Cent Eur J Public Health 1997, 5(2)

Environmental Pollution and Child Health: Critical Needs and Issues for Central and Eastern Europe. Proceedings of an international conference. Sosnowiec, Poland, May 8-10, 1996

Cikrt M.

Cent Eur J Public Health 1997, 5(2):53-96  

Active and passive smoking: hazards for children

Etzel R.A.

Cent Eur J Public Health 1997, 5(2):54-56

This manuscript describes the tobacco industry's efforts to recruit active smokers among the adolescent population, the effects of environmental tobacco smoke on nonsmokers, and lists some steps pediatricians can take to influence smoking behavior. Six health effects result from passive smoking. Children exposed to environmental tobacco smoke have increased lower respiratory illness rates, especially in the first year of life, passive smoking is associated with increased rates of chronic middle ear effusion in children. Exposure to cigarette smoke is associated with small changes in pulmonary function. Exposure to environmental tobacco smoke increases...

Environmental epidemiology at the Medical Birth Registry of Norway; strengths and limitations

Lie R.T.

Cent Eur J Public Health 1997, 5(2):57-59

A national registry of all pregnancy-outcomes was started in Norway. in 1967 to facilitate epidemiological surveillance. One aim was to detect increases in birth detect prevalences that was caused by new harmful exposures. Over the years several studies of unexpected time-trends and regional differences have been performed, but specific harmful exposures have so far not been detected. In a study of possible effects of the Chernobyl fallout, the registry enabled a detailed investigation of a possible increase in prevalence of birth detects that occurred specifically in the most exposed areas of Norway. The strength of this approach was the population...

Blood lead levels in urban children of Katowice Voivodship, Poland: results of the population-based biomonitoring and surveillance program

Zejda J.E., Grabecki J., Król B., Panasiuk Z., Jędrzejczak A., Jarkowski M.

Cent Eur J Public Health 1997, 5(2):60-64

The paper presents the results of the large-scale blood lead levels survey in pre-school urban children living in industrial area of Poland (Katowice Voivodship, Upper Silesian Industrial Zone-USIZ). The program, established in 1993, involves education, screening and medical care of case-children, as its major elements. Until December 1995 six thousand nine hundred sixty nine children aged 2-6 years have been examined in three towns (Chorzow, Kalowice, Sosnowiec). Geometric mean value of blood lead level (PbB) was slightly but not statistically significantly larger in boys (6.68 ± 1.51 µg/dl) than in girls (6.58 ± 1.54 µg/dl)....

Neurobehavioral aspects of lead neurotoxicity in children

Winneke G., Krämer U.

Cent Eur J Public Health 1997, 5(2):65-69

Neurobehavioural toxicity in occupational lead-exposure has typically not been observed at blood lead-concentrations (PbB) below 400 µg/l (e.g. 1, 2), whereas in environmentally exposed children such deficit has been reported to occur down to PbB of 100-150 µg/l and, perhaps, even below this range (4). Both cross-sectional and prospective studies have arrived at similar conclusions in this respect. The preferred endpoint in most such studies has been the IQ-measure, which has good psychometric qualities, is sufficiently well standardized to be comparable across studies, and exhibits attractive simplicity for the regulator in a public health...

Methodological problems in assessing health-related, neuropsychological effects of lead absorption in a very low-level exposed area

Lyngbye T.

Cent Eur J Public Health 1997, 5(2):70-74

Methodological problems in the low level lead studies are reviewed using the Aarhus lead study as an example. It is shown that a lead effect can be found in an area where the background blood lead level is as low as 37 µg/l (geometric mean). Even in such an area it is worthwhile looking for populations at risk. It is shown that attrition causes confounding with a directional bias towards the null-hypothesis. Longitudinal studies are associated with this type of bias. Misclassification as for past exposures will also have a bias of this type. Studies depending on blood-lead measures are liable to have this type of bias. This is the case to a lesser...

Monitoring of blood lead levels in Hungary

Bittó A., Horváth A., Sárkány E.

