodder plants ... The most widely used food baits.

Food baits are prepared on the eve of use or for future use in the form of dry
products of long-term storage. In the first case, the baits contain a food base
(grain, bread crumbs, porridge, vegetables, minced meat), raticide and various
additives that improve taste, impart the desired consistency or promote adhesion of
raticide to the grain (vegetable oil, sugar, salt). Gray rats are more likely to eat food
that contains a sufficient amount of moisture. For them, bait is prepared in the
form of various cereals, chopped vegetables. Raticides can be applied by dusting
burrow entrances, water or vegetation that rodents feed on. Dry baits are prepared
on the basis of grain, bone meal, porridge with the addition of paraffin or dough
from which dry biscuits are prepared.

To obtain a quick effect, especially in the field, zinc phosphide is used for
deratisation, as well as, if possible, monofluorin, fluoroacetamide. In stationary
conditions, when deratization can be carried out for 7-10 days or more, safer drugs
are used - zoocoumarin and ratindan.

When preparing food baits, the recommended dosage of drugs is strictly

observed, which is expressed as a percentage of the weight of the bait. Raticide is
thoroughly mixed with the food base so that the poison is evenly distributed
throughout the entire mass of the food product. Vegetable oil is added to the bait.
In field deratization, baits are used based on grain products with the addition of
vegetable oil, less often bread crumbs and green parts of plants. Grain baits are
prepared by mixing with vegetable oil at the rate of 20 g of oil per 1 kg of grain,
then the required amount of poison is added to the grain and mixing is performed
again.

When carrying out deratization by dusting holes, 2-5 g of raticide is injected

into the hole of the hole, or the poison is placed in a paper swab, which is used to
close the hole of the hole. The rodent, moving along the hole, stains its fur with
poison and, when cleaning the body, licks it off in an amount sufficient for
poisoning.

Liquid baits are mainly used to kill gray rats in heated habitats and food
warehouses. Water is poured into a flat dish and poison is applied to its surface,
which is evenly distributed over the surface with a slight rocking of the vessel.

In this case, the rats are fed with salted fish or minced meat. The effectiveness
of the use of poisoned food baits in relation to rats increases significantly when
preliminary feeding is carried out, during which, before extermination measures, an
unpoisoned bait is laid out in certain places for 5-7 days, and then the same
products with poison are placed in the same places. In settlements, extermination
measures are carried out in medical, residential, and office premises, as well as in
the open area surrounding the facilities. With a small number of rodents,
deratization is carried out mechanically (the use of traps and tops). This method is
recommended primarily in the premises of treatment units. With the insufficient
efficiency of the mechanical method of deratization and a high number of rodents,
food or water poisonous baits with zoocoumarin or ratindan are used. In habitable
areas, baits are laid out overnight, and in the morning they are removed and
destroyed or reused. Long-term baits are used in uninhabited premises.
Methodological guidance for carrying out deratization measures in units, formations
and at the stages of medical evacuation in the military echelon is carried out by
specialists of sanitary and epidemiological institutions (subdivisions) of the army
(division).

12.7. Immunoprophylaxis and emergency prevention of infectious

diseases

Immunoprophylaxis for military personnel in wartime is carried out

according to epidemic indications:

with a sharp deterioration in the sanitary-epidemic situation in military

collectives and the detection of the first cases of infectious diseases among military
personnel;

when there is a threat of the introduction of dangerous infectious diseases

from the area of ​deployment of troops (from the population, domestic animals of
natural foci, etc.);

when moving (redeploying) individual contingents of troops or groups of

military personnel to areas endemic (enzootic) for dangerous infectious diseases;

with the threat of the enemy's use of biological weapons and the elimination of
the consequences of their use.

The list of vaccinations for epidemic indications, the procedure and timing of
their implementation are announced by the order of the commander on the proposal
of the head of the medical service of the military district (group of forces, fleet,
institutions of central subordination).

When deciding on vaccinations for personnel, the presence of vaccine

immunity in military personnel as a result of vaccinations carried out in peacetime,
taking into account the terms of revaccination, is taken into account. The most
important means of active immunization, the use of which may be required in
wartime, include vaccines: brucellosis (live), typhoid VIANVAC (chemical),
Venezuelan equine encephalomyelitis (killed), yellow fever (live), Q fever (live),
smallpox live) for parenteral use and tableted for oral use, anthrax (live or
combined), typhus (chemical), tularemia (live), cholera bivalent tableted (chemical)
or corpuscular (killed) or cholerogenanatoxin, plague (live) for parenteral use or
tableted for oral administration, as well as polyanatoxins - purified sorbed
tetraanatoxin (tetanus and botulinum A, B, E); botulinum trianatoxin (A, B, E).

Vaccinations in the troops are organized by the chiefs of the medical service
of units and formations; methodological guidance and control over their
implementation are carried out by epidemiologists. Vaccinations with scarification,
syringe, intranasal and oral methods are carried out by doctors and experienced
paramedics (nurses) under the supervision of doctors in specially prepared
temporary vaccination points deployed in tents or spacious premises. In units,
formations for inoculation, vaccination teams are formed consisting of a doctor,
2-3 paramedical workers and auxiliary personnel from among the vaccinated
contingents.

Vaccinations by needleless or aerosol methods are carried out by vaccination

teams, which include medical workers who have undergone special practical
training on the basis of sanitary and epidemiological institutions (subdivisions).
Support personnel are assigned to help the vaccination teams in each military unit.

The marks of the vaccinations given to soldiers and sergeants are entered on
military cards, for officers, on identity cards (in the column "Special marks"), and
for civilian personnel of the Ministry of Defense - on separate lists.

In order to prevent diseases in military personnel exposed to or at risk of

infection, emergency prevention agents are used:

immunoglobulins (homologous and heterologous), immune sera, individual

vaccines (meningococcal, measles, anti-rabies, etc.) and toxoids (diphtheria,
tetanus), antibiotics, chemotherapy drugs, bacteriophages and interferon inducers.
Their effectiveness largely depends on the initiation of the use of fast-acting
medications. This necessitates the use of some means of emergency prophylaxis
with a wide spectrum of antimicrobial action until the etiology of emerging (or
expected) diseases is established. Such emergency prophylaxis is called general
and is effective mainly for bacterial infections and rickettsioses. Table 12.1. lists the
most frequently recommended general emergency prevention regimens.
After the etiology of diseases is established, general emergency prevention is
replaced by a special one, taking into account the nature of the pathogen and its
sensitivity to antibiotics and chemotherapy. Thus, both in wartime and in
emergency situations, sanitary and anti-epidemic (preventive) measures should be
aimed at neutralizing sources of infections, rupture of the transmission mechanism
of the pathogen and an increase in the immunity of the body of military personnel to
infectious diseases. The choice of targeted measures is carried out based on the
results of epidemiological diagnostics, and their implementation is carried out taking
into account the specific conditions of the troops' activity.

Control questions:

1. What are the general tasks of anti-epidemic protection of troops? On what

basis are they refined?

2. Indicate the measures to prevent the introduction of infection into the

troops in wartime.

3. What are the measures to prevent the introduction of infection into a military
unit with replenishment and from natural foci

4. What measures should be taken to prevent the introduction of infection into

the troops from the areas of their deployment and with prisoners of war?

5. What is the procedure for evacuating infectious patients from units and
formations? 6. Describe the grouping of anti-epidemic measures according to the
doctrine of the epidemic process.
7. How is medical control over the fulfillment of sanitary and epidemiological
requirements for the conditions of placement and cleaning of the territory carried
out?

8. Indicate the features of medical control over the implementation of sanitary

and epidemiological requirements for the organization of water supply and food for
troops in the field

9. How is medical control over the fulfillment of sanitary and epidemiological

requirements for bath and laundry services for troops carried out? 10. Explain the
basic diagram of the deployment of the sanitary checkpoint.

11. What does complete sanitization of troops mean?

12. What are the main measures to combat blood-sucking insects and
arthropods in the field

13. Specify the features of deratization measures in the field. 14. Who
determines the list of vaccinations, the timing and procedure for their
implementation in the troops?

15. Who administers vaccinations to personnel by syringe, cutaneous,

intranasal and oral methods?

13. Anti-epidemic regime and strict anti-epidemic regime of MPP and

medb operation in wartime and in emergency situations

13.1. Anti-epidemic mode of operation of MPP and medb

Anti-epidemic regime (French regime - "order") - the organization of the work

of the stage of medical evacuation (MPP, medb), excluding the possibility of the
emergence and spread of infectious diseases both within this stage, and the removal
of infections outside of it (during medical evacuation, etc.) , as well as ensuring
complete safety of the medical staff working at this stage.

The anti-epidemic regime at the stage of medical evacuation implies the

constant fulfillment of the established requirements, sanitary norms and rules:

- when choosing a place and deploying functional units of the stage of

medical evacuation;

- to the maintenance of its territory (fencing, collection, storage and disposal

of garbage, waste, sewage, etc.);

- during the medical triage of the wounded and sick with the allocation of
separate streams of the wounded, the affected and the sick, dangerous to others
(infectious patients infected with OS and radioactive substances) and sending them
to isolation wards or for sanitary treatment;

- when placing the wounded, injured and sick, carrying out diagnostic or
medical procedures; - in functional units (operating rooms, dressing rooms,
resuscitation and intensive care units, isolation wards, infectious diseases
departments);

- when organizing food, water supply, bath and laundry services, etc.

The procedure for receiving patients.

For the timely identification of infectious patients, all those entering the MPP
(MEDB) for treatment or examination are subject to a mandatory medical
examination (interview, examination of the skin and mucous membranes,
measurement of body temperature). The examination of the patient is carried out on
a couch covered with oilcloth, after taking each patient, the oilcloth is wiped with a
rag moistened with a disinfectant solution. Medical personnel work in gowns and
hats (kerchiefs) that completely cover the hair.

If a patient is identified or suspected of an infectious disease, he is

immediately sent to the isolation ward. Medical workers who examined the patient
decontaminate their hands. Furniture and all objects with which this patient and staff
came into contact are disinfected.

If an incoming patient is found to have head lice or scabies, the room and
objects with which he was in contact are subject to disinsection treatment. Personal
clothing is folded into a bag made of dense fabric, then into an oilcloth bag, stored
separately from other things and sent for chamber treatment (stationary or in a
disinfection-shower car, trailer). The patient undergoes complete sanitization. To
do this, he is given a clean washcloth, which, after use, is disinfected, dried and
stored in a clean, labeled container.

Sanitization is carried out in a sanitary checkpoint, in which counter flows of

patients are excluded. For the sanitization of patients with signs of
epidermophytosis and other skin diseases, a separate shower net (shower) and
washcloths are allocated, which are disinfected after each patient.

After sanitization, the patient receives clean underwear, a dressing gown

(pajamas), slippers. Underwear, handkerchiefs, socks, footcloths of patients are
not depersonalized, but are subject to mandatory washing (separately from hospital
items), after which they are stored along with uniforms. Summer cotton uniforms
for soldiers and sergeants must be washed if dirty. The uniforms of generals,
admirals, officers, as well as the outer woolen uniforms of soldiers, sailors and
sergeants are not washed, but cleaned if necessary.

In the medical center, a place is allocated for storing patients' belongings,

equipped with clothes hangers, shoe racks or individual lockers according to the
number of standard beds.

Personal belongings of patients (shoes, socks, footcloths, gloves) admitted

with signs of epidermophytosis are subject to disinfection. In the reception room of
the MPP (omedb) you must have:

- thermometers, spatulas, cotton wool, tweezers, alcohol, - soap, the required

number of washcloths;

- utensils for separate storage of clean and used washcloths with appropriate
inscriptions on it "Clean", "Used";
- a hair clipper, shaving accessories, a comb, nail scissors, - tips for enemas and
labeled utensils for disinfecting and keeping them clean;

- buckets with tight-fitting lids and a baking sheet made of galvanized iron;

- detergents, disinfectants and disinfestants, - auto-max or hydro-control. In

addition, property and equipment are kept in the reception room for transfer to a
strict anti-epidemic regime.

After use, the inventory must be disinfected. Wooden spatulas are destroyed
after one-time use, and metal spatulas are boiled. The whole thermometers are
placed in a container with a disinfectant solution. Bathtubs, hair clippers, combs
and shaving razors, nail scissors, tweezers, enema tips, sputum collection dishes,
bedpan and urinal are decontaminated after each use. Hand brushes are washed,
dried, autoclaved and stored in bixes.

In the ward, the patient is given individual care items (drinking cup, glass,
pocket spittoon, bedpan, etc.), which are periodically washed and disinfected.

Patients with head lice, initially treated in the waiting room, are taken under
observation in the infirmary and are re-treated with insecticides until the lice are
completely destroyed.

Requirements for an anti-epidemic regimen in the MPP infirmary

(department of the medical department). Washing patients undergoing treatment
in the shower is carried out at least once every 10 days with a change of bed and
underwear. If the laundry is dirty, it should be changed more often. Dirty underwear
and bed linen are collected in bags, sorted and disassembled in a dedicated room
and delivered on the same day to the dirty linen warehouse, from where it goes to
field mechanized laundries for washing. In the warehouse, dirty linen is stored in a
special container (metal or plastic bins with lids). After the laundry is handed over
to the laundry, the container is disinfected.

Mattresses, blankets, pillows, coats, hats are subjected to chamber treatment

after the patient is discharged after a purulent infection, the patient is transferred to
the infectious diseases department or the patient dies. Hospital clothes (pajamas,
dressing gowns) of these patients undergo chamber treatment, and bed and
underwear are soaked in disinfectant solution before being washed.

Patients must strictly follow the rules of personal hygiene, wash themselves
daily in the morning and before bedtime, and wash their hands before each meal.
Severe and bedridden patients are washed in bed, daily oral care is provided.
Shaving and hair cutting are performed according to indications. The patient is
allowed to take personal hygiene items into the ward.

Patient rooms must be kept orderly and clean. Cleaning is carried out at least
twice a day using a wet method using disinfectants. Rooms are ventilated at least
four times a day.

Garbage is collected in plastic bags and disposed of in a waste bin, which is

regularly cleaned and removed.

Cleaning equipment (buckets, rags, brushes, etc.) is marked and used

separately for latrines, wards, pantry and other rooms. It is stored in strictly defined
places and is used for its intended purpose. The use of this equipment for other
purposes or for cleaning other premises is prohibited. After use, the cleaning
equipment is decontaminated.

In order to early detection and isolation of an infectious patient, the following

measures are taken at the MPP (med): a strict record is kept of all febrile patients in
whom the period of temperature rise (37.5 ° C and above) lasts 5 days or more,
blood is taken for bacteriological studies in persons suspected of typhoid
paratyphoid, rickettsial and other infections, blood is examined (thick drop, smear)
for the presence of malaria parasites. If a patient is diagnosed with a disease
suspicious of an infectious, then he is immediately isolated in an isolator before
being transferred to the infectious diseases department of the hospital. In the ward
where the patient is identified, the final disinfection is carried out. The contact is
monitored for the duration of the incubation period.

