DOI: 10.21045/2071-5021-2017-58-6-8
Ilchenko I.N., Boyarskaya T.V., Ignatieva M.V.
I.M. Sechenov First Moscow State Medical University (Sechenovsky
University), Ministry of Health of the Russian Federation Moscow
Contacts: Irina Ilchenko, e-mail:
This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Ilchenko I.N., http://orcid.org/0000-0002-5966-7307
Boyarskaya T.V., http://orcid.org/0000-0003-0199-058X
Ignatieva M.V., http://orcid.org/0000-0002-4886-1008
Acknowledgments. The survey in the Moscow region was
funded by the Russian Academy of Sciences within the framework of the
“Fundamental sciences – to medicine” program in 2013. The survey in the
Republic of Karelia was funded by the United Nations Environment
Program; World Health Organization, WHO Regional Office for Europe, “Development
of a Plan for Global Monitoring of Human Exposure to and Environmental
Concentrations of Mercury” Project, Component 3 in 2016 (reference
number EUPCR1612113).
Conflict of interests. The authors declare no conflict of interest.
Abstract
Impact of environmental and behavioral risks is one of the causes of
poor health. Depending on socio-economic and territorial determinants,
impact of environmental and behavioral risk factors varies across
different population groups. The purpose of the study was
to analyze the degree of environmental exposure and behavioral risks
during pregnancy among female residents of the Moscow Region and
Republic of Karelia. In two epidemiological studies carried out
according to the WHO standard methodology, within the framework of
projects on harmonizing approaches to monitoring mercury content in the
human body and assessing prenatal exposure in the early stages of life,
120 parturient women were examined in the Moscow Region and 240 women -
in the Republic of Karelia. Industrial factors, environmental conditions
at the place of residence and individual exposure to mercury were
considered as indicators of environmental exposure. Smoking and drinking
during pregnancy were analyzed as a behavioral risk.
Rosstat data were used for a comparative analysis of regional
indicators. The survey results indicate significant inequalities in the
degree of exposure of women to environmental and behavioral risks. The
most serious inequalities were associated with socio-economic
determinants, especially with low education of women living in rural
areas in the Republic of Karelia.
Comparative analysis of medico-demographic, socio-economic and
natural-geographic indicators at the regional level revealed a
significantly higher burden of socio-economic disadvantages in the
Republic of Karelia in comparison with the Moscow region. The results
illustrate the scale and distribution of inequalities among parturient
women in two regions of Russia and help identify potential target groups
and priority areas for inter-sectoral actions.
Keywords. Environmental risk, pregnancy and prenatal
exposure, behavioral risk factors, health equity, socio-economic
determinants, equity-sensitive surveillance systems.
Reference
-
Egorov A.I., Il'chenko I.N., Lyapunov S.M., Marochkina E.B., Okina
O.I., Ermolaev B.V.,et al. Primenenie standartizovannoy metodologii
biomonitoringa cheloveka dlya otsenki prenatal'noy ekspozitsii k rtuti.
[Application of a standardized human biomonitoring methodology to assess
prenatal exposure to mercury]. Gigiena i sanitariya 2014; (5): 10-18. (In Russian).
-
Zubarevich N.V., Gorina E.A. Sotsial'nye raskhody v Rossii: federal'nyy
i regional'nyy byudzhety [Social expenditures in Russia: federal and
regional budgets]. Moscow: NIU VShE; 2015. 63p. (In Russian).
-
Komov V.T., Lazareva V.I. Prichiny i posledstviya antropogennogo
zakisleniya poverkhnostnykh vod severnogo regiona na primere
sravnitel'no-limnologicheskogo issledovaniya ekosistem ozer Darvinskogo
zapovednika [Causes and consequences of anthropogenic acidification of
surface waters in the northern region by the example of a comparative
limnological study of the ecosystems of the Darwin Reserve]. In:
Struktura i funktsionirovanie ekosistem atsidnykh ozer [Structure and
functioning of ecosystems of acid lakes]. St. Petersburg: Nauka; 1994,
p.3-30. (In Russian).
-
Nemova N.N., Vysotskaya R.U. Biokhimicheskaya indikatsiya sostoyaniya
ryb [Biochemical indication of fish status]. Moscow: Nauka; 2004. 214p.
(In Russian).
-
O natsional'noy strategii deystviy v interesakh detey na 2012 – 2017
gody [On the National strategy for action for children during the period
of 2012-2017]. Ukaz Prezidenta Rossiyskoy Federatsii ot 01.06.2012
¹761. [Online]. 2012 [cited 2017 Jun 24]. Available from:
http://kremlin.ru/acts/bank/35418 (In Russian).
