ZDRAVÍHEALTH

VybranÈ informaËnÌ zdroje (publikace, internet)

⁄stav zdravotnick˝ch informacÌ a statistiky »R ñ www.uzis.czï Publikace ñ Zdravotnick· roËenka »eskÈ republiky ñ akt. vyd·nÌ: ˙daje za rok 1999 (vyd. leden 2001).ï ⁄daje o zdravÌ ñ ukazatele: www.uzis.cz/cz/zdravi/Zdravi.htm.ï Publikace v elektronickÈ verzi: www.uzis.cz/cz/publikac/publindx.htm.

St·tnÌ zdravotnÌ ˙stav ñ www.szu.czï Publikace SystÈm monitorov·nÌ zdravotnÌho stavu obyvatelstva »R ve vztahu k ûivotnÌmu prost¯edÌ ñsouhrnn· zpr·va za kalend·¯nÌ rok ñ akt. vyd·nÌ: Souhrnn· zpr·va za rok 2000 (vyd. 2001).

ï Monitoring zdravotnÌho stavu obyvatelstva ve vztahu k venkovnÌmu a vnit¯nÌmu ovzduöÌ:www.szu.cz/chzp/rep00/szu_01cz.htm.Informace Centra hygieny ûivotnÌho prost¯edÌ: www.szu.cz/chzp/index.htm.Pylov˝ monitoring (Pylov· informaËnÌ sluûba): www.szu.cz/chzp/pyly/pyly.htm.

P¯ehled informaËnÌch zdroj˘ na internetu je uveden tÈû v kapitole D6.

C1 STATISTIKY ZDRAVÕOBYVATELSTVA

C1 HEALTH STATISTICS

Magistr·t hl. m. Prahy 193 PRAHA ñ éivotnÌ prost¯edÌ 2001Prague City Hall PRAGUE ñ Environment 2001

C ZDRAVÕ / HEALTH

Tab. C1.1 NarozenÌ, potraty, zem¯elÌBirths, abortions, deaths

1995 1996 1997 1998 1999 2000

NarozenÌ celkem 9 498 8 869 8 988 9 054 9 088 9 472 Births

v tom ûivÏ narozenÌ 9 470 8 842 8 967 9 026 9 057 9 453 live births

éivÏ narozenÌ na 1000 obyvatel 7,8 7,3 7,5 7,5 7,6 8,0 Live births per 1000 inhabitants

Potraty celkem 7 093 6 884 6 330 6 116 5 507 5 194 Total abortions

samovolnÈ 750 678 720 790 734 878 spontaneous

miniinterupce 5 265 5 198 4 708 4 437 3 907 3 479 vacuum aspirations

jinÈ 1 078 1 008 824 792 765 747 other

Potraty na 1000 obyvatel 5,8 5,7 5,3 5,1 4,6 4,4 Abortions per 1000 inhabitants

Potraty na 100 narozen˝ch 74,7 77,6 70,4 67,6 60,6 54,8 Abortions per 100 births

Zem¯elÌ celkem 15 193 14 490 14 083 13 705 13 616 13 425 Total deaths

Zem¯elÌ na 1000 obyvatel 12,5 12,0 11,7 11,4 11,4 11,3 Deaths per 1000 inhabitants

Kojeneck· ˙mrtnost [â] 6,5 4,3 4,7 4,9 2,8 2,3 Infant mortality [â]

Novorozeneck· ˙mrtnost [â] 4,2 2,6 2,2 2,5 1,9 1,6 Neonatal mortality [â]

Zdroj / Source: »S⁄

Tab. C1.2 ⁄mrtnost podle p¯ÌËin smrtiDeath rates by causes

1995 1996 1997 1998 1999 2000

Zem¯elÌ podle vybran˝chp¯ÌËin smrti na 100 000 obyv.

Deaths by selected causesper 100 000 inhabitants

Novotvary 323,3 309,9 304,0 310,4 310,0 313,2 Neoplasms

Alergie, nemoci ûl·za p¯emÏny l·tkovÈ

8,0 8,8 10,5 11,9 6,6 8,4 Endocrine and metabolicdiseases, allergies

Nemoci ˙strojÌ cÈvnÌho 676,5 661,1 643,4 627,8 622,4 602,8 Diseases of the circulatorysystem

Nemoci ˙strojÌ d˝chacÌho 38,4 37,5 35,6 37,7 40,4 41,6 Diseases of the respiratorysystem

Nemoci ˙strojÌ tr·vicÌho 52,2 46,9 46,5 40,2 44,6 46,4 Diseases of the digestivesystem

Nemoci ˙strojÌ moËovÈhoa pohlavnÌho

15,1 10,8 12,8 10,6 12,9 12,8 Diseases of the genitourinarysystem

⁄razy, otravy a sebevraûdy 98,5 84,6 82,2 73,9 74,1 72,8 Injury, poisoning and suicide

OstatnÌ p¯ÌËiny smrti 40,8 40,5 36,1 32,5 33,2 36,0 Other causes of death

Celkem Praha 1 252,8 1 200,1 1 171,1 1 145,0 1 144,2 1 134,0 Prague total

Zdroj / Source: ⁄ZIS

Tab. C1.3 HospitalizovanÌ podle p¯ÌËin hospitalizaceHospital admissions by cause

Kapitola (MKN 10)Classification (ICD 10)

1998 1999 2000

muûimales

ûenyfemales

muûimales

ûenyfemales

muûimales

ûenyfemales

I. NÏkterÈ infekËnÌ a parazit·rnÌ nemociSome infectious and parasitic diseases

3 880 3 292 3 552 3 137 3 669 3 235

II. NovotvaryNeoplasms (Carcinomas)

17 837 24 174 17 240 21 918 16 611 22 197

III. Nemoci krve, krvetvorn˝ch org·n˘ a imunityDiseases of the blood and haematogenous organsand immunity

751 942 733 871 650 854

IV. Nemoci endokrinnÌ, v˝ûivy a p¯emÏny l·tekEndocrinological diseases, nutritional and metabolicdiseases

2 913 6 165 2 866 5 266 2 858 4 709

V. Poruchy duöevnÌ a poruchy chov·nÌMental and behavioral disorders

5 502 3 379 4 182 2 779 4 516 3 135

VI. Nemoci nervovÈ soustavyDiseases of the nervous system

4 063 4 348 4 298 4 591 4 327 4 433

VII. Nemoci oka a oËnÌch adnexDiseases of the eye and optical adnexa

4 025 6 235 3 785 5 756 3 661 5 518

VIII. Nemoci ucha a bradavkovÈho v˝bÏûkuDiseases of the ear and papilla

1 402 1 341 1 333 1 307 1 224 1 232

IX. Nemoci obÏhovÈ soustavyDiseases of the circulatory system

33 722 27 502 32 533 25 988 34 838 27 214

X. Nemoci d˝chacÌ soustavyDiseases of the respiratory system

10 826 8 647 10 401 8 145 9 684 7 703

XI. Nemoci tr·vicÌ soustavyDiseases of the digestive system

17 159 17 672 16 027 16 115 15 837 15 521

XII. Nemoci k˘ûe a podkoûnÌho vazivaDermal and subdermal diseases

1 693 1 594 1 705 1 524 1 700 1 499

XIII. Nemoci svalovÈ a kosternÌ soustavy a pojivovÈ tk·nÏDiseases of the muscle and skeletal systems andof the connective tissue

7 374 10 133 8 237 10 374 8 764 10 402

XIV. Nemoci moËovÈ a pohlavnÌ soustavyDiseases of the urinary and genital system

7 761 18 968 7 631 16 751 7 283 16 812

XV. TÏhotenstvÌ, porod a öestinedÏlÌPrenatal, natal and postnatal

x 17 449 x 16 313 x 16 158

XVI. NÏkterÈ stavy vzniklÈ v perinat·lnÌm obdobÌSome conditions acquired in the perinatal period

995 804 935 802 1 086 938

XVII. VrozenÈ vady, deformace a chromozom·lnÌabnormalityCongenital defects

4 202 3 394 3728 3 036 3 624 3 020

XVIII. P¯Ìznaky, znaky a ... n·lezy neza¯azenÈ jindeSymptoms and characteristics and findingsnot classified elsewhere

3 049 3 862 3 087 3 699 3 262 4 184

XIX. PoranÏnÌ, otravy a ... n·sledky vnÏjöÌch p¯ÌËinInjuries and poisoning and consequences of externalcauses

13 592 9 843 12 740 9 452 12 473 9 144

XXI. Faktory ovlivÚujÌcÌ zdravotnÌ stav a kontakt se zdr.sluûbamiFactors affecting the state of health

6 309 10 575 6 841 10 645 8 340 13 651

CelkemTotal

147 055 180 319 141 854 168 469 144 407 171 559

Zdroj / Source: ⁄ZIS

PRAHA ñ éivotnÌ prost¯edÌ 2001 194 Magistr·t hl. m. PrahyPRAGUE ñ Environment 2001 Prague City Hall

