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TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

    Version Date Author Comments: TITLE 0 05/11/03 Likar, M, MD Specific socio-economic and public health aspects in zones

    Bauer, M. Mag.sci. with highly polluting and high energy - intensive industrial

    units: professional diseases 1 15/12/03 Likar, M, MD

    Bauer, M. Mag.sci.

    2

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Distribution list:

    [list of persons within consortium to whom this deliverable will be distributed]

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS:

    PROFESSIONAL DISEASES

    [The content of the deliverable chapters]

    Specific socio-economic and public health aspects in zones with highly polluting

    and high energy - intensive industrial units: professional diseases

    Likar M, MD and Bauer, M Mag sci.

Contents

    1. Introduction

    2. Global environmental change

    3. Environment and health

    '4. Europes environment and health

    5. Environment and health in Slovenia

    6. Development of occupational health

    7. International issues in occupational health

    8. Principal tasks of occupational health

    9. Occupational health in clinical praxis

    10. Occupation and the New Public Health

    11. Summary

     References

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

1. Introduction

Contamination of the environment by biological, chemical, physical or other diseases causing agents in the external environment and

    the workplace are major public health and political concerns as we are entering 21st century. Public consciousness regarding these issues has increased during the past several decades. Environmental concern has become an important part of accepted public

    philosophy in a number of developed countries. In developing countries the efforts to expand economically and struggling with severe problems of population growth and basic services have a high priority. In a number of eastern European countries industrialization has contributed to degradation of environment. The observations are not new as this also occurred in other today developed countries

    during their industrial development and urbanization.

There is a growing concern about the links between the environment and health. Worldwide one quarter to one third of the burden of

    disease appears to be attributable to environmental factors. Vulnerability and exposure, however, differ markedly between different groups and areas, with children and the elderly being particularly at risk.

    There is reasonable understanding of cause and effect relationship between water, air pollution and human health. However the health consequences of other environmental factors and exposures such as those resulting from climate and chemicals in the environment, are a result of complex interactions between the environment and humans that that far less understood? For some chemicals, such as endocrine disrupting substances, the effects on humans are particularly difficult to unravel but the impacts on wildlife have been

    substantial, with implications to human health. Other chemicals in the environment, the disposal of wastes and noise continue to cause worry.

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS:

    PROFESSIONAL DISEASES

2. Global environmental change

    In 1985 the European region of WHO issued consensus statement on health targets for the year 2000. Some of them are listed below and represent a broad social commitment to stop environmental degradation.

    Global environmental challenges for the 21st century

     l. Population growth;

    2. Economic growth:

    3. Food production and distribution;

    4. Environment and health in Slovenia;

    5. Energy and resource depletion;

    6. Soil erosion/desertification;

    7. Deforestation;

    8. Shortages of water supply;

    9. Air pollution;

    10. Chemical /toxic wastes;

    11. War armament /terrorism costs;

    12. Ozone depletion;

    13. Global warming;

    14. Social, economic and political inequalities nationally; 15. Inequalities between industrial and non - industrial countries.

WHO report 1992.

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

The effects of global environmental changes cannot be predicted with certainty, as they require an international response rather than

    the local efforts alone. Poverty, low level of education, and rapid population growth in the poorest countries with limited food

    production potential are an incredible contrast to high level of consumption and energy used and low rates of population growth in the

    industrialized countries.

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

3. Environment and health

The concept of environmental health has been widened in recent decades by the spectrum of global changes to the environment as a

    result of man made environmental pollution, and natural events. The greenhouse effect is the warming of the global environment and

    occurs partly as a result of the thinning of the ozone layer of the stratosphere. Disposal of toxic and radiological waste constitutes

    difficult public health challenges in many countries. Land degradation, loss of topsoil, deforestation, groundwater depletion, and acidification of water and soil are all challenges in environmental health for the new 21st century.

    In the developed countries the 10 most frequent work-related diseases and injuries are: l lung diseases; 2. musculoskeletal injuries; 3.

    cancers; 4. severe trauma; 5. cardiovascular disorders; 6. disorders of reproduction; 7. neurotoxic disorders; 8. noise related hearing

    loss; 9.dermatologic conditions; 10. psychological strain and boredom.

    The idea that health transcends geographic, political, economic and natural barriers is gaining ever-wider support. It is also obvious

    that developing world would never achieve economic and political stability unless the health of its people improved. If not addressed,

    the health problems of the developing world would pose a global threat.

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS:

    PROFESSIONAL DISEASES

     ,4. Europe s environment and health

    European environment agency recently (2003) published the third assessment of the state of the environment at the pan - European level. The second report published in 1998 made it clear that the policy measures that had been taken up to the mid-1990s had not yet produced a significant improvement in the state of the environment overall. Most progress on environment improvement continues to come from actions under well-established international conventions and legislation, or as a result of economic recession and restructuring. These gains will be lost again if economic growth continues to be based on traditional, environmental damaging activities. This is a particular risk for the EU accession countries and countries of eastern Europe, Caucasus and central Asia to which large amounts of manufacturing industry have been transferred from western Europe and elsewhere in the world.