-
Ob osnovakh okhrany zdorov'ya grazhdan v Rossiyskoy Federatsii [On the
bases of population health protection in the Russian Federation].
Federal'nyy zakon ot 21.11.2011, ¹ 323-FZ. [Online]. 2011 [cited 2017
Jun 24]. Available from: https://www.rosminzdrav.ru/documents/7025-federalnyy-zakon-323-fz-ot-21-noyabrya-2011-g] (In Russian).
-
Ob utverzhdenii gosudarstvennoy programmy Rossiyskoy Federatsii
"Razvitie zdravookhraneniya" [On approving the state program of the
Russian Federation “Development of health care”]. Postanovlenie
Pravitel'stva RF ot 15.04.2014 ¹294]. [Online]. 2014 [cited 2014 Apr
26]. Available from: http://www.rg.ru/2014/04/24/zdravooxr-site-dok.html
(In Russian).
-
Ob utverzhdenii Kontseptsii demograficheskoy politiki Rossiyskoy
Federatsii na period do 2025 goda [On approving the Concept of the
demographic policy of the Russian Federation for the period up to 2025].
Ukaz Prezidenta Rossiyskoy Federatsii ot 09.10.2007 g. ¹1351 (v
redaktsii Ukaza Prezidenta Rossiyskoy Federatsii ot 01.07.2014 g. ¹483)
[Online]. 2007 [cited 2017 Jun 24]. Available from:
http://kremlin.ru/acts/bank/26299 (In Russian).
-
Obzor sotsial'nykh determinant i razryva po pokazatelyam zdorov'ya v
Evropeyskom regione VOZ: zaklyuchitel'nyy doklad [Review of social
determinants and the health divide in the WHO European Region. Final
Report]. [Transl. from Eng.]. WHO; 2014. 224p. [Online]. 2014 [cited
2017 Jun 24]. Available from:
http://www.euro.who.int/__data/assets/pdf_file/0004/251959/Review-of-social-determinants-and-the-health-divide-in-the-WHO-European-Region-FINAL-REPORT-Rus.pdf
(In Russian).
-
Okhrana okruzhayushchey sredy v Rossii. 2016. [Environmental protection
in Russia]. 2016. Statisticheskiy sbornik. Moscow: Rosstat. [Online].
2016 [cited 2017 Jun 24]. Available from: http://www.gks.ru/free_doc/doc_2016/ohrana_2016.pdf (In Russian).
-
Prilozhenie k sborniku (informatsiya po sub"ektam Rossiyskoy
Federatsii), 2015 g. [Annex to the collection (information on subjects
of the Russian Federation)]. 2015. In: Sotsial'noe polozhenie i uroven'
zhizni naseleniya Rossii [The social status and living standards of the
population of Russia]. Moscow: Rosstat. [Online]. 2015 [cited 2017 Jun
24]. Available from:
http://www.gks.ru/free_doc/doc_2015/pril_soc-pol2015.rar (In Russian).
-
Puti dostizheniya vseob"emlyushchego ekonomicheskogo rosta. Rossiyskaya
Federatsiya: kompleksnoe diagnosticheskoe issledovanie ekonomiki.
[Systematic Country Diagnostic for the Russian Federation: Pathways to
Inclusive Growth]. [Trans. from Eng.]. World Bank Group; 2016 [Online]
2016 [cited 2017 Jun 24]. Available from:
http://pubdocs.worldbank.org/en/235471484167009780/Dec27-SCD-paper-rus.pdf
(In Russian).
-
Bellanger M., Pichery C., Aerts D., et al. Economic benefits of
methylmercury exposure control in Europe: Monetary value of
neurotoxicity prevention. Environment Health. 2013; (12): 3-10.
-
Closing the gap in a generation: health equity through action on the
social determinants of health. Final Report of the Commission on Social
Determinants of Health. Geneva: World Health Organization. [Online].
2008 [cited 2017 Jun 15]. Available from: http://apps.who.int/iris/bitstream/10665/43943/1/9789241563703_eng.pdf
-
Environmental health inequalities in Europe. Assessment report. WHO.
Regional Office for Europe. [Online]. 2012 [cited 2017 Jun 24].
Available from:
http://www.euro.who.int/__data/assets/pdf_file/0010/157969/e96194.pdf?ua=1).
-
Graham H. Tackling inequalities in health in England remedying health
disadvantages, narrowing health gaps or reducing health gradients? J of Social Policy. 2004; 33 (1): 115-131.
-
Schulz C., Wilhelm M., Heudorf U., Kolossa-Gehring M. Reprint of
"Update of the reference and HBM values derived by the German Human
Biomonitoring Commission". Int. J. Hygiene Env. Health. 2012; (215):150- 158.
Views: 9119
|