HUNGARIAN ENVIRONMENTAL HEALTH ACTION...

HUNGARIAN ENVIRONMENTAL HEALTH

ACTION PROGRAMME

Budapest1997

Ákoshegyi, GyörgyBenkő, GyöngyiBezegh, AndrásBíró, GyörgyBozó, PálBunyevácz, JózsefBuzásné, Harttyányi MariettaCsanády, MihályCsászár, GyörgydeBlasio, AntonioDura, GyulaFarkas, IldikóFodor, IstvánFórián, Szabó PéterGalgóczy, GáborGroszman, MáriaGyarmati, JánosHalasiné, Kőszegi ZsuzsannaHavas, PéterHibbeyné, Joó MártaHirka, FerencHorváth, AmandaHorváth, CsabaHorváth, MihályJózan, PéterKántor, MiklósKertész, MagdolnaKovács, SándorKőrösi, MáriaKöteles, György

Kvojka, FerencLantos, GézaLászló, FerencLászló, LászlóMáté, IstvánMolnár, JenőNemes, IstvánnéNikl, IstvánŐri, IstvánPintér, AlánRódler, ImreRózsahegyiné, Csapó OlgaRudnai, PéterSas, BarnabásSohár, PálnéSomfai, MagdolnaSóstói, PálnéSurján, JózsefSzerbin, PávelSzékely, KálmánTálas, ZsuzsannaTörök, EszterUngváry, GyörgyVarga, LászlóVári, AnnaVárkonyi, TiborVincze, IstvánWajand, JánosWittek, ErnőZoltai, Nándor

The Hungarian Environmental Health Action Programme

was developed by working groups consisting of the following experts:

The generous support of the Danish Government and especiallyJens Steensberg, Ph., D., Denmark is greatfully acknowledged

Responsible editor:Alán Pintér

Deputy Director General‘B. Johan’ National Institute of Public Health

1097 Budapest, Gyáli út 2-6.Tel/fax: (36 1) 215 21 46

Printed: Prospektus Nyomda, Veszprém

1997

Background 4

2. Environment and Health in Hungary 6

3. Pilot Project and Pilot Countries 7

4. Goals of the HEHAP 8

5. National Environmental Programme 10

6. Health Status of the Population 12

7. Process of Prioritisation 20

8. Overview of the Most Important Areas of Environmental Health 23

8. 1 Air Quality 23

8. 2 Water Quality 33

8. 3 Noise 44

8. 4 Soil Quality and Wastes 48

8. 5 Work Environment 55

8. 6 Chemical Safety 59

8. 7 Road Traffic Safety 63

8. 8 Radiation Safety 68

8. 9 Food Safety 72

8. 10 Urban Environment 79

9. Areas and Instruments for Implementation of the HEHAP 84

9. 1 Environmental Health Information System 84

9. 2 Role of Local Authorities and Non-Governmental Organisations 86

9. 3 Environmental Health Institutions 89

9. 4 Environmental Health Research 92

9. 5 Education and Training in Environmental Health 94

10. International Relations 98

11. Abbreviations 99

3

Contents

Human health and life perspectives are greatlyinfluenced by many factors in the surroundingenvironment. At the same time, human activitieshave their impact on the environment, which isoften harmful for both the environment and health.The World Health Organisation (WHO) has clear-ly stated that human health is not only the absenceof disease, but physical, mental ad social well-being. Similarly, the environment cannot berestricted to the physical environment and envi-ronmental health in the broad sense incorporatesthe whole verticum of human beings and the envi-ronment.

“Environmental health comprises those aspectsof human health, including quality of life, that aredetermined by physical, biological, social andpsychosocial factors in the environment. It alsodeals with the theory and practice of assessing,correcting, controlling and preventing those fac-tors in the environment that can potentially affectadversely the health of the present and future gen-erations (WHO, 1993).”

In 1984 WHO launched an ambitious pro-gramme called “Health for All by the Year 2000(HFA)”. Out of its 36 goals, 9 are concerned withenvironmental health, namely:

11. Accidents;18. Shaping Environmental Health Policy;10. Environmental Health Service;20. Water;21. Air;22. Food;23. Waste, Soil;24. Human Settlements;25. Work Environment.

Although reducing communicable diseases is notpart of the target health environment, they cannotbe separated from the environmental factors andtheir importance is undeniable owing the thedeterioration in hygiene. The programme is stillbasically valid although changes have been intro-duced. An important milestone was the FrankfurtMeeting of countries from the WHO EuropeanRegion, in 1989, where ministers from environ-ment and health sectors first met. The ministersdeclared the decisive importance and role ofenvironmental health. The official document ofthe meeting, the “European Charter on Environ-ment and Health” summarized the environmental

health tasks and the role that WHO should play inmaintaining both the environment and health.

The relationship between the state of the envi-ronment and human health was at the centre of theUnited Nations’ Conference on Environment andDevelopment, held in Rio de Janeiro 1992.Programmes were prepared in the document called“Agenda 21” on how sustainable development canbe achieved.

Countries in Europe have also recognised thatdeterioration of the environment will lead todecline in human health. In this respect, especial-ly Central and Eastern European countries experi-enced deterioration of the environment, due tohigh emission of pollutants into air, water and soil.Ministers for Environment from European coun-tries, along with international organisations suchas EU, OECD, UN/ECE, met in Dobris Castle(Czechoslovakia) in 1991.

A programme was launched called “Environ-ment for Europe” which focused on improving thestate of the environment, with human health regar-ded as high priority.

The second conference, held in Luzern in 1993,and the recently held third conference in Sofia1995, gave a further boost to countries to developNational Environmental Action Plans (NEAP).

In keeping with the resolution of the FrankfurtConference on Environment and Health, the sec-ond interministerial conference was convened inHelsinki, in 1994, where the ministers of environ-ment and health evaluated the results of the past 5years, implementation of the decisions of theConference in Frankfurt and the situation analysison environmental health called Concern forEurope’s Tomorrow, CET.

Consequences due to the deteriorated environ-ment affecting the health status and welfare ofpeople living in the region were considered trou-bling. In the “Declaration” the ministers endorsedthat an “Environmental Health Action Plan forEurope” (EHAPE) should be developed. The basicprinciples of the Action Plan are the following:

maintenance of solidarity inside and amongnations;sustainable development concerning mea-sures to be taken by environmental andhealth agencies;

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Background 1

1. Background

cooperation and partnership for the sake ofimproving environment and health status; the principle of subsidiarity has to betaken into account.

Member countries are to be supported in the elab-oration of action programmes resulting in devel-opment of an environmental health status of thepopulation.

5

1 Background

Hungary has been an active participant in the inter-national initiatives since the beginning and under-took an important role in the realization of the pro-grammes of the World Health Organisation. In1991 the WHO European Regional Committeestarted the programme EUROHEALTH supportingthe Central and Eastern European countries inimproving health status and reducing differencesbetween the East and West. Among the pro-grammes the following should be emphasised: pro-gramme for vaccination (EPI), national pro-grammes on noninfectious diseases like CINDI,etc. In 1992 the European Centre on Environmentand Health (ECEH) organised the NationalIntegrated Programme on Environment and Health(NIPEH) where Hungary actively participated.

In the framework of this programme, efforts weremade to develop an information system on envi-ronmental health, increasing the expertise in envi-ronmental epidemiology and environmental healthimpact assessment as tools for analysing healtheffects.

The Ministry of Welfare and the Ministry forEnvironment and Regional Policy did preparatorywork together for the second ministerial confer-ence held in Helsinki and declared that Hungarywished to play an active role in the implementa-tion of the Environment and Health Action Planfor Europe (EHAPE).

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Environment and health in Hungary 2.

2. Environment and Health in Hungary

Ministers from several countries declared inHelsinki that they would closely collaborate withWHO in preparing their National EnviromentalHealth Action Plans, and based on their initiative,a Pilot Project was launched. Six countries wereselected as participants in the pilot project (Bul-garia, Hungary, Italy, Latvia, United Kingdom,Uzbekhistan). The pilot countries committedthemselves to develop their National Environ-mental Health Action Plans and ensure the neces-sary financial and personnel conditions. Thegained experiences will then be shared with othercountries, helping to establish their NEHAPs.

The governments of the pilot countries and interna-tional organisations (OECD, EU, UN/ECE) pledgedto support the pilot project by providing highlevelcommitment to elaborate national programmes andharmonise work among the countries.

In Hungary a Committee was formed in the frameof the National Public Health Committee supportedby the Ministry of Welfare and the Ministry forEnvironment and Regional Policy, to elaborate theNational Environmental Health Action Programme.The Danish Government, through the WHO-ECEH, generously provided support for developingthe pilot projects in Hungary and Latvia.

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Pilot Project and Pilot Countries 3.

3. Pilot Project and Pilot Countries

Following the guidelines accepted by the confer-ence in Helsinki, the main goals and targets of theHEHAP are to provide a framework for improvingthe state of the environment and protecting andpromoting human health through environmentalimprovement.

Main aspects of the HEHAP are:

to promote an environment supportive tohuman health and improving the health sta-tus of the population;to overview the most important environmen-tal health issues and problems while settingpriorities for implementation;to develop scientifically sound projectsincluding technological, economic andadministrative details (“bankable projects”);to ensure close collaboration with respectiveministries, agencies and other parties, withthe health and environment sectors playing aleading role;to encourage local initiatives (local govern-ments, nongovernmental organisations) toimprove environmental health in local areas;to promote activities related to a healthy lifestyle;to improve the possibilities of research onenvironmental health problems; to encour-age international collaboration in the field ofenvironmental health; utilising availablefinancial tools to support priorities.

The National Environmental Health ActionProgramme will be successful if it gives supportfor setting up local programmes. Therefore it isvery important, that the regional institutionsbelonging to the Ministry of Welfare – first ofall the Regional Institutes of the NationalPublic Health and Medical Officers Service –use the Programme for elaborating their ownlocal plans.

In order to help attainment of these goals, toolsand strategic elements for the implementationshould be improved or established for:

establishment of new information systemsand further development of existing ones forthe systematic analysis of relationships bet-

ween environment and health, includingevaluation of changes and trends in time andspace;acquiring public support and cooperationamong the governmental organisations andNGOs;elaboration of a scientifically sound basis forpriority setting;improvement of the efficiency of environ-mental health services through an appropri-ate institutional infrastructure;promoting efficiency of environmental man-agement;improvement of professional and public edu-cation and training in environmental health;harmonisation of the existing and preparedprogramme such as governmental projects,National Environmental Programme, Pro-gramme of the Commission on SustainableDevelopment, etc.;publishing environmental health informationserving the prevention of environmental andhealth damage and the decisions of citizens;improvement of legal instruments.

DurationThe National Environmental Health Action Pro-gramme determines the tasks for a period of sixyears. Each second year, based on the experiencegained, the Programme should be reviewed andevaluated, priority determined, and correctionsmade.

Realisation of the Programme should be basedon wide social cooperation. Regional and localhealth and environmental institutions should playan outstanding role in the implementation. Thetasks described in the sections are to be performedwith the leadership of the specified responsibleorganisations.

Institutions responsible for implementing HEHAPImplementation of HEHAP is possible only withthe cooperation of the whole society.

Due to the leading role of health aspects, theNational Institute of Public Health and MedicalOfficers Service bears the highest responsibilityfor guiding cooperation among the other institu-

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Scope and Purpose of the HEHAP 4.

4. Scope and Purpose of the Hungarian Environmental Health

Action Programme (HEHAP)

tions and organisations, such as competent author-ities, local governments, NGOs and local popula-tion. The role of the institutions is described insection 9. 3.

Controlling and monitoring the implementation of the Programme

After the Programme has been approved by theParliament, the Environmental Health SteeringCommittee of the National Public Health Com-mittee is to control and make proposals for amend-ment.

Budget HEHAP can be implemented only with coopera-tion of all the competent agencies, national andlocal institutions. Termination of polluting sour-ces, liquidation of the existing pollution and creat-ing a healthy environment need huge amounts ofmoney. Financial programmes are included in theNational Environmental Programme and the relat-ed local plans. In the realisation of HEHAP theMinistry of Welfare and its institutions have aleading role. The following table summarizes thebudget required for the implementation during theperiod 1997–1999. For 1997 120 million forintswas approved by the government.

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4. Scope and Purpose of the (HEHAP)

Summarized budget for HEHAP(million Hungarian Forints)

Issues 1997 1998 1999 TotalAmbient air quality 10.0 39.1 49.0 98.1Drinking and surface water 10.0 56.0 47.0 113.0Noise 5.0 43.0 53.0 101.0Soil and wastes 15.0 81.3 59.0 155.3Work safety 7.0 32.0 37.3 86.3Chemical safety 10.0 39.0 27.0 76.0Radiation safety 8.0 23.5 17.0 48.5Food safety 10.0 24.0 16.0 50.0Urban environment 10.0 40.0 50.0 100.0Information 20.0 30.8 21.8 72.6Education 5.0 29.0 38.5 72.5International cooperation 5.0 8.0 10.0 23.0Management 5.0 7.0 9.0 21.0

Total 120.0 462.7 434.6 1017.3

Besides the initiative of the World Health Organi-zation, the ministers of environmental protectionof European countries decided to elaborate envi-ronmental programmes. The process “Environ-ment for Europe” is based on the environmentalprojects of the individual countries.

The Hungarian government passed the Act. LIII.of 1995 on the General Rules of Environmentalprotection, which provided for the elaboration of aNational Enviromental Programme. Taking intoaccount that the main goal of both HEHAP andNEP programmes sustain and protect humanhealth they should be harmonized.

Basic aims of the NEP are:to ensure the right to a healthy environment;conservation of nature and biodiversity;safe and protecting care for natural resour-ces, taking sustainable development intoconsideration;creating harmony between economy and en-vironment.

Defining priorities, elaborating plans and projectspreparation are included in both programmes,therefore the two programmes have to be done witha concerted approach. Cooperation to date appears toguarantee that unnecessary duplication will beavoided and that the two programmes determinetasks in a complementary way.

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National Environmental Programme 5.

5. National Environmental Programme (NEP)

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6. Health Status of the Population

Age distribution of the population by country

The health status of the Hungarian population isvery poor in absolute terms and in comparisonwith other European countries. The population isdecreasing due to the declining number of live-births and the increasing mortality. In recentdecades the proportion of middle aged and the agegroup above 60 grew significantly. Besides theageing of the population, the high mortality rate ofthe active, working population is a problem. Thereare big differences in the age distribution of thepopulation in the country – in the Eastern countiesthe rate of those aged 1–14 is high and the rate ofpeople above 60 is the lowest here. (Fig. 6. 1)

Reliable parameters characterising health statusare available only for mortality. To evaluate thereal situation and take proper measures, morbiditydata need to be known.

Infant mortality – although with declining ten-dency – is almost twice the average for Europe(11.5% versus 5.8%). Adult mortality is higherthan the European average in both men andwomen. (Fig. 6. 2 and 6. 3) The difference is hugefor middleaged men (40–60 years) where the mor-

tality is one of the highest in Europe. Life ex-pectancy at birth for males was 64.5 years in 1994,one of the lowest in Europe; that of females, 73.8years, was also lower than the European average.(Fig. 6. 4) In Europe the rate of avoidable deathsis the highest in Hungary after Bulgaria.

More than 90% of the mortality is due to fivegroups of diseases, namely cardiovascular dis-eases, cancer, violency, gastrointestinal and respi-ratory diseases. Mortality due to ischemic heartdiseases is higher than in most European countriesfor both men (Fig. 6. 5) and women. (Fig. 6. 6)Cardiovascular diseases show considerable regi-onal differences, of which causes need thoroughinvestigation. (Fig. 6. 7)

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Health Status of the Population 6.


13


14


Mortality due to respiratory diseases – althoughwith declining tendency – is higher than the Euro-pean average. (Fig. 6. 8 and 6. 9)

Outdoor and indoor air quality plays a consider-able role of in causing respiratory diseases andstatistics show regional differences within thecountry. (Fig. 6. 10) Cancer mortality is progres-sively growing, main causes being in men lung,liver, colon, pharynx/larynx, prostate cancer, inwomen the order is: breast, lung and cervical can-cer. The environment plays an outstanding role indevelopment of cancer. Smoking is the leadingcause of lung cancer but the role of environmentalfactors is also substantial. In European compari-son the increasing tendency is the greatest con-cern. (Fig. 6. 11 and 6. 12) There are regionalinequalities in the mortality of lung cancer inHungary (Fig. 6. 13) showing the importance ofsocial and economic factors. Among the causes ofviolent deaths, road accidents, murder and suicide,fatal accidents at work and home and poisoningsare the most important. The number of road acci-dents is very high, therefore this problem deservesspecial attention within the framework of the theAction Programme. Gastrointestinal diseases are

caused first of all by nutrition, life style factors,such as smoking, drinking, eating habits and thequality of food. The environment plays hardly anyrole but some elements of chemical and food safe-ty have a place in the Action Plan. Among theleading causes of mortality and morbidity arelifestyle (smoking, drinking) and nutrition, butenvironmental factors have a considerable role aswell. Besides harmful effects at work, urban envi-ronment and their mutual influence are significant.Mortality caused by environmental factors cannotbe easily determined; the estimated rate is about15–20%. The rate is different even within thecountry and the parameters show substantial dif-ferences. Analysis and assessment of the expo-sure-effectdiseaseprocess is complex. Lifestyle,smoking and nutrition have quite short-termimpacts, while impacts of environmental factorsmay appear as health damage only in the follow-ing generation. During the elaboration of theAction Programme the task is to discuss the prob-lems in details, set priorities, and evaluate possi-ble solutions. The following flowchart in chapter7 shows the steps of the process that are importantin assessing health consequences.

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16


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The process of the environmental health evalua-tion

In the frame of the Action Programme the follow-ing problems are to be discussed and reviewed:

analysis of the present situation of envi-ronmental health;critical review of the ongoing programmesin the field of; environmental health;schedule for solving the major environmen-tal health problems and their priorities;possible actions to be taken and the meansto solve the problems;financial considerations – the basis forcost-benefit analyses;the role of the main actors and participat-ing institutions.

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The Hungarian National Environmental HealthAction Programme should form the basis forachieving environmental protection with an envi-ronmental health perspective. Formulating thestrategic goals incorporates the main targets, themeans to achieve them, and the criteria for theirefficiency. The primary goal is to increase lifeexpectancy and the number of healthy life yearsby limiting the effects of harmful environmentalimpacts. One of the most important elements ofthe criteria is that the population should live alonger life in health and prosperity. The primaryrequisite for efficiency is an economic category.The category “efficiency” will determine alloptions for the highest benefit in a given econom-ic and financial circumstance. There are severaltechnical terms, which should be understood inorder to fully appreciate the whole context of pri-oritisation. To use costbenefit analysis is essentialto measure benefit. In some cases benefit appearsas reduced risk, and costbenefit analysis can becarried out with the unit of the reduced health risk.If benefit cannot be evaluated as reduced risk, orfinancial evaluation is not available, then the anal-ysis of costeffectiveness can be made.

It should also be pointed out that – concerningthe uncertainty of the present knowledge – sever-al principles should be fixed and applied, i.e:

environmental issues requiring immediateactions;issues requiring short-term action to preventor remedy environmental health problems orelaborating the mode for processing;medium-term issues in the study of factors,concerning the perception and recognitionof risk;long-term goals for securing sustainabledevelopment.

In the course of setting priorities, the goal is todecrease health risk coming from environmentalsources and jeopardising human health. In theseprocesses the following must be taken into consid-eration:

activities started earlier for improving envi-ronmental health targets;circumstances which may influence environ-mental health risks, such as the factors: mea-surability, data availability, their probabili-ties and uncertainties, etc.;

all resources (national, international andother data);options for achieving the targets, includingcost analysis.

1. Risk assessment

In order to be able to assess environmental healthrisk, a distinction must be made between the phas-es of risk estimation and risk management.

Risk assessment is a multistage process whichconsiders steps from hazard identification, throughrisk development, considering the scientificallysound evaluation of cause-effect relationships.

The essence of risk assessment is to collect andevaluate scientific knowledge and data on danger-ous processes and materials which in certain cir-cumstances are risk factors for human health andenvironment. Based on this, risk is quantifiable.

An indispensable part of the analysis is to des-cribe uncertainties.

Key elements of this process are:hazard identification, identification of thepollutant sources;prediction of environmental concentrationsin terms of processes (emission, deliberation,transmission, transformation);exposure assessment (monitoring the ambi-ent concentration, monitoring the exposurethrough biological monitoring);quantitative analysis of the effect as assessedon the basis of doseresponse;risk characterisation and perception.

2. Risk management

Risk management is an integrated part of the pro-cess, where risk assessment is considered as a gen-eral basis for action. Risk management is depen-dent on the political, social and economic contextof a given society, which means specific priorities,dependent on national, regional and local priori-ties. In the context of the HEHAP, attention will bepaid to justification of actions, for solving themost urgent environmental health problems.Problems as “hot spots” come up in the area of hu-man health (respiratory or cardiovascular diseases,cancer, toxicosis, etc.) or environmental damage

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Process of Prioritization in Environmental Health 7.

7. Process of Prioritization in Environmental Health

(air pollutants from point sources, toxic pollutants,indoor air pollutants, ozone depleting substances,noise as nuisance, etc.). Both approaches are ade-quate and necessary for preparing evaluation,although they lead to considerably different inter-ventions.

At local, regional and national levels, possibili-ties of risk management differ, so local conditionsshould be taken into consideration, setting up per-haps different priorities. The method also differsfrom the processes discussed above. In the differ-ent institutional frames, actions and measures areto be carried out with special antecedents, meth-ods and limited financial resources.

Risk assessment and costbenefit analysis can con-tribute to the objective evaluation of the tasks basedon the requirements of cost efficiency. Priority set-ting is a dynamic process with the condition of con-tinuous planning, evaluation and review.

The approach described above can promote theelaboration of concrete projects, demands for leg-islation, determination of new research fields, me-thodological development and areas of monitoringrequired.

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7. Process of Prioritization in Environmental Health

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Process of Prioritization in Environmental Health 7.

1. Situation analysis

About 13% of the Hungarian territory, where 49%of the population lives – is regarded as “polluted”.Emission sources are the following:

traffic;industry;municipal heating and other sources.

