Introduction. Maintaining sanitary and epidemiological well-being in multidisciplinary hospitals is an important condition for ensuring the health of medical staff. When operating the historical building stock, the infrastructure of medical institutions often ceases to meet modern medical and technological loads. Architectural and planning solutions and the configuration of engineering equipment, in particular ventilation and heating systems, are often not adapted to increased operational loads, which leads to a violation of microclimate parameters and the accumulation of biological aerosols [1, 2, 3]. Epidemiological observations confirm the link between the degradation of engineering systems and the growth of occupational morbidity, in particular respiratory infections [4, 5]. At the same time, existing approaches to hygienic assessment and special assessment of working conditions often consider production environment factors in isolation. Direct quantitative relationships between specific environmental factors and integrated health indicators of staff, taking into account their cumulative effects, have been insufficiently studied [6, 7]. Aim. To evaluate the synergistic effect of hospital environment factors on the morbidity with temporary disability (MTD) of medical workers in multidisciplinary hospitals and substantiate its role as a predictor of occupational pathology. Materials and methods. The study was performed as a comprehensive hygienic and epidemiological longitudinal observation (2019–2024) in three multidisciplinary hospitals in Perm. At the first stage, field instrumental measurements of microclimate parameters, lighting, noise, and aspiration air sampling for total microbial count (TMC) and Staphylococcus aureus were carried out. At the second stage, a retrospective epidemiological analysis of MTD indicators of a cohort of 180 year-round medical workers was carried out. Mathematical data processing included correlation analysis, multiple linear regression models, relative risk (RR) with 95% confidence intervals (95% CI) and etiological fraction (EF) calculations. Results. In hospitals with systemic degradation of engineering systems, critical peaks in TMC (up to 945.0 CFU/m³) and persistence of S. aureus were recorded. In all hospitals, a deficit of light positive (LPA) and negative (LNA) aeroions was stated. Respiratory diseases predominate in the MTD structure (84–87%). Correlation analysis revealed the strongest direct relationship between TMC and the frequency of MTD cases (rs=+0.82; p