Purpose: To ascertain the effect of lifelong occupational history, ambient air pollution, and biochemically verified smoking status on chronic obstructive pulmonary disease (COPD) in a general population of one the largest cities in Central Asia, Almaty. Patients and methods: 1500 adults (median age 49, interquartile range (IQR) 28 years), 50% females, were randomly selected from a registry of enlisted population of a primary care facility in Almaty, Kazakhstan and they filled in the questionnaire on demographics, respiratory symptoms (CAT and mMRC), smoking status, verified by exhaled carbon monoxide, and detailed lifetime occupational history. COPD was defined as postbronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) below lower limit of normal (LLN) using Belintelmed MAS-2 spirometer (Belarus). Results: 230 (15%) subjects had CAT≥10; 136 (9%) participants had mMRC score ≥2. Greater CAT score was associated with age, smaller income, and less exercise, but not with smoking or living closer to a major road. 26% of the population was ever exposed to vapors, gases, dusts, and fumes (VGDF). In age group 40 years and above (N=1024), COPD was found in 57 participants (prevalence 5.6%), more in men (8.7% vs 3.4%). In the multivariate model adjusted for age, sex, ever-smoking, income, and exercise, any exposure to VGDF increased the odds of COPD (odds ratio (OR) 1.71; 95% confidence interval (CI) 1.03; 2.84), more in the highest exposure category (OR 2.36 (95% CI 1.20; 4.66)). Conclusion: Lifetime exposure to VGDF, found in ¼ of the general population, increased the odds of COPD independent of smoking by 71%.
Kazakhstan, like other former Soviet Republics, inherited a number of serious environmental problems. Air pollution is one of these serious problems, leading to significant environmental health effects on the population of Kazakhstan. This study provides a baseline analysis of health damages from air pollution, based on readily available information. Mean estimates of mortality risk attributable to air pollution are about 16,000 cases per year with a 95% confidence level of the risk not exceeding 25,500. Even taking into account all the uncertainties related to the collection and processing of primary data, as well as the application of risk analysis methodology, we conclude that air pollution in Kazakhstan constitutes a significant contribution to the environmental burden of diseases. In relative terms, the impact of air pollution on premature mortality in Kazakhstan is notably higher than in Russia and the Ukraine.
Background:Air pollution in Kazakhstan is caused by many factors and poses serious threats to public health. Ambient air in the cities of Kazakhstan is polluted due to mining and processing of mineral resources, oil and gas production, gasoline and diesel fuel motor vehicles, industrial enterprises.Objective:The study aim is to assess the air pollution degree in most significant settlements of Kazakhstan and define risk levels for the population health. Ambient air monitoring was conducted in 26 cities. Air pollution severity was assessed by the analysis results and processing of air samples taken at the stationary observation posts. Health risk assessment due to chemical factors was calculated according to the approved risk assessment methodology.Findings:There is high risk of acute adverse effects risk from suspended particles, oxides and dioxides of nitrogen and sulfur in almost all of the studied cities. The most unfavorable situation is in Ust-Kamenogorsk. Also, there is the adverse chronic effects risk caused by suspended particles exposure in majority of the studied cities. Extremely high chronic effects risk as a result of heavy metals exposure was detected in Ust-Kamenogorsk, Shymkent, Almaty, Taraz and Balkhash. Unacceptable carcinogenic risk levels have been determined for professional groups and the whole population with respect to cadmium in Shymkent, Almaty, Balkhash; arsenic in Shymkent, Almaty, Balkhash; lead in Taraz; chromium – in Shymkent, Aktobe, Almaty and Balkhash. Thus, the values of the hazard quotients and indices for acute and chronic exposure in most of the studied cities of Kazakhstan exceed the permissible level equal to 1.0.Conclusion:Due to the unacceptable risk levels in the cities it is strongly recommended to conduct a detailed study of the health status of the population depending on the air pollution.
Introduction and objective. The Karachaganak oil and gas condensate field (KOGCF), one of the largest in the world, located in the Republic of Kazakhstan (RoK) in Central Asia, is surrounded by 10 settlements with a total population of 9,000 people. Approximately73% of this population constantly mention a specific odour of rotten eggs in the air, typical for hydrogen sulfide (H2S) emissions, and the occurrence of low-level concentrations of hydrogen sulfide around certain industrial installations (esp. oil refineries) is a well known fact. Therefore, this study aimed at determining the impact on human health and the economic damage to the country due to H2S emissions. Materials and method. Dose-response dependency between H2S concentrations in the air and cardiovascular morbidity using multiple regression analysis was applied. Economic damage from morbidity was derived with a newly-developed method, with Kazakhstani peculiarities taken into account. Results.Hydrogen sulfide air pollution due to the KOGCF activity costs the state almost $60,000 per year. Moreover, this is the reason for a more than 40% rise incardiovascular morbidity in the region. Conclusion. The reduction of hydrogen sulfide emissions into the air is recommended, as well as successive constant ambient air monitoring in future. Economic damage evaluation should be made mandatory, on a legal basis, whenever an industrial facility operation results in associated air pollution.
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