C ZDRAVÕ / HEALTH

Tab. C1.4 Incidence zhoubn˝ch novotvar˘ a n·dor˘ in situ v regionu PrahaIncidence of malignant neoplasms and tumours in situ in the Prague metropolitan area

C00-D09

Celkov˝ poËet / Total number Na 100 000 obyvatel / Per 100 000 inhabitants Pr˘mÏr / Average

muûimales

ûenyfemales

celkemtotal

muûimales

ûenyfemales

celkemtotal

muûi a ûenymales and females

100 000

1995 2 852 3 290 6 142 498,72 513,42 506,49 506,07

1996 3 070 3 357 6 427 538,64 526,72 532,35 532,68

1997 3 255 3 602 6 857 572,93 567,76 570,20 570,35

1998 3 303 3 728 7 031 583,61 590,82 587,41 587,22

1999* 3 281 3 516 6 797 582,70 560,90 571,20 571,80

* p¯edbÏûn· data / preliminary data

Zdroj / Source: ⁄ZIS »R, N·rodnÌ onkologick˝ registr »R / Czech Cancer Registry

Tab. C1.5 Zem¯elÌ na zhoubnÈ novotvary a novotvary in situDeaths for malignant tumours and neoplasms in situ

Celkov˝ poËet / Total number Na 100 000 obyvatel / Per 100 000 inhabitants

muûi / males ûeny / females muûi / males ûeny / females

1995 1 966 1 938 343,79 302,44

1996 1 923 1 800 337,40 282,42

1997 1 828 1 805 321,76 284,51

1998 1 869 1 828 330,20 289,70

1999 1 839 1 827 326,60 291,43

2000 1 917 1 753 341,90 281,30

Zdroj / Source: »S⁄

Obr. C1.1 V˝voj standardizovanÈ ˙mrtnosti1) podle pohlavÌStandardized mortality1) by sex

1) na 100 000 evropskÈ standardnÌ populace / per 100 000 European standard population

Zdroj / Source: ⁄ZIS »R, »S⁄

Magistr·t hl. m. Prahy 195 PRAHA ñ éivotnÌ prost¯edÌ 2001Prague City Hall PRAGUE ñ Environment 2001

C ZDRAVÕ / HEALTH

1 800

1 500

1 200

900

600

muûi »R / males CR ûeny »R / females CR

muûi Praha / males Prague ûeny Praha / females Prague

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

196

C ZDRAVÍ / HEALTH

Magistrát hl. m. PrahyPrague City Hall

Obr. C1.2 Poèet hlášených zhoubných nádorù a novotvarù in situNumber of registered malignant tumours and neoplasms in situ

Obr. C1.3 Poèet vybraných hlášených zhoubných nádorù na 100 000 obyvatelNumber of reported cases of selected malignant tumoursper 100 000 inhabitants

a) Celkový poèet / Total number

b) Poèet pøípadù na 100 000 / Number of cases per 100 000 inhabitants

Zdroj / ÚZIS ÈR, Národní onkologický registr ÈR /Source: Czech Cancer Registry

Zdroj / ÚZIS ÈR, Národní onkologický registr ÈR /Source: Czech Cancer Registry

120

8 0007 000

6 0005 0004 0003 000

2 000

1 000

650

550

450

350

600

500

400

0

1980

1980

1981

1981

1982

1982

1983

1983

1984

1984

1985

1985

1986

1986

1987

1987

1988

1988

1989

1989

1990

1990

1991

1991

1992

1992

1993

1993

1994

1994

1995

1995

1996

1996

1997

1997

1998

1999

1998

1999

120

100

100

80

80

60

60

40

40

20

20

0C16 C18 C19–C21 C33–C34 C50

0

1994 1995 1996 1997 1998 1999

celkem / total

prùmìr / average

C19–C21C16 C18 C33–C34 C61

C16C18C19–C21C33–C34C50C61

PRAHA – Zivotní prostøedí 2001PRAGUE – Environment 2001

¡

a) ZENY / FEMALES¡

b) MUZI / MALES¡

ZN zaludku /ZN tlustého støeva /ZN rektosigmoidálního spojení, rekta, øiti a øitního kanálu /ZN prùdušnice, prùdušky a plíce /ZN prsu /ZN prostaty /

malignant tumors of the stomachmalignant tumors of theintestine

malignant tumors of the recto-sigmoidal connection, rectum, rectal passagemalignant tumors of the trachea, bronchi and lungs

malignant tumors of the breastmalignant tumors of the prostatic gland

¡

muzi / males¡

zeny / females¡

muzi / males¡

zeny / females¡

C2 SYST…M MONITOROV¡NÕZDRAVOTNÕHO STAVUOBYVATELSTVA VE VZTAHUK éIVOTNÕMU PROSTÿEDÕ

Hygienick· sluûba resortu zdravotnictvÌ »eskÈrepubliky soustavnÏ sleduje a hodnotÌ rizikovÈfaktory, kterÈ majÌ vliv na zdravÌ ËlovÏka a sou-visejÌ se stavem ûivotnÌho prost¯edÌ. StÏûejnÌmmonitorovacÌm programem hygienickÈ sluûby jeSystÈm monitorov·nÌ zdravotnÌho stavu obyvatel-stva ve vztahu k ûivotnÌmu prost¯edÌ (Monitoring),kter˝ se skl·d· z relativnÏ autonomnÌch subsys-tÈm˘ a t˝k· se zneËiötÏnÌ venkovnÌho i vnit¯nÌhoovzduöÌ, kvality pitnÈ vody, zdravotnÌ nez·vad-nosti potravin, zdravotnÌch d˘sledk˘ expoziceobyvatel, ruöiv˝ch ˙Ëink˘ hluku a obecnÈho hod-nocenÌ zdravotnÌho stavu.

V roce 2000 byly do SystÈmu monitorov·nÌ novÏzaËlenÏny dva subsystÈmy:

ï zdravotnÌ rizika pracovnÌch podmÌnek a jejichd˘sledky

ï zdravotnÌ rizika kontaminace p˘dy mÏstsk˝chaglomeracÌ

Pro ˙Ëast v Monitoringu bylo vybr·no 30 mÏst,mezi kter˝mi je i hlavnÌ mÏsto Praha. Z·sadnÌmkoncepËnÌm hlediskem monitorov·nÌ je zÌsk·v·nÌdat v˝bÏrov˝m öet¯enÌm na statisticky reprezen-tativnÌch vzorcÌch obyvatelstva. V˝sledky jsou,poËÌnaje rokem 1994, publikov·ny v SouhrnnÈzpr·vÏ a Odborn˝ch roËnÌch zpr·v·ch, kterÈ vy-d·v· ⁄st¯edÌ monitoringu, pracujÌcÌ ve St·tnÌmzdravotnÌm ˙stavu (SZ⁄) v Praze. Tyto zpr·vyjsou pro odbornou ve¯ejnost k dispozici na hygie-nick˝ch stanicÌch. Pro pot¯eby praûskÈ roËenkyo ûivotnÌm prost¯edÌ uv·dÌme vybranÈ v˝sledky zesubsystÈm˘, kterÈ se bezprost¯ednÏ v·ûÌ k praûskÈmÏstskÈ aglomeraci.

