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HS.qAHO B .UAIIIM ISBN 978 92 890 2130 2 (печатная версия) ISSN 0250-8729 (печатная версия) CO.IEPTAHI,IE crp I 2 Bse.qepre . 1 P acrpoc=paxeHHocrb r(poHlrqecKux Hecnelu.r0,rqecKl,D( 6olegnefi JIerxI'D( 2.L Cxepauoc:s or XHBJI . . 3 4 6 7 9 9 L2 13 t7 L7 20 24 24 29 2.2 2.3 2.4 Bpexeru€.a He{Ty.qosloco6noc:s Crofu<aa HHBaJtr.tJlltocrb . . 3a6oneBaexoclt no,uaHHEIL rpcPrraJlH:lau{H . 3aooreBaerocrb no .qaHlsln o6paraelocrfl 9E{.ueE4onoPF{ecKHe Hc-cJIe.ItoBElHHfr . . 3arcnnrewre . . 2.5 2.6 2.7 3 EcrecraeHHoe reqeHHe OorlegHu . . 3.I Onpe.uenerne xpoHuqecKI.DC 6oaesHe* nen(I{x . . 3.2 EctecraerHoe rerlet*te )GIBJI 4 Par+ree B[rxBrreHue )CIBI 4.1 Uetro,EI EtIrBrIeHHfi paglflx ea:u,fi 4.2 fptlrrru HaceJIeHHE, no.grteratrHe o6cle.uoaaru,o XHEN 5 Bo3uoerocrH npoBe.ueHra neparqtofi rp@ularcz:arcn 5.1 llepanvnaa np@rutal<lla(a . 30 31 6. BosrrcrHocrr,r BTopr{trHoH npcxDHJEKTI.tt(H 35 37 39 39 6.1 6.2 6.3 Porr ne.tracarrelrrctHorlc JleqeHr{fr .[nxaterrsaa rHxlracrr,Ka . . 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Kqrerraren, L97S (aorcyrenr Epts 4905(5) t B Ta6mare 2 npurcgfftcfi .qaHHHe o cnyqaxx HeBuxo,qa Ha pa6oT]r B pe3yJlbrare Bcex pecnrpar@llbIx 6oaesHefi (sra${a.E rpnrrn) ra <!one noKa:,arer8 o6uex 3aooneDaerocrH B r{exocroEaxr.ar n Hnuep.naH.uax B 1973 r. r a Bem,mo6pI{TaHHH B 1974 c. Kax an.r{o rB ra6rrfl-Dr, He y.Earocb co6pat conocaaBHEte .raHHHe no grHx Tpe!( cTpaHax. 3To eEe o.rra npooJlexa, c roropotl npl,D(o.qt{rc8 clraJlKHBdTEC.E npH cpaBHeHHH norryveruofi H:, pasHux clpaH m4opxalu,lu. Ter He [eHee H:, TaOIII4.EI f,BcrB:/er, rff6 t{HcJtO CJrytIaeB BpeueHHOIi Herp:/.gocfloco6xocrr.r B pe3yJlbrare pec[I}{paropHtl)( 60reeHefi no qmoEeHHL K OoEery ru( qHcry SHaqI{TeJIbHO pa3Jl}ftlaercf, B HH.uepJEH.qax, c orHori cropoHu, x 9exocaoa?rrfivt H Bemaco6prtaHHx, c pyrofi. B asyx nerqqHl{x crpaHax pecrrHparopt[Ie 6one3EH, a 6oree ToqHo 6oae3trt, BKnxrlamu,t XHBJI, cocraBnarrr 3Haqr.f,reJrmul npouelrr or ffiero qucra cJD^BeB ga6oaegaerocrr 2.3 Cro0[<aa rumanlurocrl Crarrcrrxa pacnonaraer cKy.u{blxu,uaHHhIxH o fip]ltlHHax HHBanH.rrcCTH. .[aHtile O CeFbe3HbIX Cr]rqafix 6o.negru cpe.E{ paooTapEero HaceJIeHHfi He no.UlaxrTca @aEHeHHD B Cldrry pa3Hux npaElul u noaoxemai, ollpe,,qerfixlqHx HHBIIH.qHocEb B pasHHr( crpaHax. B tlomuei a Pforprr6 a 1974 ro.qp pecnHparopHxe ooresHH (rpoxe ry@Frrynesa) xnnawrcs octroanorl nprrwmofi Herpy,Eocnocoosoc:n y 6t or c6uero qHcJIa & Sawicki F. et a1. Postepy higieny i nedycyny doswiadczalnej, 31: 741 (L977) . 6 Mlrrl"te.uI Sanirtit 11 Centrul de Calcul si Statlsticir Sanltarla. Breviar de Statistici Sanitari 1975. Bucharest, r976. 7 f.6dEr 2. 8cr gacBga"o9E t.6q.turl a qqoqotrB x ttrAaDtraBr r 1973 roly x r B.8ro6DE"ala t 1974 roay lIDm rg.ilroi rar?rlosocooiGil CrD.E fo! IIq Ecr pac@rroDu Eoom, ,t*r.s,taOqo.fl Gil t EraE[t EgoG s ,r-ru tr q9q.d sorr- Zt ta?66 cDgd trora- r?ur6 f B.Jffio6Df,tr- 1974 t97t 1977 m rCU l5,536,6 22,3t2,8 r7ruf DIf 12,9 r 8,5 r 9,6 t 2.9 qqsor.E' r{tE-t I uf 45, I 9.0 r,5 21 ,0 t tr o6r, G, .a6qattd. 6 g9rlru trDolomrcco uol rcr t [E t K o6Lt qq,,.crD."o?E x6€ard. " I 52t qrua r 49t u Epr Durroa larrrzseoorct ia tc?ltouaf llcrqEE: o.trv prc zdloaErnlctq ttrtt.tlb. iSSn zdnrotnlotyl. I}niua t Br.tlal.y., l,gt,a. @Gltvdana, c.nt!..r hrn.u v@! da st.t1.t1.k,V.dGur g.r6dh.1d..trt1rt1.I. c!.e.nh.t, St..t$1t-e.dJ, lii. D.Brtnt o{ aa.rtb r.{ sg.trr g.@!ltv, tb.ltb ud palto.l r@l,rl r.Flc.. rtrtl,rtlc.lor Eo3lad. L6do, ll.I. Stttfs.!, otlfc.. Ln7. 8 ttrlrprrrrorr HHBaJM.uoB. B t{exocaosaxru.ra e 1975 rD.E:f sra rrrOpa cocraaHra 7t. B HuaepraH,uax6 a 1974 ro.qr xporuvecrrfr 6poxxa c6ln 3aperucrpupoBaH y 3t uyxqrr H y 2t xemuan s rc3pacrrrofi rF,ynne ot 18 JIer H eTaplIte. 