Air pollution is caused mainly by traffic. Theincreasing number of vehicles, their age and tech-nical state, use of leaded petrol and out-of-datetraffic routes in the towns contribute to the in-crease of air pollution. Industries, including powerstations, are also among major polluting sources.From energy production and fuel used for com-munal and district heating cause many problems,although the direct effects harmful to health aredifferent around the enterprises. In the small sett-lements, communal heating means temporary airpollution in the heating season. Evaluation basedon the average values of the results – measured inthe heating and nonheating seasons in 1994–1995in major inhabited settlements. The list of thehighly and moderately polluted settlements isshown in tables No 8. 1/1 and 8. 1/2.

Harmful effects of short term pollutions in highconcentration can be even more important. Thesecomponents can be measured only with realtime.

Table 8. 1/1

The levels of the socalled traditional ambient airpollutants (SO2, NO2, CO, settled dust and sus-pended particle concentrations) are relatively high(Fig. 8. 1/3, 8. 1/4, 8. 1/5, 8. 1/6). The trend of airquality is to be tracked by evaluating emissiondata with adequate frequency. Harmful air pollu-tants occurring in relatively low concentration areimportant from the aspect of human health. Toxicmetals (lead, cadmium, nickel, etc.), aromatichydrocarbons (benzene, toluene, xylene), imper-fect combustion products (polycyclic aromatichydrocarbons) and asbestos enter the environmentas a result of traffic and partly of industrial andcommunal heating and cause health damage.

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Air Quality 8. 1

8. Overview of the most important areas of environmental health

8. 1 Air Quality

Polluted settlements in Hungary

Settlements Characteristic pollutants

Budapest

NO2

Bács-Kiskun county

Kecskemét dustBaja NO2, dust

Békés county

Békéscsaba dustGyuladust

Csongrád county

Hódmezővásárhely NO2

Zala county

Zalaegerszeg NO2

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8. 1 Air Quality

Moderately polluted settlements


Baranya countyPécs SO2, NO2

Mohács NO2

Komló NO2

Siklós NO2

Sellye DUSTSzászvár SO2

Beremend NO2

Bács-Kiskun countyKiskőrös DUSTKiskunfélegyháza DUSTDunavecse DUSTKalocsa NO2, DUST

Borsod-Abaúj-Zemplén countyMiskolc SO2, NO2

Tiszaújváros SO2, NO2

Ózd SO2, NO2

Bükkszentkereszt SO2, NO2

Kazincbarcika SO2, NO2

Sajószentpéter SO2

Csongrád countySzeged NO2

Csongrád NO2

Makó NO2

Fejér countySzékesfehérvár NO2

Dunaújváros SO2, NO2, DUSTMór SO2, NO2, DUST

Győr-Moson-Sopron countyGyőr NO2

Sopron NO2

Hajdú-Bihar countyDebrecen SO2, NO2

Hajdúszoboszló SO2, NO2

Hajdúnánás NO2

Heves countyEger SO2, NO2

Gyöngyös NO2

Hatvan SO2, NO2

Moderately polluted settlements


Jász-Nagykun-Szolnok county

Szolnok SO2, NO2

Jászberény SO2

Karcag SO2, NO2

Kisujszállás SO2, NO2

Komárom-Esztergom county

Tatabánya SO2, NO2

Komárom DUSTEsztergom SO2, NO2

Oroszlány NO2, DUSTTata SO2, NO2

Dorog NO2, DUSTLábatlan NO2, DUSTAlmásfüzitő NO2, DUST

Nógrád county

Balassagyarmat DUST

Pest county

Vác NO2, DUSTBudaörs NO2

Cegléd NO2

Somogy county

Kaposvár NO2

Szabolcs-Szatmár-Bereg county

Nyíregyháza SO2, NO2

Rakamaz DUSTKisvárda DUST

Tolna county

Paks DUST

Vas county

Szombathely NO2

Veszprém county

Veszprém NO2, DUSTAjka SO2, NO2

Pápa NO2, DUSTVárpalota NO2

Zirc SO2

Zala county

Keszthely DUSTNagykanizsa NO2

Lenti NO2, DUST

Table 8. 1/2

2. Health effects

The bad health status of the population in Hungaryare – to a significant extent – related to the effectof air pollution.

2. 1 DiseasesPhysical, chemical and biological air pollutantsdamage almost the whole respiratory system anddecrease resistance against infections. They have arole in provoking and maintaining acute andchronic respiratory diseases. Acute respiratory dis-eases are the cause of 23–25% of all cases of sickleave. Connection between the prevalence of thedisease and the measured level of SO2 and sus-pended particles is justified by epidemiologicalstudies carried out among school children. Amongthe acute respiratory diseases, catarrh in the lowerrespiratory tract (e.g. bronchitis, pneumonia)should be given particular attention, because it candecisively influence the future health status.

The number of asthmatic cases is increasing allover world, first of all among children. (Fig. 8. 1/9)The causes are not very clear yet but environmen-tal factors have obviously quite an important role.To get to know the causes better, the prevalence ofthe diseases in Hungary should be better known.

A countrywide survey would be relevant besidesthe data from the pulmonology and allergologyoutpatient clinics.

The complexity of the problem can be seen inFig 8. 1/7, which shows the incidence of asthmaticpatients based on the turnover in hospitals. Severalair pollutants are recognised or suspected carcino-gens to human beings. In the occurrence of themore than eight thousand deaths from lung cancerper year – besides the obviously important smok-ing – certain polycyclic aromatic hydrocarbons andnitroso compounds, asbestos, and certain indoorpollutants (such as smoke, radon) play a major roleas well. The effects of short-term pollution in highconcentration are especially significant.

Among the health damaging factors carcinogensfrom traffic should be taken into account as well.The number of cancer cases is higher among urbandwellers.

Children are highly threatened by the lead con-tent of petrol. According to estimation based on astudy, the lead content of blood in 10% of childrenliving in towns is higher than the 10 mg/dl limitvalue, still not considered safe.

A very important element in prevention is to de-fine and track the indicators, accompanying harm-ful effects. Determination of pollutants or metabo-lites and biological materials (such as enzymes,pathological proteins) are important tools for pre-vention. Biological monitoring should be an out-standing activity in environmental health.

2. 2 MortalityMortality of patients with cardiac and vascular dis-eases rises suddenly in case of increased air pollu-tion (e.g. the smog in London), but the cause of thesocalled harvesting syndrome is not known yet. In1994 3.2% of the total mortality was traced back tochronic respiratory diseases. In recent years therewas no improvement. The rate is practically un-changed. The therapy and prognosis of the diseasesare quite good but the costs are high, which meansthat respiratory diseases have even a higher impor-tance from the economic point of view.

3. Goals to be achieved

Continuous evaluation of the impact of airquality on human health;Special attention to priority areas andprotection of human health by promotingpreventive measures;Prevention of aeroallergens and theirhealth impact;Improvement of indoor air quality;Preventive measures to limit trafficrelatedair pollution;Promotion of ongoing air quality prog-rammes;Increasing the efficiency of monitoring andof information dissemination.

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Air Quality 8. 1

4. Ongoing programmes

National Environmental Protection andNature Conservation Policy;Implementation Programme for Air QualityImprovement. This programme is of thehighest importance for preventing furtherdeterioration and ensuring improvements.The elements of the programme are listedamong this programme’s objectives;Implementation of International Agreements(emissions of SO2, NO2, ozone-depletingsubstances, etc.);Research areas: within the framework of aPHARE/CESAR project, the effect of SO2

and suspended particles of less than 10 µmdiameter on the respiratory function of chil-dren is being studied.

The most important problems and issues are listedin the following table according to types and lev-els of action:

26

8. 1 Air Quality

27

Air Quality 8. 1Ta

sks l

iste

d ac

cord

ing

to le

vels

of a

ctio

n

Subj

ect a

rea/

Lev

el

Am

bien

t air

Loc

al

Bef

ore

ente

ring

scho

ol sc

reen

ing

pro-

gram

s fo

r le

ad c

onte

nt o

f bl

ood

inca

se o

f chi

ldre

n liv

ing

in to

wns

; In

form

ing

the

publ

ic o

n in

door

cle

an-

ing

to d

ecre

ase

alle

rgen

exp

osur

e;

Act

ions

aga

inst

sm

okin

g;Ex

stirp

atio

n of

wee

ds;

Pollu

tion

cont

rol a

t pow

er p

lant

s;

Loca

l scr

eeni

ng p

rogr

amm

es a

nd e

pi-

dem

iolo

gica

l sur

veys

;Lo

okin

g fo

r m

arke

rs t

o de

term

ine

early

hea

lth e

ffect

s;C

ompa

rison

bet

wee

n m

orta

lity

data

and

ambi

ent

air

qual

ity f

or p

lann

ing

inte

rven

tion;

Dec

reas

ing

indo

or

pollu

tion

inho

mes

, qua

lific

atio

n fo

r m

achi

nery

inbu

ildin

gs;

Smog

ala

rm sy

stem

in to

wns

equ

ip-

ped

with

am

bien

t air

mon

itorin

g st

a-tio

ns.

Reg

iona

l

Prev

entin

g tra

ffic

rela

ted

pollu

tion

(des

ign

of h

uman

set

tlem

ents

, tra

f-fic

lim

itatio

ns);

Reg

ular

mon

itorin

g of

acu

te r

espi

-ra

tory

dis

ease

s, m

orbi

dity

, ev

alua

-tio

n of

dat

a w

ith p

aedi

atric

ians

;A

pplic

atio

n of

bio

logi

cal m

arke

rs in

surv

eys a

nd e

pide

mio

logi

cal s

tudi

es;

Indo

or a

ir qu

ality

con

trol a

t wor

k;C

omm

unic

atio

n ca

mpa

igns

to

pre-

vent

env

ironm

enta

l hea

lth p

robl

ems

resu

lting

from

traf

fic.

Nat

iona

l

Furth

er d

evel

opm

ent o

f inf

orm

atio

nne

twor

ks s

uch

as a

mbi

ent a

ir m

oni-

torin

g sy

stem

for m

easu

ring:

– so

lidpa

rticu

late

s sm

alle

r th

an 2

.5 µ

m; –

BTX

, PA

H,

met

als,

asbe

stos

. Sp

e-ci

al n

etw

ork

for m

easu

ring

aero

bio-

logi

cal

com

pone

nts:

– da

ta c

olle

c-tio

n an

d ev

alua

tion;

Det

erm

inat

ion

(the

miss

ion

and

im-

miss

ion

leve

ls o

f pe

rsis

tent

org

anic

com

poun

ds);

Setti

ng u

p in

door

air

qual

ity li

mits

;Li

mit

valu

es f

or s

olid

par

ticul

ates

smal

ler t

han

10 a

nd 2

.5 µ

m;

Publ

ishin

g da

ta o

n re

latio

nshi

p be

t-w

een

heal

th st

atus

and

air

qual

ity;

Reg

ular

revi

ew o

f am

bien

t air

limit

valu

es.

28

8. 1 Air Quality

Act

ions

to d

ecre

ase

emis

sion

Red

ucin

g em

issi

on fr

ompo

wer

sta

tions

;R

educ

ing

traffi

c-bo

rnem

issi

ons;

Red

ucin

g ae

ro-a

llerg

ens.

Info

rmat

ion,

dat

a co

llect

ion,

mon

itori

ng

Mon

itorin

g of

resp

ira-

tory

dis

ease

s an

d m

or-

talit

y;

Mon

itorin

g of

em

is-si

ons;

Impr

ovin

g am

bien

t ai

r-qua

lity

mon

itorin

gne

twor

k;C

ontro

l of a

mbi

ent a

irpo

lluta

nts;

Parti

cipa

tion

in in

ter-

natio

nal i

nfor

mat

ion

netw

orks

;In

form

atio

n sy

stem

tofo

llow

tran

sbou

ndar

ypo

llutio

n.

zRes

earc

h

Stud

y on

rela

tions

hip

betw

een

air p

ollu

tant

san

d re

spira

tory

dis

ease

sam

ong

child

ren;

Mea

sure

men

t and

stud

yon

the

effe

cts a

nd im

pact

of o

rgan

ic c

ompo

unds

(VO

C, P

AH

, etc

.);St

udy

on a

mbi

ent t

oxic

met

al p

ollu

tant

s;M

onito

ring

expo

sure

, re

sear

ch o

n ch

arac

teris

-tic

mar

kers

.

Adm

inist

rativ

e m

easu

res,

legi

slat

ive

tool

s

Com

plia

nce

with

em

is-

sion

lim

it va

lues

;R

evie

w o

f am

bien

t air

qual

ity li

mit

valu

es;

Con

trol o

f tra

ffic

with

to re

gard

air

pollu

tion;

Intro

duct

ion

of th

e le

-gi

slat

ive

tool

s of

the

EU/O

ECD

;El

abor

atio

n of

indo

orlim

it va

lues

;Es

tabl

ishi

ng c

ondi

tions

for s

mog

ala

rm

syst

ems.

Trai

ning

, edu

catio

n

Publ

ic in

form

atio

n;Pr

even

tion

of e

xpos

ure

to le

ad;

Traf

fic-b

orn

pollu

tion;

Impr

ovin

g aw

aren

ess

in th

e fie

ld o

f ind

oor

air q

ualit

y;In

form

atio

n on

the

dang

er o

f ae

ro-a

llerg

ens.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

29

Air Quality 8. 1

30

8. 1 Air Quality

31

Air Quality 8. 1

32

8. 1 Air Quality


Drinking waterNearly 97 percent of the population is suppliedwith piped drinking water including public outlets.The quality of the water supplied is excellent intwo thirds of the settlements and the majority ofcomplaints is not directly related to health effects(e.g. iron, manganese, lower than ideal hardness,elevated total bacterial counts). The quality ofdrinking water in the larger towns is generallygood, so that the majority of the population is sup-plied with acceptable drinking water. Incidents ofcontamination with possible health risks (e.g.nitrate, arsenic, fecal-indicator bacteria) affect 3–4percent of consumers. The microbiological con-tamination is only transient, as the risk is reducedby urgent measures. Development and harmoniza-tion of the monitoring and data collection systemsis very important (e.g. frequency and parametersof the measurements of drinking water) to indicateacute hazard and unfavourable trends. Micro-pollutants are to be monitored regularly in thefuture. Collection and evaluation of data from thewaterworks is important as well. Table 8. 2/1shows the data on measurements carried out by theNational Public Health Service in the counties andthe rate of unacceptable results.

The number of settlements with waterworks,where a particular parameter of contaminationdoes not regularly meet the limit value can be seenin Fig. 8. 2/2.

Known and partly solved problemsA longstanding drinking water quality problemaffecting population of larger size is the presenceof nitrate in ground waters and shallow subsurfacewaters. The distribution by county of nitrate con-centrations in the drinking water supplied is illus-trated in Fig. 8. 2/3.

Arsenic occurrence of natural origin in theground water of the southern Great Plain hasaffected a population of almost half a million(according to data gained in 1981–82). As a resultof consecutive government subsidised pro-grammes, the affected settlements have by nowbeen supplied with drinking water with an arseniccontent satisfying the present Hungarian limitvalue of 50 mg/l. The problem, however, still exists

in case of some smaller remote settlements andindustrial and agricultural water supply plants.

In some parts of the country, the high ammoni-um concentration of drinking water represents anenvironmental health hazard.

Some chlorination by-products that are presentin some treated waters of surface water origin andchlorinated wellwaters with high humic contentare mutagenic with suspicion of carcinogenity. Awidespread and easily perceived water qualityproblem is caused by a high iron content, some-times together with manganese. Many – mostlyadequate – iron removal units are in operation butquite often the removal efficiency, especially ofmanganese, is not satisfactory. The drinking waterof large parts of the Great Plain and many adjoin-ing regions contains too much sodium and too lit-tle calcium and magnesium. Distribution of calci-um and manganese concentrations can be seen inFig. 8. 2/4.

Known problems, not yet solvedA drinking water quality problem in considerableparts of the Great Plain is the bacterial aftergrowthin deep well waters which may lead to very highbacterial densities.

The concentration of fluoride in most drinkingwater supplies (approx. 98%) is much lower thanoptimal from a dental health point of view.However, approximately 1% of the population issupplied with concentrations above the limit valueLow iodine intake – characteristic for 80% of thesupplies – is related to a higher frequency ofgoitre. Higher concentrations of iodine causeorganoleptic complaints in the south eastern partof the country (Fig. 8. 2/5).

33

Water Quality 8. 2

8. 2 Water Quality

Lesser known problemsNo data are available on the boron content of con-sumed waters. A more stringent limit value thanthe present Hungarian one has been proposed bythe WHO. Since high boron contents may befound in deep thermal or mineral waters, a surveyseems to be needed very soon.

High lead content in drinking water represents ahealth risk. Lead pollution may come from differ-ent sources, such as new PVC pipes, plumbingmaterials and hot water storage tanks. The signifi-cance of these sources should be elucidated.

Few data are available on the occurrence of pesti-cides. Waters originating from vulnerable sources,including bank filtration, is at potential risk.Especially in agricultural areas however, the dan-ger is possibly not very high because of the de-creasing use of pesticides in recent areas.

Little is known about the water polluting effectof known and unknown waste dumping sites. Thepresence of dichloroethylene as a decompositionproduct of tri- or tetrachloroethylene in the waterof a municipal waterworks is a warning sign.

34

8. 2 Water Quality

1995 All rejected% Rejected because of Rejected because of

bacterial contamination chemical contamination

CountiesWater

Wells TotalWater

Wells TotalWater

Wells Totalworks works works

Baranya 25.4 53.7 27.8 12.6 46.3 13.1 18.9 37.9 21.0

Bács-Kiskun 55.5 70.6 59.5 12.1 19.3 13.0 39.0 74.8 57.9

Békés 56.1 98.0 59.9 24.6 84.0 25.6 34.6 23.0 34.0

Borsod 25.0 75.6 36.7 16.2 61.2 21.0 12.1 15.4 12.9

Csongrád 59.8 100.0 60.1 54.5 68.8 54.6 64.9 88.0 66.0

Fejér 45.5 62.1 50.4 20.7 52.6 25.1 33.7 36.7 34.6

Győr-Sopron 19.8 41.2 23.8 12.2 29.0 13.2 11.7 25.4 14.6

Hajdú-Bihar 67.7 72.6 68.3 18.3 26.0 18.5 48.6 30.7 42.4

Heves 50.0 51.2 52.3 27.3 42.2 28.1 44.2 32.5 41.9

Jász-Nagykun 59.3 65.8 61.0 15.9 25.9 18.4 52.4 55.8 53.2

Komárom 30.9 78.4 32.8 11.9 46.0 12.7 26.4 56.0 27.8

Nógrád 55.3 79.2 58.4 12.1 28.7 12.6 43.7 73.0 47.6

Pest 37.0 56.0 42.7 15.3 34.4 17.7 30.6 46.0 35.2

Somogy 65.1 85.3 68.1 19.8 54.7 21.0 56.0 53.3 55.3

Szabolcs 64.7 89.7 66.5 26.4 29.2 26.5 35.1 60.3 36.8

Tolna 51.1 59.0 51.3 23.9 30.0 24.0 52.3 50.0 52.2

Vas 16.3 27.6 18.1 11.7 30.4 13.3 12.0 20.5 13.4

Veszprém 30.3 57.4 34.4 18.8 47.6 21.3 17.7 37.9 21.0

Zala 22.6 44.8 23.2 14.1 43.9 14.8 11.0 13.8 11.1

County average 44.2 63.9 47.1 18.7 38.2 19.9 32.5 48.1 35.7

Budapest 11.2 11.6 10.1 11.7 2.0 2.2

National average 40.0 64.0 43.2 18.3 38.9 19.6 27.8 48.2 31.5

Table. 8. 2/1National situation of drinking water quality characterized

by the rejected samples rate (%)

2. Bathing water

BeachesBathing and swimming in our largest streams isnot recommended because of the microbiologicalcontamination, except the lower reach of theRáckeve branch of the River Danube. The riverTisza has only few bacteriologically clean beach-es at the uppermost reach between Kisköre andSzolnok but it also has heavily polluted stretchessuch as downstream Szolnok and at Szeged. Someimpounded sections of smaller streams or backwa-ters may be used for bathing. The bacteriologicalcontaminations are caused first of all by the lowlevel of sewage treatment. In such a respect hard-ly 20 percent of the sewage of Budapest is biolog-ically treated; that of, for example Szolnok, Sze-ged and Dunaujváros is untreated.

The water quality of the Lake Balaton is threat-ened by end-of-summer algal blooms as a conse-quence of eutrophication. The lake is bacteriolog-ically clean, as a whole but the water closest to theshore may become contaminated by the bathersthemselves.

Also, the protection of many small lakes, pondsand sandpit excavations has not yet been solved.However, the water users, in general, are the mostsignificant polluters.

Public bathsOnly one third of public pools is equipped withwater treatmentrecirculation devices. Some ofthem, mostly smaller swimming pools, are notoperated correctly, making the water in peak-usage periods of inadequate quality. (Table 8. 2/7)The water in untreated (fill and drain type) poolsis extremely contaminated in peak use periods,such as weekends.

Quality of water used for irrigationIrrigation by polluted surface water is an indirectdanger to human health e.g. in case of wateringvegetables consumed without cooking with con-taminated water.

35

Water Quality 8. 2

36

8. 2 Water Quality

3. Health effects

As a result of upgrading some waterworks, thepopulation at risk of high nitrate levels has signif-icantly decreased. The reported number of methe-moglobinaemia cases dropped in 18 years fromabout 300 to less than 20 per year. In 1990 nitratewas still a problem for 34, mainly small commu-nal waterworks, amounting to 1.4 percent of thetotal of about 2,400 settlements then supplied. Interms of water quantity it represents proportion-ately much less.

As a result of the decreasing fertilizer use, therisk has been reduced but not yet eliminated. Sig-nificant sources of risk are settlements withoutproper sewage treatment. All cases of methe-moglobinaemia have been caused by the con-sumption of water from private wells and not fromcommunal supply. Occasionally, such cases maybe caused by a high nitrate content in vegetables.(Table 8. 2/6)

Epidemiological studies have revealed a signifi-cantly higher proportion of stillbirths and sponta-neous abortions in the region affected by theoccurrence of arsenic, first of all in Békés county,than in other region supplied with arsenicfreewater. Also symptoms of mild arsenic toxicosis –hyperkeratosis and hyperpigmentation – werediagnosed in children, and an elevated frequencyof skin and bladder cancer has been recorded.Prevalence of goitre is high in settlements sup-plied with water with low content of iodine. (Fig.8. 2/5)

37

Water Quality 8. 2

Table 8. 2/6Reported morbidity data on methemog-lobinaemia in Hungary:

Some chlorination byproducts are mutagenic. Therisk may not be very high as the concentrationsfound have been low but this cannot yet be esti-mated with certainty.