OvzduöÌ

Na vöech praûsk˝ch stanicÌch jsou sledov·ny v antropo-gennÌ vrstvÏ atmosfÈry oxid si¯iËit˝, suma oxid˘ dusÌku ñi koncentrace oxidu dusnatÈho a oxidu dusiËitÈho, po-lÈtav˝ prach (frakce TSP a PM10) a kovy v odebran˝chvzorcÌch praönÈho aerosolu (As, Cd, Cr, Ni, Mn a Pb).Na pÏti mÌstech je mϯen oxid uhelnat˝ a koncentraceozonu, na jednÈ stanici (SZ⁄) vybranÈ polyaromatickÈuhlovodÌky (PAH) a vybranÈ tÏkavÈ organickÈ l·tky(VOC). SouhrnnÏ lze konstatovat, ûe zneËiötÏnÌ ven-kovnÌho ovzduöÌ v jednotliv˝ch praûsk˝ch obvodechpotvrdilo nalezenÈ trendy ñ mÌrn˝ n·r˘st u oxidu uhel-

C2 SYSTEM OF MONITORINGOF ENVIRONMENTALIMPACTS ON POPULATIONHEALTH

Public Health Service under the competence of theMinistry of Heath of the Czech Republic performspermanent monitoring and evaluation of riskfactors, which affect human health and are of envi-ronmental nature. The System for Monitoring ofEnvironmental Impacts on Population Health(Monitoring) has been the core programme of thePublic Health Service monitoring activities, whichdeals with pollution of outdoor and indoor ambientair, drinking water quality, heath innocuousnessof foodstuffs, health effects of population exposure,harmful effects of noise, and general assessmentof health.

In 2000 the System for Monitoring was expandedby two new subsystems as follows:

ï health hazards of labour conditions and theirconsequences;

ï health hazards of soil contamination in urbanagglomerations.

Thirty cities were selected to participate in theMonitoring and the Capital City of Prague has beenamong the selected. The fundamental concept stand-point of the monitoring is data acquisition by meansof a selective survey of statically representativesets of population. Since 1994 results have beendisclosed in the Summary Report and the ScientificAnnual Report published by theMonitoringCentrelocated at the StateHealth Institute (SZ⁄), Prague.These Reports are available to professionals atPublic Health Authorities. For the need of the Envi-ronment Yearbook of Prague here there are selectedresults directly related to the Prague urban agglo-meration acquired by the subsystems published.

Air

Every Prague monitoring station measures sulphur di-oxide, total nitrogen oxides, particulate matter ñ fractiontotal suspended particulate matter (TSP and PM10), andmetals (As, Cd, Cr, Ni, Mn and Pb) in taken samples ofsuspended particulate matter in the anthropogenic stratumof the atmosphere. At five locations carbon monoxide hasbeen measured, one station (at SZ⁄) measured selectedpolyaromatic hydrocarbons (PAH) and selected volatileorganic compounds (VOC). Overall it may stated thatambient air pollution in respective Prague districts con-firmed trends found ñ slight increase in values of carbon

Magistr·t hl. m. Prahy 197 PRAHA ñ éivotnÌ prost¯edÌ 2001Prague City Hall PRAGUE ñ Environment 2001

C ZDRAVÕ / HEALTH

natÈho a sumy oxid˘ dusÌku, dlouhodobÏjöÌ stabilizaceu vöech ostatnÌch sledovan˝ch l·tek.

U oxidu si¯iËitÈho se hodnoty roËnÌch pr˘mÏr˘ (arit-metickÈ pr˘mÏry stejnÏ jako u ostatnÌch polutant˘v ovzduöÌ) pohybovaly v rozmezÌ 7,8ñ11,7 µg.m

-3, tj. do

20 % hodnoty platnÈho imisnÌho limitu (60 µg.m-3). Hod-

noty roËnÌch pr˘mÏr˘ sumy oxid˘ dusÌku se pohybovalyv rozmezÌ 46,0ñ98,8 µg.m

-3. Ve dvou praûsk˝ch obvo-

dech (v Praze 5 a 8) byl platn˝ imisnÌ limit (80 µg.m-3)

p¯ekroËen. Hodnoty roËnÌch pr˘mÏr˘ polÈtavÈho prachu,frakce TSP, se pohybovaly v rozmezÌ 28,4ñ80,4 µg.m

-3

(maximum v Praze 8). Hodnoty oxidu uhelnatÈho, prokter˝ nenÌ stanoven roËnÌ imisnÌ limit, se pohybovalyv rozmezÌ 483ñ4482 µg.m

-3; v Praze 8 byl ve 39 %

z namϯen˝ch dennÌch hodnot p¯ekroËen dennÌ imisnÌlimit (5000 µg.m

-3).

MϯenÌ imisnÌch koncentracÌ vybran˝ch polyaromatic-k˝ch uhlovodÌk˘ (PAU) pokraËovalo v Praze 10, v SZ⁄.Monitorov·ny byly uhlovodÌky v˝znamnÈ z hygienic-kÈho hlediska (benzo(a)antracen, benzo(b)fluoranten,benzo(k)fluoranten, benzo(g,h,i)perylen, benzo(a)pyren,chrysen, dibenzo(a,h)antracen, fenantren, antracen,fluoranten, pyren a indeno(c,d)pyren). DoporuËenÈdennÌ imisnÌ hodnoty byly p¯ekroËeny pouze v p¯Ì-padÏ benzo(a)pyrenu (1 ng.m

-3) ve 48,3 %. V p¯ÌpadÏ

benzo(a)antracenu nebyla stanoven· dennÌ imisnÌ hod-nota (10 ng.m

-3) p¯ekroËena.

S pravideln˝m monitoringem tÏkav˝ch organick˝chl·tek (VOC) se zaËalo v Praze 10 v Ëervnu 1999. Jsousledov·ny 42 organickÈ slouËeniny, kterÈ uv·dÌ me-toda US EPA TO-14. Mezi nejd˘leûitÏjöÌ z nich pat¯ÌaromatickÈ uhlovodÌky (benzen, toluen, xyleny, styren,trimetylbenzeny) a chlorovanÈ alifatickÈ i aromatickÈuhlovodÌky (trichlormetan, tetrachlormetan, trichloreten,tetrachloreten, chlorbenzen, dichlorbenzeny). HodnotynejvyööÌch p¯Ìpustn˝ch koncentracÌ v ovzduöÌ nebylyv roce 2000 p¯ekroËeny.

U sledovan˝ch kov˘, ve vzorcÌch praönÈho aerosolu,jsou dlouhodobÏ koncentrace na stabilnÌ ˙rovni. RoËnÌimisnÌ limit pro olovo (0,5 µg.m

-3) nebyl p¯ekroËen

(roËnÌ imisnÌ charakteristiky se pohybovaly v rozmezÌ0,018ñ0,042 µg.m

-3). StejnÏ i v p¯ÌpadÏ kadmia ne-

byl p¯ekroËen navrhovan˝ imisnÌ limit (0,01 µg.m-3) a

roËnÌ imisnÌ charakteristiky se pohybovaly v rozmezÌ0,00041ñ0,00117 µg.m

-3pro jednotlivÈ obvody. NovÏ

bylo rokem 2000 zapoËato sledov·nÌ obsahu manganuv praönÈm aerosolu. Pro tento prvek nebyl doposud sta-noven roËnÌ imisnÌ limit, namϯenÈ hodnoty se pohy-bovaly v rozmezÌ 0,010ñ0,045 µg.m

-3, coû vöak znaËnÏ

(¯·dovÏ) nedosahuje hodnoty doporuËenÈ WHO, kter·ËinÌ 1,0 µg.m

-3.

K souhrnnÈmu popisu kvality ovzduöÌ (dlouhodobÈ ex-pozici) se pouûÌv· roËnÌ index kvality ovzduöÌ (IKOr).V jednotliv˝ch praûsk˝ch obvodech se hodnota IKOrpohybuje mezi druhou t¯Ìdou, tj. ovzduöÌ vyhovujÌcÌv Praze 6 a 2 (2,02 respektive 2,15) aû t¯etÌ, tj. mÌrnÏ

monoxide and total nitrogen oxides, and long-term sta-bilisation of values of all other substances monitored.Annual mean values (arithmetic average as for the otherairborne pollutants) of sulphur dioxide fell within therange 7.8ñ11.7 µg.m

-3i.e. within 20 % of the value of

applicable limit of ground-level concentration (60 µg.m-3).

Annual mean values of total nitrogen oxides were from46.0ñ98.8 µg.m

-3. In two Prague districts (Prague 5 and 8)

the valid ground-level concentration limit (80 µg.m-3) was

exceeded. Annual mean values of particulate matter ñfraction TSP, fell within the range 28.4ñ80.4 µg.m

-3

(maximum found in Prague 8). Values of carbon monoxideconcentrations, which has no annual ground-level con-centration limit established were from 483ñ4482 µg.m

-3;

in Prague 8 the daily ground-level concentration limit(5000 µg.m

-3) was violated in 39 % cases of the values

recorded.Measurements of ground-level concentrations of certainpolyaromatic hydrocarbons (PAH) continued at SZ⁄in Prague 10. They monitored hydrocarbons importantfrom the public health point of view as follows: benz[a]-anthracene, benz[b]fluoranthene, benz[g,h,i]perylene,benz[a]pyrene, chrysene, dibenz[a,h]anthracene, phe-nanthrene, fluoranthene, pyrene, and indeno[1,2,3-c,d]-pyrene. Recommended daily ground-level concentrationvalues were exceeded only in the case of benzo[a]pyrene(1 ng.m

-3) in 48.3% of the number of measurements. In the

case of benzo[a]antracenu the recommended daily ground-level concentration value (10 ng.m

-3) was not exceeded.

