This paper summarizes results of research carried out at the Institute of Hygiene and Health Protection of Children and Adolescents during the last 15 years. Specifically, it presents data of longitudinal studies involving 1-5-form schoolchildren residing in Moscow. Dynamic studies of morbidity and physical development in 1-2-grade schoolchildren suggest stressful effect of adaptation to increasing teaching loads. In-depth studies of senior schoolchildren conducted in 1989-2005 revealed long-standing unfavourable trends in their health status including marked deterioration of functional activities and physical development, increased prevalence of chronic diseases, and changes in the overall morbidity structure. Main schooling-dependent risk factors are identified, such as excess academic loads and authoritarian teaching style (responsible for psychoemotional stress), hypokinesia, and malnutrition during school hours. Incidence of certain diseases and functional disorders among adolescents is shown to correlate with the use of alcohol and tobacco.
A dynamic description of teenagers' health status in the Russian Federation is presented in the article over a period of 40 years. A pronounced increasing proliferation of impaired functions and a prevalence of chronic pathologies in children were outstripping the growth rates; a worsening health condition in children revealed through a sharply reduced quantity of healthy children and a bigger share of chronically sick children; a changed structure of prevalence of functional disorders and of chronic pathologies among children reflecting, to a certain extent, the negative impact produced by the social as well as by ecological-and-hygienic conditions of contemporary life of schoolchildren; as well as a pronounced influence exerted by such significant factors, as social well-being, an intensified educational process and a premature labor occupation of children, on the evolution of children's health can be attributed to specific features of the build-up of children's health during different time periods under the conditions of today. The negative dynamics of the health status in children of the country necessitated a decision on reforming the provision of teenagers with medical care and on creating a system of continuous medical check-ups for them. Various forms of medical care as applicable to teenagers are analyzed.
Prerequisites of shaping up the health condition, including health status, life mode and conditions of occupational training, in teenagers receiving workers' skills at basic-stage professional training facilities are under consideration. The specificity of adaptive responses and of health status is described in young females, mastering the jobs within the confectionary and public catering industry, during the professional training period, which is indicative of a higher sensitivity of teenagers' organisms towards the production factors' effects. Reliable trends towards aggravated indices of the health status in pupils of professional training facilities were registered during a 10-year observation period. A continued worsening of the life mode is noted in teenagers, which manifests itself mainly through a higher prevalence of smoking and frequent abuse of alcohol with the bad habits setting on at an earlier age. Labor occupation of pupils, when combined with professional training, is an extra risk factor in the building-up of health. Thus the obtained data witness to a worsening life mode of teenagers, who earn on the side, and to their worsening health status. Conclusions are made on a need to overcome the negative prerequisites related with shaping up the health condition of teenagers in the discussed social category.
For the time present becoming more common semiconductor sources of artificial lighting has become a more and more frequent practice. With the aim to study the impact of LEDs on the health of schoolchildren studies in experimental conditions (specially equipped classrooms) were performed. The comparative analysis of the state of vision, mental health and emotional state of pupils in primary, middle and high schools under fluorescent and LED lighting, meeting to the regulatory requirements, has revealed that the physiological cost of schooling in the use of LED units in classrooms is lower than in a traditional, fluorescent lighting.
In the article there are presented data of longitudinal study of the health of Moscow schoolchildren (426 children), followed throughout from the 1st to 9th class, inclusively. Students were annually clinically examined in the school. There was performed a comprehensive study of mental health and functional state of the organism in the process of education students in high school (over 2700 pupils of 5-9th classes). The health status of students was shown to deteriorate due to the increase of the prevalence of chronic disease, the rise in occupancy of the III-IV health groups, the decrease of the number of children referred to I and II health groups. Unfavorable trends in the health state among boys are more pronounced than in girls, while they are also characterized by lower functional capabilities of the CNS and lower resistance to the development of training fatigue. Relatively favorable stage of school ontogeny is characterized by period with reduced morbidity in children studying in 4th-6th classes. Deterioration in the health of students as a significant rate of the rise of chronic diseases morbidity is observed in 7-9th classes. Along with this, in the 7th and 9th classes there is revealed the deterioration of mental capacity and high frequency of the pronounced signs of fatigue among schoolchildren.
The paper analyzes morbidity among Moscow schoolchildren in the past 50 years on the basis of the results of in-depth studies of pupils by the researchers of the Research Institute for the Hygiene and Health Care of Children and Adolescents. There is a significant reduction in the number of absolutely healthy children, the proportion of which is 2-4%. There is a considerable increase in the prevalence of dysfunctions and chronic diseases among schoolchildren. Particularly high increment rates of morbidity were observed in the 1990s. The morbidity structure has changed in the past 50 years. Both biomedical and psychosocial factors are responsible for changes in the morbidity levels and structure of children and adolescents.
The paper presents the currently available methods for assessing the health status of children and adolescents, the basic principles in the organization and performance of prophylactic examinations in children, including the assessment of their physical fitness, as well as the methods and criteria for assessing the phychophysiological development of adolescents, their social adaptability and autonomic stability. It also contains the currently used basic criteria for assessing the health status of children, as well as their health groups. The high effectiveness of children's health promotion in educational establishments can be achieved, by applying the basic principles in the organization and implementation of prophylactic and health-promoting measures.
The scientific and practical aspects of medical and psychophysiological professional orientation in teenagers and young people have become more and more pressing due to their poorer health along with higher demands for their resistance to unfavourable factors. The aid of a physician and a psychophysiologist in their choice of a future profession promotes the prevention of general and occupational morbidity. Work on professional orientation should be began at school in the 5th-6th and done through school life during which they get a general and vocational education. Guidelines have been developed for effective medical and physiological professional counselling.