The rather poor hygienic situation of the publicbaths without water treatment has been shown byrepeated outbreaks of intestinal infections. Thenumber of outbreaks and registered cases duringthe last two decades is shown in Table 8. 2/7.

Most of these outbreaks were due to Shigellainfection, and the majority of cases were in children.

Table 8. 2/7Outbreaks associated with water of heatedswimming pools in Hungary:

* Includes three suspected outbreaks


Overview of the possibility and probabilityof health consequences caused by drink-ing and bathing water pollution and inci-dental contamination;Evaluation of incidental contaminantsand their health effects;Setting priorities for interventions andrecommending measures to be taken;Proposals for the elaboration of projects.

5. Problems to be solved

As far as the arsenic content of drinking water isconcerned a revision is necessary as a conse-quence of the recent lowering of the WHO limitvalue to 10 µg/l. A part of the deep aquifers uti-lised by waterworks are suspected of having in-creasing arsenic concentrations over time. Nodata are available for half of the country as towhether arsenic concentrations exceed the newWHO limit value. The earlier survey was carriedout with a measurement method that is unable todetect concentrations in the range of the new limitvalue.

Passing the ownership of waterworks to mu-nicipalities has in many cases caused an increasedrisk (that is hard to estimate). This may be because– for economic reasons – they opt out of the regi-onal water supply system and start using the earli-er abandoned local water sources that were onlykept as reserves because of poor quality. The levelof operation has also in many cases decreased with

38

8. 2 Water Quality

Year Number Numberof cases of deaths

1976 207 41977 293 71978 239 31979 180 21980 172 31981 166 11982 91 11983 67 –1984 33 –1985 46 11986 41 –1987 30 –1988 31 21989 35 21990 22 –1991 19 21992 19 –1993 23 –1994 15 –1995 9 –Total: 1,738 2

Year Number Numberof outbreaks of cases

1975–1987 36 5,977*

1989 4 428*

1990 1 449+453*

1992 5 71*

1993 2 73*

Total: 48 7,451*

this change. This may have unpredictable conse-quences, including the risk of epidemics.

These may also be caused by the improper ter-mination of disinfection on the grounds of avoid-ing chlorination byproducts. The steep increase ofwaterrates is leading to the renewed use of privatewells that also adds to the risk of waterborn infec-tions.

Artificial waters supplied in containers and bot-tles are emerging on a commercial basis. They arehard to check and the effects of prolonged storage– most often in plastic containers – are not suffi-ciently known.

The above mentioned tasks are of nationwidenature.

Regional problems include the aftergrowth in thedistribution systems on the Great Plain and first ofall in the regions along the River Tisza, that areusing warmer wellwaters. Insufficient protectivezones lead to problems in regions supplied fromshallow aquifers such as bank filtration systems onthe upper reach of the Danube or in the capital andits surroundings, karstic zones in the Transdanu-bian and Northern mountain area (Eger, Miskolc)and in some local areas. The formation of chlorina-tion byproducts needs to be prevented, first of all inthe case of drinking water supplied from surfacewater resources, as in Szolnok and its surround-ings, the Balaton region, and in waterworks in theMátra mountains and north of Nógrád.

Regular control of quality in irrigation and ba-thing water is highly important especially in themain season and measures should be taken in caseof pollution above threshold limits.

Waste disposal sites and other sources of con-tamination occasionally endangering local sour-ces, will be mentioned in section 8. 4.

6. Earlier and recent water quality projects and related programmes

Only the most important projects of nationwidesignificance will be mentioned and summarized.

Drinking water quality upgrade project of theSouthern Great PlainThe project aiming at reduction of the arsenic con-tent of drinking water was initiated with govern-ment subsidy in 1983 and after gradually coveringwaterworks of 80 settlements was finally conclud-ed in 1995. The project brought about significant

improvements not only in the arsenic content butalso in other water quality related parameters,such as ammonium, iron and manganese. Sincethe project did not cover other than municipalwaterworks, the problem is still unsolved in indi-vidual water supply systems and systems operatedby industrial and agricultural plants, and institu-tions.

Protection of aquifersAn executive decree has been elaborated for theprotection of aquifers. This may significantly im-prove the situation if finally passed and implemen-ted. Another tool is the preferential subsidy systemfor sewage treatment projects of municipalities sit-uated upon a vulnerable aquifer. For water qualityprotection purposes the resources of the CentralEnvironmental Protection Fund (CEPF) are avail-able only for these local areas.

Improvement of drinking water supply in villagesThe “target support system” launched in 1991 forthe supply of villages with healthy drinking waterstipulates a 90 percent economic support to theimplementation of supplies with public outlets.The water supply of 247 settlements was ensuredin this way in 1990–92, lowering the number ofsettlements not yet supplied to 352. By the end of1995 only 14 settlements are left without even thisform of drinking water supply. However, about150,000–200,000 persons are living in the outskirtsof towns and villages or in the countryside where itis impossible to provide piped drinking water.

Protection of surface water used for recreationThe recreational district of utmost national impor-tance is the surroundings of Lake Balaton. Exten-sive protective measures with government supporthave been taken since 1983, first of all to halt theeutrophication of the lake. The governmental pro-gramme for Lake Balaton is being extended. Pre-parations are under way to launch a programmewith EU–PHARE support for the examination ofmicrobiological contamination of other surfaceand subsurface waters.

39

Water Quality 8. 2

7. Human health priority of factors impairing thequality of drinking water

In the following, the most significant factors thatimpair the quality of drinking water are listed inorder of priority.

ArsenicArsenic is the most dangerous factor, from ahealth perspective, having chronic effects at evenlow doses. This substance occurs in large areas ofthe country. Although a major part of the problemwas successfully solved (but at very high cost) itsoccurrence in significant concentrations is not rarein individual water supply systems.

Bacterial contaminationIn the districts of the Great Plain with a uniquewater quality, a significant proportion of drinkingwater samples are not yet acceptable because ofbacterial aftergrowth. The solution is not solely ofa financial nature, since no generally applicabletechnology is available. The reorganization of wa-terworks that is taking place may aggravate theproblem. The bacterial contamination may evenlead to disease outbreaks. To prevent this, protec-tion zones must be established to avoid waste wa-ter contamination.

NitrateThe situation is expected to deteriorate in somewater sources on vulnerable aquifers. The problemhas not been solved in some, mostly peripheric set-tlements that are not yet supplied from waterworks.The prevention applied earlier to protect the healthof babies, e.g. education and bottled water supply,is less organised in these areas. Another source ofrisk stems from the consumption of private wellwater that is being used increasingly as a conse-quence of the high waterrate.

Sodium (lack of calcium and magnesium)The problem exists in major parts of the GreatPlain. The excess of sodium may especially affectthe health of patients who are dependent on a lowsalt diet due to cardiovascular disease or renal fail-ure. An inadequate intake of calcium is a problemfor pregnant and elderly women. Also, the lack ofmagnesium may be of health importance.

NitriteAs a result of secondary pollution in the distribu-tion systems, nitrite occurs in bacteriologicallycontaminated pipelines. Nitrite is 10–15 timesmore toxic than nitrate. First of all babies are atrisk, but high concentrations are also of impor-tance to the health of adults.

Chlorination byproductsAs a result of earlier measures, chlorination by-products are not generally present in high concen-trations. Potential risk is related to the presence ofunknown, less volatile (and not yet measured) mu-tagenic compounds. Sometimes it is indispensableto chlorinate water with a high humic content whichmay also produce unknown substances.

Other micropollutantsAmong microcontaminants, boron, lead and pesti-cides may be mentioned, but no general knowl-edge is available about their occurrence, so thatthe possible risk cannot be estimated. Accordingto unrepresentative exploratory surveys, pesticidecontamination of drinking water does not at pre-sent seem to be a problem. The occurrence ofboron and lead is still to be estimated but the prob-ability is low that lead should be of concern.Barium may occur in mineral water, bottled forsale, where the concentration exceeds the limitvalue by one order of magnitude. No data areavailable for piped drinking water.

Geographical differencesThis priority list is not equally valid for all Hun-garian regions. Some differences exist as someconstituents represent a health risk in only someparts of the country.

According to existing knowledge, arsenic occur-rences are confined to the region beyond the riverTisza (with the exception of the northern andsouthernmost part), and to that between the Tiszaand the Danube. Bacterial aftergrowth is charac-teristic of the major part of the region beyond theTisza river, and the flat regions laying on the rightbank of the Tisza, but it also occurs in otherplaces. Nitrate is found in drinking water in dis-tricts that use groundwater, first of all in Borsod,Veszprém, and Pest counties, but it may be foundalmost everywhere, except in the region beyondthe Tisza. Sodium, i.e. soft water, is characteristicon the Great Plain.

40

8. 2 Water Quality

Nitrite is the result of aftergrowth in warmer wa-ters. Chlorination byproducts may occur in regionssupplied by surface water, such as Szolnok and itssurroundings, the regional distribution system ofthe Mátra mountains, around Lake Balaton, andoccasionally in Salgótarján and its surroundings.

8. Future tasks

The prevention of primary pollution, that is, pro-tection of the water sources, is the task of the envi-ronmental protection and water authorities. Themost important actions of human health impor-tance are summarized in the following two tables.

41

Water Quality 8. 2

42

8. 2 Water Quality

Drin

king

wat

er

Loc

al

Prev

entio

n of

har

mfu

l he

alth

effe

cts

of a

rsen

ic i

n re

gion

s w

ithou

t ce

ntra

lw

ater

sup

ply

(loca

l w

ater

tre

atm

ent,

bottl

ed w

ater

sup

ply,

joi

ning

wat

ersu

pply

net

wor

ks);

Prot

ectin

g in

fant

s ag

ains

t nitr

ate;

App

lyin

g ne

w

tech

nolo

gies

an

dm

etho

ds i

n ca

se o

f so

ft w

ater

with

high

sod

ium

con

tent

; di

sinf

ectio

n,ag

ains

t ni

trite

pro

duct

ion;

sec

onda

rypo

llutio

n. D

evel

opin

g ne

w w

ater

sup-

ply

netw

orks

.

Reg

iona

l

Mea

sure

s ta

ken

agai

nst

seco

ndar

ypo

llutio

n;

Mea

sure

s ta

ken

agai

nst e

utro

phic

a-tio

n at

wat

erw

orks

: act

ivat

ed c

arbo

nfil

ters

etc

; Tr

eatm

ent

met

hods

for

sof

t w

ater

with

hig

h so

dium

con

tent

: tre

atm

ent

to in

crea

se h

ardn

ess

in c

ase

of s

pe-

cial

wat

er q

ualit

y;

Prev

entio

n of

alg

atox

ins

ente

ring

drin

king

wat

er,

met

hods

for

det

er-

min

atio

n (H

PLC

). In

vest

igat

ing

pos-

sibi

litie

s fo

r re

mov

al o

f to

xins

and

deve

lopi

ng te

chno

logi

es;

Dat

a co

llect

ion

and

eval

uatio

n on

nitri

te c

onte

nt in

wat

er s

uppl

y ne

t-w

orks

; Su

rvey

on

boric

aci

d co

nten

t in

drin

king

wat

er a

nd ta

king

nec

essa

rym

easu

res.

Nat

iona

l

Proh

ibiti

ng

prod

uctio

n of

PV

Cpi

pes w

ith le

ad c

onte

nt o

r mod

ifica

-tio

n in

tech

nolo

gy;

Lead

as

seco

ndar

y po

lluta

nt: i

nfor

-m

atio

n ca

mpa

igns

to li

mit

cons

um-

ptio

n (te

a m

akin

g)

from

he

ater

tank

s;

Surv

ey o

n le

ad c

onte

nt i

n w

ater

from

PV

C p

ipes

and

hea

ter t

anks

;Li

miti

ng u

se o

f pes

ticid

es in

pro

tec-

tion

zone

s an

d vu

lner

able

cat

ch-

men

t ar

eas.

Suita

ble

met

hods

for

mea

surin

g us

e of

pe

stic

ides

at

hydr

ogeo

logi

cal p

rote

ctio

n zo

nes;

Su

rvey

on

harm

ful h

ealth

effe

cts

ofar

seni

c in

im

porta

nt w

ater

sup

ply

syst

ems.

Task

s lis

ted

acco

rdin

g to

leve

l of a

ctio

n

43

Water Quality 8. 2

Bot

tled

and

recr

eatio

nal w

ater

Loc

al

Dev

elop

ing

prot

ectio

n of

su

rfac

ew

ater

use

d fo

r rec

reat

ion:

dat

a co

llec-

tion

on w

ater

qua

lity

and

equi

pmen

tof

free

bea

ches

;Im

prov

ing

hygi

enic

qua

lity

of b

each

-es

: eq

uipm

ent

(num

ber

of s

how

ers,

toile

ts, p

otab

le w

ater

, gar

bage

col

lec-

tion,

etc

.); fi

nanc

ial a

nd le

gal s

uppo

rt.

Reg

iona

l

Prot

ectio

n of

sur

face

wat

er q

ualit

y:ne

w ru

les f

or se

wag

e di

sinf

ectio

n at

catc

hmen

t are

as;

Effe

ct o

f ha

rmfu

l to

xic

alga

e on

swim

mer

s: d

evel

opin

g fo

reca

stin

gm

etho

ds;

Mea

sure

s ta

ken

agai

nst e

utro

phic

a-tio

n an

d di

min

ishi

ng t

he h

arm

ful

effe

cts

on b

each

es (

show

ers,

med

i-ca

l ser

vice

etc

.).

Nat

iona

l

Info

rmat

ion

syst

em a

nd le

gal b

ack-

grou

nd f

or c

onsu

min

g bo

ttled

wa-

ter:

labe

ling

educ

atio

n an

d ad

vice

toco

nsum

ers

(adv

anta

ges

and

disa

d-va

ntag

es)

in c

ase

of m

iner

al w

ater

with

spe

cial

con

tent

;Su

rvey

on

bottl

ed p

otab

le a

nd m

in-

eral

wat

er o

n th

e m

arke

t;Pr

omot

ing

use

of re

cycl

ing

syst

ems

in s

wim

min

g po

ols;

Dev

elop

ing

met

hods

for

han

dlin

gan

d di

sinf

ectio

n of

bat

hing

wat

er in

case

of t

herm

al w

ater

(tria

l of c

hlo-

rine

diox

ide

or q

uate

rnar

y am

mon

i-um

or

ozon

e; f

iltra

tion

thro

ugh

diat

oma

earth

); po

ssib

ilitie

s an

dlim

its o

f use

.

Task

s lis

ted

acco

rdin

g to

leve

l of a

ctio

n


Traffic and industrial activity are considered to bethe most significant noise sources, but many ofamusement places, building machinery, as well asmachines and devices used in the households andother – justified or unjustified – human activitiesare also important. The last three groups ofsources cause noise first of all in buildings and theliving environment.

Noise from road trafficToday about 50% of the population are disturbedby noise from road traffic. Especially along mainroads in the cities a significant number of inhabi-tants are exposed to noise exceeding limit values,thus being harmful to health. Few measurements,performed in a uniform way, are available on thenoise load from road traffic. However, the fewexisting data indicate an unfavourable situation allover the country. (Fig. 8. 3/1) The noise load onfacades of buildings along main public roads is70–83 dBA in daytime and 60–75 dBA at night,compared to the limit values of 65 dBA and 55 dBArespectively. When windows are kept shut thenoise is reduced by 20–25 dBA on the average.

Noise from railwaysNoise from railways has an impact on much small-er population groups but the character of the noisemay be more disturbing. There are no available

statistics on the extent of this noise problem. Thenoise level outside buildings – being 50 m away inthe protection zone – may be 70–85 dBA when atrain is passing. Sound signals from trains aremuch louder and give rise to complaints, first ofall at night.

Noise from air trafficNoise from air traffic has generally been limited tothe surroundings of the Budapest-Ferihegy inter-national civil airport. For decades this has been adominant problem around the airport. In the “innerzone” the noise load exceeds 75 dBA, in the mid-dle zone it is 70–75 dBA and in the outer zone thedaytime noise load is 65–70 dBA. The noise frommilitary air traffic is difficult to measure and sonicbooms frequently add to the noise nuisance.

Business activity with small aircraft has beenincreasing in parallel with the economic changes.This activity is taking place in the low airspaceclose to human settlements and resort areas.Hardly any measurements of the effect of thisactivity exist but it results in many complaints.The resumed use of the former Soviet military air-ports has also given rise to complaints.

Noise from industrial and service facilitiesIn Hungary the noise from industrial and serviceactivities disturbs about 5% of the inhabitants.According to present regulations only noise fromindustrial sources can be controlled. As a result of

44

Noise 8. 3

8. 3 Noise

the penalty system and the systematic inspectionscarried out by the authorities, the noise emissiondecreased to below limit values by 1991 in about40% of the industrial and service facilities in ques-tion. In recent years – due to the declining pro-

duction of large plants, the privatisation process,the growing number of small enterprises and thedelegation of power to local authorities – the situ-ation has been unclear. More and more smallenterprises are operating in buildings situated inhousing areas, where they cause noise problems.

Public complaints of the disturbing noise com-ing from cultural, sports and entertainment activi-ties are also increasing. These activities are typi-cally of a local character and their control is underthe jurisdiction of local authorities.

Noise from housing machinery and household equipmentAn increasing number of machines and equipmentare being used in housing estates and other pro-tected establishments.

There are no sufficient data available for theevaluation of the resulting noise problem.

Noise from in house human activitiesInsulation is an appropriate method for preventingnoise caused by common human activities insidebuildings. (Fig. 8. 3/2) Antisocial behaviour, wherethe person making noise does not take written and

unwritten rules into consideration, is a nuisancefor neighbours and gives rise to complaints. It isthe difficult task of the local authorities to try tosolve such problems.

2. Health effects

The effects of noise on human beings may be clas-sified as follows:

disturbance of sleep from around 20–30 dBA;psychological disturb and stress from around 25–40 dBA;disturbance of speech from around 40–50 dBA;impairment of hearing from around 85 dBA(long time exposure) and 120–130 dBA (sin-gle impulses);physiological effects.

In the case of environmental noise, the effects of thefirst three groups are relevant. Regular exposure tosuch noise levels may lead to neurological, circula-tory and digestive disorders, but the causal relation-ship cannot easily be recognised due to the effect ofmany other factors. Previously, hearing impairmentwas an occupational health problem. Nowadays itmay be caused by environmental noise as well, thatis, when young people regularly and for long peri-ods listen to loud music exceeding 85 dBA. Thismay affect 20–30% of young persons.

45

8. 3 Noise

3. Targets

As to noise load, the goal is to prevent further de-terioration, change the worsening trend and im-prove the situation.

These goals are listed below in detail:

Traffic born noise:Stop the continuous increase of excessivenoise and its spreading to protected zones;Start to decrease noise exposure in over-burdened places.

Noise from industrial and service facilities:Limit noise from new operations and stopnoise in protected areas; Start to decrease noise emissions from theexisting industrial sources.

Noise coming from sources within buildings:Establish general limits for emissionsfrom machinery;Begin sanctions against activities exceed-ing limit values.

Noise protection of buildings:Comply with requirements on insulationagainst noise in new buildings.

Noise coming from human behaviourEstablishing legislation and good practiceto reduce the problem;Process for immediate measures to betaken in case of disturbance.


National levelImprovement of economic, technical and legalregulations covering all fields of noise control inaccordance with regulations existing in theEuropean Union should be achieved. At the sametime, professional institutions and responsibleadministrative bodies must be strengthened so thatthe regulations can be enforced.

Regional levelNoise control along main traffic routes and rail-ways, and around airports close to human settle-ments should be organised. Sufficient expertise ofpublic health and environmental protectionauthorities should also be available to measure andevaluate noise related complaints.

Local levelThe control of small local point sources and theexpertise of local authorities should be improved.

5. Programmes in progress

Programmes directed at decreasing noise emissionCertain industrial products, according to specificregulations, should be tested for noise emission.However, such products are frequently sold with-out any prior testing. Limits exist on noise emis-sion from motor vehicles but compliance with reg-ulations is not checked.

Surveys and research on effectsSuch activities are, in principle, carried out by dif-ferent institutions. However, due to limited fundsduring the 1980s only “hot spot” problems have sofar been studied. Data are not being systematical-ly gathered and evaluated.

Programmes at international levelThere is a national obligation to harmonise theHungarian legal system with the EU regulations.Most directives fall under the jurisdiction of theMinistry for Industry, Trade and Tourism. Harmo-nisation of the relevant standards has recentlybeen slowed down because of the reorganisationof the National Office responsible for standardisa-tion and quality assurance.

6. Tasks to be performed

Practical operations, education, information, datacollection, necessary surveys and research, techni-cal and other types of regulation, are summarizedin the table below.

46

Noise 8. 3

47

8. 3 Noise

Red

ucin

g no

ise

load

Effe

ctiv

e sa

fety

zon

esw

ith e

leva

ted

grou

nd

leve

l and

veg

etat

ion

insu

latin

g dw

ellin

gsfro

m in

dustr

y an

d tra

ffic;

Im

prov

ing

nois

e ab

atem

ent a

t exi

stin

g es

tabl

ishm

ents

; Sp

eedi

ng u

p in

dust

rial

back

grou

nd fo

r noi

seab

atem

ent;

Spec

ial p

rogr

amm

e fo

r red

ucin

g no

ise lo

adar

ound

Fer

iheg

y ai

rpor

t; N

oise

abati

ng tr

affic

stru

c-tu

re in

pub

lic tr

ansp

ort;

Impr

ovin

g ro

ad n

etw

ork

and

traffi

c str

uctu

re;

Dev

elop

men

t of r

ailw

aytra

cks

and

elec

tric

trac-

tion.