In Prague 10 the regular monitoring of volatile organiccompounds (VOC) commenced in June 1999. There havebeen 42 organic compounds monitored as given in themethod US EPA TO-14. Among the most important ofthem are aromatic hydrocarbons (benzene, toluene, xylenehomologues, styrene, trimethylbenzene homologues)aliphatic and aromatic chlorinated hydrocarbons(trichloromethane (= chloroform), tetrachloromethane(= carbon tetrachloride), trichloroethene (= trichloro-ethylene), tetrachloroethene (= tetrachloroethylene),chlorobenzene, dichlorobenzene homologues). Thehighest acceptable concentrations in air were notexceeded in 2000.Values of concentrations of monitored metals in samplesof particulate matter have been stagnant for a long time.Annual ground-level concentration limit value for lead(0.5 µg.m

-3) was not violated (annual ground-level con-

centrations fell within the range 0.018ñ0.042 µg.m-3).

The same holds for cadmium where the suggested ground-level concentration limit value (0,01 µg.m

-3) was not

exceeded and yearly ground-level concentration characte-ristics fell within 0.00041ñ0.00117 µg.m

-3in respective

City districts. As a novelty in 2000 the monitoring ofmanganese in particulate matter was launched. Therehas been no annual ground-level concentration limitestablished for this element so far and values measuredfell in the range from 0.010ñ0,045 µg.m

-3which how-

ever, did not attain, even by the order of magnitudethe WHO recommended value that is 1.0 µg.m

-3.

Annual air quality index (IKOr) is used for overall descrip-tion of air quality (long-time exposure). In respectivePrague districts value of IKOr has been falling in betweenthe second class (2.02 and 2.15 respectively) i.e. satis-

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zneËiötÏnÈ ovzduöÌ v Praze 5 (2,97), coû je hodnotahraniËÌcÌ se Ëtvrtou t¯Ìdou ñ zneËiötÏnÈ ovzduöÌ.

Pitn· voda

V roce 2000 bylo zaznamen·no p¯ekroËenÌ vöechlimitnÌch hodnot (doporuËen· hodnota, indikaËnÌ hod-nota, mezn· hodnota, nejvyööÌ mezn· hodnota a mezn·hodnota p¯ijatelnÈho rizika) definovan˝ch normou»SN 757111 ÑPitn· vodaì pouze v 6 n·lezech z 1366stanovenÌ, tj. 0,44 % p¯Ìpad˘. Jednalo se o jeden n·lezûiv˝ch organism˘ a pÏt p¯Ìpad˘ nedodrûenÌ doporuËe-n˝ch hodnot teploty vody. Koncentrace toxick˝ch l·teks limitem definovan˝m nejvyööÌ meznou hodnotou,resp. meznou hodnotou p¯ijatelnÈho rizika, nebylyv pr˘bÏhu roku 2000 nad limitnÌ hodnotou ani v jed-nom p¯ÌpadÏ, limity mikrobiologick˝ch a biologick˝chukazatel˘ jakosti pitnÈ vody s v˝jimkou uvedenÈhon·lezu ûiv˝ch organizm˘ takÈ nebyly p¯ekroËeny.

U kontaminant˘, kterÈ majÌ stanoveny expoziËnÌ limit(vÏtöinou ADI ñ p¯Ìpustn˝ dennÌ p¯Ìvod, pro manganlimit U.S. EPA referenËnÌ d·vka RfD), bylo provedenotakÈ hodnocenÌ z·tÏûe obyvatelstva z p¯Ìjmu pitnÈ vody.V˝sledky jsou uvedeny na obr·zku jako expozice promedi·n a 90% kvantil obsah˘ kontaminant˘. Je z nichvidÏt, ûe i v roce 2000 jednoznaËnÏ dominovala expo-zice dusiËnan˘m, kter· dosahuje 8,7 % expoziËnÌholimitu pro st¯ednÌ z·tÏû praûskÈho obyvatele. ExpoziceostatnÌm ökodlivin·m je na velmi nÌzkÈ ˙rovni. Hodnotyz let 1994 aû 2000 vykazujÌ velmi podobnÈ v˝sledkybez v˝razn˝ch zmÏn, p¯ÌpadnÈ rozdÌly je nutnÈ p¯ipsatna vrub bÏûnÈmu kolÌs·nÌ koncentracÌ.

Z rozboru epidemiologickÈ situace vypl˝v·, ûe v û·d-nÈm p¯ÌpadÏ nebyl jednoznaËnÏ prok·z·n p¯Ìpad one-mocnÏnÌ, ve kterÈm pitÌ vody z ve¯ejn˝ch vodovod˘bylo oznaËeno jako d˘vod pro vznik infekce. Z hod-nocenÌ z·tÏûe chemick˝m l·tk·m takÈ vypl˝v·, ûe k p¯Ì-mÈmu poökozenÌ obyvatelstva konzumacÌ pitnÈ vodyve¯ejnÈho z·sobov·nÌ nemohlo dojÌt.

Kvalita pitnÈ vody v praûskÈ vodovodnÌ sÌti z˘st·v·v podstatÏ na stejnÈ ˙rovni jako v minul˝ch letech a p¯isrovn·nÌ s ostatnÌmi mÏsty, za¯azen˝mi do SystÈmumonitorov·nÌ, vykazuje Praha jeden z nejmenöÌch po-dÌl˘ n·lez˘ s p¯ekroËenou limitnÌ hodnotou.

Hluk

V Praze probÌh· sledov·nÌ zdravotnÌch d˘sledk˘ a ru-öiv˝ch ˙Ëink˘ hluku na t¯ech mÌstech, a to na Vinohra-dech, éiûkovÏ a ve VröovicÌch. V kaûdÈ z tÏchto mÏst-sk˝ch Ë·stÌ jsou vybr·ny tzv. tich· a hluËn· lokalita.MϯenÌ probÌhajÌ 1x mÏsÌËnÏ po 24 hodin. MϯenÌm jezjiötÏno, ûe lokality jsou vybr·ny tak, ûe hodnoty hlukuv ekvivalentnÌ hladinÏ akustickÈho tlaku A se pohybujÌod nejhluËnÏjöÌch hodnot dosahujÌcÌch ve dne 73 dB anep¯esahujÌcÌ 69 dB v noci, aû po skuteËnÏ tichÈ lokalitys hodnotami do 58 dB ve dne a 51 dB v noci. PraûskÈlokality se nach·zejÌ v hluËnÏjöÌ polovinÏ sledovanÈhorozpÏtÌ. Ze zjiötÏn˝ch rozdÌl˘ hluËnosti za minul· a le-

factory clean air in Prague 6 and 2, and almost the thirdclass (2.97) i.e. slightly polluted air in Prague 5, which isthe value at the brink of the fourth class i.e. polluted air.

Drinking water

In 2000 violations of any of the types of limits (recom-mended value, indication value, limit value, highestlimit value, and acceptable risk limit value) as definedby the Czech Standard »SN 757111 ìDrinking waterîwere recorded in six instances out of 1,366 analysesonly, i.e. in 0.44 % of all measurements. These were onecase of a finding of living organisms and five violationsof recommended value for water temperature. Concentra-tions of toxic substances were not found to exceed theestablished highest limit values and acceptable risk limitvalues in any case as well as values of microbiologicaland biological indicators of drinking water quality, exceptfor the finding of living organisms mentioned, were notexceeded as well.For contaminants, where exposure limits are established(mostly ADI ñ acceptable daily intake, for manganese theUS EPA limit as reference dose ñ RfD), the assessmentof population load from drinking water intake was alsocarried out. Results are given in the figure C2.4 as expo-sitions for median and 90% quantile of contaminantcontents. It is seen from the results that in 2000 thenitrate exposure clearly prevailed, accounting for 8.7 %of the acceptable daily intake (ADI) for medium load ofthe Prague population. Exposure of other contaminantswas at very low level. Values found in the period from1994 to 2000 demonstrate very similar results with nopronounced changes, potential differences must havebeen caused by common fluctuations in concentration.It follows from the analysis of epidemiological conditionsthat in no case there was a clear evidence produced foran instance of a disease where drinking the potablewater of the public water supply system was the reasonof the onset of an infection. It also follows from theassessment of chemical load that the population couldnot suffer any harm from consuming of drinking waterfrom the public water supply system.The drinking water quality in the Prague public watersupply system remained virtually at the same level as inthe previous years and compared to other cities parti-cipating in the System of Monitoring Prague showedone of the lowest portions of findings when limit valueswere exceeded.

