[Earthquakes--a historical review, environmental and health effects, and health care measures]. / Potresi--povijesni pregled, okolisni i zdravstveni ucinci i mjere zdravstvene skrbi.

Earthquakes are natural disasters that can occur at any time, regardless of the location. Their frequency is higher in the Circum-Pacific and Mediterranean/Trans-Asian seismic belt. A number of sophisticated methods define their magnitude using the Richter scale and intensity using the Mercani-Cancani-Sieberg scale. Recorded data show a number of devastating earthquakes that have killed many people and changed the environment dramatically. Croatia is located in a seismically active area, which has endured a series of historical earthquakes, among which several occurred in the Zagreb area. The consequences of an earthquake depend mostly on the population density and seismic resistance of buildings in the affected area. Environmental consequences often include air, water, and soil pollution. The effects of this kind of pollution can have long-term health effects. The most dramatic health consequences result from the demolition of buildings. Therefore, quick and efficient aid depends on well-organized health professionals as well as on the readiness of the civil defence, fire department, and Mountain Rescue Service members. Good coordination among these services can save many lives Public health interventions must include effective control measures in the environment as secondary prevention methods for health problems caused by unfavourable environmental factors. The identification and control of long-term hazards can reduce chronic health effects. The reduction of earthquake-induced damages includes setting priorities in building seismically safe buildings.

Respiratory symptoms in fish processing workers on the Adriatic coast of Croatia.

This article describes respiratory symptoms and lung function in 98 fish processing female workers employed in a fish processing plant located on the Croatian Adriatic coast and 95 matching controls. The study included chronic and acute respiratory symptoms which developed during the shifts. Lung function measurements included forced vital capacity (FVC), one-second forced expiratory volume (FEV(1)) and maximal expiratory rates at 50 % and the last 25 % (FEF(50), FEF(25)). Chronic respiratory symptoms were significantly dominant in fish processing workers compared to controls. The most common chronic symptoms were hoarseness (57.1 %), nasal catarrh (51.0 %), chronic cough (42.9 %), chronic phlegm (34.7 %), and frequent chest cold (35.7 %). Exposed smokers and nonsmokers had a similar prevalence of chronic respiratory symptoms. Acute symptoms over the work shift were high, with headache in lead (smokers: 62.5 %; nonsmokers: 56.1 %). Most of the ventilatory capacity parameters were significantly lower than predicted, FEF(25) in particular, indicating obstructive changes predominantly in the smaller airways. These findings suggest that fish processing workers are prone to developing acute and chronic respiratory symptoms as well as to lung function changes. This calls for medical and technical preventive measures to be introduced in the work environment of the fish processing plant.

Microbiological and chemical indicators of water quality in indoor hotel swimming pools before and after training of swimming pool operators.

The present study was undertaken in order to determine the quality of indoor pool waters in hotels along the Croatian coast. We wanted to assess the risks of exposure to microbial and chemical contaminants and find out if training pool operators to use a quality assurance system, that we developed, influenced hygienic conditions and water quality in swimming pools or not. The samples were analysed for free chlorine, pH and several microbiological indicators according to standard laboratory methodologies. Of 1,329 samples tested, 276 were found to be unacceptable either by chemical (148) or microbiological parameters (128). After training, the proportion of unacceptable samples dropped by 23.5%, mostly according to the free chlorine values. According to our results, most of the microbiologically unacceptable samples had chlorine levels within the recommended range but their pH values were too high. A free chlorine level below 0.2 mg/L was found in 106 (82.8%) microbiologically unacceptable samples suggesting the need for maintaining the lower limit at least above 0.2 mg/L in order to reduce microbial risks to a more acceptable level. This measure combined with training of pool operators might result in reduced health risks in pool waters.

Monitoring the presence of genetically modified food on the market of the Republic of Croatia.