2.4 3a6oaegaelr{ocat no .uaHHEIx rrccIrI{TEUIH:}aLPlx Hl$opualuln o )GIBJI Kax ocHoBHox .EiarHo3e 6rna noJlyqeHa rrHrrb !E! 4 epan (ra6mara 3). lloxagateru BurrHcKH H3 6orErnd-Dl, Kor.ua nprwaxoft Focnrr€ulH3alw,t fiB,,,,r[/.cr )CIBJI, aHaJronrqHH a lepuaxcrcor .[enoxparrqecr<ofi PeqryoE{Ke, flonbue, IIlBerr{H, Atrruarr H ySJEce. O.qHaxo c.reErer [o!lHl{rb, rrro 3TH noKasaTe.mn MoryT BaFEHpOBarb oT CTpaI{ht K erpaHe Kax pegyJrbrat pasrrt*di B noru{rHKe rocnr{Tarlu3alDfu, a raxxe E KOJIHqeCTBe HI{ercUHXCf, 6OrErI}fr{tGIX KOeK. 2.5 3a6oaesaer,pcrb no .uaHHhlllt o6parnaenocrn .llamue o noceuaeuoqrH npaqeft 6urr norrlnreHu ToJIbKo H=r AHrrDrH, Ygrbca, llorgun H EBeu,M. Hc-cfle.uoaaru{e .raHt*tx o 3a6oreBaexoqrH, norryqeHHux or paaa apaqefi o6i(elr npaKTHKH, 6uro npoaereHo B Annruu a 1970-71 rr. B llo.nrue HCCJre,qOBaHHe nplFrHH, no KoTopst{ 6orB}rhle oopauaJDlG B noJTHKJTHHHKH H Nyt?le 3.EPaEnyHrgu Bo Bceri C:?aHe, 65ulo npoBe.ueHo s 1967-68 rr. Ilonlrqgrll6lg B xo.ue }Truc HccneroBaHrtri rErHHHe npr{Be.rreHu n ra6ro,are 4. Hecuotpa na pa3JIrqHE HCTTOTIb3OBaHHE:X B gTl{( HCeJIe.qOBaHHfD( I{eTO.UOB, y.uerE$rri Bec 3nH3o.uoB Bcex p€cru{paroprGlx oonesHeli u )GIEll tt xoHcymrar-u,fr no Hr( noBo.uy, 3aperHcrpHPoBaHHbD( a o6oHx HccJIe.qoBaHHEx, oKa3aJIcE y.EHBl,rreJrbHo 6rM3KHr4. ?ru .uaro+te Kacaprcfl ilraBHHta oopagoil ,E{u c uawrQectrulMH cHUrIroMaxH 6one3ttrr, r{To nogEoJlHno He3ar,€.u.rEtreJlbHo HaEpaBHTb I,D( K Eparry, Ho, BepoalHo, cpe.rl HacereHHa €cab JIHIIEI, Hc[rbtrbrBarpEHe aHEUIoryqHHe @crof,HH8, Ho He oopauam(Heca K aU"t'"" p.. zdrofrotnickou statistiku. ieskoslovenske zdravotnlctvi. Prague & Bratislava, 1977, " Mlnlsterie van Volksgezondheld en Mtlieutrygie4e, Centraal Bureau voor de Statistiek, Vademecurn gezondheridsstati.stiek. Gravenhage, Staatsuitgeverij, 1977 I Ta6du 3. ILIB o rqcta tragaf,"ot, rea?ElxDo[aaq , catoq arpolaJlcBr ctDa4x tro aotqy x9ouaacaoro 69oma, rraf,laE ( ac?r. c pacEgqMasG tro tr6y tllqo qyirat ([ 100 0OO ucq.a') xo rcu tacrau{t 6qDEu r aocMtadtx9otaaaE CrDru lor !E 6dalrafi ryNau raEE rrNaB LEu r.yEtE taEu Axr&r E YtrE t973 t91 t 182 1,8 2r,l lcp[f,cur -fap- 19rffiacu 216 2,3 0,8 1 5,0 9,7 P.cE iru Iolgl qrs6 r96I 1972 87 210 6t r61 0,8 1,8 r0,7 r9, r 8, r 965- r 956 2,1 t far- Eo 116[ Gxet?g rqlro r rDometqy 6pomy E .cilt 6 r*aao r. yleua. IlctoqaE: lk d.na tut isitlch. lortbll(tup3 d.! 0D8,. tttrt.ll6a-. Xrut abl.tt, !971. II Jdrtu3. tLtt 2, 8.t!,1n - Ltchtot !t Srrick1. F. .t .1. 7dtal. Frbltoa.. fir5o1 /1976)- Allaf, lnaa DobrDotatr,6rarrebtaa t973. S-dbv. B..r rt. Stur.n krcDDaaJutvld t Upt{J,. rJutrlrdrFi,,o !,9a0 - Igrt. SJutlu.vlrdantk6e-nt.t. gel.lrttFlxn Fdov1..r. P.tl.nt.t.ttfi1l: tl. St*IhoI., l9?2 (SpRt r.pport ta/72t, Da9rlrDnt ot tLalth ed scirl, s.cur1tv. T.bI.r. Lodo, H.L St.tl,6.r, Ottlc., naDoft 6 hor9lt.l 1o-Dat16t oqulrt to! tha y.u l9?3: 1977. 10 B tr9oqaa?rot ottotcxu: Taodu 6. O6guagt! tro notoqy 9aca9r?o9su 6qaasarl x tgacu o6!aA r9arflB r AEJu a yrlDca ! 1970-1971 rr. B r q6ytl"opxo- dodr8K.cu. 6au.lu r flqDr r 1967-1968 rr, 3d!ory Ko{cyr!trw .lraar aoa iwE ryErE qqo' r qqo' t qqo' I "r-ot z d{aJM f, Ytax Ec ato Bcc pacd9r"ops 6qa!u l(9oa.crl 6pom, ,{ales a act[ IIqps Bcaro Bc.9.c89a"ogm 6qa!ffi :(goBacd 6poE, ,r*t.E x agm | 534 t02 l8 r 00,0 26,2 2,5 2 052 395 20 !0or0 19,2 t,0 2 551 603 r04 r 00,0 2i,6 4,1 3 428 535 5l r00,0 t 5,6 t,5 r 506 479 54 10o,0 27,) 3,4 642 166 L2 r 00,0 22,3 2,5 I 046 6t2 r5r r 00,0 20, l 5,0 267 5t8 r06 r 00,0 r6,5 ),2 " H. tooo ,*u.E Itc"oraE: Orllc. ol PoEI.tlo C.nNra. ud gulv.rr, taolbldlt, !t.t1.t1ct trc S.n.!.I pract1c.. Soc6d n.t16.l ttudt: rtudla.6 -dlc.l, ud poFrltrl6 rubJ@t., No. 20. Lod6, E.X. St.rt6.!tOf ,1c. l9,a. S.rlckl. P. & 0tui.rrnrc.