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U.I. KENESSARIYEV, A.E. YERZHANOVA, S.S. SULEIMENOVA
Department of General hygiene and ecology KazNMU named after Asfendiyarov
DYNAMICS OF PUBLIC HEALTH INDICATORS IN TENGIZ DEPOSIT REGION
y^K 614.2-056.22:331.43:553.98 (574.1)
Today Pre-Caspian oil and gas field is of great importance for the economy of Kazakhstan and enters into a new stage of its development. Due to its intensive development both scientists and health practitioners concerned about problem of public health. The article presents the data on environmental research subjects' quality, health status, demographics and morbidity of Zhylyoi region. The population lives in the region of influence of the Tengiz oil and gas field. It was found that from 2006 to 2013 mortality rates declined while the birth rates increased slightly. There is a progressive tendency remaining for indicators of population structure. Such indicators probably related to urbanization and industrial migration of population which has increased in recent years. Analysis of the primary diseases of population of Zhylyoi region from 2006 to 2013 shows a slight decline. In overall structure of morbidity there is a decrease in the proportion of the skin and subcutaneous tissue diseases, respiratory diseases and diseases of digestive system. At the same time the share of blood diseases, blood-forming organs and the cardiovascular diseases increased. Along with this there is a shortage of doctors, qualified nursing staff and hospital beds in the region.
Keywords: Public health, demographics, morbidity of the population, oil and gas fields
Introduction: Production of oil on the one hand is the source of financial benefits for the national economy. On the other hand it creates environmental problems for the whole nation. There are rich deposits of oil and gas in Atyrau region. The main oil reserves are in the Tengiz field of the Caspian Sea shelf, which is about half the amount of proved reserves and resources throughout Kazakhstan. Due to its intensive development both scientists and health practitioners concerned about problem of public health in this ecologically unfavorable region. This is due to the fact that some features clearly revealed in the structure of the population and the morbidity level [1, 2]. Zhylyoi is one of these regions in Atyrau oblast. Meanwhile, the region is characterized by a deficiency of quality drinking water and harsh climatic conditions. These features can also have a significant influence on the population health and sanitary and demographic processes.
Objective: Comparative assessment of health of Zhylyoi region with figures for the Atyrau oblast and the Republic of Kazakhstan between 2006 and 2013. Research Methods: The epidemiological, statistical, mathematical.
Results: Among the many factors influencing public health environmental condition plays a vital role [3, 4, 5]. In Zhylyoi area there are 16 facilities with organized air emissions. All are equipped with sanitary protection zone of standard sizes. The emissions contain 11 ingredients, 4 of which are first and second class of hazard. However, research of the sanitary-chemical indicators showed exceeded maximum permissible concentration mostly because of dust found along the main roads. In 2006 167 air samples were taken, from which 5 samples or 2.9% did not meet the sanitary and hygienic standards. In 2007 there were 0.8% of samples that did not meet the sanitary standards, in 2008 - 0.7%; in 2009 it was 6.2%; in 2010 it was 3.4%; in 2011 it was 3.5%; in 2012 it was 2.8%. Over the studied period according to the data in Zhylyoi region the number of samples of drinking water which did not meet the standards of the sanitary-chemical indicators were at the same level, and the percentage of
samples of sanitary-bacteriological indicators in 2013 was 3 times higher compared to 2006. In general the condition of soil meets the standards for sanitary and chemical, bacteriological and radiological indicators. However, there is a tendency to the accumulation of metals in the soil.
It is necessary to pay special attention to primary health care in the rural areas. In Zhylyoi region Zhylyoi Central district hospital, district hospital, children's clinic, women's clinic and district tuberculosis hospital are serving for medical assistance to the population. In Zhylyoi region the number of visits to doctors is 57.1 visits per person per annum, including preventive and screening examination.
At the same time, in the studied area in hospitals the number of beds per 10,000 people is significantly lower in comparison with the overall number by country (2.2 times) and by Atyrau oblast (2.1 times). Provision of rural population by doctors in Zhylyoi was 3.8 doctors per 10,000 people, which is 3.2 times less the national index and 2.6 times less the regional index. Thus, in the studied area there is lack of qualified doctors, skilled nurses and hospital beds.
