Äîêóìåíò âçÿò èç êýøà ïîèñêîâîé ìàøèíû. Àäðåñ îðèãèíàëüíîãî äîêóìåíòà : http://www.geogr.msu.ru/GESJournal/gi415_web_ispr.pdf Äàòà èçìåíåíèÿ: Thu Dec 31 07:52:50 2015 Äàòà èíäåêñèðîâàíèÿ: Sun Apr 10 07:42:33 2016 Êîäèðîâêà: Ïîèñêîâûå ñëîâà: guide 8.0

RUSSIAN GEOGRAPHICAL SOCIE T Y FACULT Y OF GEOGRAPHY, LOMONOSOV MOSCOW STATE UNIVERSIT Y INSTITUTE OF GEOGRAPHY, RUSSIAN ACADEMY OF SCIENCES

No. 04 (v. 08)

2015

GEOGRAPHY
ENVIRONMENT
SUSTAINABILITY


EDITORIAL BOARD
EDITORSINCHIEF:

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Kasimov Nikolay S. Lomonosov Moscow State University, Faculty of Geography, Russia

Kotlyakov Vladimir M. Vandermotten Christian Russian Academy of Sciences UniversitÈ Libre de Bruxelles, Institute of Geography, Belgium Russia

Tikunov Vladimir S. (Secretary-General) Lomonosov Moscow State University, Faculty of Geography, Russia Baklanov Alexander Danish Meteorological Institute, Denmark Baklanov Petr Ya. Russian Academy of Sciences, Pacific Institute of Geography, Russia Chalkley Brian University of Plymouth, UK Chubarova Natalya E. Lomonosov Moscow State University, Faculty of Geography, Russia De Maeyer Philippe Ghent University, Department of Geography, Belgium Dobrolubov Sergey A. Lomonosov Moscow State University, Faculty of Geography, Russia Haigh Martin Oxford Brookes University, Department of Social Sciences, UK Gulev Sergey K. Russian Academy of Sciences, Institute of Oceanology, Russia Guo Huadong Chinese Academy of Sciences, Institute of Remote Sensing and Digital Earth, China JarsjÆ Jerker Stockholm University, Department of Physical Geography and Quaternar y Geology, Sweden Kolosov Vladimir A. Russian Academy of Sciences, Institute of Geography, Russia KonecnÙ Milan Masaryk University, Faculty of Science, Czech Republic

Kroonenberg Salomon Delft University of Technology Department of Applied Earth Sciences, The Netherlands Kulmala Markku University of Helsinki, Division of Atmospheric Sciences, Finland Malkhazova Svetlana M. Lomonosov Moscow State University, Faculty of Geography, Russia Meadows Michael E. University of Cape Town, Department of Environmental and Geographical Sciences South Africa Nefedova Tatyana G. Russian Academy of Sciences, Institute of Geography, Russia O'Loughlin John University of Colorado at Boulder, Institute of Behavioral Sciences, USA Pedroli Bas Wageningen University, The Netherlands Radovanovic Milan Serbian Academy of Sciences and Arts, Geographical Institute "Jovan Cviji", Serbia Sokratov Sergei A. Lomonosov Moscow State University, Faculty of Geography, Russia Solomina Olga N. Russian Academy of Sciences, Institute of Geography, Russia Tishkov Arkady A. Russian Academy of Sciences, Institute of Geography, Russia Wuyi Wang Chinese Academy of Sciences, Institute of Geographical Sciences and Natural Resources Research, China Zilitinkevich Sergey S. Finnish Meteorological Institute, Finland


CONTENTS
Svetlana M. Malkhazova, Varvara A. Mironova HEALTH AND ENVIRONMENT: THE URGENT PROBLEM OF MODERN INTERDISCIPLINARY RESEARCH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

GEOGRAPHY
Svetlana M. Malkhazova, Natalya V. Shartova, Sergei A. Timonin SPATIAL PAT TERNS OF PUBLIC HEALTH IN RUSSIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Tatiana V. Dikareva, Vadim Yu. Rumiantsev DISTRIBUTION OF ALLERGENIC PLANTS IN RUSSIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 Tatiana A. Trifonova, Anton A. Martsev NATURALFOCAL DISEASES IN THE VLADIMIR REGION RUSSIA . . . . . . . . . . . . . . . . . . . . . . . 26

ENVIRONMENT
Altangerel Enkhjargal, Badrakhyn Burmaajav IMPAC T OF THE AMBIENT AIR PM2.5 ON CARDIOVASCULAR DISEASES OF ULAANBAATAR RESIDENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Semen A. Kurolap, Oleg V. Klepikov, Pavel M. Vinogradov, Tatyana I. Prozhorina, Liudmila O. Sereda INTEGRATED ASSESSMENT AND GISMAPPING OF THE ENVIRONMENTAL STATE OF THE CIT Y OF VORONEZH RUSSIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

SUSTAINABILIT Y
Wuyi Wang, Yonghua Li, Hairong Li, Jiangping Yu, Linsheng Yang, Li Wang ENVIRONMENTAL MECHANISM OF REGIONAL LONGE VIT Y IN CHINA . . . . . . . . . . . . . . . . . . 54 R.B. Singh, Md. Senaul Haque, Aakriti Grover DRINKING WATER, SANITATION AND HEALTH IN KOLKATA ME TROPOLITAN CIT Y: CONTRIBUTION TOWARDS URBAN SUSTAINABILIT Y . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

NEWS AND REVIEWS
Sergey R. Chalov, Vladimir A. Kolosov GEOGRAPHY, CULTURE, AND SOCIE T Y FOR OUR FUTURE EAR TH . . . . . . . . . . . . . . . . . . . . . . 82 Giovanni De Santis HEALTH MANAGEMENT. A MEDICAL GEOGRAPHICAL PERSPEC TIVE . . . . . . . . . . . . . . . . . . . 85 Taniana A. Trifonova MEDICALGEOGRAPHICAL ATLAS OF RUSSIA "NATURALFOCAL DISEASES". . . . . . . . . . . . 90

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HEALTH AND ENVIRONMENT: THE URGENT PROBLEM OF MODERN INTERDISCIPLINARY RESEARCH1
The problem of the relationships between humans and the environment is becoming increasingly urgent, which is reflected in studies of medical geographers, anthropologists, and scientists of other disciplines. The scope includes theor etical and exper imental research on natural and anthropogenic risk factors, medico-geographical consequences of regional changes of the environment, population health of urbanized territories, background factors promoting the spread of infectious and parasitic diseases, organization of health care, etc. The interest to this problem has increased as a result of new challenges of the last decades, namely, global change of natural environment, increased population migration, appearance of a new group of "emerging" diseases, etc. The results of these research efforts have been presented at numerous medico - geographical and environmental anthropology conferences.1 One of the sec tions of the Reg ional Conference of the International Geographical Union (IGU) held in Moscow in August of 2015 was devoted entirely to the issue of "Health and Environment." The section hosted 28 oral and 7 poster presentations from 12 countries. Prior to the Regional Conference, the IGU C ommission "Health and Environment " conducted a scientific and practical seminar on medical geography and human ecology in the city of Vladimir. Such workshops are a long-standing tradition of the Commission which organizes them immediately prior to the congresses or regional conferences in the hosting countr y. The 2015 seminar was
1 T he review is based on the Book of Abstrac ts of International Geographical Union (IGU) Commission on Health and Environment Pre - Conference Meeting on Medical Geography and Human Ecology, 13­16 August 2015, Vladimir, Russia. Vladimir, 2015. ­ 35 p. and the IGU 2015 Book of Abstrac ts, International Geographical Union: Moscow, 2015. ­ pp. 516 ­556.

organized by the Faculty of Geography of the Lomonosov Moscow State University and the Department of Biology and Ecology of A.G. and N.G. Stoletov Vladimir State University. The seminar was attended by 45 scientists from 7 countries; 19 oral and 11 poster presentations were made; the themes of the presentations were related to the most important modern problems. One of the main traditional research areas is the effect of various environmental factors on the population health, which covers both the role of the individual components and their combined effects. Many researchers addressed one of the most important issues of this field of studies ­ the meteorological fac tor. The presentations included wor ks on the bio - climatic and meteorological conditions in the Central (E. Kulagina et al.) and the North-Western regions of Russia (E. Semina et al.; M. Trubina) and on heat waves in the Kuban region (E. Carvajal Ciomina et al.). Natural hazards in Europe were analyzed by E. Semina et al. The role of geochemical factors (the content of arsenic in drinking water) in the spread of skin tumors was discussed by Y. Xia using Inner Mongolia as an example. I nfluence of a complex of environmental fac tors on the population health of an industrialized area was demonstrated on the example of the Vladimir region ( Trifonova et al.). The study noted that in recent years there has been a continuous increase in the incidence rate in the populations of all age groups, which the authors attributed mainly to poor environmental conditions. Local geographical factors and their impact on health in Chechnya were analyzed by H. Eldarova. Allergy has long been one of the most common problems of the population of


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HEALTH AND ENVIRONMENT: THE URGENT PROBLEM...

developed countr ies. The role of biotic factors was demonstrated in the study on the distribution range of plants-allergens in Russia (Dikareva, Rumyantsev) who studied the main pattern of their distribution. A presentation by O. Konstantinova et al. was devoted to intoxication from snake-bites in the Republic of Guinea. The use of folk remedies by local communities was discussed on the example of the population in M aharashtra, I ndia (Ravindra G. Jaybhaye, Bhaskar I. Gatkul). These interdisciplinary studies, based on traditional methods of biogeography, ecology, and human health geography, are a good example of cooperation between experts in different areas. One of the problems of human ecology on the agenda at the beginning of the XXI century is the problem of population aging. This issue has been studied relatively well in China, where the share of the older population is growing because of the government demographic policy. There is now a substantial territorial differentiation of elderly population and its growth rate ( Y. Cheng et al.). A faster growth of the elderly population is obser ved in rural areas, while the quality of life for people over 65 is much higher in large cities, due to the greater availability of medical care, medical drugs, and higher quality food. Natural and socio-economic factors play the significant role: a greater percentage of older people are in areas with a mild climate and a welldeveloped social infrastructure. The role of lifestyle for healthy aging is emphasized by W. Wang et al.; L. Wang et al. Spatial aspects of the health of older people in big cities are considered by S. Yang, Q. Zhu who used one of the world's largest cities, Beijing, as an example. The influence of environmental fac tors was analyzed as a fac tor of the longevit y phenomenon. The conference also discussed the results of studies on similar problems in Europe (for example, Luxembourg by B. Koeppen et al.). The purpose of this kind of research is the creation of forecasts and making the information available to public authorities to improve the population policy and health protection measures.

Another important topic in modern research on medical geography and human ecology is urban health. Spatial and temporal patterns of population growth in large cities in China were discussed by Wang Wuyi et al. Conventional studies have focused on different aspects of the relationship of the environment and health. The results of assessment of the impact of air pollution on environmentallydependent diseases were presented by Wang Wuyi et al. ( Y. Cheng et al. and Xiaofeng Gao, Huiping Liu. The relationships between disease incidence in various population groups and the location of large industrial enterprises for a large industrial center (the city of Voronezh, Russia) were discussed by S. Kurolap et al. The scientists demonstrated that the use of GIS technology is a reliable tool for presentation of spatial differentiation of disease incidence and can be used in development of long-term health care programs for the populations of large cities. A study conducted in St. Petersburg among the students who come to study from various regions with different climatic conditions and cultural and ethnographic charac teristics focused on problems of physical and psychological adaptation ( Y. Scor yk et al.). The urban environment has an impact on the physical and psychological state, however, this issue remains poorly understood. M or talit y is one of the k ey indicators of the state of public health. The territorial differences in the distribution of this indicator in the Russian Federation were considered by S. Timonin. The regions with the highest and lowest values of mortality were identified by N. Shar tova, S. Malkhazova. The authors made an attempt to explain the differences by the influence of historical and contemporar y natural and socio-economic factors. A sses sment of en vir onmental and socio - economic values pr ovided by ur ban ecosyst ems (climat e r egulation, maintenance of green spaces, etc.) allows identification of the benefits that may be received by societ y (the economy, health

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and w ell-being of the population) and the environment from the use of natural capital without additional in v estment. Identification of the k ey ser vice func tions as the structural elements of the ecological framew o r k allows cities t o assess their impor tance for improving the quality of the environment and health and well-being of the population (D. Dushk ova et al.). A new direction in environmental anthropology research is the study of the impact of lifestyle on health and the identification of risk factors. Studies in the US have identified the main causes of ill health in post-industrial countries, i.e., insufficient physical activity and poor diet, leading to the spread of cardiovascular disease, type II diabetes, and obesity (E. West). A study conducted in Romania by A.M. Talos showed the spatial differentiation in the level of health of the population caused by differences in lifestyle. A significant number of studies were devoted to the territorial organization of the health care system, access to health care for the various categories of the population, and the international strategy for "health for all" (Global health) ( T. Krafft, E. Pilot, Wang Li). Examples from different countr ies (I ndia, Canada, Romania, and other European countries) were used to consider regional specificity of the work of health care ser vices (M. Rosenberg, K. Wilson, L.K.P. Prem, A. Banerjee; K. Wilson et al.; A. Cruceanu et al.; L. Dumitrache et al.). Traditionally, medical geography has focused on the geography of diseases caused by live

disease - causing agents. These studies are aimed at identifying patterns of distribution of certain diseases or entire groups of diseases and development of new or improvement of existing methods of spatial-temporal analysis. Thus, the results of mathematical and car tographic modeling of tularemia in the Smolensk region (Russia) were presented by T. Vatlina; a retrospective analysis of the spread of plague in Europe was presented by R. Yue; a study on the spread of waterborne diseases (a case study of India) was presented by B.I. Gatkul; and the use of car tographic methods t o study the pr opagation of natural focal disease in Russia was presented by S. M alk haz ova et al . I mpr ov ement of methodologies of landscape -malar ia regionalization conducted on the example of southern Uzbek istan was discussed by E. Soldatova, V. M ironova. Applied aspects of the geography of natural focal diseases in Russia were considered in a case study on their impac t on t ourism ac tivities (S. Malkhazova et al.). Scientific discussion of the most urgent issues of modern medical geography and human ecology allows prioritizing problems related to the area "Health ­ Environment," which need to be addressed in order to improve the quality of life and to better understand the modern natural and socio - economic processes that determine the level of public health. Svetlana M. Malkhazova, Varvara A. Mironova


1

SPATIAL PAT TERNS OF PUBLIC HEALTH IN RUSSIA
ABSTRAC T. The paper presents the characteristics of the status of public health in the regions of Russia in 2002­2012 conducted considering life expectancy of men and women, as well as infant mortality. Public health trends were identified in comparison with 1990­2001. Five groups of regions with specific status of public health were isolated and analyzed. Cross-spectrum analysis of environmental and socio-economic factors was conducted in order to explain the existing level of mortality of the population. KEY WORDS: public health in Russia, mor tality, life expectancy, territorial differentiation, correlation analysis. INTRODUC TION Health of the population is one of the main criteria for the sustainable development of regions. I t is characterized by such health and demographic indicators as morbidity, mor talit y, lif e expec tanc y, disabilit y, t emporar y disabilit y ; its status is an indicator of the quality of the environment [Environment..., 1979; Ur banization and Health..., 2011]. I t is necessar y to draw a clear distinction between individual health and public (population) health. I ndividual health is a combination of all the individual systems of the body of a single person. Pu blic health quit e objec tiv ely re flec t s the socio - economic sphere of life and charac terizes the environmental status of a par ticular region [Prok horov, Shmak ov, 2013]. Currently, the model of public heal is undergoing transformation into the model of "environmental public health." This concept treats a person as par t of an ecosystem, not removed from it, but not at its center [Bentley, 2013]. The assessment cr iter ion implies, as a rule, the population-based level of biological responses (physiological responses, mor bidit y, and mor talit y) t o environmental changes [Revich, Avaliani, Tik honov, 2004]. PROBLEM STATEMENT The study of public health is a multifaceted problem. Initially in Russia (the beginning of the XX centur y), public health research mainly included assessment of incidence and identification of the causes of the spread of infectious diseases. These studies involved identification of the distribution of typhoid, smallpox, and malaria in Russia and relationship bet ween these diseases and the railways and river routes, the quality of health monitoring, etc. The League of Nations Epidemic Commission noted that the statistical data provided by the People's C ommissar iat of Health for such wo r k were quite correct, and sanitar y measures implemented based on this research were ver y effective [Guest, 1923]. Subsequently, the impor tance of noncommunicable diseases and the role of environmental factors in the status of public

7 GEOGRAPHY

Svetlana M. Malkhazova1, Natalya V. Shartova2*, Sergei A. Timonin3 Department of Biogeography, Faculty of Geography, Lomonosov Moscow State University; sveta_geo@mail.ru 2 Depar tment of Landscape Geochemistr y and Soil Geography, Faculty of Geography, Lomonosov Moscow State University; shartova@yandex.ru * Corresponding author 3 Institute of Demography, Higher School of Economics; stimonin@hse.ru


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health were becoming increasingly apparent. However, by the middle of the XX centur y, despite the significant number of "descriptive" works on medical and demographic situation in Russia, vir tually no studies that would present comprehensive infor mation on mor talit y and mor b idit y, environmental factors, housing and sanitation conditions, social stratification etc., had been conducted [Brock ington, 1956; M azique, 1961]. I t is also typical of the works of the later, postSoviet period, when many of the factors that determine the health of the population in Russia were identified, however, they were usually not analyzed in depth [Heilig, 1999; Tkachenko, McKee, Tsouros, 2000]. B y the beginning of the XXI centur y, a number of works analyzing the status of public health in Russia in great detail were published [Prokhorov, 2000; Public Health... 2007; Prokhorov, Gorshkova, Tarasova, 2003; Prokhorov, Tikunov, 2005; Prokhorov, 2009]. These works are based on a comprehensive comparison of the regional status of public health, the economic situation, and the levels of contamination of the environment and the comfort of natural conditions of the regions for the life of the population. Dozens of indices and indicators of public health have been developed [Rothenberg et al., 2015]. The main characteristic of the health status of the population, according to the recommendations of the World Health Organization, currently include life expectancy for men and women, the infant mor tality rate, i.e., mortality of children under 1 year of age per 1000 of live births [Bulletin..., 2009; Malhazova, Koroleva, 2011; Agenor, 2012]. This paper presents a medical- geographic assessment of the Russian territor y for 2002­ 2012 based on one of the indices of public health to reflect the current situation and to identify its trends compared to 1990­2001. Several major environmental and socio economic indicators have been analyzed to determine the possible causes of the specific status of public health [Malk hazova et al.,

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2014; Shartova, Krainove, Malhazova, 2015]. The indicators of public health used in the analysis and identification of the potential risk factors included the mor tality of men and women by the causes of death and life expectancy in the cities, because urban population may have more distinct responses to environmental change [Addington, Weiss, 1999; Pascal et al., 2013]. Materials and methods Medical-geographic assessment of the regions of Russia conduc ted using demographic indicators (life expectancy, infant mortality, the urban population mortality by causes) from the Federal State Statistics Ser vice (Rosstat), published in the collected volumes "Regions of Russia" and "Demographic Yearbook of Russia" and bulletins " The Natural Movement of the Population of the Russian Federation" and "Healthcare in Russia" for 2003­2013. For comparative assessment of public health in Russia by its regions, an integrated parameter was used, specifically, the index of Public Health (IPH) which combines coefficients of infant mor tality and life expectanc y for men and women [Prokhorov Tikunov, 2005]. I ts calculation is based on an assessment algorithm that includes normalizing of the system of the initial parameters with the formula: x ij - x X ij =
max / min x j o j

-x

o j

,

i = 1, 2, 3, ..., n; j = 1, 2, 3, ..., m. where x is the worst conditions (for each parameter) out of all occurring situation over the entire period (maximum infant mortality and the lowest life expectancy); max/min x is the parameter that deviates the most from the o x values; n is the number of territorial units under consideration (83 regions and Russia as a whole); m is the number of indicators used for the calculations (3). The calculations were per formed for 2002­2012.
o


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SPATIAL PATTERNS OF PUBLIC HEALTH IN RUSSIA

Correlation analysis was used to identify the relationships between the status of public health and environmental factors. I t was conducted using the 2010­2012 data for 168 Russian cities with a population of over 100 thousand. Two groups of parameters were selected as environmental factors. The first group includes ecological parameters, e.g., certain characteristics of atmospheric pollution. The second group includes socio-economic parameters that characterize the state of the economy, health care system, and social services ( Table. 1). Based on the nature of the distribution of the data used in the calculation, the nonparametric Spearman correlation coefficient with the 0.95 confidence interval was used.
Table 1. Ecological and socio - economic indicators Indicators Environmental Release from stationary sources, including: solids sulfur dioxide carbon monoxide nitric oxide hydrocarbons and volatile organic compounds Socio-economic Population density Increase (decrease) of population due to migration Number of retirees Average monthly wage of workers Living area per one person Number of doctors Capacity of outpatient clinics Number of sports facilities Number of recorded crimes per 1000 people rouble m2 per 10 000 people people/ha per 1000 people thousand tones/yr Units of measurement

Table 2. Public health indicators Indicators Life expectancy for men/women Overall mortality for men/women Mortality by cause of death for men/women Diseases of the respirator y system Diseases of the digestive system Diseases of the circulator y system Disease caused by human immunodeficiency virus (HIV ) External causes of death Congenital anomalies (birth defects), deformations, and chromosomal abnormalities Malignant melanoma of the skin Malignant neoplasms of breast Malignant neoplasms of female genital organs Malignant neoplasms of male genital organs Malignant neoplasms of the respirator y system Malignant neoplasms of the urinar y tract Malignant neoplasms of digestive organs Coronar y arter y diseases Neoplasms Pneumonia Event of undetermined intent Deaths caused by alcohol Suicides Tuberculosis, all forms Murders (assault, rape) Cerebrovascular diseases per 100 000 people per 1000 people Units of measurement years

The mor tality of men and women by the causes of death and life expec tanc y was used as a characteristic of public health in the analysis. A total of 24 parameters for men and women were utilized in the analysis ( Table. 2).

Results and discussion Changes in the socio-economic and political situation in Russia are accompanied by a change of basic health and demographic

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Mortality rates were standardized according to the European standard and presented per 100 000 population of the corresponding sex and age [Denisenko, Kalmykova, 2007].


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Fig. 1. Life expectanc y in Russia in 2002­2012.

Fig. 2. Infant mor talit y in Russia in 2002­2012.

indicators. After the financial and economic crisis of 1998, the life expectancy in Russia was minimal and until 2005 did not exceed 65 yrs (Fig. 1). With the improvement of the socio-economic situation in the countr y, the average life expectancy has steadily increased, reaching 69.5 years in 2012, while male life expectancy has remained low (lower than 60 yrs in 2002­2006.). Among the positive changes in health outcomes that have occurred in recent years, there is also a significant reduction in infant mortality, which, however, has stalled somewhat in 2012, probably as a consequence of the economic crisis at the end of the first decade of the XXI century (Fig. 2). Overall, in 2002­2012, the status of public health in Russia varied (Fig. 3). From 2002 to 2006, it worsened, which was reflected in the decrease of IPH which reached the absolute minimum for this period. In subsequent years,

there was a gradual improvement in medical and demographic situation, and in 2009­ 2010, the IPH value reached the level of 2002. However, in the next two years, the status of public health declined again, which may be partly due to changes in the statistical criteria of live births in infant mortality registration, which took place since 2011. The status of public health for the 2002­2012 in average is presented on the map (Fig. 4). IPH calculation for each year has allowed ranking of the countr y 's regions in terms of public health for each year and for 11 years overall for fur ther comparative analysis. As a result, the regions were grouped into five categories according to the ranking. The first group includes 8 regions with a satisfactor y status of health: rank ing from 1 to 8 (IPH 1.0­0.8) ­ Belgorod Oblast, the Republics of Dagestan, Ingushetia, Tatarstan,


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SPATIAL PATTERNS OF PUBLIC HEALTH IN RUSSIA

Fig. 3. The status of public health in Russia in 2002­2012.

Kabardino-Balkaria, Karachay-Cherkessia, and Moscow and St. Petersburg. The second group is the most extensive and consists of 41 regions (ranking from 9 to 49 (IPH 0.8­0.7) with a somewhat worse health status. Almost all regions in this group have IPH above the average for Russia; however, they differ substantially among themselves. In this group, the highest status of public health is in the Krasnodar Krai, the Republics of Adygea and Chuvashia, and the Tambov Oblast. The lowest IPH values are in the Republic of Mari El, the Ryazan and Kaluga Oblasts, and the Altai Krai. The third group includes 15 regions with a low health status (rank ing from 50 to 64; IPH 0.7­0.6). This group includes Tula, Ivanovo, Kostroma, Smolensk, Leningrad, and Murmansk Oblasts, the Krasnoyarsk Krai, and the Republic of Yakutia. The fourth group consists of 15 regions with very low health status (ranking from 65 to 78; IPH 0.6­0.5); the status is especially low in the Trans-Baikal and Khabarovsk Krais, the Republic of Khakassia, and the Magadan Oblast. The fifth group includes 5 regions with critical health indicators (ranking from 79 to 83; IPH lower than 0.4): the Republic of Tyva, the Jewish and Chukotka Autonomous Districts, Altai Republic, and the Amurskaya Oblast. The trend in the major regional IPH parameters over the past two decades shows relative

stability of health and demographic indicators in most regions of Russia: in 56 out of the 83 subjec ts of the Russian Federation, the IPH rank ing positions over 20 years have not changed; in 10 regions, the situation has w orsened (especially in the Amur Oblast and the Chuk otk a A u t onomous District); and only in 13 administrative units, including M oscow and St. Petersburg, the situation has improved. P ublic health, especially the ur ban population, is influenced by environmental factors. For example, analysis of 25 European cities shows that air pollution is still playing a major role in det er mining the status of public health. Thus, reduc tion of the content of par ticulate matter and ozone in the atmosphere is expected to increase life expectancy and lower mor tality [Pascal et al., 2013]. A number of studies found an association bet ween low socio - economic status and high lev els of mor b idit y and mor t alit y from cer t ain pathologies [Addington, Weiss, 1999]. Issues of health risk assessment of Russia's population in relation to exposure to pollutants in the atmosphere [Gur vich et al., 2004; Reshetin, K azaz yan, 2004; Zemlyanalya, Solenova, K islitsyn, 2006; Lukjanova, Popova, 2011; Revich et al., 2015; Yakovenko, Kravchenko, 2015], as well as to the impac t of socio - economic factors [ Vandenheede et al., 2014; Chubirko et al., 2014; Trifonova, Shirk in 2015] at the regional level are considered in a relatively large number of works.

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Fig. 4. Assessment of the status of public health in Russia in 2002­2012.