-(oEzyrl.L. tl. Zdrcl. publlcE., 8a:9C (Iyr3). 11 Itlqfl ..laE Bpaqalt, qro cHHxasr noKa3aTerrH 3aooreBaeuocTH no cpaEHeHHIo c .qeircatsHTeJ'tbHbtu nonoxeHHex .EeJI. 2.6 9roaleloaoaoryqecrHe Hccne.uosaHHfl Xora a xo.ue npoBe,ueHnf, gnHJqeuuoJror.?F{ecKH:x uccae.goaalo,rfi Ha )GIBJI oocre.Uoaarocb, KaK [paB!{.[o, HeooJElroe KoJItFIeqrBo ,E{u, 6rra noJlyqeHa none3Haa unQoplraurn o pacrpocrpaHeHHocrH grllx 6onesneii ora uoxer crryxr,rrb oqe}I(orl rrucJra JDrur y KoToprrx 6oneer6 npr.roopela cep6e3HFre @ptfi! HrrH Haxo.tr{Tcfl Ha paHHeli cra-rl}rH pasB&rrHa. Ilperrryuec:Ba no.uo6Hhrx Hccne,qoBarcoi 3axJmqat)rc.a B ToM, r{Bc ytreHble, Kat( npaBruro, ltclroJlb3yxrT o.trHaKoBHe ue[o.El, ocHoBHNe o[rpe.ueJreHr.H H .EuarHocTHqecKHe Kp]rrepHH, t{ro Teoperl,rqecKH oCecnew{Baer cpaBHHrrocrb pe3yrbTaroD. O.Eraxo, npx6enan K eIIr,rHLn{ uero.uar Hccne.qoBamdi c HCIIOTIb3OBaHHeU, HanpHuep, BOnpOCHUKOB H CIMpOMeTpHn, yqeHue peE(o noJrb3yrorcf, oJIlrHr{H H TeMH xe uerro.uauH npH npe.UqraBneHHH pe3yJIIrTaToB. Heq(orEKo JIe[ Ha3aI Fletchera EHeC rlpe.trfloxeHHf oTHocI.rTeJIbHo Merro.Etr(H [pe.ucTaBJIeHHE .uaHHUx. Iloemree c no.uo6Hoii HHHur,raTHBofi BbrcTlfnHn l,enOe 9 Paspa6oraHrue wxr noJroxeHuf, nGBoJMJTH yHHQHltr{poBarb nopE.qoK o6pa6qTKH .gaHHhIx, floJllqsqrrlr B pegyJlbTaTe rccae.uoaaru,ul. B ra6ruue 5 [pHBe.ueHH p€3yrbTaTbr Enr6opoqrolx Hccne.uoBaruri or.ueJlbHux rp'ynn FracereHuf, B Eapone. I,ls orryr6rnrxoBaHHux orareToB o6 srHx HccJreloBaHHEx ECHO, (xro HOXHO CpaBHHTb IIaHHhre o pacnpocTpaHeHHocTlr TaKHx cHl,trITOMOB, KaX yqrQfitrHnri rcarue.rr H c,:r.ueJreHye MoKporar, cJly)f,axrHx noKa3areJrEEr o6HrrHoro xpoHHqecKoro oporug,rra. Hccae,uoaar+r-a [oKa3bIBa-ET, r{To oc6rt{rfi,ui xpor*rvecruri oporD(I,lT gay6or:ee iurpoKo pacnpocrpaHeH cpe.uil HaceJreHr4fl Coe.trrrerorono Kopoaenctra n mate.neri ropo.qcKHx partronoa qexocnorarrrl. HeKoropoe y.uHBneHHe BusuBaer MHp\oKErf, pacrpocrpaHeHHocrb aFletcher C.M. Bronchitis Assen, Royal Van Gorcum, 1961, 6Lende . 273. R. van der et al. Nederlands geneeskunde, 119 ( I975) . p tljdschrift voor 12 3aooneBarryla cpeJllt l(yxqHH B ceJrbcKru( MecTHocTE( Owtfituttuf,4 H B DrocratHr,t. Bo Bcex cTpaHED( HaH6orEDtee qHcJro cJrl raeB 6oaegrrr Ecrpeqaercf, ee.@{ r{yxcKoFo KorrHHrerflra no cpaBHeHHp C xeHCKHil, a Taxre cpeEr ropoJla(orrc HacereHxE rp cpaSHeHHp c ceJIbcKHx. 2.7 3arcrrrqen{e .Uare H3 [pe.ucraBJreHHux s&re .qarreKo He noJrr.Dlx raHHbrx HoxHo c.ue.rlarb BLIBo.ur tlro XHBJI coqraBrrErlr ceF,besHyp rlpr,flnffiy 3a6oreBaelocrH B eBponefio(Hx czpanax,i To fe, no rcefi BeporlrHoerH, uofHo CKEE aIb H o .@ymD( qacTE( SeHHorp uapa. )(HEJI noparam B3pocJroe rac€JreHHe cpe.uHero H noEuloro Boltpacra H, nrraBHux o6pagon, rayxrrrrH. llonrlp Toro, r{ro 6oreerl,r, orHocr,Hlre x XHEII, [pHBo.qfiT K cueprH, oHH B6r3brBarrr raxxe BpeueHHyn HeTp:f,qocrroco6HoczB lr, cocrrBercrBeHHo, TpeCVpr ot cryx6 3.qpaBooxpaHeHrn 3Har{HTeJrbHhD( .qooorrHHTeJlbnux yoaruai. eoprrr [pof,BneHr{E XHBJI Bapbrp:/pr or crpaxu K cTpaHe. MHorTre QaxTofl, B qaqrHoqrH o6ycroBneHHile noruro:rofi perHcTpHpyeilux,uaHHbrXr TogHOCTbtO .E{arHOerHpoBaHrLE, uerro.uarH r(o.u{poBaHHa, HEUIT{qHex cJryxo 3.upaB@xpaHet4rtfl. H 3aKOHOIaTeJIbHI'IMH lloJloreHilf,ltu, gIeuI{OHr{Ist Ana raxaofiqrpaHbr, qe.r MoxHo r{acnfiHo o6Sacrrrrr na6ruo.uaerore pa3JIHtrHE. Tpy.EJo cKa3arb, a xaxori Mepe Ha6Jno.qaerr[,re B PaSJrHrrHhrx cTpaffx H cpeE{ oT,rleJrbHux rpyrm HacerreHHE qtnurlwf, no)rHo o6bac*rtrr pa3Jrrrrxf,l,tn a notpedneuun ra6axa, aoapac:nofi H cor,IHaJrbHo-gKoHorrqecKori c4r:rrrypori FraceJreHuf, pasarruofi creneHbxl Bo3.ue*qrBlrfi Bpe.tr.orx OaxropoE Ha npoH3BOrcTBe, lrpoBHAUH 3arpa3HeHHa aTMO@epHOnC BOCt,QrXa H .Epyrlluu rlaxtopawr orcpyxanuertr cpe.rt. llouHno erux,q/uecrByrrr gH.uoreHHre Oaxropu, pacrpe.uereHHe Kc,TopHx HeH3BeCrHO, HO KOTOpbre Tar(re iloryT Crrparatbcf, Ha 3aooJreBaeumH, pacnpocTpaHeHr4rn H nocae.qc:sHE( XHEJI. 