The procedure for receiving infectious patients.

Infectious patients, bypassing the reception room, should be sent to the

isolation ward, where they are not more than 1 day. This time is necessary for
examination, diagnosis, medical care and collection of an epidemiological history. It
is allowed to leave for treatment in the isolation ward only patients with
uncomplicated forms of angina and acute respiratory infections with a treatment
period of up to 10 days. The rest of infectious patients are hospitalized in military
field infectious diseases hospitals (VPIH).

Isolators should have a separate entrance, washbasin and toilet. They should
be equipped with containers for soaking linen, disinfecting patient secretions,
disinfecting dining and tea utensils, bags for storing clothes. Patients should be
placed separately, taking into account the mechanism of transmission of infection.

The entrance to the isolation ward is allowed only to the medical personnel
directly working in it, and to persons accompanying the patient. Simultaneous
admission of two or more patients in one isolation ward is prohibited.

The transport that delivered the infectious patient, and the stretcher, after the
patient is handed over, are disinfected directly at the MPP (medb) in a specially
designated place.

At the entrance to the isolation ward there should be gowns, caps, kerchiefs,
gauze masks for medical personnel and a mat soaked in a disinfectant solution.

After examination, the patient undergoes sanitization directly in the isolation

ward. The uniforms of incoming patients are subject to mandatory disinfection, and
underwear - disinfection and washing.

Medical personnel (nurse, nurse) should treat the patient and disinfect in an
additional gown (which is worn over the main gown) and a headdress (cap,
kerchief).
A patient with an established diagnosis is sent to the appropriate specialized room.
In case of an unclear diagnosis, the patient is in a separate room until the final
diagnosis is established, after which he is transferred to a specialized room or to the
infectious diseases department of the hospital.

Fulfillment of the requirements of the anti-epidemic regime in isolation

wards is as follows. Furniture, floors, lower parts of walls (panels), window sills
of premises are wiped with a cleaning and disinfecting solution at least twice a day.
Cleaning is carried out with labeled equipment (buckets, brushes) and rags specially
fixed for latrines and other premises. Garbage is collected in buckets (tanks) with
lids and, as it accumulates, is destroyed by incineration. The premises of the
isolation ward are also ventilated at least four times a day. The air is disinfected
using UFO lamps.

Care items and utensils are assigned to patients for the entire duration of their
stay in the isolation ward, and are washed and disinfected daily. After the transfer
or discharge of the patient, the room and equipment are subjected to final
disinfection.

Enema tips, thermometers, spatulas, bed vessels, pots, urine bags are
decontaminated after each use. Beakers for medicines and eye droppers should be
separate for each patient and should be boiled after use. Pharmacy utensils are sent
from the isolation ward to the pharmacy only after preliminary disinfection.

Underwear and bed linen, hospital clothes of infectious patients, before

washing, are subject to mandatory disinfection by soaking in tanks with a
disinfectant solution. It is strictly forbidden to send the linen of infectious patients
to the laundry without decontamination. Blankets, mattresses, pillows and other
things that cannot be washed are subject to chamber disinfection after patients are
discharged. The transport on which soft things or linen are sent to the disinfection
chamber is disinfected at the end of the work.

Dirty tableware in the washing pantry is placed on a separate table, thoroughly

cleaned of food debris with a brush, disinfected, and then washed and scalded.
Broken dishes must be taken out of use. Remains of food are subject to mandatory
disinfection by soaking in a disinfectant solution, after which they are removed to
the bin.

Patient care items and instruments should be handed over on duty only in a
decontaminated state.

Material for laboratory research of infectious patients (blood, smears from the
pharynx, mucous membranes of the eyes, sputum, nasopharyngeal lavages,
cerebrospinal fluid, duodenal contents, bile, urine, feces, punctates from various
organs, skin scales, hair, etc.) is collected in a special sterile, tightly closed
containers (test tubes, flasks, bottles, etc.) and delivered to the laboratory in closed
containers.

The evacuation of an infectious patient from the MPP isolator (omedb) to

the hospital is carried out on a sanitary or other specially designated transport for
this purpose. It is not allowed to transport infectious patients on a passing vehicle,
as well as not adapted for the transport of people. It is not allowed to transport
patients with different infections, as well as infectious and somatic patients on the
same car. To accompany an infectious patient, a paramedic or a sanitary instructor
is appointed, the car should have packing for emergency care, as well as patient
care items in accordance with the nature of the infectious disease (bedpan, bucket
for collecting and disinfecting patient's secretions, oilcloth for intestinal infections,
cotton wool - gauze respirator for respiratory infections) and disinfectants. The
transport on which the infectious patient is delivered to the hospital is disinfected
by the forces of this medical institution.

Information on the identification of an infectious patient or a case of head lice

must be reported to the unit and the corresponding sanitary-epidemiological
institution (subdivision) for conducting an epidemiological examination and
anti-epidemic measures.
Anti-epidemic regimen in operating rooms and dressing rooms

Operating rooms and dressing rooms for clean and purulent operations
(dressings) are strictly separated. In the presence of one operating room (dressing
room), first clean operations (dressings) are performed, then purulent wounds are
treated. The room and all equipment after purulent dressings are thoroughly
disinfected.

The table for sterile instruments is covered with a sterile sheet immediately
before the operation, sterile instruments are laid out on it, which is closed from
above with another sterile sheet.

The instruments used during the operation are collected in specially designated
containers and disinfected. Disposable syringes, needles, blood transfusion
systems, etc. collected separately, disinfected by soaking in a disinfectant solution
with subsequent destruction or delivery for disposal.

The operating room and dressing room doors are kept closed at all times. It is
strictly forbidden to store in these rooms items that are not used during the
operation.

Employees of operating rooms and dressing rooms must change gowns, hats
and masks daily, use disposable or cloth “shoe covers”, which are sterilized daily
by soaking in a disinfectant solution (boiling, autoclaving). A nurse during dressing
of patients with suppurative processes should wear an oilcloth apron.

After each dressing, the apron, hospital slippers are wiped with a cloth soaked
in disinfectant solution, and hands are washed with soap. After the operations and
dressings and the collection of dressings in specially designated containers, wet
cleaning is performed in the operating room and dressing room using disinfectant
solutions.

The infected material must be disinfected or incinerated.

The operating room and dressing room are cleaned with a wet method at least
twice a day using disinfectants. General cleaning takes place once a week. Premises
are preliminarily freed from items, equipment, inventory, tools, medicines, etc. A
5% chloramine solution or a mixture consisting of a 6% hydrogen peroxide solution
and a 0.5% detergent solution (surfactant) and other approved disinfectant
preparations are used as disinfectants with mandatory control of the disinfection
quality.

After cleaning and disinfection, the premises are irradiated with ultraviolet rays
for 2 hours.

Requirements of an anti-epidemic regimen when organizing meals for

patients. Meals are organized in the wards. The seriously wounded are fed in bed.
A canteen (pantry) can be equipped for walking patients.

Food from the kitchen is delivered to the wards (pantry departments of the
omedb) thermoses or enameled buckets with a lid. The use of thermoses is
preferable because the food stays hot longer in them. Moreover, thermoses protect
it from contamination with radioactive substances, ОВ, BS. Temperature of the
0
first courses the moment of delivery should not be lower than 60 С, for the
0
second courses - 55 С. For the delivery of bread, fabric bags can be used. Sugar
is delivered in small (up to 2 kg capacity) tissue bags. The bread is sliced ​just​
before eating. Dirty tableware is washed in pantries.
Medical control over the sanitary state of the kitchen and pantries is carried
out by the doctor on duty and other officials of the medical evacuation
stage. Sanitary and epidemiological supervision of catering at the stage is carried
out by specialists of sanitary and epidemiological institutions (divisions).
When delivering food and distributing it, measures should be taken to exclude
direct contact of dishes and cutlery for infectious patients with dishes for other
patients. Tableware and utensils are attached to the insulator, where they are
washed and stored.
To provide infectious patients with food, it is recommended to have two sets
of dishes, the first is used only for the delivery of food and bread from the kitchen
to the isolation ward, the second, located in the isolation ward, is used to transfer
the delivered food into it. It is allowed to heat the delivered food on electric stoves,
food warmers and in microwave ovens.
The remains of uneaten food from infectious patients are poured for 1 hour
with a 5% solution of DTS HA, after which they are taken out to specially
designated places.
444 Dishes (spoons, mugs, bowls) are washed in hot water, immersed in 1%
chloramine solution for 30 minutes and rinsed with boiling water. Disinfection of
dishes by boiling for 30 minutes in a 2% soda solution is allowed. For the purposes
indicated here, other modern certified disinfectants can also be used.

Requirements for an anti-epidemic regime in the organization of water

supply. All sources of centralized or local water supply to troops are subject to
protection. Their protection is organized by the command. The provision of MPP
(omedb) with water is organized according to three standards: full - 100 liters / bed
per day, limited - 40 liters / bed per day, minimum - 15 liters / bed per day.

Tanks for transporting and storing water are disinfected weekly, and the
quality of water is monitored at least once a month (according to epidemic
indications - more often).

Medical control over food and water supply workers (cooks, warehouse
workers, bartenders, water carriers, etc.) is necessary for the timely identification
and removal of patients and bacteria carriers from work. It provides for a medical
examination before entering work and a current medical examination (with a
frequency set by the epidemiologist as appropriate). Persons who have undergone
a medical examination, chest fluoroscopy and examination for bacterial and
helminthic carriers are allowed to work in the canteen and in the food warehouse. In
the future, a medical examination is carried out weekly, and fluoroscopy
(fluorography) of the chest - at least 2 times a year.

Bacteriological examination of these persons is carried out in the first and

fourth quarters once, from April to September inclusively monthly, and in the
presence of epidemic indications - at the discretion of the head of the medical
service of the unit (garrison), the epidemiologist. Patients with infectious diseases,
carriers of pathogens of intestinal infections, persons with pustular skin diseases,
open ulcers or abrasions, patients with scabies, persons suffering from
inflammatory processes of the eyes of an infectious origin are not allowed or
temporarily suspended from work with food products. Bacteria carriers of intestinal
infections are temporarily not allowed to work (until the end of the rehabilitation).
Chronic carriers of typhoid and paratyphoid fever are transferred to another job.

Food and water workers are required to pass a minimum health exam upon
hiring and strictly observe personal hygiene rules.

13.2. Strict anti-epidemic mode of operation of MPP and medb.

If a patient (suspicious) with a dangerous infectious disease (OID) is identified

at an outpatient appointment, the MPP (omedb) is transferred to work in a strict
anti-epidemic regime (SPER). Further admission of patients is immediately
stopped. It is forbidden to enter and exit the medical center, in accordance with the
order of the unit commander, armed guards are posted. The front door is locked
with a key, if this is not possible; a duty post is set up. All movement of patients
within the medical center (department of medical department) is stopped.
Instructions and redistribution of functional units and medical staff are carried out
in accordance with the previously developed and approved plan for the transfer of
the MPP (omedb) to the SPER, the volume and nature of the activities carried out
in the outbreak. The patient (suspicious) OIZ is isolated at the place of detection. In
the office where the patient is, the doors and windows are closed, ventilation is
turned off, the ventilation openings are sealed with adhesive tape (except in cases of
cholera).

Patients who are on an outpatient basis, as well as persons accompanying the

patient, are isolated in one of the free rooms; on them lists are drawn up indicating
the military rank, surname, name, patronymic, number of the military unit, unit, time,
degree and circumstances of contact with the patient.

If a patient suspects a dangerous infection with an airborne transmission

mechanism (pneumonic plague, etc.), a respirator mask is put on him to prevent the
spread of infection. The medical compound also protects the respiratory tract with
a respirator mask or towel before receiving protective clothing. The medical staff
directly working with the patient puts on a protective suit of the appropriate type
(pneumonic form of plague, contagious hemorrhagic viral fever - type I suit;
cholera - type IV, supplemented with an apron, gloves, respirator). Before putting
on the suit, open areas of the body are treated with a 0.5-1% solution of chloramine
or 70% ethyl alcohol, mucous membranes - with a solution of an appropriate
antibiotic or a weak solution of potassium permanganate.

Pic. 11.2. Anti-plague suit

1 - overalls, 2 - hood, 3 - full anti-plague suit - type I, 4 - cotton-gauze mask.
 In addition to the indicated "classic" types of PChO, there are modern sets of
the "Quartz-1" type, which can also be used if necessary.

The patient (suspicious) is provided with emergency medical care, material is

taken for research. In the office, current disinfection is carried out (disinfection of
secretions, vomit, patient sputum, care items, etc.). Data from the epidemiological
history are collected and recorded with an indication of the military rank, surname,
name, patronymic, military unit number, date of illness, complaints, alleged source
of infection, places of stay of the patient, possible contacts with the patient, etc.

Upon arrival at the unit, specialist consultants the patient (suspicious) OIZ is
examined by them in order to clarify the diagnosis, the necessary additional material
is taken from the patient for research, the question of his hospitalization, isolation
of persons at risk of infection, emergency prevention and other measures are being
resolved. After examination by specialists, the evacuation of the patient
(suspicious) OIZ to the hospital is organized, the material is delivered to the
laboratory, and all the necessary complex of measures is carried out among
persons who have been in contact with the sick or infected objects.

After the evacuation of the patient (suspicious) in the medical center, final
disinfection is carried out in strict accordance with the existing rules.

Features of carrying out anti-epidemic measures in identifying a patient

(suspicious ) with a dangerous infection in the infirmary of the MPP
(department of medical department). The entrance doors of the room are
immediately closed, internal posts are set up between the infirmary and the
outpatient clinic and at the patient's ward. It is prohibited to enter and exit the
medical center (department), as well as the movement of patients.

A patient (suspicious) OIZ is isolated in his ward. The rest of the patients in
this ward are transferred to a ward that is free or previously vacated from other
patients. Patients of the infirmary (department) are concentrated in their wards, they
are not allowed to leave them. Subsequent measures are carried out in the same
volume and in the same sequence as when a patient is identified with a dangerous
infection at an outpatient appointment.

Responsibilities of officials of the medical service of the unit when

carrying out measures to localize the outbreak of OIZ

The head of the medical service of the unit (medical center) is obliged to: -
clarify the clinical and epidemiological data about the patient, report the case of a
patient (suspicious) with a dangerous infection and the measures taken to the
commander of the unit to the superior medical chief , the head of the
sanitary-epidemiological institution and request the necessary assistance from them;
- organize the transfer of the medical center of the unit (organization, polyclinic) to
a strict anti-epidemic mode of operation in accordance with the developed
documentation, provide methodological guidance for the establishment of
quarantine in the unit; - to conduct an epidemiological examination of the outbreak
and identify persons who were in contact with a patient with a dangerous infection,
as well as persons who were at risk of infection at the same time as the patient; - to
instruct the persons assigned to the armed guard of the medical center; - organize,
if necessary, emergency prevention for the personnel of the unit; - upon arrival of
specialist consultants at the outbreak, act in accordance with their instructions.

