Numerous studies have shown that the factors that determine health are:
- biological (heredity, type of higher nervous activity, constitution, temperament, etc.);
- natural (climate, landscape, flora, fauna, etc.);
- state of the environment;
- socio-economic;
- level of healthcare development.
These factors influence people's lifestyle. It has also been established that lifestyle by about 50%, the state of the environment by 15-20%, heredity by 15-20% and healthcare (the activities of its organs and institutions) determine health (individual and public) by 10%.
Closely related to the concept of health is the idea of.
Health factors
In the 80s of the 20th century, WHO experts determined the approximate ratio of various factors to ensure the health of modern people, identifying four derivatives as the main ones. Subsequently, these conclusions were fundamentally confirmed in relation to our country as follows (WHO data in brackets):
- genetic factors - 15-20% (20%)
- environmental condition - 20 - 25% (20%)
- medical support - 10-15% (7 - 8%,)
- conditions and lifestyle of people - 50 - 55% (53 - 52%).
|
Sphere of influence of factors |
Factors |
|
|
Health promoting |
Impairing health |
|
|
Genetic (15-20%) |
Healthy heredity. Absence of morpho-functional prerequisites for the occurrence of diseases |
Hereditary diseases and disorders. Hereditary predisposition to diseases |
|
State of the environment (20-25%) |
Good living and working conditions, favorable climatic and natural conditions, environmentally friendly habitat |
Harmful living and production conditions, unfavorable climatic and natural conditions, violation of the environmental situation |
|
Medical support (10-15%) |
Medical screening, high level of preventive measures, timely and comprehensive medical care |
Lack of constant medical monitoring of health dynamics, low level of primary prevention, poor quality medical care |
|
Conditions and lifestyle (50-55%) |
Rational organization of life activity, sedentary lifestyle, adequate physical activity, social and psychological comfort. nutritious and balanced nutrition, absence of bad habits, valeological education, etc. |
Lack of a rational mode of life, migration processes, hypo- or hyperdynamia, social and psychological discomfort. unhealthy diet, bad habits, insufficient level of valeological knowledge |
Instructions
The genetic factor plays a significant role in human health. The presence of hereditary diseases or a predisposition to them, body constitution, general health, immunity, characteristics of the body's reaction to certain environmental changes - all this is given to a person from parents, grandparents.
Ecology can also affect human health. An unfavorable natural environment can cause a wide variety of diseases, including incurable ones, significantly weaken human immunity, and cause reproductive dysfunction. The composition of air and water can include hazardous substances that cause severe harm to the body.
Lifestyle can also affect a person's health. The general condition of the body may depend on how seriously he takes his own habits. Proper nutrition, physical activity and timely consultation with doctors have a positive effect on health. And harmful attachments, excess in eating, low mobility, smoking and alcohol abuse gradually kill a person.
The state of medicine affects how healthy a person will be. In countries with well-developed healthcare, people suffer less from various diseases because they have the opportunity to receive timely, qualified medical care. In regions where there are difficulties with medical care, there are more patients and.
General social status also greatly influences a person’s health. The poor are forced to limit themselves to the bare necessities. They do not have the opportunity to fully take care of their health, purchase quality products, get proper rest and buy the necessary medications.
A person's emotional state affects his health. Due to the tendency to often get nervous and worry about the most insignificant reasons, a person runs the risk of acquiring various diseases. Conversely, calm, balanced individuals live longer and have good health. What matters is not only a person’s view of the world around him, but also the level of stress he has to face when communicating, at home and at work.
Injuries and dangerous lifestyles can cause poor health. Those people whose work or hobbies do not involve high risk have stronger bodies. Various accidents can have undesirable consequences, including death.
The health of an individual and society as a whole is determined by a number of factors that affect the human body, both positively and negatively. According to the conclusions of experts from the World Health Organization, four main groups of factors determining human health have been identified, each of which has a positive and negative impact, depending on the points of application:
- Genetic inheritance;
- Medical support;
- Lifestyle;
- Environment.
The influence of each factor on human health is also determined by age, gender, and individual characteristics of the body.
Genetic factors determining human health
A person’s capabilities are largely determined by his genotype - a set of hereditary characteristics embedded in the individual DNA code long before birth. However, genotypic manifestations do not appear without certain favorable or unfavorable conditions.
The critical periods of fetal development are caused by violations of its genetic apparatus during the formation of organs and body systems:
- 7 weeks of pregnancy: cardiovascular system – manifested by the formation of heart defects;
- 12-14 weeks: nervous system - improper formation of the neural tube leads to congenital pathology, most often as a result of neuroinfection - cerebral palsy, demyelinating diseases (multiple sclerosis, BASF);
- 14-17 weeks: musculoskeletal system – hip dysplasia, myotrophic processes.
In addition to genetic changes, epigenomic mechanisms are of great importance as factors determining human health after birth. In these cases, the fetus does not inherit the disease, but, being exposed to harmful effects, perceives it as normal, which subsequently affects its health. The most common example of such a pathology is maternal hypertension. Increased blood pressure in the “mother-placenta-fetus” system contributes to the development of vascular changes, preparing a person for living conditions with high blood pressure, that is, the development of hypertension.
Hereditary diseases are divided into three groups:
- Gene and chromosomal abnormalities;
- Diseases associated with impaired synthesis of certain enzymes under conditions requiring increased production;
- Hereditary predisposition.
Gene and chromosomal abnormalities, such as phenylketonuria, hemophilia, Down syndrome, appear immediately after birth.
Enzymopathies, as factors determining human health, begin to affect only in cases where the body cannot cope with the increased load. This is how diseases associated with metabolic disorders begin to appear: diabetes, gout, neuroses.
Hereditary predisposition appears under the influence of environmental factors. Unfavorable environmental and social conditions contribute to the development of hypertension, gastric and duodenal ulcers, bronchial asthma and other psychogenic disorders.
Social factors of human health
Social conditions largely determine people's health. An important place is occupied by the level of economic development in the country of residence. Having enough money plays a dual role. On the one hand, a rich person has access to all types of medical care, on the other hand, concern for health is replaced by other matters. Low-income people, oddly enough, have a better chance of strengthening their immunity. Thus, a person’s health factors do not depend on his financial situation.