    The accession countries face the major challenge of managing with limited resources, and again competing economic, social and environmental priorities, the transitions to EU membership, sectoral integration and sustainable development at the same time. The eastern European countries have a much lower GDP per capita than elsewhere in Europe, but arguably and competing calls on limited resources yet have relatively limited access to the capital markets for finance to improve the social and economic welfare.

Facts and figures illustrate some of the main problems:

    - occupational exposure to certain pesticides may increase the risk of Parkinson's disease (or Parkinsonism) by 15 to 2o %; - worldwide, it has been estimated that 3 million people die prematurely because of air pollution;

    - in Europe asthma affects one child in seven. Allergies, notably asthma, have continued to increase dramatically over the past 30 years;

    - environmental tobacco smoke increases the risk of lung cancers in non-smokers by 20 to 30 %;

    - some 10 million people in Europe are exposed to environmental noise that can result in hearing loss;

    - in some European countries testicular cancer is increasing in prevalence and an increasing number of young men face a low sperm

    counts, but there is so far no clear evidence that environmental exposure to these chemicals affects male reproductive health in

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

humans.

    Many of the environmental issues are complex and will require recognition and action by a wider range of players than was necessary for sulphur emissions. Examples include climatic change, biodiversity loss and soil degradation. The start of the Kyoto protocol target period for limiting gas emissions is now five years away, the target dates for significantly halting biodiversity loss and to prevent soil degradation have yet to be agreed. New approaches such as the precautionary principle and the ECU's proposals on impact assessment should be considered further to help reduce the lead times between early warning, scientific and policy action and the resulting improvement.

Recommendations for future development in order to improve the environmental monitoring capacities in Europe and allow for a real

    pan - European monitoring and reporting process are among others to :

- develop indicators which would need to be widely agreed;

    - focus on the new information gathering on key issues and perspectives;

    - maintain the framework for cooperation on environmental reporting;

    - ensure an appropriate level of investment in basic environmental monitoring infrastructure;

    - encourage international collaboration to enhance cross border and international compatibility of information; - strive towards the effective implementation of relevant legal instruments such as Aarchus convention and its new protocol on pollutant release and transfer register.

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

5. Environment and health in Slovenia

What is the today's situation in Slovenia? The government has recently issued a preliminary report on the state of environment in

    Slovenia for 2002. The report has been prepared in accordance with the law for the preservation of the environment. The content and the structure of the report follow the system of European Union for its report on Environmental Outlook for a period of three years. A

    shorter report is published yearly with Environmental Signals for the future prospects. We will attempt to summarize the main changes in the environment for Slovenia.

Water. The northwestern part of Slovenia has an ample atmospheric rainfall and snowfall but the eastern part suffers in the summer

    from severe droughts. Potentially each inhabitant of Slovenia can use an average of 16 000 m 3 of water each year what is much higher

    than in European Union. Underground water is disproportionately divided, as some water is lost in territories with karst. Superficial

    waters have been classified as to the pollution and the majority belong to class II - III (ARSO 2002). Atrazin has become the main

    stpollutant for the underground water. Limits for all pesticides have reached 0,5 ug/l in the first few years of 21 century.

    Air. The emission for S0 has been reduced in the last twenty years for 59 %, the emissions of N0 are increasing (the main source 2x

    being motor vehicles), the emissions of lead have been reduced as from 2001 the gasoline with lead is prohibited. The emissions of

    CO, CH, NO, CF,C F HFC, SF have reached a minimum in 1991 and 1992 and later started to increase from unknown reasons. 2 4 24 266

Soil. The main problem in Slovenia is the loss of fertile land. In the period between 1993 -1998 the land used for new buildings and

    roads has increased for over 4 000, and woods for nearly 75 000 hectares. In contrast the land used for agriculture has decreased for

    approximately 80 000 hectares.

    Noise. The noise in natural and populated settings is increasing. The main source of the noise is the transport noise in urban areas. Ambiental sound levels are steadily increasing as a result of the growing numbers of road trips, kilometers driven in motor vehicles

    and higher speeds of motor vehicles.

TRAC 2002 RO / 02 / B / F / PP / 141 061

    Source: UL

    Title: SPECIFIC SOCIO-ECONOMIC AND PUBLIC HEALTH ASPECTS IN ZONES WITH HIGHLY POLLUTING AND HIGH ENERGY - INTENSIVE INDUSTRIAL UNITS: PROFESSIONAL DISEASES

    Radioactivity. The radon concentrations have been measured in some apartment houses and in some of the schools. In the majority of 3 3buildings (over 70 %) the concentrations of radon were >100 Bq/ m. Only in 2% the values of radon were higher than 800 Bq/m. 137Some areas in the Alps were contaminated with radioactive Cs immediately after Chernobyl disaster but after ten years the surface 137radioactivity diminished as Cs were partly washed by the rainfall to lower zones of the earth.

    It is obvious that Slovenia is facing in general identical problems as the central European countries. Some changes in the environment have been expected.

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