The doctor on duty at the unit's medical center (omedb) is obliged to:

- stop further admission of patients, give a command to set up internal posts,

as well as to stop the movement of outpatients and inpatients;

- report by phone or through a messenger who has not been in contact with
the sick, the head of the medical service of the unit (commander of the medical
department) about the case of illness (suspected illness) of a dangerous infection;

- isolate the patient at the place of detection;

- give a command to deliver to the door of the office (ward) sets of protective
clothing, packing for the collection of materials, care items and a first-aid kit of
special treatment;

- give instructions on taking measures to protect medical personnel, inpatients

and outpatients from further infection;

- having received the requested kits and packing, put on a protective suit of
the appropriate type and start providing the patient with emergency medical care,
taking material for research and preparing it for transportation to the laboratory;

- collect and record data from the epidemiological history;

- supervise the actions of medical personnel assigned to him;

- to report to the arrived specialist-consultants about the patient, to follow their

instructions on further measures.

The paramedic on duty (sanitary instructor) of themedical center is

obliged to:

- isolate the patient (suspicious) at the place of detection;

- report by phone or through a messenger who has not been in contact with
the sick, the head of the medical service of the unit (head of the medical center or
doctor) about the identification of a patient (suspected of being ill) with a
dangerous infection (syndrome);

- close all the doors and windows in the medical center (department of the
medb), stop access to it for personnel and leave it, set up internal posts, prevent
the removal of objects;

- block the communication between the infirmary of the medical center and the
outpatient clinic;

to concentrate patients undergoing treatment in the infirmary in their wards, to

prohibit any movement of them;

- to place all patients who were at the outpatient appointment, and the persons
accompanying the patient, in one of the free offices, make a list of them;

- upon arrival of the head of the medical service of the unit (head of the
medical center, doctor), act in accordance with his instructions.

In wartime, the SPER in the MPP (omedb) provides for the

implementation of a set of regime rules and sanitary and anti-epidemic (preventive)
measures aimed at preventing the introduction and spread of OIs among the
wounded, sick, affected, as well as among the medical staff of this stage and
preventing the transfer of these infections to subsequent stages of medical
evacuation, to the troops and the rear of the country.

The SPER of work is usually introduced by the senior head of the medical
service or the head of the stage based on the results of the assessment of the
sanitary-epidemiological state of the unit (compound).

Indications for the introduction of SPER are :

- admission of a patient (patients) with a dangerous infectious disease (plague,

cholera, nat.spa, fever Lassa, Ebola, Marburg, etc.);

- admission of a patient (patients) suspected of being ill with a dangerous

infection;

- receipt of those affected by biological agents from the focus of biological

infection;

- the arrival of the wounded and sick from the unit located in the focus of
biological infection (in quarantine or observation after the use of BW);

- admission of patients with an infectious disease (syndrome) of unclear

etiology;

- mass admission of patients with a known infectious disease. It is most

preferable to transfer the MPP (omedb) to the SPER work in advance, when the
first information about the deterioration of the sanitary and epidemiological situation
appears.

Usually SPER in the MPP (medb) is introduced for the period of the
maximum incubation period of a dangerous infectious disease identified at the stage
(with plague 6 days, with cholera 5 days, smallpox 14 days, Lassa fever 8 days,
Ebola fever 10 days, Marburg disease 7 days ) .

SPER in wartime and emergency situations provides for :

- deployment of the stage according to a certain scheme that meets the

requirements of work in special conditions with the allocation of a strict regime
zone and a restricted zone;

- carrying out medical triage of all incoming wounded and sick people in order
to identify infectious patients, persons suspected of a dangerous infectious disease
and persons who are not dangerous to others

; - preventing contact between infectious patients, persons suspected of a

dangerous infectious disease with other wounded and sick and protecting the
medical staff from infection;

- deployment of isolators for the separate placement of infectious patients and

persons suspected of a dangerous infectious disease;

- Carrying out (continuation) of emergency prophylaxis for patients

(suspicious) and medical personnel;

- supply of the strict regime zone through transfer points;

- equipment of reloading platforms;

- complete (partial) sanitization of all the wounded and sick entering the stage;

- disinfection of sanitary and other vehicles that brought the wounded and sick
from the epidemic focus (focus of biological infection);

- entry in the primary card about the stay in the epidemic focus, the focus of
biological infection (a black bar is left);

- observance by the medical staff of the established measures of protection

against infection, work in protective clothing when examining the wounded and sick
arriving from the epidemic focus (focus of biological infection), - provision of the
first medical, qualified medical care to infectious patients, their temporary isolation
and preparation for evacuation by appointment to the infectious diseases hospital
(military field infectious diseases hospital).

The organization of the translation and the content of SPER activities at the
stage of medical evacuation is a rather difficult and time-consuming task, and a
number of special requirements and provisions should be taken into account. When
choosing a site and deploying a stage, it is necessary to take into account in
advance the possibility of its transfer to SPER in the future. You should be aware
that the number of premises required during the work of stages on the SPER due to
additional functional units increases (in the MPP by 10% -15%, in the medb - by
20% -30%). The deployment of functional units should be carried out in such a
way that when they are transferred to SPER, there is no need to move them from
place to place, or it is minimized (i.e., the corresponding relative position and
distance from each other). The transfer to the SPER stage will require additional
medical personnel due to the frequent change of medical personnel working in the
strict regime zone, as well as due to the increase in the volume of work in sanitary
gates, during disinfection measures, etc. The labor productivity of medical
personnel when working in protective equipment, especially in type I PChOs, is
noticeably reduced (the duration of continuous work in type I-II PChOs is 2-4
hours, and in type III-IV PChOs - 6-8 hours). In this sense, modern PChO kits
differ for the better. The need for disinfectants and water increases 3-5 times or
more.

For the successful fulfillment of its tasks by the stage of medical evacuation in
the conditions of SPED, good special training, coordination of actions of the
medical staff are needed to restructure the work of the stage to the requirements of
the SPED, which is achieved by periodic training sessions. An important role is
played by good physical fitness, training of the medical staff to work in personal
protective equipment; the availability of a sufficient amount of emergency and
immunoprophylaxis, disinfection and other material means, as well as the timely and
qualified conduct of microbiological studies in order to establish the type of
causative agent of a dangerous infectious disease.

The BCP deployment site (including the restricted area) is fenced off or
marked with warning signs; its security and cordon off are organized.

In the restricted area there are : a special treatment area, a sorting area, a
sorting tent, dressing room, evacuation, pharmacy, kitchen, transport, tents for the
MPP personnel. In the strict regime zone there is a special treatment area, a
sorting area, a sorting tent, a dressing room, and isolators.

Pic. 11.3. Schematic diagram of MPP deployment in strict

anti-epidemic mode
All work on the provision of medical care to the wounded and sick in the strict
regime zone is carried out in protective clothing. The type of protective clothing is
determined by the type of pathogen, the mechanism of transmission and the risk of
infection.

The transfer of medical personnel from the restricted zone to the strict regime
zone is carried out through a sanitary checkpoint, which is deployed in a tent of the
USB type (PMK, UZ), its work is provided by disinfection and shower installations
(YES, DDA, DDP).

Medical personnel working in the high-security zone are housed separately

from the rest of the personnel. The tents for his placement should be located near
the sanitary checkpoint for personnel. The pharmacy and kitchen are deployed
closer to the transfer point.

Personnel in the restricted area usually work in a lightweight set of protective

clothing (depending on the type of infection with PCHO type III-IV) Access to the
strict regime zone for personnel of support units is allowed only in case of official
need and only in protective clothing, followed by full sanitary processing.

The wounded and patients with signs of OCD are admitted to the sorting yard
or to the sorting tent in the strict regime zone, where they are examined and sorted.
Here, material is taken for bacteriological research and the primary medical card is
filled out.

The wounded and sick who have undergone sanitization are sent to a dressing
room or isolation ward.

Isolators are designed for temporary accommodation of the wounded and

patients with signs of OIH. They are equipped with the necessary furniture,
medicines, disinfectants and care items. They also provide medical care.

The strict regime zone is provided with everything necessary through the
transfer point.

To ensure the operation of the MPP with all the necessary types of material
resources, a reloading platform is organized, which is located on the outer border
of the restricted zone.
WFP personnel are vaccinated (revaccinated) taking into account the real
epidemiological situation. Prior to establishing the type of biological agent used by
the enemy, the WFP personnel, all wounded and sick people undergo general
emergency prophylaxis, and after receiving the results of a specific indication of BS
(clinical diagnosis of the disease), special emergency prophylaxis is carried out.

In the omedb SPERadditionally provides for:

- the deployment of an isolation department in accordance with a special

scheme and the redistribution of personnel and property by functional units;

- temporary for 2-3 days (until the type of BS or clinical and microbiological
diagnosis of the disease is established) termination of discharge and evacuation
outside the medical hospital;

- accommodation and provision of medical care to OCD patients affected by

BW and persons with suspected BW damage - in the isolation ward, the rest of the
wounded and sick - in other functional units;

- active early detection of patients with OID and affected by BW among the
wounded, sick and medical personnel, their transfer to the isolation department, as
well as the implementation of the necessary anti-epidemic measures;

- Carrying out a complete sanitization of all incoming wounded and sick.

The procedure for the evacuation of the wounded and sick from the MPP
(omedb), working on the SPER, is determined by the instructions of the senior
head of the medical service (chief epidemiologist). For the organization of the
evacuation of the patient (suspicious) to the medical facility from the medical
department to the next stage of medical evacuation, the commander of the medical
department is personally responsible, where such patients were identified or where
they were delivered. The commander of the medical department gives permission
for the evacuation of patients with OIZ with written confirmation from the senior
medical commander (chief epidemiologist). The evacuation of OCD patients from
the medical hospital, and in some cases directly from the WFP, is carried out by a
separate specially equipped, guarded vehicle to military field infectious diseases
hospitals. It is strictly forbidden to evacuate patients with OIZ outside the hospital
base of the front.

Picture 11.4. Concept of the deployment of medb in a strict

anti-epidemic mode

Features of the evacuation of patients with OCD is as follows. Patients

identified in the units with signs of OCD, regardless of the severity of the condition,
are evacuated to the MPP (omedb) only by medical vehicles, separately from other
wounded and sick. The evacuation of patients with OID, including walking, by
passing transport and joint evacuation of patients with various infectious diseases in
one car is prohibited.

When deciding on the transportation (lying, sitting) and the sequence of

evacuation of patients with OCD (affected by BW), it is necessary to take into
account the patient's condition and the possibility of its deterioration during the
evacuation process, his high degree of danger to others and take safety measures
for the accompanying medical staff and the driver of the ambulance .

The evacuation of a patient with OIZ should be carried out by a team of

evacuators, consisting of a doctor, one or two assistants (paramedic, nurse) who
know the requirements of the SPER. The machine should be provided with utensils
with a tight-fitting lid for collecting the patient's secretions, a supply of
disinfectants, medicines for the provision of emergency medical care to the patient.
The ambulance, if possible, should not stop on the way, call in somewhere and
change the route of movement. The tow trucks and the driver are in the car at the
PCHO. If you suspect a pneumonic form of plague, a contagious hemorrhagic viral
fever, or other OID with an aerosol transmission mechanism, type I PCH is used,
for cholera - type IV, supplemented with a cotton-gauze bandage, gloves, and an
apron. On the way, none of the patients with OIZ and members of the evacuation
brigade get out of the car. Food and water intake is limited as much as possible. A
transportable supply of water and flight rations is used.

Their use is carried out in compliance with all precautions.

The feces and excretions of patients with OID are collected and disinfected.

After the delivery of the patient to the appointment, the team of evacuators
must undergo complete sanitization (in the admission department, sanitary treatment
department, sanitary checkpoint). PCHO, the clothes of medical personnel are
subjected to chamber processing, if possible, they are replaced from the
replacement fund of the military field infectious hospital. The car, stretcher and
other equipment undergo final disinfection before leaving the stage. Departure of
the car and the team of evacuators from the territory of the stage without
disinfection and sanitization is prohibited. A tow truck that caused an accident
during transportation or a violation of the rules for using protective clothing is
isolated at this stage of evacuation. For the members of the team, medical
supervision is established for a period equal to the incubation period of the OIZ,
with which the patient was evacuated. By decision of specialists, evacuators can be
isolated for the entire period of medical supervision.

When it is established that the enemy has used pathogens of dangerous

infections, after the evacuation of the wounded and sick from the MPP, all his
personnel are quarantined for the maximum incubation period for this infection. In
the functional units of the MPP, a thorough final disinfection is carried out.

SPER work of the medical evacuation stage is canceled by the decision of the
senior head of the medical service. Usually, the decision to cancel in time coincides
with the proposal to remove the quarantine (observation) regime from the part that
was provided by this stage.

Compliance with the anti-epidemic mode of operation of various stages of

medical evacuation makes it possible to diagnose infectious diseases (OID) in a
timely manner, localize epidemic foci and avoid their spread, exclude entry into
troops, removal (removal) from troops, infection inside medical units
(subdivisions) and institutions.

Control questions:

1. Give a definition of "anti-epidemic regimen".

2. The device and anti-epidemic mode of operation of the isolator.

3. Give a definition of "strict anti-epidemic regimen".

4. Translation and content of the work of the MPP (omedb) in the conditions
of SPER (with stationary placement).

5. Work of the MPP in the conditions of SPER (in the field).

6. Features of work of medb in SPER conditions (in the field).

7. Purpose and composition of protective clothing (PCHO). Types of kits. 8.

Rules for putting on and taking off type I PCHO.

9. Requirements of the anti-epidemic regime for the evacuation of an

infectious patient.

10. Features of evacuation of a patient with a dangerous infectious disease.

14. Biological weapons. Fundamentals of biological protection of

troops and stages of medical evacuation. Biological reconnaissance and
indication of biological agents

Separate attempts to deliberately spread pathogens of dangerous infectious

diseases in the troops and among the population of the enemy took place in the
distant historical past. However, the development of issues related to the creation
of biological weapons began only at the beginning of the 19th century, as soon as
mankind reached a certain level of knowledge about the nature and methods of
spreading pathogenic microorganisms. Under pressure from the general public in
1971, the 26th session of the UN General Assembly proposed to all countries to
prohibit the development of biological weapons and to destroy existing stockpiles.

The originals of the text of the Convention are kept in three depositary states:
the USA, Great Britain and Russia. Currently, the number of countries that have
acceded to the Convention has reached more than 130. However, a number of
states have not yet expressed their attitude to the Convention, and some, according
to the US Office of Technology Assessments, have undeclared offensive biological
weapons programs.

