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A study on health impact of a river pollution neighboring industrialized big city on the rural people residing along the river
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Joung Soon Kim, Seung Wook Lee, H.S Yoon, Y Heo, S.J Yang, T.W Ha, H.K Hong, Y.W Lee, H.H Kwon, D.H Lee, H.C Kim
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Korean J Epidemiol. 1986;8(1):37-95.
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Abstract
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Abstract
This study is conducted to identify any adverse health impact for the rural residents living along a certain river in Korea. The river actually accomodates all the industriral and domestic waste-water discharged from its neighboring big city. Unfortunately, the river is being served for farming water residents, while the current water cleaning system does not function satisfactorily. It means a possibility that the polluted water can contaminate underground water which is the main source of drinking water in the area.
The aim of the study is to determine the contamination level of heavy metals and evaluate the health impact of the residents with a linkage to the river pollution. The study is proceeded under the following steps.
1) The area is divided into two parts where the water is used for the farming or not. They formed study and control area. For the residents within the sites, study and control groups were formed.
2) Between the two, any statistical significance was pursued for the following items,
(1) the contamination levels by the metals in drinking water source, soil, farming products, farming products, and fishes which live in the water where the river joins the main river,
(2) the contamination levels of rural residents, blood samples, and
(3) by physicians the health evaluation results by clinical and pathological tests for the residents.
3) the correlation between the blood contamination levels and the health results,
4) the correlation between the blood and environmental pollution levels were studied.
In spite of several limitations from the nature of the study,
The findings were summarized as follows:
1) No statistical significance was found in the differences between the groups with regard to age, sex, occupation, economic status, education levels, pregnancy history, number of household members, and medical insurance status.
2) No statistical significance were found with regard to smoking habit, proportions of drinking, boiled water, number of days using pesticides and number of pregnancy poisoning, frequency of monthly meat intake. But a significance was found in the number of fish intake, while almost nobody took fishes from the river.
3) Most of the residents(93%) think the river is harmful to their health and 34% among them addressed that the river contamination is the cause of various dermatitis.
4) Stillbirth rate was significantly higher in the study group, but no correlation was found with the metal contamination.
5) The study group showed significantly higher complaints for 24 symptoms believed to appear with metal contamination, but no correlation was found. No correlation was found when the symptoms are grouped into 17 disease classification, either.
6) Neurological symptoms and clinical screening tests did not show any significant difference between the groups. Past disease history showed the same thing.
7) The results of diagnoses by physicians are classified into three groups from normal to abnormal. The control groups had higher proportion of the normal, but conjunctiva abnormaly, unspecified digestive ulcer, symptoms of abdomen and pelvic area, gasritis and duodenum inflammation were more frequent in the control group. Neurologic findings by a specialist did not show any difference.
8) The values of laboratory tests for hematopoietic system, kidney, and liver functions as indices of health measurements didn’t show any significance.
9) For the level of heavy metal contamination in blood, those of Cu, Cd, Pb but Zn were statistically higher than those determined by the National Envoronmental Protection Institute for the Yang-pyong-kun residents. For Pb, Zn, Ni at 0.1% and Hg at 5%, the values from the control groups was rather higher than those in the study group. However, at was seen that the level of Cd of the study group was higher than the control groups at 5%. They failed to show any consistent pattern, but the males has higher value than the females for Cd, Zn, Hg and lower value for Cu, Pb with statistical significance.
10) The proportions of residents above the permissible levels for the metal contamination were determined. The proportions for Pb and Zn showed that those for the control group were statistically higher than those for the study group. They were 42.3% for Pb and 6.3% for Zn, respectively, in the control group. For the case group, they were 19.3% for Pb and 4.6% for Mn, respectively. The proportions of residents who had abnormal level for more than 2 kinds of heavy meatals was 10.2% and for more than 3 kinds 0.8%.
11) The health evaluation results were linked with the classification of metal levels into the normal and abnormal groups. The abnormal group in Mn level seemed to have high proportion of lassitude, but its reliability was very low because of the sample size of 1. Also, the proportion of no symptoms was significantly higher in the group abnormally contaminated by Pb and Zn rather in the normal group.
The clinical evaluation results showed that the Pb-and Zn-high groups had more frequently hearing difficulty, the Pb-high conjuntictiva problem, the Zn-high group neurotoxic disturbance and hearing difficulty. The neurological findings showed that inflammation, neurotoxic disturbance and hearing difficulty in the Mn-and Pb-high group, respectively. Also, various pathological tests did not show any significance.
