Posterior assessment of airborne non-carcinogenic health risk of the population of a large industrial center
Authors: Zaitseva Nina V. , Kleyn Svetlana V. , May Irina V. , Kiryanov Dmitriy A. , Goriaev Dmitriy V. , Andrishunas Alena M. , Balashov Stanislav Yu. , Chigvintsev Vladimir M. , Khismatullin Dmitriy R. 
Published: December 2023

Introduction. This article suggests an alternative solution to the task of quantifying and describing health harm under exposure to non-carcinogenic risk factors.
Materials and methods. We have developed and tested a methodical approach that includes five subsequent steps; it is eligible for posterior quantification of non-carcinogenic health risks represented by additional diseases cases associated with poor ambient air quality. The approach relies on unified and validated methods for assessing exposure and health risks, mathematical parameterization of cause-effect relations within the "environment – public health" system, and calculation of additional incidence as well as combined assessment of all the obtained results.
Results. According to calculated data, which were also verified by instrumental observations of ambient air quality, the existing hygienic standards are violated as per 27 chemicals in residential areas. Elevated hazard quotients are identified for 26 chemicals (up to 98.7HQac; up to 62.7HQch). Additive effects of the analyzed chemicals crated elevated hazard indices (HI) in residential areas that could be ranked as "alerting" (3<HI≤6) and "high" (HI>6) for respiratory organs, the cardiovascular and hematopoietic systems, liver, kidneys, eyes, development, the immune, reproductive, endocrine, and other systems. The identified levels of airborne exposure annually cause approximately 80.9 thousand additional diseases among the total population (71.0‰; 4.15% of the total incidence);
23 chemicals are considered priority risk factors (contributions vary between 0.25 and 65.0%). We have identified certain regularity for some disease classes: higher levels of additional incidence associated with ambient air quality are established in zones with higher airborne health risks. Thus, in zones where airborne risks for respiratory organs are HIch≤1, we identified no additional incidence as per such diseases; in zones with 1<HIch≤3 (with population being 800 people), additional incidence reaches 1.57‰ for the total population; 3<HIch≤6 (more than 100 thousand people), 3.25‰; HIch>6 (more than 1.09 million people), 5.0‰.
Limitations. The suggested approaches have been obtained by calculation. Their results might differ from those obtained by targeted in-depth investigations aimed at creating an evidence base of health harm under adverse environmental conditions that do not conform to hygienic standards. The parameters of mathematical models within "the environment – public health" system have been obtained for a limited range of exposure to pollutants in ambient air and a limited list of airborne health risk factors.
Conclusion. The suggested methodical approaches to posterior assessment of non-carcinogenic health risks allows quantifying these health risks as additional diseases associated with poor quality of the environment; they enlarge the results of health risk assessment and make them more precise, validate and support them with hygienic significance. They can be utilized within optimization of social and hygienic monitoring and assessment of effectiveness of implemented prevention activities.