14.1. The concept of biological weapons and their damaging properties

Biological weapons (BW) are one of the types of weapons of mass

destruction, the use of which can cause, in a short time, over large areas, mass
destruction of people, farm animals and plants. Modern biological weapons are
special ammunition (aerial bombs, missile warheads, mines, shells) and combat
devices equipped with biological agents (bacteria, rickettsia, viruses, toxins)
designed to destroy people, animals, plants in order to disable personnel and / or
causing economic damage to the country.

Biological weapons can be used both for the direct destruction of military
personnel and the population by contaminating the surface air layer with biological
aerosol, and for creating a threat of their destruction through prolonged
contamination of the terrain. The defeat of people with biological agents (BS) can
come through the respiratory system, gastrointestinal tract, mucous membranes
(mouth, nose, eyes, etc.), damaged skin, as well as through bites from infected
vectors (mosquitoes, fleas, ticks, etc.). ). Under certain conditions, infectious
diseases can spread to large numbers of people, causing an epidemic. Biological
agents form the basis of the damaging effect of BO.

Biological agents, the use of which as BW is potentially possible, is divided

into groups according to the following parameters: biological nature, incubation
period, severity of the lesion, ability to mass spread (epidemicity), resistance in the
external environment.

According to their biological nature (depending on the size of

microorganisms, their structure and properties), biological agents are divided into
the following classes - bacteria, viruses, rickettsia, fungi. The main potential enemy
BSs designed to kill people are the following:

- from the class of bacteria - causative agents of plague, cholera, anthrax,

tularemia, brucellosis, glanders, melioidosis, legionellosis;

- from the class of viruses - pathogens of smallpox, yellow fever,

Venezuelan equine encephalomyelitis, Dengue, Ebola, Marburg, Lassa fevers;

- from the rickettsia class - pathogens of typhus, rocky mountain spotted

fever, Q fever, tsutsugamushi fever, etc.;
- from the class of fungi - causative agents of coccidioidomycosis,
blastomycosis, histoplasmosis.

Bacterial and plant toxins include botulinum toxin, staphylococcal

enterotoxin, shigatoxin, saxitoxin, ricin.

For the defeat of farm animals can be used pathogens of rinderpest, swine and
bird fever, African swine fever, sheep pox, anthrax, glanders, etc. , gommosis of
sugar cane and cotton, etc.

According to the duration of the incubation period, three groups of BS are

distinguished:

Fast-acting - causing the appearance of the first affected in the first day after
infection (botulinum toxin and other toxins);

Delayed action - causing lesions for 2-5 days (causative agents of plague,
anthrax, tularemia, Venezuelan equine encephalomyelitis, yellow fever, glanders,
melioidosis);

Delayed action - causing the appearance of the first affected after 5 days or
more from the moment of infection (pathogens of brucellosis, epidemic typhus,
smallpox, Q fever, hemorrhagic fevers).

Depending on the severity of damage, BS are subdivided into lethal and

temporarily incapacitating. Fatal diseases are classified as fatal ones, causing
severe injuries, often ending in death: pathogens of plague, anthrax, yellow fever,
smallpox, typhus, botulinum toxin. The pathogens that cause temporary
(sometimes long-term) loss of combat capability with a mortality rate of no more
than 1-5% are classified as temporarily incapacitating: pathogens of Venezuelan
equine encephalomyelitis, Q fever, brucellosis, staphylococcal enterotoxin,
glanders, melioidosis, etc. pathogens, in the overwhelming majority, will return to
service. However, he, like parts of personnel affected by lethal pathogens, will
require long-term treatment (from 10 days to several months).
According to their ability to mass spread (epidemicity), BS are divided into two
groups: causing contagious and non-contagious diseases. The first group includes
the causative agents of plague, smallpox and some hemorrhagic fevers. The second
- botulinum and other toxins, causative agents of tularemia, glanders, melioidosis,
brucellosis, anthrax, Q fever. In areas where there are no specific vectors, the
causative agents of yellow fever, typhus, and Venezuelan equine encephalomyelitis
should be classified as non-contagious.

In terms of survival in the external environment, BS are divided into three

groups:

Low-resistance (1-3 hours) - causative agents of plague, Venezuelan equine

encephalomyelitis, yellow fever, botulinum toxins;

Relatively resistant (up to 24 hours) - pathogens of glanders, melioidosis,

brucellosis, tularemia, typhus, smallpox;

Highly resistant (over 24 hours) - pathogens of anthrax, Kulihoradka. In

most BSs, they are not sufficiently resistant to adverse environmental factors during
storage, transportation and combat use. Therefore, they can only be used in the
form of specially prepared biological formulations (BR). Each biological
formulation consists of three essential components: a biological agent, a nutrient
medium or its residues, on which the biological agent was grown and a stabilizing
additive (amino acids, sugar, polypeptides, etc.). Biological formulations can be
liquid or powder. Powdered formulation is more stable during storage, and liquid
formulation retains its properties quite well during combat use. The use of BS for
military purposes is denoted by the term biological warfare. In recent years, another
term associated with biological agents has taken root - biological terrorism.
Biological terrorism involves the implementation of the threat of deliberate,
conscious and purposeful use of pathogenic microorganisms at a particular
address. At the same time, acts of biological terrorism can be carried out both by
independently acting loners or groups of terrorists, and by entire organizations with
support at the state level.

There is an unconditional affinity between the problems of biological terrorism

and biological warfare. The latter is characterized as a large-scale, pre-planned use
of pathogens of infectious diseases (pathogens) and waste products (toxins) as a
means of affecting a population of people or part of it in order to deprive or
weaken their combat or efficiency, disorganize the command and control of troops
and the economy, which is generally intended contribute to the achievement of
strategic goals. Acts of biological terrorism are directed against individuals or
groups of people and mainly pursue the goal of intimidation and blackmail, not only
of the infected individuals themselves, but also of those around them.

Biological weapons have a number of features that distinguish them from other
weapons of mass destruction. The main features of the damaging effect of
BW include:

- selectivity of action (only on humans, on a certain species of animals, plants,

or on humans and animals);

- variability of action (the ability to vary the combat effect by choosing

different BS);

- the defeat of people, animals or plants in large areas;

significantly exceeding the area of ​damage by other types of weapons of

mass destruction;

- the ability of the BS, when it enters the body, to cause a pronounced disease
in the majority of unprotected personnel, ending either in death or in the loss of
combat capability;

- the ability of biological aerosol to penetrate into unsealed military equipment,

protective structures and buildings, with the subsequent defeat of the people there;

- manifestation of the damaging effect of BO after a certain interval - the

incubation period; - the duration of the damaging effect, depending on the ability of
some BSs to persist for a long time in the external environment or to cause
diseases transmitted from a patient to a healthy person;

- impossibility of detecting the moment of BS impact on the human body by

the sense organs; - the difficulty of establishing the moment of application, the
duration of the specific identification of BS and the difficulty of recognizing the
diseases that have arisen, especially in the case of using combined biological
formulations;

- the dependence of the damaging effect of BW on meteorological and

topographic conditions; - a strong psychological impact on people.

14.2. Technical means of biological attack

The conversion of biological formulations (BR) into a combat state is carried

out with the help of technical means of application, which, depending on the
method of transfer and design, can be of cassette and tank types.

The technical means of using the cluster type are based on the use of
small-caliber biological bombs (BBMK) of the explosive principle of action, which,
when triggered, form a cloud of biological aerosol. The ammunition is a cassette
with a large number of BBMKs (from several dozen to several hundred). Such
cassettes can be placed in the warheads of strategic, operational-tactical missiles,
combat compartments of cruise missiles, in aerial bomb bodies and in cluster
aircraft installations of strategic and tactical aircraft. The main structural elements of
the BBMK are: the body, which is at the same time a reservoir for the ballistic
missile, an explosive charge located in its center, a fuse and a stabilizing device.
The cassette is opened at a certain height and the BBMK is scattered. The BBMK
is triggered at the moment of impact on the ground or at a height of up to several
meters above the target surface, forming a cloud of biological aerosol. The
explosion is accompanied by a less harsh sound than conventional ammunition,
with the formation of a small, rapidly dissipating cloud of aerosol.

Tank-type technical means of application are various pouring and spraying

devices designed for dispersing BR. Tank-type ammunition (aircraft pouring or
spraying device) is a container from hundreds to several thousand liters, filled with
a biological recipe, equipped with an energy source (a gas cylinder or air flow
in-flight) necessary to displace the recipe from the container into the spraying
device. Tank-type biological munitions make it possible to create a BS aerosol
cloud at a certain height (about 100 m), which, while drifting and gradually settling,
is capable of infecting large spatial areas.

14.3. Tactics and methods of using biological weapons

The effectiveness of the BO depends not only on the destructive ability of the
BS, but also on the correct choice of methods of its use. There are the following
main ways of using BW: - aerosol - spraying of special compositions containing
BS for contamination of the surface layer of air with aerosol particles; -
transmission - dispersion of artificially infected blood-sucking arthropods in the
target area; - sabotage - BS contamination of air, water, food, fuels and lubricants
and other materials using sabotage equipment.

The aerosol method of application is considered the main one, since it

allows you to suddenly and covertly infect the air, terrain and personnel and military
equipment located there on large areas. Application of BO by aerosol method is
possible at any time of the day, however, according to foreign experts, effective
results should be expected under the following conditions:

- air temperature from minus 15 to plus 10оС; - average values ​of relative
humidity - from 50 to 85%; - wind speed from 1 to 8 m / s;

- lack of solar radiation and precipitation;

- at night or early morning hours (in the period 1 hour after sunset and 1 hour
before sunrise). When using BO using the aerosol method, the following options
are possible:

- spraying biological formulations over the target;

- spraying biological formulations at a distance from the target. In the first case,
visual detection of the fact of the use of BO by the enemy is likely. The most
preferable should be considered the second option, which involves the dispersion
of biological formulations from the windward side of the target area.

In this case, the sprayed formulation is transferred to the target area by moving
air masses. The probability of early detection of the fact of such use of BW may
turn out to be insignificant.

The transmission method of using BW consists in the deliberate spread of

artificially infected arthropod vectors in a given area, the delivery and distribution of
which can be carried out using entomological munitions (aerial bombs, special
containers). The method is based on the ability of many blood-sucking arthropods
to easily perceive, preserve for a long time and transmit through bites to humans or
animals pathogens of a number of dangerous infectious diseases (typhus, tularemia,
Q fever, yellow fever, encephalitis, etc.).

The sabotage method of using BW consists in the deliberate covert infection

of BS in confined spaces of air and water, as well as food and fodder. Air
contamination by sabotage can be carried out using portable nebulizers (aerosol
generators) in crowded places, at facilities of important state and military
importance, in places where elite troops are deployed, etc. Water can become
contaminated in plumbing systems and natural bodies of water.

According to modern concepts of waging wars and armed conflicts, the use
of BO by the enemy is possible both for solving operational-tactical and strategic
tasks.

To solve operational-tactical tasks, BO can be used both in the offensive and

in defense. At the same time, it is considered the most expedient to strike at the
second echelons and reserves of the group of forces, as well as at other
concentrations of troops.

When using BW for strategic purposes, the targets of attack can be strategic
reserves and training centers for their training, large ports and naval bases, railway
junctions, supply and unloading stations, military, industrial and administrative
centers, as well as agricultural areas.

14.4. The concept of the area (focus) of biological infection

When the enemy uses BW in the area of ​an explosion of ammunition or

dispersion of biological formulations, as well as along the path of movement of the
resulting primary aerosol and in the area of ​distribution of infected vectors, foci
(areas) of biological contamination arise. In addition, after the deposition of aerosol
particles as a result of dust formation due to wind, movement over contaminated
areas, etc. a secondary rise in the air of initially settled particles and the formation
of a secondary aerosol can occur. The danger of the contaminated area will depend
on the stability of the biological agent, meteorological conditions and the nature of
the terrain (relief, soil, vegetation).

Depending on the method of using BW, the focus (area) of biological

contamination is understood as:

- when creating an aerosol - the surface layer of the atmosphere containing

biological aerosol in damaging concentrations and the area over which the cloud
has passed, with troops, population, military equipment and various other objects,
as well as elements of the natural environment;

- when using infected vectors - the area of ​their distribution;

- for sabotage use - the object of sabotage.

Personnel in the infected area are considered potentially infected. Persons who
become ill as a result of penetration of a biological aerosol into the body are
considered affected. Depending on the sources of human infection, there are two
categories of sanitary losses: primary and secondary.

Primary sanitary losses in the BW focus are the affected ones resulting from
aspiration contamination with the primary aerosol. Secondary sanitary losses -
affected, which will appear as a result of aspiration contamination with a secondary
aerosol, when contaminated products or water are consumed, in contact with
infected objects or as a result of infection from patients with contact with infectious
diseases.

14.5. Fundamentals of biological protection of troops and stages of

medical evacuation

Biological protection (BP) is a complex of operational-tactical and special

measures carried out with the aim of minimizing the damaging effect of BO on
troops, naval forces and rear facilities, maintaining combat effectiveness and
ensuring the successful fulfillment of the tasks assigned to them.

Biological protection is an integral part of the personnel protection system

against weapons of mass destruction (WMD), which is an element of combat
support. BZ is carried out in all subdivisions, units (ships), formations and
formations constantly, in any conditions of activity and includes measures:

- carried out in peacetime;

- carried out during the period of the threat of the use of the enemy by the
BO;

- for the protection of personnel at the time of the use of BO;

- to eliminate the consequences of the use by the enemy of BO.

Operational-tactical measures are common in defense against nuclear, chemical and
biological weapons. With regard to BW, they include:

- timely detection of the enemy's preparation for the use of BW;

- dispersal of troops and periodic change of deployment areas, preparation of

routes for maneuver;

- the use of protective and masking properties of the terrain;

- engineering equipment of occupied areas and positions;

- notification of an imminent threat and the beginning of the enemy's use of BO;

- identification of the scale and consequences of the use of BW;

- ensuring the safety and protection of personnel when operating in the focus
of biological contamination;

- elimination of the consequences of the use of BW. The list of special

measures includes:

- biological prospecting, assessment and forecasting of the biological

environment;

- assessment of the sanitary and epidemic state of troops and combat areas;

- special treatment of troops and disinfection (disinsection) measures;

- emergency and immunoprophylaxis;

- isolation measures (observation, quarantine);

- sanitary and anti-epidemic measures;

- veterinary and sanitary measures;

- medical and evacuation measures.

The general leadership of defense organizations against BW is carried out by

the commander (commander). Military units carry out BZ activities with their own
forces and means. If necessary, the front (army) allocate additional forces and
means to strengthen the units for the period of eliminating the consequences of the
use of BO. In addition to medical events, other services and special troops take
part in carrying out special events: radiation, chemical and biological protection
troops (RCBP), engineering troops, food and material service, veterinary and
sanitary service.