13 fr6ryla 5 . llgoqam Eq c ycrortwu t.@Gx yorDotoq I {exofo9q crgodalcffi coaEal:patytltail rtuadqomacEfi f,cqqot.afi Ctprra H aoa nDoaqaM acdqotalu tyefr Xallau legprroDu Botgacr FA zo t' z6 falff 1958 Pixx(cuEsft p.frof,) 56-64 4044 to4t 155 2 0r8 r 733 3 5687 03t t 925 6,5 I r7l 730 2 505 19 876 5 r r7 il 933 9 ,3 l3-r8 l3 9 t5 1 8-65! 20-26 21 t3 r 8-32 t0 25 llruapaar 1964 5@gD(cuEEd D.tor) 2 ro9o4t965 I 504 l-8 llogt.mr 1 964 ao9oacroil 9a-nof,cqDcun palot 35-1t35-7t !. E721 718 IIqLU I 968 Kguot(rogqcrol r.loa) r 9-70 55-66 55-64 aH4 40-59 4O-6t | 5-54 )5-62 2 430 5ll 18{ 890 2 156 l5 640 6 221 5 to-22 8-r I 5 5 6-lt l Coqiaf,f,oa Kogonax?to r958 I da"a9cm ro9oil r955, r956 2 cdEm ga.loxr Oirffi|W r96r XrDutgta(cuxEdl parox) qcroqotrm 197 4 Ky"B. fop.(cuDcu* p.*or) \96t -t97t llacrqDro aogo!- cB paroEor lotoqaru 1969-1970 tocBa tr frDoto- rru (cuxd D..f,oi) 1964 T{ra x Pammar(roporcrot/cuDcd Drnot ) a qrqo o6qqorertu o rlrooa- @ c c*?os ycronqroro x,r a rcrD*oollua-. " rlgooa- nqs?ai tro a?ymur 3aracaru r rs6Jugy r c@oarcm c &?d trDoutaa, tr9@acqeA f, ta6dalaarcctDD nxatrcro8otd t4 i{croqlffi | Yov.t. r. .t.1. Studir rr.uDloglc..t phtlt.olotlcr Cacho.lov.cr, 351 69€ (t97S) OIr.n. H.C, & GII!{. J.C.8rltlth dt,crl J@6.1, l: 45O (1960). ltuhtl . E. r FlMrsb Pnvalanca ot raagliltory ryrptoD, ch!61c brdchltlt ud Frl.6aly arpbysr !n rur.l poFrl.llo. CoD.ah.i.o, lslriurd, 1965, HlErln.. t.T.T. .r.I.8!1tt!h Jom.l ol tndu.rrLrl Ddlcltr., 16:255 (1959). seE.. ( cmtd) i Hr,rln., I.T.r.& C@h!u.. A.L. Brltr,rh J@n.l o, lndu.rrl,rl -dlcb1n., tt:93 fi,r1n.. I.1.1. & C4h!u. J.g. TubrcI., 39: 296 (lgst). ( l96l ) L.nd., 8. v.n d.r. Epid..1ol,6 ol chrdlc ndaEtllb Iud dls.{ (ch!61c b!6ch1t1!), /lt&r, Vu Gorcur L Co.9ary, 19€9. lh.nrDl . I . & Hdian, A. JaErl ot chlolc dl..o.., 25: 319 ( I9l2) . s.ricll. F. & Lrrrnca, Ph,S. Chlolo nda$ltlc {aglratorv dltaar j,n tha crtv o, Craca. v.E, il.t16.1 Inrtltut. ot Hyalana l9?7. Zallovie . c . Etlotqt ot ne-rtaclttc chr61c ntp{latolr illnaaa ed cor qlEtala i,n 8orn1. ud ltralargvl,n.. S.r.J.vo, R.dovt lnrtltut. a tcatJ.@ t Sel.lnu bdr,clnu tbdlcin.toS F.Lultar. u S.!.J.w, 197I. XozaFvla, 0. at al. In: Ecolf o, chr61c n6-E1r1c ilaDlratort dlxa&a. fa!.', tL, rslz, D. L?A. r5 IlpoaHanlcnpoBaB &D{erculHec8 .qaHHhIe, yt{acrHlrKH pa6orreti rpynror [oIqepKHyJrH neo6xo.oanocrb B nocroaHHor Har(orureHHH Ha.rIexHHx .rlaHHbtx o graquuocrH )GIB[ B [rErHe cueprltocrH, aper,reru.roli HeTpy.uoctocoonocttr H -rpeoyra[efi JreqeHHE 3a6oJreBaexocrn. Tarne .uaHHbre Moryr cJryryrb ocHoBaHHeil .qrra Bbr.qeneHlrfi cpe.ucTB .uta np@HnaKtaar &IBJI n 6opr6u c HUvtH. HtoCn onpe,ueJrl.Eb, q/uecrByrqr ml .qetrcrBHTerrHo pa3rrruHE a ga6oreBaexocrl.r Mer.Er crpaxaxH HJa omu coycloaaexx Heo.trEIaKoBhlulr Mero.UairH .urctrHocTHpoBaHuf, 91 r(o.tr{poBaHHf,, uoro{o npoaHaE€HpOBaTb .qaHrue o cuepTHocTH BpegyJlbrare )GIBII, noryveHHue B crpalrax, Koropble yxe npHcr]rrudrrr K c6opy no.uo6sofi t.t{<popualu.rr. BO3 Morra 66t oKa3aTb cq,qeristaue B npoBe.qeHHH pflla rre.nKoMaonaorux HCCAe,qOAar.II4i .tr,lE r,EyqeHHfl. 3/rbljx acneKToB n paapa.6orru lro.qeref 6y.UWeli .qe.rrTeJIbHocTH. B KaqecTBe .uorrocporrHori ueJrH MoxHo npe.rIpHHFIb norruTr(y ctaHlap(fr,t3HpoBaTb .qaHHue o cueprHocrH B pasHu( qrparax. 