Info

rmat

ion,

dat

aco

llect

ion,

mon

itori

ng

Loca

l aut

horit

ies s

houl

dde

term

ine

oper

atin

g re

quire

men

ts fo

r lei

sure

esta

blis

hmen

ts;

Reg

iste

r of b

uild

ing

mac

hine

ry b

y th

e au

thor

ities

resp

onsi

ble

for c

onst

ruct

ion

toge

ther

with

dat

abas

efo

r ins

ulat

ion

prac

tices

.

Res

earc

h

Prom

ote

R+D

pro

ject

sai

min

g at

noi

se a

bate

men

tin

the

fram

e of

envi

ronm

enta

lpr

ogra

mm

es;

Setti

ng u

p sit

ing

crite

ria

to sh

orten

tran

spor

t rou

tes;

Map

on

publ

ic tr

ansp

ort

to d

eter

min

e th

e ov

erbu

rden

ed a

reas

.

Leg

isla

tion,

adm

inis

trat

ive

mea

sure

s

Rev

iew,

cor

rect

ion

and

regu

lar u

pdat

ing

of th

e re

late

d le

gisl

a-tiv

e to

ols;

El

abor

atin

g a

nd in

tro-

duci

ng c

lass

ifica

tion

of p

rodu

cts a

ccor

ding

tono

ise re

duci

ng c

hara

cter

; Es

tabl

ishi

ng

a su

ppor

ting

syst

emus

ing

econ

omic

inst

rum

ents

for

inve

stm

ents

aim

ed a

tno

ise

redu

ctio

n;St

rict r

equi

rem

ents

for

vehi

cles

; B

an o

n lo

catio

n of

esta

blis

hmen

ts in

plac

es o

verb

urde

ned

by tr

affic

and

ser

vice

infr

astru

ctur

e;N

oise

aba

ting

requ

ire-

men

ts at

the

new

civ

ilai

rpor

ts;

Goo

d pr

actic

e in

sp

atia

l pla

nnin

g an

dur

ban

deve

lopm

ent;

New

faci

litie

s sho

uld

com

ply

with

the

limit

valu

es

for n

oise

em

issio

n.

Edu

catio

n, p

ublic

awar

enes

s

Intro

duct

ion

of te

ach-

ing

the

basi

c el

emen

tsof

noi

se a

bate

men

t m

etho

ds a

nd p

rope

rbe

havi

our.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n


Hungary’s territory is 93,030 sq km, 85.6% ofwhich is used for agriculture and the rest is occu-pied by settlements, industrial units, etc. It is ofutmost importance that the fertile soil be protectedfrom contamination.

Agricultural landsUntil 1988 fertility of soil and nutritive supplywere analyzed every third year by a unified labo-ratory network working under the direction of theMinistry of Agriculture. Metals were determinedonly as nutritive or essential microelements. Theresults cannot be compared to the limit values ontoxic metals used in other countries.

A monitoring system (Monitoring System of SoilProtection) was introduced in 1991 for regular assayof the most important toxicants at 1,236 locations.Toxic elements have been assayed and a completeinventory is being prepared. A similar activity is goingon for measurements of pesticide contamination on101 locations and the results will be available shortly.

Generally, the quality of soil is good and the pes-ticide content – due to decreasing use – can beconsidered low.

Point sources of contamination, such as pesti-cide depots and industrial pollution, should beassessed and evaluated. Toxic heavy metal con-centrations in soil are quite low as well.

Nonagricultural areasThese areas include industrial places, settlements,and road traffic surroundings.

Considerable contamination resulted from someprevious malpractice of waste disposal and theassessment of these areas is under way. The mostimportant contamination includes toxic metals(e.g. lead and cadmium), hydrocarbons (oil, tar,etc.) especially in military camps.

Abandoned industrial sites, inadequate wastedisposal, waste water treatment and storage of rawmaterials have caused soil contamination. Pollutedareas can be found inside and outside the settle-ments, where toxic metals and different organiccompounds – resulting from special technologies– constitute the highest danger.

Traffic is considered to be a significant source ofsoil pollution, mainly along the public roads and

the streets inside settlements. Lead and polycyclicaromatic hydrocarbons are the most importantpollutants. The disposal of solid and liquid house-hold wastes is not solved properly in many areas.

Overall assessment of contaminated areasA nationwide qualitative and quantitative surveyhas recently been launched by the Ministry for En-vironment and Regional Policy to assess the con-taminated areas; first of all the heavy metal contentof the soil is to be analyzed. A survey on the aban-doned military sites has been carried out and reme-diation plans elaborated. Based on the data of theNational Public Health Service and the Environ-mental Inspectorates, a joint database is to be set up.

2. Health effects

It is generally recognized that health effects of soilcontamination are very difficult to establish andascertain. So far, there is no indication that large-scale deleterious health effects have occurred inHungary due to soil contamination.

There are hardly any data on health damagecaused by point-, line- or patch-like soil pollutionsources. No quantitative analysis can be carriedout using the results of the available environmen-tal epidemiological studies. The available studieson soil pollution do not deal with the health statusof the population living in the area affected.


Continuation of the assessment of pollutedareas and setting up a joint database;Identification of the endangered popula-tionin selected pilot areas by environmen-tal epidemiological methods;Further assessment of the already existingpriority areas;Proposal for actions to remedy areas withspecial health effects;Increase public awareness and encouragepublic participation in management of soilquality;Utilization of the experience gained at pilotsites for evaluating results in Hungary andother countries taking part in the WHOprogramme.

48

Soil Quality and Wastes 8. 4

8. 4 Soil Quality and Wastes


Comprehensive legislation relating to soil asan element of the environment and its pollu-tion;Establishment of a harmonized data base forassessing all contaminated areas, utilizationof advanced technology of the GeographicInformation System (GIS) for assessingcomplex health effects;Assessment of contamination in relation towater basins and raw water reservoirs;Extension of the existing studies on uptakeof toxic contaminants by edible plants andassessing their effects;Requirements for licensing and using chem-icals in agriculture are to be reviewed due tothe changes in ownership and the increasedknowledge in this field;Introduction of limitations on land use ofarable lands together with the compensationpaid to the owners.

5. Existing programmes

The Ministry for Environment and Regional Policystarted a long-term programme to study the aban-doned contaminated areas. In the frame of this pro-gramme a medium-term proposal for remediationof contaminated areas, determination of limit val-ues and legislation is to be elaborated. Limit valuesfor soil pollutants refer to ground water pollutionlevels until the special act on soil protection comesinto force. (Protection of arable land is providedfor by Act LV of 1994, and the limit values for uti-lization of waste water and sewage sludge are offi-cially used for soil pollution).

6. Further objectives and conditions for development

Based on a unified data base the particularlycontaminated areas should be determinedand the size of the affected population ana-lysed;Ensuring availability of data and sharing theinformation among relevant parties;Further development of human exposureassessment models, risk assessment andmanagement techniques;Ensuring active participation of health andenvironment authorities in assessing andsolving the problems;Cooperation among the competent authori-ties and institutions in the field of environ-mental monitoring, data collection and pro-cessing;Ensuring the financial background for thepoints mentioned above.

49



Management of the increasing amount of waste isa problem in Hungary, as in other countries. Thequantity of waste generated in Hungary amountedto 123 million tons in 1995. The amount of com-munal waste, hazardous waste and industrialwaste was 27.1, 4.9 and 91 million tons, respec-tively.

Government Decree No. 102 of 12.07.1995 ondisposal and utilization of hazardous waste regu-lates the transport, import and export of hazardouswastes. Measures to be taken to prevent environ-mental pollution and classification system are alsoincluded in the Decree.

Communal wasteRegular collection and disposal of municipal wasteis provided for about 75% of Hungarian house-holds. In towns this proportion exceeds 90%.However, less than 50% of the liquid waste is col-lected. More than 2,700 disposal sites are known.70% of these are not suitable, while only 10% canbe regarded as safe. Another serious problem is thenature of the disposed waste – some sites still con-tain previously deposited toxic materials.

The recultivation of the abandoned waste de-posits is not solved. There is only a single incinera-tor in the country for communal waste namely inBudapest, the capacity being 310,000 t/year, half ofthe total amount of the wastes from the capital city.

A major problem is the lack of treatment capac-ity for transported sewage water. Only 10% ofsewage is being treated, 20% is directed to com-munal drainage systems. The major part of thewaste water is drained directly into the soil with-out any treatment, causing serious contaminationto the soil and ground water.

Industrial wasteIndustrial processes generate large amounts ofwaste of potential environmental health concern.So far, about 50% has been recycled. The rest isstored in special depots.

Hazardous wasteThe quantity of hazardous waste was about 5 mil-lion tons in 1995, of which “red sludge” represents64%. Compared with other countries the amount

of hazardous waste is relatively high. There areregulations on the classification and characteriza-tion, further transport, disposal, etc. of hazardouswaste. Hungary has a low capacity for incinerationor other forms of disposal.

A special problem is the management of hospi-tal waste. The result of efforts to quantify andcharacterise the amount of waste generated in thehealth sector is shown in Fig. 8. 4/1.

For disposal of hazardous waste only one state-of-the-art incinerator in the town Dorog and oneadequate final storage facility in Aszód aera areavailable. At present six interim storage sites arebeing operated.

DatabasesIn order to deal with the mounting problems ofwaste management, it has to be ensured that all rel-evant information is available for the respective par-ties. This involves: inventory of communal wastedeposit sites, existing and old ones; the inventory ofhazardous wastes should be updated; hospital wastemanagement has recently been reviewed and will becorrected; questionnaires on industrial waste havebeen sent to more than 7,000 firms but the evalua-tion is still under way.

At the National Public Health Service the com-munal waste and waste water deposits, incinera-tors, storage sites for hazardous wastes and animalcarcasses, and other source of pollution are regis-tered.

Abandoned and operating waste landfills havebeen surveyed all over the country by the Hunga-rian Geological Service. Data on hazardous wastesare collected by the Ministry for Environment andRegional Policy.

Hospital wastes were surveyed twice but thedata are not suitable for evaluation and planning.Various ministries continue to collect data for spe-cial purposes according to different criteria.Therefore it is essential that a joint and unifieddatabase be established as soon as possible.

2. Health effects

The assessment of the immediate health conse-quences of the exposure to waste is as difficult asin the case of soil contamination. Long-term pros-pective and retrospective studies are needed to

50


Wastes

substantiate any health effects. National and inter-national data suggest that an increased incidenceof allergic diseases, increased cancer mortalityand decreased birth weight may be found in settle-ments in the vicinity of waste dumping sites. InHungary no epidemiological survey on the impactof waste deposits has been carried out yet.


Systematic analysis of health effectsaround waste dumping sites, establishmentof cause – effect relationships;Establishment of comprehensive databas-es and creation of a complete inventory;Promote environmental health policy withregard to decreasing the amount of waste;Better management of hospital wastes, i.e.selective collection, characterization, anddisposal;Elaboration of programmes to reduce soiland water contamination coming from un-controlled deposits.


A unified database should be set up. Theexisting data on waste disposal and landfills,taking into account the sites abandoned be-

fore 1982 as well, are to be processed, revie-wed and corrected. Waste load is to be identi-fied in the counties and regions;A classification system should also be estab-lished for correct prioritization, consideringthe affected populations, the endangered rawwaters and reservoirs;Proper risk assessment procedures should beimplemented for managing the potentialhealth effects and for remediation activities;Concerning the institutional background, therole of public health services and the envi-ronment protection inspectorates should bestrengthened in monitoring, regulating anddecisionmaking processes;As a specific problem, an effective hospitalwaste management system should be imple-mented, which would incorporate the selec-tive collection, storage and disposal of haz-ardous wastes from health institutions;Work environment conditions in relation tohandling waste should be studied and regu-lated;

The complex system of reducing the amountof waste, selective collection, storage, treat-ment and disposal of all wastes should beincorporated into national programmes;

51


The industrial, institutional and financialbackground must be developed for wastecollection, disposal and utilization;Deposits of untreated waste water are to beliquidated and provision should be made forproper municipal waste water treatment.


New legislation on hazardous wastes cameinto force and a new decree is being elabo-rated for the export and import of industrialwastes;An overall regulation on municipal solidwastes (under the PHARE programme) isbeing formulated;The Ministry of Industry, Trade and Tourismis carrying out a survey on utilization ofwastes;The regulation on environmental productcharges is to be continued, setting up a finan-cial fund for supporting waste disposal andutilization; Elaboration of a concept for treating hospitalwastes is under way in Budapest; Action programmes have been organised inseveral settlements for selective collection ofmunicipal waste.

Duties of the public health institutionsThe unified database is to be corrected;Identification of the potentially exposed pop-ulation in geographic and regional terms;Risk assessment using quantitative modelswith special consideration to the priority list;Model regions are to be selected for epide-miological studies;Close cooperation between the institutions ofthe National Public Health Service and theEnvironmental Inspectorates;Regular health control and exposure mea-surements have to be carried out amongworkers occupied in waste management.

The most important actions are listed in the fol-lowing tables.

52


53


Goa

ls

Was

te re

duct

ion;

M

oder

niza

tion

of w

aste

disp

osal

;R

emed

iatio

n of

co

ntam

inat

edar

eas;

Mod

erni

zatio

n of

leg

isla

tion

onpe

stic

ides

and

ferti

lizer

s;

Surv

ey o

n im

pact

s of

pol

lute

dso

il on

the

food

cha

in a

nd a

qui-

fers

;Sa

fety

mea

sure

s fo

r en

terp

rises

in t

he f

ield

of

was

te m

anag

e-m

ent;

Tech

nolo

gica

l an

d te

chni

cal

tool

s an

d de

vice

s fo

r re

duci

ngco

ntam

inat

ion

at d

ispo

sal s

ites;

Trea

tmen

t of

sec

onda

ry w

aste

sfr

om in

cine

rato

rs;

Prio

rity

list f

or so

il re

stor

atio

n at

natio

nal l

evel

;M

odel

regi

on fo

r rem

edia

tion

ofso

il an

d st

artin

g ep

idem

iolo

gica

lst

udy;

Red

ucin

g ris

k in

the

field

of

en-

viro

nmen

tal

heal

th r

elat

ing

toex

istin

g so

il co

ntam

inat

ion.

Info

rmat

ion,

res

earc

h

Usi

ng e

xper

ienc

e fr

om W

HO

surv

eys

in s

tudi

es,

eval

uatio

nan

d ris

k as

sess

men

t;A

sses

sing

hea

lth r

isk

rela

ted

toso

il an

d gr

ound

wat

er c

onta

mi-

natio

n an

d w

aste

dep

osits

;C

ontro

l of

hos

pita

l w

aste

ma-

nage

men

t to

red

uce

emis

sion

from

inci

nera

tors

and

pre

vent

or

redu

ce h

ealth

dam

age.

Adm

inis

trat

ive

mea

sure

s

Elab

orat

ion

of li

mit

valu

es f

orso

il po

lluta

nts;

Esta

blis

hing

inf

orm

atio

n ce

n-tre

s an

d ad

viso

ry b

oard

s.

Edu

catio

n

Educ

atio

n of

farm

ers t

o us

e fe

r-til

izer

s an

d pe

stic

ides

in

a

way

that

pro

tect

s th

e en

viro

n-m

ent;

Usi

ng e

xper

ienc

e fr

om m

odel

actio

ns,

elab

orat

ion

of m

eth-

ods,

guid

elin

es a

nd m

odel

s.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

54


Nat

iona

l

Envi

ronm

enta

l cl

assi

ficat

ion

of p

rodu

cts

mad

e of

dan

gero

us m

ater

ials

; Pr

even

tive

mea

sure

s fo

r w

aste

dep

osits

and

inci

nera

tors

to p

rote

ct w

orke

rs;

Tech

nolo

gies

and

met

hods

for

dim

inis

hing

pollu

tion

from

was

te d

ispo

sal;

Rev

iew

of h

ygie

nic

limit

valu

es fo

r soi

l pol

-lu

tant

s;

Mod

erni

zatio

n of

rule

s fo

r usi

ng s

oil f

ertil

iz-

ers

and

pest

icid

es;

Educ

atio

n of

farm

ers o

n en

viro

nmen

t-frie

nd-

ly u

se o

f fer

tiliz

ers

and

pest

icid

es;

Dra

win

g up

a n

atio

nal

prio

rity

list

on s

oil

reha

bilit

atio

n;

Pilo

t pro

ject

s on

dim

inis

hing

soil

pollu

tion

atsp

ecia

l pla

ces;

R

epre

sent

ativ

e he

alth

sur

vey

in a

reas

pol

lut-

ed w

ith to

xic

mat

eria

ls;

App

licat

ion

of W

HO

exp

erie

nce

for

surv

ey,

eval

uatio

n an

d ris

k as

sess

men

t;Ex

ploi

ting

succ

essf

ul a

ctio

ns,

wor

king

out

guid

elin

es, m

etho

ds a

nd m

odel

s;

Esta

blis

hing

cen

tres

for

info

rmat

ion

and

advi

sory

inst

itutio

ns.

Loc

al

Trea

tmen

t of s

econ

dary

was

tes f

rom

diff

eren

tw

aste

dis

posa

l fac

ilitie

s;D

ecre

asin

g ex

posu

re o

f wor

kers

at w

aste

dis

-po

sal f

acili

ties;

Hea

lth r

isks

com

ing

from

em

issi

ons

of in

ci-

nera

tors

bur

ning

med

ical

was

tes.

Reg

iona

l

Hea

lth r

isk

com

ing

from

soi

l an

d gr

ound

wat

er p

ollu

tion

rela

ting

to w

aste

dep

osits

; En

viro

nmen

tal

heal

th r

isks

com

ing

from

prev

ious

soi

l pol

lutio

n;Ef

fect

of

pollu

ted

soil

on f

ood

chai

n an

dw

ater

reso

urce

s;Es

tabl

ishi

ng r

egio

nal

land

fills

for

sol

idw

aste

s an

d de

posi

ts f

or w

aste

wat

er d

is-

char

ges

com

ing

from

hum

an s

ettle

men

ts.

Task

s lis

ted

acco

rdin

g to

leve

ls o

f act

ion


The working environment is the most dangeroussubenvironment. The health risk is higher by 1–3orders of magnitude than in the case of all otherkinds of subenvironments.

In Hungary a characteristic change has occurredin the number of enterprises due to the privatisa-tion. The number increased dramatically: therewere 45,000 registered enterprises in 1989 and900,000 in 1994. Besides the increased number ofenterprises, the number of employees working atorganised companies decreased.

The possible reasons for that are the large num-ber of firms with one person or a family and thehigh rate of unemployment.

As always, work still means a hazard endanger-ing the health and safety of employees. In Hun-gary there are 150–200 deaths per year owing toaccidents and 40,000–50,000 injuries at work andabout 1,000 people contract occupational diseasedue to harmful effects. The number of registeredaccidents is considered a low estimate since bothemployers and employees are interested to concealthe truth. Eliminating or reducing work riskrequire special knowledge (technical, medical,legal) helping to recognise the risk factors and toimprove the methods for averting them.

Background data All over the world about 120 million work acci-dents and 60–120 million new cases of occupa-tional diseases are registered per year. The numberof deaths owing to accidents at work is 200,000per year worldwide, meaning that – calculatingwith 230 working days – 800–900 people die atwork each day (ILO, 1994). In addition, properstatistics on death cases caused by occupationaldiseases are not available.

The number of such cancers may be high.According to the most moderate estimates (Dolland Peto, 1981) 4% of fatal cancer cases are ofoccupational origin. This means the death of tensof thousands of employees per year worldwide.

Besides accidents and occupational diseases,there are so called workrelated diseases as well.These are of multicausal character, caused – alongwith several others – by the working environ-ment, meaning that certain elements of the work-

ing environment increase the risk of some di-sease.

The effect of the working environment as a fac-tor increasing the risk of certain diseases or harm-ful to certain populations has already been studied,but the data on incidence and prevalence are ques-tionable in the case of diseases occurring at work.

Sources and hazards of pollutantsAll technologies can be considered polluting in awider sense. Parameters of work environment aremainly unfavourably influenced but in somecases the effects can impact on the home environ-ment as well.

Work load, pathological and stress factorsWorkers are affected in one respect by physical,psychological and mental burdens and in otherrespects by numerous pathological factors (physi-cal, chemical, biological, ergonomical, psychoso-cial) coming from these work environment. Theinteraction between the two kinds of effects andthe genetically and anthropometrically determinedindividual is called stress. The basic task is to keepstress at an optimal level which is also very impor-tant in preventing harmful effects at work.

2. Health effects

DiseasesIn Hungary the number of work accidents andoccupational diseases are decreasing year by year.In 1989 the registered number of accidents (workand road together) was 81,310, and occupationaldiseases 1,424, in 1994 the number of accidentswas 35,919 and occupational diseases 531. In1995 there were 33,491 accidents and 829 occu-pational diseases.

The cause of the decreasing trend is unfortunate-ly not due to improvement of the working environ-ment. Since 1989, the beginning of the economic,social and political changes, the structure, produc-tivity and number of employees have drasticallychanged owing to privatisation and the transition toa market economy. The incidence of accidents andreported illnesses is mainly associated with theoperation of the Hungarian economy.

In 1994 42 cases of occupational toxicosis, a spe-cial form of occupational disease, were registered.

55

Work Environment 8. 5

8. 5 Work Environment

The number of deaths due to occupational accidents The number of fatal accidents was 324 in 1994and 176 in 1995.

Deaths due to occupational diseases are sporad-ically registered in Hungary and the number ofrecognised cases – even in case of lung cancercaused by radiation – cannot be considered as thetotal.


The basic task is to regulate the domain ofthe work environment and harmonisewith the legislation of the EU. The key ele-ment in prevention of occupational dis-eases and health promotion is to ensurework safety and an occupational healthservice for all employees. The goal is toensure all the requirements for effectiveoperation thereof. About 80% of the casesof occupational diseases are recognizedand reported by doctors working in occu-pational health services;The second important task is to improvethe quality of the work environment andachieve the optimal level of work load andstress. This problem has got priority in thelegislation as well as all the other tasksmentioned above. From a practical pointof view these two problems should be equal-ly and simultaneously prioritised;It is also necessary, that administrativemeasures be unified and strict;To ban or restrict substances harmful tohealth in Hungary in accordance with thepractice in the European Union and inharmony with the decisions of OECD.