From the beginning of the human race people have been applying different methods to change the genetic material of either plants or animals in order to increase their yield as well as to improve the quality and quantity of food. Genetically modified organism (GMO) means an organism in which the genetic material has been altered in a way that does not occur naturally by mating and/or natural recombination. Analysing the presence of GMO in food is done by detecting the presence of either specific DNA sequences inserted in the genome of transgenic organism, or detecting proteins as a result of the expression of the inserted DNA. In this work food testing for the presence of genetically modified organisms was conducted during the period from 2004 to 2007 in the GMO laboratory of the Croatian National Institute of Public Health. According to the regulations, among the samples in which the presence of GMO was detected, all those which had more than 0.9% of GMO content were either rejected from the border or removed from the market, because such GM food has to be appropriately labelled. Among the food samples which were analysed in 2004: 127 (2.37%) of a total of 1226 samples contained more than 0.9% of GMOs; in 2005 there was only one in 512 (0.20%) samples in total; in 2006 there were 4 out of 404 samples (0.99%), and in 2007: 7 of a total of 655 samples (1.07%) had GMO content above the allowed threshold of 0.9%.

[Dietary habits and cardiovascular diseases]. / Prehrambene navike i kardiovaskularne bolesti.

Cardiovascular diseases are a major public health problem worldwide. They are the main cause of death in industrialized countries, while the mortality associated with cardiovascular disease is increasing in less developed countries. The modifiable risk factors for cardiovascular disease are cigarette smoking, hypertension, hyperlipidemia, diabetes mellitus and obesity. Obesity has been recorded in 10%-25% of the population, indicating that poor or inappropriate diet is one of the most common causes of cardiovascular disease. Unhealthy dietary habits including place and way of taking meals, number of daily meals and excessive salt intake from processed foods also contribute to body mass gain. In the present study, dietary habits were assessed in cardiovascular patients versus control group by use of Dietary Habits Questionnaire. Study results showed a statistically significantly higher (P < 0.05) prevalence of inappropriate eating habits in cardiovascular patients (lower number of daily meals, more often skipping breakfast and having dinner) than in control group. In conclusion, many lifestyle and individual behavior modifications are needed in most patients with or at a high risk of cardiovascular disease.

[Food processing industry--the salt shock to the consumers]. / Prehrambena industrija--udar soli na potrosace.

Industrial food production and processing is necessarily connected with the use of salt. Salt or sodium chloride is used as a preservative, spice, agent for color maintenance, texture, and to regulate fermentation by stopping the growth of bacteria, yeast and mold. Besides kitchen salt, other types of salt that also contain sodium are used in various technological processes in food preparing industry. Most of the "hidden" salt, 70%-75%, can be brought to the body by using industrial food, which, unfortunately, has been increasingly used due to the modern way of life. Bread and bakery products, meat products, various sauces, dried fish, various types of cheese, fast food, conserved vegetables, ready-made soups and food additives are the most common industrial foods rich in sodium. Many actions have been taken all over the world to restrict salt consumption. The World Health Organization recommends the upper limit of salt input of 5 g per day. These actions appeal to food industry to reduce the proportion of salt in their products. Besides lower salt addition during manufacture, food industry can use salt substitutes, in particular potassium chloride (KCl), in combination with additives that can mask the absence of salt, and flavor intensifiers that also enhance the product salinity. However, food industry is still quite resistant to reducing salt in their products for fear from losing profits.

Workplace noise exposure after modernisation of an aluminium processing complex.

The aim of this study was to assess to which extent modernisation of an aluminium production complex reduced occupational noise hazard for jobs with the highest potential of exposure. Periodical measurements of noise level were taken at the same workplaces using the same method, before and after modernisation of all plants. The results were compared with the recommended standard. After modernisation, the noise was significantly reduced in all sections of all plants. The greatest reduction was measured in the foundry. After modernisation, the portion of workplaces with excessive noise level dropped significantly (chisquare=21.315; p<0.0001) from 78.4% to 13%. Noise remained a problem in ingot casting and dross skimming section. In the anode plant, noise remained a problem in the green mill section where noise intensities generated by mills and vibrocompactors varied from 95 dB(A) to 102 dB(A). In the electrolysis plant, the portion of workplaces with extensive noise dropped from 77.8% to 39.3% after modernisation (p=0.0019). Noise remains to be a problem at the anode covering section where levels rise up to 100 dB(A). The modernisation of the factory has considerably reduced the noise level in the working environment of all plants, but it can not be reduced completely.

