Chaika A. Hygienic assessment of the conditions of placement and operation of health care facilities built into residential buildings

The dissertation is devoted to studying of hygienic aspects of placement and operation of the health care institutions built in apartment houses in modern conditions of a dense town-planning situation, definition of the combined influence of direct and indirect indicative indicators of architectural and planning decisions on well-being and working capacity of medical staff, in order to develop hygienic architectural and planning criteria to improve the design and efficiency of built-in health facilities, which will ensure the "professional" health of medical staff, comfortable and safe living conditions for patients and satisfactory sanitary and hygienic living conditions for residents. In the dissertation work, a theoretical generalization and comparative analysis of national and European legislation on the design of built-in medical institutions is carried out. Taking into account the innovations of the reform of the medical industry, the use of modern building structures and materials with energy efficiency and the constant stay of doctors in an enclosed space and the conditions of an increased level of epidemic danger during the epidemic of coronavirus disease, we are replacing the outdated rate of air exchange rate in medical premises defined in SBN V.2.2-10-2001 "Buildings and structures. Healthcare Institutions", new hygienic standards for the frequency of air exchange have been developed for rooms of various sizes, heights and the number of persons in the room at the same time. The new standards exceed the current standard (K = 1) by 6.4-8.4 times and, when introduced, will contribute to the preservation of the health of medical premises. By analogy with the European experience, we have substantiated the implementation of the standard of the minimum area of medical premises at the level of 9 m? (domestic minimum area - 12 m?) while providing general exchange mechanical supply and exhaust ventilation with air exchange rate of 6.9-7.3, which for most Ukrainian Family physicians of private medical practice is more economically attractive. Taking into account foreign experience, a significant addition was made to the theory of preventive medicine in the design and operation of healthcare institutions built into residential buildings, which consists in the implementation of a sanitary and epidemiological assessment based on extrapolation of the compliance of the conditions of built-in healthcare institutions with hygienic requirements to create conditions for the prevention of diseases of health workers, safe and comfortable living conditions for patients and satisfactory sanitary and hygienic living conditions for residents of a residential building. Based on the materials of the work, a set of preventive measures has been developed to prevent diseases of medical workers, acquired under the influence of direct and indirect indicators of architectural and planning decisions in the process of their work, by improving existing and creating new hygienic criteria for the design of healthcare institutions built into residential buildings. Improvement of the regulatory and informational and methodological base for the design and operation of healthcare institutions built into residential buildings will contribute to the preservation and strengthening of the health and efficiency of medical workers.