The most important component of a healthy lifestyle is the correct psychological attitude aimed at long life expectancy. People who want to be healthy exclude factors that destroy human health, considering them incompatible with the norms. Regardless of place of residence, ethnicity, income level, everyone has the right to choose. Being isolated from the benefits of civilization, or using them, people are equally capable of observing basic rules of personal hygiene. In hazardous industries, the necessary personal safety measures are provided, the observance of which leads to positive results.
The social factors of human health include the well-known concept of acceleration. A child of the 21st century is far superior in level of development to his peers of the 19th and early 20th centuries. Acceleration of development has a direct connection with the achievements of technological progress. The abundance of information encourages early development of intelligence, skeleton and muscle mass. In this regard, adolescents experience delayed vascular growth, which leads to early diseases.
Natural factors of human health
In addition to hereditary and constitutional characteristics, human health is influenced by environmental factors.
Natural influences on the body are divided into climatic and urban. The sun, air and water are far from the most important components of the environment. Energy influences are of great importance: from the electromagnetic field of the earth to radiation.
People living in areas with harsh climates have a greater margin of safety. However, the expenditure of vital energy in the struggle for survival among northerners is not comparable with those people who live in conditions where favorable natural factors of human health are combined, such as the effect of the sea breeze, for example.
Environmental pollution due to industrial development can have an impact at the genetic level. And this action is almost never beneficial. Multiple factors that destroy human health contribute to shortening life, despite the fact that people try to lead a healthy lifestyle. Exposure to harmful environmental substances is today the main health problem for residents of megacities.
Constitutional factors of human health
A person’s constitution refers to a feature of their physique that determines their susceptibility to certain diseases. In medicine, the following types of human constitution are distinguished:
The most favorable body type is normosthenic.
People with an asthenic type of constitution are more often susceptible to infections and are weakly resistant to stress, so they more often develop diseases associated with innervation disorders: peptic ulcers, bronchial asthma.
Individuals of the hypersthenic type are more susceptible to developing cardiovascular diseases and metabolic disorders.
According to WHO, the main (50-55%) factor influencing human health is his lifestyle and living conditions. Therefore, preventing morbidity in the population is a task not only for medical workers, but also for government bodies that ensure the standard and life expectancy of citizens.
Health status affects a person’s well-being, physical, social and work activity. The quality of life and the level of overall satisfaction depend on this. Currently, it is believed that general health consists of several components: somatic, physical, mental and moral. It is formed under the influence of a number of external and internal factors that can have a beneficial or negative effect. Maintaining a high level of public health is an important state task, for which special federal programs are being developed in the Russian Federation.
Main factors influencing human health
All factors important for the formation and maintenance of human health can be divided into 4 groups. They were identified by WHO experts back in the 80s of the twentieth century, and modern researchers adhere to the same classification.
- socio-economic conditions and lifestyle of the individual;
- state of the environment, including human interaction with various microorganisms;
- genetic (hereditary) factors - the presence of congenital anomalies, constitutional characteristics and predisposition to certain diseases that arose during intrauterine development and during the life of the mutation;
- medical support – availability and quality of medical care, completeness and regularity of preventive examinations and screening examinations.
The ratio of these factors depends on gender, age, place of residence and individual characteristics of a person. Nevertheless, there are average statistical indicators of their influence on health. According to WHO, the greatest impact is caused by lifestyle (50–55%) and environmental conditions (up to 25%). The share of heredity is about 15–20%, and medical support is up to 15%.
Lifestyle includes the degree of physical activity of a person and the presence of bad habits. This also includes the nature of the organization of work and rest, commitment to adherence to the daily routine, duration of night sleep, and nutritional culture.
Environmental factors are natural and anthroponotic (created by people) conditions in the place of permanent residence, recreation or work of a person. They can be of a physical, chemical, biological and socio-psychological nature. Their influence can be small in intensity and permanent, or short-term but powerful.
Physical factors
Temperature, air humidity, vibration, radiation, electromagnetic and sound vibrations are the main physical factors affecting health. In recent decades, increasing importance has been attached to electromagnetic radiation, because people experience its effects almost constantly. There is a natural background that does not pose a health hazard. It is formed as a result of solar activity. But technological progress leads to so-called electromagnetic pollution of the environment.
Waves of different lengths are emitted by all household and industrial electrical appliances, microwave ovens, mobile and radiotelephones, and physiotherapeutic devices. Power lines, indoor electrical networks, transformer stations, urban electric transport, cellular communication stations (transmitters), and television towers also have a certain influence. Even constant exposure to medium-intensity unidirectional electromagnetic radiation usually does not lead to significant changes in the human body. But the problem lies in the number of sources of such radiation surrounding a city dweller.
The massive cumulative effect of electric waves causes changes in the functioning of cells of the nervous, endocrine, immune and reproductive systems. There is an opinion that the increase in the number of neurodegenerative, oncological and autoimmune diseases in society is also associated with the action of this physical factor.
The radiation factor is also important. All living beings on Earth are constantly exposed to natural background radiation. It is formed by the release of radioisotopes from various rocks and their further circulation in food chains. In addition to this, modern people receive radiation exposure during regular preventive X-ray examinations and during X-ray therapy for certain diseases. But sometimes he is unaware of the constant effect of radiation. This happens when eating foods with a high amount of isotopes or living in buildings made of building materials with a high background radiation.
Radiation leads to changes in the genetic material of cells, disrupts the functioning of the bone marrow and immune system, and negatively affects the ability of tissues to regenerate. The functioning of the endocrine glands and epithelium of the digestive tract deteriorates, and a tendency to frequent illness appears.
