Ecology

METHOD TO ASSESSMENT OF RISK TO PUBLIC HEALTH ENVIRONMENTAL CONCERNS

Bekmagambetova Z.D., Toguzbayeva K.K., Karakushikova A.S., Dzhumasheva R.T., Kaynarbaeva M.S., Madigulov A.R., Niyazbekova L.S., Seyduanova L.B., Saylybekova A.K., Nurshabekova A.B.

Kazakh National Medical University (KazNMU) named after S.D. Asfendiyarov

Сourse of Occupational Health, Almaty, Kazakhstan

Abstract. In the region of testing rocket-nuclear sites in Western Kazakhstan overall morbidity of the population, and the incidence of certain classes of nosology according to a thorough medical examination to 10.6 times higher than the benchmarks. Found high rates of relative (to 10.5) and absolute (up 144.9%) risks public health indicators of environmentally troubled region.

Key words: environmental factors, nuclear missile ranges, the risk to health, public health.

I. Introduction. For a number of areas of western Kazakhstan, near which for many years conducted the nuclear and missile and nuclear tests in the "Kapustin Yar" and "Azgyr, the question of hygienic assessment of the risk of environmental hazards to human health is not deep enough understood.

In our previous studies found that pollution levels are the main objects of the environment (soil, water reservoirs, wild vegetation, agricultural products of plant and animal origin) in areas close to these test sites radionuclides (cesium, strontium) and heavy metals (lead, cadmium, Nickel, etc.) far exceed the benchmarks, and in some cases, limit values [1, 2]. In this regard, the study of the influence of human factors associated with nuclear and missile and nuclear tests, on morbidity from a position of risk assessment is of great scientific interest.

II. Formulation of the problem. The purpose of this study is to identify risk factors for health of the rural population living near the area of testing nuclear missile ranges. Has been studied public health in the region of testing rocket-nuclear sites (more than 100 thousand people), according to the overall incidence and grade nosology according to ICD-10, derived from a comprehensive medical examination by a continuous, covering about 11% of the population. Control study conducted in the settlements located on the border "Kapustin Yar" and "Azgyr at a distance, respectively, over 500 km and 200 km.

To determine the coefficients by the relative (RR) and attribute (AP)-risk population in the region of test sites were to use the average incidence of people living near landfills, and the morbidity of the population control settlements. Determination of ER and AR were carried out according to existing methods [3, 4].

"Guidelines for assessing human health risk when exposed to chemical substances polluting the environment" (R 2.1.10. 1929-04, 2004) and "Guidance on the public health risk of chemical environmental factors" (Astana, 2007 city).

To study the influence of some anthropogenic factors on the health of the population studied regions was used by multiple correlation and regression analysis between the indicators of morbidity and annual real chemical load (RHN) on the body of heavy metals and radionuclides, as with the local staple foods of plant and animal origin and with drinking water decentralized sources.

III. Results. The study of population health according to a thorough medical examination revealed that the rate of general morbidity and morbidity in the context of individual classes of nosology (according to ICD-X) in the towns of the region "Kapustin Yar" was higher than in the control village (p. Oleksandrivka). The overall incidence exceeded the target of 1.8 times, and the class of "Infectious and parasitic diseases in various localities in the 1,4 - 1,8 times," Neoplasms"- 1,7 - 2,0 times," Diseases blood and blood-forming organs "- a 8.7 - 11.6 times, endocrine disorders, nutritional and metabolic - 5,2 - 5,4 times," Mental and behavioral disorders - in 3,1 - 1,4 times, "Diseases of the circulatory system - 2,0 - 3,0," Respiratory diseases "- 2,6 - 1,7 times," Diseases of the musculoskeletal system and connective tissue - 1, 4 - 1,4 times, "Diseases of the genitourinary system" - 1,1 - 1,9 times, "Congenital malformations, deformations and chromosomal abnormalities - in 9,6 - 10,6 times. By class "Certain conditions originating in the perinatal period" and "Symptoms, signs, abnormalities identified in laboratory and other studies - Pathology found only in advanced human settlements, and in control - was not. Analyzing the average incidence of population in the region "Kapustin Yar" You can select a group of classes of diseases, a priority in the overall structure of pathologies: "Diseases of the digestive system» (490,8 ‰), «Diseases of blood and blood-forming organs» (420,9 ‰) "Diseases of the circulatory system» (360,1 ‰), «Respiratory diseases» (331,5 ‰).

