The population health risk was assessed in the microdistricts adjacent to a future road interchange area in Moscow. Its possible negative impact was studied by many parameters, including the carcinogenic risk. Evidence is provided to a need for planning decisions on the optimization and reduction of the possible risk.
Life cycle impact assessment (LCIA) and comparative risk assessment (RA) use the same building blocks for analyzing fate and potential effects of toxic substances. It is tacitly assumed that emission-effect calculations can give uniform and decisive answers in debates on toxicity problems. For several decades, mainstream policy sciences have taken a different starting point when analyzing decision making on complex, controversial societal issues. Such controversies in essence are thought to be caused by the fact that different actor coalitions adhere to a different, but in scientific terms equally reasonable, conceptualization or "framing" of the problem. A historical, argumentative analysis of the Dutch chlorine debate and the Swedish PVC debate shows that this is also true in the discussions on toxic substances. Three frames have been identified, which were coined the "risk assessment frame," "the strict control frame," and the "precautionary frame." These frames tacitly disagree about the extent of knowledge/ignorance about the impacts of substances, the robustness/fallibility of emission-reduction schemes, and the robustness/vulnerability of nature. The latter frame, adhered to by environmentalists, seeks to judge substances mainly on their inherent safety. Under the current institutional arrangements and practices, RA and LCIA are executed mainly in line with the philosophy expressed by the risk assessment frame. This article gives various suggestions for dealing with framing in debates on toxic substances. One of the options is elaborated in somewhat more detail, i.e., the development of multiple indicators and calculation schemes for RA and LCIA that reflect the different frames. An outline is given for a possible indicator system reflecting the precautionary principle.
The most informative priority environmental, social, and economic factors reflecting with the highest significance demographic processes in the urbanized and rural areas have been substantiated from the results of analyzing the data of the Regional Information Fund of sociohygienic monitoring by multivariate (correlation, factor, and regression) analysis methods. Models were obtained, which were used to define quantitative correlations between the demographic indices and the environmental-socioeconomic ones and to identify priority criteria for urbanized and rural areas while predicting their development and taking a managerial decision.
Research has shown that the introduction of health information systems (HISs) can reduce the likelihood of medical errors. However, there is a growing body of evidence that suggests that if it is not designed or implemented properly, a HIS can actually cause or induce health professionals to make medical errors (i.e., technology-induced errors). In order to maximize the benefits of HISs while decreasing the likelihood of such inadvertent technology-induced error, it is important that we understand the range of methods that can be used to ensure the safety of our systems. In this article, we report the results of a review of the literature related to the methods used in predicting, preventing and evaluating the potential for a HIS to cause technology-induced error. These methods can be classified in terms of their application, including before a HIS is implemented, after a HIS has been implemented and after a technology-induced error has occurred.
Novel innovative technology of assessment of level of total cardiovascular risk with consideration of a broad list of parameters of the state of individual health and its determining factors is described. The proposed model of risk is based on results of 20-year prospective observation of large contingents of population of Russia. For the first time the model of risk was constructed taking into account in addition to traditional risk factors and clinical characteristics peculiarities of population of Russia, in particular level of education. It was found in prospective studies that level of education in this country appeared to be an independent marker of risk and that traditional risk factors (behavioral, biochemical etc) had different prognostic value at different levels of education. Novel scale of risk and elaborated on its basis computer program of risk assessment allow to widen indications to its application, elevate accuracy of estimation of risk of development of fatal cardiovascular diseases for population of Russia, to obtain for a concrete patient parameters of absolute as well as relative risk (in % of excess or lowering of risk relative to its average statistical value for population with same age, sex, and level of education). The elaborated technology of estimation of total individual risk was tested on various contingents of patients with verified diagnoses of cardiovascular diseases as well as in groups of relatively healthy volunteers. Medical technology of risk assessment by novel scale is designed for application during primary screening of various population groups and can be fulfilled by both physicians and intermediate medical personnel. At present the computer program for assessment of cardiovascular risk based on this novel method is being prepared for clinical testing and subsequent implementation.
In the context of modern preventive medicine and a diversity of criteria for assessing the health status and the quality of the environment, the author has used an algorithm of comprehensive studies, which includes a differential analysis of the quality of the environment, by identifying xenobiotics in the atmosphere, soil, drinking water, and foodstuffs, then by ranging environmental factors in each specific region, by making a pooled assessment of a risk, by calculating the integral indices of public and community health, and by taking into account the socioeconomic situation in an area. Six priority indices of the 35 environmental ones, as well as 8 socioeconomic conditions that are most closely related with demographic parameters (r > 0.9) have been identified from the summarized environmental and socioeconomic conditions in the urbanized areas. Four ecological indices and 11 socioeconomic conditions have been identified in the rural areas.
The question of need for standardization and validation of the complex methods to establish the maximum concentration limit (MCL) ofbiotechnological strains in the water of water bodies is under discussion. On the basis of the experimental studies it has been shown that a unified quantitative criterion for safety could not to be recommended for biotechnological strains and therefore requires the study of each strain in order to substantiate the safe level in water of water bodies. Proposed biosafety program should include the study of pathogenic properties in acute experiments and specific effects in subchronic experiments to study the influence of strains on the process of water purification and a risk assessment of transformation products of chemicals and the justification of the safety factor when establishing MCL t in terms of the toxic effect.