Scientific and methodological aspects and practical experience for the formation of the evidential base of hazard to health in the population in the zone of influence of waste from the past economic activity

There are described an algorithm and methods for collecting the evidential base for causing hazard to the health of the population of Zakamensk (the Republic of Buryatia) in the zone of influence of the waste of the past activities of the Dzhidinsky tungsten-molybdenum combine. The source of danger is lying sands, containing a complex of toxic heavy metals — lead, cadmium, manganese, nickel, chromium, etc. The algorithm for the formation of the evidential base included: a general analysis of the sanitary and hygienic situation; assessment in the dynamics of the quality of atmospheric air, drinking water, soil, food; assessment of the risk to the health of the population; epidemiological studies; in-depth clinical surveys of a representative group of city residents (280 people). In the blood of the examinees, heavy metals were identified as biological markers of the exposure. There was evaluated a complex of the response (effect) adequate to effects of laboratory markers. By methods of mathematical statistics there was established the presence of reliable relationships in the system “source of hazard — the quality of the environment — exposure to risk factors — health status.” The hazard to the health of a citizen, due to the negative impact of the factor, was considered to be proven if it was possible to build a continuous step-by-step logical chain of relationships between the source of the harmful effect, the quality of the habitat and the establishment of the fact of the disease. The quality of the habitat of the population of Zakamensk was shown to give rise in unacceptable risks to the health of residents. The main influencing factor is the pollution of atmospheric air, local food products and drinking water from public and private wells. Risks are realized in terms of a level of the primary morbidity rate of the population of the respiratory diseases, endocrine system, digestive organs that is relatively high compared to the matched area. The relationship between health hazard and environmental factors has been fully proved in 14% of the surveyed persons. At the same time, the territory was shown not be characterized as a zone of “ecological disaster” or “an emergency environmental situation”.