4. Harmonisation of legislation,regulation and supervision

Amendment of the Act on work safety and relatedlegislationThe decree of the Minister of Labour No 4 of26.12.1993 for implementation of the Act XCIII of1993 on work safety should be amended to deter-mine the obligations of the enterprises to carry outrisk assessment and on the other hand, to approachthe legislative system existing in the EuropeanUnion. The Act should be amended to set up a uni-

fied organisation in the field of occupationalhealth and safety.

Harmonisation of legislative tools with the EUdirectivesThe acceptance of the following EU directivesshould be promoted:

In the frame of responsibility of the Ministry ofWelfare:

Council Directive 90/679 EEC on protectionof workers against biological substances;Council Directive 90/394 EEC on hazard ofcarcinogens.

In the frame of responsibility of the Ministry ofLabour

Council Directive 89/654 EEC on the mini-mum occupational health and safety require-ments at work;Council Directive 89/655 EEC on the mini-mum occupational health and safety require-ments of tools at work;Council Directive 92/57 EEC on require-ments at temporary working places of con-struction work;Council Directive 92/58 EEC on occupation-al health and safety notifications used atwork places.

In the frame of the joint responsibility of theMinistries of Labour and Welfare

Council Directive 89/391 EEC on introduc-tion of rules for ensuring occupational healthand safety;Council Directive 89/656 EEC on occupa-tional health and safety requirements of per-sonal safety devices;Council Directive 89/686 EEC on approxi-mation of legislation on personal safetydevices;Council Directive 90/269 EEC on the mini-mum requirements of manual materials han-dling.

In the frame of the joint responsibility of theMinistries of Labour, Welfare, and Industry, Tradeand Tourism

Council Directive 90/270 ECC on the mini-mum occupational health and safety require-ments at work in front of a screen.

56


Ratification of ILO conventionsand recommendations

ILO 170 “Convention on work with chemi-cal substances”;ILO 174 “Convention on the prevention ofindustrial catastrophes”;National occupational health and safety leg-islation on work with chemical substances;National legislation of work with hazardoussubstances.

Establishing a uniform control system for occupa-tional health and safetyAn organisation of inspectorates should be estab-lished with up-to-date knowledge of legislationand available inventory of all work-places andworking conditions. The occupational health andsafety inspectorates should know all the activities,hazards, exposures, work loads, and risks. Thesedata form the basis for prevention and intervention.

The task is to elaborate, model and establish anintegrated practice for the occupational health andsafety control system. The following aspects andmethods should be taken into consideration:

The strategy of supervision depends onthe methods for exploring the sources of haz-ard and forecasting risks; and elaboration of sampling methods for allworking processes and areas, taking intoaccount the total working time and the work-ers exposed.

The supervising process consists of three phases:preparation (data collection, information), inspec-tion at the site, and evaluation and recommenda-tions.

In all three phases records and reports are essential.

Different modules are to be worked out:Aspects of the general supervision of the en-terprise and requirements relating to tech-nologies;Health and safety facilities (facilities, protec-tive devices);Submodules of the pathological factors char-acteristic to a certain technology (sourcesand intensity of exposure, workers exposed,preventive measures).

5. Improvement of occupational health service

The task is composed of three parts:quality assurance;education;information system.

Quality assuranceIn Hungary the new system of occupational healthstarted in 1995, based on the Act on labour safetyof 1994. The act makes it obligatory for all enter-prises to ensure occupational health service forworkers in employment. A Government decreeand a decree of the Minister of Welfare regulatesthe organisation and operation of this service.

Before the Act came into force, the basic occu-pational health activities ceased to be financed bythe Health Insurance Fund; the expenses are to becovered by the employers who are responsible forensuring safe work conditions. This means ineffect the privatisation of occupational health ser-vices, which are employed directly or hired by theenterprise.

Quality assurance has high priority in this situa-tion to determine minimum standards and set up acontrol system.

EducationAt the beginning of 1995 about 60% of employeeswere provided with an occupational health service.

Due to the shortage of doctors specialised inoccupational health, other experts (such as inter-nists, oxyologists, general practitioners) have beenlicensed to provide the service with the conditionthat they pass a special exam by 31.12.1998. Forthem and the specialised doctors – and even occu-pational nurses –, education and postgraduatetraining are highly important.

In order to carry out the task, accredited centresare to be set up to teach occupational health – in-cluding toxicology, ergonomy, psychology, etc. –to meet the needs of the different branches of theeconomy.

Information system and service To facilitate access to information on occupation-al health, utilisation of the possibilities of the In-ternet is highly desirable.

57

Work Environment 8. 5

6. Scientific research

Epidemiology and prevention of cancer of occupational originStudies of cancer of occupational origin should begiven high priority in scientific research.

On the one hand cancer stands in second place onthe list of causes of death in Hungary, and on theother hand according to international data 80–90%of all malignant tumours are caused by environ-mental factors. Even by moderate estimates, 4% ofcancers are of occupational origin. In spite of thisfact, in Hungary no more than 50 cases are consid-ered to be of occupational origin among the 30,000cancers deaths per year compared to the minimumof 1,200 cases, that could be expected.

Research work should concentrate on the following:How much higher is the risk of canceramong workers than the population livingnear or further from the factory?How does the risk of cancer change with thedecrease of exposure and what is the expect-ed risk of the present exposure among work-ers and the population living nearby?Are the workers and the nearby populationaware of the danger arising from the activity?

In the first two years of investigation, asbestos andvinyl chloride are the centre of the research work andtherefore the sites of the survey are the following:

a factory producing asbestos slate;a factory producing polyvinyl chloride (PVC);dwellings within 2 km of the factories;settlements at least 20 km away from the fac-tories as control areas.

Development of samplers suitable for measuringexposure of certain groups of workers or certainbranches of industryThere is no appliance capable of providing a largevolume of data at low cost in a short time. There isonly an experimental appliance suitable for serialproduction if financed. The samplers should com-ply with both the technical and occupationalhealth requirements, so the experiments have toconcentrate on the following:

to produce a mixture of air pollutants withregulated temperature, composition, storage,humidity and space, and connected to an ap-pliance extracting and analysing the sub-stances collected;to define the criteria for selection of thematerial of the sampler with regard to theactive component and the substance exam-ined; sampling speed; storage time; and effi-ciency of extraction.

The experimental appliance should be tested inoperation in situ and modified according to theresults before serial production.

Elaboration of personal samplersThe appliance should be suitable for both indoorand outdoor measurements. Measurement of sus-pended fibres should include MMMF as well andan evaluation system complying with the interna-tional standards.

58



Chemical safety comprises all aspects of produc-tion, use and elimination of harmful and danger-ous chemicals which might cause deleterious ef-fects on human health or the environment.

Human beings are exposed to hazardous chemi-cals during production, packaging, transport, mar-keting, use and elimination (disposal) of harmfulchemicals. Also, the environment might be con-taminated during all these processes which in turnmight lead to deterioration of the ecosystem, andagain secondarily, affect human health.

Chemical safety received much attention duringthe UNCED Conference in Rio de Janeiro, in 1992.The decision of the conference outlines the mostimportant requirements for chemical safety andtraces guidelines for developing programmes toachieve specific targets and goals:

The document suggests actions in six areas:Extension and acceleration of an internation-ally harmonised assessment of chemical risks;Harmonisation of classification and labellingof hazardous chemicals;Exchange of information on hazardous che-micals and risks;Initiation of risk reduction programmes;Development of national capacities for man-agement of chemicals;Improvement of control measures for stop-ping illegal international marketing.

As a member of the OECD, the Hungarian gov-ernment is involved in an ongoing process to har-monise the present legislation with OECD requir-ements. The present Hungarian legislation alreadycontains many important elements of the OECDinstruments, and envisaged new regulations willbe harmonised with those instruments.

National perspectiveChemical industry is an important part of theeconomy, most prominent the production of petro-chemicals, synthetic materials, basic chemicalsand pharmaceutical products. Centers of chemicalindustries are located in densely populated areas(cities) which underlines the risk of considerableemissions and accidents during production ortransport (Fig. 8. 6/1).

Important condition for chemical safety is the safehandling, packaging, transport and disposal ofchemicals. Legal instruments are needed to meetthese conditions.

For effective prevention of environmental con-tamination, inventories of pollution sources, emis-sions and transport should be established. Also,surveys of already polluted areas are needed inorder to initiate risk reduction programmes. Che-mical safety is of relevance to the whole popula-tion but with considerable differences in exposure.Especially workers in industry and agriculture areat risk. Consumers are voluntarily or involuntarilyexposed to chemicals that may involve health risks.

2. Health effects

The major determinants of the effects of chemicalson the health (and well being) of the individual are:

the nature of the chemical per se; the duration of time over which the chemicalinteracts with the individual; the quality of the chemical present;the possibility of chemicals acting togetherto cause effects that may be additive, syner-gistic, antagonistic, or independent is alwayspresent.

Acute poisoningThe traditional scope of the regulations of poisonsand hazardous substances has been the prevention ofpoisoning in human beings. Acute poisoning maynot today be a problem of great health significancebut serious problems may still persist in subgroupsof the population, for example small children.

The risk of acute poisoning is particularly highfor workers in the chemical industry and in agri-culture due to exposure to pesticides and otherchemicals. Due to insufficient reporting the exactnumber of acute poisonings is not known. Fortu-nately, cases of fatal poisoning in the chemical in-dustry are rare. In 1994, the number of deaths inchemical industry from poisoning were 3.3 per100,000 workers.

The risk of acute poisoning, however, also existsin households. Routine statistics on morbidity arenot available. Household gas presents a risk inmany homes and deficient storing of chemicalproducts frequently exposes small children to the

59

Chemical Safety 8. 6

8. 6 Chemical Safety

risk of poisoning. A recent large scale intoxicationcaused by contamination of red pepper with leadand chromium underlines the importance of chem-ical safety to the general population.

Chronic health effectsAllergic reactions represent a difficult field in thecontrol of chemicals. The morbidity scene is con-stantly changing as even less sensitising compoundswhen used by a sizeable population may eventual-ly lead to reactions such as contact dermatitis. It isnot possible to protect all allergic individualsagainst any specific chemicals to which they havebecome sensitised.

Especially the risk of cancer development fol-lowing exposure to chemicals has been a drivingforce behind the strengthening of regulations inindustrialised countries. The enormous increase inthe production and use of chemicals comparedwith the steadily rising cancer mortality is thebackground for the concern of some scientists thatthe majority of cancers might be due to chemicalcarcinogens in the environment.

In estimating the risk attributable to differentclasses of environmental agents, the firmest esti-mates relate to the effects of tobacco, alcohol andgeographical factors, while by far the largest esti-mates relate to tobacco and diet. Earlier estimatesby more conservative scientists have reckonedthat not more than 2–8% of all cancer deaths maybe attributed to occupational exposure. Even if theproportion of cancers that may be attributed tospecific hazards of occupation, pollution, the useof chemical products, medicines and medical pro-ducts are individually small, some of these haz-ards may be of great importance to sections of thepopulation on whom the risks are concentrated.

The chronic effects of chemicals occur first ofall in industrial settings. Special attention shouldbe paid not only to cancer but also the effects onreproductive organs. In Hungary, only 40–50 casesof cancer related to occupational exposure havebeen reported yearly. However, this figure doesnot reflect the actual situation, and a special sur-vey of cancers related to occupational exposureshould be initiated.

60



Protection of human health and environ-ment from deleterious effects of hazard-ous chemicals;Establishing legal, technical and other na-tional circumstances for prevention;Continuous control and survey of the po-tential effects of exposure to chemicals;Establishing programmes for remedyinghighly contaminated areas.


Establishment of an institutional frameworkfor chemical safety;Coordination of the highly complex issuesrelated to chemical safety is of utmost im-portance. A commission for chemical safety,comprising high level representation of allrelevant ministries could be operational in allissues related to production, marketing, useand disposal of chemicals. This forum coulddeal with risk reduction programmes etc;International requirements for harmonisationof legislation have high priority, especiallyconcerning OECD and EU regulations;An optimal solution would be the establish-ment of an authority for all aspects of chem-ical safety (“Chemical Inspectorate”). Thisbody should deal with theoretical, legal andpractical aspects of regulating hazardouschemicals;A new Act on Chemicals should be created,which would cover all aspects of production,packaging, labelling, transport, use and dis-posal of hazardous chemicals. The followingtable lists a number of activities relating tochemical safety.

61

Chemical Safety 8. 6

62


Loc

al

Acc

redi

ting

labo

rato

ries

mak

ing

mea

sure

-m

ents

, com

plyi

ng w

ith G

LPre

quire

men

ts;

Star

t an

d co

ntin

uatio

n of

pro

gram

s on

ris

kab

atem

ent,

dete

rmin

atio

n an

d co

ntro

l of

harm

ful c

hem

ical

s:

*Se

t up

lis

t of

che

mic

als

prod

uced

in

high

volu

me;

*In

form

atio

n ex

chan

ge o

n ba

nned

or l

imite

dch

emic

als;

*Ef

fect

s of

mer

cury

and

its

com

poun

dsbe

ing

harm

ful

to e

nviro

nmen

t an

d hu

man

bein

gs;

*D

imin

ishi

ng e

xpos

ition

of

lead

and

its

com

poun

ds;

*M

oder

atin

g ha

rmfu

l ef

fect

s of

cad

miu

man

d its

com

poun

ds t

o en

viro

nmen

t an

dhu

man

s;*

Prev

entin

g po

lych

lorin

ated

bip

heny

ls t

oge

t int

o th

e en

viro

nmen

t; *

Dim

inis

hing

eff

ects

of

poly

brom

inat

edfla

me

reta

rdan

ts;

*C

lass

ifica

tion

of c

ance

roge

n m

ater

ials

.

Reg

iona

l

Dev

elop

men

t of

educ

atio

n an

d re

sear

ch in

toxi

colo

gy a

nd e

coto

xico

logy

; Su

rvey

on

the

mos

t dan

gero

us m

ater

ials

tom

ake

up in

vent

ory

for c

ompo

unds

har

mfu

lto

env

ironm

ent a

nd h

uman

bei

ngs;

In

vest

igat

ing

effe

cts

on e

nviro

nmen

t, ris

kas

sess

men

t;Ec

otox

icol

ogic

al m

easu

rem

ents

and

eva

-lu

atio

n;

Setti

ng u

p su

itabl

e la

bora

torie

s;

Educ

atio

n of

exp

erts

; In

form

atio

n ex

chan

ge o

n ha

rmfu

l ch

emi-

cals

and

risk

s.

Nat

iona

l

Inte

rmin

iste

rial

Com

mitt

ee f

or d

ealin

g w

ithth

e co

mpl

ex p

robl

em o

f ch

emic

al s

afet

y.D

eter

min

atio

n of

task

s fo

r com

pete

nt a

utho

-rit

ies

wor

king

in th

is fi

eld;

Exte

nsio

n of

mea

sure

men

ts in

env

ironm

enta

lto

xico

logy

and

saf

ety;

Non

-clin

ical

mea

sure

men

ts i

n to

xico

logy

plan

ned

acco

rdin

g to

the

OEC

D g

uide

lines

and

Goo

d La

bora

tory

Pra

ctic

e fo

r m

utua

lac

cept

ance

of

data

in

gene

ral-

and

ecot

oxi-

colo

gy;

Prio

r In

form

ed C

onse

nt (

PIC

): ev

alua

tion

and

mut

ual n

otifi

catio

n on

ban

ned

or li

mite

dch

emic

als

in c

ase

of e

xpor

t: se

tting

up

PIC

Com

mitt

ee in

Hun

gary

; Se

tting

up

prop

er l

ist

on p

rodu

cts

of h

igh

prod

uctio

n vo

lum

e;

Ris

k de

crea

sing

pro

gram

s on

pest

icid

es: n

ewre

gist

ry s

yste

m, s

afe

usin

g, d

ispo

sal o

f pac

k-ag

es,

surv

ey o

n po

llutio

n of

gro

und

wat

er,

educ

atio

n of

use

rs,

mea

surin

g po

llutio

n of

food

stuf

fs;

Take

-ove

r an

d de

velo

pmen

t of

new

met

hods

in t

oxic

olog

y, e

duca

tion

and

postg

radu

atio

nof

exp

erts

, inf

orm

atio

n to

rise

pub

lic a

war

e-ne

ss, s

uppo

rting

rese

arch

in to

xico

logy

.

Task

s lis

ted

acco

rdin

g to

leve

ls o

f act

ion


Although the road vehicle fleet grew continuouslyin the 80s, the number of road accidents involvinginjury more or less stabilised. The balance reachedcannot, however, be considered satisfactory. Yet itmay be considered as a certain achievement thatthe significant increase in the number of vehicles(and of the kilometres travelled) has not beenaccompanied by a growth in the accident rate. Thisrate, of course, must be evaluated in comparisonwith the change of traffic volume.

From 1988 the number of accidents involvinginjury and fatalities started to increase abruptly,and road accident deaths in 1990 exceeded all pre-vious levels. From 1990, both the number of roadaccidents and of persons injured or killed began todecrease. (Fig. 8. 7/1)

In 1991, the 12–13% decrease in road accidentsinvolving injuries and fatalities was accompaniedby a 5% lower road traffic volume. Consequently,the decrease in the number of accidents to someextent may be explained by the decline in traffic.

In 1992, a 3% traffic increase was registeredwhich partly may explain why accident figures didnot decrease that year.

In 1993, both accidents involving injury and thenumber of fatalities decreased markedly (by20–21%), although the volume of road traffic re-mained practically unchanged. Thus, this consid-erable improvement must be related to the consis-tently implemented road safety provisions andseries of measures taken in 1993.

Because of their impressive results the followingmeasures are worth mentioning:

introduction of the 50 km/h speed limit in-side builtup areas;mandatory use in daytime of headlights bymotor vehicles on motorways and mainroads outside builtup areas;mandatory use of installed seat belts in therear seats of passenger cars outside builtupareas;increased traffic control activity of the police.

In 1994, compared with the previous year, a smallincrease of the accident rate (6%) was experi-enced. It is estimated that a similar growth occur-red in the volume of traffic. In 1994, a total of1,562 persons died in road accidents (6.9% lowerthan the previous year).

In 1995, preliminary data show a discontinuityof the former favourable trend: the number of per-

63

Road Traffic Safety 8. 7

8. 7 Road Traffic Safety

sons killed increased by 5% – with a 4% decreasein the number of accidents involving injury – rep-resenting an increase in accident severity.

The “severity index” – the average number of vic-tims who died as the result of 100 accidents involv-ing injury – was 8.7 in 1990; 8.5 in 1992; 8.6 in1993 and 7.5 in 1994. Compared with highlymotorised countries, notwithstanding the impro-vement of recent years, the consequences of roadaccidents in Hungary are still very severe. Data onroad accidents between 1990–1995 are shown inFig. 8. 7/2 and 8. 7/3.

2. Health effects

Accidents involving injuryIn recent years the number of injuries was the fol-lowing:

The number of fatal road accidents in the sameyears


Improving road safety;Significant reduction of injuries and fatalroad accidents even in case of increase ofvehicle mileage;Reducing the number of severe accidents;Supporting preventive methods.

Improvement of road safety is an important socialand health matter and for the year 2000 the goal isto decrease the number of fatalities and severeinjuries by 20–30% compared to 1992 even if themileage of motor vehicles may increase.


4. 1 At national levelTraffic safety (especially prevention) is theresponsibility of the State, i.e. determination of themain goals for the whole country, working outspecial action programmes, creating suitable con-ditions for complying with requirements and set-ting up managing and supervisory agencies foroperating the network.

Measures and actions for preventing accidents,which need especially fast intervention and prob-lems arising from rehabilitation which are almostimpossible to forecast, should be solved at this level.

4. 2 At regional levelEvaluation of conditions relating to accidentsdetermines priorities, giving the frame for actionsat regional and local level.

Short – and long – term programmes elaboratedat national level should be executed at regionallevel, where the tasks are to be solved according tothe special requirements.

4. 3 At local levelLocal programmes, adapted to the national pro-gramme are needed to solve problems comingfrom the special route of public roads, preventingaccidents, actions for promoting safety in trafficand transport.

5. Existing programmes

In 1993, a governmental programme for improv-ing road safety was created.

The Government Resolution No 2036 of 09.09.1993made decisions on the following:

Adoption of the National Programme for RoadSafety;Establishing financial support for executingthe tasks included in the Programme;The duties of the Minister responsible fortraffic in the field of activities relating toroad safety;

64


Year personspersons

/100,000 inhabitants

1990 36,996 356.61991 32,676 315.61992 32,577 315.21993 25,430 246.61994 26,961 262.51995 25,887 250.1

Year personspersons

/100,000 inhabitants

1990 2,432 23.441991 2,120 20.471992 2,101 20.331993 1,678 16.281994 1,562 15.21995 1,589 15.4

Setting up a Committee for the competent mi-nistries;Elaborating yearly action programmes adjus-ted to the financial possibilities.

In Hungary, passenger car drivers, first of allyoung males, are considered the principal targetgroup for road safety activities, due to their con-siderable role both in causing accidents and as theirvictims. Hence, the programme lists among themost urgent tasks the introduction of the penaltypoint system, and for young/novice drivers the useof the probation driving license period. (Fig. 8. 7/4)Since the main objective is decreasing the severi-ty of accidents, education and enforcement shouldalso concentrate on:

respect of the prescribed and safe speed limits;prevention of drinking and driving;a significant increase in the use of safety belts.

Road accidents – especially those caused by speed– have severe consequences, notably outside built-up areas. In 1994, 58% of road accident victims losttheir life outside builtup areas. In consequence, inthe future, speed control must be increased princi-pally on roads outside builtup areas. In the Govern-ment Programme’s implementation process, the de-velopment of the financing system has so far failed.Notwithstanding the weak financial background,annual action programmes were elaborated for1994 and 1995.

6. Future tasks

Tasks included in the National Road SafetyProgramme are to be regularly reviewed, takinginto consideration the situation of road safety.(This is reflected in the tasks set out in the yearlyaction programmes.) Measures taken for preventionare to be emphasised. This is a natural demand,because prevention is cheaper also in the field ofroad safety than the restoration of damage.

Human responsibilities are emphasised in thismatter, as they can have a substantial influence onroad safety even without major technical invest-ment. The following table lists tasks relating toroad traffic safety.