The RChBZ troops are entrusted with:

- carrying out non-specific biological reconnaissance with the selection of

samples from objects of the external environment and their delivery to sanitary and
epidemiological institutions;

- disinfection of weapons, military equipment, property, terrain, roads and

structures, as well as impersonal protective equipment and uniforms;

- identification of the scale and consequences of the use of BW;

- participation in the sanitization of personnel who find themselves in the area

of ​the BZ;

- provision of personnel with personal protective equipment for the

respiratory system and skin.

The engineering troops (service) are responsible for the equipment and
protection of water supply points, as well as for the disinfection of drinking water.

The food service is responsible for protecting food stocks, food items,
kitchen equipment and inventory (if necessary, decontaminating them).

The clothing service is responsible for providing the troops with an

exchange fund of linen and uniforms, organizing bath and laundry support,
including participation in full sanitization, as well as impregnating linen and
uniforms.

The veterinary and sanitary service is responsible for participation in

biological prospecting, veterinary and sanitary examination of meat and other
products of animal origin that have been contaminated, specific identification and
implementation of anti-epidemic measures among domestic animals in the area of
​biological contamination.

The medical service is responsible for:

- conducting sanitary and epidemiological reconnaissance with an assessment

of the sanitary and epidemiological state of troops and combat areas, immunization
and emergency prophylaxis, specific indication;
- carrying out sanitary and anti-epidemic measures, including complete sanitization
of the wounded and sick, disinfection at the stages of medical evacuation, as well
as in epidemic foci resulting from the use of BW;

- implementation of sanitary and epidemiological examination of water and

food, supervision over the conditions of accommodation, food, water supply and
bath and laundry services for troops;

- training of personnel in preventive measures in conditions of biological

contamination;

- provision of personnel with medical protective equipment.

14.6. Peacetime Measures to Protect Troops from Biological Weapons

To ensure the constant combat readiness of troops and their reliable

protection from BO in peacetime, measures are being taken to prepare for the BZ.
For this purpose, combat and special training is carried out in all units (formations),
on ships, in units and institutions of the rear, in the process of which a high degree
of training of troops is developed to quickly and efficiently carry out the necessary
BZ measures. The training of troops on the BZ (regardless of the nature of the
activity) is carried out by the commanders of the subunits and includes the study of
the striking properties of the BO and the methods of its use, familiarization with the
external signs of the use of the BO by the enemy, the development of skills in the
use of individual and collective means of protection, the study of the rules of
behavior in the OBZ, actions personnel during observation and quarantine, the
procedure for carrying out partial and complete special treatment, the rules for the
use of emergency prophylaxis, training in the rules for the prevention of infectious
diseases, the causative agents of which can be used as BS.

Special training of the medical service is carried out for differentiation, in

relation to different categories of personnel and provides for:

- study of the combat properties of BW, methods of its use, characteristics of

the damaging action and means of protection against it;

- study of methods for assessing and predicting the biological environment;

- mastering the methods of carrying out vaccinations by methods of mass

immunization;

- mastering the methods of specific indication;

- study of the features of the clinic, diagnosis, treatment and prevention of

infectious diseases arising from the use of BW;

- study of the features of medical triage, methods of providing medical

assistance to the affected, medical and evacuation measures in the conditions of the
enemy's use of BW;

- mastering the methods of sanitization at the stages of medical evacuation

and disinfection of uniforms, equipment, footwear, medical and sanitary property
and sanitary equipment;

- study of the order of deployment and the peculiarities of the work of the
stages of medical evacuation in a strict anti-epidemic regime;

- studying the issues of organizing events in the troops during observation

and quarantine.

In addition, on a national scale, the threat assessment and forecasting of the

possible consequences of the use of BW are carried out, the collection, synthesis
and analysis of data and the capabilities of various countries in the development
and production of BW elements, a complex of research and development work to
improve measures, forces, means and methods of protection against BW and
prevention of emergencies in peacetime (accidents at biologically hazardous
facilities, outbreaks of epidemics, etc.).

14.7. Measures to protect troops from biological weapons carried out

during the period of the threat of a biological attack
Measures carried out in units during the period of the threat of the use by the enemy
of BW are carried out with the aim of ensuring the maximum readiness of the
troops for defense against it and ensuring the fulfillment of the assigned tasks in the
event of its use.

The main features characterizing the threat of the enemy's use of BW are:

- the beginning of work on undocking some warheads from carrier rockets

and replacing them with others;

- enhanced sounding of the atmosphere;

- Carrying out mass vaccination of personnel;

- the supply of biological ammunition to the positional areas of the missile

forces and to tactical aviation airfields;

- additional equipment of positions and shelters, strengthening of their sealing,

installation of filtering and ventilation units;

- additional provision of enemy formations and units with protective

equipment.

The effectiveness of protection during this period is determined primarily by

the timeliness of identifying the enemy's capabilities to use BW and alerting troops
about the threat of biological contamination. During this period, the command and
staffs plan and implement measures to protect against BW, including the
appropriate operational and tactical measures, and the special forces and services
bring their forces and resources into immediate readiness to eliminate the
consequences of its use.

At the same time, it is envisaged for medical units and institutions:

- ensuring the work of all stages of medical evacuation in a strict

anti-epidemic regime;

- readiness to receive and treat wounded and sick from the focus of biological
contamination (OBZ) in the medical department with a temporary cessation of
further evacuation;

- constant readiness of laboratories to carry out specific indication of BS;

- the creation of stocks of medical equipment necessary for the provision of

medical care to the wounded and sick from health protection facilities,
disinfectants, as well as an exchange fund for uniforms and linen for the stages of
evacuation.

Sanitary and epidemiological reconnaissance and surveillance are carried out

with the aim of early detection of the covert use of BW, which is achieved by
analyzing changes in the sanitary and epidemiological state of troops in comparison
with the data of previous observations and makes it possible in some cases to
differentiate between natural and artificial morbidity. The participation of the 459
medical services in biological reconnaissance is reduced to the analysis of
intelligence data revealing the enemy's intentions to use BW. To this end, various
documents and materials seized from the enemy (including medical ones) are
studied, anti-epidemic measures carried out by the enemy's medical service
(including the immunization scheme) are analyzed, special equipment available to
the enemy (biological drugs and special-purpose medicinal products) are studied. ).

Immunoprophylaxis of personnel is carried out according to the routine

vaccination scheme for wartime, which can be supplemented by vaccination for
epidemic (combat) indications.

14.8. Measures to protect troops during the use of BO

Detection of the fact and method of the enemy's use of BW is made by

observation posts (points), observers of all branches of the armed forces and
special forces, air and ground reconnaissance units, units of the RChBZ troops, as
well as with the help of other observation equipment. T he main methods of
detecting the fact of the use of BW (non-specific indication) are:
- collection and analysis of external (indirect) signs of the use of BW by the
enemy;

- registration and signaling of signs of biological air contamination using

automatic devices for non-specific biological intelligence;

- sampling from environmental objects (soil, vegetation, water, washings from

equipment, etc.), presumably contaminated with BS, using specialized kits by the
forces of the NBC protection troops.

The headquarters organize the notification of the units about biological

contamination. It is carried out with a view to the immediate use of protective
equipment by personnel and is carried out out of order by all means of
communication with a single, constantly operating signal. In subdivisions, personnel
are alerted, in addition, by voice, sound or light signals.

At the signal of a biological attack, the personnel use individual and collective
technical means of protection.

Individual technical means of protection against BW include filtering,

insulating gas masks and skin protection equipment (combined arms protective kit -
OZK, light protective suit - L-1, combined arms complex protective suit - OKZK,
etc.). When operating in conditions of possible formation of a secondary biological
aerosol, a respirator P-2 can be used.

Collective technical means of protection include mobile objects (military

equipment) and fortifications with special equipment that allows personnel to stay
or operate in them without the use of personal protective equipment.

To protect personnel from BW, field shelters (ceilings, cracks, dugouts) and
engineering-prepared basements, residential and office premises are also used.
They do not completely protect against biological aerosol, but depending on the
degree of air exchange in them, to one degree or another, they provide a decrease in
the concentration of BS in the air of the object.
When the enemy uses infected vectors, properly fitted and worn uniforms, personal
skin protection and a gas mask protect from their bites. Repellents are effective
means of protection against vector attacks.

To reduce the damaging effect of BW, personnel must:

- during the passage of a cloud of biological aerosol, being in personal

protective equipment, strictly observe the rules for their use and, if the combat
situation allows, widely use various types of shelters as additional means of
protection;

- after passing through the aerosol cloud, at the command of the commander,
leave the shelters, carry out partial special treatment, take means of general
emergency prevention and strictly observe the rules of conduct in the contaminated
area. In the OBZ, it is forbidden to take off personal protective equipment, drink,
smoke, eat, touch contaminated objects unnecessarily, sit down and lie down on
the soil if it has not been previously disinfected.

14.9. Measures to protect personnel during the elimination of the

consequences of a biological attack

Elimination of the consequences of the enemy's use of BW begins

immediately after the fact of its use is established and is carried out, as a rule, by
the forces and means of the units (formations) themselves. Measures to eliminate
the consequences of the use of BW include special treatment of troops and
disinfection (disinsection) of the terrain, roads and structures, uniforms, protective
equipment, weapons and military equipment, emergency prevention and
vaccination, isolation and medical evacuation measures, and specific indication.

Special treatment of troops in the centers of biological contamination

consists in disinfection of weapons and military equipment, uniforms, equipment,
footwear, personal protective equipment, ammunition and other materiel, including
medical property, and, if necessary, in the sanitization of personnel. Special
processing of troops in OBZ can be partial or complete.
Partial special treatment at the direction of the subunit commander is carried out
by personnel in the course of a combat mission. It includes partial disinfection of
open areas of the skin (face, neck, hands) of a person, protective equipment,
personal weapons and military equipment.

Full special treatment is carried out at the command of the unit commander,
as a rule, after the completion of the combat mission, as well as after the subunits
leaves the battle. It is carried out in occupied areas, on traffic routes, as well as in
areas of special treatment (RSO), which are assigned, if possible, on
non-contaminated terrain. It includes the full disinfection of weapons, military
equipment and ammunition, all material resources, and, if necessary, sanitization
(sanitization may not be carried out if the personnel at the time of use of the BS was
in sealed facilities). Responsibility for the organization and high-quality
performance of special treatment is assigned to the commanders of units and
formations, and the direct management of the work is carried out by the
commanders of the subunits in accordance with the requirements of the Manual for
special treatment in subdivisions. The medical service is responsible for the
methodological management of these activities, quality control of disinfection,
sanitary and epidemiological examination of food and water before and after
disinfection, as well as the direct implementation of the entire range of measures to
eliminate the consequences of the use of BW at the stages of medical evacuation
and medical support of units in the OBZ. In order to ensure the conditions for the
fastest elimination of the consequences of the use of BO by the enemy in units
(formations) subjected to a biological attack, the command introduces observation
and quarantine.

Observation is a complex of restrictive and sanitary and anti-epidemic

measures aimed at localizing and eliminating infectious diseases of the heart of
personnel exposed to the risk of BS infection, and preventing the spread of
infection outside the observation area.

Observation is established by order of the commander of the unit (formation)

when it is established that the enemy has used BW or when there are massive
infectious diseases of the same type among the personnel of the same type of
unclear etiology. During observation, the units continue to perform combat
missions.

Observation restrictive measures include:

- limitation of communication between the personnel of various units, as well

as with the personnel of neighboring units and the population;

- restriction of exit, entry and transit passage through the observation area and
the removal of weapons, military equipment and materiel from it without their
preliminary disinfection;

- compliance by personnel with the established rules of conduct in the hearth.

Sanitary and anti-epidemic measures during observation include:

- enhanced medical supervision of personnel, active identification of the

affected or suspected to be affected by BW, their isolation and the conduct of
disinfection and other measures;

- the introduction of a strictly anti-epidemic mode of operation of the stages of

medical evacuation, the prohibition of evacuation outside the Omedb until the type
of BS used is established;

- strengthening supervision over the organization of food and water supply;

- carrying out general emergency (special) prophylaxis;

- vaccination or revaccination (according to indications).

In the case of the use of pathogens of non-contagious diseases or toxins,

restrictive measures are canceled after complete sanitization and disinfection.
Sanitary and anti-epidemic measures continue to be carried out taking into account
the characteristics of the infection until the expiration of the maximum incubation
period of the disease, calculated from the moment of isolation of the last patient
and the implementation of decontamination measures. In the event that the enemy
uses pathogens of especially dangerous infections or when these diseases appear in
the affected person, as well as when the personnel of the same type, unclear in
etiology, diseases that are widespread epidemic and threaten the combat
effectiveness of troops are detected, observation is replaced by quarantine.

Quarantine is a complex of regime and sanitary and anti-epidemic

measures aimed at complete isolation of the focus and the elimination of
infectious diseases in it.

Quarantine is established by an order of the commander of the front (army)

forces, which determines the procedure for further use of the quarantined units
(formations). During quarantine, the restrictive measures carried out in the unit are
additionally strengthened by the regime ones, which include:

- armed guards and cordoning off the quarantine area;

- prohibition of leaving the quarantine area and strict restriction of entry into
it;

- maximum separation of personnel;

- organization of a special commandant service;

- supply of parts through transshipment points (platforms).

Sanitary and anti-epidemic measures in quarantine additionally provide for

mandatory daily double thermometry, which in time can be combined with special
emergency prophylaxis.

The duration of quarantine is set in accordance with the maximum incubation

period of the disease and is calculated from the moment of isolation of the last
patient and the final disinfection in the outbreak.

Emergency prophylaxis in foci of biological infection is divided into general

and special.
General emergency prophylaxis is carried out to all personnel of units and
formations who find themselves in a focus of biological infection with a
broad-spectrum antibiotic, which is in the individual first-aid kit of each serviceman.
The duration of the course of general emergency prophylaxis is determined by the
time required for isolating, identifying and determining the sensitivity of BS to
antibiotics, and in the absence of such data, it takes at least 5 days

Table 12.1.
General emergency prophylaxis regimens

Average
Continue
Way dose for
One-ti Multiplicity strength
A drug example dose, well
g application reception,
nenia prophylactic
days
tics, g
Doxycycline Inside 0.1 * 2 5 1.0

Tetracycline Also 0.5 ** 3-4 5 7.5-10.0

Rifampicin Also 0.3 2 5 3.0
Pefloxacin Also 0,4 2 5 4.0

Note: - on the first day of the course 0.2 g (2 capsules or tablets, 0.1 g
each, on the following days, 0.1 g each (1 capsule or tablet 0.1 g each) of
doxycycline per dose.
Special emergency prophylaxis is carried out to all personnel of parts and
connections after the species identification of the biological agent has been
established and its sensitivity to antibiotics has been determined. The transition
from general to special emergency prophylaxis provides for continuity in the timing
and doses of prescribing drugs if the selected agents are sensitive to the drug that
was used as a means of general emergency prophylaxis. Depending on the nature of
BS, the duration of the course of special emergency prophylaxis can be 10-12
days. Immunoprophylaxis of personnel as a biological protection measure is
carried out in the event of a threat of the enemy using BW or during the elimination
of the consequences of its use, for which drugs are used that ensure the
development of immunity in a relatively short time (plague, natural smallpox, etc.).
14.10. Features of the work of the mpp and medb in the conditions of the
use of biological agents

Medical care for the affected BW, the wounded and the sick is organized
taking into account the work of the stages of medical evacuation in a strict
anti-epidemic regime.