3To norpe6yet BHeceHHn H3ueHernfr B ctBpexeHHue nporpauxu no.urproBKr apaveri n CT/IEHTOB MEII'g.I}rHCKHX F{E6HbIX 3iBE.qEHr,trI. I,lcrroJBsyene B Haerorrltee BpelrE, Eo MHorox pagnHtrHHe Mqro.rr c6opa ,uajHHblx o ga6oaeaaeuocrH, orHocunoi 3a cqer XlIBJl, a raxre crrnwruf, B THne rar(Hx .uaHHu( He ncrBo[arT npoBecrH r 6rotxarhueM 6y.Erueu BaJu.rrrhre cparHeHr.rE. Ecrpl 6y,uee coqreHo Heo6xo&il,uil npoBecrH cpaBHeHHe Mex.qr crpaHar{H, TQ, KaK H npH H3yqeHHI,r ,EaHHLD( O CMepTHOCTH, Moxno opraHr,Boaarb cneuHEurbHue uerxouacltra6r+re Hctne.uoBaHHfl. 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Bce grrr npo6lera rro6yraJvt Enponericxoe peruoHaJrbHoe Ospo BO3 u Eaponericroe oeuecrBo KrruHrqecKori pecrnrparopsori Oraroaorran npHcr:/nrrb K oc'l/ueqrBJleHHlo o6le.u,trreunofi nporpar,u,N, HanpaBrreHHori ua aupa6orqr a.qeKBaTHux onpeaereHrfr TepxHHoB, Koropue Has6oree qacro HcnoJrb3yrrc.f, a o6aacra 6o-nesHefi JreFKtac. B pegyrrTare gTorb Hat{HHerHHn a 1975 roJI/ B Bulletin de physiopathologie respiratoire , Tou 11, 1975 , crp. 937-959 (no Qpamr. w34.),Crtrnl 17 ofiydrtrrKoBarur Houeraclar]rpa n ortpe.qereHl,ta, HcfloJlb3yeuble B pecnHpaTopHori ongHononfiu u KJTHHHKe XpOHHqeCKHX oOIeeHeli Jler]<I.D(. Oupe.qerers.rfi XHBJI, rponr,FqecKoFo 6porogrta, sxQuaemt a acrlot, .IBHHHe B ElueyKa3ar*roi rry6ma<auru, 3acrlyxxBaxrt Tono, qroeu npuBecrn nx a .qanHofi Opcurcpe. a) Xporcrveocre Hecrteq@HrrecKHe 6oaegr*r JIerIsr((xHsrrlT oonr ffi,ui, rrpr Koropux ra6rm.Eaetca xpoHl{rrecKoe o:r.ueJleHHe rioKporu tr/uta o.&trrxa B noKoe ufuwr npn xo.o6e. flpuxerralue: Hueet Mecro nepexo,q o.uroft OoPloI B rpyryD; .cna nepgoli 0opl6l xapal(TepeH K:tilerlb H or.IIeJreHHe MoKporlr, a I,J.tf, ,qpyncfi - xpHrrH u/ttt*r o.EoIExa. Taxun o6pagou, B or.qeJlbHhtx cJlyr{a.Ex EIBII npeaeraEllnlqr cc6ofi rur6o xpoxnqecrcd 6porocrr (nror.qa co[poBor.uaertfr o6crpyxruaefr rc3,rytrHux nyre*i), au6o 6poH:o.raJIbFIyE ac=t,ry HrEr 9l4x3euy H .uare xon6 nan-uryr grrrx coctomral. 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BO3MOmioSIU BI'OPEqHOH IIpOddltAIg'HKI4 B orrtrr{He crr nepBl,rqHofi, atoprrunaa rlpooHrraxrta(a rIpHE BaHa BHf,BJlErb fiHUt y KOTOpUX yre Hilerrref, TTpHSHEIKH OoJiegrur, H rryTeu cHHreHH.E r.r,rrH ycrpar{em{.a Boa.ueficrBHf, cocrrBeTcrBlrEEta( gTHoJrorl{qea(Hx oaKTopoD, Hap8.try, r.ue 9To yMecTHo, c Me.u,IuHHcKHI ngq"r*a*, oqraHoEtflb pa3El,rrHe 6oaegrfi HrDr, B onpe.uereHHbrx ycrloBrtx, B6r3Barb ee perpecc. 35 B o.Eror Hg BtrrreH3nofeHHlrx pag.ge.noB [p]tBo.E{Jrrcb rgroJDr, rrpHroEfle .uJrE BrraBrreHuf, pa*lefi craJIr{H &IBJI, r rp]rrrtrI HarceJIeHH.E, no.qIelarrtHe oocne.EoBaHl,oo. B .uarnrou pa3.qe.[e crreArerr elle pa3 o6qr.ryrrr Meiro.ur noJDrqgHHs ruroopxar-ErH o B@.ueficTBHH gTHorroryqecKrc( OaKTopoB, Koropa.E Heo6xo.trtua .Enf, H:tyr{eHHa gD0ertoa r*or.BuEatJug't rurH cHHxeHHagrorD rcE.qeficrBnar .ttE B KoHetlHota rflrcre nclBoJIHT c.ueJlarb npe[IororeHr.{e o noJlb3e rer{eH}rE. B npe,El.ryuen pag.qere rrcBopr,Llrocb o ro!{, rrro .gocraroqHo nen(o xolo.ro no,IyqlrTb .qaHHHe o BoS.ueFrcrBy&t ta, 3,qopoEbe oTIeTIbHttX J[,rU nolrpedneHHE cHraperr H .upynrx ta6arnolx r€.ueJ[4l. B To fe BpexE 6oJE!8{e THr,rrcqnr Bcrpeqax}Tc.E IIpH o[IeHKe BOS.qefiCrBHE 3arpASHeHHOrO aTtaOGDepHOrO BO3.q]rXa goooEe H BGIA/xa paooqefi 3oHH, B q€rcTHoqrH. EcrH TaxHe ,BHHUe Huerrrc8, He Bcer.ua iloll.p BbtEBItrb orr{ocprrerrb}ry-D greneHb Bog.ueiiqrB}rf, Toro t{ rH .qFynoro Oal(Topa Ha pa3Br,rnre Ooresru{ B cJlyqae npHc.:rrcrp!.x pa.ua raxHx Oamopoa. 3zrt Oaxropu Mor:/T oKalrErBarb HHE{BHA/aJIbHoe HrH KOEIJTeKCHOe EO3.qefiCrBHe B TeqeHHe npo.qonrlfTeJlbHore nepHo.qa .qo rorp, Kar( noaBrrrca [pu3]raxH 6oaegru. nogToxy noJlesHo pacclroTperb Bonpoc o Tox, KaNHe nocJre.ucIBl,r8 !