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Table 3. Significant correlation coefficients (R) between the causes of death and environmental indicators Environmental indicators Causes of death Respiratory diseases, men Respiratory diseases, women Malignant neoplasm of the respirator y system, men Malignant neoplasm of the respirator y system, women Pneumonia, men Pneumonia, women Malignant neoplasm of the urinar y system, women Digestive diseases, women Release into atmosphere of pollutants from stationary soruces 0.38* ­ _ _ 0.36* 0.37* 0.35 ­ including: solid pollutants 0.40/0.41* 0.36 0.36/0.36* 0.36* ­ _ _ 0.35* nitrogen oxide 0.36* ­ _ 0.37 _ 0.37* 0.36 ­ carbon monoxide 0.36* ­ _ _ _ 0.36* ­ ­ sulfur dioxide ­ _ _ _ _ _ _ 0.36*

Note. An asterisk indicates correlation coefficients for the sample of cities with a population between 100 and 800 thousand with a confidence inter val of 0.95; values without an asterisk indicate correlation coefficients for the sample of cities with a population of 100 thousand to 11 million with a confidence inter val of 0.95; dash indicates that a statistically significant correlation was not established.

The analysis conduc t ed for the entire territor y of Russia produced rather low cor r elation coefficients bet w een the en vir onmental paramet ers and public health parameters. The most significant coefficients are presented in Table 3. For example, mortality from respirator y diseases, including pneumonia, as well as malignant tumors of the r espirat or y syst em, has statistically strong association with release of solid pollutants into the atmosphe re. A correlation between the mor tality of men from respirator y diseases and emissions of nitrogen oxides and car bon monoxide has been established . Not ew or th y the relationship between female mor tality from cancer of the respirator y system and release of solid pollutants, and bet ween diseases of the digestive system and release of solid pollutants and sulfur dioxide. The findings are consistent with other studies on the effec ts of air pollution on human health [Pascal et al., Shaposhnik ov et al., 2014]. The calculations showed ex tremely low statistically significant correlation coefficients bet ween the status of public health in the regions of Russia and the considered

socio-economic parameters, which require additional research. Conclusion Analysis of long-term indices of life expectancy and infant mortality rates and the calculation of the integral IPH has allowed us to evaluate the medical and demographic situation in the regions of Russia and to reach the following conclusions: ­ The subjec ts of the Russian Federation differ substantially in terms of public health, first and foremost, on infant mor tality and life expectancy ; a critical status is obser ved in the Far East (Chuk otk a Au tonomous District, Jewish Autonomous District, Amur Oblast) and Southern Siberia (Altai and Tyva Republics); ­ Trends in the status of public health for the 1990­2012 indicate a relative stability of the situation. In most regions of Russia, the status of public health has not changed; the deterioration occurred primarily in the Far East (Amur Oblast, Chuk otk a Autonomous District); in Moscow and St.

13 GEOGRAPHY


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Petersburg, there has been a significant improvement in public health;

­ Long-term dynamics of the basic indicators of public health reflects trends in socioeconomic sphere of the countr y, above all, the consequences of the crisis period characterized by a general decline of the economy and an increase in social tension; ­ Cross-spectrum analysis of the environmental and socio-economic factors, taking

into account the health care system, can explain the current level of mor tality or mor bidit y. Thus, a positive cor relation bet w een mor t alit y fr om r e spirat or y diseases , including pneumonia and malignant neoplasm of the respirator y organs, and emissions of pollutants into the atmosphere has been established. In order to obtain data on other causal relationships it is necessary to develop and use additional approaches and methods of medical and geographic analysis.

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REFERENCES 1. Addington W.W., Weiss K.B. (1999) Chicago's response to the public health challenge of urban asthma // American College of Chest Physicians. 116. pp. 132­134. 5. AgÈnor P.R. (2012) Public capital, growth and welfare: Analytical foundations for public policy. ­ Princeton University Press. ­ 252 p. 3. Bentley M. (2013) An ecological public health approach to understanding the relationships between sustainable urban environment, public health and social equity // Health Promotion International. Vol. 29. . 3. pp. 528­537. DOI:10.1093/heapro/dat028 4. Brockington C.F. (1956) Public health in Russia // Lancet. Vol. 271. Pp. 138­141. 5. Bulletin of the World Health Organization (2009). 87: 714­719. DOI: 10.2471/BLT.08.058321 6. Chubirko M.I., Pichuzhkina N.M., Masajlova L.A., Lastochkina G.V. (2012) Otsenka vliyaniya social'no-ekonomicheskikh faktorov na mediko-demograficheskiye pokazateli (Assessment of the impact of socio-economic factors on health and demographic indicators) // Gigiena i sanitariya. 6. S. 36­38. 7. Denisenko M.B., Kalmykova N.M. Demografiya: Uchebnoye posobiye (2007) (Demography : Textbook). M.: INFRA-M. 424 s. 8. Okruzhayushchaya sreda i zdorov 'e (Environment and Health) (1979). M.: Nauka. 214 s. 9. Guest L.H. (1923) Public health in Soviet Russia // British Medical Journal. Part: 2. pp. 677­679. 10. Gurvich V.B., Plotko Je. G., Selyankina K.P., Nadeenko V.G., Ryzhov V.V., Sajchenko S.P., Veprintcev V.V. (2004). Dinamika zabolevayemosti detskogo naseleniya kak kriterij neobkhodimosti rekonstrukcii alyuminievykh zavodov (Dynamics of child morbidity as a measure of the need for reconstruction of the aluminum smelters) // Vestnik RAMN. 3. S. 46.


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12. Lukiyanova N.I., Popova E.S. (2011) Problems of risk assessment to public health in megacities (by example of some districts of St. Petersburg, Russia) // Russia Journal of General Chemistr y. Vol. 81. Issue. 13. Pp. 2682­2687. DOI: 10.1134/S1070363211130093 13. Malkhazova S.M, Koroleva E.G. (2011) Okruzhayushchaya sreda i zdorov 'e cheloveka (Environment and Health). M.: Geogr. f.-t MGU. 180 s. 14. Malkhazova S., Yang L., Wang W., Orlov D., Shartova N., Hairong L., Wang L. (2014) Health of urban population in Moscow and Beijing agglomerations // Geography. Environment. Sustainability. 4. pp. 41­53. 15. Mazique E.C. (1961) Public health and medical care in Russia // Journal of the National Medical Association. Vol. 53. pp. 352­355. 16. Pascal M., Corso M., Chanel O., Declerq C., Badaloni C., Cesaroni G., Henschel S., Meister K., Haluza D., Martin-Olmedo P., Medina S. (2013) Assessing the public health impacts of urban air pollution in 25 European cities: Results of Aphekom project // Science of the Total Environment. 499: 390­400. 17. Prokhorov B.B. (2000) Obshchestvennoye zdorov 'e v Rossii za 100 let (1897­1997) (Public Health in Russia over 100 years (1897­1997)) // Rossija v okruzhayushchem mire: 2000 (Analiticheskij yezhegodnik). M.: MNJePU. S. 133­168. 18. Prokhorov B.B. (2009) Social'naya stratifikatsiya obshchestva i zdorov 'e naseleniya (Social stratification of society and the health of the population) // Problemy prognozirovaniya. 3. S. 112­133. 19. Prokhorov B.B., Gorshkova I.V., Tarasova E.V. (2003) Usloviya zhizni naseleniya i obshchestvennoye zdorov 'e ( The living conditions of the population and public health) // Problemy prognozirovaniya. 5. S. 127­140. 20. Prokhorov B.B., Shmakov D.I. (2013) Prichiny gibeli lyudej v mirnoye vremya i ekonomicheskaya otsenka stoimosti poter ' ( The causes of death of people in peacetime and economic valuation of losses) // Problemy prognozirovaniya. 4. S. 139­147. 21. Prokhorov B.B., Tikunov V.S. (2005) Obshchestvennoye zdorov 'e v regionakh Rossii (Public Health in the Russian regions) // Geografiya i prirodnyye resursy. 2. S. 26­33. 22. Obshhestvennoye zdorov 'e i ekonomika (Public Health and Economics) (2007) / Otv. red. Prokhorov B.B. M.: MAKS Press. 300 s. 23. Reshetin V.P., Kazaz yan V.I. (2004) Public-health impact of outdoor air pollution in Russia // Environmental Modelling & Assessment. Vol. 9. Issue 1. pp. 43­50. DOI: 10.1023/B:EN MO.0000020889.41526.66

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11. Heilig S. (1999) A modern public health crisis: A physician speaks about healthcare in post-glasnost Russia // Cambridge Quarterly of Healthcare Ethics. Vol. 8 Issue 2. pp. 257­258.


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24. Revich B.A., Avaliani S.L., Tikhonova G.I. (2004) Ekologicheskaya epidemiologiya: Uchebnik dlya vyssh. ucheb. zavedenij. (Environmental Epidemiology : Textbook for Higher Educational Institutions). M.: Izdatel'skij tcentr "Akademija". 384 s. 25. Revich B.A., Shaposhnikov D.A., Avaliani S.L., Lezina E.A., Semutnikova E.G. (2015) Izmeneniye kachestva atmosfernogo vozdukha v Moskve v 2006­2012 gg. i riski dlya zdorov 'ja naseleniya (Changes in air quality in Moscow in 2006­2012 and public health risks) // Problemy ekologicheskogo monitoringa i modelirovaniya ekosistem. 1. S. 91­122. 26. Rothenberg R., Stauber C., Weaver S., Dai D., Prasad A., Kano M. (2015) Urban health indicators and indices ­ current status // BMC Public Health. 15:494. DOI: 10.1186/s12889015-1827-x 27. Shaposhnikov D., Revich B., Bellander T., Bedada G.B., Bottai M., Lind T., Pershagen G., Kharkova T., Kvasha E., Lezina E., Semutnikova E. (2014) Mortality related to air pollution with the Moscow heat wave and wildfire of 2010 // Epidemiology. Vol. 25. 3. pp. 359­364. 28. Shartova N.V., Krajnov V.N., Malkhazova S.M. (2015) Tekhnologiya integral'noj otsenki bioklimaticheskoj komfortnosti i zagr yaznennosti vozdukha na urbanizirovannykh territoriyakh (Methodology of integrated assessment of bioclimatic comfort and air pollution in urban areas) // Ekologiya i promyshlennost' Rossii. 1. S. 24­29. 29. Tkachenko E., McKee M., Tsouros A.D. (2000) Public health in Russia: the view from the inside // Healthy Policy and Planning. Vol. 15. Issue 2. pp. 164­169. DOI: 10.1093/ heapol/15.2.164 30. Trifonova T.A., Shirkin L.A. (2015) The analysis of cumulative influence of factors of environment on the status of health of the population of Vladimir region // Global Journal of Health Science. Vol. 7. 3. pp. 309­316. 31. Urbanization and health: Health equity and vulnerable populations. Case studies from the Eastern Mediterranean Region (2011). ­ WHO Regional Office for the Eastern Mediterranean. ­ 35 p. 32. Vandenheede H., Vikhireva O., Pikhart H., Kubinova R., Malyutina S., Pajak A., Tamosiunas A., Peasey A., Simonova, G., Topor-Madr y R., Marmot M., Bobak M. (2014) Socioeconomic inequalities in all-cause mortality in the Czech Republic, Russia, Poland and Lithuania in the 2000s: findings from the HAPIEE Study // Journal of Epidemiology and Community Health. Vol. 68. 4. pp. 297­303. DOI: 10.1136/jech-2013-203057. 33. Jakovenko O.N., Kravchenko N.A. (2015) Zagr yazneniye atmosfernogo vozduk ha g. Irkutska vybrosami ot peredvizhnykh istochnikov (primeneniye raschetnoj metodiki) (Air pollution of Irkutsk from mobile sources emissions (application of the calculation method)) // Gigiena i sanitarija. 1. S. 64­68. Received 05.10.2015 Accepted 06.11.2015


S.M. Malkhazova, N.V. Shartova, S.A. Timonin

SPATIAL PATTERNS OF PUBLIC HEALTH IN RUSSIA

Natalya V. Shartova has Ph. D. degree in Geography. She is Scientific Researcher, Department of Landscape Geochemistr y and Soil Geography, Faculty of Geography, Lomonosov Moscow State University. Her main research interests are in medical geography and human ecology, particularly in relation to the problems of urban ecology and urban population health. She is the author of 35 scientific publications.

Sergei A. Timonin has Ph. D. degree in Geography. He is Research Associate at the Institute of Demography of the Higher School of Economics. His main interests are associated with life expectancy, mortality from non-communicable diseases, spatial demography, and GIS.

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Svetlana M. Malkhazova is Doctor of Geographical Sciences, Professor, Head of the Department of Biogeography, Faculty of Geography, Lomonosov Moscow State University. Her main research interests relate to biogeography, ecology, and medical geography. She is the author of over 250 scientific publications, including 10 books, several textbooks, and medical and environmental atlases.


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Tatiana V. Dikareva1*, Vadim Yu. Rumiantsev2 1 Faculty of Geography, Lomonosov Moscow State University, Moscow, Russia; Leninskie gory, 1, 1199911, Tel. + 7 9060823239 * Corresponding author: e-mail: tvdikareva@yandex.ru 2 Faculty of Geography, Lomonosov Moscow State University, Moscow, Russia; Leninskie gory, 1, 1199911, Tel. + 7 9060823239, vyurum@biogeo.ru

DISTRIBUTION OF ALLERGENIC PLANTS IN RUSSIA
ABSTRAC T. We analyzed, for the first time ever, the geographical distribution of the main allergenic plants in Russia. All materials were organized as database and attached to the map in GIS Mapinfo. For each region of Russian Federation, two indices were calculated: the total number of allergenic plants in the region and the "allergenic index ". A series of maps was compiled: the number of spring-flowering species, the number of summer-flowering species, the total number of species flowering during the whole year, the overall allergen danger during spring and summer seasons, respectively, and the overall allergen danger during the whole year. In terms of the number of allergenic species and by the "allergenic index," the most dangerous regions appeared to be the Ryazan and Voronezh Oblasts, while the less dangerous ­ the Chukotka Autonomous Okrug, and the Magadan Oblast. The maps may ser ve as a reference source for allergologists and allergy sufferers. KEY WORDS: allergenic plants, pollinosis, allergenic index, cross allergy, maps of distribution. INTRODUC TION B y the end of the XXth centur y allergy became one of the most widespread diseases in the industrial countries. One of the causes of allergy is plant pollen. Plant pollen allergy ­ pollinosis ­ is the disease of each four th inhabitant of our planet. More than 700 species of allergenic plants are known. Allergenic plants produce the largest amount of pollen early morning; that is why this time is the most dangerous for allergy sufferers. Maximum concentration of pollen in the air occurs during the warm sunny weather, while rain and dr yness slow down the pollen ripening and allergy sufferers feel better in such weather. Pollinosis symptoms appear when pollen concentration in the air reaches the threshold values. It is accepted that the dangerous limit is 10­20 pollen granules per 1 cubic meter of air. T her e ar e mor e than 700 species of aller genic plants . I n medical lit eratur e aller genic plants are divided int o three groups ­ trees, cereal grass, and weeds. T hey bloom during different periods and pollinosis exacerbations occur during two periods ­ spring-summer (from the beginning of April through the middle of June ­ trees) and summer (June-July ­ cereal grasses and from the end of June through the end of August ­ weeds). Usually the allergy sufferers react to the blooming of not one but several plants; that is why the seasonal exacerbations last approximately one month. Pollen allergy tak es the form of allergenic r hinitis and conjunc tivitis and causes the symptoms of runny nose with clear discharge from nose, cough, and tick ling feeling in the throat, as well as water ing ey es, it ch, and redness of ey es. Aller gy may tak e the form of bronchospasm and bronchial asthma attack .


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DISTRIBUTION OF ALLERGENIC PLANTS IN RISSIA

In Russian medical literature much attention is paid to various aspects of pollen impact on human organism. One can find the calendars of allergic plants flowering [www. kestine.ru], but the geographic distribution of those plants has not been analyzed. Foreign allergologists have been addressing this issue in detail beginning from the end of the XXth centur y [May, Smith, 2008; RondÑnet al. 2011]. There is the website in the USA [www.pollenlibrary.com], which shows daily flowering and danger for all 300 allergic species in all states and large settlements. The work presented herein is the first attempt of geographical analysis of the main allergenic plants distribution in Russia. MATERIALS AND ME THODS We selected for analysis 119 allergenic species. Even this operation was difficult because there is no generally recognized list of such plants in Russia. In the workbook for allergologists [Allergologiya i immunologiya..., 2009; Po r i adok ok azaniya..., 2010], the most dangerous species and groups of species (of ten families) are named. We followed this wor k book , internet resources [w w w. allergology.ru, www.pollenlibrar y.com], and some additional literature sources [Esch et al, 2001]. We selected the most widespread species or the species that produce the largest amount of pollen ­ the most dangerous for allergy sufferers during flowering period. We included into this list only those decorative plants that overstep the limits of ar tificial plantings (for example, ash-leaved maple). For each species, the degree of allergenic danger was estimated on a three-grade scale: dangerous (3), medium (2) and weak (1). This estimation was based on the materials of the above-mentioned websites and on the available data of pollen production of selected species. The selected species were divided into two groups: spring-flowering (April-May ­ beginning of June) and summer-flowering (middle of June ­ beginning of September).

Table 1. Number of analyzed allergenic species by categories of danger and terms of flowering Categories of allergenic danger Total weak (1) 4 6 10 medium dangerous (2) (3) 24 33 57 18 34 52 46 73 119

Flowering period

Spring Summer Total

For the spr ing per iod, we selec ted only 4 weak ly dangerous species. Those are: the dominant species in the communities (common beech and oriental beech) and the widespread species (common juniper). The bald cypress is an example of rare species but is frequently mentioned as allergenic in practically all foreign literature. For the summer period, we selec ted 6 weak ly dangerous species widespread in the European territor y of Russia (ETR) (see Table 1). Data on the allergenic species ranges were obtained from the plants guide -books [Gubanov, et al., 1995; Sosudistie rasteniya Sovetskogo Dal'nego Vostok a, 1996; Flora Sibiri, 1987­2003] and from the database Agroatlas [www.agroatlas.ru]. The distribution of selected species was then associated with the subjects of the Russian Federation (RF). I t is not well accepted in biogeographical mapping of taxonomic entities. But such approach is well understood by a large section of the population including allergologists and allergy sufferers. The mater ial was organized as database and the association with the subjec ts of the RF was mapped with the help of GIS Mapinfo. The database was created using the methodology developed by the authors for the database of the Russian terrestrial ver tebrates [Rumiantsev, Danilenko, 1998]

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The number of analyzed species according to the danger categor y and period of flowering is given in Table 1.


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For each region of the RF two indices were calculated: the total number of allergenic plants in the region and "allergenic index " ­ the sum of allergenic danger grades in the scale. For estimation we used the software applications Visual FoxPro and Statistika. A series of maps were designed: the number of spr ing-flower ing species (Fig. 1), the number of summer-flowering species (Fig. 2), the total number of species flowering during the whole year (Fig. 3), the overall allergenic danger during spring (Fig. 4) and summer (Fig. 5) seasons, respectively, and the overall allergenic danger during the whole year (Fig. 6). RESULTS AND DISCUSSION The results obtained through analysis of the compiled maps are presented below. The maximum number of allergenic species that flower during spring (Fig. 1) is found in the central regions of the ETR. The number decreases towards north, south, and east and is the lowest in the Chukotka Autonomous Ok rug and the Magadan Oblast. This can be explained by the fact that during spring

flower, the allergenic deciduous trees and some coniferous trees are distributed in the southern part of the forest zone. The maximum number of allergenic species that flower during summer (Fig. 2) is in the southern regions. Those are broadleaved forests, forest-steppe, steppe, and the forests of Ciscaucasia. The species are: cereal grasses, wor mwoods, and " weeds" ­ goose -foot, pigweed, nettle, plantain etc., and for the trees ­ tillet. The number of such species is maximal in the zone of broadleaved forests. The total number of allergenic species for the whole period of flowering (Fig. 3) is maximal in the central regions of the E TR, the K aliningrad Oblast, the K arsnodar Kray, and Crimea. This can be explained by the fact that allergy is studied and registered mostly in the territor y of the ETR and only local species are considered. The second reason is that the variety of allergenic species reflects the total species diversity in communities, which is the greatest in the broadleaved forest and forest-steppe zone. Allergenic species include weeds as well, which are the produc t of anthropogenic impact on vegetation, thus,

Fig. 1. Number of allergenic plant species flowering during spring:

1 ­ 10 and less (3), 2 ­ 11­15 (6), 3 ­ 16­20 (39), 4 ­ 21­25 (11), 5 ­ 26­30 (12), 6 ­ 31 and more (11). (In brackets ­ number of administrative units within the range).


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DISTRIBUTION OF ALLERGENIC PLANTS IN RISSIA

Fig. 2. Number of allergenic plant species flowering during summer:

1 ­ 34 and less (15), 2 ­ 35­39 (12), 3 ­ 40 ­ 44 (1), 4 ­ 45­ 49 (31), 5 ­ 50 ­54 (16), 6 ­ 55 and more (7). (In brackets ­ number of administrative units within the range).

the impact is maximal in the well-developed regions of the ETR. The concentration of allergenic species in the central regions of the ETR can be associated with one more factor. The allergy morbidity

rate is higher in those regions where the indices of air, water, and food pollution are higher. The high level of pollution stimulates the so called "cross" allergenic response [Romaniuk , 2010], which mak es human organism more sensitive to pollen. Thus,

Fig. 3. Number of allergenic plant species flowering during the whole vegetation period:

1 ­ 30 and less (3), 2 ­ 31­ 40 (3), 3 ­ 41­50 (8), 4 ­ 51­ 60 (14), 5 ­ 61­70 (21), 6 ­ 71 and more (33). (In brackets ­ number of administrative units within the range).

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Fig. 4. Summarized "allergenic index" in spring:

1 ­ 30 and less (4), 2 ­ 31­ 40 (11), 3 ­ 41­50 (29), 4 ­ 51­ 60 (15), 5 ­ 61­70 (2), 6 ­ 71 and more (21). (In brackets ­ number of administrative units within the range).

the allergenic species are concentrated in industrially developed and, because of this reason, polluted regions of Russia. The highest overall allergy danger during spring (Fig. 4) is detec ted in the central

regions of the ETR and the Kaliningrad Oblast; it decreases to the south and east. It is higher (but not much) in the Far East (the Primorsky Kray, the Khabarovsk Kray, the Amur Oblast, and the Jewish Autonomous Oblast). This fact can be explained by the high allergy danger

Fig. 5. Summarized "allergenic index" in summer:

1 ­ 40 and less (2), 2 ­ 41­ 60 (7), 3 ­ 61­80 (6), 4 ­ 81­100 (13), 5 ­ 101­120 (42), 6 ­ 121 and more (12). (In brackets ­ number of administrative units within the range).


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DISTRIBUTION OF ALLERGENIC PLANTS IN RISSIA

Fig. 6. Summarized "allergenic index" in the whole vegetation period:

1 ­ 70 and less (3), 2 ­ 71­100 (5), 3 ­ 101­130 (10), 4 ­ 131­160 (24), 5 ­ 161­190 (32), 6 ­ 191 and more (8). (In brackets ­ number of administrative units within the range).

resulting from the predominance of willows and oaks in the broadleaved forests of the Far East. The allergy danger is minimal in the Sakha Republic, the Chukotka Autonomous Okrug, the Magadan Oblast, and the Kamchatka Kray, as well as in the Ciscaucasian republics during this period. Forest-steppe and steppe regions of the E TR are the most dangerous for allergy sufferers during summer (Fig. 5): the Kursk, the Vo ronezh, the Saratov, the Samara, the Lipetsk, and the Penza Oblasts, as well as the Stavropol K ray and the K rasnodar Kray, Crimea, and the Republic of Adygeya. It can be explained by high allergenic danger of most cereal and wor mwood species, abundant in the Russian steppes [Dikareva, 2004]. A relatively high danger is t ypical of broadleave d, smalleave d, and mixed forests, mostly because of the cereal species flowering. The minimum danger is typical of the nor thern and the Far East regions (the Sak ha Republic, the Chukotk a, the Nenets, and the Yamalo-Nenets Autonomous Okrugs, the Magadan and the Sakhalin Oblasts, the Kamchatka and the Khabarovsk Krays during this period).

For the whole period of flowering (Fig. 6), the most dangerous regions are the Kursk, the Belgorod, the Voronezh, the R yazan, the Lipetsk , the Tambov, and the Penza Oblasts and the Republic of Mordovia. As it was mentioned above, these regions have developed industr y and high level of environment pollution. As a whole, according to the number of allergenic species and the "allergenic index," the most dangerous are the Ryazan and the Voronezh Oblasts, while the least dangerous are the Chukotka Autonomous Okrug and the Magadan Oblast. CONCLUSION Thus, the analysis re vealed the pr incipal la ws of allergenic plants distr ibution in Russia. The most dangerous for allergy sufferers region of Russia during spring and summer are the R yazan and the Voronezh Oblasts, respec tively. The least dangerous dur ing spr ing and summer ar e the Chuk otk a A u t o nomous Ok rug and the M agadan

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Oblast, respectively ; both regions were the least dangerous if the entire per iod was considered. Fur ther research on connection between pollinosis and environment pollution in the region is necessary. We also plan to compare our results with data on the pollinosis morbidity rate. The compiled maps could ser ve as reference material for allergologists and allergy sufferers. These maps and the database could be used REFERENCES

in development of an interactive information system. ACKNOWLEDGEMENTS The research was suppor ted by the Russian Geog raphical Societ y and the Russian Fund for Basic Research ( 13-05-41165) "I ntegral assessment and mapping of the natural fac tors impac t on the public health in Russia"

1. Agroecologicheskiy atlas Rossii i sopredel'nykh stran. [Agroecological atlas of Russia and adjacent countries]. Available from: www.agroatlas.ru (in Russian). 2. Allergologiya i immunologiya: nacional'noye rukovodstvo. (2009). [Allergology and Immunology: national guidebook]. ­ Editors R.M. Haitova, N.I. Iliena ­ .: GEOTAR-Media. (in Russian). 3. Allergologiya. [Allergology]. Available from: www.allergology.ru (in Russian). 4. Calendar ' pyleniya. [Calendar of pollen production]. Available from: www.kestine.ru (in Russian). 5. Dikareva T.V. (2004). Okhrana biotsenoticheskogo i botanicheskogo raznoobraziya stepey Evrazii na territorii Rossii [Protection of biocoenotic and botanical diversity of Eurasian steppes on the Russian territor y]. Aridnie ecosistemi [Arid ecosystems]. V. 10. 22­23, pp. 69­80. (in Russian). 6. Esch Robert E. et al. (2001). Common allergenic pollens, Fungi, Animals and Arthropods. Clinical Reviews in Allergy and Immunology. V. 21, pp. 261­292. 7. Flora Sibiri. [Siberian Flora]. (1987­2003).Vv. 1­14. Novosibirsk: Nauka. (in Russian). 8. Gubanov I.A., Kiseleva K.V., Novikov V.S., Tihomirov V.N. (1995). Opredelitel' sosudistykh rasteniy tsentralnykh regionov Evropeyskoy territorii Rossii [Guide-book of vascular plants of the central regions of European Russia. ­ 2-nd edition, supplemented and revised]. ­ M.: Argus. (in Russian) 9. May, J.R.; Smith, P.H. (2008)."Allergic Rhinitis". In DiPiro, J.T.; Talbert, R.L.; Yee, G.C.; Matzke, G.; Wells, B.; Posey, L.M. Pharmacotherapy : A Pathophysiologic Approach (7th ed.). New York: McGraw-Hill. pp. 1565­1575. 10. PollenLibrary. Available from: www.pollenlibrar y.com 11. Poriadok okazaniya meditsinskoy pomoshchi bol'nym s allergicheskimi zabolevaniyami i boleznyami assotsiirovannymi s immunodefitsitami. Prilozheniye k prikazu Ministerstva


T.V. Dikareva, V.Yu. Rumiantsev

DISTRIBUTION OF ALLERGENIC PLANTS IN RISSIA

12. Romaniuk L.I. (2010). Pollinoz i perekrestnaya pishchevaya allergiya. Problemi diagnostiki, lecheniya i profilaktiki. [Pollinosis and cross food allergy. Problems of diagnostics, cure and prevention] // Zdorovia Ukraina. 1, pp. 46­48. (in Russian). 13. RondÑn C., Blanca-LÑpez N., Aranda A., Herrera R., Rodriguez-Bada J.L., Canto G., Mayorga C., Torres M.J., Campo P., Blanca M. (2011). Local allergic rhinitis: allergen tolerance and immunologic changes after preseasonal immunotherapy with grass pollen. The Journal of Allergy and Clinical Immunology. 127 (4): 1069­1071. 14. Rumiantsev V.Yu., Danilenko A.K. (1998). Informatsionnaya Sistema "Naseleniye nazemnykh poz vonochnykh Rossii" [Data system " The population of terrestrial vertebrates of Russia"]. Problemi ecoinformatiki. Materialy tretiego mezhdunarodnogo simpoziuma. [Problems of ecological informatics. Materials of the third international symposium]. Moscow, pp. 126­129. (in Russian). 15. Sosudistye rasteniya Sovetskogo Dal'nego Vostoka. (1996). [ Vascular plants of the Soviet Far East]. Vv. 1­8. ­ Editor S.S. Kharkevich. ­ Sankt-Petersburg: Nauka, (in Russian). Received 10.10.2015 Accepted 06.11.2015 Tatiana V. Dikareva has a Ph. D. degree in Geography. She is Senior Researcher at the Department of Biogeography, Faculty of Geography, Lomonosov Moscow State University. Her main research interests include biodiversity, management and conser vation of water protection vegetation, successions of vegetation, and changes in floristic composition. Her current main scientific activities are in the field of dynamics of vegetation under the impact of climate change and impact of changes in vegetation on public health. She is the author and a co-author of more than 70 scientific publications.