At the regiment's medical station, a strict anti-epidemic regime provides

for:

- restructuring the operation of the medical center, taking into account the
separate implementation of all necessary medical and evacuation measures in
relation to two streams:

affected by BW, as well as wounded and patients with suspected BW

damage; the second stream - wounded and sick without signs of BW damage, at
risk of infection;

- medical sorting of all applicants, with the allocation of these two streams,
partial sanitization of all applicants;

- disinfection of vehicles that brought the injured, wounded and sick from the
outbreaks, as well as stretchers and other sanitary and economic property on the
vehicles; - increasing the capacity of insulators for affected BW, as well as
wounded and patients with suspected BS damage;

- putting on the patient with signs of respiratory injury of the simplest

cotton-gauze respirators;

- Carrying out (continuation) of emergency prophylaxis for all applicants, as

well as for the WFP personnel;

- the use of protective equipment for the respiratory system, eyes and skin by
the medical personnel, their compliance with the established behavior regime, as
well as other safety measures that exclude its infection or spread of infection during
the provision of medical care and care;

- entry in the primary medical card of information about the stay in the
outbreak;

sanitization and emergency prevention, leaving a black strip - "isolation";

- separate evacuation of the affected BW (suspicious for defeat) from the

wounded and sick from the BO focus, but without signs of damage. In the medb,
the strict anti-epidemic regime also provides for:

- the deployment of an isolation department in accordance with a special

scheme and the redistribution of personnel and property to functional units;

- temporary for 2-3 days (until the type of BS is established) termination of

discharge and evacuation outside the medical hospital;

- placement and provision of medical care to those affected and suspected of

being affected by BW in the isolation ward, to the rest of the wounded and sick
from the outbreaks - in other functional units;

- active early detection of the affected among the wounded, sick and medical
personnel, their transfer to the isolation ward, as well as the implementation of the
necessary anti-epidemic measures;

- Carrying out a complete sanitization of all incoming wounded and sick; -

carrying out current and final disinfection in all functional units.

The evacuation of the injured, wounded and sick and the medical department
is organized by the decision of the head of the front medical service, taking into
account the results of a specific indication. Upon detection of pathogens of
non-contagious diseases, MPP and medb switch to the usual anti-epidemic mode
of operation, and medical and evacuation measures are carried out according to the
generally accepted scheme.

When pathogens are detected, a separate evacuation direction is created and a

group of hospitals is allocated, the profile and bed capacity of which, as well as the
necessary forces and means of reinforcement, are determined by the magnitude
and structure of sanitary losses.

14.11. Biological prospecting and indication of biological agents

Biological reconnaissance (BR) - a set of measures carried out by the

command with the involvement of intelligence units of the combat arms and
individual services, to identify and collect all types of information about the
preparation and use of the enemy by the enemy, including establishing the fact and
determining the type of biological damaging agents used, as well as notification of
biological contamination.

The organization of the BR, as well as the intelligence of other weapons of

mass destruction, is a constant duty of all commanders and staffs. The direct
organizers of the BR is the headquarters, which implements it through the head of
the RHBZ service and the medical service in their part.

The main tasks of biological reconnaissance are:

- detection of the fact of the use of BO by the enemy;

- Establishing a method for using BS, the boundaries of the contaminated area
for predicting and assessing the biological situation;

- sampling for research and confirmation of the fact of the use of BW by the
enemy.

Detection of the fact and method of the enemy's use of BW is carried out by
observation posts (points) of all branches of the armed forces, special forces,
ground and air reconnaissance units, and subunits of the RChBZ troops based on
external signs: less harsh sounds of ammunition explosions with the formation of
clouds, fog or smoke at the surface of the earth; the appearance of a rapidly
disappearing strip of fog or smoke behind the enemy aircraft or along the path of
the movement of balloons; drops of a cloudy liquid or a coating of powdery
substances in places of ammunition explosions, on objects of military equipment
and the environment; clusters of insects, ticks and corpses of rodents, unusual for
the given area, near the fall of bombs and containers. The detection of the fact of
the use of BW is also carried out by intelligence units of the RChBZ troops and
special laboratories (LMP-V, LMP, etc.) of the medical (veterinary and sanitary)
service, equipped with automatic devices of nonspecific biological reconnaissance
(ASP), which provide detection within 1-2 minutes in air of BS aerosols without
determining their species. At the same time, the medical service conducts
reconnaissance and sampling from objects of the external environment, materials
from sick people, food and water at all stages of medical evacuation, as well as in
places of deployment of medical institutions of army and front-line subordination.

Data on the fact that the enemy is using BO is immediately transmitted to the
higher headquarters, which alerts the troops.

The most important component of the BR is the indication, which includes:

- Nonspecific indication (nonspecific biological intelligence), the task of

which is the timely establishment of the fact that the enemy is using BW;

- taking samples and delivering them to the laboratories of the medical and
veterinary and sanitary services;

- specific indication (biological control), the main task of which is to confirm

the fact of using BW, to determine the species (identification) and to identify
special properties (resistance to drugs, etc.) of the applied biological agents.

When an ASP of BS aerosols is detected in the air or when external signs of

the use of BW by forces and means of the RChBZ troops, medical and
veterinary-sanitary services are detected, samples are taken for specific indication.

The RCHBZ troops take samples of air, shells and contents of biological
ammunition, as well as samples from the surfaces of weapons, ammunition,
vegetation and other objects suspicious of BS infection.

The medical service carries out the selection of materials from infected and
sick people, the collection of arthropod vectors and rodent corpses, and also takes
samples of food, water and other objects of the external environment suspicious of
infection.

The Veterinary and Sanitary Service selects materials from infected and
sick farm animals, collects arthropod vectors, corpses of rodents, as well as
samples of forage, raw materials and products of animal origin suspicious of BS
infection of environmental objects.

First of all, air samples of the surface layers of the atmosphere, fragments of
biological ammunition and washings from mucous membranes and skin of people
who are in the zone of biological aerosol without protective equipment are taken as
the most representative.

Sampling for a specific indication of the BS is carried out using standard tools
- aerosol samplers automatically coupled with ASP devices, kits for sampling on
the ground of the RChBZ troops, a microbiological KOPM sampling kit and a
medical chemical reconnaissance device (MPHR), containing the necessary tools
for sampling in sealed container.

All samples taken should be immediately (no later than 1.5-2.5 hours from the
moment of taking the material) sent to the nearest sanitary and epidemiological
institution on a specially designated transport.
In order to avoid infection, the sampling and delivery of samples to the laboratory
should be carried out by personnel in gas masks (respirators) and protective
clothing (skin protection). Collecting insects, ticks and dead rodents can be carried
out in ordinary or insecticide-impregnated clothing, but with the obligatory
observance of personal safety measures: rubber gloves, collars and cuffs are tightly
tied with ribbons on the hands, the jacket is tucked into trousers tightened with a
belt and a belt. The face and neck are protected with a Pavlovsky mesh treated with
repellents. To prevent infection of persons delivering samples to the EEC, each
container with samples from the outside is treated with disinfectants.

Samples are sent to the SEU along with accompanying documents: direction
and report (cover note). The direction indicates: where and to whom the sample is
sent, what it is (from which objects of the external environment it was taken); time
of sampling and their number in a common container; the desired scope of the
study (in a reduced or full amount of indication); the address to which the results of
the specific indication of the BS should be reported.

The report (accompanying note) must indicate the exact information about the
place of sampling (the area of ​the location of the troops, the settlement, etc. must
be oriented on the map); the time and method of using the enemy by the enemy; the
basis for sampling (the presence of general external signs of the use of BW, the
results of nonspecific indication, the sudden appearance of patients, etc.); results of
the survey of the area (sampling site) for OM (time of the survey, in case of a
positive result and concentration of OM, etc.).

Both documents are drawn up in duplicate, one is sent along with the samples
to the laboratory, the second (copy) remains with the person who sent the sample
for research. Samples, along with accompanying documents, are sent to the
laboratory by courier, observing all precautions.

14.12. Specific indication

Specific indication is a set of special measures carried out by medical and

veterinary and sanitary services to confirm the fact of using BW (with positive
results of non-specific indication) and to determine the type of biological agent. Its
implementation is entrusted to: - laboratory subdivisions of the SEU of armies,
fronts, military districts, fleets, hospital bases and other equal laboratory
subdivisions of sanitary and epidemiological institutions of the armies and the front;
- at the laboratory of veterinary and epizootic units and other institutions of the
veterinary and sanitary service. Microbiological laboratories of infectious diseases
hospitals and research institutions of the country can be involved in specific
indication. Taking into account the peculiarities of modern military operations,
which lead to frequent relocations of sanitary and epidemiological institutions, and
the need for a phased sequential study of samples in various laboratories, the
organization of a specific display of BS provides for strict adherence to the
principle of continuity in work.

The principles of continuity in the work of laboratories presupposes:

- uniform sampling methods; - uniform research methods and analysis

scheme; - general unified (continuous) numbering and designation of sample
materials;

- obligatory for all laboratories carrying out specific indication in a reduced

volume, sending in the shortest possible time at least 2/3 of each sample to the SEO
of the Army Medical Department and (or) the SEA of the front, ensuring the study
of the samples in full.

Continuity in work also provides for the possibility of sending test samples (in
the form of primary crops or infected animals) to other laboratories for further
analysis.

The specific indication of BS is based on the methods of laboratory rapid

analysis of samples using the method of fluorescent antibodies (MFA) in direct or
indirect modification with contrasting nonspecific fluorescence with albumin labeled
with rhodamine derivatives, enzyme-linked immunosorbent assay (ELISA) or
indirect hemagglutination reaction (RNGA) according to a single scheme , which
provides for two complementary research stages: - the first stage - detection of BS
using express methods directly in the native sample without its biological
enrichment; - second stage - detection and identification of BS after preliminary
biological enrichment of samples by accumulation of pathogens on nutrient media
and cell cultures, as well as in organs and tissues of sensitive laboratory animals.

The listed methods are not the only ones used for express analysis. In
microbiological laboratories, various modifications of ELISA and polymerase chain
reaction (PCR) are widely used. As the laboratories are saturated with the
appropriate technical and reagent means for SI BPA, you can use ELISA (for
mobile medical complexes - only membrane filtration point dot-ELISA) and PCR.
First of all, the following are subject to research: - air samples; - content and
fragments of biological ammunition; - washings from the nasopharynx of people
who find themselves without protection in the zone of passage of the aerosol cloud;
- materials from people who suddenly fell ill.

Combining these samples is not allowed.

Specialists of sanitary and epidemiological laboratories of compounds (and

their equals) participate mainly in a dignity. epid. reconnaissance, collection and
sorting of samples and ensure their transfer, respectively, to the SEO of the army,
front or TsGSEN of military districts, army or front for specific indication.

Sanitary and epidemiological units of the army, front, Central State Sanitary
and Epidemiological Service of military districts and fleets, as a rule, carry out an
indication of the BPA in volume.

First of all, SI should be subjected to samples for the content of BPA in them
that are most dangerous for personnel (high degree of contagiousness, short
incubation period, stability in the external environment). In this case, the causative
agents of plague, anthrax, smallpox and some hemorrhagic fevers (Lassa, Ebola,
etc.), as well as botulinum toxin, are subject to identification. Subsequently, the
causative agents of tularemia, brucellosis, glanders, melioidosis, Q fever, epidemic
typhus, Venezuelan equine encephalomyelitis, fevers of the Rift Valley and the
West Nile, psittacosis, and staphylococcal enterotoxin are subject to SI.

The scope of research, depending on specific conditions, can be determined

by changing the list of types of BPA to be identified and the number of stages of
sample analysis.

With the strengthening of the laboratories with the necessary forces and
means, the scope of research can be expanded to conduct SI in relation to other
causative agents of dangerous infectious diseases (eastern and western equine
encephalomyelitis, Dengue fevers, Machupo fevers, Argentinean and yellow fevers,
Crimean-Congo hemorrhagic fever, Japanese encephalitis, etc. ), as well as ricin
and saxitoxin toxins.

Depending on the stage and results of the study, the answers given by the
laboratory may be preliminary and / or final.

A preliminary answer is issued only on the basis of positive results of the

study of native sample materials (4-12 hours). The laboratory does not issue a
negative preliminary answer based on the results of the study of the native material
of the sample.

The final answer about the presence of BS in the sample (48-72 hours) can be
given by the laboratory when, using the MFA and RNGA, positive results of the
study of biologically enriched samples (positive results of the bioassay for
botulinum toxin).

A final negative answer is given only on the basis of repeated negative results
of the study at the first and second stages of the analysis, as well as a complete
microbiological analysis carried out in accordance with classical research methods.

Techniques and methods of complete (classical) microbiological analysis are

lengthy and laborious, since they involve the mandatory isolation of a pure culture
of the pathogen and its identification. As a rule, in laboratories of the military
medical service, they are not used for specific indication of BS.

14.13. Operating procedures of institutions conducting specific

indication

Successful indication of bacterial agents requires not only knowledge of

schemes and research methods, but also a clear organization of the work of
laboratories performing the indication. In the context of the use of biological
weapons by the enemy, the unified organizational principles of conducting
indicator studies provide for:

- the formation in laboratories of certain working groups that ensure the main
stages of research;

- equipment and assignment of equipped workplaces to each functional group;

- determination of the procedure for deploying laboratories in the field for
indication according to reduced or expanded schemes;

- observance in the laboratory of an operating mode that meets the

requirements of work with pathogens of especially dangerous infections.

All samples entering laboratories should be considered suspicious of

contamination with DOP pathogens. To prevent the spread of infection outside the
laboratory, internal regulations should be developed and laboratory security
established during non-working hours. To work in the laboratory are allowed
persons who have mastered the mode of operation, notified of their responsibility
for its exact observance and must be vaccinated against the most dangerous and
highly infectious microorganisms (plague, smallpox, tularemia, cholera, Venezuelan
equine encephalomyelitis, Q fever), as well as against botulism. The list of
infections for which vaccination is carried out may be supplemented depending on
the likelihood of using a particular pathogen as a means of biological attack.

The personnel of the laboratories must be fully provided with the necessary
protective clothing (protective suit, gowns, gloves, etc.). All personnel at the
entrance to the laboratory must take off their outer clothing and put on protective
clothing.