It is known that it is impossible to carry out a deep analysis of health without the knowledge of the quantitative and qualitative composition of the population. Analysis of the region's population structure showed that the total population size of the region is constantly growing. So, for the period from 2006 to 2013. The population of Zhylyoi reagion increased by 14.5%. It can be assumed that this trend is related to the economic growth of the region.
The study of population age structure shows that there is a progressive tendency. The proportion of adults was 59.1%. At the same time, the proportion of teens is 7.5% and for children is 33.4%. The proportion of women of childbearing age is 25.5%. The proportion of children in Zhylyoi region is higher than that of the republic indicator. Our analysis of the dynamics of indicators of the natural population growth has shown the tendency of growth of birth rate in all levels from the Republic of
Kazakhstan (growth by 17.1%), Atyrau oblast (up 17.5%) to Zhylyoi region (14.5 %).
At the same time, the level of mortality on Zhylyoi between 2006 and 2013 decreased by 16.7%. Zhylyoi mortality rates are below national and regional rates. As a result, over the studied period, the natural the population growth is characterized by 25.0%. Such indicators may be associated with urbanization and industrial migration.
It should be noted that among all mortality causes in the region the leading causes are cardiovascular diseases, injuries and poisoning, digestive diseases, respiratory
diseases. These five classes are responsible for 62.3% of all deaths in the region.
Comparative analysis of the structure of mortality reasons by five classes showed that in Zhylyoi the proportion of circulatory system diseases and digestive system diseases was lower than that of the oblast and the country level, figure 1. The proportion of mortality from cancer, accidents, injuries and poisonings by Zhylyoi was slightly higher than that of the country and the oblast. The proportion of deaths from respiratory diseases is lower than that of the Republic rate, but higher than in the oblast.
Figure 1 - The structure of causes of death in Zhylyoi region in comparison with the Republic of Kazakhstan
and Atyrau oblast in 2013 (% of total number)
Morbidity along with sanitary and demographic indicators is one of the most important criteria for defining public health [6, 7, 8, 9].
Retrospective analysis of primary morbidity in Zhylyoi from 2006 to 2013 shows a slight decline (1.3 times). At the same time in 2006, as in 2013, these figures were higher than that of the Atyrau oblast. The main causes of primary morbidity were respiratory diseases, diseases of the digestive system, nervous system
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diseases, cardiovascular diseases, injuries and poisonings. The share of these classes of disease was 62.1% of all illnesses.
The study of dynamics of primary morbidity in Zhylyoi showed a reduction in diseases of the skin and subcutaneous tissue, diseases of the respiratory system, the digestive system. However, there is an increase in levels of blood diseases, blood-forming organs, diseases of the circulatory system. Figure 2.
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Figure 2 - Dynamics of the leading causes of primary morbidity in Zhylyoi region between 2006 and 2013
(per 100 thousand people)
Conclusion:
1. There is a tendency of accumulation of the chemical substances of industrial enterprises and the formation of anthropogenic emissions of biogeochemical province, which is a result of water-migration and translocation cycle of pollutants.
2. There is a lack of qualified doctors, nurses, not enough hospital beds and the overall health care system should be developed in studied region.
3. The birth rate of the population between 2006 and 2013 increased by 16.7%, mortality rate decreased by 16.7 %, population growth increased by 27.6%, mainly
due to the migration of adult population to the studied region.
4. Analysis of primary morbidity of Zhylyoi region from 2006 to 2013 shows a slight decrease in its level. However, these figures were higher than that of the Atyrau oblast. In the structure of primary morbidity the proportion of diseases of the blood forming organs, diseases of the circulatory system increased.
5. In order to achieve sustainable positive changes in health indicators of the region further work on environmental protection and social transformations such as improvement of health care in the region are necessary.
