Медицина/3. Организация здравоохранения

Master of Public Health A.S. Nurbayev

Kazakhstan school of public health

 EPIDEMIOLOGICAL STUDIES OBJECTIVES

IN THE ENVIRONMENTAL HYGIENE 

          Intensive environmental contamination and its influence on health of the population is one of the global problems for number of regions of Kazakhstan in present. These regions declared as zones of ecological disaster.

          The modern hygienic science develops and offers more adequate concepts, which reflect complexities of interaction of an organism and environment. These concepts are real exposure, maximal allowable concentration, an allowable daily doze, etc. An estimation of a degree of intensity of the limited set of the protective mechanisms available at the person is setting on the basis of such approach. On the basis of the estimation is possible to receive a general characteristic of a set of factors influence on an organism (G.I. Sidorenko and auth.), including an intensity of harmful influence.

          However the traditional way of research studies on a problem is based on prevalence in the analysis and determination of one-dimensional ethiopathogenic interactions in cause - effect system, that not always allows giving an adequate risk and/or danger assessment.

          In connection with told, it is more reasonable to collect and analyze data not only on the state of environmental hygiene, but also about environment influence on health of the population. The similar combination of materials and results allows giving complete hygienic assessment of a research object, to estimate a state of an environment and to develop strategy and tactics of risk management in real conditions of this or that region. Therefore the modern approach to hygienic studies provides carrying out of focused epidemiological researches among the population or its basic groups in a combination with determination of quality of an environment.

          Such methodology of research studies is approved in Aral region. In particular, with the goal of the characteristic of the state of an environment there were determined heavy metals, pesticides, polychlorinebyphenils and other pollutants in atmospheric air, ground, water, plants, food stuffs, biosubstrata of animals in Aral region. The concentrations of these chemicals were investigated in biological tissues and liquids of people for an estimation of an environment influence on the population health of region. The general assessment of a degree of actually existing inhabitancy danger is given in result. Real exposure by the main from researched toxicants is determined and the dependence of reproductive function of women differentiated on factors and congenital developmental anomalies at children from a condition of an environment is established.

          Influence of the contaminated drinking water on growth of chronic esophagitis disease is proved and accumulation of toxic heavy metals and chlorine organic pesticides in biosubstrata (blood, saliva, gastric juice, urine, hair, bilious stones) is revealed.

          The received results show the necessity of development of hygienic monitoring systems and real models of environment and its separate factors influence on an organism of people in conditions of concrete regions with use of modern approaches to epidemiological studies. It allows to obtain the data for a scientific proof of environment management, to define an actual state of health of the large groups of the population, to predict and to operate it, to optimize systems of public health services.

          The following principles should be taken into account at carrying out of work:

- Studying a state of various objects of an environment on the basis of the complex approach;

- The description of social and economic features of investigated region;

- Studying influence on health of the person and/or a population of the revealed hazards of an environment;

- Carrying out of research studies in relative limited territories characterized by general on structure and intensity in parameters of harmful factors of an environment and climatic conditions;

- An assessment of quality of an environment by the revealed features of its influence.

Thus, for researches on hygiene problems now there is not enough establishments of hygienic specifications for separate factors of environment and the control over observance of such specifications in connection with complexity and dynamism of elements of an environment. Speech should go about necessity of risk assessment and risk management that demands development and realization of special programs.       

Literature:

1. Banerjee B.D., Ray A., Pasha S.T. A comparative evaluation of immunotoxicity of DDT and its metabolites in rats // Indian J. Exp. Biol.-1996.-№6.-Р. 517-522.

2.    Krauthacker Blanka, Reiner Elsa, Votava-Raic Ana, Tjesic-Drinkovic Duska, Batinic Danica. Organochlorine pesticides and PCBs in human milk collected from mothers nursing hospitalized children // Chemosphere. -1998. -№1. -Р.27-32.

3.    Сидоренко Г.И., Захарченко М.П., Маймулов В.Г., Путсков Е.И. Проблемы гигиенической диагностики на современном этапе. -М., 1995. -С.191.

4.    Большаков А.М., Крутько В.Н., Пуцилло Е.В. Оценка и управление рисками влияния окружающей среды на здоровье населения. - М.: Эдиториал УРСС, 1999.-256с.

5.    Айтбембетов Б.Н., Лукашев А.А., Нурбаев С.К. и др. Ак­туальные задачи и значение гигиенических, токсикологических и эпидемиологических исследований в выявлении и оценке зон эко­логического бедствия //Проблемы охраны здоровья населения РК:. Тез.докл. I съезда врачей Казахстана. - Алматы, 1997. - С. 312-313.