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METHODOLOGY OF HYGIENIC EVALUATION OF HEALTH RISKS IN THE POPULATION OF THE REGION IN THE CONDITIONS OF RADIATION-CHEMICAL IMPACT
Altai State Medical University, Barnaul
Institute for Water and Environmental Problems, Barnaul
B.A. Balandovich, A.V. Boyarinov, A.A. Krasikov, N.Yu. Potseluev, N.Yu. Tulin, I.A. Sutorikhin, Zh.S. Serebryakova
There are presented methodological approaches of hygienic health risk assessment in the population of Altai Krai in conditions of radiation-chemical territory pollution. There are given the data of individual annual effective doses of both artificial and natural radionuclides. A specific feature of industrial emission effect on various groups of Altai Krai population is a combined and long-term influence of atmospheric air ecotoxicants on the level of variably changing concentrations depending on the pollution zones, thus, there is separately presented the calculation of morbidity conditioned by the negative affect of the main atmospheric pollutants. Key words: risk assessment, chemical factor, radiation factor, radiosensibility, ecotoxicant, environment.
The methodology of hygienic assessment of the risk to public health in the regions of the Russian Federation is currently rightfully leading in the formation of management decisions aimed at implementing the main provisions of the Concept of the Demographic Policy of the Russian Federation for the period up to 2025. At the same time, this approach needs, in our opinion, more precise analysis and assessment of risk levels at the regional level, considering that the key element in the activity of a significant number of state institutions of the ecological and hygienic profile at the present stage is the so-called "risk oriented approach" [3, 5, 6].
Research methods
There were used methodological approaches to the assessment of the health risks of the population of the Altai Krai, which, on the one hand, is considered to be an ecologically safe region with sanatoriums and health resorts of federal significance - the city-resort Belokurikha and Yaro-voye, and, on the other hand, is an affected region of the explosions at the Semipalatinsk test site, which were carried out at a distance of 650-700 km from the south-western borders of Altai Krai from 1949 to 1963. Moreover, during the intensive chemical use in agriculture, which coincided with the period of development of virgin and fallow lands in the region, there were quite intensively used mineral fertilizers and pesticides, which also requires appropriate hygienic assessment, along with the study of complex natural and anthropogenic environmental factors (radon, natural radioactivity of drinking water, polymetals, deposits of mirabilite) with the help of chromatographic, radiometric, radonometric and spectrophotometric methods of investigation. A total of 6,285 measurements were made in various areas of this study, in-
cluding the use of methods for estimating radiation factors - 3568 measurements, chemical factors (air pollution) - 2717 measurements.
Results
In the development of this concept of conducting regional studies by a group of scientists of the Altai State Medical University and the Institute for Water and Environmental Problems of the SB RAS during 1990-2016 complex ecological and hygienic research aimed at assessing the risk to the health of the Altai Krai was carried out, which was the aim of the study. It should be noted that Altai Krai, located in the southeast of Western Siberia and occupying the territory of 169,1 thousand km2 with a population of 2,543,300 people, attracted the attention of scientists in the 1990s with its tense medico-ecological situation [1, 3, 4]. The level of total morbidity in Altai Krai was 1.3 times higher than in Russia, and in the Siberian Federal District, Altai Krai ranked among the first places in terms of the incidence of diseases of the circulatory system and oncological morbidity [1]. A stable trend was the low fertility rates and high death rates of the population, which made it necessary to assess the medical and demographic situation in the region as unfavorable. And, despite the positive demographic trends of the second decade of the 21st century - an increase in the birth rate for the period 2005-2016 by 37.5%, a decrease in infant mortality by 8.3%, overall mortality in Altai Krai exceeds the birth rate, causing a negative natural increase in the population in 2016, 4909 people. (in 2015, the negative natural increase in the population was 3,711 people).