Vadim Yu. Rumiantsev has a Ph. D. degree in Geography. He is Senior Researcher at the Department of Biogeography, Faculty of Geography, Lomonosov Moscow State University. His main research interests include mammalian environmental geography, biogeographic mapping, and the use of GIS technology in biogeography. His current main scientific activities are in the field of theoretical, methodological, and practical aspects of geoinformation mapping of the distribution of terrestrial vertebrates. He is the author and a co-author of more than 230 scientific publications, including more than 90 thematic mapsheets in complex national and regional atlases.

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zdravookhraneniya i social'nogo raz vitiya Rossiyskoy Federatsii ot 4 fevralya 2010 goda. (2010). [Medical care procedure of allergy sufferers and patients with immunodeficiency. Enclosure to the order of the Public Health and social development Ministr y of Russian Federation from Februar y 4]. 602. (in Russian).


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Tatiana A. Trifonova1, Anton A. Martsev2* Lomonosov Moscow State University, Faculty of Soil Science; e-mail: tatrifon@mail.ru 2 A.G. and N.G. Stoletov Vladimir State University ; e -mail: volfg_n@inbox.ru * Corresponding Author

NATURAL-FOCAL DISEASES IN THE VLADIMIR REGION (RUSSIA)
ABSTRAC T. The paper describes a study that monitored the epidemiological situation of a complex of natural-focal diseases in the Vladimir region (Russia), from 1958 to 2012. The morbidity rates of these natural-focal diseases have been differentiated by territor y using ArcView 3.1 (GIS software). The activity of natural foci for each zooanthroponosis varied between administrative districts in the region. A schematic map has been compiled; the map reflects the danger of infection caused by natural-focal diseases in the Vladimir region. The paper discusses the role of the anthropogenic factor in natural-ecosystem development: it likely promotes the transit and localization rates of carriers. Correlation and regression analysis of the data showed that climatic factors such as the average temperatures in July and September in the preceding year influence Lyme disease (Lyme borreliosis) patterns. This is likely related to particular stages in the life cycle of Ixodidae ticks. Using multiple linear regression analysis, a mathematical model for the prediction of Lyme borreliosis patterns has been created. KEY WORDS: Vladimir region, epidemiological situation, natural-focal diseases, predicting. INTRODUC TION Today the study of patterns in the natural circulation of the infectious agents of naturalfocal diseases is becoming increasingly relevant, especially in the context of climate change and anthr opogenic t e r r i t o r ial changes. Aside from that, natural-focal disease monitoring is gaining relevance due to active migration to certain regions, which leads to populations without an appropriate immune system response in various zones with natural foci. Similarly, the risk of infection has been rising because of the increased popularity of gardening and outdoor activities [Istomin, 2006]. Ranges of many wild animals and, in many cases, blood-sucking arthropods are localized in specific te r r i to r ies, where natural foci are fo r med. Natural foci boundar ies are controlled by endotherm and ar thropod (in transmissible infections) ecology. Within these boundaries, infectious agents are transmitted bet ween animals. People only become infected only when they are within a natural focus [Zuyeva, 2005]. Active human impact on natural ecosystems, along with a decline in conser vational, epizoological, and epidemiological activity, promotes the transmission of infec tious agents of natural-focal diseases and intensifies their epidemiological manifestation. I n terms of registered morbidity rates, naturalfocal diseases are relatively insignificant in the structure of human infectious diseases. However, the endurance of natural foci and their often unpredictable spur ts of activity increase the morbidity rates for these diseases [Kormilenko, 2010]. Determining factors that influence morbidity rat es , analyzing t e r r i t o r ial distr ibution, zoning by degree of epidemiological risk , and defining high-risk groups are the most per tinent objec tiv es in r esear ch t oda y [Utenkova, 2009].


T.A. Trifonova, A.A. Martsev

NATURAL-FOCAL DISEASES IN THE VLADIMIR REGION (RUSSIA)

A lack of necessary funding and absence of specialized entomologists and zoologists in Rospotrebnadzor 's (the Russian Federal Ser vice for Sur v eillance on C onsumer R ights Protec tion) regional branches and of testing systems to gage the presence of infectious agents of natural-focal diseases in a carrier-present areas represent serious and sometimes impossible-to-overcome obstacles for objective research. Bearing in mind the problems listed above, only morbidity rates can objectively indicate the epidemiological situation and allow prediction. Many authors note the relationship between zooanthroponoses disease patter ns and ecological, socio- economical, and climatic factors [Antov, 2005, Aminev, 2013, Kolominov, 2012, Utenkova, 2004], however the data can be quite contradictory. The ecolog ical and geog raphical characteristics of a region influence the tick population size, whereas the infection rate is influenced by climatic factors [Suntsova, 2004]. A number of authors note that climate indices such as precipitation rates, humidity, and average monthly temperature in the months that precede the epidemic season influence natural-focal disease morbidity rates. Based on statistically significant data, attempts have been made to create a prognostic model [Aminev, 2013, Kolominov, 2012]. MATERIALS AND ME THODS The studies were conducted in the Vladimir region. The territor y 's topographic features are determined by its location within the East European Plain which has low elevations and minor terrain irregularity. The southwestern par t of the re gion is occupied by the Meshchera lowlands ­ a homogenous and flat wetland area that is sometimes interrupted by sandy ridges. There are many forest lakes with turbid water, large wetlands overgrown with alders and aspens and sandy hillocks with tall pines, and juniper bushes and heather. The

Oksko-Tsninskiy embankment, composed of limestone, stretches out longitudinally in the eastern part of the region, south of the city of Kovrov. The northwestern elevated part of the region consists of branches of the KlinskoDmitrovsky ridge. These branches take the shape of ridges and flat morainic hills. The absolute elevation reaches 240 meters. This is the most elevated area in the Vladimir region. The sur face is heavily dissected by deeply embedded riverbeds, ravines, and gulches. The relative elevations reach 40­60 meters. The Nerlinsko-K lyazminsk aya lowlands are located in the nor thern and nor theastern par t of the region, along the left bank of the Klyazma River. On its western side, they merge with the Balak hninsk aya lowland in the Nizhny Novgorod region. This land is 100 meters above mean sea level and has an abundance of wetlands and lakes. The Vladimir re gion is in a t emperat e and continental climate zone, which is characterized by a warm summer, moderately cold winter with stable snow cover, and welldefined intermediate seasons. The majority of the region is sufficiently humid. Precipitation is unevenly spread throughout the area, with the lowest precipitations rates in the eastern part. The flora is quite diverse and consists of about 1200 species. Pines and birches dominate sandy soil and sandy loam, fir trees and aspens dominate clay soil and clay loam, and coniferous trees with underbrush dominate bog soil. The fauna consists of 62 mammal species, 43 fish species, 212 bird species, 10 amphibian species, 6 reptile species, and approximately 1500 in v e r t ebrat e species . The most epidemiologically significant species are rodents ­ bank voles (M yodes glareolus), tundra voles (Microtus oeconomus), striped field mice (Apodemus agrarius), house mice (Mus musculus), brown rats (Rattus norvegicus); and Ixodidae ticks ­ I. ricinus and I. persulgatus. The materials from the authors' own field work on collecting epidemiological data in

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the Vladimir region, as well as statistical data from 1958 to 2012 were used in this study.

28 GEOGRAPHY

The data on natural-focal disease morbidity rates were taken from the Vladimir Oblast Center for Hygiene and Epidemiology, as well as from Rospotrebnadzor 's official reports on infectious and parasitic diseases. The degree of natural-focal disease infection risk in human population was gaged using a point system. Each natural-focal disease morbidity rate was calculated per 100 000 people. The morbidity rates for each separate zooanthroponoses in a particular district were summed and, based on the total, each district was assigned a rank that corresponded to the degree of risk: 1 (low risk), 2 (moderate risk), or 3 (high risk). I n order t o evaluat e the influence of hydrometeorological factors on the naturalfocal disease mor bidit y rat e s, data on the following indices were used: average monthly t emperature, number of da ys with precipitation per month, atmospheric pressure, snow cover size, and oxygen levels in the atmosphere from 1977 to 2012. Initially, factors (predictors) were determined that were statistically significantly correlated with morbidity rates (p m 0,05), using Pearson's correlation coefficient. Elucidating factors like these is worthwhile even when cause-andeffect relations cannot be interpreted. As long as the correlation is statistically significant, a lack of knowledge about its role in shaping the dynamic of the process in question should not lead to a removal of these indicators from a prognostic equation [Caughley, 1979, K orotk ov, 1999]. The influence of climate indices for the cur rent and preceding years on mor bidit y rates was also tak en into consideration when calculating the correlation coefficient (i.e. by shifting climate indices one year back relative to the morbidity rate). Af ter wards, by using multiple linear and nonlinear re gression analysis the most

significant predic tors were incrementally deter mined. A prognostic equation was derived using the R2 value and distribution of residuals. STATISTICA software was used to conduct correlation and regression analysis. ArcView 3.1, GIS software, and Microsoft Paint were used to compile and edit the maps. RESULTS AND DISCUSSION Vladimir region's natural conditions allow for the circulation of the infec tious agents of a number of natural-focal diseases, which is confirmed by the statistical data gathered in this study. The analysis demonstrates that territor y is endemic to the following natural-f ocal inf ec tions: hemor r hag ic fe ver with renal syndrome (HFRS), Lyme borreliosis (or Lyme disease), leptospirosis and tularemia. However, Lyme bor reliosis has by far the highest mor bidit y rat e s among all infec tions. The focal activity of different zooanthroponoses in the region varies. Therefore, the highest HFRS morbidity rates (per 100 000 people) from 1978 to 2012 were recorded in the Gorokhovetsky, Kameshkovsky, and Yur yevPolsk y distr ic ts; the highest leptospirosis morbidit y rates in the same time period were recorded in the Gorok hovetsk y and Petushinsk y distr ic ts; the highest Lyme bor reliosis mor bidit y rates from 2005 to 2012 were recorded in the Kolchuginsk y, Petushinsk y, and K ovrovsk y distr ic ts; the highest tularemia morbidity rates from 1958 to 2012 were recorded in the Gus-Khrustalny district. Experience shows that information on the degree of infection risk not just for a single infection, but for the entire complex of naturalfocal diseases, is necessar y for planning and human activity in any area. In order to evaluate the territor y in question, we suggest a method that involves equalizing all cases of zooanthoponosis infections with regard to their danger to public health. In


T.A. Trifonova, A.A. Martsev

NATURAL-FOCAL DISEASES IN THE VLADIMIR REGION (RUSSIA)

Fig. 1. Natural-focal disease infection risk in the Vladimir region.

other words, in this model, becoming infected with a carrier of tularemia poses the same health risk as becoming infected with a carrier of Lyme borreliosis. The final map reflec ting the natural-focal disease infec tion risk for the population of the Vladimir region was compiled based on rank ing of the multi-year zooanthroponosis morbidit y rates. Our analysis demonstrates that the natural-focal disease infec tion risk var ies in different distr ic ts in the re gion (Fig. 1). Furthermore, an attempt was made to locate factors that influenced the Lyme borreliosis epidemiological process, as cases of this disease were registered most frequently in this territory. I n the Vladimir region, Lyme bor reliosis morbidity rates have been monitored since 2005. 1211 cases have been registered from 2005 to 2012, and the morbidity rates have increased by 46 %.

The highest mor bidit y rates have been recorded in the Kovrovsky, Kolchuginsky, and Petushinsky districts. The disease is unevenly distr ibuted throughout the ter r itor y : for example, there has only been one case of infection in the Melenkovsky district during the entire monitoring period. However, the epidemiological situation in the nor th of the region is most serious, even though the southern districts are more heavily populated (Fig. 2). First, the pot ential influence of land dev elopment on Lyme bor reliosis was analyzed by conducting a spatial correlation analysis and comparing the Lyme borreliosis morbidity rates; then, the influence of forest and wetland cover were analyzed. This analysis established that there is no statistically significant correlation between the above indices (r = ­0.19 p = 0.47; r = ­0.26 p = 0.33 respectively) in the Vladimir region. In our view, this fact deserves attention. A few decades ago, tick-borne infections generally

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Fig. 2. Lyme borreliosis morbidit y rates in the Vladimir region.

affec ted people living in the taiga or in forested landscapes; they were not ver y common among the urban population in central oblasts of the Nonchernozem belt. Evidently, that explains why there was no urgent need to organize medical monitoring in such areas. Toda y the situation has changed dramatically : morbidity rates have been increasing independently of differences in landscape charac ter istics. This can be explained by the fact that commercial land and land intended for development used to be quite isolated from one another. However, in the last 20­30 years Russia's population has significantly changed its way of life and thus its ecological niche. Human mobility has increased and far more suburban homes, vacation homes, summer cottages, rural recreational zones, and roads have been built. The struc ture of rural settlements has also changed because of the arrival of ur ban populations. Forests, especially on their outsk ir ts, are often settled, as well as meadows and former arable land. Abandoned

cr oplands ar e int ensely ov er g r owing , creating new convenient ecological niches for the circulation of I xodidae ticks and their hosts. Therefore, the boundar ies of more or less isolated (naturally structured) ecosystems are disintegrating, leading to negative transformations. Evidently, it can be asser ted that it is not climate change that is to blame for the spread of Lyme disease (by the way, this explanation has recently gained popular it y, because it absolv es humans of personal responsibility!); rather, anthropogenic activity which disrupts the ecological balance is the real culprit. Our study also analyz ed the pot ential influence of the following climate indices on Lyme bor r eliosis: a v erage monthly temperature, the number of days per month with precipitation, humidit y, atmospheric pressure, snow cover size, and monthly o x y gen lev els in the atmosphere from 2004 to 2012 (a total of about 100 different indices).


T.A. Trifonova, A.A. Martsev

NATURAL-FOCAL DISEASES IN THE VLADIMIR REGION (RUSSIA)

Correlation analysis of the array of indices revealed a statistically significant correlation between the Lyme disease morbidity rates and the fo llowing indices: the average temperature in July of the previous year (r = 0.77 p < 0.05), the average temperature in September of the previous year (r = ­0.91 p < 0.05), the humidity in Januar y of the previous year (r = 0,71 p < 0.05), snow depth in March (r = 0.94 p<0.05), and oxygen levels in the atmosphere in July of the previous year (r = ­0.94 p < 0.05). Because Lyme borreliosis' epidemiological process beg ins in lat e Apr il, only the values that precede the beginning of the epidemiological process can be included in the model. Multicollinearity was ruled out in modeling by removing predictors with pair correlations from the prognostic equation. Ultimately, the following predic tors were used in the prognostic model: the average temperature in July of the preceding year, the average temperature in September of the preceding year, and the humidity in Januar y of the preceding year (these indices do not have pair correlations with each other). As a result of this incremental multiple nonlinear regression analysis, achieved via STATISTICA software, the most significant epidemiological predictors were determined and a prognostic equation was derived. Its validity was defined by the R2 value and the distribution of residuals. The sof t war e demonstrat ed that the most significant values influencing the epidemiological process are the average temperature in July of the previous year and the average temperature in September of the previous year. The software ruled out the humidity in Januar y of the previous year because it did not have a significant effect on the epidemiological process, despite its high correlation with morbidity rates. The final multiple nonlinear re gression equation is shown below :

y = ­577.938 ­ 0.84(x12) + 58.538(x2) ­ 0.037(x23); R2 = 0.99 p < 0.001 y ­ Lyme borreliosis morbidit y rate in the population; x1 ­ a v erage t emperatur e in September of the previous year ; x2 ­ average temperature in July of the previous year. A ccor ding t o the equation, the epidemiological process of Lyme borreliosis depends on the average temperature in July of the previous year and the average temperature in September of the previous year; the dependence on July 's temperatures is stronger. The R2 value allows us to infer that this model describes the epidemiological process with a probability of 99 %. The data in Table 1 allows us to compare the obser v ed mor bidit y rat e values and the pr edic t ed values , as w ell as the residuals.
Table 1. Predicted Values and Residuals of Multiple Nonlinear Regression Observed Morbidity Rates 150 127 96 179 194 94 198 219 Predicted Morbidity Rates 157.4 129.0 91.9 176.8 194.4 93.5 200.9 212.9

Year

Residuals

2005 2006 2007 2008 2009 2010 2011 2012

­7.4 ­2 4.1 2.2 ­0.4 0.5 ­2.9 6.1

To ensure the accurac y of the der ived equation, the distr ibution of recursiv e residuals was analyzed: the plot in Fig. 3 demonstrates that all the values lie close to the line and are normally distributed.

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04 (08) 2015

Therefore, the conclusion we have reached is statistically accurate [ Trukhacheva, 2013].

temperature in September can be interpreted in the following way : high temperatures in September cause recently molted females to search for hosts; which then (af ter the first frost) leads to their death and the death of their eggs (if the females found a host and had a sufficient food supply). Lower temperatures in September cause recently molted female ticks to enter diapause and successfully endure low temperatures in the winter. Conclusions

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Fig. 3. Normal Probabilit y Plot of Residuals in Multiple Nonlinear Regression.

1. The Vladimir r e g ion is endemic t o the f ollowing natural-f ocal inf ec tions: HFRS, Lyme bor reliosis, leptospirosis, and tularemia. The natural foci of these infections are confined t o different t e r r i t o r ies. The compiled map reflec ts the risk of infec tion caused by various natural-focal diseases in the Vladimir region. 2. The Lyme borreliosis morbidity rate in the Vladimir region is not related to the extent of forest or wetland cover in any of the territories. These parameters were traditionally thought to define the spread of Ixodidae ticks. We have demonstrated that anthropogenic factors lead to the destruction of natural ecosystems and the delocalization of infectious agents and thus the disease itself. 3. The identified climate indices (the average temperature in July of the previous year and the average temperature in September of the previous years) are lik ely to have to affec t the ticks' life c ycle, which in tur n impac ts the epidemiological situation in the region. 4. The derived mathematical model can be used to predict the epidemiological situation and to take the appropriate steps to fight Lyme borreliosis. The model demonstrates that higher Lyme borreliosis morbidity rates are associated with a year preceded by hot July and cold September.

Fig. 4. Distribution of Standard Residuals.

The histogram of standard residuals that shows the distribution of residuals close to the normal (Fig. 4) also supports the validity of the model. The der i v ed model indicat es that the epidemiological process of Lyme borreliosis depends on the average temperature in July of the previous year and the average temperature in September of the previous year. This can most likely be explained by the life cycle of Ixodidae ticks. The positive correlation between Lyme borreliosis and the average temperature in July can be explained by the abundance of hosts in this period, which contributes to the ticks' development and thus the spread of the infectious agent of Lyme borreliosis. The negative correlation between Lyme borreliosis and the average


T.A. Trifonova, A.A. Martsev

NATURAL-FOCAL DISEASES IN THE VLADIMIR REGION (RUSSIA)

REFERENCES

2. Aminev, R. (2013) Epidemiologicheskie i epizootologicheskie osobennosti gemmoragicheskoy likhoradki s pochechnym sindromom v stepnykh landshaftakh i ikh vliyanie na zabolevaemost' voennosluzhashchikh (Epidemiological and Epizootological Characteristics of Hemorrhagic Fever with Renal Syndrome in Steppes and their Influence on Morbidity Rates in Ser vice Members). avtoref. dis. ... kand. med. nauk St. Petersburg. 23 pages. 3. Caughley, G. (2004) Analysis of Vertebrate Populations. Caldwell, N.J.: The Blackburn Press. 4. Istomin, A.V. (2006) Regional'nyy monitoring prirodno-ochagovykh infektsiy (Regional Monitoring of Natural-Focal Infections). Pskov Regionologichesky Zhurnal. 5. Kolominov, S.I. (2012) Epizootologicheskie i ekologicheskie aspekty rasprostraneniya i prognozirovaniya zabolevaemosti v prirodnykh ochagakh gemorragicheskoy likhoradki s pochechnym sindromom (Epizootological and Epidemiogical Aspects of the Distribution of Prediction of Hemorrhagic Fever with Renal Syndrome). avtoref. dis. ... kand. med. nauk. Nizhny Novgorod. 24 pages. 6. Kormilenko, I.V. (2010) Ekologichskie i epidemiologicheskie aspekty KGL, Likhoradki Ku i iksodovykh kleshchevykh borreliozov v Rostovskoy oblasti (Ecological and Epidemiological Aspects of Congo-Crimean Hemorrhagic Fever, Q Fever and Lyme Borreliosis in Rostov Oblast). Avtoref. dis. ... kand. biol. nauk. Rostov-na-Donu. 24 pages. 7. Korotkov Yu.S., Okulova N.M. (1999) Khronologicheskaya struktura chislennosti taezhnogo kleshcha v Primorskom krae ( The chronological structure of the taiga tick population in Primorsky Krai) // Parazitologiya. ­ 1999. ­ T. 33, vyp. 3. ­ pp. 257­266. 8. Suntsova O.V. kleshchevogo of the Natural nauk Irkutsck. (2004) Ekologo-parazitologicheskaya kharakteristika prirodnykh ochagov borrelioza v Pribaykal'e (An ecological and Parasitological Characterization Foci of Lyme Borreliosis in the Baikal Region). avtoref. dis. ... kand. biol. 20 pages.

9. Trukhacheva, N.V. (2012) Matematicheskaya statistika v mediko-biologicheskikh issledovaniyakh s primeneniem paketa Statistica (Mathematical Statistics in Biomedical Research with the Use of Statistica Software). GEOTAR-Media. 10. Utenkova, E.O. (2009) Prirodno-ochagovye infektsii v Volgo-Vyatskom regione (NaturalFocal Infections in Volga-Vyatka Economic Region). avtoref. dis. ... d-ra med. nauk Kirov. 38 pages. 11. Zueva, L. and Yafaev, R. (2005) Epidemiologiya (Epidemiology). St. Petersburg: Izdatelstvo Foliant. Received 10.10.2015 Accepted 06.11.2015

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1. Aitov, K. (2005) Prirodno-ochagovye transmissivnye kleshchevye infektsii Pribaykal'ya (Natural-Focal Transmissive Tick-Borne Infections in the Baikal Region): n. pag. www.dissercat.com. Web. 12 July 2015.


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34 GEOGRAPHY

Tatiana A. Trifonova, D. Sc., is Professor and Senior Researcher at the Faculty of Soil Science, Lomonosov State University. She is also Head of the Department of Biology and Ecology at A.G. and N.G. Stoletovs Vladimir State University. Her research interests are in the field of theoretical and practical aspects of environmental protection, human ecology, and environmental management. She is the author of over 250 scientific publications, including several monographs and textbooks.

Anton A. Martsev is a graduate student of Biology and Ecology at A.G. and N.G. Stoletovs Vladimir State University. He studies medical geography.


