четвъртък, 29 октомври 2015 г.

APPLICATION OF BIOSTATISTICS IN RISK ASSESSMENT - the CESAR study

This is presented on Conference "Remediation of Hazardous Wastes: Technology and Health Effects", Prague, 16-19.11.1997
CESAR is acronym of "Central European Study of Air Pollution and Respiratory Health"

Статията на Български

BACKGROUND

The data obtained from routine health statistics during the last years show an increased rate of respiratory diseases among children.
Together with that, monitoring of environmental pollution evidences elevated concentrations in the ambient air of our country.
There is no evidence for effect of PM10 on the respiratory system.
The information about the role of socio-economic factors for children’s health during the last years is insufficient.

OBJECTIVE

Assessment of environmental risk factors for children’s respiratory health. The results reported concern mostly the role of some individual factors.

PROCEDURE AND METHODS

An epidemiological study was carried out in four regions of Bulgaria with different kind and degree of ambient air pollutants. The data were obtained from 3948 children (randomly selected), aged 7 to 11 years, both sexes.

A questionnaire about children’s health and some individual factors, e.g. social status, living conditions, nutrition patterns etc., have been administered. The bronchial asthma, bronchitis and pneumonia have been chosen as indicators of the respiratory health. The variables selected for the individual factors are given in Table1. The logistic regression technique was used to evaluate the effect of these factors on the health risk. 


RESULTS

Results are shown in next table and figures.

Table 1

Name of Variables
N0 of variables
Respondent of questionnaire: Mother
father or other relative
1
Education: mother: hight

secondary
2
primary
3
Occupation: mother: manager

clerical
4
skilled manual
5
unskilled manual
6
Employment: mother: employed

entrepreneur
7
at home
8
unemployed
9
Birth weight >=2.5kg.
<2.5kg.
10
Perinatal complications: no
yes
11
Nutrition: vegetables: >4 times per week

2-4 times per week
12
<4 times per month
13
time spend outdoors: more than other
14
like other

less then other
15
sport: in school
additional
16
Day care: in the first 2 years: no

yes
17
Housing conditions: Household density: <=1 people per room
1.1-1.4 people per room
18
>=1.5 people per room
19
material of bedroom floor: smooth surface
20
carped on a smooth surface
21
chipboard furniture: yes
no
22
moisture frequency: never
sometimes
23
often
24
always
25
moisture: no

yes
26
Traffic intensity: low
middle
27
high
28
very high
29
Smoking: total number of cigarettes smoking in household, in group by 10: none

1-10 per day
30
11-20 per day
31
>20 per day
32

fig 1 Bronchial Asthma, Bronchitis and Pneumonia (percentage rates) according to the four areas


fig 2 Odds Ratios and 95% Conf. Intervals of Bronchitis According to some Environmental Factors, Adjusted for Area, Age and Sex

fig 3 Odds Ratios and 95% Conf. Intervals of Asthma According to some Environmental Factors, Adjusted for Area, Age and Sex

fig 4 Odds Ratios and 95% Conf. Intervals of Pneumonia According to some Environmental Factors, Adjusted for Area, Age and Sex


CONCLUSIONS

The incidence rates of bronchial asthma, bronchitis and pneumonia were directly related with the poor housing conditions, and particularly the presence of moisture and mould spots in the homes
The insufficient amount of vegetables in children’s diet also affect significantly their respiratory health
Children, born with perinatal complications or low birth weight are predisposed to bronchial asthma and pneumonia
The decreased physical activity, as indicated by the insufficient sport and games in the open air also contributes to the development of asthma and bronchitis
The prevalence of bronchial asthma is higher with children, residents of the areas with intensive traffic
The exposure to tobacco smoke, when living with parents - smokers, also has an unfavorable effect for the development of bronchial asthma
Parents’ education, occupation and qualification did not affect significantly the children’s respiratory health

ACKNOWLEDGEMENTS

This project is financed by the European Union’s Phare Programme, which provides grant finance to support it's partner countries in Central and Eastern Europe to the stage where they are ready to assume the obligations of European Union membership.


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