Chemical factors
All compounds entering the human body are chemical factors that affect health. They can enter through food, water, inhaled air or through the skin. The following may have a negative impact:
- synthetic food additives, taste improvers, substitutes, preservatives, dyes;
- household and auto chemicals, washing powders, dishwashing detergents, air fresheners in any form;
- deodorants, cosmetics, shampoos and body hygiene products;
- medicines and dietary supplements;
- pesticides, heavy metals, formaldehyde contained in food products, traces of additives to accelerate the growth of livestock and poultry;
- glue, varnishes, paints and other materials for renovation of premises;
- volatile chemical compounds released from floor and wall coverings;
- preparations used in agriculture to control pests and weeds, means to get rid of mosquitoes, flies and other flying insects;
- tobacco smoke, which can enter the lungs of even a non-smoker;
- water and air polluted by industrial waste, urban smog;
- smoke from burning landfills and burning leaves from city trees (which accumulate heavy metals and other products from exhaust gases).
Chemical factors that affect health are especially dangerous if they tend to accumulate in the body. As a result, a person experiences chronic intoxication with damage to peripheral nerves, kidneys, liver and other organs. The functioning of the immune system changes, which leads to an increased risk of developing bronchial asthma, autoimmune and allergic diseases.
Biological and socio-psychological factors
Most people place increased importance on the role of microorganisms in maintaining a reasonable level of health. To destroy pathogenic (disease-causing) bacteria, some people use disinfectants for daily room cleaning and washing dishes, thoroughly wash their hands, and even take antibacterial drugs for preventive purposes. But this approach is wrong.
A person is constantly in contact with a huge number of microorganisms, and not all of them pose a health hazard. They are found in soil, air, water, and on food. Some of them even live on human skin, in the mouth, vagina and inside the intestines. In addition to pathogenic bacteria, there are opportunistic and even beneficial microbes. For example, vaginal lactobacilli help maintain the necessary acid balance, and a number of bacteria in the large intestine supply the human body with B vitamins and promote more complete digestion of food residues.
Constant interaction with a variety of microorganisms has a training effect on the immune system, maintaining the necessary intensity of the immune response. Uncontrolled use of antibacterial agents and the use of unbalanced diets lead to disruption of the normal microflora (dysbacteriosis). This is fraught with the activation of opportunistic bacteria, the formation of systemic candidiasis, the development of intestinal disorders and inflammation of the vaginal wall in women. Dysbacteriosis also leads to decreased immunity and increases the risk of developing allergic dermatoses.
Social and psychological factors affecting health also play an important role. Stressful situations initially lead to mobilization of the body with activation of the sympathetic nervous system and stimulation of the endocrine system. Subsequently, adaptation capabilities are depleted, and unreacted emotions begin to transform into psychosomatic diseases. These include bronchial asthma, gastric and duodenal ulcers, dyskinesia of various organs, migraine, fibromyalgia. Immunity decreases, fatigue accumulates, brain productivity decreases, and existing chronic diseases worsen.
Maintaining health is more than just managing symptoms and fighting infections. Preventive examinations, proper nutrition, rational physical activity, competent organization of the workplace and recreation area are important. It is necessary to influence all factors affecting health. Unfortunately, one person cannot radically change the state of the environment. But he can improve the microclimate of his home, choose foods carefully, monitor the purity of the water he consumes, and reduce the daily use of pollutants.
The article was prepared by doctor Obukhova Alina Sergeevna
Risk factor - a general name for factors that are not the direct cause of a particular disease, but increase the likelihood of its occurrence. These include conditions and lifestyle features, as well as congenital or acquired properties of the body. They increase the likelihood of an individual developing a disease and (or) can adversely affect the course and prognosis of an existing disease.
In general, the influence of environmental factors on human health can be presented in the following diagram (Fig. 4.1).
Rice. 4.1.
According to WHO, there are biological, environmental and social risk factors (Table 4.1). If factors that are the direct cause of the disease are added to risk factors, then together they are called health factors. They have a similar classification.
TO biological risk factors include genetic and acquired characteristics of the human body during ontogenesis. Some diseases are known to be more common in certain national and ethnic groups. There is a hereditary predisposition to hypertension and peptic ulcers, diabetes mellitus, etc. Obesity is a serious risk factor for the occurrence and course of many diseases, including diabetes mellitus and coronary heart disease. The existence of foci of chronic infection in the body (for example, chronic tonsillitis) can contribute to the disease of rheumatism.
Table 4.1
Grouping of risk factors and their importance for health (Lisitsin, 2002)
|
risk factors |
Risk factors |
Health value, % |
|
Biological factors |
||
|
Genetics, biology person |
Hereditary and acquired during individual development predisposition to diseases |
|
|
Environmental factors |
||
|
State surrounding |
Pollution of air, water, soil, food, sudden changes in weather conditions, increased levels of radiation, magnetic and other radiation |
|
|
Social factors |
||
|
Conditions and lifestyle |
Smoking, alcohol consumption, drug use, unhealthy diet, lack of sleep, stressful situations, hypo- and hyperdynamia, harmful working conditions, poor material and living conditions, family fragility, high level of urbanization |
|
|
Medical security |
Ineffectiveness of preventive measures, low quality of medical care, untimeliness of its provision |
|
Environmental risk factors. Changes in the physical and chemical properties of the atmosphere affect, for example, the development of bronchopulmonary diseases. Sharp daily fluctuations in temperature, atmospheric pressure, and magnetic field strength worsen the course of cardiovascular diseases. Ionizing radiation is one of the oncogenic factors. The peculiarities of the ionic composition of soil and water, and consequently of food products of plant and animal origin, lead to the development of diseases associated with excess or deficiency in the body of atoms of one or another element. For example, a lack of iodine in drinking water and food in areas with low iodine content in the soil can contribute to the development of endemic goiter.
Social risk factors. Unfavorable living conditions, various stressful situations, such features of a person’s lifestyle as physical inactivity are a risk factor for the development of many diseases, especially diseases of the cardiovascular system. Bad habits, such as smoking, are a risk factor for bronchopulmonary and cardiovascular diseases. Alcohol consumption is a risk factor for the development of alcoholism, liver disease, heart disease, etc.
Risk factors may be significant for individual individuals (eg, the genetic makeup of an organism) or for many individuals of different species (eg, ionizing radiation). The most unfavorable assessment is the combined impact of several risk factors on the body, for example, the simultaneous presence of risk factors such as obesity, physical inactivity, smoking, and carbohydrate metabolism disorders significantly increases the risk of developing coronary heart disease.
