Public Health Epidemiologic Service

(in Russian, sanitarno-epidemiologicheskaia sluzhba), in the USSR, a network of state facilities that perform state health inspections and that develop and carry out national health, preventive, and counterepidemic measures.

There was no single public health epidemiologic service in prerevolutionary Russia. In 1913 and 1914 the system of local independent agencies included health commissions or health bureaus that were engaged primarily in statistical work in 73 cities and 40 provinces. After the October Revolution of 1917, beginning in 1919, public health epidemiologic subdepartments were incorporated into the public health departments of local soviets throughout the country; these subdepartments were supervised by the public health epidemiologic division of the People’s Commissariat of Public Health of the RSFSR. In 1922 a government decree established a single public health epidemiologic service, legalized a system of state health inspection, and defined the rights and duties of health agencies.

In order to improve public health services, the Central Executive Committee and the Council of People’s Commissars of the USSR in 1933 decreed that a public health inspectorate be established as part of the central and local public health agencies of the Union republics. This inspectorate was to be headed in each republic by a public health inspector (deputy commissar of public health) and locally by regional public health inspectors. In 1935 a decree of the Council of People’s Commissars of the USSR approved a statute establishing the All-Union Public Health Inspectorate, which was to be subordinate to the Council of People’s Commissars of the USSR and headed by a chief state public health inspector.

The structure of the public health epidemiologic service in existence today was established by the Statute on State Health Inspection, which was approved in 1973 by the Council of Ministers of the USSR. According to the statute, the agencies and institutions belonging to the public health epidemiologic service include the main public health epidemiologic administrations of the ministries of public health of the USSR and the Union republics and the local public health epidemiologic stations. The service is headed by a chief state public health inspector of the USSR (deputy public health minister of the USSR). Its local organs and institutions are directed by the chief health inspectors of the localities. The medical services of the ministries of railroads, civil aviation, and defense of the USSR are responsible for providing health inspections and counterepidemic measures. The medical services of the ministries of railroads and civil aviation of the USSR are under the jurisdiction of the Ministry of Public Health of the USSR.

The main function of the public health epidemiologic service is to provide preventive and routine state health inspections. The service checks on the implementation of nationwide programs aimed at preventing or eliminating environmental pollution and at improving working and living conditions, as well as on the observance of health, hygienic, and counterepidemic regulations by establishments, organizations, and private citizens. Preventive health inspections include preliminary hygienic evaluations of new design norms, state standards, and industrial conditions, substances, and articles that have been introduced into practice. Plans for the construction and reconstruction of individual buildings and structures and whole inhabited localities are also evaluated. Routine health inspections include regular planned checks on the observance of established counterepidemic regulations by establishments, institutions, and facilities, as well as the sanitary conditions of inhabited localities and working and living conditions.

In 1969 the health legislation of the USSR and Union republics granted the public health epidemiologic service of the Ministry of Public Health of the USSR the right to approve hygienic standards and regulations and to establish the procedure for state health inspections. The latter specifically involves checking on radiation safety measures and border and national health regulations designed to protect the country against the spread of contagious diseases. The powers of the public health epidemiologic service in the area of environmental protection were greatly broadened by a decree issued on Sept. 20, 1972, by the Supreme Soviet of the USSR entitled On Measures for the Further Improvement of the Conservation of Nature and for the Rational Use of Natural Resources. This decree called for increasing the responsibility of ministries, organizations, enterprises, and institutions with respect to preventing the pollution of the water by industrial and household sewage, the pollution of the air by industrial wastes, and the improper removal of both sewage and wastes dumped in the soil.

The individuals heading the public health epidemiologic service are authorized to demand the implementation of health and counterepidemic measures, to make mandatory judgments on all hygienic matters, to halt the construction of buildings and structures until the necessary health-related improvements have been made, to carry out decrees on the destruction of foods deemed unfit for consumption, to remove individuals from work who are suffering from contagious diseases and require their hospitalization, to carry out disinfection, to isolate individuals in contact with those that have a disease, and, when necessary, to impose a quarantine. The various agencies and institutions of the public health epidemiologic service also deal with matters concerning the immunization of the population.

Many methods are used by the public health epidemiologic service in performing its functions. Inspections determine the sanitary conditions of a structure and the necessary sanitary and hygienic measures that must be taken. Statistical studies provide estimates and reports on, for example, the incidence of contagious and occupational diseases and the work performed. Laboratory tests, including physical, chemical, physicochemical, bacteriological, and virological tests, are used in evaluating the health conditions in a facility and the effectiveness of the actions that have been taken. Studies on the health conditions of inhabited localities and structures and the incidence of infectious, parasitic, and occupational diseases provide the basis for the establishment of essential corrective and counterepidemic measures.

The structure and functions of public health epidemiologic services in other socialist countries are similar to those within the USSR. The capitalist countries do not have a single public health epidemiologic service empowered to supervise counter-epidemic activities and protect the environment, nor do they possess the necessary equipment to do this. The coordination and planning of counterepidemic and environmental-protection activities and the establishment of occupational and nutritional hygiene standards are primarily done by special departments or by the administrations of different ministries and agencies independently of one another.

In many countries health inspectorates are under the jurisdiction of independent local government agencies, governors, heads of states, and heads of provinces and districts; these inspectorates largely control matters concerning environmental protection and usually do not have laboratory facilities. In other countries the different aspects of health and preventive work are done by different departments. In the developing countries of Africa, Asia, and Latin America the health and preventive activities of public health agencies are limited to counterepidemic work.