Cardiovascular effects of environmental noise: research in Serbia.

Research on the cardiovascular effects of noise in Serbia started in the year 2002, including experimental studies on humans and epidemiological studies on the adult and children population of Belgrade and Pancevo. Experimental exposure to noise [L eq = 89 dB (A)] had a hypodynamic effect, significantly lowering the cardiac index, cardiac work, and pump performance (P < 0.01). The vasoconstrictive effect of noise was shown through the significant elevation of after-load (P < 0.01). In a cross-sectional population study that was carried out on 2874 residents [1243 males and 1631 females] in Pancevo City, a significant odds ratio (adjusted for age, body mass index (BMI), and smoking habits) was found for self-reported hypertension (OR = 1.8, 95% CI = 1.0 - 2.4, P < 0.01) in men with a high level of noise annoyance compared to those with a low level of noise annoyance. In another study on 2503 residents (995 men and 1508 women) residents of Belgrade, the proportions of men with hypertension in the noisy [(L night , 8h > 45 dB (A)] and quiet areas [(L night , 8h ≤ 45 dB (A)] were 23.6% and 17.5%, respectively. The adjusted odds ratio (OR) for hypertension of the exposed group was 1.58 (95% CI = 1.03 - 2.42, P = 0.038), where men living in quiet streets were taken as a reference category. Associations between road traffic noise and blood pressure were also investigated in 328 preschool children in Belgrade. The systolic blood pressure was significantly higher among children from noisy residences and kindergartens, compared to children from both quiet environments (97.30 ± 8.15 and 92.33 ± 8.64 mmHg, respectively, P < 0.01). As a continuation of the study on preschool children, investigations were also carried out on 856 school children, aged between seven and eleven years, in Belgrade. It was found that systolic pressure was significantly higher among children from noisy schools and quiet residences, compared to children from both quiet environments (102.1 ± 9,3 and 100.4 ± 10.4 mmHg, respectively, P < 0.01).

Prevalence of Arterial Hypertension and Myocardial Infarction in Relation to Subjective Ratings of Traffic Noise Exposure.

A cross-sectional study was performed on a 5% sample of the adult population of the city of Pancevo (3622 residents). The response rate was 79 % (2874), with 1243 interviewed males (43%) and 1631 females (57%). Noise annoyance was assessed on a five- grade verbal scale (Not at all; Slightly; Moderately; Very; Extremely). Arterial hypertension was defined by antihypertensive treatment, information on which was obtained from questionnaire. Myocardial infarction was also subjectively confirmed. Prevalence and odds ratios of arterial hypertension and myocardial infarction were computed for subjects who were very much and extremely annoyed by noise, or moderately annoyed, using residents who were slightly annoyed or not annoyed at all as a referent category. Significant odds ratios (adjusted for age, body mass index and smoking habits) were found for self-reported arterial hypertension [1,8 (1,0-2,4 - 95% confidence interval), P < 0,01] and myocardial infarction [1,7 (1,0-2,9), P < 0,05] in very much or extremely noise disturbed male subjects, compared to those who were not annoyed at all, or were slightly annoyed by noise. The respective odds ratios for females were lower and not statistically significant 1,1 (0,8-1,7) and 1 (0,4-2,0).

[Risk factors and health condition of workers in school environment].

INTRODUCTION: An assessment of influence of risk factors and distress on the health of workers in school environment was performed as pilot study with the objective to identify problems and to further improvement of school environment and health of teachers. OBJECTIVE: The objective was to determine the prevalence of mental health problems and risk factors of workers from preschool and school facilities in Pancevo. METHOD: An interview method in cross-sectional study. Standardized The Four-Dimensional Symptom Questionnaire (4DSQ) with 5 level graduated scale contents questions about symptoms in last seven days was used as well as the questionnaire about risk factors. The studied sample included 174 workers in preschool facilities and 180 teachers in primary and secondary schools. RESULTS: A total of 255 (response rate 72.0%) teachers fulfilled the questionnaire: 28 (11.0%) men and 227 (89.0%) women, average age 41.85 +/- 8.87 years. One third of workers (33.3%) somatized their health problems, 27.5% were occasionally or regularly distressed. The most frequent regular difficulties were concern (31%), back pain, neck pain and headache, and sometimes workers were most frequently tense (49.8%), with headache, worries, easy emotional reactions and easily irritated. Diseases of bone and locomotion system appeared to be the most frequent chronic disturbances in 38 (14.9%) cases, chronic respiratory diseases in 24 (9.4%), cardiovascular diseases in 22 (8.6%), gastrointestinal diseases in 12 (4.7%) and endocrine diseases in 12 (4.7%) cases. More than a half of workers were smokers (44.4% on regular and 9.8% on occasional basis). Physical inactivity was documented in 16.1%, while 47.5% were occasionally active. 4.3% were undernourished, and excessive body weight was recorded in 38.5% of workers. 34.5% workers had irregular nutrition, and 9.8% had superabundant meals. Self-estimation of health condition was stated as good by 31.8%, relatively good by 61.2% and bad by 7.1% of workers. CONCLUSION: Our investigation showed high prevalence of mental health problems as a consequence of distress and somatization. Most reported risk factors were smoking, obesity and irregular nutrition.

[Air quality and respiratory health of school children in Pancevo].

INTRODUCTION: Air pollution is the leading environmental problem in Pancevo. Sources are traffic, home heating, industry, land fields, and street dust. Air pollution has harmful effect on population health, particularly the health of children. OBJECTIVE: To estimate school-children's respiratory health in Pancevo. METHOD: The air quality in Pancevo and Vrsac was measured by standard methods. The health condition was tested by anthropometric, clinical examination and spirometric measures in school children of II-V classes of three primary schools in Pancevo and one in Vrsac, in 2002. Data from 1136 children were analyzed: 796 in Pancevo, and 340 in Vrsac. Parents answered the questions in questionnaires: non standardized questionnaire about children's health, social status and smoking in the family, questionnaire about pregnancy, physical activity and standardized ISAAC questionnaire about asthma and eczema. RESULTS: During the 2002/2003 heating season in Vrsac, concentrations of SO2 and soot were less than limit concentrations of emission and significantly less than in Pancevo air. Results showed that the asthma, wheezing during physical activity (p < 0.05), dry cough at night (p < 0.001), cold and tonsilo-pharyngitis (p < or = 0.05) were significantly more frequent in girls from Pancevo than girls from Vrsac. Morning cough (p < 0.05) and wheezing (p < 0.01) was significantly more frequent in boys from Pancevo than boys from Vrsac. Children from Pancevo were much higher than children in Vrsac. Less vital capacity (p < 0.05) and mild restriction (p < 0.001) were more often in children from Pancevo than children in Vrsac. CONCLUSION: Our investigation confirmed that children from Pancevo had problems with respiratory health more often than children in Vrsac.