population of urban territories in changing environment condition - PowerPoint PPT Presentation

Prediction of morbidity in the population of urban territories in changing environment condition Nataliya V. Efimova Zarodnyuk T.S., Gornov A.Yu., Anikin A.S. East Siberian Institute of Medical and Environmental Research, Angarsk, Matrosov Institute for System Dynamics and Control Theory of SB RAS, Irkutsk

Main domains of ecopathy Cultural Natural Anthropogenic Social

The main causes of environmental health disturbances Occupational factors Air pollutions Drink water pollutions Non balanced, dangerous nutrition Psychological stresses Radiological factors

Air pollution (C/RRfC) Concentration F in air 1,4-6,2 parts of Maximum allowable concentration Index of hazard (all) HI=28 Risk for Osseous system HI=1,9

Verification of calculated results forecast « Shelekhov air pollution – children morbidity », ‰ 2500 2000 - calculated - real 1500 1000 500 0 ВОЗРАСТ 1-2 3-6 7-14 1-2 3-6 7-14 1-2 3-6 7-14 3-6 7-14 1-2 All morbidity Acute respiratory disease of skin Muscles-ossous disease (noninfection) disease (Baturin et al. 2004)

Results of forecasting « Shelekhov air pollution – muscles-osseous morbidity », ‰ 45 40 35 30 25 20 15 10 5 0 Age groups 1-2 г 3-6л 7-14л 2010 2000 1995

Growth of length and thickness of bones Intake group Exposed group Пястные кости Пястные кости 15 20 12 20 10 8 10 6 10 10 4 5 2 0 0 0 0 -2 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -4 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -5 -6 -10 -10 Проксимальные фаланги Проксимальные фаланги 8 10 12 15 10 8 10 3 6 5 4 5 2 0 0 0 -2 -2 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -4 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -5 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л -6 -8 -10 -5 -7 Средние фаланги Средние фаланги 6 6 6 5 5 4 4 4 3 3 2 2 2 1 0 1 0 -1 -2 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л 0 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л -1 -2 -4 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -3 -2 Дистальные фаланги Дистальные фаланги Дистальны 5 6 10 4 4 3 5 2 1 -1 0 0 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -1 -2 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -6 -4 -5 -3 Толщина стенки диафиза Толщина стенки диафиза 0,9 1,0 1,0 0,5 0,5 0,4 0,4 0,0 0,0 -0,1 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -0,1 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -0,5 -0,5 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л 5л 6л 7л 8л 9л 10л 11л 12л 13л 14л 15л 16л -1,0 -1,0 -0,6 -0,6 М ale Female М ale Female (Shalina et al.2008)

Characteristic of groups adolescents absense of synostosis inadequete exposed mineralization group pseudoepiphisis osteoporosios norma R-way intake group frequency higth excretion F excretion F median Mkmol/l 0 20 40 60 80 %

Meteorological conditions of Bratsk ( Irkutsk region) 73 80 max temperature 60 (ºC) 44 min temperature(ºC) 33 35 40 26 average temperature(ºC) 20 relative humidity(%) 0 low wind velocity (%) -1,2 -20 fog (%) -40 temperature -43 inversion (%) -60

Air pollution (parts of Maximum allowable concentration (MAC) 2005 year 1990

Induced Disturbances Correlation (Rs) between air pollution and incidence of respiratory organs (on weekly data) Acute 0.46 Methanetiol respiratory Acute SO 2 disease respiratory 0.75 disease Acute H 2 S respiratory 0.8 disease Chronic Methanetiol 0.8 bronchitis Acute 0.7 NO 2 respiratory disease Chronic H 2 S 0.8 bronchitis

Forecast of the children incidence У = Z-1,69 × X 1 +3,2 × X 2 +16,8 × X 3 +0,0085 × X 4 +245,2 × X 5 +23,2 × X 6 где У - incidence (per 1000 children) Z - average incidence in intake territory X 1 - T ( °С) X 2 – humidity (%), X 3 – vel. wind (м/ s) X 4 – atm. pressury (мм Hg) X 5 – summary air pollution F-contaning (HI) X 6 - summary air pollution S-contaning (HI) R2 =0,93 Divergent calculated and real incidence Bratsk = 16,2 %, Shelekhov = 9,5 %

Induced Disturbances The forecast of children ׳ s respiratory incidence Attributive risk, % 160 1 – average meteorological parameters, pollution < MAC 140 2 – average meteorological parameters 120 pollution P = 43, low wind velocity 3 – average meteorological parameters, 100 pollution < MAC, 80% humidity 80 4 – average meteorological parameters то же 60 index of sulfure pollution P= 18 5 – average meteorological parameters то же 40 index of fluoride pollution P= 6 20 6 – negative meteorological conditions for dispersion, winter (t= - 22˚С), P=43 0 1 2 3 4 5 6

Result of medical socio-ecological model The average calculated data were ▪ as follows: in children - 1756 cases per 1000 persons (95% confidence ‰ ), LnP interval 1126 - 2386 in =  +  +  +  +  i ( ) Z a a T a W a V a a LnC i 1 i 2 i 3 i 4 5 i adolescents - 1256 ‰ (1122 - 1391 LnV i ‰ ), in adults 846 ‰ (558 - 1134 ‰ ). Comparison of calculated and actual incidence rates showed: the actual indicator in children exceeded the upper limit of the estimated incidence by 3.6%, adolescents by 6.7%. Primary morbidity is 8.5% below the lower estimated border In the adult population in recent years. Note that the mean differences in all groups are statistically insignificant (p> 0.05), which reflects the good approximating properties of the model and allows using it for further research

Assessment of a contribution of factors to incidence children adults 49 50 38,3 35,6 35,7 50,4 40 60 45,2 43,3 21,3 37,9 30 50 16,9 20 40 7,4 2,5 6,1 0,1 0,4 10 30 0,6 0 20 7,3 до ФЦП после ФЦП 0,7 3 2,6 6,7 1,1 0,4 1,2 10 0 до Ф ЦП после Ф ЦП adolescents T W V P C Q 80 the received results testify about 63,7 57,1 - preservation of the significant 60 contribution of technogenic pollution to 40 30,9 27,1 variability of incidence of the population, 20 3,6 - a bigger role of social factors in 3,4 3,4 1,1 3,1 1,1 2 3,2 formation of health of teenagers 0 до ФЦП после ФЦП

⚫ Finally, physician/scientists are directing or collaborating in multidisciplinary research that capitalizes on both clinical knowledge in individuals and epidemiologic information from populations and results in new knowledge of clinically translatable value. They work on a wide variety of research topics and use a full range of clinical, epidemiologic and environmental health science skills to shed light on the environmental exposures and complex causal pathways that underlie the pathogenesis and progression of disease ⚫ Environmental medicine is not just about clinical practice for patients concerned about environmental diseases; thus, we welcome ubmissions of epidemiologic and communitybased studies that have relevance to the public health practice of environmental medicine

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