1

IMPAC T OF THE AMBIENT AIR PM2.5 ON CARDIOVASCULAR DISEASES OF ULAANBAATAR RESIDENTS
ABSTRAC T. Mongolia is a landlock ed countr y with a total land area of 1,564,116 square k i lomet ers. The ambient annual a v erage par t iculat e matt er (PM) concentration in Ulaanbaatar is 10­25 times greater than the Mongolian air qualit y standards (AQS). More than 40 percent of the nation's total population lives in Ulaanbaatar. The study aims at defining the relationship bet ween the ambient air PM2.5 level and hospital admissions in Ulaanbaatar in 2011­2014. The pollution data included a 24-hour average PM2.5. The air was sampled daily and recorded by the national air monitoring stations located in Ulaanbaatar. The sampling frame of hospital admissions for cardiovascular disease (C VD) were the records of all outpatient hospitals of Ulaanbaatar. The data covered the period from Januar y 2011 to Januar y 2014. To test the differences of the results, appropr iate statistical tests were employed. During 2011­2014, the highest concentration of PM2.5 was in the coldest period and the par ticulate matter level recorded was 3.7 times higher in the cold period than the warm period. The number of admissions for C VD were the highest during cold periods. Four days after exposure, the PM2.5 impac t on hospital admissions weak ened but there remained a positive correlation. For PM2.5, 100 g/m3 growth of the pollutant led to 0.65 % increase in the hospitalization for C VD on the exposure day. On the second day of exposure, 10 g/m3 growth of the pollutant led to 0.66 % increase; on the third day of exposure, 10 g/m3 growth of the pollutant led to 0.08 % increase of hospital admissions for C VD, and at the four th day, such growth led to 0.6 % increase of C VD cases in 2011­2014 in Ulaanbaatar. I n conclusion we may state that most incidences of C VD registered during the cold months in Ulaanbaatar in the last four years were a result of PM2.5 exposure. This shows that the PM2.5 exposure and hospital admissions for cardiovascular system chronic diseases are positively correlated. C VD in Ulaanbaatar residents was affec ted greater on the same and the third day of exposure. KEY WORDS: PM2.5, exposure, CVD, health impact, Ulaanbaatar air pollution. INTRODUC TION Mongolia is a landlocked countr y with a total land area of 1,564,116 square k ilometers. Steppes and deser ts stretch in its southern and east er n par ts , while mountains surround the nor thern and western par ts. The countr y has ex tr eme continental climates with long, cold winters and shor t dr y summers. The average temperature in Januar y and Februar y is ­20 °C, with winter night t emperatures dropping t o ­40 °C (NSO 2015). The atmosphere is a mix ture of gaseous substance pr oduced ov er the Ear th's long histor y by biogenic, geologic, and atmospher ic processes. B y definition, air pollution is a mixture of solid, liquid, gaseous, and biological substances emitted to the atmosphere by natural and anthropogenic ac tivities, which has detrimental effec ts

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Altangerel Enkhjargal1*, Badrakhyn Burmaajav2 Ach Medical University, Ulaanbaatar, Mongolia * orresponding author; e-mail: ajargal8@gmail.com 2 Mongolian Academia of Medical Sciences, Ulaanbaatar, Mongolia


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on animals, human health, and economy (Godish, 2004). The ambient annual average par ticulate matter (PM) concentration in Ulaanbaatar is 10­25 times greater than the Mongolian air quality standards (AQS) and is among the highest recorded measurements compared to any other world's capital. The Mongolian annual ambient air quality standard is 25 g/ m3 for PM2.5 (MNS 2008). More than forty percent of the total population of Mongolia lives in Ulaanbaatar (STU 2015). In 2014, over 184,000 households live in the "ger" areas of six central Ulaanbaatar districts and approximately 3,200 entities operated by the heating of low-pressure steam boilers in the capital. Eighty percent of air pollution comes from these pollution sources (CNAP et al 2014). Particulate matter in the air of Ulaanbaatar is the main source of air pollution. According to the findings of relevant sur veys, the content of par ticles (PM10 and PM2.5) in household (indoor) air with furnaces is at the level which impacts negatively health (PHI 2007). Not many sur veys have been conduc ted in relation to the PM2.5 level and health outcomes in Mongolia. This study aims at defining the relationship between the ambient air PM2.5 level and hospital admission cases of Ulaanbaatar in 2011­2014. MATERIALS AND ME THODS The data cover the period from Januar y 2011 to January 2014. Exposure data. The pollution data included a 24-hour a v erage of PM2.5. The PM2.5 data come from a net work of 2 monitoring stations. The air was sampled daily and recorded by the national air monitor ing stations locat ed in Ulaanbaatar. The air qualit y stations used an instrumental method , which utiliz es aut omat ed equipment to analyze air qualit y.

Morbidit y data. The data f or hospital admissions for cardiovascular disease (CVD) were the records of all outpatient hospitals in Ulaanbaatar. The ICD-10 disease classification system was used by each hospital's statistics department. Data analysis. The data were analyzed using SPSS Version 21.0. For testing the differences in the results, appropriate non-parametric tests were used. Kruskal-Wallis one way analysis of variance, Mann-Whitney U tests, and Spearman correlation and linear regression were also used. RESULTS AND DISCUSSION Ambient air PM2.5 level, 2011­2014 A ir qualit y of Ulaanbaatar in 2014, as measured by par ticulate matters (PM2.5), was 64 g/m3 (2.6 times higher than the permissible level of the Mongolian air quality standard). The average PM2.5 concentration from October 2013 to April 2014 was lower by 27 g/m3 (21 %) than the concentration measured from October 2012 to April 2013. During 2011­2014, the highest concentration of PM2.5 was during the coldest periods. The PM2.5 level was relatively high during cold periods because of high household (indoor) burning of raw coal during cold temperatures. The following histograms show a 24-hour average PM2.5 level in cold and warm seasons. According to the sur vey of D elger zul. L (2012) of ambient air around Ulaanbaatar 's Sukhbaatar district, the annual average PM2.5 level was 375.09±722.6 g/m3. I n comparison to Delger zul 's sur vey, the average PM2.5 concentration in ambient air declined during cold periods by 2.29 times. Basically, our study found that the PM2.5 level is 3.7 times higher in colder periods than warmer periods (warm 34.15±20.39 g/m3, cold 127.6±11 g/m3) ( Table 1). Actually, the mixture of particles is likely to var y within the study areas by size, number,


A. Enkhjargal, B. Burmaajav

IMPACT OF THE AMBIENT AIR PM2.5 ON CARDIOVASCULAR...

Fig. 1. Histogram of a 24 -hour average PM2. 5 level in Ulaanbaatar, 2011­2014. Table 1. Some descriptive statistics on the PM2. 5 level and daily admission cases for C VD PM2.5 g3 Warm season Mean Median Std. Deviation IQ Range Minimum Maximum p value * 34.15 33 20.39 22 2 194 0.0001 Cold season 127.60 88 119.51 110 14 854 0.0001 Total 80.08 46.18 95.81 59 2 854 Warm season 54.13 44 36.17 43 10 230 CVD cases Cold season 79.63 76 44.56 66.5 10 230 Total 68.42 58.0 43.04 59 10 230

* Mann-Whitney U test

and chemical composition. The t o xicit y of par t iculat e matt er depends on its chemical composition and size distribution. Fine par ticles (for instance, PM2.5) have been found t o ha v e bigger effec ts on health than PM10 (Bremner et al, 1999; Ha et al., 2001).

Cardiovascular disease admission, 2011­2014 The following figures show time sequence of seasonal cases of CVD. The number of cases increased in last 2 years and the highest number of cases was registered during the cold months (Fig 2).

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Fig. 2. Daily morbidit y counts of C VD, by date, Ulaanbaatar, 2011­2014.

In spring, the most hospital admissions for C VD occurred, while during the summer
Table 2. Distribution of C VD incidence, by season and gender, UB, 2011­2014 Seasons Summer (June 1­Aug 31) Autumn (Sep 1­Nov 31) Winter (Dec 1­Feb 28) Spring (Mar 1­May 31) Total Male 5753 22.8 % 4400 17.5 % 6771 26.9 % 8254 32.8 % 25178 Female 10157 24.6 % 7091 17.2 % 10480 25.4 % 13551 32.8 % 41279 Total 15910 23.9 % 11491 17.3 % 17251 26.0 % 21805 32.8 % 66457

months, the number of admissions declined. On the other hand, during cold periods, the most cases of hospitalization for CVD were registered (r2 = 34.6, p = 0.00001) ( Table 2). The most common CVD of admitted cases in Ulaanbaatar during 2011­2014 were hypertension and ischemic heart disease (Fig. 3). Impact of ambient PM2.5 on CVD of Ulaanbaatar residents The research conducted in 2003 in major cities and towns of Mongolia found that respiratory diseases were caused by pollution. Its result

Fig. 3. Leading causes of C VD, Ulaanbaatar, 2011­2014.


A. Enkhjargal, B. Burmaajav

IMPACT OF THE AMBIENT AIR PM2.5 ON CARDIOVASCULAR...

According to the 2009 World Bank survey, PM2.5 and PM10 in the ambient air of Ulaanbaatar had a constant and strong correlation with hospital admissions for CVD. For PM2.5, 10 g/m3 growth of the pollutant led to a 0.8 % increase in CVDcaused hospitalization ( W 2009). In this study, we estimated the correlation (Spearman's) between PM2.5 and CVD lag03. It was shown that after the fourth day of exposure, a weak positive correlation was obser ved (CVD lag0: r = 0.13, p = 0.0001, CVD lag1: r = 0.21, p = 0.0001, CVD lag2: r = 0.12, p = 0.00001, CVD lag3: r = 0.09, p = 0.004). I n 2011­2014 in Ulaanbaatar, on the first day of exposure, 2.7 %of hospitalizations

The impac t of C VD was re latively low compared to the 2009 World Bank sur vey. For PM2.5, 10 g/m3 growth of the pollutant led to a 0.065 % increase in CVD- caused hospitalizations on the exposure day. On the second day of exposure, 10 g/m3 growth of the pollutant led to a 0.066 % increase in hospitalizations; on the third day of exposure,10 g/m3 growth of the pollutant led to a 0.08 % increase of CVD related hospital admissions, and on the fourth day, a 0.06 % increase in CVD cases (Fig. 4). Many studies verify that CVD are caused by air pollution. For instance, scientists Dockery and Pope from Harvard University discovered that by reducing the content of PM10 in the air (until

Fig. 4. Scatter diagram of Spearman correlation between C VD lag0 -3 and ambient air PM2. 5 annual level.

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shows the respiratory diseases have moderate level relationship with monoxide (r = 0.538 p = 0.011), sulfur (r = 0.44 p = 0.019), and nitrogen (r = 0.34 p = 0.013), respectively (PHI

a direct car bon dioxide dioxide 2003).

for cardiovascular disease was due to PM2.5; on the second day, 2.2 %; on the third day of exposure, the rate of hospital admissions increased 2.8 %, and on the four th day, CVDcaused hospitalizations were 2.1 %.


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the standard rate), CVD-related mortality can be reduced by 15 percent (Dockery et al 1994; Pope et al 2002). Similar findings were found in a sur ve y conducted by Enkhjargal et al (2010), which showed the percentage of combined effects on respiratory diseases in the winter season is 52.9 for average temperature, humidity, nitrogen dioxide and 10; the percentage of combined effects on cardiovascular diseases in the winter season is 37.2 for average temperature, humidity, nitrogen dioxide and 10; the percentage in autumn is 5.4 for 10 only, and the percentage in summer is 17.4 for wind speed and average temperature, while in autumn, the percentage of combined effects of sulphur dioxide, nitrogen dioxide, and PM10 is 25.4. Time-series analysis Variability of the PM2.5 level and acute disease admissions declined from 8.0 % to 3.9 % during days of 1­3 (lag0­lag3), respectively. In this variability, the highest PM2.5 level and acute CVD admissions was obser ved on the first day (8.0 %) and the lowest variability was obser ved on the third day (3.9 %). For the total acute admissions and the PM2.5 level, only lag0 significant correlation (4.0 %, p = 0.02) was observed. Variability significantly increased for chronic disease admissions and particular matter. Variability of chronic CVD admissions and the PM2.5 level was increasing REFERENCES

to the second day (lag 2) (lag0, 12.1 %, p = 0.00001 ­ lag2, 15.9 %, p = 0.000001) and on the third day (lag 3) it decreased to 10.1 % (p = 0.0003). Va r iabilit y of chr onic C VD admissions and the PM10 lev el was increasing t o the second da y (lag 2) (lag0, 10.91 %, p = 0.0002 ­ lag2, 11.1 %, p = 0.0002) and on the third day, (lag 3) it decreased to 7.1 % (p = 0.0003) ( Table 1). Variability of chronic C VD and the PM2.5 level was the lowest on the first day (lag0, 6.5 %, p = 0.004) and the highest on the third day (lag3, 15.0 %, p = 0.0001). Variability of chronic CVD and the PM10 level was higher than variability of chronic C VD and the PM2.5 level in all 4 days. The highest variability was obser ved on the second day (lag1, 19.3 %, p = 0.000001) and the lowest was obser ved at the first day (lag0, 15.3 %, p = 0.0001). CONCLUSION Most incidences of CVD registered during cold months in Ulaanbaatar in the last 4 year were the result of ambient air PM2.5. However, the impact of exposure to other air pollutants and meteorological fac tors in Ulaanbaatar should be tak en int o consideration. Ambient air PM2.5 exposure positively influences chronic CVD admissions to hospitals. The hospitalizations for CVD in Ulaanbaatar residents were higher on the first and the third day of exposure.

1. Bremner, S.A., Anderson, H.R., Atkinson, R.W., McMichael, A.J., Strachan, D.P., Bland, J.M., et al (1999) Short term associations between outdoor air pollution and mortality in London 1992­4. Occup Environ Med 56: 237­244. 2. CNAP, MOEGD, SICA (2014), Registration of stationar y air pollutants, Ulaanbaatar, p. 25. 3. Delgerzul, L. (2013), Air particular matter (PM10 and PM2.5) influences to human health, master thesis, Ulaanbaatar. 4. Dockery, D.W. Pope, C.A. III (1994). Acute respirator y effects of particulate air pollution. Annu Rev Public Health 15: 107­132. 5. Enkhjargal A.B., Suvd B., Burmaa B., Enkhtsetseg Sh. (2010), Health impact assessment of PM10 and PM2.5 of Ulaanbaatar, Mongolian Journal of Medical Sciences, 4: 154­161.


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IMPACT OF THE AMBIENT AIR PM2.5 ON CARDIOVASCULAR...

6. Godish, T. (2004), Air quality, 4th edition. Boca Raton, USA: Lewis Publishers. 7. Ha, E.H., Hong, Y.C., Lee, B.E., Woo, B.H., Schwartz, J., Christiani, D.C. (2001). Is air pollution a risk factor for low birth weight in Seoul? Epidemiology 12: 643­648. 8. Mongolian national standard, (2008) Mongolian air quality standard, Ulaanbaatar. 9. PHI, MOH (2003) Hygienic assessment of some chemical, physical and biological risk factors to human health, Ulaanbaatar. 10. PHI, MOH (2003) Hygienic assessment of some chemical, physical and biological risk factors to human health, Ulaanbaatar. 11. Pope C.A. III, Burnett R.T., Thun M.J., Calle E.E., Krewski D., Ito K., Thurston G.D. (2002). Lung cancer, cardiopulmonar y mortality, and long-term exposure to fine particulate air pollution. J. Am. Med. Assoc. 2002; 287 (9): 1132­1141. 12. Public health institute, Ministr y of Health, World Health Organization, (2007), Indoor air quality survey, Ulaanbaatar. 13. Statistical department of UB (2015), available online at: http://ubstat.mn/StatTable. aspx?tableID = 20, 15 October 2015. 14. World Bank (2009), Mongolia ­ Air pollution in Ulaanbaatar: Initial assessment of current situation and effects of abatement measures (Mongolian), Ulaanbaatar, p. 35­52. Received 02.11.2015 Accepted 06.11.2015

Altangerel Enkhjargal is epidemiologist, lecturer of Ach Medical University and Ph. D. student. She has a Master of Science degree in public health/environmental health. She has 16 years of experience in environmental health, strategic planning of health sector, and project management. She conducted more than 20 environmental health and public health sur veys, participated in the development of the national public health policy and program. She is an expert in the field of public health of the Mongolian population.

Prof. Badrakhyn Burmaajav received her MSc from the National Medical University, Mongolia (1978); Ph. D. from the Institute of Child and Adolescent, Moscow, Russian Federation (1992); D. Sc. (Med) from the National Medical University, Ulaanbaatar, Mongolia (2001). She is a physician, hygienist, researcher, health policy and medical research administrator, lecturer, and General Scientific Secretary of the Mongolian Academy of Medical sciences. She has been dedicated to research and teaching in the field of hygiene, epidemiology, environmental health, children environmental health, public health, health technology, and climate change. She published more than 400 papers in Mongolian, Russian, and English, including more than 70 books (author or editor).

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Semen A. Kurolap1*, Oleg V. Klepikov2, Pavel M. Vinogradov1, Tatyana I. Prozhorina1, Liudmila O. Sereda1 1Depar tment of Geoecology and Environmental Monitoring, Faculty of Geography, Geoecology and Tourism, Voronezh State University, Universitetskay sq., 1, Voronezh, 394006, Russian Federation, tel: + 7 (473) 2665654 * Corresponding author, e-mail: skurolap@mail.ru 2 Department of Environmental Engineering, Voronezh State University of Engineering Technologies, 19, Prospekt Revolyutsii, Voronezh, 394036, Russian Federation, tel: + 7 (473) 2496024

INTEGRATED ASSESSMENT AND GISMAPPING OF THE ENVIRONMENTAL STATE OF THE CITY OF VORONEZH (RUSSIA)
ABSTRAC T. The authors have created a geoinformation-analytical system (GIS) for integrated assessment and mapping of the ecological conditions of the territor y according to the criteria of anthropogenic impact and quality of the urban environment, as well as the response of woody plants and the health of the child population (on the example of Voronezh ­ the largest industrial city of the Central Chernozem region). I t has been identified that anthropogenic pollution is formed by the industrial-transpor t sector and varies with regard to the features of the functional planning infrastructure; near the industrial facilities of the petrochemical profile in the left-Bank sector of the city, conditions for the existence of woody plants significantly worsen, which is manifested in the inhibition of their development; child morbidity rate is significantly higher in industrially polluted neighborhoods with high load of pollutant emissions from industr y and transpor t. The diseases primarily associated with pollution are congenital anomalies, neoplasms, endocrine pathology and diseases of the urogenital area. The industrial zone is the main contributor to the total pollution of air, but the transport zone is the main contributor to the total pollution of soil and snow cover. KEY WORDS: geographical information system, industrial pollution, health of the population, environmental assessment, Voronezh. INTRODUC TION Modern large cities are the centers of the most acute ecological problems. The monitoring and mapping of the ecological status of the urban environment are impor tant tools of spatial planning and environmental safety and contribute significantly to solution of the contemporar y urbanization problems. At the turn of XX­XXI centuries, increasing densit y of ur ban development in large industrialized cities and the increase of air and soil pollution contributed to the decline of the quality of the urban environment. This is manifested in a certain environmental response ­ the inhibition of development of woody plants. Morbidity of the population has also increased. Research in the field urban ecology and en vir onmental geochemistr y of ur ban landscapes in combination with the concept of environmental risk supports the relevance


S.A. Kurolap, O.V. Klepikov et al.

INTEGRATED ASSESSMENT AND GIS-MAPPING...

Theoretical approaches to the study of this problem have been discussed in numerous wor ks of national and foreign scientists in the field of urban ecology, ecological geochemistr y and medical geog raph y [Bezuglaya et al., 1991; Ek ogeok himiya gorodsk ik h..., 1995; K asimov et al., 2013; Malkhazova et al., 2011, 2014; Revich, 2010]. This allowed justification of risk-based modern approach to the problem of "environment - health," focused on the identification and quantitative estimation of environmental risk factors, as well as on minimization of their negative impact on the biota and population. These problems are relevant for many large industrial centers of Russia, including the city of Voronezh. Earlier, a number of analytical studies on the environmental zoning of urban environment and risk assessment for public health from adverse environmental factors on the territor y of Voronezh city was conducted [Kurolap, K lepikov et al., 2006, 2010]. Methodologically these studies were based on the leading environmental risk factors, particularly, air-technogenic and soilgeochemical. However, aspects of integrated environmental assessment of linkages in the system "atmosphere ­ soil ­ biota ­ health of the population" remain insufficiently studied. The aim of this w o r k is dev elopment and testing of approaches to integrated assessment of the ecological state of the territor y of a large industrial center with application of moder n geoinfor mation technologies. Voronezh is selected as a model city because it is a major industrial town of the Central Chernozem region with a population of over 1 million people. MATERIALS AND ME THODS The following methods were used: methods of environmental, geochemical, biological,

We have developed an automated GIS system for ensuring environmental monitoring in the Voronezh territory ("ECOGIS Voronezh"), including the storage subsystem of the environmentalgeochemical and health-geographical data, as well as program-algorithmic suppor t of ecological risk assessment. The main pr inciples of creation of the specialized GIS are complex systematic organization of diverse environmental data, linking to an existing environmental control system, automatization of procedures of data analysis and calculation of environmental risks, and the potential of timely GIS-based mapping. The source data for creating of "ECOGIS Voronezh" were obtained during experimental research by the authors and provided by the regional ecological and monitoring agencies of the city. The structure of the GIS is shown in Fig. 1. The 5-year period (2009­2013) was selected as a basic time period for assessment of the qualit y of the ur ban environment. Three levels of information generalization were defined as operational territorial units (OTU): 1) functional planning city zones (6 zones and the background, altogether 7 territorial units); 2) areas of ser vice children's clinics in the city (12 areas); 3) special points of monitoring of the state of the urban environment (75 points, including fixed and mobile control posts of the air system of the hydrometeorological ser vice, the sanitar y-epidemiological ser vice, and, additionally, the selected monitoring points for uniform coverage of the territory of the city environmental management system).

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of quantitative evaluation of correlations "dose-effect" for a wide range of factors that shape the ecological situation and public health in large cities.

and GIS research and assessment of ecological risk for the health of the population. Methods of probabilistic and statistical analysis in MS EXCEL and STADIA, as well as GIS technologies in the of MapInfo Professional 9.0 environment were used as integrating instrument for a comprehensive assessment and mapping of the environmental situation of the urban environment.


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blocks (divided into 3 functional sub-zones: "CH" ­ the Central historical part of the city, includi ng multi-stor ied public -busi ness development and "old " 5-store y building of the 1950s­1970s; "MD" ­ neighborhoods with moder n high-r ise buildings mostly from 9 floors and higher constructed in the 1980s ­ the beginning of this centur y ; "PS"­ the "private sector ": predominantly low-rise and cottage resedential construc tion); 4) "I nd" ­ industrial zones (area occupied by industr ial ente r p r i ses and their sanitar yprotec tion zones); 5) " Tr " ­ traffic areas, including main automobile highways (and major traffic streets); 6) "R" ­ the recreationalresidential zone cover ing the ur ban area and subur ban " bedroom" micro - distr ic ts. Suburban territories outside of urban areas are selected as the background ("B"). The registr y of 351 sources of technogenic pollution of the urban environment (199 industrial facilities and 152 transpor tation struc tur es) with the charac t e r istics of parameters of their impac t (emissions of pollutants into the atmosphere, the intensity of traffic) was created to assess the impact of industr y and transpor t on the ur ban environment; these data were "attached" to the spatial data. Using the programming language MapBasic, the process of r isk assessment for public health associat ed with chemical air pollution was automated. Was designed a special software module that implements calculations of quantitativ e r isk lev els for health in accordance with hygienic approaches [Onishchenko, Rachmaninov et al., 2002]. Formulas (1) and (2) were applied for calculating the levels of risk. Carcinogenic risk (CR) in the course of life was determined by the formula (1): CR = ADD*SF (1)

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Fig. 1. The struc ture of the database for the integrated environmental assessment of the urban environment state.

Analysis of the fo r mation of zones of t echnogenic pollution of the ur ban environment was conducted in several main directions: 1) influence of seasonal factors and dispersion of pollutants on the concentrations of pollutants in the atmospher e; 2) estimation of the statistical influence of the charac teristics of industrial and transpor t load on concentrations of pollutants in the atmosphere, snow, and soil; 3) analysis of the correlation between pollution of soil and pollution of snow cover by comparing the pollution of these environments based on the most representative items of environmental monitoring. All the objects on a digital map of Voronezh differ entiat ed int o the following basic thematic layers: 1) vegetation (intra- cit y and subur bs-nativ e g reen areas, par ks, squares, fo r m ing a "green frame" of the ur ban agglomeration); 2) h y dr og raph y ( V or onezh r eser v oir, per manent and t emporar y wat ercourses); 3) residential

where ADD is average daily dose in the course of a lifetime, mg/(kg*day); SF ­ carcinogenic potential factor.


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INTEGRATED ASSESSMENT AND GIS-MAPPING...

HQ = Ci/RfC

(2)

where HQ is the hazard ratio; Ci ­ average concentration (mg/m3); RfC ­ reference (safe) concentration (mg/m3). Based on the created registr y of industrial and mot or v ehicle contr ibut ors t o the pollution of the atmosphere, an or iginal technique for hazard assessment of the impac t of sources of air pollution was developed. This technique includes a gradual implementation of the following calculation procedures (1)­(4). 1. Assessment of the potential hazard of industrial contribution. For each industrial facility (industrial site), the hazard indexes of emissions of polluting substances were calculated. The hazard classes of substances were tak en into account. The weighted average index of ecological danger of the enterprise was determined similarly to the approach in [K.A. Bushueva, 1979], used to calculate the total air pollution index ­ Katm, according to the formula (3): K Atm = C1 C2 Cn = + + ... + N1MPCC N2MPCC NnMPC 1 2 (3) t,

2. Evaluation of potential hazards of motor vehicle contribution. First, the average intensity of movement of vehicles for each of the main streets the city was determined taking into account their categor y [ Yakushev et al., 2013]. Further, according to the Directory of the streets, indices of the potential danger of emissions from motor vehicles were determined: index of the potential danger of emissions from passenger vehicles /Ilgc/ ­ they are the ranking indicators according to the traffic flow of vehicles through the streets of various categories; similarly, for trucks /Igrs/, buses /Iawt/, and the total grade of vehicle load by the total intensity of vehicles on the street of a given categor y /Iatn/. 3. Calcula tion of the t otal index of environmental burden of industrial and transpor t infrastructure (I) on the urban environment for any operational territorial unit is based on weighting the importance of the three main indicators of risk of emissions of pollutants from stationar y and mobile sources of air pollution (for example, in the ser vice area of the pediatric clinic) by the formula (5): I = ( Iind + ICR + Iatn ),
i =1 n

Cn

where Ci is the average annual concentration of i-substance; MPCi ­ average daily maximum permissible concentration of i-substance; Ni is a constant that takes values 1; 1,5; 2; 4 respectively for substances 1, 2, 3, 4 hazard classes; t = P/Po, where P ­ average annual percentage frequency of calms, %; Ro = 12.5 percent. Using weight constants, the following formula was applied (4): Iind = I1cl I2cl I3cl I4 cl + + + . N1 N2 N3 N4 (4)

(5)

where i...n is the number of objects (industrial areas, street slopes) within a given territorial unit. 4. Creation of digital maps of technogenic impac t on environment. I t is per for med int er polation of values of of hazard the ur ban by spatial indices of

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Non-carcinogenic risk (for air pollution) was quantitatively evaluated by calculating the hazard ratio (HQ) by the formula (2):

Separately was determined the risk index of emissions of carcinogenic pollutants (CR) ­ total emissions of substances with an established carcinogenic effect in % of cit ywide emissions (IR). The carcinogens considered were the emission of carcinogenic substances belonging to groups 1, 2A and 2B according to the IARC classification given in [Onishchenko G.G., Rakhmanin et al., 2002].


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environmental risk of industrial and motor vehicle contr ibutors by the method of isolines. As a result, we calculated areal rates of emission of pollutants and the intensity of traffic through the residential areas of the city (example of the spatial distribution of the emission load is presented in Fig. 2). To assess the response of biota to industrial pollution we have used special bioindicative research methods. The most abundant

species of woody plants-bioindicators were selec ted: birch (Betula pendula Roth.) and Lombardy poplar (Populus pyramidalis Borkh.). This analysis of the leaves samples following the accepted techniques for analysis of fluctuating asymmetr y of leaf plates made it possible t o calculat e the int egrat ed indicator of stability of development. Various morphometric parameters of the lamina of these species in different functional zones of the city were evaluated as biological criteria.

