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Using GIS in Exposure assesment to study health effects of Hazardous Waste Sites in Slovakia

Using GIS in Exposure assesment to study health effects of Hazardous Waste Sites in Slovakia. 1 Trnava University,Faculty of Health and Social Work, Department of Hygiene and Epidemiology,Trnava, Slovakia 2 University of Southern Denmark, Health Promotion Unit, Esbjerg, Denmark.

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Using GIS in Exposure assesment to study health effects of Hazardous Waste Sites in Slovakia

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  1. Using GIS in Exposure assesment to study health effects of Hazardous Waste Sites inSlovakia 1 Trnava University,Faculty of Health and Social Work, Department of Hygiene and Epidemiology,Trnava, Slovakia 2 University of Southern Denmark, Health Promotion Unit, Esbjerg, Denmark Marek Majdan1, Gabriel Gulis1,2 ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  2. Objectives • To show the possibility and relevance of using GIS as a tool to asses the exposure in studies of health effects of hazardous waste sites • To discuss the advantages and limitations of this method • To demonstrate our methodology on a case of a HWS in Slovakia and its impact on the incidence of low birthweights in the surrounding area ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  3. Background • The hazardous waste sites (HWS) are a potential source of hazardous substances and therefore a potential threat for the health of people working on them and living nearby • There is a lack of specific research done in this field of environmental health in Slovakia • The results of studies conducted in the UK and in the USA confirm that research in this field is of high relevance • We decided to set up a methodology for such research in the environment and conditions of Slovakia ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  4. Methods • Step 1-to seek for HWS which might pose a threat for the health of the people • Step 2-health outcome and exposure assesment • Step 3-to analyze the data and to calculate the risk (OR) • Step 4-to interprete the results properly ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  5. Step 1-to seek • There are officially13 HWS operating in Slovakia • Many old, forgotten HWS which were not properly closed up and are not officially in use anymore • We choosed one of these sites – a HWS near a former nickel refinery to demonstrate the steps of our methodology ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  6. Methods • Step 1-to seek for HWS which might pose a threat for the health of the people • Step 2-health outcome and exposure assesment • Step 3-to analyze the data and to calculate the risk (OR) • Step 4-to interprete the results properly ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  7. Step 2-Health outcome • Low birth weight (below 2500g) as a negative health outcome • A dataset of birth weights in Slovakia for the period of 1997-2002 • One record: • Name of the place of living of the mother • Birth weight of her newborn • Age of the mother • Number of children in the pregnancy ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  8. Step 2-exposure assesment • The exposure assesment using the GIS as a tool is based on the distance from the HWS • Additional Exposure data • Individual measurements • Air and water pollution data • Surrogate exposure data (cytogenetic measurements) • In our model case we found these additional exposure data: • Measurements of ambient air pollution in teh area of the HWS (heavy metals) • Measurements of dust sediments and their analyses on heavy metals • Measurements of ground water pollution in the area of the HWS ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  9. Methods • Step 1-to seek for HWS which might pose a threat for the health of the people • Step 2-health outcome and exposure assesment • Step 3-to analyze the data and to calculate the risk (OR) • Step 4-to interprete the results properly ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  10. Step 3-to analyze • We created 3 circle-zones of exposure around the HWS in Sered using the GIS with the diameters of 5, 10 and 15 km • We took out the records which refered to one of the places included in these zones from our birthweight dataset • We devided this extracted dataset into three datasets which refered to three zones of exposure • We assumed that in the zone 1 – the closest to the HWS there is the biggest exposure ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  11. ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  12. Step 3-to analyze • We conducted a cross-sectional study considering low bithweight newborns (under 2500g) to be our cases and normal birtweight newborns (more than 2500g) to be our controls • The records refering to twin-newborns were excluded and settlements which area intersected by one of the zone-borderlines as well • We calculated the Odds Ratio of • Zone 1 vs zone 2 • Zone 1 vs zone 3 • Zone 2 vs zone 3 ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  13. Table 1: Number of cases and controls in the exposure zones ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  14. Table 2: Odds Ratio of the relationships of cases and controls in the exposure zones ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  15. Methods • Step 1-to seek for HWS which might pose a threat for the health of the people • Step 2-health outcome and exposure assesment • Step 3-to analyze the data and to calculate the risk (OR) • Step 4-to interprete the results properly ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  16. Step 4-Interpretation • The results of our model case suggest that the residence near the HWS is a risk factor for developing a low birthweight newborn when comparing to teh areas furtherfrom the HWS • The results are not statistically significant though • We must consider different factors which may confound the result and make the interpretetion complicated and unclear ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  17. Step 4-Interpretation • Confounding factors: • Socio-economical (income, marrital status, education level) • Individual (lifestyle, age, occupational exposure) • Environmental (other sources of pollution in the area) • Data quality: • The exact address of the mother (street, number,zip code) would make this exposure assesment methodology more appropriate and valid ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

  18. Conclusions • Because of the lack of detailed data for exposure assesment the methodology using the distance of the residence as a basic for exposure may be in the conditions of Slovakia appropriate • In this methodology the GIS are very usefull and can help in the exposure assesment procedure and also can help to calculate and interprete the results • Detailed geographical data and additional data which will make the exposure assesment more valid are neccessary ISEE, New Challenges of Environmental Health, 9-11 June, 2005 Budapest

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