65


66


67


Prac

tical

task

s (or

gani

zatio

n, c

ontr

ol)

Act

ivity

of t

he a

mbu

lanc

e se

rvic

e; im

prov

ing

spec

ial m

edic

al c

are

on th

e sp

ot b

y sh

orte

ning

arriv

al ti

me

incr

easin

g th

e nu

mbe

r of

am

bu-

lanc

e ca

rs a

nd d

evel

opin

g th

e ne

twor

k of

spe-

cial

, mob

ile e

mer

genc

y ca

re u

nits;

Impr

ovem

ent

of t

he a

mbu

lanc

e se

rvic

e to

trans

port

mor

e pa

tient

s by

hel

icop

ter;

Impr

ovin

g te

chni

cal p

ossi

bilit

ies a

nd st

aff f

orem

erge

ncy

resc

ue;

Cam

paig

ns to

forc

e re

spec

t of t

he s

afet

y re

g-ul

atio

ns o

n ro

ads,

regu

lar c

heck

ing

base

d on

loca

l pro

blem

s and

cau

ses o

f acc

iden

ts;El

abor

atin

g an

d in

trodu

cing

a “

poin

t sys

tem

”to

pen

alise

beh

avio

ur e

ndan

gerin

g ro

ad sa

fety

.

Info

rmat

ion

(edu

catio

n. tr

aini

ng, c

omm

unic

atio

n)

Reg

ular

info

rmat

ion

syst

ems s

houl

d be

wid

e-ly

int

rodu

ced

with

the

hel

p of

pub

lic a

ndco

mm

erci

al T

Vne

twor

ks;

Non

-pro

fess

iona

l firs

t aid

and

res

cue

shou

ldbe

im

prov

ed w

ith e

xper

t ed

ucat

ion

unde

rco

ntro

l and

org

aniz

ing

“ref

resh

er”

cour

ses.

Mea

sure

s tak

en b

y au

thor

ities

(te

chni

cal,

legi

slat

ive)

Intro

duci

ng d

rivin

g lic

ence

for

pro

batio

ntim

e fo

r yo

ung,

nov

ice

driv

ers

in c

onne

c-tio

n w

ith re

gist

erin

g fu

nctio

n of

the

pena

ltypo

int s

yste

m;

Poss

ibili

ties

for

repo

rting

acc

iden

ts a

re t

obe

dev

elop

ed,

such

as

tele

phon

e ne

twor

kal

ong

road

s w

ith h

igh

traffi

c de

nsity

(be

-si

des m

otor

way

s), C

B ra

dios

and

mob

ile te

-le

phon

es.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n


Radiation dose from natural sourcesA thorough investigation was begun in the lateseventies for the assessment of the radiation doseof the population from various sources. Data ob-tained so far indicate an average of 0.34 mSv fromthe cosmic and 0.48 mSv from the terrestrial com-ponent of natural radiation. The average radiationdose is the same as all over the world, namely0.82 mSv/year, in the same way as the internal ra-diation dose from 40K assessed to be 0.18 mSvannually.

Among the manmade sources, the Paks NuclearPower Plant contributes only one thousandth(1/1,000) of the natural level.

Occupational and environmental exposureA well organized personal dosimetry system is inoperation covering 1,200 working places, approx.1.5 per thousand population. Based on the findingsobtained, the exposure did not exceed 10–15 percent of the occupational dose limit.

Despite this favourable situation, several problemshave still to be solved:

In the surrounding countries more and morenuclear establishments are operating quitenear the borders. Although in the opinion ofexperts the nuclear power plants are amongthe safest industrial establishments, the oc-currence of serious accidents at reactors cannot be excluded. Institutions monitoringradioactivity in the environment should mo-nitor for the background radiation, forecastcontamination and handle the consequences;Restoration of the environment contaminat-ed with radioactive substances due to urani-um mining is to be solved;Radioactive wastes of different activity lev-els, originating from the nuclear cycle andduring operation of industrial, health care,educational and other institutions should besafely deposited;A nationwide survey on indoor radon con-centrations from natural sources – causingsignificant radiation dose to the population –has been carried out only in dwellings. Thepreliminary survey of indoor radon concen-

trations must be continued and extended.The average value of 55 Bq per m3, however,might result in an annual dose of 2,5 mSv,approx. twice the world average value.

Radiation dose of the population from medicalapplications of ionizing radiationA project was started and has to be continued forthe assessment of the population dose from medi-cal applications of ionizing radiation. It is sup-posed that the resulting value may be higher thanthe European average and it is considered to be themost significant factor of the radiation dose fromartificial sources, among them medical X-rays anddiagnostic processes carried out with isotopes.More than 10 million X-ray and about 3 millionlung screening examinations are carried out in thecountry per year. It can be determined during theproject how much of the radiation burden is unjus-tified and should be reduced. The project cancooperate with experts in this field and also fulfillobligations to harmonize with the legislation ofthe EU relating to the reduction of radiation dosefrom medical sources. Based on the project, levelsrecommended by the National Regulation for Pro-tection from Radiation are to be introduced as aguide for radiologists.

The measurement of occupational exposures hasto be extended to include the excess dose fromnatural sources and to control nonhomogenous,irregular doses of radiation. A survey on equip-ment emitting nonionizing radiation should alsobe initiated.


To maintain and extend radiation safety;To coordinate monitoring activitiesamong the different branches in the frameof OKSER;To monitor the radiation dose of the pop-ulation, environmental elements and foodand to achieve a suitable level of prepa-redness in case of nuclear emergency;To carry out a survey on the radiation doseof the population from X-ray and isotopediagnostic sources, to study the feasibilityof possible reduction and to serve as a basisfor the determination of acceptable levels;

68

Radiation Safety 8. 8

8. 8 Radiation Safety

To decrease the radiation dose of the pop-ulation from both manmade and naturalsources;To arrange and solve disposal of wastefrom uranium mining and the use of nucle-ar energy;To reveal and decrease the dose and possi-ble health effects of nonionizing radiation.

3. Main current programmes

Environmental Monitoring Programme of JointAuthorities for Radiological Protection around thePaks Nuclear Power PlantThe monitoring system is focused on the radioac-tive emission from the Paks Nuclear Power Plantand has been operating since 1983. The followinginstitutions participate in the programme:

Centre for collecting, processing andevaluating data;

Ministry of Agriculture;Ministry of Welfare;Ministry for Environment and RegionalPolicy;Paks Nuclear Power Plant.

The annual report of the Data Processing andEvaluation Centre (at the National Institute of Ra-diation Hygiene) contains detailed measurementdata on the excess radiation dose of the populationliving near the Nuclear Power Plant. This radia-tion dose is in the order of one tenth microsievertper year, according to the calculations made on thebasis of the distribution model of emitted radioac-tive substances.

Monitoring Network for Medical RadiationSince 1978 this network has been operated by theMinistry of Welfare and its institutions: RegionalInstitutes of the National Public Health Serviceare taking part in it with the guidance of theNational Institute for Radiation Hygiene. Themonitoring network controls the level of radioac-tivity of the environmental elements and food.The goal is to give information on and forecastcontamination (in air, food, water, etc.) and theradiation dose affecting the population. The net-work cooperates with international networks suchas GERMON operated by the WHO by exchang-ing data. Results of measurements are regularlypublished.

National Radiation Control System (OKSER)Based on the favourable experience of interminis-terial cooperation in the field of operating thenationwide monitoring system mentioned above,the control system has been created for ministriesand other national institutions, establishmentsusing nuclear technology, and several laboratories.

Nationwide survey of the environmental radiationlevelThe Nuclear Plant monitoring programme wasexpanded to survey the environmental radiationlevel all over the country. Systematic control ofthe radiation level takes place at 123 measuringpoints in the country using thermoluminescentdosimeters. This method is combined with highpressure ionizing chambers and in situ gamma-spectrometric measurements in some places. Thismonitoring system was able to assess changes inradioactive pollution in Hungary after the Cherno-byl accident.

Centralized personal dosimetry service for alloccupationally exposed personsThe National Personal Dosimetry Service routine-ly sends filmdosimeters to employees at variousworkplaces where it is considered justified and re-quested by the Radiation Protection Service or thelocal management. If the Dosimetry Service findslevels that give rise to concern, the local RadiationProtection Service and local authorities areinformed.

Cytogenetic monitoring of occupationally exposedmembers of high risk groupsThe human lymphocyte micronucleus test wasintroduced to detect genotoxic effects in exposedworkers or population groups. The test is suitableto detect overexposure to ionizing radiation and forprediction of the radiation dose. This method mayalso be applied for in vitro assessment of adversehealth effects caused by chemicals (metals, organicsolvents, antioxidants, radioprotective agents).This test seems to be more suitable than investiga-tion of chromosome aberration in metaphase.International cooperation is therefore proposed tostudy the possibilities of introduction/applicationof this screening method.

69


Preparatory Program for the survey on radiation burden from medical sourcesThe NEXT (Nationwide Evaluation of X-rayTrends) was adapted to the Hungarian conditionsin 1990. The National Institute for RadiationHygiene elaborated a project applied to the prac-tice carried out in Hungary. A survey has beenstarted on the screening tests and examinationsconsidered to lead to the highest exposure to radi-ation like mammography CT, etc.


Monitoring networksTwo different monitoring networks are operated,One of them belongs to the Ministry of Welfareand the other to the Ministry of Agriculture. Thetask is to monitor the level of radioactivity in theenvironment and food consumed by the popula-tion and also to estimate the radiation dose fromradionuclides. The duties of the two networksoverlap in many cases so the sharing of the workand good cooperation should be established.

For the nationwide network, the most importantrequirement is regular monitoring besides enablingpreparedness for emergency. A project should beelaborated for a new – perhaps joint – institution.

Radiation dose from radonA representative survey on radiation exposure ofthe population caused by radon has been carriedout in dwellings, but there are many problems tobe solved. The survey has found the radiation dosefrom radon to be about twice as much as theworldwide average, but before taking any mea-sures these data should be reviewed. For calcula-tion of the acceptable doses, the rate of balanceamong radon and its several elements, and thetime spent in the premises has to be known, andthe level of radon should be studied at work, edu-cational institutions, etc. Legislation and determi-nation of threshold limits can follow the accom-plishment of these tasks.

Restoration of damage caused by uranium miningRestoration of damaged environments caused bythe activity of uranium mining is an importantregional problem. For the purpose of elaboratingrequirements and technology of restoration, differ-ent institutions collaborate, such as the institutesof National Public Health Service, the NationalInstitute for Radiation Hygiene, and a PHARECentre is to be set up to support the work.

Disposal of radioactive wastesDisposal of radioactive wastes is a regional and atthe same time a nationwide problem.

Taking the international tendencies into account,transmission and transport to other countries can-not be expected in the long run, and a solution hasto be provided inside the country. The selection ofsites for deposits of wastes with low and mediumactivity is under way and a deposit site for wastesof high activity is available in Paks. Russia is stillwilling to accept the spent fuel cassettes, but anational project has been started to find an under-ground deposit site as a final solution.

The National Institute for Radiation Hygiene istaking part in the preliminary study, and elabora-tion of the requirements is an important task forthe future.

Radiation dose of the population from medicaldiagnostic processesA survey is under way with international supportto measure the dose of the population, howeverthe staff and technical equipment are to be en-larged for accomplishing the task. An intersectoralcooperation is needed among radiologists, scien-tific experts and associations for this purpose, andmethods for data collection, processing and evalu-ation are to be elaborated as well.

5. Future tasks

The following table gives a summary of the futuretasks.

70

Radiation Safety 8. 8

71


Edu

catio

n

Bas

ic a

nd p

ostg

radu

ate

educ

a-tio

n of

the

wor

kers

at a

n ap

pro-

pria

te le

vel;

Educ

atio

n of

the

staf

f wor

king

inth

e na

tiona

l mon

itorin

g ne

twor

k;G

ener

al e

duca

tion

of th

e po

pula

-tio

n w

ith th

e he

lp o

f mas

s med

ia;

Publ

ishi

ng

the

Inte

rnat

iona

lB

asic

Leg

isla

tion

for

Prot

ectio

nA

gain

st R

adia

tion

in H

unga

rian

new

spap

ers a

nd m

agaz

ines

.

Res

earc

h an

d de

velo

pmen

t

Expa

ndin

g te

sts

for

dete

ctin

gge

noto

xic

effe

cts;

Nat

ionw

ide

surv

ey o

n ra

dioa

c-tiv

ity o

f ind

ustri

al b

y-pr

oduc

ts;

Stud

y on

beh

avio

r of

rad

ionu

-cl

ides

in

the

envi

ronm

ent,

ex-

amin

ing

poss

ibili

ties

for

rest

o-ra

tion

of c

onta

min

ated

ara

ble

land

;Im

prov

ing

met

hods

of

mea

sur-

ing

radi

oact

ive

dose

s.

Adm

inis

trat

ive

mea

sure

s

Det

erm

inat

ion

of l

imit

valu

esfo

r ra

dion

uclid

es

cons

umed

with

food

and

drin

king

wat

er;

Legi

slat

ion

on i

ndoo

r ra

don

conc

entra

tion;

Legi

slat

ion

on w

aste

dis

posa

lan

d de

term

inat

ion

of li

mit

val-

ues

for e

mis

sion

;El

abor

atio

n of

requ

irem

ents

and

basic

met

hods

for r

esto

ratio

n;Le

gisl

atio

n on

no

n-io

nizi

ngra

diat

ion;

Intro

duct

ion

of i

nter

natio

nal

reco

mm

enda

tions

for t

he ra

dia-

tion

dose

from

med

ical

sour

ces

into

the

Hun

garia

n le

gisl

atio

n.

Info

rmat

ion,

dat

a co

llect

ion

Impr

ovin

g da

ta c

olle

ctio

n in

the

mon

itorin

g ne

twor

k;Es

tabl

ishin

g in

form

atio

n ce

ntre

;N

atio

nwid

e su

rvey

on

rado

nco

ncen

tratio

n in

side

pre

mis

es;

Stud

y on

rad

iatio

n do

ses

from

med

ical

exa

min

atio

ns;

Surv

ey o

n do

se f

rom

iso

tope

diag

nost

ic m

etho

ds.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

Situation analysis, legislative background

The existing laws and/or decrees, aimed at pre-venting health against hazardous chemical andmicrobiological contamination of food, provide anadequate regulatory basis for creating food safetyin Hungary. The majority of Hungarian foodhygiene regulations are already in agreement withdirectives of the European Union. Priority foodhygiene problems, relating partly or totally toenvironmental contaminations, are mentioned inthe following.

Chemical contamination

1. Lead

The major part of lead exposure of the populationcomes from foods. The lead concentration in foodhas been controlled for 40 years in Hungary. Leadcontamination of food may occur during techno-logical processes but, today, it mainly comes fromenvironmental sources. Significant differences inthe lead level of food of plant origin have beenfound in different regions of the country. The leadcontent in vegetables has been decreasing. Resultsof the surveys are shown in Table 8. 9/1.

The result of meat tests carried out by the Na-tional Institute for Testing Meat shows a decreas-ing trend in the lead content of food. The reductionis due to the stricter limit values in fodder intro-duced in 1990 (see Table 8. 9/2). There is a nation-wide decreasing trend in lead content of differentfoods.

In 1995 the highest level of lead was 408 mg/kgin cereals, 234 mg/kg in vegetables, 320 mg/kg infruits measured by the Regional Laboratories ofthe Food Control Stations. However the situationis not as good as that, because the most contami-nated types of food and vegetables were not anal-ysed in 1995.

Tasks:Quality assurance/control/management;Clarification of sampling problems;Monitoring the lead content in food prod-ucts; evaluation of contamination of smallergroups of food products; analysis of differ-ences between regions;

Survey of food contamination in pollutedareas;Studying lead intake in daily diets;Elimination of contamination sources; Minimisation of emissions.

2. Cadmium

A considerable part of human cadmium exposurecomes from foods. According to food examinationdata, Hungary belongs to the moderately contami-nated countries. Cadmium levels in food show aslightly increasing tendency all over the world.Different foods contain cadmium in the followingorder: milk, eggs, fruit, vegetables, cereals, meat,fish and internal organs. The cadmium uptake ofplants depends on the type and species of soil andplant. The highest level of cadmium occurs inbran. Cadmium levels in Hungarian foods havenot changed considerably over recent years.The following median values were reported in 1995:in cereals 15–18 g/kg, in vegetables 4–150 g/kg, infruits 1–7 g/kg. Results are shown in Fig. 8. 9/3and 8. 9/4.

Cadmium levels above the limit value werefound in 10 of the sampled potatoes and Hunga-rian red pepper. The average cadmium content ofpig kidneys has not changed since 1992, but thatof cattle kidneys shows a continuous increase:357, 485 and 375 mg/kg, in the years 1992, 1993and 1994 respectively.

Tasks:Quality assurance/quality control of testinglaboratories;Clarification of sampling problems;Monitoring the cadmium level in food prod-ucts; evaluation of contamination of smallergroups of food products; analysis of differ-ences between regions;Investigation of the cadmium content in foodin polluted areas;Studying cadmium uptake by plants;Elimination of emission sources and min-imising emissions.

72

Food Safety 8. 9

8. 9 Food Safety

Contamination of vegetables with leadTable 8. 9/1

Contamination of meat with leadTable 8. 9/2

Contamination of vegetables with cadmiumTable 8. 9/3

*Note: one or two extreme values in bran

Contamination of meat with cadmiumTable 8. 9/4

73

8. 9 Food Safety

Food Number of samples Lead content (µµg/kg)median maximum

Cereals 8 50–600 110–2100Vegetables 22 3–308 90–6400

Fruit 9 3–190 40–750

YearAverage content of lead (µµg/kg)

Pork Beef Poultry Game 1989 430 500 310 3601990 210 250 240 4001991 190 190 200 4601992 150 140 130 3701993 70 70 60 111994 40 40 40 50

Food Number of samplesCadmium content (µµg/kg)

median maximumCereals 9 5–62 200–800*

Vegetables 8 5–30 20–461*

Fruit 7 1–16 5–90

YearAverage content of cadmium (µµg/kg)

Pork Beef Poultry Game 1989 41 144 15 151990 42 57 27 751991 32 31 17 551992 23 22 19 271993 13 16 10 141994 11 12 9 13

Average benzo(a)pyrene concentration of some vegetables (µµg/kg)Table 8. 9/5

Average benzo(a)pyrene and total PAH content in cereals (µµg/kg)Table 8. 9/6

Content of chlorinated hydrocarbon pesticides in meat (µµg/kg)Table 8. 9/7

nd = not detectable = 0.5 mg/kg

Weekly intake in 1995 of PCB from foodstuffsTable 8. 9/8

74

Food Safety 8. 9

In the vicinity of

Food Produced in clean air areaOil refinery Oil refinery

with old technology with modern technology

Carrots 0.37 8.5 3.5Lettuce 0.42 3.8 3.4

Produced in clean air area Polluted area (traffic)benzo(a)pyrene 0.2 2.1

total PAH 1.40 4.52

HCB HCH isomers Total DDTPork 1–2 1–2 20Beef 2 1–3 60

Poultry nd–2 nd–4 6–7Game 1–6 nd–10 10–400

Sampling place Number Total content of PCB (µµg/kg)of sample of samples median 90-percentile rangePécs 30 < 0.01 47.2 < 0.01–112.4Budapest 30 < 0.01 24.0 < 0.01–118.0Szolnok 30 < 0.01 14.4 < 0.01–22.5

3. Mercury

Foods of plant origin contain mercury in negligi-ble quantities. Fish are the best indicators of envi-ronmental mercury contamination. The mercurycontent of fish from fish ponds and Lake Balatonhas never reached the limit value. Higher concen-tration levels were detected in some cases in fishcaught from the rivers Danube and Tisza. Mercury,as an environmental contaminant, has no priorityfrom a food hygiene perspective in Hungary.

4. Nitrate

The increasing nitrate content of vegetables may bepartly due to the excessive use of artificial fertiliserscontaining nitrogen. The content of nitrate in veg-etables strongly depends on the plant species, agri-cultural methods and climate. Characteristic valuesare similar to those measured in Western Europe.

The nitrate content in fruit is considerablylower than in vegetables. The natural nitratecontent of foods of animal origin is insignif-icant; The high nitrate content of vegetables haspriority from a food hygiene perspective, es-pecially in the fields of targeted plant im-provement and good agricultural practice.

5. Radionuclides

In Hungary the regular monitoring of food is car-ried out by the Ministry of Agriculture. Since 1978the National Network for Measuring Radiationhas been working as well under the Ministry ofWelfare, monitoring and controlling radioactivityof the consumed food and water. The radiationdose from food in Hungary is the same as thatfrom the background level. Concentrations ofradionuclides in plants near the Paks NuclearPower Station have never reached the level of con-cern. They have been monitored systematicallysince the beginning of the plant’s activity. Thisproblem has no priority at present in Hungary, butmonitoring and controlling have to be continued.Control of imported food is not properly solvedyet, the monitoring laboratories sampled and ana-lysed imported food (such as milk powder, cannedfish) where the concentration of radioactivity wasseveral tenths or thousandths higher than theallowed value.

In addition, greater preparedness for emergency isvery important due to the increasing number ofnuclear establishments around the border in theneighbouring countries. (The problem is describedin detail in the section 8.8 on Radiation Safety).

6. Polycyclic aromatic hydrocarbons (PAHs)

PAHs may enter foods as technological contami-nation and as environmental pollution. Contami-nation can be minimized with appropriate techno-logical measures. Studies on environmental PAHsand their adverse effect through the food chainhave priority. PAH contamination might be con-siderable in soil and vegetation around busy roads,aluminium smelters, oil refineries, airports etc.Unprocessed, raw foods of animal origin do notcontain PAHs. (see Fig. 8. 9/5 and 8. 9/6)

Tasks:Collection of data;Measurements of PAHs in indicator foods;Elimination of sources.

7. Polychlorinated compounds

Hundreds of environmental pollutants of differenttoxicity belong to this group. Due to their fat sol-ubility, persistency and biomagnification in thefood chain, the highest concentrations areobserved in human adipose tissue. Human expo-sure comes almost only from food. Reduction ofemissions is the only effective preventive mea-sure, because the rate of elimination of polychlori-nated compounds from the environment is a verylong process.

8. Chlorinated pesticides

Even after more than 25 years of ban on their useas pesticides, they can be detected, first of all, indomestic foods of animal origin. Concentrationsof DDT, HCB and HCH isomers are presented inTable 8. 9/7. The monitoring of chlorinated hydro-carbon pesticides has no priority in Hungary.