Fig. 2. The index of the total emission load of pollutants from stationary sources (tons per year per 1 km2).


S.A. Kurolap, O.V. Klepikov et al.

INTEGRATED ASSESSMENT AND GIS-MAPPING...

The analysis of internal interactions in the system "atmosphere ­ snow ­ soil ­ biota ­ population health," as well as the evaluation of the dependence of child morbidity on the parameters of technogenic pollution of the urban environment were based on the standard correlation and regression analysis with coverage of data on the ter r itor ial polyclinics of the city and on formal territorial interpolation for specially allocated items of monitoring of the urban environment. RESULTS AND DISCUSSION The analysis of correlations in the system "sources ­ pollution ­ transit environment ­ sequestering abiotic environment" has shown, in general, a logical pattern: in the total number of correlations, significant positive coefficients dominate (mostly in 55­84 % of cases for the majority of the criteria). The most stable relationships are marked by the most massive emissions of substances 3 and

A rank ing of the re verse "response" of geochemical indicators on the industrial traffic impact showed stronger response criteria for the quality of atmosphere and soil and lesser for snow. The priority geochemical indicators include: carbon black and formaldehyde in the atmosphere, nitrogen compounds in snow, the total index of soil contamination by mobile forms of heavy metals ­ lead, zinc, copper, and cadmium. The most transpor t indicators soil there polluted are the industrial and areas, and between the integral of atmospher ic pollution and is a proved positive correlation,

Table 1. Generalized indicators of the stabilit y of correlations between the parameters of the impact of industrial traffic loads and indices of air, snow and soil pollution Impact criteria (Pi) Impact rate * "Response" criteria Ecological and geochemical criteria the atmosphere (formaldehyde) the atmosphere (carbon black) the atmosphere (atm) Index of integral industrial and transport load (I) snow (NO3­) 84.2 % snow (Pb2 +) soil (Pb) soil (Cd) soil () soil (AIP) the atmosphere (carbon black) snow () snow (mineralization) The ratio of total vehicle load () 60.5 % snow (Cl­) snow (NH4 +) snow (NO3­) soil (benzopyrene) *) The proportion of positive significant correlations **) Statistically significant correlation coefficients (r) > 0.56. Correlation coefficients Pi ** 0.39 0.51 0.38 0.41 0.32 0.44 0.65 0.45 0.49 0.43 0.68 0.54 0.51 0.66 0.44 0.63

Designation

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4 classes of hazard, carcinogens, as well as the intensity of the total industrial traffic load, determined largely by passenger vehicles and the contribution of carcinogens, which present in the emissions from stationar y sources. A fragment of the most typical links is shown in Table. 1.


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indicating a significant dependence of the aerogenic pollution of the soil by the inflow of pollutants (r = 0,77). Conduc ted bioindicative studies based on the technique [Zak harov, Clark , 1993] using a scale to evaluate the favorability of species growing conditions showed that the zones with adverse conditions are located near industrial plants and major transpor t routes, which is most clear ly manifested in the left-Bank sector of the city, near JSC " Voronezhsintezk auchuk " and CHP-1. The safest indicators of environmental quality are found in the recreation area and the residential district of the private sector. Most of the city 's territor y has the average level of deviations from conventional norms, which is a moderate degree of anthropogenic pollution of the urban environment. The correlation of biological indices for functional planning zones is shown in Fig. 3. In general, the deviation of the integral index of stability of development from the physiological norm is higher in the left-bank part of the city. This is due to the concentration there of many industrial objects, and also to features of low-lying terrain, which are not conducive to purification of the atmosphere.

Fig. 3. The integrated indicator of stabilit y of development of silver birch (Betula pendula) and poplar (Populus pyramidalis).

Selective statistical analysis of bioindicative features supported the conclusion that the data on the qualit y of the environment, obtained by calculating fluc tuating asymmetr y, are generally consistent with available information on the concentrations of various pollutants in ambient air, as well as with the layout of the main industrial pollution sources of the urban environment. Quantitative assessment of the impact of industrial traffic pressure criteria and of the environmental and geochemical indicators of the quality of the atmosphere, snow and soil showed prevalence of positive correlations (about 60 % of cases), confir ming the

Table 2. The main geochemical criteria of the ecological state of the functional and planning areas of Voronezh Atmosphere (substances ­ mg/m3) Functional planning zones Sulfur oxide IV 0.071 0.050 0.081 0.138 0.144 0.036 0.028 Snow
­ NO3 (mg/l)

Soil

Formaldehyde 0.037 0.069 0.083 0.179 0.181 0.014 0.007

Phenol

atm 0.48 0.66 0.55 1.05 0.97 0.31 0.26



Mineralization, (mg/l) 123.9 109.5 112.9 135.0 143.5 116.0 104.5

Lead (mg/kg) 2.26 2.99 2.71 2.45 3.92 2.02 2.00

AIP*

Residential (MD) Residential (CH) Residential (PS) Industrial (Ind) Transport ( Tr) ResidentialRecreational (R) Background

0.072 0.101 0.071 0.251 0.202 0.032 0.029

6.03 6.27 5.72 6.11 6.55 5.74 5.39

8.10 8.69 3.25 9.73 17.30 5.80 1.56

29.8 23.4 18.0 52.9 66.0 12.2 16.1

*) AIP ­ the aggregate index of soil pollution with heavy metals


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INTEGRATED ASSESSMENT AND GIS-MAPPING...

The priority health risk factors (for common weight positive significant correlations) are: the ratio of the emission load of carcinogenic substances, especially, the indices of road congestion. I n such areas, children have generally higher levels of morbidity for several diseases (congenital anomalies, neoplasms, endocrine pathology and diseases of the

The indicator parameters of chemical pollution of snow cover that reflect general industrial and transport pollution include the total dissolved solids, nitrogen compounds, chloride ions and the presence of lead in the melting snow. A multifactorial model (formula (6)) was built based on the priority risk factors; the model

Fig. 4. Integrated assessment of the ecological condition of the territor y of the cit y of Voronezh (method IDW interpolation).

49 ENVIRONMENT

increase in morbidity of children living in technogenically-loaded areas.

urogenital area). The majority of correlations are reliable.


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reflects the total effect of the 5 risk factors on the overall morbidity rate of the children population (multiple correlation R = + 0.82): Y = ­88.34 ­ 25.18(1) + 0.0037(2) +

of up to about three-fold level, in risk indexes in affluent suburban neighborhoods and the community center, as well as the industrial and transportation areas of the city. CONCLUSION

+ 545.59(3) + 4.70 (4) + 8.93 (5),

(6) The conduc t ed r esear ch allows us t o f o r mulat e sev eral basic conclusions: 1) industrial pollution is formed by industrialtranspor t sec tor and func tional planning of the cit y infrastruc ture; 2) qualit y criteria for soil and atmosphere gi ve a stronger response to industrial and traffic impac ts; snow is a geochemical indicat or with a significantly smaller effect; 3) near industrial petr ochemical ent er pr ises in the lef t Bank sec tor of the cit y, conditions for the existence of woody plants are significantly worse. This is manifested in the deviation from the back ground of the indicator of stabilit y of development of silver birch and poplar; 4) there is a statistically valid increase in the incidence of children diseases in the areas of technogenic load. Diseases with the greatest environmental dependence include congenital anomalies, neoplasms, endocr ine pathology and diseases of the urogenital sphere; 5) the priority health risk fac tors ­ the ratio of the emission load of carcinogens and indices of road congestion; 6) the territor y of Voronezh industrial zone "leads" in the total pollution, while transpor t "leads" in the total pollution of soil and snow cover. The identified trends may be useful for r e g ional en vir onmental and h y g ienic ser vices for the development of targeted environmental monitoring programs and may reduce the risk of ecologically caused diseases of the population in the conditions of intensive technogenic pollution of the ur ban envi r onment. I n par ticular, ther e is a need for a tar get ed environmental polic y to reduce environmental r isk and t o impr ov e the ur ban en vir onment of Vo ronezh. I ts components ma y include the following: reconstruc tion of transpor t net works by increasing their width and the

where X1 ­ (PCR) ­ coefficient of emission levels of carcinogens (t/year per 1 k m2); X2 ­ ( Tatn) ­ the total traffic intensity of vehicles (auto/h per 1 km2); X3 ­ is the comprehensive index of atmospheric pollution (Katm); X4 is the total mineralization of snow cover (mg/l); X5 ­ the total index of soil pollution with heavy metals (SDRs). To increase the validity of zoning, we applied methods of multivariate statistical analysis. In particular, the use of cluster analysis has led to a more accurate classification of functional-planning areas according to the similarit y of the nature of environmental pollution and feedback of living organisms. Thr ee clust er g r oups w e r e isolat ed: a) industr ial and transpor tation z ones together (the most technogenic polluted); b) residential, including all the sub -zones regardless of the number of floors and historical-compositional construction (areas of moderate contamination); c) residential recreation and the background (the most environmentally safe, comfortable). The main geochemical criteria of the ecological state of the urban environment are shown in Table 2. We have calculated the integral evaluation score based on set of particular indicators of the ecological state of the urban environment and children health. This score was obtained by calculating a weighted average of scores characterizing the degree of medico-ecological tension of the area. The final element of the integrated assessment was the creation of a map which shows gradient differences of environmental risk indices. The data was processed in respect to 46 of the most representative monitoring points (Fig. 4). The compiled map illustrates spatial differences,


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INTEGRATED ASSESSMENT AND GIS-MAPPING...

average speed of movement of vehicles and enhancing quality of road sur face; creation of " transpor t cor r idors" similar to "organic systems" of urban transpor tation in many European cities; change in the fuel balance of the thermal power generation industr y with a complete transition to gas as fuel; larger green ur ban space with the introduc tion of pollution resistant green plantings and a more widespread use of "ver tical gardening" REFERENCES

ACKNOWLEDGEMENT This work was supported by the grant of the Russian Geographical Society, 14/2014 and Russian Foundation for Basic Research (RFBR), 13-05-41401.

1. Bezuglaya Y.E. Rastorguev, G.P., Smirnov V.I. (1991). Chem dyshit promyshlennyi gorod ( What industrial city breathes). ­ L.: Gidrometeoizdat. ­ 256 p. (in Russian) 2. Bushueva K.A., Sluchanko I.S. (1979). Metody i kriterii otsenki sostojanija zdorovja naselenja zagrjazneniem okruzhajuschei sredy (Methods and criteria for evaluating the health status of the population affected by pollution). ­ M.: Medicine. ­ 160 p. (in Russian) 3. Ecogeokhimiya gorodskih landshaftov (Eco-geochemistr y of urban landscapes) (1995) / ed. by N.S. Kasimov. ­ M.: Publishing house of Moscow state University. M.V. Lomonosov Moscow State University, 1995. ­ 336 p. (in Russian) 4. Kasimov N.S., Nikiforova E.M., Kosheleva N.E., Khaybrakhmanov T.S. (2013). Geoinformatsionnoe landshaftno-geohimicheskoje kartografirovanie gorodskih territorij (na primere VAO Moskvy) (Geoinformation landscape-geochemical mapping of city territories (on the example of the Eastern administrative district of Moscow)). Landscape-geochemical map // Geoinformatics. No. 1. S. 28­32. (in Russian) 5. Kurolap S.A., Eprintsev, S.A., Klepikov O.V. and others (2010). Voronezh: sreda obitanija i zony ekologicheskogo riska ( Voronezh: habitat and areas of environmental risk). ­ Voronezh: Istoki. ­ 207 p. (in Russian) 6. Kurolap S.A., Mamchik N.P., Klepikov O.V. (2006) Otsenka riska dl'a zdorov 'a naseleni'a pri tehnogennom zagrjaznenii gorodskoj sredy (An assessment of risk to the health of the population from technogenic pollution of the urban environment). ­ Voronezh: VSU. ­ 220 p. (in Russian) 7. Malkhazova S.M., Koroleva E.G. (2011). Environment and Human Health: A Training Manual. ­ M.: Geography Faculty of Moscow State University. ­ 180 p. 8. Malkhazova S.M., Linsheng Y., Wuyi W., Orlov D.S., Shartova N.V., Hairong L., Li W. (2014). Health of urban population in Moscow and Beijing agglomerations // Geography. Environment. Sustainability. 4 (v. 7). pp. 41­53. 9. Osnovy otsenki riska dlja zdorovja naselenija pri vozdejstvii himicheskih veschestv, zagrjaznjajauschih okruzhajuschuju sredy (Principles of risk assessment for health when

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of walls and roofs, based on the experience of several major cities in Europe, which will reduce air pollution near the highways.


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exposed to chemical substances polluting the environment) (2002) / ed. by Yu. A. Rakhmanin, G.G. Onishchenko. ­ M.: Institute of STATE and ECH. ­ 408 p. (in Russian) 10. Revich B.A. (2010) Environmental priorities and health: vulnerable areas and populations // Human Ecology. 7. pp. 3­9. 11. Yakushev, A.B., Kurolap S.A., Karpovich, A.M. (2013). Ekologicheskaja otsenka vozdejstvija avtotransporta na vozdushnij bassejn gorodov Tsentral'nogo Chernozemja (Environmental assessment of the impact of transport on air basin of the cities of the Central Chernozem region). ­ Voronezh: Publishing house "Scientific book." 207 p. (in Russian). 12. Zakharov V.M., Clark D.M. (1993). Biotest. Integral'naja otsenka zdorovja ekosistem I otdel'nyh vidov (Biotest. Integrated assessment of health of ecosystems and individual species). ­ M.: Moscow DEP. Intern. Fund Biotest. ­ 68 p. (in Russian). Received 09.10.2015 Accepted 06.11.2015

Semen A. Kurolap has a Dr. Sc. degree in Geography. He is Head of the Depar tment of Geoecology and Environmental Monitoring, Voronezh State University, and the author and a coauthor of over 300 scientific papers and 12 monographs. The areas of scientific interests are urbanistic ecology, human ecology and medical geography.

Oleg V. Klepikov has a Dr. Sc. degree in Biology. He is Professor of the Department of Engineering Ecology of Voronezh State University of Engineering Technologies. He is the author and a co-author of over 150 scientific papers and 13 monographs. His research interests are in environmental monitoring (ecological monitoring) and risk assessment for public health due to the influence of anthropogenic factors.


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INTEGRATED ASSESSMENT AND GIS-MAPPING...

Pavel M. Vinogradov has a Ph. D. in Geography. He is Instructor at the Department of Geoecology and Environmental Monitoring, Voronezh State University ; the author and a co-author of over 20 scientific papers. His research interests are in environmental monitoring (ecological monitoring) and geographic informational systems.

Tatyana I. Prozhorina has a Ph. D. in Chemistr y. She is Associate Professor of the Department of Geoecology and Environmental Monitoring, Voronezh State University. She is the author and a co-author of over 100 scientific papers and abstracts. Her research interests are in improving the level of wastewater treatment and evaluation of quality of natural waters.

Liudmila O. Sereda is a post-graduate student, Department of Geoecology and Environmental Monitoring, Voronezh State University. She is the author and a co-author of over 20 scientific papers and abstracts. Her research interests are in environmental assessment and mapping of urban environment, geochemistr y of the city and medical geography.

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54 SUSTAINABILIT Y

Wuyi Wang1*, Yonghua Li1, Hairong Li1, Jiangping Yu1, Linsheng Yang1, Li Wang1, 2 Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China. Tel: + 86 10 64889286 2Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, the Netherlands *Corresponding author; e-mail: wangwy@igsnrr.ac.cn
1Key

ENVIRONMENTAL MECHANISM OF REGIONAL LONGEVIT Y IN CHINA
ABSTRAC T. The integrated study on environment of typical China's longevity areas was conducted by using comprehensive methods of health geography. It was found that Chinese longevity areas mainly located in the south China and clustered in Sichuan-Chongqing, Central plain and Southeast region, the Yangtze River Delta and Pearl River Delta; in which drinking water was of weakly alkaline, Se, Fe, K content was moderate, higher content of Ca, Co, Mn, and low Cr, Cd, Pb; the concentration of trace elements benefit for health in soils and food staples was higher; hair of centenarians had higher Li, Mg, Mn, Ca, Zn content, lower concentration in Cd, Cr, Cu, Ni; healthy centenarians were also benefited from a favorable social environment factors, such as physiological health, psychological state, light meals and higher proportion of vegetables. The study was the first time to reveal quantitatively the relationship between longevity and the natural and human environment, and provided a scientific basis for the promotion of development of China's longevity area, to achieve the construction of ecological civilization. KEY WORDS: regional longevity, environment, centenarians, chemical elements. INTRODUC TION China has entered into the aging societ y, and it is in the rapid aging period. According to the six th national census data in 2010, the population of aged over 60 years old is 177,648,705 people, accounting for 13.26 % of the total population of China, and the population aged 65 and over is 118,831,709 people, accounting for 8.87 % of the total population. Compared with last national census in 2000, the propor tion of the population aged 60 and over has increased by 2.93 %, the propor tion of the population aged 65 and over has increased by 1.91 %. These data suggest that the construc tion of healthy aging societ y has become an important issue, but also an important task to cope with rapid aging. The so-called healthy aging refers to a healthy state of complete physical, mental and social functions to the most of elder ly in the aging societ y, but also means that the social development w o uld not be ex cessiv ely influenced by fast population aging. Therefore, it is necessar y to reveal the mechanism of the formation for longevity, especially carr ying on a comprehensive analysis on aspects of physiology, psychology, socio-economy with natural environment. For a long time, we obser ved the problem of aging in China and found the phenomenon of regional longevity, in another words, the distribution of longevity people has been of the geographic clustering in China [ Wang et al., 2008; Lv et al., 2011; Wang et al., 2014]. Centenarians have been a symbol of health and longevit y, and it can be considered as the outcome of interac tions bet ween lifest yle, heredit y, environmental, health care level and psychological factors. Among


Wuyi Wang, Yonghua Li, et al.

ENVIRONMENTAL MECHANISM OF REGIONAL LONGEVITY IN CHINA

First, the regional longevity in China is an objec tive phenomenon, which requires a multiple study to reveal the factors on longevity for scientific understanding and bett er explanation. Fo r m ing of r e g ion longevity is the result from the integration of many fac t ors. As a t ypical case, the longevit y ar ea, in which cent enar ians gather ing live, more influenced by the geographical environment. The so - called geographical environment re fers to the ear th's sur face in which mank ind depends on, sur vival and development, is the unity of two par ts as the nature environment and human environment. Natural environment is consisted of rock, soil, water, air, biological and other components (elements), all these int egrat e t o fo r m the natural complex. According to the perspective of the ear th's sphere, the natural environment could be divided into the lithosphere, hydrosphere, atmospher e and biospher e . Human environment is the regional combination of social, cultural and production activities, including var ious components such as population, ethnic, settlement, politics, societ y, economy, transpor tation, militar y, social behavior, and others (elements). They constitute the spheres of the ear th's sur face, called the humanities sphere, also k nown as social sphere. Geographical environment consist ed of natural en vir onment and human environment plays a decisive role on human health. Until now there are many studies on the factors of longevity, but no satisfied explanation to longevity of regional aggregation has been reached; some studies just made simple comparison on the different fac t ors of the longevit y en vir onment; the study on the relationship bet ween longevity and the chemical elements only present single correlation analysis, lack of research on the multi- chemical elements from environmental transfer to human, and

Second , it is the needs t o summar iz e the compr ehensiv e featur es of natural en vir onment and human en vir onment for building healthy aging societ y. The mechanism of longevit y en vir onment could provide a scientific basis for the gove r nment, institutions, and public to promote environmental protec tion, social development and economic growth, and will be benefit for actively respond to the challenge of aging. Third, learning from the different experiences of innovative measures to protect the local elderly in the typical longevity areas could provide economic and effective way to be implemented for the construction of healthy aging society, and these would be suitable to diversity of natural environment, var ying degrees of aging, and different economic regions. Therefore, we did a comprehensive study on environmental factors of longevity region. This ar ticle briefly described the distribution feature of aging and longevit y population. Contrar y to the defects of the former studies on longevit y with natural environmental fac t ors and social fac t ors , fiv e t ypical "longevity county ", Xiayi in Henan province, M ayang in Hunan province, Zhongxiang in Hubei pr ovince , Yong fu in Guangxi Autonomous region, Sanshui in Guangdong province were chosen to study. By sampling of water, soil, food and hair of centenarians, and macro and trace elements of analysis, the relationship bet ween trace elements and longevit y could be established, and the chemical elements spectrum impacting longevit y could be identified. Therefore the common regular pattern of the natural en vir onment t o health and longevit y could be initially revealed. Simultaneously, the human geographical environmental charac t e r istics of t ypical of longevit y areas were also analyzes, and preliminar y

55 SUSTAINABILIT Y

these, environment could play an extremely impor tant rule resulted in the re gional distribution of longevity in China. The reason we study regional longevity in China will be as the follows:

lack of a comprehensive study to find out the common characteristics of the different regions.


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discussion to build up China's " longevit y count y " was present. ME THODOLOGY Human health refers to the struc ture and func tions of the human body syst ems continuing in a r elativ ely stable stat e , and maintains dynamic equilibr ium with the ex t e r nal en vir onment. Health and longevit y are the impor tant indicators of ear th's environmental quality. Based on the close relationship bet ween human health and the geog raphical environment, the main academic idea of this study is focused on the en vir onmental charac t e r istics of longevit y area in China, and re vealing the fac t ors of longevit y with the environment. The t echnical appr oach is that with geography 's ideas and methods, we study the distribution features of longevit y areas and their environmental charac teristics; at the same time, using compar ison on the environment to find out the differences and similar ities bet w een longevit y and non-longevit y ar eas; and then pr opose suggestion f or pr omoting health and longevit y. The demographic database of the six th census of China in 2010 was utilized mainly and the statistical yearbooks in recent years for our studies. With the suppor t of ArcGIS sof t ware, we construc ted the spatial and attr ibut e database of the cent enar ians using the map of China and the six th census population data. Before that, field sur vey and sampling in different counties, and chemical analysis were carried on. The water, soil, food, hair samples were prepared accor ding t o the methods of national standard for qualit y control, and using ICPOES to analyze for the content of Al, Ba, Ca, Fe, K , Mg, M n, Mo, Na, P, Sr, V, Zn and others, the concentration of Cd, Co, Cr, Cu, Li, Ni, Pb and Se were determined by ICP-MS. All the statistical analysis was done with different modeling methods.

RESULTS The spatial distribution of centenarians in China According to China's six th census, the geographical distribution of longevity population is of significant regional characteristics. Figure 1 shows those sub-provincial administrative units with the centenarian rate 2.7 per 100,000 people, which is the current average level of the centenarian rate in China. The gathering areas of centenarians in China are distributed mainly in the south of the country, located substantially on the south boundary of the North-South climate stripe of China; more in Sichuan-Chongqing region, the Central Plains region of China; most along the river watershed distribution such as the Yangtze River, Pearl River; and more gathered in the Yangtze River Delta, Pearl River Delta region; the areas distributed in the hilly and alluvial flood plains; non endemic areas. These show that the distribution of longevity areas relates to natural and human environment factors. I n provinces, autonomous re gions and municipalities as the administrative unit, the proportion of centenarians in Hainan province is 18.75/100,000 as the highest in the China. Guangxi autonomous region (7.80/100,000), Sich uan pr ovince (4.21/100,000) and Guangdong province (3.65/100,000) respectively ranked as second to four. The longevity index referred to the ratio of population over 65 years old to 90 years and above in Hainan province is 2.89 % ranking the first in China, Shanghai (2.63), Guangdong province (2.41) and Guangxi autonomous region (2.31), respectively ranked as second to four. M ak ing compar ison analysis on meteo rological data with the longevity areas, it was found that China's longevity areas mostly located in warm climate type zone, average temperatures were bet ween 8.6­24.9 °C, relatively abundant rainfall, relative humidity more than 68 %, and average annual sunshine hours higher than 821.5 hours in the most longevity areas.


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ENVIRONMENTAL MECHANISM OF REGIONAL LONGEVITY IN CHINA

Fig. 1. The distribution map of centenarians in China.

The correlation analysis on chemical elements in the centenarian and the environment Selected five typical "longevity county " of China, Xiayi county in Henan province, Mayang county in Hunan province, Zhongxiang city in Hubei province, Yongfu county in Guangxi autonomous region, Sanshui distr ic t in Guangdong province as the study areas, the chemical environment where centenarians live in was studied. The samples of drinking water, soils, staple grains and hairs of centenarians were collected and the contents of chemical elements were analyzed to find the impact of chemical elements on health and longevity. Characteristics of chemical elements content in drinking water Drink ing water may make an impor tant contribution to total dietary intake of required macro- and trace elements essential for human

health and affect the desirable balance of these elements. In this study, the pH and Na, Fe, Ba, Cd, Cr, Cu, Mn, Mo, Ni, Pb, Se, Zn, F concentrations of the collected 182 drinking water samples from longevity areas were compared with the national standards for drinking water quality GB 5749­ 2006 and World Health Organization guidelines. The results show the quality of drinking water samples could meet these standards and had pH > 7, these were classed as weakly alkaline, which is beneficial to health and longevity according to some studies. All these results show as well that the drinking waters of longevity areas are clean and free from pollution, and with enough contents of Se, Fe and Ca, this is the important factor to local longevity. Characteristics of chemical elements content in soil Soil quality is not only the indicator of local environmental quality also affects the levels

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Table 1. The content of chemical elements in rice(µ g/g)

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Element Minimum Maximum Mean Standard deviation Median * g/kg

Ca

Cu 0.369

Fe 0.259 291.3 24.15 2.464 15.74

K 197.1 4993. 2234. 107.1 1485.

Mg 39.54 1749. 751.2 39.13 629.5

Mn 2.024 45.65 14.42 0.878 9.2

P 196.9 4127. 1951. 81.60 1724.

Zn

Se* 18.35

6272. 233.0 38.54 81.64

7.558 2.895 0.125 2.332

45.90 20.26 0.679 16.64

199.6 56.69 2.445 49.44

of nutrients in food crops. By analyzing the collected 325 soil samples, the results shown that content of Cd, Cr, Cu, Pb, Zn, N i and other heav y metals could meet well the national soil environmental quality standard as the grade II which means no pollution of heavy metals in the soils of longevity areas. Nevertheless, Fe, Se, Zn are relatively affluent, and these would be benefit for health [Liu et al., 2013]. By the multiple regression analysis on the background values of chemical elements in soils of China according to the national survey, with the centenarian index (number of centenarians/per 100,000 people) and the longevity index (number of centenarians/the population of 65 years old and above) it was found: Y (centenarian index) = 1.679 ­ 0.205 Ni + 0.413 Co + + 0.006Se (R2 = 0.402, p < 0.01); Y (longevity index) = = 3.425 ­ 0.262Ni + 0.435 Co + 0.006 Se (R2 = 0.369, p < 0.01). The regression equation shows that the trace elements, cobalt and selenium which are benefit for health are positively correlated with centenarian index and longevity index, and nickel is negatively correlated with these two indicators. These imply that longevity could be result from the good soil environmental quality.