The region polygon "Azgyr" total incidence of these in-depth medical examinations of different localities ranged from 3131,8 ‰ prior to 4256,8 ‰, whereas in the control section Ganyushkino - 2303,2 ‰, that in 1,4 - 1,8 times lower. Analysis of the structure of morbidity of the population of this region revealed that a number of classes of diseases ("diseases of the digestive system", "Diseases of the genitourinary system," "Diseases of the circulatory system", "Diseases of blood and blood-forming organs", "Mental and behavioral disorders," "Neoplasms") was significantly higher than control values (P <0.05 to P <0.001).

To better understand this problem, we calculated the relative and attributive risks of morbidity regions of test sites "Azgyr" and "Kapustin Yar", subject to the harmful influence of anthropogenic factors related to the operation of landfills. For this purpose the average incidence of people living near landfills, and the morbidity of the population control settlements.

It was found that the region polygon "Azgyr" the relative risk of overall morbidity was 1.6, and by class of disease from 1,1 to 4,6. Thus the greatest PR (I to V of rank places) have been detected by class "Infectious and parasitic diseases" - 4,6, "Diseases of the digestive system - 3,7," Neoplasms"- 3,3," Congenital malformations, deformations and chromosomal abnormalities "and" endocrine disorders, nutritional and metabolic - 2,1, "Diseases of blood and blood-forming organs" - 2,0.

Attributive risk to public health in the region polygon "Azgyr" total incidence was 144.9% and for different classes of pathologies from 1,1% to 15,7%. The highest AR (I to III place rank) are set by class "Diseases of the digestive system" - 15,7%, "Diseases of blood and blood-forming organs" - 12,2%, "Diseases of the circulatory system" - 11,0%.

The relative risk of total morbidity in the region "Kapustin Yar" on the level of impact factors was 1.8, and for some types of diseases - from 1,1 to 10,5. The highest relative risks (I to III place rank) identified by class "Congenital malformations, deformations and chromosomal abnormalities" - 10,5, "Diseases of blood and blood-forming organs" - 10,2, endocrine disorders, nutritional and metabolic "- 5,3.

Attributive risk for common diseases of the population of the region polygon region, "Kapustin Yar" from exposure to harmful anthropogenic factors totaled 128.4%. Attributive risk of morbidity in the region "Kapustin Yar" for individual classes of diseases on the level of impact factors ranged from 1.7% to 37.9%. The highest AR (I to III place rank) are set to "diseases of blood and blood-forming organs" - 37,9%, "Diseases of skin and subcutaneous tissue" - 33,1%, "Diseases of the circulatory system" - 21,8%.

Multiple correlation and regression analysis between the incidence of the population above mentioned regions and the actual chemical load (RHN) on the body of heavy metals and radionuclides, with local foods from plants and animals, and with decentralized drinking water sources, has shown that there is a connection between the real loads of heavy metals in plant and animal foods and the level of morbidity in the region of western Kazakhstan test sites for the classes "Infectious and Parasitic Diseases" (Co, Zn), «Neoplasms» (Fe, Ni), «Diseases of the circulatory system" (Co) "Diseases of the digestive system» (Fe, Cd). At the same time, the morbidity of the population of the region, by class of "Diseases of blood and blood-forming organs", "Endocrine disorders, nutrition and metabolism", "Congenital malformations, deformations and chromosomal abnormalities" had a direct correlation with the actual nutritional stress not only heavy metals (Co, Pb, Cu, Zn, Cd), but also man-made ¹³⁷Cs.

IV. Conclusions. Thus, the results of a comprehensive sanitary survey conducted in the region nuclear-missile testing ranges in Western Kazakhstan, indicating the presence of combined exposure to harmful anthropogenic factors on health. High levels of general morbidity of the population of the region, as well as the incidence of several classes of diseases are caused by the influence of complex chemical (heavy metals) and physical (radiation) factors. Due to the current adverse ecological conditions in these areas must conduct ongoing monitoring of the main objects of the environment, as well as regular preventive medical examinations of the population.

Literature

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Authors:

1. Bekmagambetova Zhamilya Dzhataevna - MD, PhD, PhD, Prof.

2. Toguzbayev Karlygash Kabdeshevna - MD, PhD, PhD, Prof., Head of the Department of Occupational Hygiene

3. Lukashev Anatoly Alekseevich - MD, PhD, PhD, Prof.

Mailing address: Kazakhstan, 050099 Almaty, Furmanova st. 247, Apt. 24, Z.D. Bekmagambetova.