Affiliation:
1. Federal Scientific Center for Medical and Preventive Health Risk Management Technologies; Russian Academy of Sciences, the Department for Medical Sciences
2. Federal Scientific Center for Medical and Preventive Health Risk Management Technologies
3. Krasnoyarsk Regional Office of the Federal Service for Supervision in Protection of the Rights of Consumer and Man Wellbeing
Abstract
Introduction. This article suggests an alternative solution to the task of quantifying and describing health harm under exposure to non-carcinogenic risk factors.
Materials and methods. We have developed and tested a methodical approach that includes five subsequent steps; it is eligible for posterior quantification of non-carcinogenic health risks represented by additional diseases cases associated with poor ambient air quality. The approach relies on unified and validated methods for assessing exposure and health risks, mathematical parameterization of cause-effect relations within the "environment – public health" system, and calculation of additional incidence as well as combined assessment of all the obtained results.
Results. According to calculated data, which were also verified by instrumental observations of ambient air quality, the existing hygienic standards are violated as per 27 chemicals in residential areas. Elevated hazard quotients are identified for 26 chemicals (up to 98.7HQac; up to 62.7HQch). Additive effects of the analyzed chemicals crated elevated hazard indices (HI) in residential areas that could be ranked as "alerting" (3<HI≤6) and "high" (HI>6) for respiratory organs, the cardiovascular and hematopoietic systems, liver, kidneys, eyes, development, the immune, reproductive, endocrine, and other systems. The identified levels of airborne exposure annually cause approximately 80.9 thousand additional diseases among the total population (71.0‰; 4.15% of the total incidence);
23 chemicals are considered priority risk factors (contributions vary between 0.25 and 65.0%). We have identified certain regularity for some disease classes: higher levels of additional incidence associated with ambient air quality are established in zones with higher airborne health risks. Thus, in zones where airborne risks for respiratory organs are HIch≤1, we identified no additional incidence as per such diseases; in zones with 1<HIch≤3 (with population being 800 people), additional incidence reaches 1.57‰ for the total population; 3<HIch≤6 (more than 100 thousand people), 3.25‰; HIch>6 (more than 1.09 million people), 5.0‰.
Limitations. The suggested approaches have been obtained by calculation. Their results might differ from those obtained by targeted in-depth investigations aimed at creating an evidence base of health harm under adverse environmental conditions that do not conform to hygienic standards. The parameters of mathematical models within "the environment – public health" system have been obtained for a limited range of exposure to pollutants in ambient air and a limited list of airborne health risk factors.
Conclusion. The suggested methodical approaches to posterior assessment of non-carcinogenic health risks allows quantifying these health risks as additional diseases associated with poor quality of the environment; they enlarge the results of health risk assessment and make them more precise, validate and support them with hygienic significance. They can be utilized within optimization of social and hygienic monitoring and assessment of effectiveness of implemented prevention activities.
Publisher
Federal Scientific Center for Hygiene F.F.Erisman
Subject
Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health,Pollution,General Medicine
Reference21 articles.
1. Basov A.V. Some aspects of the definition of the concepts of sanitary and epidemiological nutrition of the population. In: Development of Statehood and Rights in the Republic of Crimea: Proceedings of the All-Russian Scientific and Practical Conference [Razvitie gosudarstvennosti i prava v Respublike Krym: materialy Vserossiyskoy nauchno-prakticheskoy konferentsii]. Krasnodar; 2016: 247–50. https://elibrary.ru/wiprjn (in Russian)
2. Rakhmanin Yu.A. Current problems of the human environment and environmental hygiene in the provision of Russia’s population with sanitary and epidemiological well-being. Zdravookhranenie Rossiyskoy Federatsii. 2008; (1): 12–3. https://elibrary.ru/ijaajx (in Russian)
3. Bakhtin Yu.K. Factors in the formation of human health and their significance. Molodoy uchenyy. 2012; (5): 397–400. https://elibrary.ru/rfysap (in Russian)
4. WHO. The European Health Report 2021. Taking stock of the health-related Sustainable Development Goals in the COVID-19 era with a focus on leaving no one behind; 2022. Available at: https://iris.who.int/handle/10665/352137
5. WHO. European Health Report 2015: Targets and beyond – reaching new frontiers in evidence; 2015. Available at: https://iris.who.int/handle/10665/327873