Characteristics of chemical elements content in rice as the staple grain The grains could direc tly affec t human health. Table 1 presents the concentration of chemical elements in 235 staple grain samples collected from longevity areas. The data shows that sufficient supply of essential chemical elements from food is beneficial to health and longevity. For example, selenium content in the grain level from the national perspective, less than 25 g/kg is the level of selenium deficiency, 40­70 g/kg selenium is middle level, greater than 1000 g/k g is excess selenium levels [ Tan 1989]. The selenium content in rice of longevity areas is the averaged 56.69 g/kg, the median is 49.44 g/k g, which means moderate selenium content good for health. Characteristics of chemical elements content in the hair of centenarians Collected 153 samples of hair from longevity people, the results of chemical element level of hair are shown in Table 2 with reference values. Compared with the reference value [Miekeley et al. 1998], centenarian's hair is significantly enriched for Ca, Li, Mg, Mn with low level of Cr, Cd, Cu, K, Ni, and Fe, P, Pb, Sr, Zn, Se are within the normal reference range. Due to the presence of extreme values, a simple average value of the chemical element could not reflect the true distribution feature of the elements, so we further calculated the probability inside and outside of the reference range of the element content in hair. Table 3 shows the probability of element content


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ENVIRONMENTAL MECHANISM OF REGIONAL LONGEVITY IN CHINA

Table 2. The content of chemical elements in the hair of centenarians (µ g/g) Element Ca Cd Cr Cu Fe K Li Mg Mn Ni P Pb Sr Zn Se Reference 350-860 <1.0 0.78-1.0 13-35 6.0-15 17-140 0.05-0.3 40-110 0.26-0.75 <1.6 120-180 <6.0 1.0-7.6 125-165 0.38-0.7 Mayang 1743 0.112 0.020 5.15 12.95 16.83 1.651 180 1.91 0.037 137 3.47 4.85 170.78 0.39 Sanshui 993 0.214 0.860 7.33 31.44 12.25 0.083 93.76 1.04 0.653 152.38 6.95 3.27 176.03 0.58 Xiayi 1049 0.047 0.046 6.50 10.33 13.29 0.660 147.36 2.97 0.035 107.34 2.66 5.17 135.15 0.24 Zhongxiang 1252 0.039 0.016 6.54 12.79 11.37 0.963 134.49 1.14 0.020 112.98 1.67 3.82 151.08 0.39 Yongfu 630 0.046 0.038 7.07 10.22 12.42 0.643 65.76 3.50 0.034 106.67 2.77 2.07 140 0.31

Table 3. Probabilit y inside and outside of the reference range of the element content in hair of centenarians (RVs, %) < RVs Mayang Sanshui Xiayi Zhongxiang Yongfu RVs Mayang Sanshui Xiayi Zhongxiang Yongfu > RVs Mayang Sanshui Xiayi Zhongxiang Yongfu Cr 100 100 100 100 100 Cr 0 0 0 0 0 Cr 0 0 0 0 0 Cd 99.9 96 100 100 99.2 Cd 0 0 0 0 0 Cd 0.1 4.0 0 0 0.8 Cu 100 99.5 99.8 99.9 100 Cu 0 0.5 0.2 0.1 0 Cu 0 0 0 0 0 Ni 100 100 100 100 100 Ni 0 0 0 0 0 Ni 0 0 0 0 0 Ca 3.1 19.8 6.8 18.3 2.7 Ca 0.73 2.32 1.97 20 14.4 Ca 89.6 57.0 73.5 61.8 82.9 Li 4.3 15.2 0.2 0.46 18.4 Li 2.6 4.2 4.0 9.7 4.5 Li 93.1 80.6 95.8 85.7 77.2 Mg 2.6 2.62 0.58 22.6 4.1 Mg 11.6 31.4 16.8 44 22.2 Mg 85.9 42.4 77.4 33.4 73.6 Mn 2.24 1.73 11.2 17.9 23.2 Mn 4.2 10.7 3.2 2.1 5.2 Mn 73.4 72.0 85.6 80.0 71.6 Zn 8.0 18.6 33.2 25.6 23.9 Zn 31.7 23.8 44.6 55.1 32.8 Zn 60.4 57.7 22.3 19.4 43.3

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in the hair within the range by identifying the normal distribution of the sample. [Chojnacka et al. 2005; Chojnacka et al. 2006; Zaichick 2010]. As shown in Table 3, compared with the reference value of elements in the hair, the content is generally higher in Li, Mg, Mn, Ca, Zn, lower in Cd, Cr, Cu, Ni and no significant different to other elements. This commonality of chemical elements contents of centenarians may be the important factors for longevity. Using Stepwise -MLR analysis, centenarians age ( Y ) as the dependent variable, with trace element contents in hair as the independent [Li et al. 2011], it was found that: Y = 101.156 ­ 0.796Cr + 0.008Zn ­ 0.034Pb + + 2.270Se ­ 7.335Cd (R2 = 0.37; F (5,101) = 3.26, P < 0.01). This shows that positive relation of zinc and selenium, negative relation of chromium, lead and cadmium is the main feature. This may suggest that supply of Se, Zn and less exposure of heavy metal are helpful for the health of centenarians. Life and psychological characteristics of centenarians Social environmental factors including family situation, physical health, self-care and activities of daily living, mental health status and lifestyle are of major impact on health and longevity. To understand this, the inter view sur vey to centenarians and other elderly people were conducted, and 2674 questionnaires were collected from Sanshui district of Guangdong province, Mayang county of Hunan province, Zhongxiang city of Hubei province, Xiayi county of Henan province, Yongfu county of Guanxi autonomous region and other longevity areas. By statistical analysis, it was found that longevity people have not only healthy physiological function, but also in positive mental status, in addition they have a light style of meal, with high proportion of vegetable intake.

Healthy physiological function Sleeping and disease status is the main indicator of health for the elderly. Fair sleeping quality and enough sleeping hour are the important effects for health and longevity. According to the study on the elderly people who had no sleeping interferers in Pittsburgh, it was shown that mortality could be increased with sleeping efficiency decreasing [Dew et al. 2003]. Concerning sleeping time in our sur vey, it was shown that centenarians had 9.6 sleeping hours in average, 80 to 99 year old people had 8.33 hours, and 60­79 years younger elderly had only 7.64 hours of sleeping time. This gave us an image that centenarians had more adequate sleeping time and its sufficiency could ensure the physical recovery of centenarians. We graded the sleeping quality of centenarians into five types as ver y good, good, fair, poor and very bad, and found that centenarians had ver y good and good sleeping accounted for 76.64 %. The average illness and hospitalization times for centenarians were 0.71 and 0.76 per two years respectively, considerable lower than the national hospitalization average level of 5 times per year. Some research indicated that with age increasing, the elderly tended to use health ser vices more frequency, our survey found that this tendency might stop at the ver y old age. Among older age groups, illness and hospitalization declined especially to the centenarians ver y much, and it suggested that these individuals were either more robust physically to begin with and/or better adapted to tackling the challenges brought about by old age. Positive mental state The longevity group had a relatively positive mental state, characterized by reporting that they had a "let it be" attitude when faced with adversity, and that they felt "as happy as when I was young". A negative mental state was characterized by reporting as "feeling nervous or fearful," and "feeling lonely". In the interviews, most of the longevity group had a positive


Wuyi Wang, Yonghua Li, et al.

ENVIRONMENTAL MECHANISM OF REGIONAL LONGEVITY IN CHINA

1) the distr ibution of centenar ians are aggregated roughly in the south of China, especially along the Yangtze River basin, Pearl River and their Delta. 2) preferable natural environment factors, such as mild climate, clean water, sufficient trace elements including calcium, selenium, zinc, and cobalt in the environment and low exposure of heavy metals are beneficial for longevity and health. 3) health and longevity are also benefited from a favorable social environment factors, the common feature of centenarians is the positive mental state, the light meal with higher ratio of vegetable. Longevity is the comprehensive indicator of the harmonious development on environmentsociet y- economy-health. We believe that the "longevity county " is not simply shown how much population of longevity in certain region, but contains a wealthy content of the harmonious development in the regional environment, society, economy and health. The so-called comprehensive indicator, which contains a wide range of meanings, can be mainly summarized as four points: First, the longevity is long term formed and could not be established in a short period. Because people's longevity is the result of long-term to maintain a healthy state in several decades or even centuries in the good natural environment, social and family conditions for the formation of long-term accumulation. Second, the longevity is an interactions result from multi-factor and multi-condition of the genetic, psychological, physical and social environment. The longevity is also the result

Fig. 2. The mental state of centenarians and elderly.

Light dietary and high proportion of vegetables Regarding the food habit, the centenarians ate rice and flour as the major staple grains, accounting for 90 % of all staple food consumption. As shown in Fig. 3, they ate relatively light, plain food which means a light taste, not salty, not spicy, and not oily. The typical feature is that they had lots of vegetables for meal accounted for 60 % above every day. DISCUSSION AND CONCLUSIONS The longevity phenomenon is the integrated effect of many factors, including physical en vir onment, cust om habit, cultural characteristic, health care system and heredity factors and so on. Other factors may include

Fig. 3. The vegetables consumption for centenarians and elderly.

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mental state, and more than 80 % of the aging group had a "let it be" attitude. The proportion for centenarians was even higher as "let it be" accounted for more than 50 % (Fig. 2).

as life style, physical exercise, nutrition status, social relationships and the psychological factor. This paper intended to explain mainly the longevity mechanism from the prospect of geographical environment including natural and human environment. The main findings are as follows:


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of government, institutions, communities, families and individuals working together to continuously improve the social security, economic development, health care coverage, education, culture improvement, environmental protection and other aspects of the society. Third, the longevity is the most concentrated expression of harmonious relations between the human and material world. Four th, the longevit y is a dynamic development progress. Longevity embodies the har monious dev elopment of man and the environment both in the past and the current situation, but it is also the

enlightenment and requirements for the future development. In summar y, we must fully understand that longevit y is the comprehensive result of re gional development on environment, society, economy and human health, and improve the awareness of the construction of longevity society to achieve sustainable development. ACKNOWLEDGEMENT This research was supported by the National Natural Science Foundation of China (No. 41171082). The authors declared there are no conflicts of interest.

REFERENCES 1. Chojnacka K., GÑrecka H., Chojnacki A., GÑrecki H. (2005) Inter-element interactions in human hair. Environmental Toxicology and Pharmacology, 20: 368­374. 2. Chojnacka K., GÑrecka H., GÑrecki H. (2006) The influence of living habits and family relationships on element concentrations in human hair. Science of the Total Environment, 366: 612­620. 3. Dew M.A., Hoch C.C., Buysse D.J., Monk T.H., Begley A.E., Houck P.R. (2003) Healthy older adult's sleep predicts all-cause mortality at 4 to 19 years of follow-up. Psychosomatic Medicine, 65: 63­73. 4. Li Y.H., Yang L.S., Wang W.Y., et al. (2011) Trace element concentrations in hair of healthy Chinese centenarians. Science of the Total Environment, 409: 1385­1390. 5. Liu Y., Li Y.H., Jiang Y., et al. (2013) Effects of soil trace elements on longevity population in China. Biological Trace Element Research, 153: 119­126. 6. Lv J.M., Wang W.Y., Li Y.H. (2011) Effect of environmental factors on the longevous people in China. Archives of Gerontology and Geriatrics, 53: 200­205. 7. Miekeley N., Dias Carneiro M.T.W., Porto da Silveira C.L. (1998) How reliable are human hair reference inter vals for trace elements? Science of the Total Environment, 218: 9­17. 8. Tan J.A. (1989) Environmental selenium and health. Beijing: People's Medical Publishing House. 9. Wang L., Wei B.G., Li T.H., et al. (20140 A study of air pollutants influencing life expectancy and longevity from spatial perspective in China. Science of the Total Environment, 487: 57­64. 10. Wang W.Y., Yang L.S., Li H.R., et al. (2008) The effect of environment on longevity. China Society Periodical, 32: 21­23. 11. Zaichick S., Zaichick V. (2010) The effect of age and gender on 37 chemical element contents in scalp hair of healthy humans. Biological Trace Element Research, 134: 41­54. Received 09.10.2015 Accepted 06.11.2015


Wuyi Wang, Yonghua Li, et al.

ENVIRONMENTAL MECHANISM OF REGIONAL LONGEVITY IN CHINA

Wuyi Wang, Professor, Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China. Since 1975, Wang has engaged in the study of environmental change and its impact especially to human health. He worked in the Imperial College London from 1984 to 1986. He was the PI in different national scientific projects and international cooperative projects related endemic diseases in most poverty areas such as Tibet, Loess Plateau, northeast and southwest parts of China, and risk of urban environmental health, and is the author of more than 200 scientific publications. He is the co-chair of the Commission on Health and the Environment of the International Geographical Union (IGU); chairman of the Committee of Medical Geography, the Geographical Society of China; vice chairman of China Association of Gerontology and Geriatrics.

Yonghua Li, Professor, Key Laborator y of Land Sur face Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.

Hairong Li, Associate Professor, Key Laborator y of Land Sur face Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.

Jangping Yu, Senior engineer, Key Laborator y of Land Sur face Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.

Linsheng Yang, Professor, Key Laborator y of Land Sur face Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China. Li Wang, Research Assistant, Key Laborator y of Land Sur face Pattern and Simulation, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China. Now she is at the University of Maastricht.

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R.B. Singh1*, Md. Senaul Haque2, Aakriti Grover3 1 Depar tment of Geography, Delhi School of Economics, University of Delhi, Delhi, India; e-mail: rbsgeo@hotmail.com. *Corresponding author 2 Depar tment of Geography, Delhi School of Economics, University of Delhi, Delhi, India; e-mail: senaulhaque68@gmail.com. 3 Department of Geography, Swami Shraddhanand College, University of Delhi, Delhi, India; e-mail: aakriti.grover@gmail.com.

DRINKING WATER, SANITATION AND HEALTH IN KOLKATA ME TROPOLITAN CIT Y: CONTRIBUTION TOWARDS URBAN SUSTAINABILIT Y
ABSTRAC T. In an urban area, the water is supplied through centralised municipal tap water system. For the present enquir y, the municipal supply of water for drinking and sanitation purposes has been assessed in terms of its availability and accessibility to the people, possible sources of water contamination and related health issues in Kolkata. The relevant data have been accessed from various secondar y sources where the published data from West Bengal Pollution Control Board ( WBPCB) and Kolkata Municipal Corporation (KMC) are noteworthy. The data thus obtained have been assessed qualitatively to depict the ground reality on sanitation and health related issues. The analyses of the data reveal that in Kolkata, the availability of good quality drinking water is not sufficient as the supply is low and inadequate. On the other hand, the underground water which is considered as the alternative source to the people is found to be contaminated with heavy metals like arsenic and lead. The non-availability of sufficient water for drinking and sanitation purposes and consumption of contaminated water may result into poor health condition with various water borne diseases. The data on diseases from dispensaries (aided by KMC) in Kolkata has revealed that people with water borne diseases are significant in number where they are found to be affected with diseases like Acute Diarrhoeal Infection and Dysenteries. Some suitable measures have been proposed whereby applying those, the availability and accessibility of water for drinking and proper sanitation could be enhanced and the occurrences of diseases might be avoided. KEY WORDS: drinking water, sanitation, health, water borne diseases, dispensar y, KMC. INTRODUC TION The availability and quality of fresh water resources is the most pressing of many environmental challenges in India [Central Pollution Control Board, 2013]. Although 89 per cent of the urban population in India has access to water supply, the average availability is less than four hours a day and in some areas water is supplied only for one hour on alternate day [Asian Development Bank, 1997]. The human body requires minimum approximately 3 litres per capita per day (lpcd) intake of drinking water to sustain life before dehydration occur in tropical climate [ White et al., 1972]. When other uses like hygiene (washing and cleaning) get added to it, the requirement increases to 45­55 lpcd [Bhandari


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DRINKING WATER, SANITATION AND HEALTH...

and Gupta, 2010]. Safe drink ing water is essential for good health as is sanitation [Bhandari and Gupta, 2010], and lack of these two essential elements result in significant increasein morbidity and mortality conditions [Jalan and Ravallion, 2001; Shreshtha, 2006; Wor ld Bank , 2006]. I n developing wor ld, majority of children and adults suffer from repeated episodes of infec tious diarrheal diseases annually, where water is considered as the major source of exposure to diarrheal pathogen [Sobsey et al., 2003]. Urban I ndia largely depends upon water supply syst em that either dra ws from proximate surface or subsurface water bodies [Bhandari and Gupta, 2010]. There has been a constant problem regarding the availability of safe drinking water to the inhabitants in an urban area. In Kolkata, the problem is severe. Despite its location along the east bank of the River Hugli which means availability of abundant water in its vicinity, instead the city faces a grave problem of good quality water supply [ Tata Energy and Research Institute, 2013]. The problems are acute to those living in the slum [Kundu, 2003]. On the other hand, in the absence of efficient sur face water availability, people depend on underground water sources where its overuse leads to an increase in the arsenic concentration in many wards of the city [Shaban and Sharma, 2007]. Groundwater is generally less susceptible to contamination and pollution as compared to sur face water bodies. But its intensive use for irrigation and industrial purposes causes aquifer contamination which resulted into mineralization of water resource [ West Bengal Pollution Control Board, 2011]. Poor living conditions and lack of adequate city ser vices such as safe piped water and sewage, lead to serious health and sanitation problems [Douglas, 1983]. I t is estimated that throughout the world nearly 1.5 billion people lack safe drink ing water and that at least 5 million deaths per year can be attributed to waterborne diseases [K rants and Kifferstein, 1998]. A variety of pathogens infect water supplies in circumstances where

poor sanitation allows exer ted waste to contaminate drinking water [Anthamatten and Hazen, 2011]. Water borne diseases are caused by viral or bacteriological contamination of water. This is exemplified by the fact that a single gram of faeces can contain 10 million viruses, 1 million bacteria, 1,000 parasite cysts and 100 eggs of worms [ Water Supply and Sanitation Collaborative Council, 2002]. Water borne diseases are among the highest cases of morbidity and child mortality in India. India loses about 1.5 million children under 5 years of age annually to diarrhoea, and this might be an under estimate [Planning Commission, 2002]. In order to have a proper understanding of the water related problems and health issues in urban India, the present study is concerned with identification of problems related to municipal supply of dr ink ing water and health issues in Kolkata. The major area has been covered are the sources of water supply, factor affecting the water supply, sources of water pollution and the resulted health outcome due to non-availability of water and consumption of contaminated water. It has also focuses on the sanitation problems where the availabilit y of sufficient water for household purposes, efficient drainage facilities and proper garbage disposal facilities to the city inhabitants were evaluated to assess the health consequences. STUDY AREA The present study has conducted by taking case study of Kolkata, the capital city of West Bengal (Fig. 1). Spread roughly north-south along the east bank of the River Hugli, Kolkata sits within the lower Ganga Delta of Eastern India. The city lies about 136.79 kilometres (86 miles) away from the sea and 4.57­6.09 metres (15­20 feet) above the mean sea level [Imperial Gazetteer of India, 1984]. Its latitude and longitude are 22°56 North and 88°36 East respectively. According to the Census of India [2011], Kolk ata had 4.5 million population with density 24,252 persons per K m2.The annual mean temperature is 26.8 °C (80°F)

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Fig. 1. Location of the study area.

and monthly mean temperatures ranges from 19 °C to 30 °C (67°F to 86°F).Maximum rainfall occurs during the month of August (306 mm) and the average annual total is 1,582 mm [District Census Handbook, 2001]. Kolkata is an unplanned city that has grown gradually to accommodate the influx of people from across the city, state and national borders. As a result, it is characterized by poor drainage and resulted water logging, waste effluent and sewage which create health risks for the city dwellers [Hasan and Khan, 1999]. DATABASE AND ME THODOLOGY The study has been completed based on mainly secondar y sources of data along with obser vation of the researcher that are substantiated with images from the study area to reflect the ground reality of

health related problems resulted from nonavailabilit y of water for proper sanitation and drinking purposes to the city inhabitant. The relevant data have been gathered from the existing literatures available in the form of research ar ticles, published government reports, books etc. The important sources are West Bengal Pollution Control Board ( WBPCB), Kolk ata Municipal Corporation (KMC ), and District Census Handbook etc. The data thus obtained have been reviewed and assessed qualitatively. The data on groundwater quality have obtained from WBPCB and the assessments were done through comparing the data with the I ndian Standards (IS) specification for drinking water along with their desirable and permissible limit and possible health effects (Appendix 1). The data pertaining to diseases have been obtained from the dispensaries run by KMC. Initially, the data were


R.B. Singh, Md. Senaul Haque, Aakriti Grover

DRINKING WATER, SANITATION AND HEALTH...
Table 1. Water statistics in Kolkata Domestic Water Use Households with Water Access Water Loss due to Leakage in Pipe Household with Sewerage Ser vices Wastewater Treated Main Water Sources 130 litre per capita 79 per cent 35 per cent 52 per cent 20 per cent Sur face water from the Hugli branch of the Ganges Groundwater from deep and hand tube wells Water use inefficiency Pollution Flooding Ecosystem destruction International dispute

STATUS OF WATER RESOURCES IN KOLK ATA The city of Kolkata has a centralised filtered water supply which is distributed to the city dwellers via a complex network of pipelines. Two most common allegations against the existing water supply net work is the inadequacy of the quantity and deteriorating quality of water [Roy et al., 2004]. The majority of the greater Kolkata's water is treated surface water from the Hugli branch of the River Ganges [Dudley and Stolton, 2003], along with groundwater from various deep and hand tube wells and private pumps [Segane, 2000]. Kolkata Municipal Corporation is claims that 94 per cent of the city 's households are connected to piped water and the water is supplies continuously up to 20 hours per day. However, a study by the Asian Development Bank (ADB) in 2007 on the water utilities in India found that only 74 per cent of the households in Kolkata are connected to piped water supply and that the average time of daily uninterrupted water supply is 8.3 hours. The households not connected to the water supply system mainly extract groundwater through private wells and pumps. A brief over view of the water resource in Kolkata covering the domestic use, its access at the household level, loss due to leakage, treatment of waste water, sources of water supply and associated problems etc. reveal that about 80 per cent of the households have access to the supplied piped water. About 35 per cent of the supplied water gets wasted due to leak age whereas only 52 per cent households are connected with the sewerage services and merely 20 per cent of the waste water is treated before its final dumping. Inefficiency in the use of water resources at the end point is the major problem followed by pollution and flooding ( Table 1).

Main Water Problems

Source: WWF Report, 2011.

The daily water supply needs for Kolk ata Municipal Authority (KMA) is 2.75 million cubic metres per day of which KMC accounts for 1.63 million cubic metres. Tak ing into account the average utilization of the existing capacity, KMA faces a supply deficit of filtered water of about 1.18 million cubic metres per day. This is par tially met through pumping of ground water using deep tube wells with average yield of 0.6 million cubic metres per day [ World Bank, 2011]. Kolkata and the Ganges delta lie in a geological zone with naturally occurring arsenic in deeper layers of the bedrock and thus the groundwater naturally contains var ying levels of arsenic [Segene, 2000]. An analysis of ground water quality in Kolkata revealed that the concentration of mercury in locations near Tangra (3.649 mg/l), Cossipore (1.755 mg/l), Dhapa (0.932 mg/l) and Inside Kolkata Leather Complex (0.719 mg/l) have exceeded the permissible limit (0.001 mg/l). The concentration of Total Dissolve Solid ( TDS) has found beyond the desirable limit (500 mg/l) in all the monitoring stations and it was beyond the permissible limit (2000 mg/l) at the location near Cossipore (2080 mg/l) ( Table 2).Mercury is a highly toxic liquid metal and consuming water with mercur y

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available in weekly format which later converted into monthly format for interpretation. The monthly data then interpreted by looking at the variation in the total number of patients with water borne diseases.


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Table 2. Ground water qualit y in Kolkata Nitrate Faecal Coliform MPN/100ml Fluoride Arsenic BOD < 2500/100ml 2 4 8 4 _ 80 2 2 13 4 110 0.4 0.42 0.37 _ 0.41 9 0.61 0 0 0 0 0 14 0.37 0 7 0.49 0 NT NT NT NT NT NT NT 5 0.34 0 NT < 5000/100ml 1.0 mg/l ­ 0.05 mg/l 30 mg/l 0.6 1.4 0.4 1.4 1.1 0.9 0.9 0.5 Total Coliform MPN/100ml Total Pesticide Mercury TDS

Sl. No. 45 mg/l 0.09 0.1 0.04 0.04 0.1 0 0.04 0.11

Ground Water Stations

pH

Water Quality Criteria

6.5­8.5

0.001 mg/l 3.649 0.588 0.932 BDL BDL 1.755 BDL 0.719

500 mg/l 1888 1370 1218 896 826 2080 1292 1036

1

Tangra,Calcatta, West Bengal

7.6

GEOGRAPHY. ENVIRONMENT. SUSTAINABILITY.

2

Topsia, Calcatta, West Bengal

7.8

3

Dhapa, Calcatta, West Bengal

7.9

4

Garia, Calcatta, West Bengal

8.2

5

Behala, Calcatta, West Bengal

7.8

6

Cossipure- North Kolkata

7.2

7

Central Kolkata

7.8

8

Inside Kolkata Leather Complex

7.8

Source: WBPCB, Annual Report 2010­11.

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DRINKING WATER, SANITATION AND HEALTH...

Industrial discharge In the eastern part of Kolkata near Tangra-TopsiaTiljala, leather industries are located and the industrial effluents released from the tanneries causes serious environmental hazards through polluting the bheries (fishing pond), wetlands and agricultural fields. The manufacturing of leather in these industries produce large quantities of waste which is discharged into the natural water bodies directly or indirectly through open drains, causing pollution and leading to serious health hazards [Ganguly, 2012].

SOURCES OF WATER CONTAMINATION IN KOLK ATA The contamination of water takes place when external substances with the possibility to modify the water in negative manner get discharged into it. In general, the sources of municipal waste water are domestic, industrial, storm water and by ground water seepage enter ing the municipal sewage network [Purk ait et al., 2008]. The possible

Table 3. Possible sources of metal contaminants in water Contaminants Sources of Contaminants in Drinking Water WHO Cadmium (Cd) Impurity in the zinc of galvanized pipes, water heaters, water coolers and taps Leather tanning industry, the manufacturing of catalysts, paints, fungicides, the ceramic and glass industry, photography, chrome alloy chromium metal production, chrome plating and corrosion control Production of lead-acid batteries, solder and alloys. Its presence is primarily from plumbing systems containing lead in pipes, solder, fittings or the ser vice connection to homes Industrial uses. US EPA Corrosion of galvanized pipes; erosion of natural deposits; discharge from metal refineries; run off from waste batteries and paints Discharge from steel and pulp mills; erosion of natural deposits

Chromium (Cr)

Lead (Pb)

Corrosion of household plumbing systems; erosion of natural deposits

Mercury (Hg)

Erosion of natural deposits; discharge from refineries and factories; runoff from landfills and croplands

Source: Based on Chacraverti et al., 2011. Table 4. Number of samples showing detection of metal contaminants All samples No. of detections No. of samples Dry season 0 3 51 0 Wet season 0 6 56 3 No. of samples River water samples No. of detections Dry season 0 3 8 0 Wet season 0 6 8 1 No. of samples Drinking water samples No. of detections Dry season 0 0 43 0 Wet season 0 1 48 2

Metals

Cd Cr Pb Hg

56 56 56 56

8 8 8 8

48 48 48 48

Source: Chacraverti et al., 2011.