Since from a biological point of view, health is a state of homeostatic equilibrium, broad adaptability and resistance, the modern concept of health expands from a narrow to a broader understanding of the health of different types of organisms, communities and even ecosystems.
Let's consider some of the most typical pathological conditions and human diseases. First of all, it should be noted that a pathological condition in each individual organism, in each individual person most often does not arise immediately, but through the accumulation of fatigue, uncompensated stress conditions, i.e. what in medicine is often called a pre-disease state.
When classifying diseases, they can be divided into several main groups.
Hereditary diseases. Diseases that occur in carriers of mutant genes. With simple (Mendelian) inheritance, this is the presence of one mutant gene. Examples of such diseases that are caused by mutations (gene or chromosomal) are Down syndrome, which appears as a result of violations of the chromosome set, as well as phenylketonuria - a metabolic disease, a consequence of a gene mutation, which threatens the child with mental retardation if he does not receive special (dietary) nutrition from birth. ) nutrition. Gene mutations are the cause of diseases such as retinal tumor (retinoblastoma) and hemophilia.
Hereditary predisposition to diseases as a result of polygenic inheritance is often found: ulcerative and cardiovascular diseases, diabetes mellitus, various types of allergies.
Hereditary diseases are largely related to the conditions of the human environment. In particular, mutations can appear in the body not only spontaneously, but also under the influence of certain environmental factors, called mutagenic. The main mutagenic factor in the environment is ionizing radiation
(radiation). A number of chemical mutagens entering the environment from many chemical industries have also been identified. A number of viral diseases also have a mutagenic effect, making the heredity of an individual more variable and causing hereditary predispositions to pathologies.
Ecopathology - diseases caused by environmental factors. First of all, these are “lifestyle diseases” associated primarily with insufficiency or excess nutrition. With insufficient nutrition, the content of vitamins, microelements, and proteins in food is below normal, which leads to severe health problems. With excess nutrition, obesity develops, which leads to such serious pathologies as diabetes, cancer, and cardiovascular diseases. Therefore, excess or imbalance of nutrition plays no less destructive role than its deficiency. An excess of refined food consumed by the population of economically developed countries, especially urban residents, excessive consumption of animal fats, sugar, various canned foods, sausages, smoked meats - all this contributes to the occurrence of a number of systemic diseases of both digestion and the entire body as a whole.
The human environment is also a source of “stress” influences. These are primarily factors influenced by physical and chemical stress. Physical stress factors are associated with disturbances in light, acoustic or vibration conditions, as well as in the level of electromagnetic radiation. As a rule, deviations from the norms of these factors are characteristic of an urban or industrial environment, where the conditions to which the human body is evolutionarily adapted are most often and to the greatest extent violated. Chemical stress factors are extremely diverse. In recent years, more than 7 thousand different substances, previously alien to the biosphere, have been synthesized - xenobiotics (from the Greek. xenos - stranger and biote- life). Decomposers in natural ecosystems cannot cope with so many foreign substances, for the decomposition of which there are no specialized biochemical mechanisms in nature, therefore xenobiotics are a dangerous type of pollution. The human body also cannot cope with these foreign artificial substances, because it does not have the means to detoxify them.
In addition to physical and chemical stress, people in the modern world are affected by overpopulation stress, typical for big cities. He finds himself in numerous psychological stressful situations of intense social life. It is important that a person faces stress factors not only in real situations, but also in virtual ones, arising from an excess of information received through television, radio, and when using personal computers. And finally, the very nature (content) of incoming information often leads the human body to stressful conditions.
Concept "stress" was introduced into medicine and physiology by G. Selye in the 30s. XX century, who considered stress as a nonspecific reaction of the human body that occurs in response to increased environmental demands, and gave it the definition of “adaptation syndrome.” This definition is acceptable for stress caused by a variety of reasons and characterizes the adaptation mechanisms of a variety of living systems. Stress in both animals and humans is a nonspecific neurohumoral reaction of the body, carried out by mobilizing the nervous and humoral systems to adapt to the demands of the environment. The state of stress is the most important factor in regulating the reproduction of all living beings, i.e. factor regulating population numbers. There are several phases of stress:
- - the first phase is the phase of anxiety or mobilization, when the nervous system, more precisely receptors, perceive signals from the external environment, and the nerve centers, assessing their significance, transmit a command to the humoral system. After a complex chain of interactions, “stress hormones” are released - mainly adrenal hormones;
- - the second phase is the resistance phase, which the body then enters when, under the influence of stress hormones, all organs and systems of the body begin to work in a mode of increased activity;
- - the third phase can occur in different ways. If the body has coped with stress and reached a higher level of adaptability, then this is the compensation phase (ew stress).
Repeated eustress with increasing load leads to a training response and greater adaptation of the body. Overcoming stress brings the human body to a new, higher level of tolerance. If exhaustion occurs in the body, often leading to illness or even death, this is debilitating stress (distress). The outcome of stress depends not only on the nature and strength of the impact of the factor that caused it, but also on the initial physiological state of the body. The more stable the body is (healthy and adaptive), the better all its systems maintain homeopathic balance, the greater the chance of a favorable outcome of stress.
Natural focal diseases(endemic) - a group of ecopathologies (diseases associated with an unfavorable environment). They are caused by the fact that a person lives either in an area where pathogens of a disease live (for example, tick-borne encephalitis), or in an area of the globe that has geochemical or geophysical features.
Features of biogeochemical provinces of large territories, characterized by specific features of the composition of the biological environment, affect human health, as well as the species composition of the biota. Special biogeochemical provinces can be characterized by: volcanic activity of the geosphere; anomalies of the Earth's physical fields; tectonic phenomena; phenomena of weathering or destruction of rocks; characteristics of incoming solar radiation and biogeochemical reactions; regime of changes in temperature, precipitation, and wind activity.
