Methodical aspects in assessing risks of comorbid pathology occurrence under exposure to chemical environmental factors

View or download the full article: 
PDF icon health-risk-analysis-2020-4-6.pdf
UDC: 
614.1:614.7
DOI: 
10.21668/health.risk/2020.4.06.eng
Authors: 

O.A. Maklakova1,2, N.V. Zaitseva1, D.A. Kiryanov1,2

Organization: 

1Federal Scientific Center for Medical and Preventive Health Risk Management Technologies, 82 Monastyrskaya Str., Perm, 614045, Russian Federation
2Perm State University, 15 Bukireva Str., Perm, 614990, Russian Federation

Abstract: 

Risk assessment methodology is a promising trend in examining effects produced by environmental factors on population health. However, at present little attention has been paid to issues related to comorbid pathologies occurrence under chronic exposure to toxicants.
Our research goal was to improve methodic approaches to assessing risks of co-morbid pathology occurrence under exposure to multi-component chemical factors in the environment.
Data and methods. To develop an algorithm for establishing a probability that comorbid pathology would occur, we analyzed scientific publications that focused on effects produced by technogenic chemicals on a body and health risk assessment methodology. Methodic approaches were tested with epidemiologic hygienic analysis techniques and statistical processing of data obtained via profound medical and biological examination of children living in Perm region where chemical enterprises were located.
Results. We suggested a systemic approach to assessing risks of co-morbid pathologies caused by complex exposure to chemical environmental factors; the approach includes reference groups creation; determining responses in critical organs and systems via stage-by-stage modeling within «chemical factor – exposure marker – marker parameter – disease» system; determining population and individual risks of environmentally induced comorbid diseases. The performed analysis allowed establishing marker parameters of bronchial asthma and comorbid pathologies occurrence in children living on a territory with multi-component contamination of ambient air predominantly with saturated spirits, aldehydes, and particulate matter. It was shown that a number of additional comorbid diseases that were probabilistically related to increased chemicals contents in the examined children’s blood could amount up to 15‰, and a contribution made by the examined chemicals into comorbid pathology occurrence would reach 14.2–23.4%.
Implementation of mathematical analysis procedures outlined in the present work will make for higher efficiency of activities aimed at managing and minimizing health risks for people living under combined exposure to chemical environmental factors.

