Results of the Environmental Health Monitoring System in the Czech Republic
for the year 2002 represent a standard data series that has been obtained
through a stabilized system of monitoring activities in its nineth year
of operation. It represents important material for the control and management of
health risks for the national and regional authorities, and valuable information
for the general public, as it facilitates activities connected with transition
to active health promotion. In its complexity it also represents documentation
for the objective informing of other countries of Europe and in the world. It
documents the degree of contamination of the environmental components and
the health of our population.
The results obtained regularly for each season from the localities under
monitoring serve as a cornerstone for creating long-term series on population
health and on environmental pollution. Evaluation of the data series thus
formed will facilitate a responsible assessment of trends and correlations
be they of a lasting or seasonal character, from which there may originate
eventual recommendations and drafts of measures to be taken.
The following facts can be presented as the most significant positive as
well as negative findings acquired by the Environmental Health Monitoring
System in the year 2002:
As regards the quantity and frequency of the limit or reference concentrations
exceeding in ambient air, the fine fraction of airborne particulate matter
(PM10) and polycyclic aromatic hydrocarbons seem to be the most serious
for health. Over a half of the inhabitants in the cities under follow-up
(altogether 3.2 mill.) are exposed to potential exposure to particulate
matter exceeding limit concentrations, and the situation between the years
1999–2002 has been gradually worsening. In seven cities from a total of
21, where measurings of particulate matter took place, ambient air quality
in regard to particulate matter pollution did not meet the legislative criteria
of health protection. After comparing the annual mean values of PM10 with
the limit which should be met by the year 2010 (20 µg/m3), the levels found
were not satisfactory in any of the cities except for one. For example,
in Ostrava the mean annual values were found to be double the target limit.
The fact is, that in the period 1995–2002 the levels of toxic metals in airborne
particulate matter have been gradually declining – markedly that of lead,
moderately in arsenic, or have been more or less stabilized (those of cadmium
and chromium).
The concentration of benzo[a]pyrene, the most serious carcinogen in the
group of polycyclic aromatic hydrocarbons, exceeded the annual concentration
limit at most measuring sites. Most significantly at the measuring unit
in Ostrava, where the annual mean concentration was 7.8 ng/m3 (almost eight
times higher than the concentration limit of 1 ng/m3) and the highest values
in November and December exceeded 30 ng/m3. In Ostrava and Karviná, the
highest levels of the carcinogenic potential of the sum of polycyclic aromatic
hydrocarbons have been found, which were three and two times higher than
those obtained at the measuring unit in Prague 10, respectively.
Mutagenic activity in the ambient air (genotoxic effects of substances
bound to particulate matter) has been rising from 1996 through 2001, in
2002 a stabilization being recorded. Results of the mutagenic activity detected
in the tester strain of the bacterium Salmonella typhimurium YG1041 signalize increasing
concentrations of other chemical structures with mutagenic potential bound
to particulate matter, namely that of nitroarenes.
The number of new cases of treated acute respiratory diseases has a declining
trend for all combinations of age and diagnostic groups from the beginning
of monitoring in the year 1995. The decline is manifested most markedly
in children of the age group between 1 to 5, in older age groups being
more moderate. The declining trend in lower respiratory tract morbidity
is more moderate than in that of the upper respiratory tract.
The quality of drinking water in the public water supply networks under
the Monitoring System has a continuously good standard, both as for the frequency
of exceeding limit values according to the Regulation of the Ministry of
Health of the Czech Republic No. 376/2000 Dig. as well as from the point
of view of tapping the exposure limits. As in the whole previous period
under monitoring, the exposure to nitrates through consumption of drinking
water is the most marked, which, however, represents for the inhabitants
of the cities under follow-up a median of only 8 % of the acceptable intake;
90 % of the inhabitants in the cities monitored (altogether 3.5 million)
are then exposed to nitrates through consumption of drinking water from
public water supplies in a volume of only less than 10 % (90% quantil). The
median of tapping on the exposure limit didn’t exceed 1 % of the acceptable
intake in any other substance harmful to health. Within the framework of
a three-year study, markedly increasing concentrations of by-products of
desinfection (trihalomethanes) in drinking water have been found, that of
chloroform in particular. The levels of trihalomethanes nevertheless are
up to limits set in the Regulation of the Ministry of Health of the Czech Republic
No. 376/2000 Dig.
As in previous years, neither in 2002, has the mean chronic population
exposure, due to food consumption, either to organic or inorganic substances
under follow-up, reached values that are connected with an inadmissible
increase in the probability of health impairment due to a non-carcinogenic
effect. Exposure to chemical substances estimated according to the model
of recommended foodstuff doses, signalizes a need to follow up and study
more closely the situation in children of 4 to 6 years of age from the point
of view of any potential excessive intake of certain toxic substances.
In the nutrition of the population, there is a relative lack of certain
essential elements such as calcium, magnesium, potassium, copper and iron.