Examples of biogeochemical provinces are Inner Mongolia and the Hu-bao and Yellow river basins. These areas are enriched with arsenic, fluorine, chlorine ions and sulfate ions, hydrocarbons, and organic substances. The characteristic endemic diseases occurring in these areas are arsenic poisoning, fluorosis and diarrhea. There are areas in China where waters and soils are enriched with chromium, nickel and vanadium. Stomach cancer is very common among people in these areas. There are significant areas where waters are enriched with fluoride. Dental and bone fluorosis is common there. There are many places around the globe where iodine deficiency occurs, and thyroid disease and cretinism are endemic diseases there. An excess of selenium in the environment leads to poisoning and often to lung cancer, while its deficiency leads to Keshan disease.
On the territory of Russia, an excess of strontium against the background of a lack of calcium, as well as intoxication with phosphorus and manganese are characteristic of Eastern Siberia. In this case, arthrosis occurs simultaneously with deforming osteochondrosis. In the Karelo-Kola region, with a significant lack of fluorine and iodine in water and soil, an increased incidence of caries and thyroid dysfunction are observed. In the Volga River basin, especially in Mordovia, where there is an excess of fluoride, fluorosis occurs more often than in other places.
Local areas of the Earth's surface that have anomalies in physical fields are called geopathogenic zones. They are associated with the phenomenon of geopathogenic stress, which causes rapid pulse, high blood pressure, insomnia, nightmares, and early mortality. These phenomena occur in places where faults in the lithosphere have been identified, so they are often associated with the presence of radon, which comes to the surface from the bowels of the Earth through faults. The geopathogenic influence on people in seismic areas, especially before an earthquake, is known. It is there that powerful anomalies in the Earth’s physical fields arise, causing biochemical changes in the human body, as well as changes in the behavior of animals. People in such places experience depression, their blood count changes, and attacks of heart failure often occur. A significant contribution to data on geopathology was made by the scientific school of heliobiology, founded by A.L. Chizhevsky, who was the first to show the fundamental influence of solar activity on various biosphere processes, including changes in the pathogenicity of pathogens of various diseases. Solar activity plays a big role in changes in the geomagnetic situation on Earth. Forecasts based on the study of the periodicity of solar activity have very important environmental and medical significance.
Diseases of aging - a large group of human diseases and pathological conditions that are associated with age-related changes (obesity, cancer, diabetes, hypertension) - syndromes associated not only with age, but also with environmental factors. The concept of biological age reflects a certain complex of morphofunctional changes in the body, simple indicators of which are a person’s performance and adaptability, his functional activity. Age-related changes occur in each individual person not only in accordance with his astronomical age, but also depending on environmental factors. All ecopathologies lead to premature aging, which is especially clearly visible in places of environmental disasters, environmental disasters, and in places where geopathological phenomena are noted.
Understanding of the role of the environment as a critical determinant of public health has increased significantly in recent years (Revich et al., 2004). All risk factors associated with the environment can be divided into 2 groups: controllable and uncontrollable.
TO controllable factors risks include atmospheric air pollution by emissions from stationary and mobile sources; organized and unorganized discharges of contaminated water, changes in the quality of drinking water as a result of the addition of reagents in the process of water treatment and disinfection; soil pollution as a result of the receipt of liquid and solid waste, the introduction of chemicals to increase crop yields.
Uncontrollable factors are global in nature and affect the hydrosphere, atmosphere, lithosphere, flora and fauna, as well as the human population. The importance of global risk factors (climate warming, thinning of the background shell of the atmosphere, activation of solar rays, especially the ultraviolet spectrum, changes in the earth’s magnetic field and air ion composition, transboundary transport of pollutants, etc.) is increasing from year to year.
Table 4.2 provides a generalized list of environmental factors that contribute to the emergence and spread of certain classes and groups of diseases.
Table 4.2
The relationship between adverse environmental factors and human diseases (Ecology..., 2004)
|
Disease |
||
|
Malignant neoplasms |
and nitrites, pesticides and other carcinogens.
|
|
|
Mental disorders |
|
|
|
Pathology of pregnancy and congenital anomalies |
|
|
|
Diseases of the circulatory system (heart, blood vessels) |
|
|
|
Respiratory diseases |
|
|
Disease |
Impact of an unfavorable factor |
|
|
||
|
Digestive diseases |
|
|
|
Endocrine system diseases |
|
|
|
Blood diseases |
|
|
|
genitourinary |
|
Atmospheric air as a natural resource it is a common property for all mankind. The constancy of its composition (purity) is the most important condition for the existence of humanity. Therefore, any changes in composition are considered as atmospheric pollution (Nikolaikin et al., 2004).
Atmospheric air plays a significant role in everyday metabolism in the human body, therefore the most important condition for a healthy environment is the presence of clean and comfortable air (Keller et al., 1998).
The growth of cities, the number of motor vehicles, and the development of industry lead to an increase in the content of various pollutants in the atmospheric air.
The danger of exposure to polluted atmospheric air on health is due to: the variety of pollution (and the combined effect of harmful substances can lead to an increase in the toxic effects they cause); the possibility of massive impact, since the act of breathing is continuous; direct access of pollutants to the internal environment of the body (breathing air comes into almost direct contact with blood, in which almost all substances dissolve) (Protasov, 2000). In addition, gases, aerosols and dust entering the air basin from stationary and mobile sources cause phenomena such as the greenhouse effect, acid rain, smog, and destruction of the ozone screen (Khotuntsev, 2004).
The impact of atmospheric air on humans has its own characteristics and is distinguished by the following (Stozharov, 2007):
- - alveolar tissue of the lungs has enormous absorption capacity, therefore, xenobiotics, even in trace quantities, can easily penetrate into the internal environment of the body;
- - xenobiotics absorbed through the lungs immediately enter the systemic circulation and thereby bypass the powerful filter - the liver, where they are neutralized;
- - it is impossible to use personal protective equipment.
The degree of danger of atmospheric air pollution is assessed by two main classes of substances - carcinogenic substances that can cause malignant tumors, and non-carcinogenic substances. A number of carcinogenic substances also affect heredity, which is reflected in an increase in the frequency of genetically determined diseases.