Keywords: 
chemical factors, risk assessment, exposure marker, biomarker of an effect, comorbid pathology, cause-and-effect relations, medical and biological examinations
Maklakova O.A., Zaitseva N.V., Kiryanov D.A. Methodical aspects in assessing risks of comorbid pathology occurrence under exposure to chemical environmental factors. Health Risk Analysis, 2020, no. 4, pp. 54–61. DOI: 10.21668/health.risk/2020.4.06.eng
References: 
  1. Klepikov O.V., Samoilov A.S., Ushakov I.B., Popov V.I., Kurolap S.A. Comprehensive assessment of the state of the environment of the industrial city. Gigiena i sanitariya, 2018, vol. 97, no. 8, pp. 686–692 (in Russian).
  2. Leshchuk S.I., Surkova I.V., Senkevich N.V. Interrelation of environmental pollution and environmentally caused morbidity in the territory of technogenic pollution. Izvestiya vysshikh uchebnykh zavedenii. Severo-Kavkazkii region. Seriya «Estestvennye nauki», 2017, no. 2, pp. 110–117 (in Russian).
  3. Movchan V.N., Zubkova P.S., Kalinina I.K., Kuznetsova M.A., Sheinerman N.A. Assessment and forecast of the ecological situation in St. Petersburg in terms of air pollution and public health indicators. Vestnik Sankt-Peterburgskogo universiteta. Nauki o Zemle, 2018, vol. 63, no. 2, pp. 178–193 (in Russian).
  4. Meshkov N.A., Val'tseva E.A., Baeva Yu.I., Krylitsyna E.A. Assessment the conditionality of Samara city population incidence under the influence of environmental factors. Izvestiya Samarskogo nauchnogo tsentra Rossiiskoi akademii nauk, 2017, vol. 19, no. 2 (2), pp. 300–306 (in Russian).
  5. Pichuzhkina N.M., Chubirko M.I., Mikhal'kova E.V. Socially-hygienic aspects of environment-related diseases. Prikladnye informatsionnye aspekty meditsiny, 2018, vol. 21, no. 4, pp. 19–22 (in Russian).
  6. Tabakaev M.V., Artamonova G.V. Particulate matter air pollution effects on the incidence of heart diseases among the urban population. Vestnik RAMN, 2014, no. 3–4, pp. 55–60 (in Russian).
  7. Onishchenko G.G., Zaitseva N.V., Zemlyanova M.A. Gigienicheskaya indikatsiya posledstvii dlya zdorov'ya pri vneshnesredovoi ekspozitsii khimicheskikh elementov [Hygienic indication of consequences for health under environmental exposure to chemical factors]. Perm', Knizhnyi format Publ., 2011, 532 p. (in Russian)
  8. Shevchuk L.M., Dzerzhinskaya N.A. Pecularities of dynamic health processes formation within a multicomponent air pollution. Profilakticheskaya i klinicheskaya meditsina, 2017, no. 1 (62), pp. 25–28 (in Russian).
  9. Preventing disease through healthy environments: a global assessment of the burden of disease from environmental risks. World Health Organization, 2016. Available at: http://www.who.int/iris/handle/10665/204585 (02.09.2020).
  10. West J.J., Cohen A., Dentener F., Brunekreef B., Zhu T., Armstrong B., Bell M.L., Brauer M. [et al.]. What we breathe impacts our health: improving understanding of the link between air pollution and health. Environ. Sci. Technol, 2016, vol. 17, no. 50 (10), pp. 4895–4904. DOI: 10.1021/acs.est.5b03827
  11. Zavodova E.I., Os'kina O.F. Complex hygienic assessment of health and environmental factors. Sanitarnyi vrach, 2015, no. 4, pp. 43–46 (in Russian).
  12. Kleyn S.V., Vekovshinina S.A., Sboev A.S. Priority risk factors of drinking water and the related with it economical loss. Gigiena i sanitariya, 2016, vol. 95, no. 1, pp. 10–14 (in Russian).
  13. Kon'kova M.N., Spirin V.F. The levels of individual risks to the health of children depending on area of residence. Sanitarnyi vrach, 2018, no. 5, pp. 41–45 (in Russian).
  14. Lomov O.P. Health and mortality risk as an assessment criteria of public health. Profilakticheskaya i klinicheskaya meditsina, 2018, no. 2 (67), pp. 35–39 (in Russian).
  15. Zaitseva N.V., Shur P.Z., May I.V., Kir'yanov D.A. On the question of the application of the prediction of the evolution of health risk in hygienic assessments. Gigiena i sanitariya, 2016, vol. 95, no. 1, pp. 106–112 (in Russian).
  16. Zaitseva N.V., Zemlyanova M.A., Peregozhin A.N., Zhdanova-Zaplesvichko I.G. Scientific and methodological approaches to conducting the research for communication of health infringement with the multi-medical influence of chemical factors in the zone of influence of enterprises on production of aluminum and pulp and paper industry. Zdorov'e naseleniya i sreda obitaniya, 2017, no. 9 (294), pp. 29–32 (in Russian).
  17. Mezynska M., Brzóska M. Environmental exposure to cadmium – a risk for health of the general population in industrialized countries and preventive strategies. Environmental Science and Pollution Research, 2018, vol. 25, no. 4, pp. 3211–3232. DOI: 10.1007/s11356-017-0827-z
  18. Peden D.B. The epidemiology and genetics of asthma risk associated with air pollution. Journal of Allergy and Clinical Immunology, 2005, vol. 115, no. 2, pp. 213–219. DOI: 10.1016/j.jaci.2004.12.003
  19. Tajudin M.A.B.A., Khanb F., Mahiyuddin W.R.W., Hodd R., Latif M.T., Hamid A.H., Rahman S.A., Sahani M. Risk of concentrations of major air pollutants on the prevalence of cardiovascular and respiratory diseases in urbanized area of Kuala Lumpur, Malaysia. Ecotoxicology and Environmental Safety, 2019, vol. 171, pp. 290–300. DOI: 10.1016/j.ecoenv.2018.12.057
  20. Zhang K., Batterman S. Air pollution and health risk due to vehicle traffic. Science of the Total Environment, 2013, vol. 15, pp. 307–316. DOI: 10.1016/j.scitotenv.2013.01.074
  21. Bakirov A.B., Suleimanov R.A., Valeev T.K., Rakhmatullin N.R. Hygienic substantiation of risk factors to health of the population of territories with the developed oil refining. Bezopasnost' zdorov'ya cheloveka, 2016, no. 1, pp. 41–49 (in Russian).
  22. Baktybaeva Z.B., Suleimanov R.A., Valeev T.K., Rakhmatullin N.R. Evaluation of oil refining and petrochemical industry impact on environmental and hygienic state of environmental objects and population health (literature review). Meditsina truda i ekologiya cheloveka, 2018, no. 4, pp. 12–26 (in Russian).
  23. McKenzie L.M., Crooks J., Peel J.L., Blair B.D., Brindley S., Allshouse W.B., Malin S., Adgate J.L. Relationships between indicators of cardiovascular disease and intensity of oil and natural gas activity in Northeastern Colorado. Environmental Research, 2019, vol. 170, pp. 56–64. DOI: 10.1016/j.envres.2018.12.004
  24. Gudkov R.A., Konovalov O.E. Reasons and risk factors of the combined pathology in children. Rossiiskii mediko-biologicheskii vestnik im. akademika I.P. Pavlova, 2016, no. 2, pp. 144–152 (in Russian).
  25. Zhuravlev Yu.I., Tkhorikova V.N. Sovremennye problemy izmereniya polimorbidnosti [Contemporary issues related to measuring polymorbidity]. Nauchnye vedomosti Belgorodskogo gosudarstvennogo universiteta. Seriya: Meditsina. Farmatsiya, 2013, no. 11 (154), pp. 214–219 (in Russian).
  26. Barnett K., Mercer S.W., Norbury M., Watt G., Wyke S., Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet, 2012, vol. 380, no. 9836, pp. 37–43. DOI: 10.1016/S0140-6736(12)60240-2
  27. Menno di Bucchianico A.Di, Brighetti M.A., Cattani G., Costa C., Cusano M., De Gironimo V., Froio F., Gaddi R. [et al.]. Combined effects of air pollution and allergens in the city of Rome. Urban Forestry & Urban Greening, 2019, vol. 379, pp. 13–23. DOI: 10.1016/j.ufug.2018.04.001
  28. Tonelli M., Wiebe N., Guthrie B., James M.T., Quan H., Fortin M., Klarenbach S.W., Sargious P. [et al.]. Comorbidity as a driver of adverse outcomes in people with chronic kidney disease. Kidney International, 2015, vol. 88, no. 4, pp. 859–866. DOI: 10.1038/ki.2015.228
Received: 
12.08.2020
Accepted: 
05.11.2020
Published: 
30.12.2020

You are here

Home