9. Polychlorinated biphenyls (PCBs)

PCBs are typical industrial contaminants and canbe found everywhere in the environment. In the air0.002–15 ng/m3, around industrial plants in rain-

75

8. 9 Food Safety

fall 1–250 ng/l, in the ocean 0.05–06 ng/l.Vegetables contain about an average of 10 mg/kg,milk 5–200 mg/kg, butter 30–80 mg/kg, animal fats20–240 mg/kg. In the nutrition chain there is a sig-nificant cumulation and in breast milk 0.5–1 mg/kg,in human fat 1–5 mg/kg can be found.

Production of PCBs has been limited all over theworld. There has never been any production inHungary and the application has also been restrict-ed. The presence of PCBs has to be reckoned within food of plant origin in our industrial regions, inthe environment of big industrial plants, wasteincinerators and waste deposits. Examination ofdomestic meat samples has shown no PCB con-tamination with a method of 1 mg/kg sensitivity.

According to WHO/EURO the acceptable week-ly intake is 100 mg. From a food hygiene perspec-tives this topic has high priority in Hungary.

The results of dietary analyses carried out by theNational Institute for Nutrition Hygiene in 1995are shown in Table 8. 9/8.

Tasks:Monitoring the PCBs in food, breast milkand daily diet;Banning the use of materials containing PCBs;Control of industrial PCB emissions (includ-ing incinerators).

10. Polychlorinated dibenzo-dioxins and poly-chlorinated dibenzo-furans

There are no national data on the occurrence andlevel of dibenzo-dioxins and polychlorinateddibenzo-furans in food. As part of an internationalcooperation, two human milk samples were exam-ined abroad and proved to be less contaminatedthan samples from other European countries. Thetopic can be regarded as of high priority.

Tasks:Creating testing capacity;Monitoring of indicator foods, breast milk anddaily diet.

11. Pesticides

The registration of pesticides takes place understrict conditions in Hungary. Respect of instruc-tions of use and waiting times ensure the degrada-tion of residues before harvesting. Examinationsin recent years found that about 1% of the samplestested exceeded the maximum limits.

Microbiological contaminationHistorically, infections acquired through theintake of food have been of great public healthimportance. For example, the centralization ofmilk processing in dairies and the wide distribu-tion of milk in urban areas led to epidemics untilheat treatment was made obligatory, and hygienicinspection of the food production chain was estab-lished. Food control aiming at the prevention offoodborne infections is, therefore, still of greatimportance for the health of the population. Thereported food infections and food poisonings areshown in Fig. 8. 9/9, 8. 9/10 and 8. 9/11.

The infection of animals occurs in the environ-ment of animal husbandry partly due to hygienicdeficiencies and partly to the infectivity of import-ed fodder. In food-borne epidemics and diseases,Salmonellae bacteria of animal origin play thedecisive role. Therefore, the environmental hygieneof animal husbandry and of food processing ofanimal origin must be prioritized.

The following table lists some main tasks to besolved.

76

Food Safety 8. 9

77

8. 9 Food Safety

78

Food Safety 8. 9

Prev

entio

n of

food

cont

amin

atio

n

Prev

entio

n of

food

co

ntam

inat

ion

with

lead

; B

anni

ng p

rodu

ctio

n on

soil

cont

amin

ated

with

cadm

ium

; R

educ

ing

nitra

te c

onte

ntin

food

; El

imin

atin

g po

llutio

nso

urce

s an

d re

duci

ngem

issi

on;

Prev

entin

g us

e of

su

bsta

nces

with

PC

B;

Prev

entio

n of

mic

robi

olog

ical

co

ntam

inat

ion

of fo

od.

Dat

a co

llect

ion,

su

rvey

and

stud

y

Syst

emat

ic a

naly

sis

ofco

ntam

inat

ed s

oil (

for

lead

, cad

miu

m, P

CB

,et

c.);

Impr

ovem

ent

of c

apac

ityan

d m

etho

ds o

f lab

orat

orie

s.

Res

earc

h, d

evel

opm

ent

Con

tinuo

us m

onito

ring

of fo

od;

In c

onta

min

ated

regi

ons,

com

plex

sur

vey

(soi

l and

pop

ulat

ion)

;M

onito

ring

PCB

con

tent

of b

reas

t milk

and

dai

lydi

etar

y in

take

.

Leg

isla

tion,

adm

inis

trat

ive

mea

sure

s

Ada

ptat

ion

to th

e EU

legi

slat

ion;

Am

endi

ng n

atio

nal

legi

slat

ion.

Edu

catio

n, in

form

atio

n

Educ

atio

n fo

r pro

per

nutri

tion;

Reg

ular

info

rmat

ion

ofth

e po

pula

tion.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

1. Analysis of the situation

Housing situationAccording to the statistics 62.7% of the populationlives in towns in Hungary. This is due to migrationand an increasing number of settlements beinggiven the status of “town”. The concentrated de-velopment of industry resulted in migration andshortage of housing and the only solution was tobuild large housing estates. Between 1961 and1990 more than 2 million flats were built, includ-ing a 15-year period of the socalled “housing pro-gramme”.

Not only the number of home units but also thenumber of rooms and the average area of flats hasincreased. The proportion of one-room flats hasdecreased while the number of flats with two orthree rooms has increased. The number of roomsper flat increased by 50% between 1970 and 1990(Table 8. 10/1). The geographical situation, how-ever, differs, as in Budapest the proportion of flatswith 3 or more rooms is only 25% against 38.5%in the rest of the country. (Table 8. 10/2)

The increasing number of apartments has resultedin a favourable development of the density of occu-pants. In 1960 their number per 100 rooms was245, decreasing over 35 years to 108. However,this improvement hides the fact that the larger flatswere built by smaller and, therefore, better-offfamilies. By the end of the 1990s, in about 22% ofthe flats there were 1.5 persons per room.

Unfortunately not enough green areas were laidout for the large housing estates. In 1994 the aver-age area of green public sites in towns was 35.2 m2

per inhabitant (13.3–76.4 m2; Budapest: 38.6m2). While the new housing estates were followed by

a reasonable development of the basic infrastruc-ture, the density of dwellers was intolerable. Alsothe industrialised construction process broughtmany problems resulting from new materials,equipment and technology.

Factors like low ceilings, low permeability ofconcrete walls and improved insulation for energysaving reasons since the second half of the 1980shave caused emission of pollutants in apartmentsin harmful concentrations.

New equipment, coating and covering materialsdischarge several pollutants, including formalde-hyde emanating from chipboard (glued wood-

fibres), insulating and adhesive materials, wallpa-pers, carpets, etc. Hardly any information exists inHungary about the concentration of organic com-pounds used in paints, lacquers, building and cov-ering materials used in homes.

In villages, homes are usually heated with solidfuel. In towns, gas heating is quite frequent butmodern housing estates are supplied with districtheating (Table 8. 10/3). The negative side of theimprovement brought by district heating is that thehumidity is low and the temperature cannot beadjusted to individual needs.

Gas heating may be considered an advantage ifthe flue gas is conducted away through a chimney.In many cases so-called “parapet” appliances areused where the exhaust gas is emitted from theroom directly under the windows. Around largebuildings with several storeys heated by this sys-tem, the nitrogen oxide and carbon monoxide con-centrations may become so high in the heating sea-son that the apartments cannot be effectively aired.

Even in one-storey buildings the exhaust gasmay enter rooms through the windows.

Radon is a special pollutant in the indoor atmo-sphere of apartments. Radon emanates from thesoil with large geographical variations. In Mátra-derecske in the Mátra mountains extremely highconcentrations have recently been measured. Theconcentration of radon is much lower in buildingsconstructed with a cellar but building materialsmay discharge radon as well, or it may be foundalong the water supply system. Improved insula-tion and a low rate of ventilation can result inhigher concentrations. Besides the natural contentof radioactivity in building materials some addi-tives such as slag and ash from power stations mayshow high activity.

Among building materials, products made ofconcrete with asbestos should be specifically men-tioned because they are used for roofs, coveringsheets and pipes.

From the 1980s the growth of mould in apart-ments is an increasing problem due to insufficientventilation and heating and the construction prin-ciples used. Table 8. 10/4 showes the utilities ofhome units.

79

Urban Environment 8. 10

8. 10 Urban Environment

2. Health impacts

The relationship between urban conditions and thehealth status of the population is generally quitecomplex.

According to Hungarian studies, a high densityof dwellings, heavy traffic, noise and polluted aircontribute to the high incidence of neurosis andother pshychosomatic diseases such as high bloodpressure and gastric ulcers.

In housing estates conditions are not generallysuitable for the kind of physical exercise thatwould promote a healthy life style. Among chil-dren living in housing estates the prevalence ofvegetative instability is quite high due to lack ofphysical exercise and staying too little outdoors.According to the results of a survey covering morethan 2,700 apartments in Budapest, the signs of“sick building syndrome” were significantly morefrequent in modern housing estates than in tradi-tionally built buildings.

The unfavourable conditions of housing estates– besides the density of dwellers – originate fromthe ground-plan of the flats which is not adoptableto individual needs. Owing to plastic materials,formaldehyde emission and mites in the dust,allergic respiratory diseases (such as asthma) aremuch more frequent in modern buildings made ofconcreteelements than in traditional brick build-ings. Mould also seems to be one of the main caus-es of asthmatic disease.

In crowded flats the incidence of respiratory dis-eases – spread by droplet infection – is increased.The social conditions and resistance to disease ofpeople living in crowded apartments are generallypoorer than where fewer people live together, con-tributing to a higher frequency of diseases.

Many studies have found a relationship betweenthe high nitrogen oxide concentrations caused bygas appliances and acute respiratory diseases inchildren.

Radon is a well-known carcinogen. Calculatedon the basis of the WHO Guideline (1987), inHungary, 100–400 lung cancer cases annually areestimated to be due to the effect of radon and itscomponents. The estimated figure is ten timeshigher among uranium miners. In several countriesthe proportional mortality of lung cancer caused byradon and its components is 5–15%. The popula-tion risk estimated for Hungary on the base of thecancer cases referred to above, seems reasonable

because the main cause of the 7,500 annual casesof primary lung cancer would be smoking.

Asbestos is another carcinogen – inducing mainlymesotheliomas by inhalation. The number ofmesothelioma cases per year (among these all pri-mary and secondary cancers of the pleura) is about100, registered by the National PulmonologicalInstitute.


The conditions of the urban environment with itsbuildings and apartments should satisfy the fol-lowing demands:

ensure adequate protection against theunfavourable effects of the outdoor envi-ronment;ensure the necessary circumstances forthe regeneration of the organism;ensure the necessary conditions for thedwellers to wash, cook, learn, run culturalactivities and live a healthy family andsocial life.

If these requirements are realised, the urban sur-roundings can contribute to the health status envis-aged by the broad WHO definition.

Besides the long-term optimal goals, it shouldbe ensured as a short-term minimum requirement,that housing does not damage the health status ofinhabitants.


One basic problem is the contradictory and imper-fect legislation. The “Act No. III 1964 on BuildingAffairs” is under review but not yet approved. The“National Building Rules” has been amended sev-eral times but is not longer up-to-date.

Several new types of buildings, constructionforms and specifications have appeared in recentyears along with new enterprises, but without anyappropriate legal background. The national stan-dards are no longer valid and the former technicalguidelines are not obligatory.

According to the law on local authorities, specialbuilding regulations may be issued locally but theymust not contradict the provisions of the NationalRules. This creates many practical difficulties.During the industrialised building era, the tradition-al building culture could not be maintained. Theemerging problems were solved in a practical way

80


with little attention being paid to the principle ofprevention. Thus, hardly any experience has beengained in how to plan buildings, and which materi-als to use to prevent harmful health effects.

In Hungary no rules are in force to regulate theclassification of building materials from a healthperspective and to determine requirements forchemical and microbiological discharges into theindoor atmosphere.

There is no limit value for acceptable radioac-tive concentrations (the standard No. 62 does notcontain any regulation). Based on research, twodecrees are presently in force (26/1960 ÉM and46/1969 ÉVM) banning the use of certain slagsfrom power stations to construct dwellings anddetermining the types of storage buildings wherethis material may be used.

The insufficient areas of parks and green areasmean that important functions of dwellings (likerecreation and sport) are missing and also that thebuilt-up area is crowded with urban traffic, caus-ing air pollution and noise.

In big towns the air and soil of playgrounds isoften so polluted that they are unsuitable for theirintended functions.

In urban areas rules for dog-keeping are non-existentcausing health risks first of all for small children.

Another serious public health problem is the fre-quent presence of Ambrosia weed on neglectedsites in towns causing allergic and asthmatic dis-ease. (As shown in Fig. 8. 1/8)


Efforts to implement the WHO “Health for All”programme target No. 24: “by the year 2000 townsand rural settlements should ensure for the inhabi-tants a physical and social environment promotinghealth conservation”.

Amendment of the Law On Construction WorkManagement and development of the newNational Building Rules.


Tasks are summarized in the following table.

81


Total population, number of home units, average number of rooms per unit and the number of dwellers per room

Table 8. 10/1

Distribution of the number of rooms per occupied home units (196–90)Table 8. 10/2

1960 1970 1980 1990 1995Population (thousands) 9961 10322 10709 10375 10246Number of home units

2758 3122 3542 3853 3971(thousands)Average number of rooms per flat 1.5 1.6 2.0 2.4 2.4Number of dwellers per room 245 202 152 114 108

Number1960 1970 1980 1990 Of which

of rooms

Budapest Other

Villagestowns

1 room 62.5 45.7 27.7 17.5 52.2 14.5 16.52 rooms 32.8 43.8 52.2 50.6 49.7 55.2 44.83 rooms 4.7 10.4 20.1 32.2 25.0 30.3 38.5

Distribution of occupied home units by heating formTable 8. 10/3

Utilis in the occupied home units, 1990Table 8. 10/3

82


As a percentage (%) of the occupied flatsEquipment National total Budapest Other towns VillagesPiped water 84.5 98.7 89.8 70.6Of which: Water network 79.1 98.4 87.7 58.8Gas mains 40.9 78.7 50.4 8.7Bottled gas 45.8 5.7 35.8 79.7Flush toilets 75.3 90.7 83.0 57.9Local sewage Of which: Sewage network

85–44.3 98.8–86.9 90.3–58.9 71.3–3.8

National total Budapest Other towns VillagesNumber of occupied

3637 765 1518 1354home units (thousands)

Heating form As a percentage (%) of the occupied flats

Central heating 42.6 51.8 49.5 29.8Of which:

District heating16.9 31.6 24.2 0.4

Central heating in the building 2.9 5.8 3.4 0.7Central heating in the flat 22.8 14.4 21.9 28.7

Individual heating in the rooms 57.4 48.2 50.5 70.2Of which:

Electricity3.4 6.4 2.5 26.0

Gas 18.1 32.4 22.5 5.0Oil 4.5 2.6 4.3 5.8Wood 7.8 1.0 3.6 16.4Coal 23.4 5.4 17.5 40.3Other 0.2 0.4 0.1 0.1

83


Prac

tical

task

s

Intro

duci

ng

clas

sific

atio

n of

equi

pmen

t, bu

ildin

g an

d co

ver-

ing

mat

eria

ls u

sed

indo

ors

indw

ellin

gs, a

nd a

n ap

prov

al s

ys-

tem

for

thei

r ap

plic

atio

n fr

om a

heal

th p

oint

of v

iew

; H

eatin

g an

d co

okin

g m

etho

dsan

d ap

plia

nces

tha

t po

llute

the

indo

or a

ir sh

ould

be

avoi

ded;

D

urin

g th

e pl

anni

ng,

cons

truc-

tion

and

oper

atio

n of

new

hou

s-es

, he

alth

as

pect

s sh

ould

be

take

n in

to c

onsi

dera

tion;

Furth

er d

evel

opm

ent o

f par

ks an

dgr

een

area

s sh

ould

be

a fu

n-da

men

tal g

oal o

f urb

an-p

lann

ing.

All

negl

ecte

d ar

eas s

houl

d be

sur-

veye

d w

ith th

e ai

m o

f es

tabl

ish-

ing

park

s or

at

leas

t er

adic

atin

gA

mbr

osia

wee

ds;

In s

ettle

men

ts,

spec

ial

plac

essh

ould

be

desi

gnat

ed f

or d

ogex

erci

sing

in th

e ne

ighb

ourh

ood,

and

dogs

sho

uld

not b

e al

low

edac

cess

to p

layg

roun

ds.

Surv

ery,

mon

itori

ng

Asu

rvey

sho

uld

be i

nitia

ted

tom

easu

re th

e ex

posu

re o

f the

pop

-ul

atio

n to

ra

don

in

diff

eren

tty

pes o

f bui

ldin

gs a

lso

dete

rmin

-in

g th

e ra

dioa

ctiv

ity o

f bu

ildin

gm

ater

ials

an

d na

tura

l w

ater

sour

ces;

Furth

er re

sear

ch is

nee

ded

on th

ehe

alth

effe

cts

of r

adon

con

cen-

tratio

ns i

n dw

ellin

gs a

nd w

ork-

plac

es. F

urth

er re

sear

ch is

nee

d-ed

on

the

rela

tions

hip

betw

een

life

cond

ition

s res

ultin

g fr

om th

eus

e of

bui

ldin

g an

d ot

her m

ater

i-al

s an

d eq

uipm

ent,

and

the

heal

th st

atus

of d

wel

lers

to d

eter

-m

ine

requ

irem

ents

.

Offi

cial

mea

sure

s, le

gisl

atio

n

Rev

isin

g th

e N

atio

nal B

uild

ing

Rul

es;

App

roxi

mat

ing

to

and

har-

mon

isin

g w

ith t

he l

egis

latio

nof

the

EU.

Edu

catio

n, in

form

atio

n

Engi

neer

s, fa

mily

doc

tors

and

the

popu

latio

n sh

ould

be

in-

form

ed o

n th

e he

alth

asp

ects

of

hous

ing;

Reg

ular

pub

licat

ion

of i

nfor

-m

atio

n ab

out h

ousi

ng;

Educ

atin

g pr

oper

beh

avio

ur.

Tank

s lis

ted

acco

rdin

d to

type

s of a

ctio

n


The health status of the population is influencedby environmental factors – in many cases to a con-siderable extent. In order to analyse and evaluatethese factors and their impact, reliable informa-tion, based on solid data should be available.There is a continuous need for registering andanalysing relevant data on the environment andfactors characterising health status to evaluaterelationships. This can be carried out only withharmonised work.


Establishment of harmonised databaseson the status of human health and theenvironment;Establishment and development of corre-sponding infrastructure (like GIS);Development of an evaluation and report-ing system for decision makers on theinteraction of environment and health;Public information and ensuring avail-ability of data are basic requirements.


Since establishing a complex system includes thelong-term operation as well, it is important to en-sure an adequate budget for operation and mainte-nance. The legal and financial background are alsoessential. Data concerning the environment andhealth are collected, stored and evaluated in anumber of institutes, belonging to different min-istries. Quite understandably, the aspects of datacollection, the method of verification and valida-tion is different in various institutes. It is desirableto achieve a system in which data could be mutu-ally beneficially used.

It is necessary to establish an up-to-date infra-structure to deal with all informationrelated issues.

There are administrative, legal and very oftenfinancial obstacles which prevent further develop-ment of the existing system.

4. General tasks and basic principles

The complex relationship between environment andhealth can only be understood and dealt with, if thechanges and their results can be followed in timeand space. In order to achieve this, a well organisedstructure should be established for data collection,storage, elaboration, evaluation and reporting.

Data collection, structure of data basesWhen collecting data, the smallest possible aggre-gation level should be the aim. By utilising geo-graphic presentation and evaluation, an effortshould be made to attain the highest possible reso-lution. Individual data should be collected at thelowest level (district, city, county).

Analysis and mode of evaluationRoutine and ad hoc analyses are required. For con-tinuous, routine analysis, a comprehensive systemshould be established with relevant experts.Changes and tendencies should be evaluated atintervals. Ad hoc evaluation is also needed forspecific purposes. Validity and fidelity of the eval-uation should always be ensured. Tools for betterunderstanding are statistical methods.

Selection of indicators for environmental healthProper assessment and evaluation of tendencies ofenvironmental health require indicators that arecharacteristic for the given changes. Despite seve-ral international conferences and workshops, noestablished system yet exists. It is highly desirablethat in collaboration with international institutesand agencies, a system of indicators for environ-mental health be established.

MandateIt is essential to understand that a system of suchcomplexity can only be achieved if the necessarymandate for collecting, storing, evaluating anddisseminating information is ensured and secured.

5. Tasks for achieving goals

The tasks are summarized in the table below.

84

Environmental Health Information System 9. 1

9. Implementation of the Hungarian Environmental Health Action Programme

9. 1 Environmental Health Information System (EHIS)

85

9. 1 Environmental Health Information System

Prac

tical

task

s(o

rgan

izat

ion,

con

trol

)

Det

erm

inat

ion

of th

e lis

t of

rou-

tine

anal

yses

and

of

the

user

sre

ques

ting

the

resu

lts;

Dat

a pr

oces

sing

and

det

erm

inin

gpr

oble

ms f

rom

the

prev

ious

per

i-od

s;D

efin

ing

prob

lem

s us

ing

heal

thin

dica

tors

;D

etai

led

anal

ysis

for

ide

ntifi

ca-

tion

of e

nviro

nmen

tal

fact

ors

influ

enci

ng h

ealth

sta

tus;

Ana

lytic

al m

etho

ds f

or e

valu

a-tio

n of

the

effe

cts;

Stud

y fo

r id

entif

icat

ion

of a

llco

ncer

ned

grou

ps.

Info

rmat

ion,

edu

catio

n,

publ

ic a

war

enes

s

Elab

orat

ion

of t

he s

yste

ms

with

activ

e pa

rtici

pant

s fro

m th

e pr

o-je

ct f

or r

eque

st of

inf

orm

atio

n,an

d fo

r use

of d

ata

and

resu

lts;

Publ

ishin

g re

sults

of

anal

ysis

onhe

alth

and

env

ironm

enta

l iss

ues;

Det

erm

inat

ion

of d

ata

publ

ishe

dfo

r the

pub

lic th

roug

h th

e m

edia

.