[The 60th anniversary of the Croatian Balneological and Climatological Institute]. / Sezdeseta obljetnica osnutka Balneolosko-Klimatoloskog Instituta Hrvatske.

Sixty years ago, more precisely on 28 August 1949, Croatian Ministry of Health founded the Balneological and Climatological Institute as a result of a long-term endeavor and attempts to provide Croatia with an institution of this type, already existing in many European countries. In 1953, the Institute came under the management of the Yugoslav Academy of Arts and Sciences/YAAS [today Croatian Academy of Sciences and Arts and became the Department of Balneoclimatology of the Medical Research Institute of YAAS. In 1958, it was transferred to the Medical School of the University of Zagreb, continuing to function first as the Institute of Balneoclimatology and Physical Therapy and, since 1963, as the Institute of Physical Medicine and Rehabilitation. In spite of financial difficulties and occasional lack of understanding from the officials in this field, significant contributions have been made to balneology during this time, justifying the need for such an institution. On 15 April 2008, the Institute of Physical Medicine and Rehabilitation became Department for Balneoclimatology, under the Department of Environmental and Occupational Health of Andrija Stampar School of Public Health, Rockfellerova 4, Zagreb.

[Causes of climatic changes and their consequences on human health]. / Uzroci klimatskih promjena i njihove posljedice za zdravlje covjeka.

Environmental disasters are common phenomena caused by human factors. Disaster episodes may be the result of climatic changes such as global warming, which can lead to floods or drought. Greenhouse gases, and especially the ozone, represent a special problem. Atmospheric pollutions are the result of fire, storm dusts, winds, acid rain, etc. Underwater earthquakes very often end in tsunami with waves of up to 30 meters. Disasters described in the territory of Croatia include atmospheric pollutions, fires, floods, and droughts. All disasters affect the health of the population, particularly of the elderly. This most often includes the cardiovascular and respiratory systems, allergic reactions, and carcinogenic effects, resulting in increased mortality.

[Effects of volcanic eruptions on environment and health]. / Ucinci vulkanskih erupcija na okolis i zdravlje.

Volcanoes pose a threat to almost half a billion people; today there are approximately 500 active volcanoes on Earth, and every year there are 10 to 40 volcanic eruptions. Volcanic eruptions produce hazardous effects for the environment, climate, and the health of the exposed persons, and are associated with the deterioration of social and economic conditions. Along with magma and steam (H2O), the following gases surface in the environment: carbon dioxide (CO2) and sulphur dioxide (SO2), carbon monoxide (CO), hydrogen sulphide (H2S), carbon sulphide (CS), carbon disulfide (CS2), hydrogen chloride (HCl), hydrogen (H2), methane (CH4), hydrogen fluoride (HF), hydrogen bromide (HBr) and various organic compounds, as well as heavy metals (mercury, lead, gold).Their unfavourable effects depend on the distance from a volcano, on magma viscosity, and on gas concentrations. The hazards closer to the volcano include pyroclastic flows, flows of mud, gases and steam, earthquakes, blasts of air, and tsunamis. Among the hazards in distant areas are the effects of toxic volcanic ashes and problems of the respiratory system, eyes and skin, as well as psychological effects, injuries, transport and communication problems, waste disposal and water supplies issues, collapse of buildings and power outage. Further effects are the deterioration of water quality, fewer periods of rain, crop damages, and the destruction of vegetation. During volcanic eruptions and their immediate aftermath, increased respiratory system morbidity has been observed as well as mortality among those affected by volcanic eruptions. Unfavourable health effects could partly be prevented by timely application of safety measures.

Exposure to chemical agents in aluminium potrooms.

