The factors that contribute to cardiac emergencies in Russian workers at remote sites should be addressed by both occupational physicians and industrial hygienists. Psychological stress is one of the contributing hazards, and shift work—typical for remote operations—is a risk factor for cardiovascular disease. (A study of Jordanian workers published in the Oman Medical Journal in 2018 found that the duration of night shifts and the number of night shifts per month significantly increased workers’ Framingham 30-year risk score, one of the predictors of cardiovascular disease.) Risk assessment is needed to quantify various contributing factors and determine the most effective measures to prevent the need for medical evacuations at remote locations.  ASSESSING RISKS AT REMOTE SITES Though risk assessment theory and practice have been in development for many decades already, understanding of this methodology is still not uniform among experts and practitioners. However, more facilities internationally are using risk assessment to deal with complex and emerging occupational health problems. Remote sites seem to be an important area where the most current health risk assessment techniques could be tested because of the numerous challenges at these locations that can be resolved only by collaboration between industrial hygienists and occupational physicians.  Especially important is to view risk assessment as a process, not just an isolated study with narrow targets. For companies whose workers are situated at remote locations, we recommend implementing an annual risk assessment cycle covering diverse hazards, including workplace agents along with personal exposome, lifestyle, and behavioral parameters. The risk assessment procedure should cover the usual steps, including hazard identification, exposure assessment, dose-response assessment, and risk characterization. It is important, however, to transition from qualitative and semi-quantitative ways of evaluating risks to more consistent quantitative approaches.  Consider a worker at a remote site who would be exposed to crystalline silica at the level of 0.05 mg/m3 (95th percentile of exposure distribution) for five years (the average employment duration) during the shifts that accounted for 30 percent of her total annual work time. Her excess risk of lung cancer can reach 40 cases per 10,000 per lifetime (an average of various dose-response models selected by OSHA). We can interpret this value in many ways. For example, we might recommend additional workplace air quality control measures for risk exceeding 1 x 10-3 and development of an individual health improvement and preventive program for risk exceeding 1 x 10-4. If this person, however, smoked one pack of cigarettes per day for 15 years, her excess risk of lung cancer from smoking, based on various estimations, would be around 400 cases per 10,000 per lifetime. By quitting smoking for five years, she would reduce her risk approximately by a factor of 2.  This information is useful for preparation of individual risk assessments and recommendations for workers and should inform the pre-deployment health evaluation for the remote workforce. For example, regular checklists can be recommended for workers who have specific risk factors and risk levels to facilitate regular assessment of early symptoms of unwanted health conditions. Industrial hygienists and occupational physicians can be involved in telecommunication with the sites, and they should have access to the risk assessment information so they can fully understand the workers’ health challenges.  THE FUTURE OF REMOTE INDUSTRIAL HYGIENE Remote industrial hygiene should significantly benefit from future technological developments. For example, wearable devices and “smart clothing” can provide ergonomics assessments and send information about the risk of musculoskeletal injuries to central servers in real time. Unmanned aerial systems could help with the collection of information about environmental and occupational hazards at remote locations. Also, artificial intelligence can be an effective tool in the remote recognition and interpretation of hazardous behavior and potentially dangerous health and safety situations. In particular, the remote monitoring of workers to ensure that they’re wearing personal protective equipment can be performed through computer vision- and image analysis-driven systems. Development of analytical real-time monitors for detecting hazardous substances—one of AIHA’s content priorities—also will bring additional opportunities to control the occupational environment at remote sites and to reduce health risks for workers. These developments suggest that as remote healthcare continues to progress, remote industrial hygiene won’t be left behind.   ANDREY KORCHEVSKIY, PhD, DABT, CIH, is director of Research & Development at Chemistry and Industrial Hygiene, Inc., in Wheat Ridge, Colo. SERGEY ANTIPOV, MD, PhD, is general director of the Center of Corporate Medicine in Tomsk, Russian Federation.  ANDREY KARPOV, MD, PhD, is president of the Remote Healthcare Association in Tomsk, Russian Federation. DARYA ANTIPOVA, MBChB, MSc, PhD, is a researcher at the University of Aberdeen and specialty doctor at the National Health Service in Highland, United Kingdom. Send feedback to The Synergist.