Water-borne diseases

3.2.9  Water-borne diseases

According to the official definition of the European Regional Bureau of the World Health Organisation, water-borne diseases mean any significant and widely spread negative effect on human health (death, disability, disease or disorder) that is directly or indirectly caused by the state or changes in quantity or quality of any water resource.

There is a continuous threat of outbreaks of waterborne diseases in the Dnipro River Basin. Available data shows numerous limited outbreaks of diseases caused by exposure to or consumption of poor quality water containing pathogenic bacteria that are responsible for transmitting various contagious diseases.

In 2000-2001, 10 outbreaks of contagious viral and bacterial diseases were officially recorded within the Russian part of the Dnipro Basin, attributed to microbial contamination of drinking water. The total number of people affected was 307, about 38% of them children under 14 years of age. Enteric fever, A, B, and C-paratyphoid and bacterial dysentery are the most frequent water-borne diseases. In the Kaluga, Orel and Bryansk Oblasts, the incidence of dysentery, hepatitis A and other acute contagious diseases is higher than the country average level.

Over the period of 1994-2001, 12 outbreaks of contagious waterborne viral and bacterial diseases were recorded in the Belorussian part of the Dnipro Basin. The total number of people affected was 1,135 with over 50% of them children under 14 years of age. In addition to contagious viral and bacterial diseases, human health in the Dnipro Basin is threatened by parasitic invasions. In the Pripyat River Basin, parasitic invasion levels are relatively low. This is because fish have never dominated the local food pattern, with only between 2% and 9% of the local population engaged in non-commercial fishing. The incidence of opisthorchiasis is different in the Dnipro River Basin where as many as 20% of the local population is engaged in such activities. In this area, fish is consumed in large quantities, particularly dried and pickled. Inadequate existing water treatment and disinfection technologies are considered to be the major causes of water-borne disease outbreaks.

In Ukraine, contaminated water is considered as one of the major causes of enteric infections. There is a direct relationship between the increasing contamination of water and the incidence of water-borne diseases (enterocolitis, dysentery, salmonellosis, viral hepatitis А, etc). Results of studies carried out in the Dnipro Basin suggest that microbiological contamination of drinking water is the major contributor to the growing frequency of contagious disease incidence (Table 3.8).

Table 3.8  Percentage of cases of contagious diseases attributed to microbiological pollution

Between 1990 to 2000 the incidence of human disease has been growing at an average rate of 0.7%. Notably, the incidence of diseases relating to or associated with environmental pollution has been growing at a significantly higher rate.

This picture varies across the Basin. For example, the highest disease incidence rate has traditionally been recorded in the Central Ukrainian Oblasts with disease patterns being dominated by circulatory system diseases and respiratory diseases. This, in some part, can be attributed to the ageing population of this region. Malignant tumors are frequent in the industrialised areas of the Basin (Dnipropetrovsk, Zaporizhzhia and Kirovograd Oblasts) which can be attributed to higher levels of environmental pollution.

The incidence of endocrine and digestive system diseases remains high in the central and north-western areas of the Basin, where thyroid adenoma has been a serious issue. Since 1999, the situation has become even more complicated due to higher incidence of hyperplasia of the thyroid gland, indicative of the impact of the Chernobyl accident.

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