Noise

In Prague the monitoring of health affects of disturbanceeffects of noise has been performed at three locationsas follows: Vinohrady, éiûkov, and Vröovice. In every ofthese city parts there were so called silent locality andthe noisy one selected. Measurements are performed oncea month for the period of 24 hours. The measurementsrevealed that the localities were selected the way thatnoise level values at equivalent level of acoustic pres-sure A fell from the noisiest values reaching 73 dB indaytime and not exceeding 69 dB in night-time till reallysilent localities featuring values 58 dB in daytime and51 dB in night-time. Prague localities are placed inthe noisier half of the span monitored. It follows from

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C ZDRAVÕ / HEALTH

toönÌ monitorovacÌ obdobÌ vypl˝v·, ûe u noËnÌch ekvi-valentnÌch hladin doch·zÌ k n·r˘stu hluËnosti v tich˝chlokalit·ch. Jedn· se vöak o malÈ rozdÌly vysvÏtlitelnÈtÌm, ûe v tich˝ch lokalit·ch u p˘vodnÏ malÈ dopravnÌz·tÏûe, m˘ûe snadno dojÌt k zdvojn·sobenÌ hluËnosti.CelkovÏ nelze konstatovat v˝znamn˝ n·r˘st Ëi pokleshluËnosti v »R ani v Praze.

⁄Ëinek hluku na obyvatelstvo vybran˝ch lokalit jesledov·n dotaznÌkem zamϯen˝m na sledov·nÌ v˝skytuvybran˝ch tzv. civilizaËnÌch onemocnÏnÌ (infarkt myo-kardu, v¯edov· onemocnÏnÌ ûaludku a dvan·cternÌku,ledvinovÈ a ûluËnÌkovÈ kameny, cukrovka, vysok˝ krevnÌtlak, n·dorov· onemocnÏnÌ a ËastÈ katary hornÌch cestd˝chacÌch) a hodnocenÌ vztahu mezi mϯenou hluË-nostÌ a v˝skytem tÏchto ÑcivilizaËnÌchì chorob. Opako-vanÏ zjiötÏn˝ vztah mezi hluËnostÌ a v˝skytem tÏchtoonemocnÏnÌ byl pouûit pro odhad relativnÌho rizikapoökozenÌ zdravÌ hlukem ve venkovnÌm prost¯edÌ, p˘-soben˝m z tÈmϯ 90 % dopravou. Vytvo¯en˝ programHluk M, kter˝ na z·kladÏ ˙daj˘ o poËtu obyvatelv jednotliv˝ch domech a hlukovÈ expozice dovoluje od-hadnout procento obyvatel poökozen˝ch na zdravÌ hlu-kem v noci ve dvoudecibelov˝ch p·smech od 40ñ72 dBv LAeq. Odhad individu·lnÌho rizika poökozenÌ zdravÌhlukem se p¯edpokl·d· p¯i minim·lnÏ desetiletÈm po-bytu v prost¯edÌ s noËnÌ hluËnostÌ.

SouËasnÏ na z·kladÏ v˝öe uveden˝ch v˝sledk˘ byl vevÏtöÌch oblastech navazujÌcÌch na z·kladnÌ sledovanÈlokality propoËÌt·n modelov˝ odhad relativnÌho rizikapoökozenÌ zdravÌ hlukem v ûivotnÌm prost¯edÌ na 6,2 %obyvatel Prahy.

ToxickÈ l·tky v poûivatin·ch, diet·rnÌ expozice

Odhad pr˘mÏrnÈ expozice populace »R vybran˝mchemick˝m l·tk·m st·le pokraËuje (v˝znamnÈ kontami-nanty, nutrienty, mikronutrienty), protoûe jejich obsahv potravin·ch m˘ûe p¯edstavovat zdravotnÌ riziko ne-n·dorov˝ch i n·dorov˝ch onemocnÏnÌ. V roce 2000probÌhalo vzorkov·nÌ podle schÈmatu zavedenÈho v mi-nulÈm roce. Byly vytvo¯eny 4 regiony, zahrnujÌcÌ vûdy3 svozn· mÌsta (jednÌm ze svozn˝ch mÌst je i Praha).Vzorky potravin z Prahy nebyly analyzov·ny samostatnÏ,ale v r·mci regionu B spoleËnÏ se vzorky z ⁄stÌ n/L aJablonce n/N. ZjiötÏnÈ koncentrace chemick˝ch l·tekbyly pouûity pro v˝poËet odhadu pr˘mÏrn˝ch expozicv roce 2000 spoleËnÏ s hodnotami spot¯eby potravinpodle spot¯ebnÌho koöe. Pro dlouhodobÈ srovn·nÌ ex-pozic (od roku 1994) byl pouûit model doporuËen˝chd·vek potravin pro »R, kter˝ je stanoven pro 5 skupinpopulace (dÏti, dospÏlÌ muûi, dospÏlÈ ûeny, tÏhotnÈ/kojÌcÌûeny, osoby staröÌ 60 let).

Pr˘mÏrn· chronick· expozice v regionu B sledovan˝morganick˝m l·tk·m z potravin nedos·hla ani v roce 2000kritick˝ch hodnot, kterÈ jsou spojov·ny s nep¯Ìpustn˝mzv˝öenÌm pravdÏpodobnosti poökozenÌ zdravÌ spot¯e-bitele pro nekarcinogennÌ efekt. PopulaËnÌ expozice od-hadovan· podle spot¯ebnÌho koöe potravin dos·hla nej-

the differences in noise pollution level found in theprevious and last monitoring periods that noise pollutionlevel of night-time equivalent levels have been increasingin silent localities. These differences are, however, smalland may be explained that in silent localities, withoriginally low traffic load, doubling in noise pollutionlevel may easily happen. Overall it may not be statedthat any substantial increase or decrease in noise pollu-tion level in the Czech Republic or in Prague happened.Noise affects in population of the selected localities hasbeen monitored by means of a questionnaire focused onthe monitoring of selected, so called civilisation diseases(myocardial infarct, ulcer diseases of stomach and duo-denum, nephrolith and cholelith, diabetes, high bloodpressure, tumours, and frequently occurring catarrhs ofthe upper airways) and evaluation of the relation of noisepollution level and the occurrence of such ìcivilisationîdiseases. Repeatedly found relation of noise pollutionlevel and occurrence of such diseases was employed forthe estimate of relative hazard of noise damage due toenvironmental noise outdoor which is by 90% caused bytraffic. The developed software Hluk M which by meansof data on number of inhabitants in respective housesand noise exposition enables to estimate the percentageof the population suffering some health damage due tonoise in night-time at two-decibel zones starting from40 to 72 dB of LAeq. The estimate of individual risk ofhealth damage due to noise is assumed at 10 year longstay in environment with night-time noise pollution levelas minimum.At present and based on the results mentioned abovemodel estimates of relative hazard of human healthdamage due to environmental noise covering 6.2 % ofthe Prague population were calculate for larger arearelated to the localities monitored.