{oxerr HleTb fiytt<E,H,lEr.vrf, BoB.qericrBEa Toro rurH HHoro oatcopa. Kru,trrqeocne BneqarrleHnfl, KotoFtte renepb fIoJIHocEbx) no.qEBepx.qetGl noJIyqeHHbIIr{H .uaHHHt{H, IIO3BOJr.ENIr C.qenaTb BStBoL IITO npeKpaueHHe KypeHHfl HliteeT pe3yJlbTaTou ct{PrxeHue HJnt ,qare noJrHoe Hcqe3HoBeHHe uoKpcrrooT.uerleHHf, y Kyptur,f,x, crpa.Earo4a( or.qeneHneM uor(porhr. Eczr .uaruue, qro B ps3yrrbTaTe crrKa3a oT KypeHHf 3are.q,[8t]TcE TeurrH pa3Br,fTr,ra }BXeHet.trtrl ,ErXaneJlbnofi oyHlo-u,e{ y firllt, capa.qa.I)u{x par+reri c=a.uefi o6capyKrHBHcri 6oaesHx. a 3tx pesyroraru The natural history of Brltish medlcal journal, I:chronlc alrf }ow obstruction 1645 ( L977) . 36 --.----Fletcher, C.& Peto, R. no3EoJrErqr Bpaqail H oorEFsru ,ryque noHflfb Heo6xo.@{uocTb npeKpa[eHxfl KypeHu.E Kax EaxHoro Oar<topa KJrHHHqecKoro JrerreHHE 6oJE,6rx, crpa,qaroE{x paHHeri c:a.ulea )GIBJI. Bpawr ,qoJlilGt peKoueHloBaTb H noqp,tTb MeFr, KoTophre Hueur ueJrbpy6e.wrm raxxx 6orrrsrx orKa3arbcf, or KypeHHF. C .upyrofi (=opoHu, npu aanorl o6crplrKrutH Bos.B/uHUx nyref Taxue HgueHeHHa [oryr Hocnrb Heo6pararofr xapar(Tep, Hecuqrpa ra rm6ue norlurKH ycrpar*r:b aog.uerictaHe srHorronrqecKlrx OaKTopoB. O,uraxo B 3Tox cryqae CIn(eCTBeHHUIII,qOCTHIeHHet( MOxllO Cq}(ralb OcTEtHoBKy nporpeco{poBaHH.8 oong3rs,r. Bce gao norrHocfbD oTHoctrTc.E H x aog.qefic=BHD 3arprritHeHHora Bo3.q/)a ra pa6oqex ueqre, r.re qruecTByeT MeHblle,qoKa3aTerlbcTB noroxKreJlbHhrx pe3yJIbTaToB ycTpaHeHnE nos.gerictaua yKa3aHHux oaxTopoB Ha ooJIbHOrO. 3to nansaa o6rac1B, Tpeoynqaa rIpoBe.EeHHE .uatEaera[ux nccae.uoaarqal. Yqacrrr.tr(x Pa6orrefi rpl/rtru npHEJrH K BUBo.Er o HeBO3rI(OXHOCTH TOqHOTO Onpe,ge.rreHHa ypoBlrs coKpar[eHHf,gaooaeaaerocg,r XHBJI B pe3yrlbrare ycrpaHeHHff aos.qerlcrrHE ?THonopFrecKHx OaxropoB. 6.1 PoJ6 te.Etr(arerro3Horo Jrer{eHHE Cae.Qrtcoul rpe,ru,reTox o6cyx.uerrra Paoo'reri npyrtrEl 66In BOIIpOC O neKapsrBeHHux cpe.EcTBax B TepanHr,r H npegmper.ueroau na-rrseriuero pasBr,rrnn )GIBJI. 6. 1. 1 AHrr.r6uou,rcu Coaeuaru.re He fipH&no K e.tr{Hor,ry MHeHHto orHocttreJlbl.p povu arml6HoTHKoB B ,rerreHHH Aaxe pacno3HaBaerdx ElBn. OcHosal+reM D.nfl nx H(noJ'tb3oBauun cryxwt na6mo.qenue, rr:to B HeKoroph[x crryqa.E( pegKoro o6octperuta 6o.neerrr, canFoBoxFto(erocE noamrerurofi ret,rrtepa.rypoi H orleneHHer MoKpo:ru, HHoF.E rrorinoro xapaxTepa, ltoxerr Hilerfb Mecro OaxrepHanbHa-a HlrOeKr-u{a. 9ro npHae.no K 3r{aqu:reJlbHoxy Hcnor:bgoBaHr,m aHrH6lrorHKoB, oco6ercro aHTH6HorHKoB Er{poKoro(rIeKTpa, npHqett He TorrbKo B crryr{a.ax ooocrperom, Ho H E rlerE( .qqrrnScpo!fiorl npooHnaxTHKH. cyUeCrryer ua-no 37 .qocraro(rHo oCocnoaaloflx pe3yJlbraroa rccre.qoBanloi, cBH,uereJlbcray@fi o rolt, qro [pHHeHeEre arrrrr6uorHKoB B no,uaBJrf,rEeu t{HCJe cJlyqaeB BHocltr clruecraem$fr BKrIau B ,et{eHue gnH=}o.EoE o60crperuo{. xqTfi B OT.UeJIrHHX, cpaBHHTe.rIbHO HeHHOrOqHCIeHlslX CJryqaru( CJIe.ryeT nphlt€H.EEb aHTH6HorHr(H, nx HcnorE3oBaHI{e co[pEf,eHo c pHcKol,t, flOCKOJIbKy, HanpHIep, Ot['! BU3UBaICTf pa3Bl'ffHe pe3]tqreHTHbIX K aFTHOHorI,tr(alx l{Itr(pooHtlx ET€lxl,toB. KpoHe Tonc, 3To .qoporr3cTo&He cpe.IlcTlrar. Y'{ac.rru,og Pa6oqe}i rpyrru He clrorrlH Erpa6orarb el!,rHoe uHeHHe oTHOCr,rre,rIbHo KoHxpeTHoIT poJpr arru6Ho[nx(oE B JreqeHHH parfl,D( cra.uai xHBJI. Teu He MeHeHe oHu cqHTaxrr Heo6xo.u,r.lGlx llpoBo,u]t:fb H Bnpe.E KoHIpo[r{p:/exHe KJIHHHIIeCKHe HCnHTaHHf, .4nE OTIeHKH SooeKTHBHOCTH JIeqeHHt arnra6sorrxaHH B XHM, ocr6eslo r.D( paHprx cra.tr{fi. 6.L.2 BpoHxopacrupf,Ioo.re cpe.ucrB.t 3:u aexapc:aeHHue cpe.qcrBa rrpHxeHf,prcf, lrtf, YJrynalar-, npoxoE{uerH 6porD(oB. OrpaH}rqeH}lttri o65et{ Hrerro{xct .qal:tr$D( He nGBOrfretr OUeHr{:[b .qonroBpereEilrl eooexr ]rKalraHHux npenaparoB, ocooeHHo npH neqeHHH paHHHx crarud XHB'I. 5.1.3 Hec:eporutore uporrBoBocnarrre.rrbxue JreKapcrBeHHNe cpe.ucrrxr 3TH cpe.qcrEa Moryr npHueHfrbcn NE cHETHE crIEKa cJrH=tr{erofi o60ro.rrx u E tf, yJryrfleHHf, npoxoE{xocrH 6poHxoB. 