Dragana Nikic

Report: Treatment of medical waste in Nisava and Toplica districts, Serbia.

If there are no clearly defined management procedures, medical waste may represent a source of serious health hazards. Medical waste management was evaluated at the three hospitals in the Nisava and Toplica district, in Serbia. All the stages of existing waste management (segregation, collection, storage, transportation and disposal of waste) were examined by interviewing the personnel involved in the management of waste. The generated waste was a mixture of hazardous and non-hazardous waste. The study found that waste management performance in this district was poor and that there were problems in every stage of management. The results indicate that the waste generation rate was 1.92 kg bed— 1 day—1 and consisted of 98.7% general waste and 1.3% sharps. Inappropriate segregation practices were the biggest problem and led to increased quantities of general waste. There were no specific regulations for the segregation of the medical waste. None of the surveyed hospitals have a system to refine wastewater and there were no training courses about hospital waste management.

THE INFLUENCE OF MARITAL STATUS ON EPIDEMIOLOGICAL CHARACTERISTICS OF SUICIDES IN THE SOUTHEASTERN PART OF SERBIA

BACKGROUND The support of close persons is a protective factor in the suicide epidemiology. The aim of this paper is to determine if there are differences between epidemiological characteristics of the suicides committed by married people in relation to singles. METHODS In order to determine epidemiological characteristics of suicide among married and single people in the southeastern Serbia 628 suicides committed from 1995 to 2002 among persons 20 years of age and over were analysed. To compare suicide rates between married and single persons chi2 test was performed. RESULTS From 628 registered suicides, 188 were performed by women, and 440 by men. The average annual suicide rate among males was 24.1 per 100,000 and among females it was 9.9. The highest rates were among widowed (139.0) and divorced men (63.2). The highest risk factor for suicide was to be widowed (men: RR=8.35; women: RR=2.75). The suicide trend among women, both married and single has been declining, whilst among males it has been on significant increase. Seasonality of suicides, weekly and daily distribution had a small influence on the epidemiological characteristics of suicides. Married women committed more suicides by poisoning than single women (p=0.02). In both groups, the most frequent way is hanging. CONCLUSION Though marital status plays important role in an increasing rates of suicide, time and the way of its happening, this role is not decisive. Single people are very vulnerable and the time and way of suicide show that their reasons are more serious than among married ones.

Black smoke air pollution and daily non-accidental mortality in Nis, Serbia

The short-term effects of ambient black smoke concentrations on total non-accidental, cardiovascular and respiratory mortalities in Nis, during the 2000-2003 period, were investigated.Daily measurements for black smoke (BS), as well as the daily number of deaths have been collected. Generalised linear models extending Poisson regression were applied. The e.ects of time trend, seasonal variations, days of the week, temperature, humidity and air pressure were adjusted.The per cent increase in the daily number of total deaths associated with a 10 μg/m3 increase in BS was 1.13% (0.08–2.20%). The e.ect size was slightly higher for cardiovascular mortality (1.25%, 95% CI: 0.53–1.97%). There was no signi.cant association between air pollution and respiratory mortality.These results indicate that current levels of ambient BS have signi.cant e.ects on total and cardiovascular mortalities in Nis.

Air quality monitoring in NIS (SERBIA) and health impact assessment

The aim of this study is to indicate the significance of air quality monitoring and to determine the air quality fields for the assessment of air pollution health effects, with special attention to risk population. Radial basis function network was used for air quality index mapping. Between 1991 and 2005, on the territory of Nis, several epidemiological studies were performed on risk groups (pre-school children, school children, pregnant women and persons older than 65). The total number of subjects was 5837. The exposed group comprised individuals living in the areas with unhealthy AQI, while the control group comprised individuals living in city areas with good or moderate AQI. It was determined that even relatively low levels of air pollution had impact on respiratory system and the occurrence of anaemia, allergy and skin symptoms.

[Effects of air pollution on children's health in Nis and Niska Banja].

BACKGROUND Epidemiological studies point out that air pollution in the cities was a major risk for health of the exposed population. In particular, the effects of air pollutants were adverse to the respiratory tract. In Nis and Niska Banja, the concetrations of pollutants were mainly below the threshold values. However, according to the literature, even these concentrations could exert negative effects, especially the health of the most sensitive group, such as the preschool children. The aim of our study was to evaluate the effects of the current levels of air pollutants in the city of Nis on respiratory symptoms and diseases. METHODS A pilot, cohort, retrospective study included 1 385 children of 1-5 years of age from the zones with statistically significant concentrations of air pollutants, in the period after the birth of the children. The prevalence of respiratory symptoms and diseases was determined on the basis of a modified WHO standard questionnaire completed by the parents. RESULTS It was revealed that in the more polluted of the studed zones, the prevalence of some respiratory symptoms (cough with cold and phlegm), and the lower respiratory tract diseases was significantly higher. CONCLUSION The results of our study showed that the current concentrations of air pollutants in Nis and Niska Banja could represent the important etiological factor for the development of respiratory symptoms and diseases. Our study showed that in the children of up to 5 years of age, the frequency of respiratory symptoms and diseases was significantly higher in more polluted than in less polluted environments.

Indoor exposure to chemical and biological agents and health efects in primary school children

The aim of this study has been to estimate effects of indoor air pollutants on children’s health. An anamnestic retrospective study was done on 1074 children aged between 7 and 11 years old who lived in Nis (Serbia). An original questionnaire was used in an interview between training physicians and children’s parents. Interview data were processed by using Microsoft Excel and Epiinfo 6. The investigation determined that children who were more often exposed to combustion by-products had respiratory and nonspecific symptoms. Parental smoking was strongly associated with wheezing, bronchitis, headache and fatigue. There was no association between health and keeping pets, apart from partial nasal congestion. Presence of insects (e.g., cockroaches) and rats in households was a significant risk factor for all symptoms and diseases estimated except for asthma and pneumonia. Homes abundant in textiles were the cause of nasal congestion, wheezing and fatigue in children. Old mattresses were associated with respiratory symptoms, bronchitis, and nonspecific symptoms. It has been concluded that indoor air quality plays a major role in children’s health. Sources of indoor air pollution are present in every home. Being aware of the risks associated with indoor air quality problems, consequently, leads to their mitigation.

Effects of Chronic Exposure to Urban Air Pollution on Red Blood Cells in Children

Air quality has become a dominant factor in relation to environmental change in the last decades. The study presented in this chapter aims to indicate the significance of air quality monitoring, with special attention to children as a segment of the population at greater risk. In the study, the city of Nis is examined with regard to the effect of chronic exposure to urban air pollution on red blood cells in children. It is a pilot retrospective study including 354 schoolchildren aged 11–14 years. The group of exposed children (n = 215) attend school in a city area with a high level of air pollution while the children in the comparative group (n = 139), designated as the non-exposed group, attend school in an area with a lower level of air pollution. The diagnosis of iron deficiency anaemia is made using pre-defined criteria. The concentrations in air of black smoke, nitrogen dioxide, sulfur dioxide and lead in sediment matter are determined for the period from 1990 to 2000. The red blood cell count and average amounts of hemoglobin in blood levels of the exposed children differ significantly from those of the non-exposed children. Also, the prevalence of anaemia in children exposed to higher levels of air pollutants is significantly higher than in the non-exposed children. These findings suggest that even relatively low levels of air pollution have negative effects on red blood cells in children and increase the risk of anaemia occurrence.