Toxic substances in foodstuffs, exposure throughingestion

The assessing of the average exposure of the CzechRepublic population to selected chemicals has been stillongoing (important contaminants, nutrients, micronu-trients) because their content in food may pose healthrisk of diseases and neoplasms. In 2000 the samplingmethod was performed according to the scheme intro-duced in 1999. There were 4 regions established, alwaysincluding 3 collecting points (Prague is one of the points).Food samples from Prague were not analysed separatelyyet along with other samples from the cities ⁄stÌ nadLabem and Jablonec nad Nisou of the Region B. Theconcentrations of chemicals and foodstuffsí consumptionfigures in market basket were utilised for calculationsof average exposures in 2000. In order to make a long-term comparison of exposures (since 1994) the model ofrecommended food dose for the Czech Republic, whichis defined for 5 groups of population (children, adultmales, adult females, gravid/breastfeeding women,persons over 60 years of age), was employed.Average chronic exposure in the Region B to the moni-tored organic substances in foodstuffs did not reachcritical values in 2000, which relate to unacceptableincrease in probability of customer health damage ofnon-cancer type. Population exposure estimated on

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vyööÌ ˙rovnÏ u PCB ñ 10,4 % tolerovatelnÈho dennÌhop¯Ìvodu (TDI) pro sumu sedmi indik·torov˝ch konge-ner˘. NejvyööÌ poËet pozitivnÌch analytick˝ch z·chyt˘byl pozorov·n u kongener˘ PCB Ë. 153, 138 a 180(62%, 57% a 56%), ale takÈ pro kongener Ë. 52 (75%).Vysok˝ poËet analytick˝ch z·chyt˘ byl tradiËnÏ pozo-rov·n v p¯ÌpadÏ p,p- DDE (85 %) a HCB (83 %), alei pro alfa izomer HCH (70 %). ExpoziËnÌ d·vky tÏchtol·tek vöak byly tradiËnÏ velmi nÌzkÈ. To svÏdËÌ o p¯e-trv·vajÌcÌ ploönÈ kontaminaci, ale na ˙rovni velmi nÌz-k˝ch koncentracÌ. Expozice odhadovan· podle modeludoporuËen˝ch d·vek potravin dosahuje nejvyööÌch hod-not u dÏtÌ ve vÏku 4ñ6 rok˘. Expozice sumÏ sedmi indi-k·torov˝ch kongener˘ PCB dos·hla u dÏtÌ 40 % TDI, coûp¯edstavuje, ve srovn·nÌ s loÚsk˝m rokem, mÌrn˝ pokles.

Pr˘mÏrn· chronick· expozice pro populaci v regionu Banorganick˝m l·tk·m nevedla k p¯ekraËov·nÌ expoziË-nÌch limit˘ pro nekarcinogennÌ efekt. Expozice odha-dovan· podle spot¯ebnÌho koöe potravin ukazuje ros-toucÌ z·tÏû dusiËnany a dusitany (21 % resp. zv˝öenÌ na32 % ADI). Z·tÏû kadmiem se mÌrnÏ zv˝öila na 19 %provizornÌho tolerovatelnÈho t˝dennÌho p¯Ìvodu (PTWI),z·tÏû olovem vzrostla na 15,4 % PTWI. Expozice rtutia arzenu trvale dosahuje nÌzk˝ch hodnot (1,3 % resp.4 % PTWI). Expozice odhadovan· podle modelu dopo-ruËen˝ch d·vek potravin dosahuje opÏt nejvyööÌch hod-not pro dÏti ve vÏku 4ñ6 rok˘: dusiËnan˘m 95 % ADI,expozice dusitan˘m stoupla na 130 % ADI a manganudokonce tÈmϯ na 180 % RfD.

Teoretick˝ odhad pravdÏpodobnosti zv˝öenÌ poËtun·dorov˝ch onemocnÏnÌ v naöÌ populaci v d˘sledkuexpozice vybran˝m chemick˝m l·tk·m Ëinil asi 76 p¯Ì-pad˘ pro celou »R a rok 2000. NejvyööÌ podÌl na zv˝-öenÌ rizika p¯edstavovaly jiû tradiËnÏ PCB a arzen.

Biologick˝ monitoring

SystematickÈ monitorov·nÌ mutagennÌ aktivity praön˝chË·stic (PM10) ovzduöÌ bylo zah·jeno koncem roku 1996a od roku 1997 kontinu·lnÏ probÌh· s 18-ti dennÌmiodbÏrov˝mi intervaly v n·vaznosti na anal˝zu PAUv subsystÈmu ovzduöÌ. Vzhledem k signifikantnÏ vyö-öÌm hodnot·m prokazovan˝m v zimnÌch mÏsÌcÌch sev r. 2000 odbÏr vzork˘ omezil na obdobÌ ledenñb¯ezena ¯Ìjenñprosinec. V r. 1999 byly odbÏry v BeneöovÏzastaveny a nahrazeny odbÏry v Praze. Vzorky z ob-lasti Prahy vykazovaly v˝znamnÏ vyööÌ hodnoty neûu ostatnÌch lokalit. MutagennÌ aktivita vöech vzork˘,vyj·d¯en· poËtem revertant/m

3, korelovala s v˝sledky

anal˝zy PAU (sumou PAU, hodnotou TEQ i koncen-tracÌ benzo(a)pyrenu), kter· byla prov·dÏna v r·mcisubsystÈmu ovzduöÌ. V˝sledky mutagennÌ aktivity dete-kovanÈ u indik·torovÈho kmene YG1041 signalizujÌzvyöujÌcÌ se koncentraci i dalöÌch chemick˝ch strukturs mutagennÌm potenci·lem, v·zan˝ch na praön˝ aerosol,zejmÈna nitroareny.

V˝sledky mutagennÌ aktivity organickÈho extraktu PM10ovzduöÌ potvrzujÌ vyööÌ hodnoty u vzork˘ odebran˝ch

the basis of food market basket attained the highestlevel in PCBs ñ 10.4 % of tolerable daily intake (TDI)for the total of seven indicating congeners. The highestnumber of positive analyses was found in PCB congenersNo. 153, 138, and 180 (62 %, 57 %, and 56 %, respe-ctively), yet also for the congener No. 52 (75 %). Highnumber of positive analyses happened, as usual, in thecases of p,p-DDE (85 %) and HCB (83 %), and alsofor alpha-isomer of HCH (70 %), but exposure doseswere very low also as usual. This provides evidence ofpermanent spatial contamination yet at the level of verylow concentrations. The exposure estimated accordingto the model of recommended food doses attained highestvalues for children 4ñ6 years of age. The exposure tothe total of seven indicating PCB congeners reached40 % TDI for children that means a slight decrease ifcompared to the last year results.Average chronic exposure of the Region B population toinorganic substances did not reveal violation of expo-sure limits for non-cancerogenic diseases. The exposureestimated on the basis of food market basket revealeda growing load of nitrates and nitrites (21 % and in-crease to 32 % ADI, respectively). Cadmium load wasslightly elevated to 19 % of provisional tolerable weeklyintake (PTWI), lead load increased to 15.4 % PTWI.Exposure to mercury and arsenic have been permanentlyat low level (1.3 % and 4% PTWI, respectively). Exposureestimated according to the model of recommended fooddoses again demonstrated highest values for children4ñ6 years of age: by nitrates 95 % ADI, by nitritesgrown even to 130 % ADI, and by manganese almostto 180 % RfD.A theoretical estimate of probability for increase innumber of tumours and neoplasms in our populationdue to the exposure to the selected chemicals was about76 instances for the entire Czech Republic in 2000.PCBs and arsenic posed the highest contribution to therisk increase as usual.

Biological monitoring

A systematic monitoring of mutagenic activity of suspendedparticulate matter (PM10) was launched at the end of1996 and since 1997 it has been continuously performedat 18-day sampling interval related to the PAH analysisin air. In 2000 due to significantly higher values shownin winter months samples were taken in the periodsJanuaryñMarch and OctoberñDecember. In 1999 thewithdrawals in Beneöov were cancelled and replacedby sampling in Prague. Samples taken in the Praguemetropolitan area demonstrated significantly highervalues than those form other localities. Mutagenicactivity of all samples expressed as the number ofrevertants/m

3correlated with results of the PAH ana-

lysis (that means sum of PAH, TEQ value and con-centration of benz[a]pyrene), which were carried outwithin the air subsystem. Results of mutagenic activitydetected in the indicator tribe YG1041 give sign thatalso concentration of other chemical substances bearingsome mutagenic potential bound to suspended parti-culate matter namely nitroarenes.Results of mutagenic activity of organic extract of air-borne PM10 confirmed higher values found in samples

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v Praze, a u indik·torovÈho kmene YG1041 stoupajÌcÌËasov˝ trend.

PracovnÌ lÈka¯stvÌ

NovÏ zaveden˝ subsystÈm do SystÈmu monitorov·nÌzdravotnÌho stavu obyvatelstva zahrnuje sledov·nÌzdravotnÌho poökozenÌ zamÏstnanc˘ jako d˘sledek ne-gativnÌho vlivu faktor˘ pracovnÌch podmÌnek a pra-covnÌho prost¯edÌ. Jedn· se o nov˝ subsystÈm, kter˝obsahuje ˙daje celost·tnÌho monitoringu v˝skytu ne-mocÌ z povol·nÌ a ohroûenÌ nemocÌ z povol·nÌ (moni-torov·nÌ zdravotnÌch ˙Ëink˘), monitorov·nÌ expozice(kategorizace pracÌ a pracoviöù) a sledov·nÌ negativnÌchvliv˘ vybran˝ch faktor˘ pracovnÌch podmÌnek a pra-covnÌho prost¯edÌ na zdravÌ zamÏstnanc˘. KonkrÈtnÏ sejedn· o jednostrannou dlouhodobou a nadmÏrnou fy-zickou z·tÏû a chemickÈ karcinogeny, vËetnÏ zaloûenÌregistr˘ pracoviöù a pracÌ, kde se tyto l·tky vyskytujÌ.

