1. Setting up an environmental health surveillance system (EHSS) around a toxic waste incinerator P. Rudnai 1, A. Páldy 1, Gy. Dura 1, É. Vaskövi 1, J. Szaniszló 2, M. Náray 2, Á. Moró 3 1 National Institute of Environmental Health, 2 „József Fodor” National Center for Public Health 3 Public Health Institute of Town Dorog

2. BACKGROUND 1. Dorog a small town with about 13,000 inhabitants. It used to be a coal- mining area. After closing down mining activity, new job opportunities were needed

3. BACKGROUND 2. In the 1980’-ies an incinerator was built here for burning wastes of a pharmaceutical plant. In 1996 this was converted into a big toxic waste incinerator with a capacity of 30,000 tons per year.

4. BACKGROUND 3. EHSS EU-funded project: 2004-2006 (Interreg IIIC) Environmental Health Surveillance System (EHSS) is being set up in Dorog. Its aim is to monitor and evaluate the possible environmental contamination on one side and the changes in the health status of the population on the other side, and to act if necessary

5. EXPOSURE ASSESSMENT Continuous monitoring of air pollution (PM 10, SO 2, NO 2, CO, O 3, benzene) Yearly average concentrations of PM 2.5 and its metal components Dioxin and furan compounds in dustfall (collected monthly) Dioxin and furan compounds in mothers’ milk

6. HEALTH OUTCOMES Children's acute respiratory morbidity (CHARM), using the local paediatricians' weekly report Pregnancy outcomes (normal or preterm births, birth weight, spontaneous abortions or stillbirths, etc) with the participation of the district nurses, Number of patients with acute allergic conditions admitted to the local allergological outpatient unit Analysis of the mortality patterns of Dorog and its neighbourhood

9. Acute respiratory diseases among children in DOROG 2005Month: from…… till……. Paediatrician: 01-23-56-14 TOTAL Number of registered children ICD-10 Age groupMondayTuesdayWednesdayThursdayFridaySaturdaySunday 0 1-2 3-5 6-14 0 1-2 3-5 6-14 0 1-2 3-5 6-14

10. Incidences of pre-term birth in Dorog, its neighbouring area and County Komárom-Esztergom between 1994-2003.

11. Infant mortality rates in Dorog, its neighbouring area and County Komárom-Esztergom between 1994-2003.

12. Rapid Environmental and Health Risk Assessment of the incinerator in Dorog Risk perception assessment (P. Gorinski et al.) Mortality analysis (G. Nádor et al.) FURTHER ANALYSES

13. CONCLUSIONS The EHSS should be suitable for immediate intervention when needed As the nature and the quality of the toxic wastes burnt in the incinerator may vary time-to-time, besides the assessment of long-term health effects, short-term health effects may be even more important

14. Thank you for your attention