The impact of air, water and soil pollution on mortality and morbidity of certain classes of diseases and nosologies in the Republic of Tatarstan (2019–2023)

We have examined influence exerted by eight microbiological and chemical environmental factors on mortality, primary incidence and disease prevalence per 19 disease classes in 45 municipalities in Tatarstan, including children, working age population and elderly people, over 2019–2023. The study aimed to identify priority environmental risk factors causing medical-demographic losses of the population per specific classes of diseases and nosologies in Tatarstan. The study tasks included establishing correlations between environmental and medical-demographic factors as well as their strength; building predictive regression models; assessing regression coefficients of additional mortality and morbidity risks.

The results obtained by comparative analysis of influence exerted by ambient air, water and soil quality in Tatarstan confirmed the existing national trends in Russia as regards associations between mortality and morbidity and chemical pollution in ambient air, water supply deviating from the existing sanitary-epidemiological rules and standards, soils not conforming to safe standards per microbiological indicators; in addition, we established some health risks specific for Tatarstan. The greatest number of strong correlations was established for ambient air quality; a smaller number of medium correlations was established for water quality; the smallest number of correlations was established for soil quality. Children remain the most susceptible population group as regards primary incidence and disease prevalence. Multifactorial models established that additional risk of environment-associated incidence ranged between 44 and 67 % for children, equaled 57 % for working age population and 30 % for people older than working age per the existing mean morbidity rates per various classes of diseases.

A strong direct correlation was established between incidence of neoplasms in children and the proportion of ambient air samples containing NO2 and NH3 in levels beyond the maximum permissible concentration; the same correlation was established between NH3 levels exceeding the maximum permissible concentration and prevalence/incidence of complications of pregnancy and childbirth among working-age women. Regarding mortality, we revealed correlations of varying strength; a strong non-linear correlation was found between all-cause mortality among people older than 80 years and the proportion of air samples containing NO2 in levels beyond its maximum permissible concentration. Predictive models allow us to calculate a positive effect of modifying environmental factors for reducing additional risk of population morbidity and mortality.