Monitorov·nÌ zdravotnÌch ˙Ëink˘ existuje prakticky10 let a je jiû plnÏ stabilizov·no. V »R byl v˝skyt ne-mocÌ z povol·nÌ, p¯ÌpadnÏ ohroûenÌ nemocÌ z povo-l·nÌ v roce 2000 niûöÌ neû v p¯edchozÌch letech. Cel-kov˝ poËet profesion·lnÌch onemocnÏnÌ dos·hl poËtu1751, z toho bylo 1691 nemocÌ a 60 ohroûenÌ nemocÌz povol·nÌ u celkem 1713 zamÏstnanc˘ (incidence na100 000 zamÏstnanc˘ je 38,3); diagnÛza profesion·lnÌhoonemocnÏnÌ byla stanovena u 1104 muû˘ a 647 ûen.

P˘da

P˘da v mÏstsk˝ch aglomeracÌch, kontaminovan· v d˘-sledku z·tÏûe ûivotnÌho prost¯edÌ, se m˘ûe podÌlet nazv˝öenÈ expozici mÏstskÈ populace toxick˝m l·tk·mi mikroorganism˘m. Studie zab˝vajÌcÌ se vztahy mezikontaminacÌ p˘dy a zdravotnÌmi riziky prok·zaly, ûedoch·zÌ k nez·mÏrnÈmu p¯Ìjmu neËistot z p˘dy a prachudÏtmi i dospÏl˝mi, u dÏtskÈ populace se p¯id·v· ob-Ëasn˝ v˝skyt geofagie. V˝sledky studiÌ potvrdily zv˝-öenou expozici obyvatel ökodliv˝m l·tk·m (p¯edevöÌmtoxick˝m kov˘m) z p¯Ìjmu p˘dy a prachu v oblastechs kontaminovanou p˘dou.

Projekt monitoringu p˘dy v mÏstsk˝ch aglomeracÌchje jednÌm z ˙kol˘ AkËnÌho pl·nu zdravÌ a ûivotnÌhoprost¯edÌ NEHAP.

V »eskÈ republice nebyla dosud komplexnÏ sledov·na˙roveÚ kontaminace p˘dy mÏstsk˝ch aglomeracÌ (dlou-hodobÏ je monitorov·na p˘da zemÏdÏlsk·) a chybÌ takÈinformace o ploch·ch, kterÈ by mohly b˝t zdrojem nad-mÏrnÈ expozice p¯edevöÌm dÏtskÈ populace.

Rok 2000 se nesl ve znamenÌ zpracov·nÌ projektu (a ovÏ-¯ov·nÌ StandardnÌch operaËnÌch postup˘ vËetnÏ jejichovϯenÌ na p˘d·ch mate¯sk˝ch ökol v KarvinÈ a Olo-mouci), kter˝ m· tyto hlavnÌ cÌle:

ï ZjistÏnÌ kontaminace povrchovÈ vrstvy p˘dy vybra-n˝mi prvky (Pb, Cd, Cu, As, Be, V, Tl a Hg), organic-k˝mi l·tkami (polyaromatickÈ uhlovodÌky) a mikro-organismy ve sledovan˝ch lokalit·ch.

taken in Prague and time growing trend in the indicatortribe YG1041.

Occupational medicine

This subsystem newly introduced into the System ofMonitoring of the Population Health includes the moni-toring of health damage in employees as consequencesto adverse effects of factors of working conditions andworking environment. It is a new subsystem, which con-tains data of the national monitoring of occupationaldisease occurrence and hazard of occupational disease(monitoring of health affects), monitoring of exposition(classification of occupational activities and workplaces),and furthermore the monitoring of adverse effects ofselected factors of working conditions and workingenvironment on the employee health. Here this actuallymeans unilateral, long-term and excessive physical loadand chemical carcinogens including the establishingof registers of workplaces and work activities, wheresuch substances occur.The monitoring of health effects has been here for almost10 years and now it is a completely stabilised system.In 2000 the occurrence of occupational diseases orhazards of occupational disease in the Czech Republic,respectively was lower than in the previous year. Totalnumber of occupational diseases reached the numberof 1,751, out of that 1,691 were diseases and 60 hazardsof occupational disease in 1,713 employees (incidenceper 100,000 employees is 38.3), the diagnosis of someoccupational disease was determined in 1,104 men and647 women.

Soil

Soil in urban agglomerations contaminated as a resultof environmental load may contribute to an increasedexposition of urban populations to toxic substances andwell as micro-organisms. Studies dealing with relationsof soil contamination and health hazards have proventhat children and adults make unintentional intake ofcontaminants from soil and dust, concerning the childrenpopulation also sporadically occurring geophagia maycontribute to it. Results of the studies confirmed that thepopulation has higher exposition to harmful substances(namely to toxic metals) from soil and dust intake inareas where there is contaminated soil.A project on the soil monitoring in urban agglomerationsis one of the objectives of the Action Plan for Health andEnvironment of NEHAP.In the Czech Republic no complete monitoring of soilcontamination level in urban agglomerations has beencarried out so far (farmland has been under a long-termmonitoring programme) and also information on areas,which could do as sources of overexposition, especiallyof children population, is missing.In 2000 a project (and verification of standard operatingprocedures including their verification by means of soilsat kindergartens in the cites of Karvin· and Olomouc)was developed having major aims as follows:ï to determine the contamination of topsoil by selectedelements (Pb, Cd, Cu, As, Be, V, Tl, and Hg), organiccompounds (polyaromatic hydrocarbons), and micro-organisms on localities monitored;

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ï ZhodnocenÌ expozice dÏtskÈ populace ökodliv˝ml·tk·m a mikrobi·lnÌmu zneËiötÏnÌ z p¯Ìjmu p˘dya prachu, a n·slednÈho zdravotnÌ rizika.

ï P¯ehodnocenÌ a vypracov·nÌ n·vrhu nov˝ch limit-nÌch koncentracÌ chemick˝ch a biologick˝ch konta-minant˘ v mÏstsk˝ch p˘d·ch.

Pro z·jemce jsou v˝sledky anal˝z p˘d p¯Ìstupny, mimojinÈ, na internetovÈ adrese http://www.szu.cz/chzp/reporty.htm, kap. 11 SouhrnnÈ zpr·vy za rok 2000. ProzahraniËnÌ n·vötÏvnÌky je urËena adresa http://www.szu.cz/chzpa/sumrep.htm.

Z·vÏr

Shrom·ûdÏnÈ v˝sledky za rok 2000 p¯edstavujÌsadu informacÌ, kterÈ byly zÌsk·ny rutinnÌm a stabi-lizovan˝m souborem monitorovacÌch aktivit öestÈhoroku provozu SystÈmu monitorov·nÌ. Jsou z·vaû-n˝m materi·lem pro ¯ÌzenÌ a kontrolu zdravotnÌchrizik jak pro org·ny st·tnÌ spr·vy, tak pro öirokouve¯ejnost, protoûe usnadÚujÌ Ëinnosti spojenÈ s p¯e-chodem k aktivnÌ ochranÏ zdravÌ. Svou komplex-nostÌ p¯edstavujÌ podklad pro objektivnÌ informo-v·nÌ ostatnÌch zemÌ Evropy a celÈho svÏta z pohleduobchodnÌch a kulturnÌch kontakt˘. Jsou d˘kazemo ˙rovni zdravotnÌho stavu naöÌ populace a zne-ËiötÏnÌ sledovan˝ch sloûek ûivotnÌho prost¯edÌ.

SouhrnnÏ lze z prezentovan˝ch v˝sledk˘ vyvodit,ûe k p¯ekraËov·nÌ limitnÌch hodnot doch·zÌ v Prazei v ostatnÌch monitorovan˝ch mÏstech jen ojedi-nÏle. Tyto situace jsou p¯ev·ûnÏ hodnoceny jakonesystematickÈ zmÏny, kterÈ nejsou v ËasovÈ ¯adÏv˝sledk˘ potvrzov·ny. Naopak, pro naprostouvÏtöinu monitorovan˝ch cizorod˝ch l·tek jsou sta-novenÈ limity Ëerp·ny jen v omezenÈ m̯e.