Cent Eur J Public Health 1997, 5(2):75-78

Monitoring of blood lead levels (BLL) in children started in Hungary only in the 80's. A study on exposed areas of Budapest and Szolnok indicated a mean BLL higher than 20 µg/dl. Data from studies show a strong relationship between the BLLs of children and traffic. As a result of reduction of the lead content of gasoline, the BLLs of children decreased steeply in the early 90's. In 1994 a 6.9 µg/dl mean BLL was found in school children living in provincial towns, and 7.9 % of the data exceeded the limit of 10 µg/dl. Recently a representative survey in preschool children (n = 1401, age 0-4 years) showed a mean BLL of 5.7 µg/dl,...

Using the Hungarian Birth Defects Registry for surveillance, research and intervention

Siffel C., Czeizel A.E.

Cent Eur J Public Health 1997, 5(2):79-81

The Hungarian Congenital Abnormality Registry (HCAR) was established in 1962 due to the growing public health importance of congenital abnormalities (CAs). The HCAR is a population-based registry; it collects and keeps permanent records of medical and personal information about malformed newborns and infants (notification of CAs Is mandatory for physicians) in order to develop baseline data for different types of CAs, to search for increases in the incidence of specific CAs, to provide rates, and identify geographic areas of concern for cluster investigation. In the last 25 years numerous studies have been carried out. In the 1970s two significant...

Association between ambient air concentrations of nitrogen dioxide and respiratory symptoms in children in Prague, Czech Republic. Preliminary results from the Czech part of the SAVIAH Study

Pikhart H., Príkazský V., Bobák M., Kříž B., Čelko M., Danová J., Pryl K., Pretel J.

Cent Eur J Public Health 1997, 5(2):82-85

The primary objective of the SAVIAH, a multi-centre study funded by European Union, was to assess new methodology for study of small area health statistics and to implement it in epidemiological health statistics and geography. In Prague, the study has been conducted in two city districts with large variation in air pollution. Data at individual level (health symptoms and socio-economic circumstances of the family) were collected by questionnaires completed by parents of 3680 children aged 7-10 both resident and attending schools within the area (response rate 88 %). Aggregated data for geographical areas were available from census and urban planning...

A search for environmental and genetic background for neural tube defects: twenty-five years of experience

Pietrzyk J.J.

Cent Eur J Public Health 1997, 5(2):86-89

The present paper illustrates the author's 25-year experience in a step by step approach to the definition of environmental and genetic background of neural tube defects. Based on the birth defects registry, a complete ascertainment of all deliveries was performed in Southern Poland during two periods: 1970-1972, and 1979-1981. The birth prevalence of neural tube defects (NTD), as well as other CNS malformations was determined. The empiric recurrence risk was calculated as 3.2 % ± 1.6. Based on this figure, the relative risk (RR = 37.6 p < 0.001) and heritability (h² = 74.7 ± 6.7) were estimated. Our own modification of...

The analysis of registry data in relation to various different types of hypothesis regarding the geographical distribution of disease

Draper G.J.

Cent Eur J Public Health 1997, 5(2):90-92

Disease registries will often contain the addresses of cases included in the registry. If the registry includes information on all cases, or deaths, occurring in a defined geographical area and time period and if there is a postcode/zip code or map reference for each case it is possible to carry out a variety of different types of geographical analysis that may give clues to the aetiology of the disease. For such analyses it will usually also be necessary to have population data for the region covered by the registry and for separate sub-regions within it. In this paper we review types of analysis that may be applied to such data and give references...

Assessment of Polish population exposure to lead and cadmium with special emphasis to the Katowice Province on the basis of metal concentrations in environmental compartments

Gzyl J.

Cent Eur J Public Health 1997, 5(2):93-96

Polish data of lead and cadmium concentrations in such environmental compartments as: air, dust, soil, diet and drinking water were presented in the paper. Special emphasis was placed to the Upper Silesian industrial Region, the central part of the Katowice Province, the most polluted area in Poland. An attempt was made to assess human exposure to heavy metals. According to the available data it can be concluded that the WHO tolerable intake (ADI, PTWI) could be exceeded in an extremely disadvantageous situation occurring in the Katowice Province. Furthermore, a critical review of heavy metal standards in soil, dustfall and edible plants, obligatory...