In people over 60 years of age, food consumption in the range of recommended
foodstuff doses, does not cover the recommended intake of certain minerals.
Estimated population exposure to organic substances in foodstuffs reached
the highest level in polychlorinated biphenyls (PCB); exposure to the sum
of seven PCB indicator congeners reached the mean level of about 8.8 % of
the tolerable daily intake. A theoretical estimate of a probable increase of
the number of cancer diseases in the Czech population in consequence of
the annual exposure to selected chemical substances (the mean of exposure
doses according to the consumer food basket) amounted to about 68 cases
for the Czech Republic and the year 2002. The greatest share in increasing
the risk was traditionally represented by PCB (38 cases) and arsenic (17 cases).
On the basis of an evaluation of biomarker levels in biologic material
in the Czech population can be stated that the burden due to environmental
xenobiotics is well within the range of the European mean in general, and
in principle it corresponds with suggested reference values for the Czech
population. In particular, there has been demonstrated a declining trend
in lead levels in the blood, a tendency towards a decrease in cadmium concentration
has been confirmed, as well as towards a stabilized, although not optimum,
selenium saturation in the adult population. From the aspect of long-term
trends, the level of PCB indicator congeners in breast milk shows a declining
tendency with considerable individual variability and potential local differences
in the population burden. A gradual decline has been observed in the concentration
of hexachlorobenzene and since 2001 a rise of the sum of DDT in breast milk.
For the incidence of so-called civilization-linked diseases there has
been found repeatedly a correlation with the level of night-time noise at
the 90 % level of statistical significance. This correlation is valid for
the sum of all monitored diseases and individually for hypertension. The
other diseases (diabetes mellitus, ulcer disease, myocardial infarction)
do not show any correlation. A statistically significant correlation was
found between the number of people disturbed by outdoor noise and the noise-levels measured.
A statistically significant correlation has been also found between the
noise levels in the locality and the proportion of people who have problems
with falling asleep and with the quality of sleep.
Half of the urban population of the age category between 45–53 years suffer
from long-term chronic health complaints (either treated or not), namely
most often from complaints of the locomotion system. At that age the most
frequent cause of long-term follow-up by a physician are cardiovascular
diseases. A half of the men and a third of the women of that age suffer
from being overweight. About 20 % of people are obese, i.e. with a serious
risk factor of, e.g. cardiovascular diseases. Increased blood pressure can
be found in almost one third of the population, more than half of them
(males), or two thirds out of them (females) had underwent some treatment.
In that age group there can be found about 35 % active smokers in males and
27 % in females. A significant proportion of women – nearly one quarter –
consume less liquids daily than recommended. In principle, 52 % of subjects
are satisfied with their life. A half of the urban population under follow-up
evaluated their health as good, almost ten percent as poor. 62 % of people
perceive distinctly their responsibility for their health, conversely 5 %
of men of the age group mentioned above have no sense of responsibility
for their own health. People of the age group of 45–54 years consider most
frequently permanent mental stress and the smoking habit to be the most
serious factors influencing human health; the effects of the environment
were, in order of importance, in sixth place only, following factors of lifestyle.
Also in the year 2002 there continued the declining trend in newly reported
cases, as well as in the overall number of reported profession-linked diseases,
observed since the year 1995. The incidence of profession-linked affections
(35.7 per 100,000 insured) has fallen in comparison with the year 2001 by
1.7 case. The greatest number of profession-linked diseases, in the year
2002, has again been reported in the Moravian-Silesian Region and in the
Central Bohemian Region. As against previous years, in 2002, the greatest
numbers of profession-linked diseases appeared in the healthcare branch
of economic activities, the coal mining branch occupying second place only.
The most frequent occupational disease diagnosis were affected peripheral
nerves due to the overburdening of the extremities and due to vibrations.
Over the period of existence of the Monitoring System, there were relatively
frequently exceeded the limit or recommended concentration values in certain
airborne pollutants, especially in strongly burdened localities such as
Prague, Ostrava and Karviná. In drinking water, failure to meet the limit
values of contaminants hazardous to health occurred only singularly. From
estimates of dietary exposure (including drinking water) to chemical substances
under follow-up, it can be stated that the recommended exposure limits
(for non-carcinogenic effects) are drawn upon within the monitoring network by
an “average person” to a limited degree only. However, for carcinogenic
substances generally, in view of their no-threshold effect, it is not possible
to determine any safe concentration, or exposure limit. Therefore, it is necessary
to reduce or keep the population exposure on an as low level as is reasonably possible.
In order to apply such a strategy of focusing efforts where it is really most
needed, systematic monitoring of hazardous substances in the environment
and of already apparent effects on health is necessary, supplemented with estimates
of probable health risks. Monitoring of the environment and health will thus contribute
to a gradual reaching of exposure levels to contaminants, as well as of parameters
of health comparable with those in the EU countries, and the ensuring of
conditions for sustainable life.