Non-carcinogenic substances cause a wide range of human health disorders, which can be considered as different forms of manifestations of toxic effects recorded at the molecular, cellular, tissue, organismal and population levels. The latter effects are manifested in the form of increased morbidity and mortality. First of all, this is an increase in the number of chronic respiratory diseases and mortality associated with these diseases, as well as an increase in mortality as a result of diseases of the circulatory system (Revich et al., 2003).
Motor transport makes a significant contribution to air pollution. Over the years, the number of vehicles in Russia has increased noticeably, which in turn leads to an increase in the volume of pollutants released into the atmosphere. Gaseous products of automobile exhausts enter the ground layer of air practically without any purification. In the immediate vicinity of traffic jams and traffic jams, the level of air pollution, even under the most favorable weather conditions, exceeds permissible standards and is a real threat to human health and the environment (Taneeva et al., 2009). Toxic substances contained in exhaust gases can remain in the atmosphere for a long time and be transported over long distances.
The main pollutants entering the air from motor vehicles include: carbon dioxide (CO2), carbon monoxide (CO), sulfur dioxide (SO2), nitrogen oxides (NO x), volatile hydrocarbons (VOCs) and particulate matter derived from them , including a substance of the 1st hazard class - benzopyrene, etc. (Nikolaikin et al., 2004). All of them have a negative effect on the human body: they affect the nervous and cardiovascular systems; irritate the mucous membranes of the respiratory tract; cause dizziness, headaches, lead to poisoning and the development of cancer (Protasov, 2000).
Table 4.3
Consequences of exposure to certain air pollutants on human health (Protasov, 2000; Revich, 2002; Revich et al., 2003; Korobkin et al., 2007)
|
Pollutants |
Consequences of exposure to the human body |
|
Weighted substances |
Increased frequency of cough, exacerbation of bronchial asthma, bronchitis; increase in mortality from respiratory and cardiovascular diseases |
|
Nitrogen oxides |
Increased susceptibility of the body to viral diseases (such as influenza); lung irritation, bronchitis, pneumonia |
|
Sulfur dioxide |
Irritant effect, damage to the respiratory system, central nervous system, skin, eyes; increase in mortality from cardiovascular and respiratory diseases |
|
Carbon monoxide |
An increase in the level of carboxyhemoglobin in the blood, a change in psychomotor reactions in children; increase in referrals for heart disease; when exposed to high concentrations - acute poisoning |
|
Irritation of the mucous membrane of the respiratory system, cough, impaired lung function; decreased resistance to colds; bronchitis, asthma, exacerbation of chronic heart diseases |
|
|
Hydrocarbons, including benzo(a)pyrene |
Irritation of the respiratory tract, dizziness, drowsiness, decreased immunological activity of the body, malignant neoplasms |
|
Effect on the circulatory, nervous and genitourinary systems; increased blood pressure; violation of psychological parameters and behavior |
The atmospheric air of a number of cities also contains such specific inorganic substances as copper, mercury, lead, cadmium, hydrogen sulfide, carbon disulfide, fluoride and some other substances (Revich et al., 2003).
Table 4.3 summarizes possible health problems caused by exposure to a particular pollutant.
Internal environment of premises. People spend a significant part of their lives in various premises (residential buildings, kindergartens, schools, offices, etc.). The quality of the internal environment of the home is of greatest importance for such high-risk groups as children, pregnant women, the sick, the elderly, etc. Chemicals (nitrogen dioxide and carbon monoxide, suspended solids, volatile organic compounds, etc.) enter the indoor air when burning coal, gas and other fuels in kitchens, during the destruction of polymer materials, from atmospheric air (Revich et al., 2003).
Below are general requirements for environmental quality in residential premises.
Table 4.4
Optimal standards for temperature, relative humidity and air speed in residential, public and administrative premises (SNiP 2.04.05-91 “Heating, ventilation and air conditioning”)
Note. The standards are set for people staying indoors for more than 2 hours continuously.
Hygienic standardization thermal factors must ensure their complexity, differentiation and guarantee. The last principle means that normalized microclimate parameters should guarantee the preservation of health and ability to work even for a person with reduced tolerance to fluctuations in environmental factors. From the point of view of ensuring human thermal comfort, the ratio of convective, radiant and conductive components of heat exchange when using different engineering heating systems is of great importance. Optimal temperature parameters range from 20 to 23 °C in cold climates, from 20 to 22 °C in moderate climates, and from 23 to 25 °C in hot climates.
Of great importance for human heat exchange is air humidity in room. Relative humidity of 30-65% is considered acceptable. Exceeding these values in winter is extremely undesirable, since moist air has high thermal conductivity and heat capacity, and this increases heat loss by radiation and convection. To create comfortable conditions in heated rooms, it is desirable to maintain a relative air humidity of 30-45%, since at a humidity below 30% the mucous membrane of the respiratory tract begins to dry out, in addition, there is a danger of an electrostatic charge appearing on the surface of carpets.
An important microclimatic indicator is air speed. Moving air affects the human body in two ways: physically and physiologically (reflexively). A slight movement of air not only blows away the water vapor-saturated and overheated layer of air, but also acts on human tactile receptors and stimulates complex reflex processes of thermoregulation. At the same time, its excessive speed, especially in conditions of hypothermia, increases heat loss by convection and evaporation and contributes to cooling the body (Communal..., 2006).
Table 4.5 summarizes the main sources of pollutants in residential air and provides recommendations for reducing pollution.
The consequences of exposure to chemicals on the human body can be various: inflammation of the respiratory tract and lungs, pneumonia, lung cancer, weakened immune response, allergies, respiratory diseases, etc. There is also evidence of a connection between indoor air pollution and low birth weight babies body, coronary heart disease, as well as cancer of the nasopharynx and larynx.
The population in their houses and apartments is exposed not only to polluted air, but also to physical factors: increased levels of electromagnetic fields, noise and reduced levels of illumination and insolation. Figure 4.2 shows the frequency ranges of human technology used in everyday life.
As the distance from the device increases, the magnetic field decreases (Fig. 4.3).
