Chemical and Water Safety in Rural Central and Eastern Europe

September 6-8, 2002
Hortobagy National Park, Hungary

• Topics of Discussion
• Participants
• Presentation Summaries
• Discussions
• Conclusion

Topics of Discussion

The theme of this conference/workshop was Chemical and Water Safety in Rural Central and Eastern Europe. Each country delegation was asked to provide an overview on issues related to water quality and water pollution in rural areas, particularly with respect to agricultural chemicals (i.e. pesticides). In addition, several research studies relevant to the topic and to all the countries represented were presented.

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Participants

Co-Chairs

Roza Adany, MD, PhD, DSc

Director, School of Public Health, University of Debrecen, Hungary

Ivan Ciznar, PhD, DRSc

Senior Scientist, Department of Microbiology, Institute of Preventive and Clinical Medicine, Bratislava, Slovakia; and Co Director, International Institute for Rural and Environmental Health

Keynote Speakers

Nida Bisbelli

Programme on Chemical Safety, World Health Organization

Anna Tompa, MD, PhD, DSc, MPH

Director, National Institute of Chemical Safety, Budapest, Hungary

Tomas Trnovec, MD, CSc, DrSc

Professor, Institute of Preventive and Clinical Medicine, Bratislava,Slovakia

Catherine Zeman, PhD

Assistant Professor, Health Division, Department of Health, Physical Education and Leisure Studies, University of Northern Iowa, USA

Country Delegation Presenters

Metka Macarol-Hiti, MD

Head of the Center for Environmental Health of the Institute of Public Health of Slovenia

Frantisek Kozisek, MD, PhD

Head, National Reference Center for Drinking Water at the National Institute of Public Health; Head of the Research Group for Water Hygiene, Prague, Czech Republic

Ioan Bocsan, MD, PhD

Director, Iuliu Moldovan Institute of Public Health, Cluj-Napoca, Romania

Wojciech Hanke, MD

Deputy Director for Research, Nofer Institute of Occupational Medicine and Associate Professor, Dept of Environmental Epidemiology, Lodz, Poland

Katarina Halzlova, MPH

Head, Department of Environmetnal Health at the State Health Institute of the Slovak Republic, Bratislava, Slovakia

Anna Paldy, MPH, MD, PhD

National Coordinator of the Hungarian National Environmental Health Action Programme, Senior Investigator, Jozsef Fodor National Public Health Center, National Institute of Environmetnal Health, Budapest, Hungary

Discussants

Vladimir Janout, MD, PhD

Head, Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic

Milan Matousek

Central Checking and Testing Institute of Agriculture

Ivanka Matouskova, PhD

Department of Preventive Medicine, Medical Faculty, Palacky University, Olomouc, Czech Republic

Balint Dobi, MD, MSc

Deputy Head, Department for Environmental Safety and Environmental Health, Budapest, Hungary

Jerzy Konczalik, MSc, PhD

Assistant Professor, Department of Environmental Health Hazards, Nofer Institute of Occupational Medicine, Lodz, Poland

Ryszard Rolecki, MSc, PhD

Assistant Professor, Department of Environmental Health Hazards, Nover Institute of Occupaitonal Medicine, Lodz, Poland

Stanislaw Stobiecki, MSc

Head, Department of Analysis of Pesticides, Plant Protection Institute of Poznan, Sosnicowice Branch, Poland

Mihail Costache, MSc

Senior Advisor, Directorate of Strategies, Regulations and Permitting, General Water Management Directorate, Ministry of Waters and Environmental Protection, Bucharest, Romania

Ioana Jacob, MD, PhD

Head, Water Laboratory, Institute of Public Health, Bucharest, Romania

Mariana Vlad, MD, PhD

Professor and Head, Environmental and Community Health Department, Institute of Public Health, Cluj-Napoca,Romania

Stefan Nyulassy, MD, DRSC

Director of the Institute of Preventive and Clinical Medicine, Bratislava, Slovakia

Mladen Franko, PhD

Head, School of Environmental Sciences; Head, Laboratory for Environmental Research, Nova Gorica Polytechnic, Nova Gorica, Slovenia

Marko Vudrag, MD

Head, Department of Health Ecology, Hygiene and Epidemiology, Institute of Public Health, Ljubljana, Slovenia

Victor Kirsenko, MD

Head, Laboratory of Pesticide, Toxicology and Safety Application, Institute for Occupational Health, Kiev, Ukraine

Thomas M. Cook, PhD

Professor, Department of Occupational and Environmental Health, The College of Public Health, The University of Iowa, USA

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Presentation Summaries

EU Accession Countries Facing Environmental Health Challenges

This presentation by Dr. Tompa outlined the process of developing an Institute for Chemical Safety in Hungary that would coordinate with other national agencies and be responsive to the requirements for harmonization necessary for entry into the European Union.

Status of the Epidemiology of Pesticide Poisoning Project

Dr. Bisbelli from the WHO Programme on Chemical Safety described the study which aims to estimate the extent of human exposure and poisoning in various countries, to implement preventive and educational strategies, and to reduce the morbidity and mortality related to pesticide poisoning.