Specificity of the current ecological and hygienic situation in Altai Krai is determined by the long-term pollution of the environment of the territories of the region (air, water, soil, workplace air,
food) by xenobiotics of various origins, as proved by the MODIS aerospace system satellite monitoring of the snow cover condition in the region. In the course of the study, 5 zones of environmental and hygienic pollution were identified as a major indicator of environmental emissions - the Industrial District of Barnaul (the zone adjacent to TPP-3), the city of Zarinsk (the district of OAO Altaykoks), Beloyarsk village (the area of the mast-impregnation plant), the v. Step-noye Ozero in the Blagoveshchensky District (the zone adjacent to OAO Kuchuksulfat, which produces mirabilite), and the town of Gornyak (the area of the previously functioning Loktevsky Ore-Dressing Combine) [2]. Another regional peculiarity is that the morbidity rates of various population groups are inadequate to the general sanitary and hygienic situation and give more pronounced values i n comparison with the predicted values. The growth of oncological morbidity and mass cases of neonatal diseases with conjunctive icterus of unknown origin in the 90s of the last century, as well as the damage to the nervous system of the indicator groups of the children of different territories of the region, especially on the background of long-term radiative impact as a result of air nuclear tests at the Semipalatinsk test site [1].
The peculiarity of Altai Krai lies in the fact that the radiation factor in the territories of the region is represented as natural ionizing radiation from natural uranium, radium, thorium, the products of their decay (primarily gaseous radon in the southern upland areas of Altaisky and Smolensky districts where the Belokurikha resort town is territorially located), and artificial (ce-sium-137, strontium-90, plutonium-239), brought in as a result of air nuclear tests at the Semipal-atinsk test site. According to modern concepts, the radiation risk factors for this irradiation, calculated by retrospective analysis methods, are somewhat higher than for chronic irradiation. Since irradiation took place in the past years, as a criterion for the risk of long-term consequences, the radiation dose received by nuclear tests is currently taken. In accordance with the "Norms of Radiation Safety" (NRB-99/2009) for the most complete assessment of the harm that can be caused to health as a result of irradiation in small doses, damage that quantitatively takes into account both the effects of irradiation of individual organs and tissues of the body differing in radiosensitivity to ionizing radiation, and the whole organism is determined. In accordance with the generally accepted linear non-threshold theory of the dependence of the risk of stochastic or probabilistic effects on dose, the magnitude of the risk is proportional to the dose of radiation and is related to the dose through linear coefficients of radiation risk.
8 regions of Altai Krai, located along the conditional axis from the southwest to the northeast -
Uglovsky, Rubtsovsky, Zmeinogorsky, Loktevsky, Pospelikhinsky, Krasnoshchekovsky, Zarinsky and Zalesovsky, are currently referred to the territories affected by the nuclear tests. Over a period of many years, more than 270,000 people received radiation doses in Altai Krai in excess of 5 cSv, including about 47,000 people, more than 25 cSv [1].
At the present time, the radiation situation in the Altai ecosystem is mainly formed by natural sources of ionizing radiation and, in particular, by natural radionuclides (NRN) contained in almost all environmental objects and causing up to 80% of the collective annual dose of population exposure in the region due to radon and the products of its decay.
Radon-dangerous territories of Altai Krai are the settlements of the southern and southeastern highland and foothill regions located within the boundaries of the uranium occurrences of the Belokurikha granitoid massif. According to the data of the joint research of the department of hygiene, the fundamentals of ecology and safety of vital activity of the ASMU and the radiological laboratory of the FBHI "Center for Hygiene and Epidemiology in Altai Krai", the excess of hygienic standards for the equivalent equilibrium volumetric activity (EEVA) of radon in the operated premises was mainly recorded in Altaisky (230480 Bq/m3), Charyshsky (220-250 Bq/m3), Pet-ropavlovsky (214-245 Bq/m3), Ust-Kalmansky (245-324 Bq/m3) and Zarinsky districts (284-480 Bq/m3), causing the coefficients of the radiation risk for men is 0.0760-0.200 0, and for women, 0.0197-0.0502.