ï to evaluate the children population exposition toharmful substances and microbial contaminationthrough the soils and dust intake and the consequentialhealth hazards;

ï to make a revision of and to develop a new proposalfor novel limit concentrations of chemical and bio-logical contaminants in urban soils.

The interested may find results of soil analyses, amongother sources, at the internet address http://www.szu.cz/chzp/reporty.htm, chapter 11 Summary Reports for 2000.Foreign visitors find the same information at the addresshttp://www.szu.cz/chzpa/sumrep.htm.

Conclusion

The results collected in 2000 form a set of infor-mation, which was acquired through a routine andstabilised group of monitoring activities of thesixth year operation of System of Monitoring. Theymake a substantial material for the abatement andcontrol of health hazards both to the governmentbodies and the general public because they makeactivities related to the transition to some ratheractive approach to the health protection easier.In its complete nature the set makes a backgroundmaterial for the providing of objective informa-tion to other countries Europe and the whole worldfrom the view of business and culture contacts.The results give the evidence on the level of ourpopulation health and pollution of the monitoredenvironmental compartments.

Just to summarise it may be derived from theresults presented that cases when limit valuesare exceeded, in Prague as well as in other citiesmonitored, occur sporadically. Such situations aremostly judged as non-system changes, which haveno confirmation in time series of measurements.On the contrary, for a vast majority of contaminantsmonitored the established limits are achieved onlyin a limited number of cases.

Magistr·t hl. m. Prahy 203 PRAHA ñ éivotnÌ prost¯edÌ 2001Prague City Hall PRAGUE ñ Environment 2001

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Tab. C2.1 Odhad relativnÌho rizika poökozenÌ zdravÌ hlukem v ûivotnÌm prost¯edÌEstimate of relative human health damage due to environmental noise

dB LAeq

PravdÏpodobnost rizikapostiûenÌ hlukemProbability of noisedamage hazard

[%]

dB LAeq

PravdÏpodobnost rizikapostiûenÌ hlukemProbability of noisedamage hazard

[%]

dB LAeq

PravdÏpodobnost rizikapostiûenÌ hlukemProbability of noisedamage hazard

[%]

40 ñ 50ñ52 4,0 60ñ62 7,6

40ñ42 0,4 52ñ54 4,7 62ñ64 8,3

42ñ44 1,1 54ñ56 5,4 64ñ66 9,1

44ñ46 1,8 56ñ58 6,2 66ñ68 9,8

46ñ48 2,5 58ñ60 6,9 68ñ70 10,5

48ñ50 3,3 60ñ62 7,6 70ñ72 11,2

Zdroj / Source: SZ⁄ Praha

Obr. C2.1a Oxid si¯iËit˝ a oxidy dusÌku, hodnocenÌ roËnÌch imisnÌch hodnot, 1991ñ2000Sulphur dioxide and nitrogen oxides, evaluation of yearly ground-levelconcentrations, 1991ñ2000

RoËnÌ imisnÌ limit SO2 = 60 µg.m-3 / Annual immission limit SO2 = 60 µg.m-3

RoËnÌ imisnÌ limit NOx = 80 µg.m-3 / Annual immission limit NOx = 80 µg.m-3 Zdroj / Source: SZ⁄ Praha, Monitoring

Obr. C2.1b PolÈtav˝ prach, frakce TSP a PM10, hodnocenÌ roËnÌch imisnÌch hodnot, 1991ñ2000Suspended particulate matter ñ fractions TSP and PM10, evaluation of yearlyground-level concentrations, 1991ñ2000

RoËnÌ imisnÌ limit TSP = 60 µg.m-3 / Annual immission limit TSP = 60 µg.m-3

Odvozen˝ roËnÌ imisnÌ limit PM10 = 30 µg.m-3 / Derived annual immission limit PM10 = 30 µg.m-3

Zdroj / Source: SZ⁄ Praha, Monitoring

Obr. C2.2 RoËnÌ index kvality ovzduöÌ, 1995ñ2000Annual index of air quality, 1995ñ2000

Zdroj / Source: SZ⁄ Praha, Monitoring

PRAHA ñ éivotnÌ prost¯edÌ 2001 204 Magistr·t hl. m. PrahyPRAGUE ñ Environment 2001 Prague City Hall

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110 110120 120130 130

A5 A5A9 A8A4 A1A6 A10A2 A9A1 A4A8 A6A10 A2

2-1

-12

ko

ncen

trace

SO

[µg

.m]

co

ncen

trati

on

SO

[µg

.m]

x-1

-1x

ko

ncen

trace

NO

[µg

.m]

co

ncen

trati

on

NO

[µg

.m]

praûskÈ obvody / Prague districts

100 10090 9080 8070 7060 6050 5040 4030 3020 2010 100 0

rozpÏtÌ / 1991/2000range2000

110 110120 120130 130

A8 A10A5 A1A1 A5A4 A9A7 A4A6 A6A10 A2 A8

-1

-1ko

ncen

trace

TS

P[µ

g.m

]co

ncen

trati

on

TS

P[µ

g.m

]

10

-1

-11

0

ko

ncen

trace

PM

[µg

.m]

co

ncen

trati

on

PM

[µg

.m]

praûskÈ obvody / Prague districts

100 10090 9080 8070 7060 6050 5040 4030 3020 2010 100 0

mϯeno od r. 1995 / measured since 1995

2000

rozpÏtÌ TSP / 1991/2000range TSProzpÏtÌ PM / 1991/2000range PM10 10

6

5

4

3

2

1

0

rIK

O[1

]

A5 A8 A9 A1 A10 A2 A4 A6

praûskÈ obvody / Prague districts

ovzduöÌ ËistÈ / clean atmosphere

ovzduöÌ vyhovujÌcÌ / acceptable atmosphere

ovzduöÌ zneËiötÏnÈ / polluted atmosphere

ovzduöÌ silnÏ zneËiötÏnÈ / highly polluted atmosphere

ovzduöÌ zdravÌ ökodlivÈ / harmful to health rozpÏtÌ / 1995/2000range2000

ovzduöÌ mÌrnÏ zneËiötÏnÈ / moderately polluted atmosphere

Obr. C2.3 Kvalita pitnÈ vody v praûskÈ spot¯ebitelskÈ sÌti, mikrobiologickÈ a biologickÈukazatele, 1994ñ2000Drinking water quality in Prague consumer network, microbiological and biologicalindicators, 1994ñ2000

Zdroj / Source: SZ⁄ Praha, Monitoring

Obr. C2.4 Expozice vybran˝m kontaminant˘m z p¯Ìjmu pitnÈ vody, 1994ñ2000Selected contaminants exposition due to the intake through the drinking waterconsumption, 1994ñ2000

p¯Ìjem pitnÈ vody ze sÌtÏ = 1 l/d / ingestion of tap water = 1 l/dADI ñ p¯Ìpustn˝ dennÌ p¯Ìvod / ADI ñ acceptable daily intake Zdroj / Source: SZ⁄ Praha, Monitoring

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monitoring: hyg. sluûba a provozovatelÈmonitoring: Public Health Service, distributors

biËÌkovci bezbarvÌ / flagelates

0 1 32 4 5

p¯ekroËenÌ limitnÌ hodnoty [%] / excess of limit value [%]

bakterie koliformnÌ / bacteria coliform

bakterie mesofilnÌ / bacteria mesofil

abioseston-tripton / abioseston-tripton

bakterie kolif. fek. / bacteria colif. fec.

organismy ûivÈ / organisms living

enterokoky / enterococci

organismy mrtvÈ / organisms dead

bakterie psychrof. / bacteria psychrof.

rozpÏtÌ / 1994/2000range2000

dennÌ p¯Ìvod ADI [%]daily intake ADI [%]

nulov· hodnota znamen· < 0,005 / 0 means value < 0.005

baryum /

dusiËnany /

dusitany /

hexachlorbenzen /

hlinÌk /

chloroform /

kadmium /

mangan /

mÏÔ /

nikl /

olovo /

rtuù /

zinek /

ûelezo /

barium

nitrates

nitrites

hexachlorobenzene

aluminium

chloroform

cadmium

manganese

copper

nickel

lead

mercury

zinc

iron

0 2 4 6 8 10 12 14 16

rozpÏtÌ / 1994/2000rangemedi·n / 2000median90% kvantil / 200090% quantile

.