Table 4.5
The main sources of air pollution in residential premises and the main recommendations for reducing pollution levels (Zhilishche..., 1998)
|
Main air pollutants (sources of pollution) |
||
|
pollution |
pollution |
|
|
Gas stove |
Products of incomplete combustion of natural gas |
Maintain the serviceability of the stove: do not cook at maximum gas flow rates; When preparing food, close the door connecting the kitchen with other living spaces, open the window or window |
|
Components of adhesives, furniture |
Formaldehyde, etc. |
|
|
Components of electrical insulating materials |
Formaldehyde, etc. |
Systematically ventilate the premises; place indoor flowers in them; systematically carry out wet cleaning |
|
Varnished floor coverings |
Formaldehyde, etc. Dust particles of varnish coating |
Systematically ventilate the premises; place indoor flowers in them; systematically carry out wet cleaning |
|
Products made of polymer materials, film materials |
Plasticizers. Dust particles of polymeric materials |
Systematically ventilate the premises; place indoor flowers in them; systematically carry out wet cleaning |
|
Films for paint and varnish coatings of walls and ceilings: films of putty compounds, sealants |
Solvents |
Systematically ventilate the premises |
|
Dust from powdered synthetic detergents |
Surfactants, etc. |
Use synthetic detergents in liquid or paste form; Be careful when dosing powdered drugs; systematically carry out wet cleaning |
|
Household chemicals stored in residential premises |
Gaseous products. Dust-like |
Do not allow long-term storage and do not have excess household chemicals in residential premises |
|
Main air pollutants (sources of pollution) |
||
|
Chemical products remaining in the air of a living space due to increased consumption of drugs during their use |
Gaseous products. Dust-like |
Follow the rules for using drugs according to the instructions: do not allow them to be used for other purposes and do not exceed dosages. |
|
Tobacco smoke |
Gaseous products |
No smoking in residential areas |
|
Pile of carpeted floors, carpet runners and curtains made of synthetic and artificial fibers |
Dust-like |
Systematically carry out wet cleaning using a vacuum cleaner |
|
Polluting components of the external (external) air pool |
Gaseous products. Dust-like |
Plant trees and shrubs near houses; keep fresh flowers on balconies, terraces and residential premises; systematically carry out wet cleaning of premises |
Rice. 4.2.
Rice. 4.3.
Rice. 4.4.
A feature of many residential premises is also a high level of biological pollution (bacteria, fungi, mites, pollen), which leads to allergization of people living in them (Revich et al., 2003).
Changing of the climate is considered as one of the negative global factors affecting public health. The impacts of climate change on human health are varied. The direct impact is mainly associated with an increase in the number of days with extremely high and/or low temperatures, the frequency and intensity of floods, storms, typhoons, etc. The indirect impact is due to a decrease in the volume of available good-quality drinking water, an increase in the frequency of elevated levels of air pollution under unfavorable meteorological conditions (Assessment report..., 2008).
Direct and indirect impacts negatively affect human health and lead to increased morbidity and mortality. Thus, persistent, prolonged hot weather causes an increase in the incidence of cardiovascular diseases and mortality. On hot days, angina pectoris also worsens with the appearance of chest pain, headache, dizziness, nausea, fatigue, etc. Groups at greatest risk include young children, people of retirement age, people whose professional activities involve being outdoors, and people with low incomes (Revich, 2008). Natural disasters (floods, storms, hurricanes, typhoons, etc.) caused by climate change lead to an increase in the number of injuries, mental disorders, and infectious diseases (dysentery and intestinal infections).
The effects of extreme heat can be exacerbated by air pollution. Concentrations of pollutants in the air often increase on hot days, which leads to an increase in the incidence of diseases of the respiratory system, circulatory system and an increase in mortality from myocardial infarction.
Extremely low temperatures also have a negative impact on health. When exposed to low temperatures, the groups at greatest risk include older people, alcoholics and people without a fixed place of residence (Assessment report..., 2008).
In addition, it should be noted that climate change affects the prevalence of natural focal diseases, changing the conditions of existence of vector populations and the conditions for the development of pathogens in the vector (Revich, 2008).
Drinking water. Water is not only the basis of life on Earth, but also a significant factor in shaping population health and quality of life. The World Health Organization estimates that up to 80% of all diseases are related to water in one way or another (Keller et al., 1998). The hydrochemical composition of drinking water, the presence of various impurities, bacteriological contamination - all this affects health and leads to the development of certain diseases.
According to the World Health Organization (WHO), poor quality of water and supply, poor sanitation and hygiene are considered the second biggest cause of loss of potentially healthy years of life due to death and disease, after poor nutrition.
Hygienic requirements and drinking water quality standards are based on three methodological principles:
- - water must be safe in epidemiological and radiation terms;
- - harmless in chemical composition;
- - have favorable organoleptic properties.
Water must meet these requirements before it enters the distribution network, as well as at the water intake points of the external and internal water supply network (Revich et al., 2003).
Table 4.6 provides generalized examples of possible health problems associated with excess or deficiency of certain chemicals in drinking water.
The soil is the most important element of the biosphere, on which the state of human health depends. A number of chemical elements contained in the soil are necessary for the normal functioning of the body. Their deficiency, excess or imbalance can cause diseases called microelementoses, or biogeochemical endemics, which can be both natural and man-made. In their distribution, an important role is played not only by water, but also by food products, into which chemical elements enter from the soil through food chains (Keller et al., 1998).