6.L.4 flpsreoruTfiqecKHe OepMeHTil 9rrl cpe,uBa HcnorlbgoBanucb .tr If, noHI{reHHB Ba3KocrH 6porDora.rEHoro ceKpe,ra, B pegyJlbrare qero yrfnrtaerct xyKotr{rrHapruu x.rupenc. O.rraxo ru( EpHHeHeHHe rrroxer EbrgBarb HexeJTareJIbrGIe noooqlGle EBJTeHHf, . 38 6.1.5 llpousao.ucle L[,rcreHHa 3cu upenapa$l crtoco6crByut cHHTegy cJma,tt, 6orarol cranoBofi KHc;tcrroH, rrro t(oxerT ca.qeficrBoBarb yJrJrqueHux) r.yKolu,trrHapHorc KrrHpeHca. 9ru rpoleao.urre TaKre oKEEHBaxIT nporr.{BoBoclrtul}rrerlbnoe .qeriic-rsre Ha cnn3ncrlno 6paHxon. {* , B cJryqae c aHTuOllorttr(€lltn, {e oqeHb MaJIo ?tslBeCTHO O pOJ[,r ]TtO( rpenapaTon B netreHHn parflgx cra.uai XllBrI. yt{ac"Trf,,tr(H Pa6orrerl rpyrrnr eue pa3 o6parr.r.ru EHHTaHHe tiEl orclrrrsTBge .uoctarolrHux cae.uemfr a sTorl o6nac{r H npe.qrDltruur llpoBeerl{ TorrHyp o[IeHrcy poJtr{ gIaD( cpe.gcTD B aetremaa )GIM. 6.2 lluxaremnaa rT,tI{HA THKA Yqacrrutr(n fp:nru o6cywral Bero)Eryn porrb .srxare.rrsnofi r:IilHaqrHKH a neqemet XHBJI. Xora grc/r xerTo.u rr{ox}ro peKorreHloEarb .4rtfi o6uenc yJryq![eHl{f, .rtxElHHE H EJtfl ycTpaHeHHf, noKaJlbr.tHx 3oH aTeJreKTaSa, noKa Hsr .qoctaTot,l}rcrl Hloopualtr{H, rpATBepx,qaroEeft gOOeKTHBHocrb u€rro.qa B Jret{eHHH pasanswu<ca XHBJI. lloctcolrxy 6brlo ErErcxagaHo ilHeHHe, r{:ro .trIxaTe.rlbHErf, rHlt{HaenlKa HrpaeT Onpe.qereH}ryE pqrrb B neqeHHH parm,o( qawdr XIIM, cne.qgerr npoBecrn TuareJrbHlno oUeHKy .uaHHoro MeTo.ga JreqeHHE. 6.3 llporpaxror pea6rumraua Taxse nporpatoor no BceJi B@otrrHocrH EHpoKo npHileHflxrrca K JIt{Iau, crpa.qarto{ta uaruOec.*tori u npuao.q.aqertr r r,urBaJrn.Erocrr Oopttrotr )GIEI. Her aee<ux .qoKa3alerrbcrB sOOeKTrrEHoc=I{ uo.qo6r6D( flporpaxx, ]r nosrorry Heo6xolurro[poBecrH HccJre,uoBaxre Hx poJr! B 6opb6e c grol rpyrmofigaooresaErl. 39 YqacTl*rxu Paooqefr rpyrlrEl KoHcrarHpoBarlH orcyrcraHe seo6xo.urrox,uoKEBareJIbcrB, no3BorIfrIC(H:x c-o aceli onpeleJleHHocrbp yqraHoBHE eoOerr aog.Eelrclana reqeHnf, Ha ecreqrBeHHoe reqeHl{e paHH{x cra.rual xHBn. oru eue pae no.qTBep.E!,rrtr{ Heoo(o.rtrocTb B paH.EoUH3HpOBaHHblX KoHrpoJup:/euHx HcIE[raH]rEx coorBercrElrrctrera MaG[Ta6a .trrtf, oueHKH go0extuauocru srL,tx nporpafix. Bruno nprsuaxo Heo6xo.u,lrcu o6yqart spaqefr xero.@r 6opn6u c )GIBflf sro oco6o crrlioctrrcfl K Bpatail ooEefr npar(Tt'It(H, KoroFHe qal(e Bc€rD oKa3HBa.rrr re.qa-u,{}IcKyD noxoG OorEI[Iil, crparEro[o'ol)GIB,I. PeByJETaTH PaH.qolHSHpoBaHHLIx I(oHI?orIHWeloIx ugtLrtamai paSJIFtrIb[X [ierTO.EtoB JIeqeHHE .qOJIETE 6HTb .qOse.UeEl .uo cBe.qeHnfr Bcex apa.{efi H rpyrHx JrHq, npuqacrHux K 6opree c grHxu ga6oaesaplroln. OPTA}II,I3AIIHOHHUE ACIIEISIU IIPBI,IIIHOI,I I,I RIOPITIIHOT nPoo,IJlAicIlIKU Y'*ac=ruagr Pa6o'qe[ rp]rnnu oocy.tr{Ju rryTH opraHu3alrHH nepsr.uoii r atopr.arofi npoOuraxrtaol XHBJI. Kax qruerralocs BIue, EarHbIu Kor,rnoHeHtox nnOoli rrporpamoI .goJtrl{a qrarb pa6ota, HanpaBJIeHHa.E Ha y6ex.qernae o.rrHx He rlpHoouarbcE K rq/peHHlo, a AH/no(, yxe Kypr[oo(, - opocrflb 3T:f npHBrqxy HJIvt coKparHTb no:pe6lerare ra6aKa, HE'r xe HsueHHTb rIpHBtrrKH l(ypeHl{f,. },tero.El peaJIHSauHI,r raxlo( t{ep pa3JrHrrarrc.E B 3aBHCHldOCTr ct ycaoarri KoHKpeTHux crpaH. B to re Bpeun HeooxoElrro, qro6al npasl'freJlbcrBa, Har-u,roHEUIbHHe H Uef,.qlHapo.trrble opraHr€allM 3Har{l{rerlbHo pa@HpruIu cBop no.q,ueprxy ]rcurlrf,u no paspaOort(e, oueHKe H Koop.E{Halua{ TEu(}tx nporpa.ux. Bonee noapo6tto 9TI'I [po6re$I paccuorpeJl Koruter sKcneproB BOO no Oopb6e c K:/perurex.a Jlp6ue MeporrpHETtIE no yueHbueHxx, awHo Technical Report Series, No,636, 1979 (Controlling the smoklng epidenic: report of the l{HO Expert Committee on Smoking Control) 7 40 3arPa3HeHr{OCTr,r aTuo@epHoro Bos.qrxa H Bct.qrxa npoH:rBo.qcTBeHHH:X noreueHHr Tpe6yroT pactil{peHH8 OKa:rbrBaeuori Hil no&UepE(H, OC!6eHHo no.q,Uepe<H cto CTOpOHH npasnre.rEcrB. 