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contamination over many years could result into kidney damage. Similarly, when TDS levels exceed 1000 mg/l, it is generally considered unfit for human consumption.

sources of water pollution in Kolkata are as following:


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A study by Chacravarty et al. [2011], traced the source of contaminants in water through testing the level of mercury (Hg), lead (Pb), cadmium (Cd) and chromium (Cr) in samples taken from tube wells, river Hugli and taps at different sites in the KMA during both the dry and wet seasons ( Table 3). The detection of lead in river water and drinking water were very much noticeable in almost all the samples in both summer and winter seasons while the presence of chromium has been noticed in river water during wet seasons ( Table 4).The drinking water although has been found free from the chromium and cadmium contamination, the presence of mercury during wet season has detected in some places. Leakage from the landfills Landfills are huge pile of city garbage. The disposal of garbage is a big problem in India and other developing countries where open

dumping at road sides, in open spaces, in front of the r i v e r banks [Hogland and Marquis, 2007] and any other unorganised places are prac tised which ma y pollut e the adjacent environment (Fig. 2). When it rains, the landfills get leak ed and the leak age pollutes the underground water. One severe problem associated with open dumping is the infiltration of leachat e int o the sur r ounding en vir onment and subsequent contamination of the land and water [ Walk er, 1969; Chain and D e walle, 1976; K elley, 1976; M ast ers , 1998]. I n Kolk ata, the major disposal site i.e., Dhapa is located at the eastern fringe of the city. The qualit y of natural leachate sampled from the disposal site (Dhapa) has shown that the concentration of solids, Biochemical Ox ygen Demand (BOD), Chemical Ox ygen D emand (COD) and chlor ide we re much higher than it is allowed to discharge into inland sur face water [Mandal, 2007].

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Fig. 2. Disposal of solid waste in Kolkata: (a) Taltala (b) Hatibagan (c) & (d) Park Street.


R.B. Singh, Md. Senaul Haque, Aakriti Grover

DRINKING WATER, SANITATION AND HEALTH...

Leakage from piped water supply The quality of water at the end use point depends to a great degree on the state of the network of pipelines through which the water flows over vast distances. Nothing is more dangerous to public health than intermittent water supply [Ghosh, 2002]. The intermittent supply of water leads the iron pipelines to be idle for long stretches, augmenting their rusting process, which in turn is largely responsible for the fall in the quality of water. Faecal contamination of drink ing water is often associated with untreated water distribution systems through leaking and cracked pipes and causes shallow wells to become contaminated [Roy et al., 2004]. Sewage and waste water disposal O f the t otal wast ewat er generat ed in metropolitan cities, barely 30 per cent is treated before its final disposal. Untreated water finds its way into water system such as r i vers, lak es, ground water and coastal wat er [Gov er nment of I ndia, 2002]. I t is estimat ed that 75 t o 80 per cent of the wat er pollution by v olume is caused by domestic sewage [ T he Ener gy and Research I nstitute, 2003].The sewage and waste water generated at the household lev el is released int o the r i v er and fresh wat e r bodies without pr oper tr eatment [Bhandar i and Gupta, 2010]. Wast ewat er generat ed in K olk ata gets discharged into East Kolkata Wetlands (EKW ); 12,500 ha. of marshy wetlands connected to the Hugli branch of the Ganges and treating about 2.8 billion litters of sewage from the city [ WWF Report, 2011]. The vegetables are grown in Kolk ata sewage fed land shows variable toxicity [Gupta et al., 1990],which when mix with water bodies leads to its contamination. On the other hand, recycling of waste water often causes contamination of ground water by mixing of toxic elements like heavy metals and pathogens [Mitra, et al., 1998].

WATER AND HUMAN HEALTH I ndia though improves it 's conditions in terms of water supply and sanitation in last few decades, but still not commensurate with the requirements. Health outcome therefore, continue to be adversely affected and show up as infant mortality, prevalence of communicable diseases and overall morbidity [Bhandari and Gupta, 2010]. It is estimated that about 89 per cent of Indians use drinking water that could be classified as `safe drinking water ' but only about 28 per cent have access to improved sanitation [ World Health Organisation, 2009]. India stand far behind when compare to other emerging countries in meeting the water and sanitation needs to its population ( Table 5). Safe and good quality drinking water and sanitation is an essential aspect of public health. Vulnerable groups such as children, the elderly and immune compromised patients (e.g., those who are undergoing chemotherapy) are at special risk of diseases caused by water contamination [USEPA, 1999; Tibbettes, 2000].
Table 5. Access to safe drinking water and improved sanitation in emerging economics (per cent) Country India Brazil China Mexico South Africa Drinking water 89 91 88 95 93 Sanitation 28 77 65 81 59

Source: World Health Organisation, 2009.

Most of the diseases associated with water are communicable and preventable. Although water is the key to sustenance of life; poor water qualit y due to sewage disposal, dumping of industrial and agricultural effluent can mean increased exposure to carcinogenic compounds, insecticides such as DDT and heavy metals [Brain, 1999]. It may also mean infection with a range of enteric pathogens causing diarrhoeal diseases estimated to be responsible for 4 million child deaths per year in India. Inadequate sanitation implies

71 SUSTAINABILIT Y


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04 (08) 2015

72 SUSTAINABILIT Y

reduced levels of personal and domestic hygiene, which lead in particular to the faecal oral transmission of diarrhoea, dysenter y, gastroenteritis etc. [Brian, 1999]. In Kolkata, it could be evaluated the ground reality of inadequate sanitation for those living in the congested area (referred to as slum) while look ing at them to wash their utensil in dirty water and presence of uncovered drain at their vicinity (Figs. 3, 4). In some places people are also seen having their bath at roadsides. These are some of the issues of grave health concern where

the improvement in availability of sufficient water at the household level for sanitation purposes must be given priority for a better well-being and for that the KMC need to play the pivotal role. Safe water supply is not always available in the less developed regions of the world, where water borne diseases represent a significant public health threat [Friis, 2007]. Even piped water which is available in big cities gets mixed with number of impurities causing jaundice, cholera, typhoid and gastroenteritis etc. [Kudesia, 1980].

Fig. 3. Washing of utensils in dir t y water.

Fig. 4. Open drainage in Garden Reach, Kolkata.


R.B. Singh, Md. Senaul Haque, Aakriti Grover

DRINKING WATER, SANITATION AND HEALTH...

Table 6. Water borne diseases in Kolkata Acute Diarrhoeal Disease (Include acute gastroenteritis) 2012 Narkeldanga Dispensary 24 50 103 103 280 Total Ultadanga Rajabazar Dispensary Dispensary 13 36 118 26 193 55 76 95 64 290 92 162 316 193 763 Bacillary Dysentery Total Ultadanga Dispensary 76 129 172 129 506 Rajabazar Dispensary 0 0 0 0 0 76 129 172 129 506

Narkeldanga Dispensary 0 0 0 0 0

January February August September Total

Source: Kolkata Municipal Corporation, 2012.

According to Wor ld Health Organization Repor t [2004], 88 per cent of diarr hoeal diseases are attributed to poor sanitation and hygiene, lead to 1.8 million deaths per year. Children under five years of age comprise 90 per cent of these deaths. Young children have little time to adapt physiologically to local disease causing pathogens, which make them practically susceptible. According to Shanmuganandan [1999], around 105 million children under 5 years of age die each year due to water bor ne diseases and I ndia experienced a loss of 200 million man-hours a day every year because of these diseases. I n K olk ata, the data on diseases from dispensar ies cov e r ing Nar k eldanga Dispensar y, Ultadanga Dispensar y and R a jabazar Dispensar y r e v e al that the patients with acute diarrhoeal diseases (include acute gastroenteritis) and bacillary dysenter y occupying major share among other diseases (Appendix 2). These are water borne diseases resulted due to consumption of contaminated drink ing water and nonavailability of sufficient water for drinking and sanitation purposes at household level. The dispensaries are the destination for medical check-up mainly follows by those residing in slums and having poor living standards where they get their treatment with free of cost. There are more than 25 major dispensaries and many more minor dispensaries operating throughout K olk ata and these are fully aided by KMC. It has been inferred that the

patients with acute diarrhoeal diseases are present in almost all the stated dispensaries while the patients with dysenter y are mainly concentrat ed in Ultadanga dispensar y. The concentrations of patients with water borne diseases have found few in number in the month of Januar y (92 with diarrhoeal infection and 76 with dysenter y) while it is higher in the month of August (316 with diarrhoeal infection and 172 with dysenter y) ( Table 6). The more concentration of patients in the month of August may be due to the monsoonal rainfall where the rainwater get mixed with the municipal piped water through broken pipes and leakages and thus contaminate the water at its sources of supply. Therefore, the direct consumption of water supplied through the broken municipal pipes with mixed impurities may result into several water borne diseases. MEASURES FOR SUSTAINABLE WATER MANAGEMENT Water is one of the basic resources as it is essential for the ver y existence of human life. The use of water is manifold i.e. domestic, industr ial, recreational and for aesthetic purposes. Among the various facets of uses of water, the availability of good quality water for consumption is of utmost importance for sustenance of human life and for healthy wellbeing. Supplying safe drinking water is therefore an important issue for sustainable dev elopment which r equir es explicit

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74 SUSTAINABILIT Y

Fig. 5. Municipal supply of tap water in Kolkata.

emphasis on quality. Following are some of the measures which could be made functional in bringing sustainability for water resources in Kolkata: Availability and accessibility of safe drinking water The problem regarding the water in Kolkata is poor availability of drinking water at the household level as the supply of water is low. The ever increasing size of the population and their demand for potable drinking water has always been a big problem for KMC to successfully cope up. Therefore, securing the availability of safe drinking water must be taken as a fundamental issue to bring sustainability in the society. Connect household with processed municipal tap water In an urban environment the slum dwellers are seldom connected with the municipal supply of piped water system. In Kolkata, the urban poor are living in a condition where there is less connectivity of piped water within the premises as well as near premises. Therefore, all households especially the slums need to be connected with the piped water so that the requirement of water can be fulfilled at

the domestic level and the contaminations of water get controlled (Fig. 5). Minimize the wastage of water: practice inclusive use of water In Kolk ata, one of the major drawbacks of the water supply is the wastage of water from the direct tap water (Fig. 6). The water supplied through KMC gets wasted without its proper utilization and even reaching to the beneficiaries. This wastage of water must be stopped by tak ing strict action. Proper utilization of water must be practised at every stage as the wastage of water at one place will create scarcity in another place. So, for the enhancement of sanitation and healthy well-being, an inclusive use of water should be the main focus for the urban planner and municipal supplier of water resources. Improvement in sewage treatment and disposal Sewage treatment plant helps in removing the contaminants from wastewater including household sewage and runoff. I t produces environmentally safe fluid waste suitable for disposal and reuse. With suitable technology, it is possible to re -use sewage effluent for drinking and sanitation purposes. Therefore, by looking at the utility, the establishment and


R.B. Singh, Md. Senaul Haque, Aakriti Grover

DRINKING WATER, SANITATION AND HEALTH...

Fig. 6. Wastage of water from the tap in Kolkata.

proper functioning of sewage treatment plant is required. It will helps to curb the problem of shortage of water for drinking and sanitation purposes and can bring sustainability through making water available at the household level. CONCLUSION K olk ata is blessed with abundant water resources where the R i ve r Hugli is the biggest source of sur face water for human consumption after it gets filtered. Throughout Kolkata the water is supplied through piped water as a major source of water supply with underground water as a secondar y source. The t wo major problem regarding water supply in Kolkata are the availability of good qualit y water and its accessibilit y to the city inhabitants. Among the major sources of contamination of water, the release of industrial effluent to the water bodies without its proper treatment is the prominent one which is followed by domestic sewage and leak ages from piped line. The industr ial effluents may result into the contamination of underground water where the presence of leather industries in Tangra led to the lead

contamination to the nearby underground water. On the other hand, the leakage of pipe may contaminate the underground water and if continue for a long duration may also contaminate the sur face water. The solid wastes are disposed without taking proper care and when it rained, theplastic waste get choked with the mouth of the drain and resulted into flooding. Lack of availability and accessibility of sufficient water for drinking and sanitation purposes at the household level exert a great pressure in sustenance of human life. It has been noticed that due to absence of sufficient water for sanitation purposes at the household level, people are having their bath at roadside. These are ver y common phenomena for those living in the slums where they also use dirty water for washing the utensil. These are the serious health issues, where there is a need to focus in sufficient supply of water for sanitation purposes. In this regard, the role of KMC is of prime concern as municipalities are the custodian of main supply of water resources to the city inhabitants. On the other hand, the consumption of water with mixed

75 SUSTAINABILIT Y


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04 (08) 2015

impurities may result into several water borne diseases where acute diarrhoeal infection is the pressing one. It has been found that the patients with water borne diseases at dispensaries like acute diarrhoeal infection and dysenteries are quite alarming. Water borne diseases are mainly the outcome of consumption of contaminated drinking water and non-availability of sufficient water for proper sanitation. Measures such as; make REFERENCES

water available at household level, connect ever y household with proposed municipal tap water, minimize wastage of water and practice inclusive use of water are of prime significance in enhancing the availability and accessibility of water resources at household level. Once the problem with the availability of water for drinking and sanitation purposes gets controlled, the related health issues will be minimized at greater extent.

76 SUSTAINABILIT Y

1. Anthamatten, P. and Hazen, H. (2011). An Introduction to the Geography of Health. Routledge. Tayler and Francis Group. London and New York. 2. Asian Development Bank. (1997). Urban Infrastructure in Asian Countries. ADB, Manila. 3. Asian Development Bank. (2007). 2007 Benchmarking and Data Book of Water Utilities in India, In: Big Cities Big Water Big Challenges, Water in an Urbanised World, WWF Report 2011, WWF Germany, Berlin. 4. Bhandari, L. and Gupta, A. (2010). Inputs for Health. In: Mahal et al. (Eds.), India Health Report 2010, R.K. Books, New Delhi. 5. Brian, H.K. (1999). (Eds.), Water Resources: Health, Environment and Development. Taylor & Francis. London and New York. 6. Census of India. (2011). Provisional Population Totals, Paper 1 of 2011, West Bengal Series 20. Office of the Registered General and Census Commissioner, India. Ministr y of Home Affair. Government of India. 7. Central Pollution Control Board. (2013). Status of Water Quality in India-2011. Ministr y of Environment and Forests, Government of India, New Delhi. 8. Chacraverti, S., Dey, B.C., Mallick, S., Ghosh, R. and Mallick, S. (2011). The Kolkata Metropolitan Area: Probing for Four Toxic Metals in Drinking Water. Society for Direct Initiative for Social and Health Action (DISHA). 9. Chain, E.S. K. and Dewalle, F.B. (1976). Sanitar y Landfill Leachates and their Treatment. In: Municipal Solid Waste Management in Kolkata, India: A Review by Chattopadhyay et al. 2008, Waste Management, Vol. 29 (4), Pp. 1449­1458. 10. District Census Handbook. (2001). Census of India 2001. Registrar General and Census Commissioner, India. 11. Douglas, I. (1983). The Urban Environment. Edward Arnold (Publisher). Ltd., London. 12. Dudley, N. and Stolton, S. (2003). Running Pure: The Importance of Forest Protected Areas to Drinking Water. World Bank/WWF Alliance for Forest Conservation and Sustainable Use. In: Big Cities. Big Water. Big Challenges. Water in an Urbanised World, WWF Report 2011.


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DRINKING WATER, SANITATION AND HEALTH...

14. Ganguly, S. (2012). Leather Processing Industries Generate Effluents Causing Environmental and Water Pollution: An Asian Perspective. In: Water Pollution from Various Sources and Human Infringements: An Editorial. Indian Journal of Scientific Research and Technology. Vol. 1 (1). Pp. 54­55. 15. Ghosh, G.K. (2002). Water of India (Quality and Quantity). A.P. H. Publishing Corporation. New Delhi. 16. Government of India. (2002). India Assessment 2002: Water Supply and Sanitation. Planning Commission, GOI, New Delhi. 17. Gupta, S.K., Mitra, A. and Adhikari, S. (1990). Post Irrigation Effects of Calcutta Sewage Effluents on Soil and Vegetation. In: Impact Assessment on Various Parameters Polluting Ganga Water in Kolkata region: A Study for Quality Evaluation and Environmental Implication by Purkait et al. Environmental Monitoring Assessment. Vol. 155. Pp. 443­454. 18. Hasan, S., and Khan, M.A. (1999). Community Based Environmental Management in a Megacity Considering Calcutta. Cities, Vol. 16, (2). Pp. 103­110. 19. Hogland, W. and Marques, M. (2007). Sustainable Waste Management: International Perspective. In: Municipal Solid Waste Management in Kolkata, India: A Review by Chattopadhyay et al. 2008. Waste Management. Vol. 29 (4). Pp. 1449­1458. 20. Imperial Gazetteer of India. (1984). Provincial Series Bengal. Usha Publication, Ansari Road, Darya Ganj, New Delhi. Vol. 1. Pp. 393­421. 21. Jalan, J. and Ravellion, M. (2001). Does piped water Reduce Diarrhoea for Children in Rural India? Indian Statistical Institute. In: Mahal et al. (Eds.), India Health Report 2010. R.K. Books, New Delhi. 22. Kelley, W.E. (1976). Groundwater Pollution near a Landfill. In: Municipal Solid Waste Management in Kolkata, India: A Review by Chattopadhyay et al. 2008. Waste Management. Vol. 29 (4). Pp. 1449­1458. 23. Kolkata Municipal Corporation. (2012). Weekly Reports of Diseases at Narkelanga, Razabazar and Ultadanga Dispensar y. Government of West Bengal, India. 24. Krants, D. and Kifferstein, B. (1998). Water Pollution and Society (September 23, 2004); http://www.umich.edu. 25. Kudesia, V.P. (1980). Water Pollution: Principles of Disinfection of Drinking Water and its Analysis. Pragati Prakashan, Meerat, India. 26. Kundu, N. (2003). Understanding Slums: Case Studies for the Global Report on Human Settlements. Urban Slums reports: The Case of Kolkata, India. Institute of Wetland Management and Ecological Design, Kolkata.

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13. Friis, H. Robert. (2007). Essentials of Environmental Health. Jones and Bartlett Publishers. Sudber y, Massachusetts, USA.


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27. Mandal, M. (2007). Leachate from Municipal Solid Waste- Generation, Characteristics and Effects. In: Municipal Solid Waste Management in Kolkata, India: A Review, Chattopadhyay et al. 2008. Waste Management. Vol. 29 (4). Pp. 1449­1458. 28. Masters, G.M. (1998). Introduction to Environmental Engineering and Science. In: Municipal Solid Waste Management in Kolkata, India: A Review by Chattopadhyay et al. 2008. Waste Management. Vol. 29 (4). Pp. 1449­1458. 29. Mitra, A., Adhikari, S., Gupta, S.K. (1998). Pollution Metal Content of Vegetables Irrigated with Sewage Water. Journal of the Indian Society of Soil science. Vol. 46 (1). Pp. 153­155. 30. Planning Commission. (2002). India Assessment 2002, Water Supply and Sanitation. A WHO- UNICEF Sponsored Study. 31. Roy, J., Chattopadhyay, S., Mukherjee, S., Kanjilal, M., Samajpati, S. and Roy, S. (2004). An Economic Analysis of Demand for Water Quality : Case of Kolkata. Economic and Political Weekly. Vol. 39 (2). Pp. 186­192. 32. Segane, R. (2000). Water Management in Mega-Cities in India: Mumbai, Delhi, Calcutta, and Chennai. Water for Urban Areas, Challenges and Perspectives. United Nations University Press. In: Big Cities Big Water Big Challenges. Water in an Urbanised World. WWF Report 2011, WWF Germany, Berlin. 33. Shaban, A. and Sharma, R.N. (2007). Water Consumption Pattern in Domestic Households in Major Cities. In: TERI Environmental Sur vey, 2013. The Energy and Research Institute, India Habitat Centre, New Delhi, India. 34. Shanumganandan, S. (1999). Water Quality, Water Resources and Health Water Quality in Relation to Human Health: A Study with References to Water Borne Diseases and Major Environmental Issues in Indian Subcontinent. Working Paper, Madurai Kmaraj University, India. 35. Shreashtha, L.B. (2006). Life Expectance in the United States. Congregational Research Service. In: Mahal et al. (Eds.), India Health Report 2010. R.K. Books, New Delhi. 36. Sobsey, M.D., Handzel, T., Venczel, L. (2003). Chlorination and Safe Storage of Household Drinking Water in Developing Countries to Reduce Waterborne Diseases. In: Diarrheogenic Escherechia Coli in Potable Water Source of West Bengal, India by Batabyal et al. Acta Tropica. Vol. 127. Pp. 153­157. 37. Tata Energy and Research Institute. (2013). TERI Environmental Sur vey. TERI. India Habitat Centre, New Delhi, India. 38. The Energy and Research Institute. (2003). The Energy Data Director y and Yearbook 2002­03. TERI, New Delhi. 39. Tibbetts, J. (2000). Water World 2000. Environmental Heath Perspective, Vol. 108. Pp. A69­A73. 40. USEPA. (1999). Drinking Water and Health: What You Need to Know! United State Environmental Protection Agency. Available at: http://www.epa.gov/safewater/ dwh/dwhealth.pdf.


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42. Water Supply and Sanitation Collaborative Council ( WSSCC). (2002). It's the Big Issue. Available at http://www.wsscc.org. 43. West Bengal Pollution Control Board. (2011). Annual Report 2010­11. WBPCB, Government of West Bengal, Kolkata. 44. White, G.F., Bradley, D.J. and White A.U. (1972). Drawer of Water: Domestic Water Use in East Africa. In Mahal et al. (Eds.), India Health Report 2010. R.K. Books, New Delhi. 45. WHO. (2004). Water, Sanitation and Hygiene Links to Health. World Health Organisation. Available at: www.who.int/water_sanitation_health/facts2004/en. 46. WHO. (2009). World Health Statistics. In Mahal et al. (Eds.), India Health Report 2010. R.K. Books, New Delhi. 47. World Bank. (2006). India Inclusive Growth and Ser vice Deliver y : Buildings on India's Success. Development Policy Review. In Mahal et al. (Eds.), India Health Report 2010. R.K. Books, New Delhi. 48. World Bank. (2011). Vulnerability of Kolkata Metropolitan Area to Increased Precipitation in a Changing Climate. Environment, Climate Change and Water Resources Department, South Asia Region. Document of the World Bank. 49. WWF. (2011). Big Cities Big Water Big Challenges. Water in an Urbanised World. World Wide Fund for Nature. WWF Germany, Berlin. Received 29.10.2015 Accepted 06.11.2015

Appendix 1. Indian Standard (IS) Specifications for Drinking Water Sl. No. 1 2 3 4 5 6 7 8 9 10 11 Parameters Total pesticide (ppb) Arsenic (mg/l) BOD (mg/l) Mercury (mg/l) TDS (mg/l) Temperature pH Nitrate (mg/l) Faecal Coliform Total Coliform Fluoride (mg/l) Desirable Limit Absent 0.05 30 0.001 500 5 °C 6.5­8.5 45 < 2500MPN/100 ml < 5000 MPN/100 ml 0.6­1.2 No Relaxation ­ ­ 1.5 Bitter taste, affects aquatic life. Algal growth, blue baby disease. Gastrointestinal illness. Gastrointestinal illness. Dental and skeletal fluorosis. Permissible Limit No Relaxation No Relaxation 100 No Relaxation 2000 Highly Toxic, causes minamata' disease, neurological impairment. Undesirable taste, gastro intestinal irritation. Health Effects Affect Central Ner vous system. Toxic, Carcinogenic, Affect Central Ner vous system.

Source: Indian Standard, 10500­1991.

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41. Walker, W.H. (1969). Illinois Groundwater Pollution. In: Municipal Solid Waste Management in Kolkata, India: A Review by Chattopadhyay et al. 2008. Waste Management. Vol. 29 (4). Pp. 1449­1458.


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Appendix 2. Major Diseases at Dispensaries in Kolkata Bacillary Dysentery Total R* 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 16 129 41 234 265 122 889 42 268 172 995 1625 542 668 423 210 1843 62 356 370 51 156 402 193 315 1090 240 284 240 290 1054 24 237 401 138 33 111 302 223 636 776 751 1041 3710 1050 1186 928 622 3786 2 135 150 221 506 129 351 684 923 1958 11 92 96 121 210 227 746 315 322 241 266 1144 25 59 147 189 395 2 36 100 0 132 159 203 365 859 423 414 300 275 1412 21 94 190 210 494 3 33 41 105 195 263 563 4 1 26 28 45 140 81 77 112 109 136 515 194 245 270 302 1011 42 93 152 261 506 2 30 41 76 165 485 747 1397 4 104 80 188 73 31 64 83 251 173 305 392 522 728 2120 932 981 811 843 3567 23 26 110 109 245 0 15 13 28 14 59 157 226 442 0 30 39 69 9 17 54 26 28 25 30 109 0 0 0 0 0 0 0 0 0 0 0 17 25 97 178 300 2 25 0 27 10 22 55 121 234 410 2 34 28 64 18 0 0 0 0 0 0 57 0 0 57 230 0 0 0 0 230 0 0 0 0 0 N* U* R* N* U* Total Malaria Total R* 0 11 0 0 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 18 21 9 17 65 26 85 25 30 166 230 0 0 0 0 230 0 0 0 0 0 N* 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 129 16 30 41 42 172 62 51 24 33 2 129 25 21 41 42 76 23 14 17 22 U* Fever of Unknown Origin (PUO)

2012

Acute Diarrhoeal Disease (Include acute gastroenteritis) N* U* R*

Total

Acute Respiratory Infection N* U* R*

Total

1st week

5

5

23

33

2nd week

8

4

6

18

January

3rd week

5

2

18

25

4th week

6

2

8

16

Total

24

13

55

92

1st week

3

8

17

28

2

February

week 3rd week

nd

10

15

24

49

12

7

16

35

GEOGRAPHY. ENVIRONMENT. SUSTAINABILITY.

4th week

25

6

19

50

Total

50

36

76

162

1st week

19

50

23

92

2nd week

18

12

27

57

3 week

rd

16

13

7

36

August

4th week

21

17

20

58

5th week

29

26

18

73

Total

103

118

95

316

1st week

23

9

19

51

2nd week

22

2

19

43

3 week

rd

23

8

23

54

September

4th week

35

7

3

45

04 (08) 2015

Total

103

26

64

193

Note: N* Narkeldanga Dispensar y, U* Ultadanga Dispensar y, R* Razabazar Dispensar y. Source: Kolkata Municipal Corporation, 2012.