Table 4.6
Possible health problems due to insufficient or excessive levels of chemicals in drinking water (Keller et al., 1998; Protasov, 2000; Revich et al., 2003;
Stozharov, 2007)
|
Chemical substance |
Health disorders |
|
Endemic fluorosis, destruction of tooth enamel, impaired ossification of the skeleton in children, kidney damage, disruption of the thyroid gland - in excess; dental caries - with a lack of |
|
|
Itching, dryness, flaking of the skin - with excess |
|
|
Strontium |
Hypoplasia of tooth enamel, reversible changes in bone tissue - with excess |
|
Manganese |
Effect on the formation of connective tissue and bones, carbohydrate and lipid metabolism, body growth |
|
Calcium and magnesium salts (water hardness) |
Urolithiasis, hypertension - in case of excess; diseases of the cardiovascular system - with insufficiency |
|
Endemic goiter, thyroid cancer - with deficiency |
|
|
Malignant neoplasms, intoxication of the liver, kidneys, nervous system disorders |
|
|
Kidney damage, malignant neoplasms |
|
|
Minamata disease (mercuriosis) (accompanied by visual, hearing, touch, and neurological disorders) |
|
|
Damage to the liver and kidneys, weakening of the immune system - in excess; anemia, diseases of the cardiovascular system - with a lack of |
|
|
Weight loss, depression, malignancy |
|
|
Chlorine and its derivatives |
Cancer of the bladder, rectum; depression of the nervous system, damage to the kidneys, liver, pregnancy pathologies |
|
Nitrates and nitrites |
Methemoglobinemia, increased incidence of acute respiratory infections, pneumonia, influenza, skin infections |
|
Damage to the nervous system, irritation of the mucous membrane of the mouth, nasopharynx, and gastrointestinal tract |
|
|
Petroleum products |
Pathologies of the gastrointestinal tract |
Food contamination. The majority of many toxic substances enter the human body with food. Thus, heavy metals may be present in plant products grown on lands near industrial areas and along roads; fish and seafood; canned food in tin containers; dishes and packaging material. Nitrosoamines are found in fish and meat products, milk, tobacco smoke, and are also formed and released into the air when smoking products using nitrates and nitrites, frying, drying, and salting (Revich et al., 2003).
Intensive use of fertilizers and agrochemicals in agriculture increases the risk of nitrates and pesticides entering the human body along with plant products. Persistent organic pollutants, such as dioxins, polychlorinated biphenyls, come from seafood, butter, chicken, and cereals. This list can be continued indefinitely (Stozharov, 2007).
All of the listed substances have a toxic, carcinogenic effect, negatively affect people’s health and lead to various consequences: an increase in the incidence of diseases of the blood and hematopoietic organs, cardiovascular, endocrine, digestive, genitourinary systems, an increase in cases of poisoning and nervous disorders, the occurrence of neoplasms, reproductive health disorders (Revich et al., 2003; Stozharov A.N., 2007).
Electromagnetic fields(EMF) can be broadly divided into static and low frequency electric and magnetic fields (LFF). Common sources of EMF include power lines, household appliances, computers, radar installations, radio and television installations, mobile phones and their base stations, induction heating and anti-theft devices. According to WHO, exposure of the general population to EMFs is high and continues to increase.
Research in the field of biological effects of EMFs has made it possible to determine the most sensitive systems of the human body - nervous, immune, endocrine and reproductive. Among the registered consequences of exposure to electromagnetic pollution on humans are damage to the basic functions of the body, including damage to the cardiovascular and digestive systems, the development of mental disorders, etc.
The result of prolonged exposure to EMF, even at relatively weak levels, can be cancer, insomnia, memory loss, Parkinson's and Alzheimer's diseases, behavior changes, bronchitis, asthma, migraines, chronic fatigue, etc. (Khotuntsev, 2004).
Noise and health. Noise impact is one of the forms of harmful physical impact on the environment. Noise pollution occurs as a result of an unacceptable excess of the natural level of sound vibrations (Korobkin et al., 2007). There are household, transport and industrial noise. Sources of noise in populated areas are: motor transport, railways, air transport, industrial and municipal facilities (Revich et al., 2003).
From an environmental point of view, in modern conditions noise becomes not only unpleasant to the ear, but also leads to serious physiological consequences for humans (Korobkin et al., 2007). Noise affects all organs and systems of the body. This influence can be either specific in nature - a change in hearing, or manifest itself in the form of such non-specific phenomena as increased blood pressure, weakened attention, memory, eye fatigue, sleep disturbance, nervous overload, as well as a decrease in school performance (Revich et al., 2003).
Radiation. Sources of radiation can be either natural or artificial. The main contribution to the dose received by people from sources of artificial radiation comes from various medical procedures, including x-ray diagnostics and radiotherapy units. A significantly lower dose is associated with nuclear explosions and the operation of nuclear power plants, despite a number of disasters.
A natural source of radiation is the element radon, which is formed by the decay of natural uranium and thorium. Radon can be contained in soil, building materials and water from underground sources (Stozharov, 2007). Natural sources of ionizing radiation create about 70% of the total dose received by humans from all sources of radiation (Revich et al., 2003).
Exposure to ionizing radiation has an extremely negative impact on the health of the population and leads to the occurrence of malignant neoplasms of the gastrointestinal tract, kidneys, thyroid gland, as well as leukemia (Revich et al., 2003; Stozharov, 2007).
In addition to the factors discussed above, human health is also influenced by geological structures, which include zones of increased permeability and stress of the earth’s crust, geopathogenic zones (tectonic faults), geochemical anomalies, increased background radiation, etc.
Thus, it has been proven that there is a statistically significant connection between the incidence of malignant neoplasms, multiple sclerosis, coronary heart disease, as well as changes in behavioral reactions and road traffic injuries with geopathogenic zones.
The heterogeneity of the structure of the earth's crust is also manifested in other medical-ecological (medico-geographical) phenomena. For example, when studying the health status of the rural population, it was found that in the areas of the Kursk Magnetic Anomaly there is an increased incidence of diseases of the cardiovascular system.
The heterogeneity and geologically active zones of the earth's crust are associated with changes in physical (geophysical) and energy fields, which are also not indifferent to human health, although their influence has not yet been sufficiently studied (for example, gravitational and electromagnetic fields).
It is also known that there are entire regions “lying” on rocks, the composition of which negatively affects human health. Such anomalies are explained by increased or decreased content in rocks, soils, underground and groundwater of a number of chemical elements - calcium, fluorine, iodine, selenium and especially phosphorus, mercury, arsenic, strontium, and natural radionuclides. Such territories also include areas of development of sandy-clayey rocks with a high uranium content. These deposits give rise to gas anomalies, including radon, which create conditions of biological discomfort (Keller et al., 1998).
