Academic journal article Central European Journal of Public Health

Natural and Man-Made Health Hazards in Rural Slovakia

Academic journal article Central European Journal of Public Health

Natural and Man-Made Health Hazards in Rural Slovakia

Article excerpt

SUMMARY

Context: There is little information on health situation of the people of rural Slovak Republic. The rural environment is often a mixture of natural and man-made hazards, which under some conditions, might turn to be a health risk to humans.

Purpose: The aim of this study was to compare two regions of the Slovak Republic, two different hazards (natural and man-made), two different methods of health outcome measurement (routine statistics and individual diary based data).

Methods: Ecological study design with focus on cancer incidence analysis was employed in case of natural hazard analysis. Standardized incidence ratios (SIR) were calculated and are presented in paper. Observational study design was employed to study rural gardening practices and their impact on health.

Findings: Statistically significant differences in SIR were found in rural areas of Spis-Gemer Region (SGR) among males for lip, oral cavity and larynx (1.60, Cl 95% 1.12-2.34), respiratory (1.25, Cl 95% 1.01-1.55) and digestive organ cancers (1.22, Cl 95% 1.01-1.47); hematopoetic cancers are significantly elevated among males in rural areas as well (1.58, Cl 95% 1.05-2.39). Pesticide use (83.1% of gardeners use pesticides) without any protective equipment is still widespread among gardeners in rural Slovak Republic (16.9%). The produced fruits and vegetables are substantial part of total fruit and vegetable consumption (51% in summer and 42.7% in winter season) increasing the risk of exposure to pesticides.

Conclusion: Our study shows that on ecological level, mortality and morbidity statistics could be used to assess human health status in linkage to broad exposure measures (urban- rural); on dose response level (arsenic in soil) this method lacks sensitivity. Health survey and diary method on the other hand are useful tools in analysis of rural health especially with respect to man-made hazards.

Key words: rural health, cancer, gardening, pesticide

INTRODUCTION There is a growing interest in rural health worldwide, however the definition of what rural is, is not fully clear. Muula (1) made an attempt to define rurality summing up different classification systems of rurality, mostly based on literature from the USA. Countries of the European Union define as rural areas those with pre-dominantly agricultural activities, where green zones with ecological functions prevail, low population density, inhabited zones spread across large areas, communities are of limited size, high physical work demanding employment possibilities are prevailing, there are natural beauties and a local or regional culture exists (2). In the Slovak Republic these communities are considered as rural, provided that they do not have a statute of a town; do have typical signs ofhousing; economic structure based on agriculture or forestry; less developed infrastructure and low population density. Most of them are below 5,000 inhabitants. Based on data of the statistical office of the Slovak Republic in 2005, there were a total of 2,891 municipalities among them 138 with a statute of a town. 55, 4% of inhabitants (2,986,802 persons) lived in urban and 44, 6% of inhabitants (2,402,378 persons) in rural settings (3). The average population density was about 110 inhabitants per km2. Using the OECD definition of rurality in 2002, about 63.3% of Slovak population lives in rural regions compared to about 37% of the total population of the European Union member states (4). The OECD definition is based on local administrative units and regions. Based on the definition (based on population density) of rurality by Eurostat (4), 85.3% of Slovak population lives in scarcely populated areas compared to about 26.4% of the European Union member states population. Rural environment is often a mixture of natural and man-made hazards, which under some conditions turns to be a health risk for humans. The presented study focused both on natural and man-made hazards in rural Slovak Republic with objective to put rural health on the agenda. …

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