OBJECTIVES: To assess the effects of modernization of aluminium production on reducing the chemical health hazards in the working environment in aluminium potrooms (smelter). Modernization included the introduction ofa technique of point feeding of alumina and aluminium fluoride into the pots, semi-automatic equipment and computerized control. METHODS: Periodical environmental measurements of chemical substances, dusts containing alumina and fluorides, and gases, i.e., carbon monoxide, carbon dioxide, sulphur dioxide, hydrogen fluoride, nitrogen dioxide, and difluorosulphide, were performed at the same workplaces before (1986-1988) and sixteen years later, after modernization (2004). The measured values were compared with the recommended occupational safety and health standards. RESULTS: The concentrations of total dust (alumina and fluorides) and gases, i.e., carbon monoxide, carbon dioxide, sulphur dioxide, hydrogen fluoride and phenol, were above the recommended standards in 76.6% (95/124) of the samples before modernization and in only 23.8% (57/240) of the samples tested after modernization. Before modernization in almost all jobs the workers were simultaneously exposed to higher concentrations of all chemical agents present in the working environment. After modernization high concentrations of hydrogen fluoride were the primary pollutant in this plant (GM = 4.5451 ppm), while the presence of other gases was significantly reduced. Dusts containing alumina and fluorides and hydrogen fluoride gas were still present in considerable concentrations in the working environments of jobs such as changing and covering of anodes. CONCLUSION: The modernization of the aluminium smelter plant reduced the concentrations of the most harmful substances in the working environment and reduced the number of jobs where workers were simultaneously exposed to a variety of health hazards.

Body mass index and nutrition as determinants of health and disease in population of Croatian Adriatic islands.

AIM: To investigate the relationships between body mass index (BMI), dietary habits, and cardiovascular risk factors in isolated Adriatic island populations of Croatia. METHODS: Random sample of subjects (n=1001) was interviewed, using a validated questionnaire developed for this research program. Dietary habits were assessed on the basis of applied Food Frequency Questionnaire (FFQ). Biochemical analyses of total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, and blood glucose were performed. Blood pressure (mm Hg), height (m), and weight (kg) were measured following standard procedures. RESULTS: Out of 1001 study participants, 507 (50.7%) were overweight (247 [48.7%] men and 260 [51.3%] women), whereas 268 (26.8%) were obese (122 [45.5%] men and 146 [54.5%] women). In both genders, there was a positive correlation between body mass index (BMI) and levels of triglycerides (P<0.001), glucose (P<0.001), diastolic blood pressure (P<0.001), and systolic blood pressure (male: P=0.002, female: P<0.001). Logistic regression showed that female gender (OR, 2.31; 95% CI, 1.61-3.31), overweight (OR, 1.97; 95% CI, 1.34-2.88), obesity (OR, 1.90; 95% CI, 1.22-2.96), more frequent consumption of meat (OR 1.17; 95% CI, 1.06-1.30) and beer (OR 1.14; 95% CI, 1.03-1.27), and less frequent consumption of potatoes (OR 0.91; 95% CI, 0.83-0.99) were predictive for the presence of cardiovascular risk factors. CONCLUSION: Prevalence of obesity and related health outcomes was surprisingly high for the studied population. We found a correlation between BMI, dietary habits, and cardiovascular risk factors.

Managing occupational safety and health in aluminum production: case study of aluminum production factory, Mostar, Bosnia and Herzegovina.

AIM: To assess the effect of modernization of the aluminium production on physical and chemical health hazards at work environment in the Aluminium Mostar factory. The modernization included introduction of automatic equipment, computerized management, and rationalized coke manipulation in Anoda, Electrolysis, and Cast House plants. METHOD: Periodical measurements of chemical (gas concentrations and aerosols) and physical (microclimatic factors, noise, and illumination) factors were performed at the same workplaces by the same methods of measurements before (1982-1988) and after the modernization (2004). The measured values were compared with the recommended Occupational Safety and Health Standards of Bosnia and Herzegovina. RESULTS: The number of workplaces with a high noise level was reduced from 65.0% (89/137) in 1982-1988 to 28.7% (51/178) in 2004. The best results were achieved in Cast House plant. The illumination of the workplace was partly improved. Values of microclimatic factors did not considerably change; they deviated from the recommended values at nearly all the workplaces in the factory. The concentrations of chemical agents were above the recommended standards in 56.3% (196/348) of the samples in 1982-1988, and in only 15.4% (99/645) of the samples tested in 2004. High concentrations of hydrogen fluoride have remained the primary pollutant in Electrolysis plant. CONCLUSION: The modernization of the factory has considerably reduced the amount of harmful substances at work environment in the Aluminum Mostar. However, the exposure to unfavorable physical factors has been only partly reduced.