Experience in organizing and conducting epidemiological studies to detect and prove the causal relationship between ambient air quality and health disorders in the population of industrially contaminated sites
Introduction: Within the framework of the Federal Clean Air Project, it is envisaged to implement comprehensive action plans aimed at reducing air pollution and increasing the level of public satisfaction with the environmental situation in a number of industrial centers of the Russian Federation with high and extremely high levels of ambient air pollution. Decree No. 1792 of the Russian Government of December 24, 2019 approved the requirements for compensatory measures aimed at improving ambient air quality, preventing and eliminating adverse health effects of environmental factors. To increase the validity and adequacy of the measures taken, it is necessary to elaborate method approaches for Rospotrebnadzor bodies to designing and conducting studies on establishing the association between air pollution and adverse health outcomes in the population living in industrially contaminated areas. The purpose of our work was to substantiate an algorithm of actions and to demonstrate its efficiency within epidemiological studies focused on establishing and proving the causal relationship between airborne chemicals and observed health consequences in the population. Materials and methods included a set of modern hygienic and epidemiological research methods, assessment of risk and its health damage, in-depth research, and modeling of cause and effect relationships. Results: We proposed approaches and conducted studies to establish the link between industrial air pollution and the diseases diagnosed in the exposed population. Conclusions: The suggested algorithm of actions tested in the city of Bratsk proved to be effective and helped identify risk-attributed health disorders; specify the pollutants requiring development or adjustment of measures to reduce their ambient emissions; clarify and expand the list of target organs and systems for prediction and monitoring; substantiate and fulfil managerial decisions and adequate targeted preventive measures based on health damage criteria.