It is prohibited to remove all types of equipment, inventory, linen, materials

from the laboratory without the permission of the head of the laboratory and
appropriate disinfection. In the premises where samples are analyzed and
processed, as well as work with infectious material and infected animals, there
should always be a disinfectant solution in an amount sufficient for consumption
during the day.

At the end of the research (at the end of the working day), it is strictly
forbidden to leave non-disinfected samples, cups and test tubes with inoculations,
unfixed smears and other infectious material, as well as dishes with nutrient media
prepared for inoculation, signed, but not inoculated at the workplace. All material to
be stored at the end of the work must be removed to the appropriate places
(refrigerator, thermostat, safe) and sealed or sealed. All entries in the documents
accompanying the sample, work journals and protocols are made with a graphite
pencil, then the paper is disinfected. At the end of the working day, under the
supervision of a responsible employee, the laboratory premises are wet cleaned and
laboratory tables, objects and utensils are treated with disinfectant solutions.

When the laboratory is closed down and relocated to a new area, it is

necessary to completely decontaminate the place where it was located.

The materials presented in the chapter indicate that in some respects biological
weapons are more dangerous than nuclear weapons, since they do not require a
colossal waste of financial and scientific resources. Almost all countries, including
small and developing countries, can have access to this type of weapon, which can
be produced very inexpensively, quickly and secretly in small laboratories and
factories. This fact in itself makes the problem of control and inspection more
complex. The latest events in the United States in 2001, when anthrax spores were
repeatedly found in mail sent by bioterrorists, convincingly confirm the fact of the
real threat of using biological weapons both as a strategic weapon and in the form
of biological attacks. These circumstances dictate the urgent need for a serious
study of the damaging properties of BW and methods of biological protection
against it.

Control questions:

1. What is the basis of the destructive effect of BW?

2. By what parameters are BSs classified?

3. What are the ways of using BW and types of biological weapons?

4. List the main features of the destructive effect of BW.

5. Give the definition of an area (focus) of biological contamination. 6.

Decipher the concepts of primary and secondary sanitary losses during BW. 7.
Outline the list of operational and tactical measures carried out in relation to BW.

8. Outline the list of special measures to be carried out in the conditions of

BW application.

9. What services, besides the medical one, take part in the organization of the
military personnel defense and their tasks?

10. List the main activities of the knowledge base that are assigned to the
medical service.

11. List the main activities that are carried out in the troops in the BZ system in
peacetime.

12. List the main activities that are carried out during the period of the threat of
a biological attack.

13. List the main activities that are carried out during the period of BO
application.
14. List the main activities that are carried out during the elimination of a biological
attack.

15. Outline the list of restrictive (regime) and sanitary and anti-epidemic
measures during observation and quarantine.

16. Outline the procedure and means of general emergency prevention.

17. State the content of non-specific indication and sampling rules.

18. State the content of accompanying documents for samples sent for
specific indication.

19. Outline the order and scheme of the specific indication of the BS.

20. Outline the procedure for the laboratories performing specific indication.

Chapter 15.SITUATIONAL ISSUES

PROBLEM No. 1
Determine the required air exchange in a ventilated shelter for 5 wounded
soldiers.
PROBLEM No. 2
A ventilated shelter with an area of ​50 m2 and a height of 3 m is expected to
accommodate 96 soldiers. Calculate the frequency of air exchange, ensuring the
concentration of CO2 in the shelter is not higher than 1%.
PROBLEM No. 3
At what speed should atmospheric air enter the ventilated shelter, in which
there are 24 soldiers, with a ventilation opening area of ​0.05 m2 and a CO2 content
of 0.4˚ / oo (ppm).
PROBLEM No. 4
Determine the minimum volume of an unventilated shelter for 4 soldiers per
hour with an initial CO2 content of 0.6% (or 6˚ / oo).
PROBLEM No. 5
For how long can 10 wounded soldiers be accommodated, if the volume of
the unventilated shelter is 240 m3, and the initial CO2 content is 1% (10˚ / oo).
SITUATION PROBLEM No. 6
For the unit engaged in the construction of a special facility in the taiga, a mine
well was opened and equipped in accordance with sanitary rules. The well is fed
from an aquifer lying at a depth of 7 m. The flow rate of the water source is
sufficient. There are no possible sources of soil contamination in the surrounding
area. Swamps begin 0.5 km from the property. The analyzes of two water samples
from the well, taken at intervals of 7 days, carried out on the basis of the regional
Center for Hygiene and Epidemiology, showed the following: transparency - 30 cm,
color - 50 °, smell and taste - woody by 2 points, pH - 6.2, ammonia nitrogen -
0.5-0.7 mg / l, nitrite nitrogen - 0.3 mg / l, oxidizability - 10-11 mg / l О2, chlorine
ion - 15-18 mg / l, total hardness - 1, 5 mEq, iron - 0.1 mg, thermotolerant coliform
bacteria - 15.
Questions: 1. Assess the quality of the water and suggest, if necessary, the
type, method and means of its treatment.
SITUATION PROBLEM No. 7
The subdivision serving the communication point located on an island in the
delta of a large river uses water from a mine well located 120 m from the nearest
shore. The walls of the well are made of cement rings. Its head rises 45 cm above
the ground level. There is no clay castle and no paving around the well, and there is
no shed either. Water rises from the well with a special bucket. During periods of
rising water in the river (flood, heavy rains), the well fills. The soil of the island is
sandy. The water in the well is not disinfected.
Questions: 1. Assess the water supply and make suggestions for improving its
condition.
SITUATION PROBLEM No. 8
The military town is supplied with water from an artesian well (depth - 120 m,
flow rate - 30 m3 / h, pump capacity - 5 m3 / h). The population of the town is 300
people. Due to power outages, there are interruptions in the water supply to the
water supply network, especially at night. According to laboratory studies, the
water in terms of physical and chemical parameters meets the requirements of
SanPiN, but the number of total coliform bacteria in it is 6.
Questions: 1. Give an assessment of the existing water supply and make
suggestions for its improvement.
SITUATION PROBLEM No. 9
The water received from the artesian well No. 1, located on the territory of the
military camp, meets SanPiN in terms of physical, chemical and bacteriological
indicators. However, in the last 2 weeks, the following phenomena began to be
observed: water, 2-3 hours after rising, acquires a yellow-brown color, becomes
cloudy, and flakes are formed in it.
Questions: 1. Determine the reasons for the deterioration of water quality and
make appropriate recommendations.
SITUATION PROBLEM No. 10
The garrison is supplied with water from a group of coastal wells, equipped
5–10 m from a large navigable river, on the banks of which industrial enterprises are
located, including a large oil refinery, 75–80 km upstream. The daily flow rate of
water is 1000–1200 m3. At the waterworks, water is chlorinated in normal doses
(1.5–2 mg of active chlorine per 1 liter of water) using a stationary Kulsky
chlorinator. In January, the water from the water supply network acquired a strong
aromatic smell and taste, which made it impossible to use it for drinking and
cooking. Water for these purposes began to be brought from the nearest center (30
km away), which has boreholes.
In a laboratory study of this water in a sanitary-epidemiological laboratory,
contamination in it, including nitrogen compounds, was not detected, however,
coliform bacteria (12) and bacteria forming colonies of 1 cm (100) were detected.
The head of the garrison's medical service ordered the doctor of the military unit
operating the waterworks to take measures to establish the reasons for the
deterioration of the water quality.
Questions: 1. what is your plan of action?
SITUATION PROBLEM No. 11
Since spring, cases of gastrointestinal diseases, including acute dysentery (March
1, April 8, May 17), have become more frequent in the military unit. During the
sanitary and epidemiological survey, the following was established: the source of
the household drinking water supply of the garrison is 2 captive descending springs
located on the slope of the hill. In terms of physical, chemical and bacteriological
indicators, the water is benign, however, in samples from individual points in the
network (barracks), an increase in the total microbial count of up to 150 was noted.
All latrines and cesspools in the garrison have watertight cesspools. The town has
a technical water supply system that supplies water from the local river without
treatment. The technical water supply taps in the vehicle fleet are not labeled
accordingly. In the laundry room, a connection was found between drinking and
technical water pipelines without a check valve. The business executives explained
the need to connect a technical water supply to this facility by interruptions in the
supply of water through the drinking water supply. The distance between the
laundry and the barracks is 35 m.
Questions: 1. Explain the reason for the deterioration of the bacteriological
indicators of water and outline measures to streamline the water supply of the
military camp.
SITUATION PROBLEM No. 12
The military town is supplied from an artesian well 140 m deep. The well is
fed from an interstratal aquifer; in addition, it receives groundwater through holes in
the casing pipes at a depth of 15–20 m. The water is collected in a reservoir with a
capacity of 500 m3, from which a pump of the second lift is fed into the water
tower, and from there it enters the distribution network. Water is supplied to
residential buildings periodically, to barracks and kitchens-dining rooms - around
the clock. At 35 m from the well, higher on the slope of the terrain, there is an
absorption-type latrine, which is used by the personnel of the construction battalion
located here. Sandy soil. It rained in the first half of August. The result of the water
analysis is shown in the table. Table 1. Results of analysis of water samples
Questions: 1. Give an assessment and recommendations for improving the
condition of the military town's water supply.
SITUATION PROBLEM No. 13
During the next examination of the soldier's tea room, the paramedic found 9
kg of minced ham sausage in an uncooled cabinet. The sausage loaves are intact,
without external damage. Their shell is slightly slimy. There are focal softening in
the surface layer of the minced meat, in the section - gray-green spots, the
consistency of the minced meat is loose. The bacon is softened, with a sour smell.
Its taste is uncertain. The paramedic banned the sale of sausages, and he reported
to you about this.
Questions: 1. Do you need to give instructions and say if the paramedic did
everything correctly?
SITUATION PROBLEM No. 14
While tasting the food prepared for breakfast, you noticed an unusual
"pistachio" color and a slight "fishy" smell of butter. In the warehouse of the unit
there are three more boxes of butter (25 kg each), received at the same time.
Questions: 1. What can cause the above mentioned disadvantages of oil
quality?
2. What are your next steps?
SITUATION PROBLEM No. 15
When inspecting food at the food warehouse, you noticed the appearance of
fine flour dust ("tormented") on the bags with buckwheat and on spills under the
racks. Acceptance, shipment and transfer of cereals were not carried out. The
warehouse manager claims that every week he sweeps the stacks while cleaning the
warehouse, removing about 1 kg of basting.
Questions: 1. What can it be?
2. What are your next steps?
SITUATION PROBLEM No. 16
Bread from the garrison bakery was brought to the canteen of the military
unit. Loafs of the correct shape. The crust is pale, with many cracks. The crumb
on the cut is large-pored, in some loaves - with breaks, the taste and smell of the
crumb is pronounced sour. Upon a telephone request, the bakery's laboratory
assistant reported the physical and chemical parameters of this batch of bread:
porosity - 46%, moisture - 52%, acidity - 14 ° Turner.
Questions: 1. What is your opinion on the quality of the bread?
2. Can I use it for ration?
3. Probable causes of the identified defect?
SITUATION PROBLEM No. 17
Rye wallpaper bread, molded, obtained from a local bakery. The loaves are
low, the upper crust is flat. On the cut, the crumb is large-pored, moist to the
touch. Its taste and smell were unremarkable, acidity - 10 ° Turner, porosity - 19%,
humidity - 50%.
Questions: 1. What is the quality of the bread?
2. Make a recommendation to the food supervisor.
SITUATION PROBLEM No. 18
Recently, in the unit in which you serve as the head of the medical center,
complaints about poor nutrition have become more frequent. Soldiers and
sergeants tell the unit commanders that the food is being supplied in insufficient
quantities, too “liquid” or “without fat”. The unit commander has set up a
commission under your chairmanship to investigate the causes of unsatisfactory
nutrition and to develop recommendations for their elimination.
Questions: 1. What is your action plan?
SITUATION PROBLEM No. 19
Summarizing the results of the medical examination, you found that 10% of
the personnel showed a decrease in body weight from 100 to 500 g in comparison
with the data of the previous weighing.
Questions: 1. What are your actions?
SITUATION PROBLEM No. 20
At the command post of the unit, the air temperature, according to the
readings of a dry thermometer at a height of 1.5 m, was 25 ° С, humid - 19 ° С. No
air movement is felt. The personnel perform light work in field uniforms without
outer clothing.
Questions: 1. Give a comprehensive assessment of the microclimate and
hygiene recommendations.
SITUATION PROBLEM No. 21
In the classroom of the barracks, with an area of ​48 m2 and a height of 3 m,
29 people are engaged.
Questions: 1. What is the required air exchange rate in this class?
SITUATION PROBLEM No. 22
The dormitory of the barracks, measuring 262 m2, is illuminated with 16
incandescent lamps, 60 W each.
Questions: 1. Does it comply with current regulations?
SITUATION PROBLEM No. 23
Based on the established limits, electricity consumption for lighting the
classroom of the barracks and the office is allowed no more than 27 W / m2 when
illuminated with incandescent lamps.
Questions: 1. What lamp power should be recommended to provide
illumination of at least 150 lux in rainy weather?
SITUATION PROBLEM No. 24
During the sanitary and hygienic examination of the military camp, it was
established that in its residential area (3200 people), a planned cleaning of
household solid waste (garbage and food waste) is carried out. For this purpose,
there are 4-container platforms for 8.5, 5 and 4 containers, respectively, made of
sheet steel (each with a capacity of 1.7 m3). Replaceable containers, they are taken
out once every 2-3 days. The sites are located at a distance of 15–20 m from the
entrances of residential buildings.
Questions: 1. Are there enough containers in this case?
2. Are there any other violations in the organization of cleaning the residential
area from solid household waste?
SITUATION PROBLEM No. 25
In the sleeping quarters of the soldiers' barracks, the average daily air
temperature is 20 ° C. At night and in the morning, it drops to 14 ° С, and in the
daytime, it rises to 24 ° С.
Questions: 1. Assess the temperature conditions and the possible
consequences of their influence on people.
SITUATION PROBLEM No. 26
In the military unit, from the first days of March, cases of acute respiratory
viral infections of the upper respiratory tract and other respiratory infections began
to be recorded. The incidence of diseases tends to increase. All patients are
isolated and hospitalized.
When examining the accommodation of the personnel, it was found: bunk
beds, the air temperature in the barracks is 21 ° C, the relative humidity is 65%, the
CO2 content in the air is 0.2-0.25%. Natural ventilation.
Questions: 1. What are your suggestions for the prevention of respiratory
diseases in part?
SITUATION PROBLEM No. 27
During the summer field exercises, tankers began to complain about the high
temperature in the tank. Corresponding measurements established that the air
temperature inside the tank reaches 32 ° C, humidity 75%, air speed - 0.3 m / s, the
average temperature of the armor - 40 ° C. The uniforms of the tankers are normal.
Questions: 1. Evaluate the complex effect of the tank's microclimate on the
human body and give recommendations for maintaining the combat effectiveness of
tankers in these conditions.
Problem number 28
Dechlorinate water in PE-600 l, if the amount of residual chlorine in 1 l of
water is 2.5 mg.
Problem number 29
Determine the sufficiency of the flow rate of the well for 10,000 soldiers on the
defensive in hot climates, if the well is of square cross-section with a side of 1 m,
with an initial water level in the well of 2 m, lowering it after pumping out to 3 m and
returning to the initial level within an hour.
Problem number 30
What amount of dry bleach should be taken to re-chlorinate water in RC-1200
l, if the water has a transparency of 20 cm, a color of 15, and the content of active
chlorine in bleach is 20%?
Problem number 31
How much dry bleach should be taken in order to chlorinate water in a round
well with a diameter of 1 m and a water level of 1.5 m, if the amount of residual
chlorine of 0.4 mg / l is determined in the second glass (200 ml), where 2 drops of
1% bleach solution added?
Problem number 32
What amount of dry aluminum sulfate should be taken to coagulate 100 liters
of water, if the fastest coagulation occurred in the first glass (200 ml), where 2 ml
of 5% Al2 (SO4) 3 solution was added?
Answers to problems (option No. 1) 1. 32.6 m3 / hour 2. 2 times 3. 1500 m3
/ hour; 0.4 m / s 4.5 m3 5.8 hours
Answers to the problems : 31. 5.25 g. 32. The flow rate of the well is
insufficient. 33. 60 g; 90 g; 150 g 34.5.9 g 33.50 g
TEST
to the final lesson in military hygiene Option 1
1. The required frequency of air exchange in the sleeping quarters of the
barracks with two-tier placement of beds is (number of times):
a) 1;
b) 2;
at 3;
d) 5.
2. The modern type of field dwellings for radio-technical air defense troops is:
a) pneumatic tent;
b) all-metal unified block (TsUB);
c) container type dwelling;
d) ground unified building (NUZ).
3. The minimum level of the KEO value in the classrooms of the barracks must be
at least (in%):
a) 0.3-0.5;
b) 0.5-0.7;
c) 0.8-1.0;
d) 1.0-1.2.
4. An indirect integral indicator characterizing the sanitary condition of the air
in the living quarters for military personnel is the content in it:
a) carbon dioxide;
b) carbon monoxide;
c) ammonia;
d) microorganisms.
5. Tents with increased water resistance are ideal from a hygienic point of
view:
a) true;
b) wrong.
6. When choosing a land plot for a field camp, it is planned to locate it at a
distance from landfills, farms and other polluting facilities at a distance (in km):
a) 1;
b) 2;
at 3;
d) 5.
7. When organizing meals for servicemen in hot climates, the main amount of
proteins, fats and vitamin preparations are issued:
a) for breakfast;
b) for lunch;
c) for dinner.
8. The nutritional status of a serviceman with a body weight of less than 70%
of the ideal is assessed as:
a) defective;
b) premorbid;
c) painful.
9. For bringing the prescribed nutritional standards to each serviceman, an
official bears responsibility:
a) the head of the food service;
b) deputy commander for logistics;
c) the head of the medical service.
10. The minimum required carbohydrate content in “survival” diets is (in g):
a) 50;
b) 75;
c) 100;
d) 200.
11. The most common causes of food poisoning in the army are (indicate 3
dishes):
a) first hot dishes;
b) cold appetizers - salads, vinaigrette;
c) sweet dishes;
d) side dishes from cereals;
e) mashed potatoes.
2. Additional food for servicemen with a height of 190 cm and above is (in%
of the ration norm):
a) 25;
b) 50;
c) 75;
d) 100.
13. With a decrease in the body weight of servicemen within a month by 10%
of the initial value, they should be sent to medical military institutions:
a) true;
b) wrong.
14. If a deficiency of vitamin C is detected in ready-made food and
vegetables, C-vitaminization of third courses is performed per person (in mg, not
less):
a) 25;
b) 50;
c) 75;
d) 100.
15. Tin cans with "tongues" on the seaming seams are allowed for use in the
food of military personnel:
a) true;
b) wrong.
16. Food can be cooked even while driving in the field auto kitchen:
a) PAK-170;
b) KP-125;
c) KP-2-49.
17. The main disadvantage of combined-arms ration No. 1 in terms of its
biological value is as follows:
a) imbalance and deficiency of animal proteins;
b) lack of fat;
c) low energy value;
d) vitamin deficiency.
18. Sampling of water from the source for subsequent laboratory research is
made from two layers:
a) superficial;
b) medium;
c) bottom.
19. Monitoring compliance with the rules of water purification and disinfection
in the field is carried out by the service:
a) food;
b) medical;
c) engineering.
20. Points of field water supply are equipped for:
a) companies;
b) battalion;
c) shelf;
d) divisions.
21. The main indicator of the reliability of water disinfection in the field:
a) the content of residual chlorine in the amount of 0.8-1.2 mg / l;
b) microbiological indicators.
22. Hyperchlorination of water in the field is carried out taking into account the
content of active chlorine in the drugs used:
a) true;
b) wrong.
23. Allowable maximum values ​f or odor and taste of water in the field are (in
points):
a) 1;
b) 2;
at 3;
d) 4.
24. The drug has the highest content of active chlorine:
a) bleach;
b) chloramine;
c) DTS GK; d) NGK.
25. When choosing a source of water supply in the field, preference is given
to waters:
a) unpaved;
b) artesian;
c) river;
d) lake.
26. Individual means of disinfecting water to servicemen are issued by the
service:
a) food;
b) RChBZ;
c) medical.
27. Permissible storage time of boiled water in the field (in hours):
a) 8;
b) 12;
in 20;
d) 24;
e) 30.
28. When treating contaminated water with TUF-200, it is possible to
simultaneously introduce a coagulant and a chlorine-containing preparation into it:
a) true;
b) wrong.
29. Diet food for servicemen is assigned for a period (number of months): a)
1;
b) 2;
at 3;
d) 6.
30. Physical inactivity as a forced condition for the habitability of servicemen
in shelters refers to a group of factors:
a) chemical;
b) physical;
c) biological.
ANSWERS TO THE TEST PROBLEM
For the final lesson in military hygiene Option 1
1.c 7.c 13.a 19.b 25.b 2.b 8.c 14.b 20.b 26.c 1.c 9.b 15.b 21. a 27. d 2.a 10. c
16.a 22.a 28.a 5.b 11.b, c, e 17.a 23.c 29. c 6.c 12.b 18.a, c 24. d 30. c
Исходныйтекст
Предложитьлучшийвариантперевода
 LITERATURE