R.B. Singh, Md. Senaul Haque, Aakriti Grover

DRINKING WATER, SANITATION AND HEALTH...

R.B. Singh is Vice-President, International Geographical Union (IGU)), Head, Department of Geography, University of Delhi, India; Member, IUGG-IGU Committee of the Indian National Science Academy ; Springer Series Editor Advances in Geographical and Environmental Sciences. He is representing IAP­Global Network of Science Academies in the UNISDR Science and Technology Conference. He was awarded prestigious JSPS Research Fellowship at Hiroshima. Dr. Singh has specialized in Environmental Studies, Climate Change, Urban Regional Development, Disaster Management, Remote Sensing and GIS. He has to his credit 39 research volumes/books and more than 194 research papers published in national and international journals. In 1988 the UNESCO/ ISSC (Paris) awarded him Research and Study Grants Award in Social and Human Sciences. He was also associated with prestigious international research programs such as ICSSRIDPAD, CIDA-SICI, DFID and Ministr y of Agriculture. He has super vised 30 Ph. D. and 72 M. Phil students. He was also associated with NIAS, Copenhagen in 1998 and Visiting Professor at the University of Turku (Finland). He was also associated as one of the contributors in the famous-The World Atlas-Earth Concise, Millennium House Ltd., Australia.

Md. Senaul Haque is currently a Ph. D. Research Scholar in Department of Geography, Delhi School of Economics, University of Delhi, India. He obtained his M. Phil degree from University of Delhi in 2015. He is the recipient of University Merit Scholarship under the Faculty of Science in M.A. for the period of 2010­2012. He also occupied the post of Secretary, A.M.U Geographical Society for the session 2010­2011 in Department of Geography, Aligarh Muslim University. His area of interest for the research is Urban Environment and Human Health where it focuses on epidemiologic assessment of respiratory diseases among the city inhabitants.

Aakriti Grover is an Assistant Professor of Geography at the Swami Shraddhanand College, University of Delhi. She is also a research scholar at the Department of Geography, Delhi School of Economics, University of Delhi, India. Her research interests include Urban Environment and Urban Health.

81 News and Reviews


82 News and Reviews

GEOGRAPHY, CULTURE, AND SOCIE T Y FOR OUR FUTURE EARTH
INTERNATIONAL GEOGRAPHIC AL UNION CONFERENCE IN MOSCOW, 17­22 AUGUST 2015

I n 2015 (from August 17 to 21), Moscow hosted the Regional Conference of the International Geographical Union (IGU) for the third time since the International Geographical Congress of 1976, when over 2,000 participants from around the world gathered in the Soviet capital for lectures, discussions, workshops, and excursions. The motto of the conference was "Geography, Culture, and Society for our Future Earth". The IGU 2015 conference was preceded by the IGU Congress took place in Cologne in 2012 and the IGU regional conferences in Tel Aviv (2010), Santiago (2011), Kyoto (2013), and Krakow (2014). The IGU 2015 Regional Conference was organized by the Faculty of Geography of Lomonosov Moscow State University, the Institute of Geography of Russian Academy of Sciences, and the Russian Geographical Societ y. I ts v enue was M oscow Stat e University. It gathered 1658 participants from 73 countries. Naturally, Russian geographers r epr esent ed the lar gest g r oup ­ 764 par ticipants. Many par ticipants came from China (173), India (90), USA (57), Germany (38), Spain (28), and Brazil (28) ( Table 1). The "IGU Moscow 2015" was focused on five main themes: Urban Environment, Polar Studies, Climate Change, Global Conflict, and Regional Sustainability. The program was based on

principles of diversity and interdisciplinar y exchange. It featured a variety of meetings, including plenar y sessions, lectures, panel discussions, workshops, and other events. The conference had 32 working Commissions. A number of "thematic" sessions were held on the initiative of separate scholars and research teams. Oral sessions were composed of three, four, or five presentations. When three or four presentations took place in a single time slot, the duration of each presentation was set at 20 minutes with a shor t discussion after each presentation. When five presentations took place in a single time slot, the duration of each presentation was set at 15 minutes with a 5-minute -long discussion after each presentation. K ey note and interdisciplinar y " thematic " lectures were in the focus of the conference and were attended by many par ticipants. Professor Gordon Macbean (Canada), a wellknown climatologist and President of ICSU, discussed different views on the problem of climate change and its challenges to the international scientific community and in particular the program "Future Earth". Professor Georg Gar tner (Austria), President of the International Cartographic Association, talked about the role of cartography in contemporary


S.R. Chalov, V.A. Kolosov

GEOGRAPHY, CULTURE, AND SOCIE T Y...
Table 1. List of countries by attendance

Country

Number of participants 764

Country

Number of participants 22

Country

Number of participants 12

Country

Number of participants 8

Russian Federation China India Japan United States of America Germany

Canada

Romania

Saudi Arabia

173 90 59 57

South Africa Italy Mexico Turkey

22 21 20 20

Finland Australia Iran Portugal

10 9 9 9

Poland Czech Republic Egypt Singapore

8 7 7 7

38

Republic of Korea United Kingdom Israel Switzerland

17

Netherlands

9

Hungar y

6

Spain

28

17

Belgium

8

Kazakhstan

6

Brazil France

27 24

15 11

Indonesia Nigeria

8 8

Nor way Sweden

6 6

society. Benno Werlen (Germany), Chair of the IGU Commission on Cultural Approach in Geography and Coordinator of the International Year of Global Understanding, informed the audience about the progress of this ambitious project initiated by the IGU. Professor John O'Loughlin (USA), one of the world leading political geographers, focused his presentation on the results of a large interdisciplinary project on the impact of global change on violence in Africa. Professor Alexander Murphy, former President of the Association of American Geographers, raised the question of the future of geographical disciplines facing dynamic transformations in society and environment. Professor Solomon Kroonenberg (the Netherlands) discussed the problem of geographical forecasts and predictability using the case of the Caspian Sea. Professor Valery Tishkov, the most prominent figure in the studies of identities, ethnology, and cultural anthropology in Russia, entitled his lecture "Culture Complexity of Contemporary Nations". Professor Vladimir Kolosov, President of the IGU, summarized specific features and the main trends in the development

of geography in Russia. Professor Shirlena Young (Singapore) offered a key lecture on the achievements of the IGU Commission on Gender in Geography which was recognized the most active IGU Commission in 2014. The lec tures g i v en by Professors K arl Doner t (UK , President of Eurogeo), CÈline Rozenblat (Switzerland), Elena dell'Agnese (I taly), Takashi Yamazaki ( Japan), Cosimo Palagiano (I taly), Brad Coombes (New Zealand), Melinda Laituri and Lee Schwartz (USA), and Ale xander Pely aso v and Nadezhda Zamiatina (Russia) were related to diverse themes of interest to experts and gathered full classrooms. A special room was designated specifically for the social program and contained pr esentations of var i ous geog raphical enter pr ises and institutions, conference partners, and exhibitors. Geographical education and integration of young scholars was central to each of the Conference themes. The program included special events:

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"The Day of Young Scholars", with a competition for the best presentation and other awards; a master Class "Fundraising and Writing Proposals" (led by Andrey Petrov and Dmitry Streletskiy; YES Network ­ IGU joint Session "Geoheritages, a Recorder of the Global Change Along the Silk Road for Future Sustainable Development" (led by Meng Wang); a panel discussion "The Role of Young Researchers' Networks in Shaping the Future of Geographical Sciences"; and a videotraining workshop "Improving Your Presentation Skills" (by Joos Droogleever FORTUIJN and Joop van der SCHEE). To support attendance by young scientists, the Local Organizing Committee grants were given to postgraduate students and early career scientists from low income countries (50 in total).

The Commission on Geographical Education held the Day of Geography Teacher together with the Russian Association of Geography Teachers. Special sessions included "Academic Geography for Secondar y Schools" and " Teaching Geography in the Universit y ". The "IGU Moscow " also conducted the 2015 International Geographical Olympiad. The IGU 2015 Or ganising C ommitt ee encouraged Co nference par t icipants to enjoy campus tours and a variety of other excursions in and around Moscow. Following the conference, there was a series of trips to St. Petersburg and Kazan. Sergey R. Chalov, Vladimir A. Kolosov


HEALTH MANAGEMENT.
A MEDICAL GEOGRAPHICAL PERSPEC TIVE
At the conclusion of the eleventh meeting, held in "Sala delle Adunanze" in Palazzo Manzoni, home of the Depar tment of Humanities ­ Languages, Literature and Civilization ancient and modern at the University of Perugia in December 2014, I think it is necessary and useful to give some interesting results to the national and international scientific community.

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First of all I would like to make some general reflections on medical geography seminars taking place now for over 30 years and whose acts are regularly published. I would like to point out, with some pride, that we had come so far from when in Rome, in the wonder ful setting of Villa Mirafiori, where Gabriella Arena and Cosimo Palagiano, thanks to their intuition, started, with diligence and determination this path: none knew that we could get for now, until 2014. During this last seminar, I noticed with pleasure the presence of friends, old and new, that I would like to thank: the first to have been close throughout this period, the other for having accepted our invitation with enthusiasm, enriching this workgroup. In the context of clearly defined and equal relationship between man and the environment, which for Medical Geography can be expanded to include relationships that are established between society, territory and the disease, find full realization that it can be compared to the State of human health.1 That realit y includes many implications that affect, inevitably, on the social level, population, settlement, economic, political, ethical, ... whole populations, with important and inevitable effects on the entire range of human activity. As a result, the relationship between health and medical facilities is strong, at first for their presence and accessibility in the context of territorial reference, and after for the many consequences that can generate not only on the general framework of help to those who need it the most but also for the oppor tunity to put in place preventive
1 The problems associated with the disease and its treatment, which at first glance might seem closely related to specific fields of disciplines such as medicine, epidemiology, hygiene, ... also greatly affect the work of the geographer especially because they are increasingly close reports that tend to establishment and intertwining between medicine and geography, as they fall into that sphere which highlights the relationship between man and environment. Geography, understood primarily as a science of synthesis, looking, in fact, to identif y the relationships that interact between man and the environment. Therefore man should be seen in the complex of multiple interventions that creates the environment and the specific events that are to affect the socio-economic life of the same individual, but also of entire communities; in this context it cannot be ignored by a particular state of man, what the disease, because of the huge inter-generating against the company and, consequently, fall in the same territory.

measures designed to protect and safeguard the health of entire communities. In fact, not just the weak and marginalized to need the help and the support of others, and among them, are there those whose health is in danger or has already been lost, most in need of care and assistance? That's why this issue is fully relevant with the peculiarities inherent in the concept of health.2 In a ver y simple ecosystem it is easier to find cause - effec t than complex systems with radical transfor mation of an increasingly artificial plus the changed conditions of life and relationship between human groups. However, it should also be pointed out that in such systems, the company ­ this is the cohort targeted by the Medical Geography which is not so interested in the "health" of the individual, as that of the entire human group that lives in that territor y ­ has provided to achieve strong changes in environments favorable to the development of infections, not separat ed fr om the fundamental development of medicine, with drugs and techniques more and more advanced, it aims to control the disease, even those which lack the triggers, so to note that today, in the more developed countries, people live better and longer lives but more with the disease, unlike the situation that exists in those developing countries where the whole society undergoes strong and mortality rates indigence. This can be appropriately synthesized with the phenomenon that Palagiano simply called "health ar tificial" and that has its points in the best conditions of life determined not only by an improved relationship of human
2 Health is a state of complete physical, mental and social, not just a mere absence of disease or infirmit y. The enjoyment of the highest at tainable standard of health is one of the fundamental rights of ever y human being without distinc tion of race, religion, and political belief, economic or social condition. The health of all peoples is fundamental to the achievement of peace and securit y and is dependent on the broader coop eration of individuals and States. The commitment of ever y State in the promotion and protec tion of health is useful for the world. The unequal development among countries in the promotion of health and control of communicable diseases is a danger to ever yone.


Giovanni De Santis

HEALTH MANAGEMENT. A medical geographical perspective

groups with the environment ­ especially in countries with Advanced Development ­, the introduction of external factors such as medications, diets, diets and healthier life, spor ts practices, reduction of smok ing cigarettes or drugs, spor ts and/or in the open air..., which add health and surgical interventions offered by health facilities. Sure, there would never be the aim of the giving assistance and help those who are fine and have a good quality of life. If, then, of those suffering from disease or malnutrition or other diseases or in ser ious financial difficulties, often due to serious conditions, the help that is given without receiving something in return is required to be crucial for better quality of life. Closely connec ted with what has been said is the theme proposed and developed during the work of the Eleventh International Seminar, about health management, at which inter ventions have focused mainly on how health is managed in health care systems

in the world, both for the enormous impact that creates the person and, consequently, the whole society, and for the possibility of access to all facilities of care and protection even and especially against those who are in trouble and needs help. The work was divided into three main sessions: FIRST SESSION ­ General aspects (related to health, human, law, economics, social, territor y...) linked to health management as a way to promote and improve the quality of life. The first session intended to focus in a general way about how the health protection depends almost completely on the management of health ser vices and about their accessibility. Particularly it focused on the effects on society in a way to create an improvement of health conditions and wellness of the subjects that are studied, both the ones that are objects of solidarity as the ones that make this behavior leave.

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SECOND SESSION ­ Health management in different health systems. The session intended to know more about the role and the differences that work in several systems in each countr y deter mined on health protection and on the uses of services, not forgetting That in a lot of cases we are facing a real and proper industr y that takes advantage of pain of people, with consequent economical management of the funds and political development on a big scale. THIRD SESSION ­ The practical applications and the impact on the community determined by the type of service operating at the local level in relation to the combination of public/ private. This session examined , how e v e r, the prac tical effec ts that different t ypes of health management can have on society both in health, both at the local level, since the presence of shelters of ten leads to urbanization and territorial transformations.

Common background, which allows tracking of a unit within the various contributions, has been the intent to focus on the relationship between health management and the types of health services in the context of a world in full globalization and in which the differences of health care in place in highly developed countries and those in the developing world are increasingly tending to increase, partly because of the serious economic and financial crisis that for several years affects the entire Earth system. The review made according to the global, found a full accomplishment in the many r e f e r ences t o local situations in r ich countries, which is a trend to a progressive differentiation in health management that goes hand in hand with the growth of the gap bet ween the lower classes and the economically better-off. The comparisons resulted in the vastness of these issues was possible thank to the convinced participation of many colleagues, Italian and foreigners, old and new scholars in


Giovanni De Santis

HEALTH MANAGEMENT. A medical geographical perspective

the discipline of Medical Geography: what came out from the reports presented and discussions, has found its rightful place in the volume of Acts3 that collects, in over 550 pages of text, as many as 41 papers published in the language of presentation and equitably distributed in sections which the jobs were divided. At a methodological level, charac ter istics of the A c ts ar e mainly good internationalization of the topics and the constant int er disciplinar y 4 : nex t t o the contribution of foreign scholars and I talian colleagues ha v e shown that while the I talian situation and that of other countries, should be recorded, lik e the presence of not only geographers, but also doc tors,
3 Giovanni De Santis (a cura di), Gestione della Salute, "At ti dell'Undicesimo Seminario Internazionale di Geografia Medica (Perugia, 18­20 dicembre 2014)", Perugia, Edizioni Guerra, 2015, pp. 552, ISBN 978-88-557- 0553- 0. 4 It is wor th citing, as an example, the contention in key pedagogical and philosophical, Chiara De Santis (pp. 133­146): "The discussion about what actually can be referred to as `health', it is more open than ever and current, especially since the given the profound change recorded by the epidemiological picture in recent years, with the increasing prevalence of chronic diseases and the need to revise the concept of health, in terms of dynamic balance bet ween the individual and the environment. Critical reflection of this debate is ex tremely relevant to an assessment of health management in all its complexit y. In par ticular, it is noted as the contribution of the human sciences, and pedagogical reflection in par ticular, from the account of the act of education as a process of increasing par ticipation of the population and of the individual to protect his health."

epidemiologists, historians, archaeologists, economists , sociolog ists , philosophers , psy cholog ists who ha v e per mission t o enlarge the field of investigation and the possibilit y of enhanced interac tion with the methodolog ies of other disciplines. Both fe atures are appreciat ed thanks t o the interesting discussions that followe d the different repor ts, whose faithful and accurate transcription opens the volume. Very satisfying and very important ­ this is an element that has always characterized the seminars ­ was also see the significant presence of so many young people, with results extremely flattering, are catching up, some for the first time, the issues of medical geography, finding in it a fertile ground for discussion. The volume is a worthy conclusion Appendix represented Catalogue decades of repor ts presented in previous seminars, in 1982 to 2012, which lists the titles of more than 600 papers discussed at meetings and published in the Proceedings. It is an important reference tool that can offer multiple interpretations, helping to put once again to light the remarkable and consistent interdisciplinary approach that has always characterized this discipline. Giovanni De Santis

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MEDICAL-GEOGRAPHICAL ATLAS OF RUSSIA "NATURAL-FOCAL DISEASES"
(Edited by S.M. Malkhazova. ­ Faculty of Geography, Lomonosov Moscow State University, Moscow, 2015. ­ 208 .) Natural-focal disease prevention is one of the most impor tant problems of public health. The agents and vec tors of these diseases are par t of natural landscapes and the spread of these diseases, which may be a serious hazard for the population, is deter mined by natural fac tors. Therefore, medical geography has an impor tant task: evaluating the risk of epidemic hazard of natural ecosystems and providing public health authorities with recommendations necessar y to prevent disease outbreaks and conduct epidemiological sur veillance. Considering the impor tance of the problem, a team of researchers at the Facult y of Geography of Lomonosov M oscow State University (Russia) has published a Medicogeographical Atlas of Russia "Natural-Focal Diseases" ­ a first cartographic generalization of diverse and multifaceted infor mation about diseases caused by agents circulating in natural en vir onment independently from humans. The spatial distr ibution of natural-focal diseases is consider e d at different hierarchic levels. I n the readily understandable way the Atlas informs about their historical and current distribution in Russia, epidemiological aspects, natural and socio - economic deter minants conducing natural foci. The ser ies of maps depic ts population morbidity rates in the par ticular re gions as well as countr y wide in 21st


T.A. Trifonova

MEDICO-GEOGRAPHICAL ATLAS OF RUSSIA "NATURAL-FOCAL DISEASES"

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centur y. The publication features numerous color illustrations and or ient ed t o ward mainstream audience. The Atlas has fiv e thematic blocks and more than 100 maps . The I ntr oduc t o r y sec tion covers the theor y of natural-focal infections and invasions as a complex set of interdependent populations of pathogens, animal hosts and ar thr opod v e c t ors that r epr esent a biolog ical component organically bound with natural ter r itor ial complexes. Also, this block consists of the comprehensive information on the scientificmethodological and prac tical exper ience of the national medico - geog raphical mapping and on the car tographic coverage of natural focal diseases in Russia. The Natural and Socio - economic C onditions block compr ehensiv ely descr ibes the charac te r istics and cur rent conditions of the natural en vironment that influence the f o r mation and func tioning of the parasit ogenic disease syst ems (agent ­

vec tor­host) in the territor y of the Russian Federation and also includes maps on the patt er ns of the population distr ibution within the Russian t e r r i t o r y and on its demographic indices. The Natural Hosts and Vectors of Natural-Focal Diseases block contains the maps of geographic ranges of animals - potential hosts of infec tions. The Spread of Pr imar y Natural Focal Diseases block contains the description of 23 primar y natural focal diseases of Russia along with maps based on the official statistics, showing the average long-term incidence of cer tain natural-focal infec tions and their multiannual dynamics. The Organization of Public Health System block re flec ts the spatial structure of public health ser vice in Russia. The Atlas can be of interest for geographers, environmental workers, epidemiologists and other specialists invested in environmental and public health issues. Tatiana A. Trifonova


AIMS AND SCOPE OF THE JOURNAL The scientific English language jour nal "GEOGRAPHY, ENVIR ONMENT, SUSTAINABILIT Y " aims at infor ming and cover ing the results of research and global achievements in the sphere of geography, environmental conser vation and sustainable development in the changing wor ld. Publications of the jour nal are aimed at foreign and Russian scientists ­ geographers, ecologists, specialists in environmental conser vation, natural resource use, education for sustainable development, GIS technology, car tography, social and political geography etc. Publications that are interdisciplinar y, theoretical and methodological are par ticular ly welcome, as well as those dealing with field studies in the sphere of environmental science. Among the main thematic sec tions of the jour nal there are basics of geography and environmental science; fundamentals of sustainable dev elopment; environmental management; environment and natural resources; human (economic and social) geography ; global and regional environmental and climate change; environmental regional planning; sustainable regional development; applied geographical and environmental studies; geo-informatics and environmental mapping; oil and gas exploration and environmental problems; nature conser vation and biodiversity ; environment and health; education for sustainable development.

GENERAL GUIDELINES 1. Authors are encouraged to submit high-quality, original work: scientific papers according to the scope of the Journal, reviews (only solicited) and brief articles. Earlier published materials are accepted under the decision of the Editorial Board. 2. Papers are accepted in English. Either British or American English spelling and punctuation may be used. Papers in French are accepted under the decision of the Editorial Board. 3. All authors of an article are asked to indicate their names (with one forename in full for each author, other forenames being given as initials followed by the surname) and the name and full postal address (including postal code) of the establishment(s) where the work was done. If there is more than one institution involved in the work, authors' names should be linked to the appropriate institutions by the use of 1, 2, 3 etc superscript. Telephone and fax numbers and e-mail addresses of the authors could be published as well. One author should be identified as a Corresponding Author. The e-mail address of the corresponding author will be published, unless requested other wise. 4. The GES Journal style is to include information about the author(s) of an article. Therefore we encourage the authors to submit their photos and short CVs.

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5. The optimum size of a manuscript is about 3 000­5 000 words. Under the decision (or request) of the Editorial Board methodological and problem ar ticles or reviews up to 8 000­10 000 words long can be accepted.

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6. To facilitate the editorial assessment and reviewing process authors should submit "full" electronic version of their manuscript with embedded figures of "screen" quality as a .pdf file. 7. We encourage authors to list three potential expert reviewers in their field. The Editorial Board will view these names as suggestions only. All papers are reviewed by at least two reviewers selected from names suggested by authors, a list of reviewers maintained by GES, and other experts identified by the associate editors. Names of the selected reviewers are not disclosed to authors. The reviewers' comments are sent to authors for consideration. MANUSCRIPT PREPARATION Before preparing papers, authors should consult a current issue of the journal at http://www. geogr.msu.ru/GESJournal/index.php to make themselves familiar with the general format, layout of tables, citation of references etc. 1. Manuscript should be compiled in the following order: authors names; authors affiliations and contacts; title; abstract; key words; main text; acknowledgments; appendices (as appropriate); references; authors (brief CV and photo) 2. The title should be concise but informative to the general reader. The abstract should briefly summarize, in one paragraph (up to 1,500 characters), the general problem and objectives, the results obtained, and the implications. Up to six keywords, of which at least three do not appear in the title, should be provided. 3. The main body of the paper should be divided into: (a) introduction; (b) materials and methods; (c) results; (d) discussion; (e) conclusion; (f ) acknowledgements; (g) numbered references. It is often an advantage to combine (c) and (d) with gains of conciseness and clarity. The next-level subdivisions are possible for (c) and (d) sections or their combination. 4. All figures (including photos of the authors) are required to be submitted as separate files in original formats (CorelDraw, Adobe Photoshop, Adobe Illustrator). Resolution of raster images should be not less than 300 dpi. Please number all figures (graphs, charts, photographs, and illustrations) in the order of their citation in the text. Composite figures should be labeled A, B, C, etc. Figure captions should be submitted as a separate file. 5. Tables should be numbered consecutively and include a brief title followed by up to several lines of explanation (if necessary). Parameters being measured, with units if appropriate, should be clearly indicated in the column headings. Each table should be submitted as a separate file in original format (MS Word, Excel, etc.). 6. Whenever possible, total number of references should not exceed 25­30. Each entr y must have at least one corresponding reference in the text. In the text the surname of the author and the year of publication of the reference should be given in square brackets, i.e. [Author1, Author2, 2008]. Two or more references by the same author(s) published in the same year should be differentiated by letters a, b, c etc. For references with more than two authors, text citations should be shortened to the first name followed by et al.


7. References must be listed in alphabetical order at the end of the paper and numbered with Arabic numbers. References to the same author(s) should be in chronological order. Original languages other than English should be indicated in the end of the reference, e.g. (in French), (in Russian) etc. Journal references should include: author(s) surname(s) and initials; year of publication (in brackets); article title; journal title; volume number and page numbers. References to books should include: author(s) surname(s) and initials; year of publication (in brackets); book title; name of the publisher and place of publication. References to multi-author works should include after the year of publication: chapter title; "In:" followed by book title; initials and name(s) of editor(s) in brackets; volume number and pages; name of the publisher and place of publication. All references in Cyrillic should be transliterated (please use http://www.translit.ru); English translation of the name of publication is given in square brackets after its transliteration. 8. Authors must adhere to SI units. Units are not italicised. 9. When using a word which is or is asserted to be a proprietar y term or trade mark, authors must use the symbol ® or TM. 10. As Instructions for Authors are subjected to changes, please see the latest "Example of manuscript style" at http://www.geogr.msu.ru/GESJournal/author.php MANUSCRIPT SUBMISSION Authors are encouraged to submit their manuscripts electronically. Electronic submissions should be sent as e-mail attachments to GESJournal@yandex.ru

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ISSN 2071-9388

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SOCIALLY SCIENTIFIC MAGAZINE "GEOGRAPHY, ENVIRONMENT, SUSTAINABILIT Y"
No. 04(v. 08) 2015
FOUNDERS OF THE MAGAZINE: Faculty of Geography, Lomonosov Moscow State University and Institute of Geography of the Russian Academy of Sciences The magazine is published with financial suppor t of the Russian Geographical Society. The magazine is registered in Federal ser vice on super vision of obser vance of the legislation in sphere of mass communications and protection of a cultural heritage. The certificate of registration: 77-29285, 2007, August 30. EDITORIAL OFFICE Lomonosov Moscow State University Moscow 119991 Russia Leninskie Gory, Faculty of Geography, 2108a Phone 7-495-9392923 Fax 7-495-9328836 E-mail: GESJournal@yandex.ru DESIGN & PRINTING Advertising and Publishing Agency "Advanced Solutions" Moscow, 119071 Russia, Leninskiy prospekt, 19, 1 Phone 7-495-7703659 Fax 7-495-7703660 E-mail: om@aov.ru DISTRIBUTION East View Information Ser vices 10601 Wayzata Blvd, Minneapolis, MN 55305-1526 USA Phone +1.952.252.1201 Fax +1.952.252.1202 E-mail: periodicals@eastview.com www.eastview.com Sent into print 28.12.2015 Order N gi415 Format 70 ½ 100 cm/16 7.8 p. sh. Digital print Circulation 900 ex.