Mortality Characteristics of Two Populations in the Northern Mediterranean (Croatia) in the Period 1960⁻2012: An Ecological Study.

In the second half of the 20th century, the town of Bakar (Primorje-Gorski Kotar County, Croatia), where a coking plant was operational 1978⁻1994, experienced intensive industrialisation. The town of Mali Losinj (Primorje-Gorski Kotar County, Croatia) in this period based its economy on non-industrial sectors. The study goal was comparing mortality characteristics of these populations in the northern Mediterranean for 1960⁻2012. An ecological study design was used. Data were analysed for 1960⁻2012 for the deceased with recorded place of residence in the study area. Data on the deceased for 1960⁻1993 were taken from death reports, for 1994⁻2012 from digital archives of the Teaching Institute of Public Health, Primorje-Gorski Kotar County. Data on causes of death for 1960⁻1994 were recoded to the three-digit code of underlying cause of death according to the International Classification of Diseases (ICD⁻10). Among studied populations significant difference was found among the causes of deaths coded within ICD⁻10 chapters: neoplasms (particularly stomach carcinoma), mental and behavioural disorders and diseases of the respiratory system (particularly chronic obstructive pulmonary disease, (COPD)). Increase in mortality from neoplasms, increase in respiratory diseases for the area exposed to industrial pollution, also stomach carcinoma and COPD particularly in the town Bakar require further research.

Vaccine regulations in Croatia.

In this paper legal prerequisites for vaccine licensure in Croatia are discussed. The Croatian legislation concerning vaccine licensing, marketing authorisation and utilization is reviewed. The procedures for including a vaccine into the Mandatory Childhood Vaccination Programme are also discussed with focus on Human papillomavirus (HPV) vaccines. Non-obligatory vaccination recommendations are given when according to professional opinion; vaccination is beneficial for the vaccinee. There is little doubt that HPV vaccines should be recommended for preadolescent girls in Croatia. However, reaching a decision on its possible introduction into the Childhood Vaccination Programme will require careful consideration of the larger picture and a comparison of the cost-effectiveness of a mandatory vaccination against other competing public health priorities.