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86. Yaney, G. The Urge to Mobilize: Agrarian Reform in Russia 18611931 /

George Yaney. Urbana, Chicago., L., 1982. - 602 p.
Table of contents

Foreword
…………………………………………………………………………​
Part one. Military hygiene ……………………………………… ..
Chapter 1. Methodology of military hygiene. Basics of sanitary and
epidemiological surveillance and medical control over life activity and
everydaylife troops ……………………………………… ..
1.1. Military hygiene as a science and area of ​practice for doctors
1.2. The purpose and objectives of training students in military hygiene
(methodologicalinstructions)………………………………………………………
1.3. The system of state sanitary and epidemiological supervision and medical
control over the vital activity and everyday life of troops in peace
time ………………………………………………………………………………
1.4. Features of sanitary and epidemiological surveillance and medical control over
the vital activity and life of troops in wartime and emergency
situations ………………………………………………………………
1.5. The forces and means of the medical service used in the organization and
conduct of sanitary and epidemiological surveillance and medical control over the
vital activity and life of troops in wartime and emergency situations
……………………………………………………………………
Control questions ……………………………………………………………
Chapter 2. Hygiene of troop deployment ………………………………………
2.1.Accommodation in the barracks ………………………………………………
2.2. Field placement. Collection and disposal of sewage and waste ………….
2.3. Bath and laundry service …………………………………………
2.4. Sanitary cleaning of battlefields. Obligations of the medical service
……………………………………………………………………………………
Control questions ……………………………………………………………
Chapter 3. Food hygiene of troops .....................................................
.....................
3.1. Organization of catering for personnel in the field …………… ..
3.2. Organization of medical control over the nutrition of personnel in
field conditions …………………………………………………………………
3.3. Catering in extreme conditions ……………………………
Control questions ……………………………………………………………
Chapter 4. Hygiene of water supply for troops
…………………………………
4.1. Water consumption norms and requirements for water quality
…………………
4.2. Water exploration and hygienic assessment of water sources …………….
4.3. Personnel facilities for field water supply of troops ...……………… ..
4.4. Points of field water supply and water points ………… ..
4.5. Water purification in the field ……………………………………… ..
4.6. Water quality control ……………………………………………………
4.7. Hygienic features of water supply to a military unit in a combat situation and in
conditions of the use of weapons of mass destruction ……………………………
Control questions ……………………………………………………………
Chapter 5. Hygiene of military work …………………………………………
5.1. Hygiene of military labor and its place among other sciences …………… ..
5.2. Working conditions (factors) and their hygienic classification ………….
5.3. Hygienic characteristics of the main chemical and physical factors of the
working environment of the labor of military specialists ……………………….
5.3.1. Chemical factors ………………………………………………………
5.3.2. Physical factors ……………………………………………………
5.4. Hygienic features of service in certain branches of the armed forces …………
5.5. Prevention of occupational pathology in military personnel .........
5.6. Medical control over the military professional activities of military personnel .
5.7. Hygienic requirements for military clothing, footwear and equipment Test
questions ……………………………………………………………
Chapter 6. Hygiene of troop movement ..................... ... ... ... ...
6.1. Sanitary and anti-epidemic (preventive) measures when transporting troops by
rail, water and air transport…………………………………………………… ..
6.2. Sanitary and Epidemiological (Prophylactic) Measures During the
Transportation of Troops by
Road…………………………………………………
6.3. Sanitary and anti-epidemic (preventive) measures to ensure the march on foot
……………………………………………
Control questions ……………………………………………………………
Chapter 7. Dangerous and harmful factors of the environment and their
impact on human life._
_____________________________________________________

7.1. Hygienic characteristics of the main chemical factors of the working

environment of military specialists
_____________________________________

7.2. Hygienic characteristics of the main physical factors of the working

environment of military specialists
_____________________________________
Chapter 8. Expertise of water and food for contamination of substances and
radioactive substances in sanitary and epidemiological institutions
___________
8.1. Organization of sanitary and anti-epidemic measures for the control
and protection of food products, food raw materials, water and the
organization of their sanitary examination in emergency situations
________________________

8.2. Methodology for sampling water and food for testing for contamination
with toxic or radioactive substances
____________________________________

8.3. Basic methods for determination of radioactive substances and organic

substances in water and food
__________________________________________
8.4. Standard means for determining RS and TS in water and food
__________
8.5. The procedure for the examination of water and food for contamination
with toxic, highly toxic and radioactive substances
________________________
Part two. Military epidemiology ………………………………… ..…
Chapter 9. Military epidemiology. Tasks. Features of the development of
the epidemic process among the personnel of the troops and the civilian
population in wartime and emergency situations ………. ……………… ..…
9.1. Definition and objectives of military epidemiology ……………………………

9.2. The purpose and objectives of training students in military epidemiology

(guidelines) ………………………………………… .. ………………… ..…
9.3. Formation and development of military epidemiology …………………………

9.4. Ways of introducing infection into troops and factors (conditions) affecting
the development and manifestations of the epidemic process in emergency
situations and in wartime ……………………………………………………​
9.5. Peculiarities of the etiological structure of infectious diseases in wartime and
during natural disasters ………………….
Test questions …………………………………………………………… ..
Chapter 10. Sanitary and Epidemiological Institutions (subdivisions) of the
Ministry of Defense of the Republic of Uzbekistan in wartime. Organization
of their work in extreme conditions and in wartime ... ... ...
10.1. Sanitary and Epidemiological Units of Compounds ... ... ... ... .. ...
10.2. Sanitary and Epidemiological Institutions of Operational Associations
Test questions ………………………………………………………. ………
Chapter 11. Organization of sanitary and epidemiological
reconnaissance in the troops. Criteria for assessing the sanitary and
epidemiological state
troops and their area of ​operations​
………………………………………………
11.1. Sanitary and epidemiological
reconnaissance …………………………………​
11.2. Assessment of the sanitary-epidemic state of the unit (area of ​its operation)
…………………………………………………………………………………
Control questions ……………………………………………………………
Chapter 12. The content and organization of sanitary and anti-epidemic
(preventive) measures in the troops in wartime and in emergency situations
… .. ………………………………………………………… .
12.1. Measures to neutralize sources of infection… …………… ..…
12.2. Measures aimed at breaking the mechanism of transmission of infection and
prevention of mass non-communicable diseases and poisoning (defeats) of military
personnel …… ………………………………………………… ..…
12.3. Sanitary processing according to epidemic indications ………………… ..…
12.4. Disinfection.. …………………………………………………………………

12.5. Disinsection. … .. ……………………………………………………………

12.6. Deratization …………………………………………………………………
12.7. Immunoprophylaxis and emergency prevention of infectious
diseases… ……………………………………………………………………… ..
…​
Control questions ……. ………………………………………………………… .
Chapter 13. Anti-epidemic regime and strict anti-epidemic regime of
operation of the mpp and medb in wartime and in emergency situations ……
………………………………………. …………………………
13.1. Anti-epidemic mode of operation of the mpp and medb …………………… .
13.2. Strict anti-epidemic mode of operation of the mpp and medb ……… ..…
Test questions … .. ……………………………………………………… ..…
Chapter 14. Biological weapons. Fundamentals of biological protection of
troops and stages of medical evacuation. Biological prospecting and
indication of biological agents
…………………………………………………………
14.1. The concept of biological weapons and their damaging properties ... ... ...
14.2. Technical means of biological attack ……………………….
14.3. Tactics and methods of using biological weapons ……………… ..
14.4. The concept of the area (focus of biological contamination) .....................
14.5. Fundamentals of biological protection of troops and stages of medical
evacuation
14.6. Measures to protect troops from biological weapons carried out in peacetime
​……………………………………………………………………
14.7. Measures to protect troops from biological weapons carried out during the
period of the threat of a biological attack ………………………………………
14.8. Measures to protect troops during the period of the use of BO
………………
14.9. Events on protection personal composition v liquidation period
consequences biological attacks …………………………………… ..................
14.10. Peculiarities work mpp and medb v conditions of use biological funds
…………………………………………… ................................. ....
14.11. Biological prospecting and indication of biological agents …………
14.12. Specific indication …………………………………………… ..
14.13. Operating procedures of institutions conducting specific indication
……………………………………………………………………………… ...
Control questions ……………………………………………………………
Chapter 15.SITUATIONAL ISSUES____________________________