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У.И. КЕНЕСАРИЕВ, А.Е. ЕРЖАНОВА, С.С. СУЛЕИМЕНОВА
Жалпы гигиена жэне экология кафедрасы СЖ.Асфендияров атындагы Каз¥МУ
ТЕНГИЗ 0ЛКЕСШЩ ХАЛКЫНЫН, ДЕНСАУЛЬЩ ДИНАМИКАСЫНЬЩ К0РСЕТК1ШТЕР1
Тушн: K^азiргi тан,да Каспий мацайтындагы мунай-газ орындарынын, Казахстан экономикасында басым ман,ыздылык;к;а ие болуда жэне eзiнiн, дамуынын, жан,а сапалы; децгешне етуде. Осы орындары ;арк;ынды игеруге байланысты галымдардын, да, тэжрибелiк денсаулы; са;тау ;ызметкерлершщ де назарын тургындар денсаулыгы мэселелерi аударуда. Ма;алада Жылыой ауданындагы ;оршаган ортанын, негiзгi нысандарынын, сапасын зерттеу мэлiметтерi, денсаулы; са;тау жагдайы,ауданнын, демографиялы; кeрсеткiштерi мен тургындар аурушацдыгы кел^ршген. Тургындар Тен,пз мунай-газ орнынын, эсер ету аймагында eмiр CYредi. 2006 жэне 2013 жылдар аралыгында тургындардын, eлiмшiлдiк темендеп, туу кeрсеткiштерi арткэндыгы аны;талган. Тургындар ;урылымы кeрсеткiштерiнiн, прогрессивт типтi тенденциясы бай;алады. Мундай гарсетюштер сон,гы жылдары урбанизация мен тургындардын, eндiрiстiк миграциясынын, артуына байланысты болуы MYмкiн. Жылыой ауданы тургындардын, бiрiншiлiк аурушылды; кeрсеткiштерiн 2006 жэне 2013 жылдар аралыгындагы динамикасын талдау гарсетюш децгешнщ болмашы тeмендегенiн кeрсеттi. Аурушылдын, курылымында терi мен терiасты ауруларынын,, тыныс алу мен ас;орыту MYшелерiнiн, ауруларынын, Yлесi тeмендегендiгi бай;алады.Сондай-ак;, ;ан жэне ;ан TYзу, ;ан айналым ЖYЙесiнiн, ауруларынын, Yлесi арт;ан. Ауданда дэр^ерлердщ, маманданган орта медициналы; ;ызметкерлердщ, тeсек орнынын, жетiспеушiлiгi ба;ыланады.
ТYЙiндi сездер: тургындар денсаулыгы, демографиялы; гарсетюштер, тургындар аурушылдыгынын, кeрсеткiштерi, мунай-газ орындары
У.И. КЕНЕСАРИЕВ, А.Е. ЕРЖАНОВА, С.С. СУЛЕЙМЕНОВА
Кафедра общей гигиены и экологии КазНМУ им. С.ЖАсфендиярова
ДИНАМИКА ПОКАЗАТЕЛЕЙ ЗДОРОВЬЯ НАСЕЛЕНИЯ РЕГИОНА ТЕНГИЗСКОГО МЕСТОРОЖДЕНИЯ
Резюме: В настоящее время Прикаспийское нефтегазовое месторождение приобретает первостепенное значение в экономике Казахстана и вступает в качественно новый этап своего развития. В связи с интенсивным освоением этих месторождений особую остроту и внимание, как ученых, так и работников практического здравоохранения привлекают проблемы здоровья населения. В статье приводятся данные исследования качества основных объектов окружающей среды, состояния здравоохранения, демографических показателей и заболеваемости населения Жылыойского района. Население проживает в регионе влияния Тенгизского месторождения нефти и газа. Установлено, что уровень смертности населения за период с 2006 по 2013 годы снизился, рождаемость несколько повысилась. Показатели структуры населения сохраняют тенденцию к прогрессивному типу. Такие показатели, возможно, связаны с урбанизацией и промышленной миграцией населения, увеличившейся в последние годы. Анализ первичной заболеваемости населения Жылыойского района в динамике с 2006 г. по 2013 г. показывает незначительное снижение уровня. В структуре заболеваемости наблюдалось снижение удельного веса болезней кожи и подкожной клетчатки, болезней органов дыхания, органов пищеварения. Вместе с тем, удельный вес болезней крови, кроветворных органов и болезней системы кровообращения повысился. Вместе с тем, в регионе ярко прослеживается нехватка врачей, квалифицированного среднего медицинского персонала и койко-мест. Ключевые слова: здоровье населения, демографические показатели, показатели заболеваемости населения, нефтегазовые месторождения