By calculating the health risks of the region's population from chemical factors, the circumstance was taken into account that a specific feature of the influence of industrial emissions on different groups of the population of Altai Krai is the combined and long-term effect of ecotoxicants of atmospheric air at the level of variablely varying concentrations, depending on the contamination zones [5, 6]. The degree of atmospheric air pollution of the investigated territories depends on a number of factors determining the regularities of the behavior of che-mo-xenobiotics in the surface layer of the atmosphere. One of such factors are the climatic and hygienic features of the observation zones. In the climatic conditions of South-West Siberia, periods with a relatively low level of atmospheric air pollution are observed in cyclonic weather conditions, characterized by precipitation and strong winds, as well as the absence of inversions. Dispersion of emissions is due to turbulent exchange, which carries out vertical transfer of aerial contamination due to the temperature stratification of the atmosphere. When the anticyclone was established, the concentra-
tions of the aerosol-pollutants in the studied areas of Altai Krai were largely determined by the topographic features of the terrain and microclimatic processes - relief, relative location of the source of pollution and the residential area, speed and direction of the wind. So, the prevailing winds in Barnaul, where according to MODIS data a zone of long-term aerosol-chemical contamination is noted, are southwestern, with a specific gravity of 30%.
Analyzing the state of the air environment in Barnaul, it should be noted that the main contribution to the pollution of the atmosphere is made by energy enterprises (TPP-1, TPP-2, TPP-3) -58.82% of all harmful emissions, engineering (OAO "Altai Motor Plant" , OAO "Sibenergomash", OAO "Barnaultransmash", OAO "Altai Plant of Aggregates") - 14.68%, petrochemical and chemical industries (tire and soot plants, RTI, chemical plant) - 11.52%. Total emissions of harmful substances into the atmosphere from stationary sources amounted to 275.3 thousand tons/year, and from motor vehicles - 72,3 thousand tons/year. Analysis of the distribution of integrated indicators of total air pollution by M.A. Pinigin in various parts of the city showed that the air in the northeastern part of the city and the adjacent area "Potok" are the most polluted, where the Pingin coefficient values varied from 10.8±0.6 to 15.3±0.5. Following the north-eastern part of the city, the district for air pollution is the northern industrial hub and the adjacent area of Leninsky and Industrial districts. Enterprises of this industrial unit - black carbon plants, technical asbestos plants, tire plant, RTI and TPP-3 cause high values of integral indicators of atmospheric pollution in the adjacent residential area "Solnechnaya Polyana" due to dispersion of emissions in the north and northeast wind directions in the settlement "Urozhainy", where the values of the indicator varied from 2.5±0.1 to 3.7±0.2.
The western steppe territories of Altai Krai are characterized by the presence of a unique production, such as the extraction of mirabilite or decadent sodium sulfate in the territory of Bla-goveshchensky District near the village Stepenoye Ozero. For several decades, the atmospheric air in the residential zone of Stepenoye Ozero, Bla-goveshchenka and Nizhny Kuchuk settlements was polluted by a complex of harmful chemicals with hydrogen sulfide, sulfur dioxide and sodium sulfate aerosol. The analyzed impact on the environment is related to the production activity of AOA Kuchuksulfat, which produces technical sodium sulfate Ks-01-90 from mirabilite.
Analysis of the field of hydrogen sulphide concentrations in the zone of influence of the above-mentioned enterprise showed that the formation of a hotbed of increased pollution was observed in the immediate vicinity of Kriv-oye Lake (9.3 MPC). Zones of increased concen-
trations of sulfur dioxide were formed, mainly in the central part of the village Blagoveshchenka and constituted 1.2-9.4 MACs.
According to the results of the studies performed, a statistically significant difference was noted between the concentration of sodium sulfate aerosol in the ground layer of atmospheric air of the four main investigated territories located in the zone of influence of OAO Kuchuksul-fat, Stepenoye Ozero, Blagoveshchenka, Nizhny Kuchuk and Orlean. The average concentrations of sodium sulfate aerosol in the atmospheric air of these settlements were, respectively, 0.043 ± 0.0001 mg/m3, 0.027 ± 0.0001 mg/m3, 0.020 ± 0.0002 mg/m3and 0.015 ± 0.0001 mg/m3. The differences between the content of sodium sulfate aerosol in the atmospheric air of Stepenoye Oz-ero and Nizhny Kuchuk (Student's test is 14.3). The analysis of the dispersed composition of re-spirable aerosol fractions showed the presence of 6 main particle intervals, depending on their diameters. In the study areas, mainly aerosol fractions predominated, having a particle diameter of 0.5 ^m to 1.0 ^m. The specific gravity of these particles ranged from 44.8% in control region No. 1 (Nizhyn Kuchuk village) to 54.1% in the main region (Stepenoye Ozero).