Country Report from Slovenia

Dr. Macarol-Hiti focused on recent legislation in Slovenia concerning drinking water; outlining the responsible authorities in the government and how the legislation is monitored. She also provided a comparison of rural versus urban water supplies (number of consumers and quality of water). Nitrate and atrazine levels in rural and urban supplies over the last seven years were shown.

Country Report from the Czech Republic

Dr. Koziseck discussed the quality of drinking water in rural communities in the Czech Republic in terms of the sources of data, private well-water quality, and small public water supply systems. Microbiological indicators of quality that were used included E. coli, C. perfringens, and cryptosporidium. Chemical indicators were also discussed, including those which have exceeded the limits. Dr. Koziseck’s conclusions were that targeted screenings will help to maintain compliance with legislation and improve water quality for the rural population.

Country Report from Romania

Professor Bocsan described the water situation in rural Romania, where only about 18% of the drinking water is from a central water supplying system. Problems of deteriorating water sources and the inability to monitor and control water sources leads to many people being exposed to chemical and biological contaminants. Field surveys have shown that nitrate concentrations in the ground water exceeded 45 mg/L in more than 28% of the tested wells. GIS methods are being applied to allow better and faster causal inference so that preventive and control measures can be applied.

Country Report from Poland

Dr. Hanke reported on the proportion of households using municible and private water sources and rural water contamination problems. A high percentage of familes are engaged in vegetable gardening for family consumption. He described the level of pesticide and fertilizer use; methods for registration and professional application of pesticides; regulation of pesticide application and compliance; activities for risk reduction; risk assessment methods and adoption of good work and assessment practices. Also a short review of data on disparities of cas3es of hematologic cancers, including leukemia, Hodgkin’s disease, non-Hodgkins lymphoma, and multiple myeloma in rural populations versus urban populations; incidence of acute toxic reactions to agricultural chemicals; and waste management in rural areas.

Country Report from the Slovak Republic

Dr. Trnovec provided a general overview of the drinking water status which situated the severity of current problems of the Central and Eastern European countries and of the Slovak Republic. Slovakia has reached a stage of acquiring most of the legal regulations and framework needed for ensuring environmental protection, but enforcement remains an issue. He discussed the most recent challenges for a Slovak water resources policy, and cited the worst polluters (intensive agriculture and the chemical industry). He discussed water quality monitoring as well as what is still needed concerning public sewerage systems; the important laws and regulations; and strategies for CEE countries for the new future.

Country Report from Hungary

Dr. Paldy reviewed important ministerial conferences on environment and health, focusing on the NEHAP (National Environmental Health Action Plan) programs’ goals, tools and strategic elements. She then looked specifically at Hungarian NEHAP subprograms, which include water quality. Arsenic contamination of ground water is one of the biggest problems in Hungary, affecting more than half of the population. Hungary’s greatest success story to date is the dramatic decrease, since the late 1970s, of cases of methemoglobinemia.. The use of GIS mapping showed the distribution of various diseases as well as those areas with unacceptable drinking water due to coliform, ammonium content, iron, arsenic and manganese

Chemical Pesticide Contamination in Waters of the Region

Dr. Tomas Trnovec reported on the condition of the Danube River Basin, shared watershed of a large part of the Central and Eastern European Region. A PHARE project evaluated the risks of pesticide application to humans and aquatic life in the region and made recommendations concerning legal management and policy measures.

Water Quality and Health Concerns in Rural Village with Emphasis on Nitrate Contamination

Dr. Catherine Zeman looked at nitrates in rural well water and reported on a series of studies that she conducted in the Transylvania region of Romania that were concerned with nitrate contamination of private wells and of outbreaks of methemoglobinemia in village areas. She looked at related contaminants.

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Discussions

Discussions were held following the country reports.

General procedural topics

• Methods for collecting and calculating data
• Types and designs of studies conducted in each country
• General sharing of information and experiences: what has worked – what hasn’t worked

Discussions concerning research areas that need attention

• Obsolete chemicals – what happens to them?
• Danube River Basin – coordination of sampling in all countries it borders or runs through
• Monitoring of private wells
• Pesticide exposure
• Health hazards related to exposure to agricultural chemicals
• Safe disposal of empty pesticide containers and proper cleaning of sprayers
• Family gardens for family consumption – use of chemicals without personal protective equipment
• Use of GIS and other methods that would provide comparable data and initiate common efforts to common problems
• Importance of surveillance systems and identification of environmental health indicators

Issues for working collaboratively

• Prioritization of problems and identification of areas of strength for each country
• Need for arriving at common key definitions so we can speak the same “language”
• Keeping to a “medical” approach to public health issues to convince politicians
• Improve communications

Other action areas

• Need for more information about what the data means (e.g. chemical exceedences) for human health
• More aggressive approach to health promotion is needed
• Addressing minority or special populations issues: Gypsy (Rom); Children; Elderly

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Conclusion

This group will plan to meet again in two years, with an offer from the Romanian colleagues to host the workshop in Transylvania.