12) The water quality was examined for the river and drinking water. The river seemed to be polluted by not heavy metal but various organic materials. This can be backed up by high levels of COD, BOD, and DO. The drinking water classified into underground water, well and simple-lined pump didn’t bear any significant difference from that in the control area and was believed to be generally appropriate for drinking. In the simple-lined pump and well water, the levels of Cu, Pb, and Ni were slightly higher than in the foot site river. It needs further attention to find Hg, As, Cr in the well water which did not exist in the river.
13) The sample of fishes to determine heavy metal contamination level was taken in the main river around the various sites where the river joins. While the site difference couldn’t be identified because of the fish morbidity, the levels were below being serious. However, the levels of Pb and Hg were slightly higher but not significant.
14) For the farmig product, nine crops sampled. The levels of Pb and Zn were significantly higher in brown rice, corns, garlics, while the others were below the permissible level. This results are consistent with the residents results But no significance were found when compared to the control area, while some metals show higher levels in the contral area.
15) The metal contaminatin levels in the soil of the study area were significantly higher for Pb, Zn and Mn. Although the Mn level in the residents blood is very low, the high levels for of Pb and Zn need attention beeanse they were also high in the crops.
16) The correlation between the soil and crops did not show any consistent pattern. However, in certain sites, the high correlations were found and suspected due to the confounding factors such as the regional nature of soil contamination, pesticides and fertilizer.
17) For the corelation between the blood and environmental contaminations, the levels of metals except Mn which showed the high levels in the soil and crops were also high in the blood. The relatively great portion of the residetns with high levels can cause serious health impact. However, the origin of their contamination seems to come from the soil not from the river. It deserves a further investigation on this matter.
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Summary
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An epidemiological study on HBsAg and anti-HBs prevalence in relation to liver function tests among farmers in Korea
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Joung Soon Kim, Won Young Lee, S.W Lee, Hee Sup Yoon, Sook Ja Yang, D.H Lee, H.C. Kim
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Korean J Epidemiol. 1985;7(1):16-27.
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Abstract
This study was carried out in a rural area for the adult population older than 20 years of age to find out the prevalence of HBsAg and Anti-HBs among the population, and particularly the relationship between the presence of HBsAg and liver function tests during November 1984. Six hundred fourteen persons were interviewed according to structured questionnaire, examined by physician, and blood was drawn for the tests. For the detection of HBsAg and Anti-HBs Eliza method was used. The liver function test including SGOT, SGPT, alkaline phosphatase, total bilirubin and albumin was done in an university hospital laboratory of clinical pathology.
The results summarized are as followings:
1. The prevalence rate of HBsAg positive was 13.0% and Anti-HBs positive was 43.6% among the population studied. The age adjusted positive rate by sex showed higher rate in males(14.6%) than females(12.7%) for HBsAg, whereas the positive rate was higher in females than males for anti-HBs although these differences by sex were not statistically significant (p〉0.05).
2. The age specific positive rate for both HBsAg and anti-HBs revealed peaks on 30~39 yrs. age group even though the Anti-HBs showed a slight increase for the age group older than 60 years.
3. The HBsAg positive rate was the highest (17.6%) among simple labourers accompanied by the highest positive rate of anti-HBs (58.8%) and then farmers, sales worker, clerical workers showed higher positive rate in order when the positive rates were compared by occupation. Also the lower socioeconomic class revealed higher positive rate.
4. The positive rates of both HBsAg and Anti-HBs were not different statistically between alcohol drinkers and non-drinkers, cigarette smokers and non-smokers, and the group with past history of liver disease and that without the history.
5. The HBsAg positive group when compared with HBsAg and Anti-HBs negative group showed 1.9 times more in family history of liver disease, 1.5 times in surgical operation, 1.4 times in blood transfusion.
6. The abnormal liver function test was found to be much more frequent among persons with past or present history of liver disease than those without; 84.2% versus 17.9%. By each item of the liver function test the HBsAg positive group had 1.6 times more abnormal value of bilirubin, 1.3 times of SGPT, and 1.2 times of SGPT than those who were negative for both HBsAg and Anti-HBs. The SGOT/SGPT ratio was not statistically different between two groups HBsAg positive and negative.
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Summary
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