In order to take into account the prevalence of diseases of the respiratory system of the working population and the calculation of the health risk in the zone of influence of the mirabilite deposit, the following indicators were used: the morbidity rate, the pathological damage by respiratory diseases, the proportion of frequently ill persons. All indicators were standardized taking into account the number of working population living in the observation zones. As the summary criteria for combined air pollution by ecotoxicants there were used the indicators of Pinigin and Averyanov. Statistical processing of survey data for 2002-2015 showed that by a statistically significant (p <0.01) difference in the indices of the total air pollution between Stepnoye Ozero and N. Kuchuk, there is observed a significant differentiation (p <0.01) in the incidence rate of the working population with respiratory diseases (an intensive standardized incidence rate in Stepnoye Ozero is 4.5 times higher than in N. Kuchuk).
Mathematical processing of the standardized indicators of morbidity of the working population and air pollution has made it possible to obtain an approximate relationship between the incidence of respiratory diseases and the concentrations of ecotoxicants in the vicinity of OAO Kuchuksul-fat with an average respiratory rate of 212.4 ± 3.6 per 1000 workers:
212, 4 Morbidity = 0.983 CO + 0.171 H2S + 0.997 SO2 + + 0.615 Dust + 0.981 NO2 + 0.185 Zn + 0.410 Cd + 0.084 Pb (1)
Conclusion
Thus, linear regression analysis indicates that the main influencing chemical factors in forming the health risk of the working population are: carbon monoxide, sulfur dioxide, nitrogen dioxide and suspended substances with risk factors correspondingly equal to 0.983, 0.997, 0981 and 0.615. The results of the study suggest that the adverse effects of such common pollutants as sulfur dioxide, nitrogen dioxide, carbon monoxide and sodium sulfate aerosol may manifest primarily in the reduction of respiratory and oxyhemometric functions.
References
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Contacts
Corresponding author: Balandovich Boris Ana-tolievich - Doctor of Medical Sciences, Associate Professor, Head of the Institute of Occupational Health and Industrial Ecology of the Altai State Medical University, Barnaul.
656038, Barnaul, Lenina Prospekt, 40. Tel.: (3852) 566898. E-mail: dr.balandovich@mail.ru Boyarinov Andrei Vladimirovich, Head of the Inspection Body of the Institute of Occupational Health and Industrial Ecology, Altai State Medical University, Barnaul. 656038, Barnaul, Lenina Prospekt, 40. Tel.: (3852) 566898. E-mail: a.boyarinov@expertsb.com Krasikov Aleksandr Anatolyevich, junior research associate of the Institute of Occupational Health and Industrial Ecology, Altai State Medical University, Barnaul.
656038, Barnaul, per. Nekrasova, 65.
Tel.: (3852) 566898.
E-mail: grizly137@yandex.ru
Potseluyev Nikolai Yurievich, Candidate of Medical Sciences, Associate Professor of the Department of hygiene, the fundamentals of ecology and safety of vital activity of the Altai State Medical University, Barnaul.
656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 249719. pocelueff@gmail.com
Tulin Nikolai Yurievich, junior research associate of the Institute of Occupational Health and Industrial Ecology, Altai State Medical University, Barnaul.
656038, Barnaul, per. Nekrasova, 65. Tel.: (3852) 566898. none184@yandex.ru
Sutorikhin Igor Anatolievich, Doctor of Physical and Mathematical Sciences, Professor, Chief research worker of the Institute for Water and Environmental Problems, Barnaul. 656031, Barnaul, ul. Molodezhnaya, 1. Tel.: (3852) 666460. E-mail: sia@iwep.ru
Serebryakova Zhanna Sergeevna, Expert Inspection Body of the Institute of Occupational Health and Industrial Ecology, Altai State Medical University, Barnaul.
656038, Barnaul, Lenina Prospekt, 40.
Tel.: (3852) 566898.
E-mail: serebryak2909@yandex.ru