3to nueruro ra o6rac:t, r paOore a xotopofi cJIeIVeir rpHBreqb IIp@con3H H cEr]tr.D( pa6oqHx. Heo6xo.u.rxopasbacuatr rry.uf,lo{rcf, B€lrHocf,b oepeEroro orHorleHHE K cBoery 3.qopoBbp, HanpHxep, nyrer oTKana c,r r(ypeHHE. Brue roaoprraocs o ror, Kau(oe BJDTaHHe Ha 3.uopoabe oKa3HBaerr lrype!{re B Coqe[aHHH C SarprEHeHHUr EOS.qrXOrl pa6ouD( xec:. K gTcti onacFrocrr cJre,rygr npuBreqb BHHxaHHe paOcrro,mreaefi, npoOcorcoB, pa6orrHx H plrKoEo.umenefi 3.UpaBoo)(paHet;&7f,. a Taxre paoorHHxoB garo.qcrofi ue.oamcrcol cllyr6r. TorEKo IIpH TecHot coTp:/.trnfiecrBe Bcexx srro( rprynn ror{o oq/EecrBurb Heo6xor[rnre npo0xlaxr]F{ecK}re reponpHarr{E. B KaqegrBe n@Borc Eara, He l:lpeo:fnlero 6oJEEa( 3atpar H BpexeHr, uorHo npoBecD{ Kor{c}rJlbral[{H o BFE.qe rrypeHr{B H BBeCAH OrpaHEqeHHA }ra KypeHHe Bo BpexEpa@rtr. Ilem atoprruorl rrpc,oHraxfla<tl - BbrEEJreHHe ,rxu c paHHHxH npH:rlrara.rH 3a6oleBamtn, KoHcyJrbrnpoBaHHe I,DC no Botrpocard, qBEtaHHbrx c yxeHbueHuex onacHocm aoe.qefictBrn HerarHBHLIx oar<ropoa H, IiaxoHeu, onpe.qe.neHHe cocrrBercrq/Eero Kypca neqeHxa. Oueau.ryro, qro .ILTIE BuaBneHHE TaI(Hx Jrlru norpe6yercf [poBecrn oocne.uoBar*re KotxrHHrelItDE Hrfri rp]/rrl lrac€.neHHfr, B COCTaB KCII1cFDIX BXO.qTIT nulJa, nolBeprapuHecs Bo€.qerlcrBro Bpe.u[lx Oaxtopos, o6ycaoaaeru*x K]rpeHuex n/nnr ETrrEHHeX sarpE=lHeHHOTO BO3.q/Xa npoEtBo.qcTBeHHHX nOXeuerrfr ta aruocQepHoro Boe.q]rxa. y yqacrHHKoB paOoqeri rpfmru Her cBe.ue}tr,tri crrHocr,r:reJlbHo ryuecrBoBaHHE XarCri-ma6o rorucpe,,rxofi nporparnl o6creaoaaru{.8 race.nemral oHH crof,ragr BaJrHLtx, rPe&ue rcerD, ycrErr{oBrirtb uelecooopa3HocTb npoBe.qeHHs TaKrX nporpar.r B rle.rrfrx ETTEJTeHHE parnnD( cra.uai xHBrI, a 3aTex r,rtyr[frb Bcnpoc o BctrorHogrH EtIHeceHHE cootteacrsymeri pexoleHlar-u,tH. 41 Yqacrlu.{KH npe.oroxruIH pfi.q [pHrn-u/fioB peueHnf, Bo[poca o uenectooopaSHocrH o6caeaoaaH}rfl HaceJIeHHfi c uerlbx) EDIfiBneHHf TOnC rurH HHOrrf, aaoorteBattr{8. Hexctrophle H3 STHX rtpHHI-E{nOB B [pHMeHeHHu K )OIBI o6cyx.m.mrcs yqasrHxl(auH Pa6oqefi rpyrrDl H rIpHEO.IIETC.A HHXe C COOTBeTgTB:/rrEHraH 3arerraHHFl0t: f ) 3a6oreEaro{e, no.@epraeiloe cKpuHH}rry, Hueer BarHoe 3HaqeHHe. B me,rt.Eruer pa3.qere oTxet{aJIHCb xaqurad,t cueprHocru, orHocttlofi sa cqerr XHBTI. ypoBelG 3aooreDaetaocrH H, ocooeHHo, HHBaJtr{IEImH .IiocaarorreH, r{To6st XHBJI grsec:a K qucrty 3a6oreEarufr, rant6oaee qacro noparanryrx B3pocJloe HaceJIeHBe. 2l Bore3[6 Hocr,rr crcputtoi xapaKTep na onrpe,uelerurofi qra.Etrr, T. e. KOr.Ua HXeITT XeCrO JIHIb He3HaqI'rreJIbHHe KtreHeHHE. Ecnn curro:ottsl co cropoHx opraHoB .rtxaHHE .uefrcraxterrHo yxa3[raall:r Ha paHHnD craJun )GIBJI, Tor.ua 3Tor rpnrepxir roxHo ct{lrrarb oOasoaarcux. 3 ) Ilpouecc ecrecrBeHHoro reqeHr.E 6orssHH HgBeereH. Iloxa o65ex Hvem[Hxcfr .uaHHbIx o pa3BI,rrHH )GIBJI se.qocraror{eH. 4) Paspa6oralor coorBererE:/rEne recrbl pJl;f, ilffinevuf, paHHHx ctaalfr 6onegsn. 3ro cpa.ae.uJr{Eo no orHcueHHD K curclToxax co cropoHu rp:r,uHotr KJIeirKH, trlp xe Kacaerca npHra.uHocrr,r .upyErx recroB ra XHBII, HanpHxep, noragatereli Oyril(t-u,{H BHeEHero btxaH!4f,. !o HHoopralu{fi o Hr{x flBJIEgrca Henorurofi. 5) Paspa6oralu o@errpu3Hamtle r€rro,rr reqeHnf,. npeKpauerc e r(ypeHufi r{oxeir np!.{Becrl.{ K yHeHbueHHD HJIH Hct{e3HoBeHHp cHxrrro}toB paxrefi c=a.uar X}IBIII Oonee no3.urux craru,fr sa6oreaal+{n. 6) Hr.eprcf, Heo6xo.E{lde BosrrorgocrH rrIE n€TaHoBKH ,E{arHGa H [poBe.EHHf, ner{eHBE. 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Всемирная организация здравоохранения (ВОЗ / WHO) · Publications
Раннее выявление хронических болезней легких: отчет о совещании Рабочей группы ВОЗ, Вена, 31 мая–2 июня 1978 года
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