Water, sanitation, and hygiene services in health care facilities in the Autonomous Province of Vojvodina, Serbia.

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.

Short-term health effects of air quality changes during the COVID­19 pandemic in the City of Novi Sad, the Republic of Serbia.

OBJECTIVES: The objective of this research is to determine the change in outdoor air quality during the COVID­19 related state of emergency resulting in a lockdown and the potential health benefits for the urban population. MATERIAL AND METHODS: During 53 days of the COVID­19 related state of emergency with a lockdown (March 15-May 6, 2020) in the Republic of Serbia, as well as in the corresponding periods of 2018 and 2019, data on the daily sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3) and particulate matter (PM10 and PM2.5) concentrations were analyzed. The total mortality data were analyzed to estimate the impact of the COVID­19 related lockdown measures on the burden of health in a given population, attributed to the outdoor air quality in the City of Novi Sad, using AirQ+ software. RESULTS: The average daily concentrations of PM2.5, NO2, PM10 and SO2 were reduced by 35%, 34%, 23% and 18%, respectively. In contrast, the average daily concentration of O3 increased by 8%, even if the primary precursors were reducing, thus representing a challenge for air quality management. In the City of Novi Sad, a reduction in the average daily PM2.5 concentration of 11.23 µg/m³ was significant, which resulted in a quantified number of avoided deaths. CONCLUSIONS: Air pollution in the City of Novi Sad had a chance to be improved due to some preventive measures related to the infectious disease (the COVID­19 related lockdown), which in turn was the mitigation measure to air pollution with positive public health effects. The confirmed positive effects of the improved air quality on public health could also include raising collective resistance to mass non-communicable and infectious diseases such as COVID­19 and reducing economic costs. Int J Occup Med Environ Health. 2021;34(2):223-37.

Impact of climate conditions on hospital admissions for subcategories of cardiovascular diseases.

BACKGROUND: The aim of this study has been to examine the association between climate conditions (CC) and hospital admissions for the subcategories of cardiovascular diseases (CVD), according to patients' age. MATERIAL AND METHODS: From January 2010 through December 2011, the daily number of hospital admissions for angina pectoris (AP), essential hypertension (EH), acute myocardial infarction (AMI) and ischemic heart diseases (IHD) for adults (19-64 years old) and the elderly (≥ 65 years old), as well as for the CC (N = 728 days) was collected for multivariate Poisson regression analysis, confounding with season and weekends. The results were expressed by using the relative risk with the corresponding 95% confidence interval. RESULTS: The risk for the AMI among the adults and the elderly is significantly higher for 41.8% and 38.9%, respectively on the days with lower ambient temperature and lesser for 32.7% and 29.8%, respectively on the days with lower air pressure values. The risk for the IHD among the elderly is significantly higher on the days with lower ambient temperature and lower relative humidity for 50.6% and 37.4%, respectively. CONCLUSIONS: Our findings explain how the CC and subcategories of CVD are associated, which could be used for adequate public awareness of the risk for hospitalization due to climate conditions. Med Pr 2017;68(2):189-197.

Testing for viral material in water of public bathing areas of the Danube during summer, Vojvodina, Serbia, 2014.

From August to September 2014 a water quality study was conducted on five popular public Danube beaches in Vojvodina, Serbia. To assess the safety of Danube water for bathing, physical, chemical, bacteriological tests were performed. While many parameters for monitoring the quality of water are regulated by law, there are neither national nor international legislations addressing the presence of viruses in recreational waters. In this study, we performed analyses that surpassed national requirements, and investigated if adenovirus, enterovirus or rotavirus genetic material was present in samples of recreational water collected for quality monitoring. Of 90 water samples obtained during the study, enterovirus material was not found in any sample, but adenovirus and rotavirus genetic materials were respectively detected in 60 and 31 samples. Statistical analyses showed a significant correlation between adenovirus DNA and total coliforms in the water. Even when water samples were adequate for recreational use, adenoviruses were detected in 75% (57/76) of such samples. Our results indicate that implementation of viral indicators in recreational water might be helpful to better assess public health safety. This might be particularly relevant in areas where urban wastewater treatment is insufficient and surface waters affected by wastewater are used for recreation.

Cardiovascular diseases and air pollution in Novi Sad, Serbia.

OBJECTIVES: A large body of evidence has documented that air pollutants have adverse effect on human health as well as on the environment. The aim of this study was to determine whether there was an association between outdoor concentrations of sulfur dioxide (SO2) and nitrogen dioxide (NO2) and a daily number of hospital admissions due to cardiovascular diseases (CVD) in Novi Sad, Serbia among patients aged above 18. MATERIAL AND METHODS: The investigation was carried out during over a 3-year period (from January 1, 2007 to December 31, 2009) in the area of Novi Sad. The number (N = 10 469) of daily CVD (ICD-10: I00-I99) hospital admissions was collected according to patients' addresses. Daily mean levels of NO2 and SO2, measured in the ambient air of Novi Sad via a network of fixed samplers, have been used to put forward outdoor air pollution. Associations between air pollutants and hospital admissions were firstly analyzed by the use of the linear regression in a single polluted model, and then trough a single and multi-polluted adjusted generalized linear Poisson model. RESULTS: The single polluted model (without confounding factors) indicated that there was a linear increase in the number of hospital admissions due to CVD in relation to the linear increase in concentrations of SO2 (p = 0.015; 95% confidence interval (95% CI): 0.144-1.329, R(2) = 0.005) and NO2 (p = 0.007; 95% CI: 0.214-1.361, R(2) = 0.007). However, the single and multi-polluted adjusted models revealed that only NO2 was associated with the CVD (p = 0.016, relative risk (RR) = 1.049, 95% CI: 1.009-1.091 and p = 0.022, RR = 1.047, 95% CI: 1.007-1.089, respectively). CONCLUSIONS: This study shows a significant positive association between hospital admissions due to CVD and outdoor NO2 concentrations in the area of Novi Sad, Serbia.