Adm

inis

trat

ive

mea

sure

s(te

chni

cal,

legi

slat

ive)

Cho

osin

g in

dica

tor p

aram

eter

s;M

arki

ng o

f pr

oble

mat

ic a

reas

by u

sing

sele

cted

hea

lth in

dica

-to

rs a

nd d

ata

with

the

hel

p of

expe

rts,

star

ting

eval

uatio

n,te

stin

g in

dica

tors

;Ta

sks

for c

ompl

etin

g da

taba

se:

– de

term

inin

g th

e ex

istin

g an

dco

mpl

emen

tary

dat

a –

dete

r-m

inin

g so

urce

s and

ava

ilabi

lity

of d

ata

– en

surin

g le

gal

and

finan

cial

bac

kgro

und

– de

ve-

lopm

ent

and

amen

dmen

t of

prog

ram

mes

for

mai

nten

ance

and

regi

stra

tion

of d

atab

ase.

Stud

y, su

rvey

, dat

a co

llect

ion

Iden

tifyi

ng in

dica

tors

;D

ata

proc

essi

ng;

Cho

osin

g pr

oper

in

dica

tors

,an

alys

ing

thei

r effe

ctiv

enes

s;Pr

ogra

mm

e fo

r eva

luat

ion;

St

atis

tical

pr

ogra

mm

es

and

elab

orat

ion

of d

ata

prep

arat

ion

syst

ems

for s

patia

l ana

lyse

s;D

evel

opm

ent

of p

rogr

amm

esan

d te

chni

cal

cond

ition

s fo

rst

orag

e an

d ac

cess

of r

esul

ts.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

1. Analysis of the present situation

The development of a health promoting environ-ment is one of the legal obligations of local aut-horities. However each local authority has to de-termine how this should be provided, dependingon local demands and financial conditions.

The basic health requirements of Hungarian laware the protection of healthy water supply, mainte-nance of public roads and cemeteries, lighting andprimary health and social care. The local authori-ties, of course, strive to comply with the require-ments but financial conditions make it difficult tolive up to the intentions of legislators.

The situation is complicated by the fact thatlocal authorities have limited powers in issuesrelating to the health status of inhabitants. ThisHungarian Environmental Health Action Prog-ramme cannot be implemented without the parti-cipation of local authorities but in many areas theyhave not been empowered to make decisions.

The implementation of the Action Programme isvery much dependent on central governmentaction as well. This means that all competent mini-stries must cooperate in solving the many environ-mental, regional planning and management prob-lems.

The public has become more and more aware ofits own responsibility for the environment andhealth. Hundreds of organizations, foundationsand associations have been set up and are operat-ing for different environment and health goals.Some county administrations have registeredthese non-governmental organizations (NGOs)and try to assist as coordinators, while others payless attention.

It should however be pointed out that whenreferring to NGOs, also the local professional/sci-entific and the business players (that is the localcommunities) are ment as well, all belonging tothe NGOs sector.

To solve special problems, cooperation betweenseveral local authorities may be necessary. Thismay facilitate the solution of problems and lead toa more uniform environmental health standard.Local authorities are not generally collecting envi-ronment and health data that allow comparison of

results with established limit values. Such collec-tion and evaluation of epidemiological data is newto these authorities and can only be performedwith the help of local Public Health Institutes.

Local authorities play an important role in limit-ing the harmful effects of pollution from localsources, such as industrial plants, traffic, energyand heat production and supply, and in securingwaste disposal and environment oriented regionalplanning.


Helping local authorities to develop a spe-cial environmental health strategy basedon sufficient expertise;Elaboration of guidelines for setting uplocal programmes;Ensuring availability of environmentalhealth data;Facilitating the opportunity for the publicand different economic and interestpro-tecting organizations to cooperate in theevaluation and solution of environmentalhealth problems.


National levelWithout the active involvement of the populationthe environmental health targets cannot be reached.

The principle of sustainability should be builtinto the strategies of all sectors. The conservationand safe exploitation of natural resources shouldbe taken into consideration to ensure – from anecological point of view – long-term improve-ments in the quality of life of the population andthe preservation of diversity in nature.

Regional levelLocal authorities (municipalities) should cooper-ate in the organization and evaluation of environ-mental health studies.

The environmental health status for an extendedarea with similar conditions should be charac-terised as this would lead to a more reliable ap-praisal of the situation.

86

Role of Local Government and NGOs 9. 2

9. 2 Role of Local authorities and NGOs in the implementation

of the Environment and Health Action Programme

Local levelPriority should be given to the approval and con-trol of industrial activities taking into account theprinciple of limiting any harmful impacts on healthor the environment.

In environmental health decision-making, atten-tion should be paid to the different effects of envi-ronmental pollutants.

Local authorities are obliged to monitor the localenvironmental conditions and the impacts on thehealth status of the population, to register relevantdata and to make these available to the public (inaccordance with existing legislation).


Most local authorities have plans and activities forthe management of parks and green areas andwaste collection and disposal.

As an indication of interest shown by the publicmany organizations have been established in re-cent years with the aim of improving health andpreserving the environment. The appearance ofthese NGOs is favourable and local authoritiesshould pay attention to their views. However, theyshould not depart too much from the necessarybasic environmental health activities.

Local authorities should be willing to coordinatethe work of the different NGOs. Their targets andmethods should be reviewed so that their re-sources could be used to facilitate the implemen-tation of the Action Programme.


The following table contains future tasks.

87

9. 2 Role of Local Government and NGOs

88

Role of Local Government and NGOs 9. 2

Adm

inis

trat

ive

mea

sure

s, lo

cal l

egis

latio

n

Revi

ew o

f rel

evan

t leg

islat

ion,

eva

luat

ing

fea-

sibili

ty a

nd a

men

ding

if n

eces

sary

; R

evie

w,

eval

uatio

n an

d ha

rmon

isat

ion

ofex

istin

g lo

cal p

rogr

amm

es;

Prom

otio

n of

the

wor

k of

loca

l aut

horit

ies

toim

prov

e ca

pabi

lity

for s

olvi

ng e

nviro

nmen

tal

heal

th p

robl

ems;

Rev

iew

of c

ompe

tenc

y an

d m

easu

res

of d

if-fe

rent

aut

horit

ies.

Stud

y, su

rvey

, dat

a co

llect

ion

and

eval

uatio

n

Prio

rity

setti

ng a

t loc

al le

vel,

colle

ctin

g, e

val-

uatin

g an

d ra

nkin

g da

ta;

Publ

ishi

ng d

ata

from

mon

itorin

g ne

twor

ks,

eval

uatin

g th

e ch

ange

s.

Edu

catio

n, in

form

atio

n, p

ublic

aw

aren

ess

Educ

atio

n of

repr

esen

tativ

es to

be

expe

rts in

the

field

of e

nviro

nmen

tal h

ealth

;En

forc

emen

t of e

nviro

nmen

tal h

ealth

vie

ws

in t

he w

ork

of l

ocal

aut

horit

ies

and

smal

len

terp

rises

;In

form

atio

n fo

r the

pop

ulat

ion

and

NG

Os;

Prom

otin

g lo

cal

initi

ativ

es a

nd p

artic

ipa-

tion

of th

e po

pula

tion.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

1. Environmental health institutions

The network of different institutions all have toanalyse the interrelations between human beingsand the environment, prevent harmful effects andrestore existing damage. These tasks are part ofthe social responsibility of the State.

Because of its special role, the “EnvironmentalHealth Service” should act independently and pur-posefully, being sufficiently sensitive to recognisethe needs and demands of the population, while per-forming its the authoritative duties and activities.

The activity is based on cooperation betweenseveral ministries. The most important ministriesand other bodies are the following:

2. Responsibilities of institutions

In Hungary environmental health issues tradition-ally belong to several ministries. However, in sev-eral respects, the existing system in not sufficient-ly efficient and effective due to fragmentation andoverlapping of responsibilities.

In the following, environmental health functionsare listed with an indication of the responsible mi-nistries and institutions:

89

Environment Health Institutions 9. 3

9. 3 Institutions Responsible for Environmental Health Issues

Ministry of Welfare (NM)National Public Health Service (ÁNTSZ)Ministry for Environment and Regional Policy (KTM)Environmental Inspectorates (KÖFE)Ministry for Traffic, Communication and Water Management (KHVM)Water Management Directorates (VIZIG)Ministry of Agriculture (FM)Agrochemical and Plant Protection Stations (NAK)Veterinary and Food Control Stations (VA)Ministry of Labour (MüM)Ministry of Internal Affairs (BM)Local governmentsMinistry of Defence (HM)Ministry of Industry, Trade and Tourism (IKIM)

Discharges (emissions)Registering and controlling emissions to the environment (air, water, soil) KTM, KHVM, NMRegistering and controlling waste collection and disposal KTM, NMProduction, transport and trading of chemicals IKIM, NMRadiation IKIM, NMMicrobiological factors and vectors FM, NMWork environment MüM, NM

Ambient concentrations (immissons)Air: ambient air quality NM

background concentration KTMtransmission KTM

Water: Surface water KTM, KHVM, NMGroundwater KTM, KHVMDrinking water, recreational water NMMineral water, bottled water NM, FMSewage KHVM, KTM, NM

Soil: Quality, pollution FM, KTMDwellings: Quality, pollutants, urban environment KTM, NMCustomer products, household chemicals NM, IKIM, KTM

Quality assurance and control of food stuff FM, NMMonitoring of health status NM

Revealing harmful impacts NMAnalysis of factors relating to health NMPreventive measures and evaluation NM

Monitoring environmental status KTM

The role of the National Public Health ServiceAnalysis and monitoring with laboratory methods:

Ambient air quality in urban areasIndoor air qualityDrinking water qualityQuality of bathing and surface waterWork environmentDisposal of household wastes (interministerial task)Qualification and disposal of hazardous wastes (interministerial task)Nuisance caused by noise in settlements

Inspection and survey:Health status of population with epidemiological methodsActivities (places of work, settlements, institutions, enterprises)

Control, approval:Work with dangerous materialsUsage of buildings and other establishments

Research:In the field of preventionCauses of infectious and other diseasesImpacts of pollutants on health (air, water, waste, chemicals, physical agents, etc.)

90

9. 3 Environment Health Institutions

Assistance from other organizationsAt university departments of public health, epi-demiology, hygiene and social medicine researchin the different fields of environmental health, epi-demiological studies and provisions for regionalduties are undertaken besides education.

The activity of representatives from NGOs andlocal governments is very useful. For examplethey are actively participating in the WHOHealthy Cities Movement which also involvessome rural settlements and regions

2. Future tasks of the institutions

The future tasks of the environmental health ser-vice should be redefined as part of the healthreform, bearing in mind the results of previousnational and international analyses.

The basic elements should be the following:determination of the duties of the State;improvement of effectiveness;closer cooperation among the competentagencies.

It is essential that the different institutions andagencies performing similar activities coordinatetheir work to avoid unnecessary duplication. Themost important requirement is to clarify the res-ponsibilities of the state.

91

Environment Health Institutions 9. 3

The Ministerial Conference in Helsinki confirmedand declared the need to improve and extendresearch on environmental health issues.

Identification of the possibilities of preventioncannot be achieved without recognising the rela-tionship between causes and effects. Besides themany well-known pollution impacts, new factorshave appeared whose effects are not yet known.The early recognition of damages and monitoringof the exposed population – especially sensitivesubpopulations – are activities of great signifi-cance. The improvement of methodology shouldbe emphasised as well because of the unbelievablyfast technological development.

Analysis of solutions and technical means ori-ented towards improving the present status of theenvironment may also be an important area for theAction Programme.

Research of relevance to environmental healthcannot be separated from other environmental andhealth research activities and it is impossible tomake an exhaustive list.

Research in this field may be divided into fivemain groups:

Identification, qualitative and quantitative de-termination of environmental impacts (physi-cal, chemical, biological) and experimentalstudies of the mechanisms of health effects;Qualitative and quantitative identification ofexpected and real exposure. Methodology ofhow to estimate exposure;Studying the relationship between exposuredose and health effect; qualiative and quanti-tative doseresponse analyses, experimentallyand in human populations;Based on the above work, risk estimation ofthe damage to health and risk analysis;Different forms of risk control and practicalrealization.

1. Ongoing and future epidemiological researchin the field of environmental health

Air pollution and respiratory diseases:Acute and chronic respiratory diseases (asth-ma, allergic syndromes). There is an ongoingepidemiological study – in international co-operation – on the effects of sulphur dioxideand suspended particulates on the occurrenceof respiratory diseases;Measuring indoor air quality; monitoring theeffects of passive smoking; studying the roleof indoor allergens, radon and other physicalfactors; Monitoring some components of air pollu-tants coming from traffic; identification andtesting biological effects of indicator com-pounds (toxicity, genotoxicity, etc.) (lead,benzene, PAH, ect.);Testing and monitoring of carcinogenic airpollutants at molecular level (identificationand methodological development of carcino-genic adducts);Research on the relationship between air pol-lution and the frequency of congenital disor-ders.

Pollution of drinking water, analysis of the appear-ance and biological effects of harmful factors withspecial regard to carcinogenic compounds:

Chlorination by-products (trihalomethanes,MX-type compounds);Epidemiological study in populations con-suming water containing arsenic to revealhealth damages;Analysing microcomponents of naturalwater (mineral and medicinal water);Microbiological pollutants of surface andbathing water – methodological develop-ment (virus diagnostics, using molecularmethods).

Research on the toxic, mutagenic and carcinogeniceffects of chemical factors in the environment:

Study of mutagenic and carcinogenic effectsof pesticides;Analysis of xenobiotics with oestrogeniceffects; prevention of harmful effects.

Improvement of methods for classifying wastes:

92

Environmental Health Research 9. 4

9. 4 Improvement and Support of Environmental Health Research

Introduction of micromethods for identifyingand characterising chemical and microbio-logical pollutants;Development of methods for determinationand analysis of environmental hazards; im-proving ecotoxicological methods.

2. Institutions taking part in environmental research

The national institutes and the relevant faculties ofthe different universities take part in the researchwork. Possibilities should be given to the regionalorganizations and institutions to become involvedinto the elaboration of research programmes,evaluation of results and accomplishing the tasks.

93

9. 4 Environmental Health Research

Today environmental health forms a new branchof science dealing with the single or combinedimpacts and consequences of physical, chemical,microbiological, toxicological, psychological andbiological factors – existing in the natural, socialand urban environments – on individual humanbeings and the whole population. Environmentalhealth practice applies the results of scientificstudies and laboratory activities. Environmentalhealth interventions are preventive in character.The aim is to ensure harmony between the indi-vidual (or the whole population) and the envi-ronment for the benefit of society, bearing in mindthe concept of sustainable development. Educa-tion and training in the field of environmentalhealth can be divided into two main areas:

Specialised training is needed for profes-sionals who are working in this field and,therefore, must acquire a sufficient level ofexpertise;A culture of environmental health should bepart of our life style. It should be an impor-tant element in human behaviour and cus-toms. This cultural side should be recognisedin the everyday life of people. It should berooted in the family and later on formed byschools and other educational institutions.

The culture of environmental health is based onprevention and its goal is to achieve harmonybetween people and the environment in the inter-est of sustainable development.

1. Situation of environmental health education and training

The formation of habits starts in the family andcontinues in kindergarten, then by the institutionaleducational system, to influence future life styleand value systems.

KindergartensKindergartens, as institutions, function accordingto the Law on Public Education teaching childrenbetween 3 and 7 years until they enter school.Education takes the form of special lessons butmost important is the whole way of life in thekindergarten. In the educational programme, envi-ronmental health should be a pedagogical ideawhich inspires the whole lifestyle in the kinder-

garten. The development of children is continu-ously monitored with screening for growth prob-lems and any need for medical and psychologicalhelp so that any deviations can be corrected orcompensated. There are many differences amongkindergartens depending on regional conditions,size, staff and equipment, and consequently, on theeducational programmes. There are hardly anykindergartens where only the minimal require-ments are ensured. In recent years more and morekindergartens have achieved excellent results inthe field of environmental health education.

Primary schoolsThe practice of enrolling pupils in primary schoolsmay be considered exemplary compared withstandards in other European countries. By laweach child should go to a type of school which issuited to its maturity. All children have the right toan education that “corresponds to their interest,maturity and ability”. This requirement, however,does not always meet the ambition, interest andfinancial resources of the parents. Many factors ofthe schooling system jeopardise the health statusof children. Due to the high number of lessons, thelack of physical exercise and hardly any time tostay outdoors, the living conditions of school chil-dren cannot be said to be satisfactory.

Secondary schools and vocational schoolsAt most of the secondary schools and vocationalschools environmental and health education takesplace during the lessons of the principal form teach-er. In other subjects this education depends on thementality and expertise of the particular teacher.

Higher educationAt the institutions of higher education environ-mental health is not properly and satisfactorilytaught.

Postgraduate educationEducation at the postgraduate level is mainlyaimed at training experts who are already workingin the environmental health field.

Education outside the school system, further trainingSpecialised training is most important in this fieldof education.

94

Education and Training 9. 5

9. 5 Education and training in environmental health

2. Health impact

Environmental health education, generally, canonly be expected to have long term and indirectresults. This education, if properly performed, canprevent the effect of existing harmful factors in theenvironment. If this subject is not treated properlyby teaching institutions it can be expected to havea negative effect on the health of the population.


The goal of improving environmental healtheducation is to introduce this form of know-ledge – necessary for a healthy everyday life –into all types of teaching institutions, fromkindergartens to universities. Besides this, spe-cial training is needed at expert institutions toteach health workers and other professionalswho will work in this field.


KindergartensIn recent years several kindergartens joined thenetwork of the Environmental Educational Centreor are members of KÖRLÁNC (Chain circle).Further training of teachers is a regular activityand information about their experience has beenwidely spread to colleagues.

Primary schoolsThe idea of primary prevention appears in the cur-ricula. The main goal is to instruct and informchildren about a healthy lifestyle.

In practice, the lessons of the principal formteacher (in classes 3–8), biology lessons (in class-es 6–8), “residential schools” (in classes 1–8) and“daycare centres” give an opportunity for this kindof education. In the practice of teachers the appli-cation of new pedagogical methods like those ofWaldorf, Freinet and Rogers, Montessori and“Gesamtschule” has meant a positive change.These methods represent new directions in peda-gogical practice emphasising the relationshipbetween environment and human beings, theirlifestyle and basic values. In the school system thefollowing alternative methods have been intro-duced since 1986:

Programme of “transmitting values anddeveloping skills” led by Dr J. Zsolnai where

children gain basic knowledge of environ-ment and health issues in the frame of thesubject “Human nature”. The programmehas been developed for 8 class levels, andteachers are assisted by special teaching ma-terial;The plan of teaching called “Fifty-fifty” hasbeen available since 1990. In the frame of“nature” and “social issues” important ex-amples of the damage done by human beingsare analysed; An alternative curriculum for biology waspublished in 1991. Lessons on physiology andevolution – containing environment and healthtopics as well – are included for the 8 class lev-els of primary school; “Forest schools” were started in 1986, mean-ing that lessons are held in the “classroom ofnature”. Students make observations, study-ing the characteristics of the given naturalenvironment. The value of this form is tolearn to work together and it may have animpact on the future lifestyle of the childrenas well.

Secondary schoolsIn the 1980s a new programme called “Mankind andNature” was started. It was elaborated for schoolswhere the curriculum does not include biology as anindependent subject. The programme has been fur-ther developed by the schools and also serves asbasic material for the “special schools” that giveparticular emphasis to biology or other subjects. In“vocational schools” the subject is taught in theframe of occupational health and safety.

The tuition is not comprehensive, consistingonly of special and firstaid issues relating to thegiven trade. In secondary schools for health work-ers (nurses, laboratory assistants, emergency staff,etc.) environmental health is an independent sub-ject. This is to supplement traditional subjects likehygiene and epidemiology.

Higher educationAt the universities and special colleges medicaldoctors, dentists, pharmacists, hygienists, ambu-lance officers, nurses, etc. are trained, but envi-ronmental health is not included as a special sub-ject. This topic is taught in the frame of other sub-jects and the emphasis given depends on the atti-tude of the lecturers and the number of lessons.

95

9. 5 Education and Training

To improve the general understanding of environ-mental health problems, the education of teachers isvery important. The main goal of the education ofteachers is to prepare them for improving the wholepersonality of the child. Forming behaviour andcustoms in childhood is a part of the tuition. In theframe of other topics such as training for familylife, home economics, nature and health education,environment and health are given considerableemphasis. In pedagogy and psychology, studentslearn about developmental disorders, the causes andmethods for correction and compensation.

The effect of this education depends on the atti-tude of the teachers, their personal beliefs andconvictions. As the teachers are generally over-burdened the results do not always live up to theaims.

Post-graduate and extracurricular educationIn this field the following forms of education areavailable:

Education of medical doctors specialising inpublic health and hygiene (including envi-ronmental health), epidemiology, occupa-tional health, etc;Special courses for health managers, publichealth medical officers, infectious diseaseepidemiologists, etc. It is planned to be estab-lish in the near future a public health school.

Project activitiesEnvironmental health education and training issupported by special projects frequently in co-operation with international organizations or indi-vidual countries.

In 1992 Hungary joined a programmeoffered by the UN. By 1996 2,000 teacherswere to be trained. Each school gets theprogramme, adapted to Hungarian condi-tions, free. This programme can be used bothin primary and secondary schools for teach-ing health issues; Among the environmental projects support-ed by PHARE is a postgraduate programmefor teachers, including environmental healthissues;A programme supported by the Swiss gov-ernment to make the school curriculum“green”. Special courses are organized andsuggestions given as to how to the topic canbe integrated into other subjects;

The DADA programme developed in theUSA, against smoking, drug use and the pre-vention of AIDS. This programme is beingused by many schools in Budapest withpolice assistance;A European measuring programme for theimpact of ozone and acid rain, initiated byNorway. About 1,000 Hungarian schools areparticipating in the programme;Movements and campaigns for selectivewaste collection; applications for grants andcompetitions; celebration of environmentallyimportant occasions; and the “cleaning up”movement, are all significant activities;The KÖRLÁNC (Chain circle) projectinvolves hundreds of schools, kindergartensand teacher training institutions. Its maintask is to inform and help with organizingconferences and publishing literature;The Soros Foundation, Tempus Programme,Fact Foundation and other similar sourceshelp with environment and health educationby giving possibilities for financial support.

The work of the Environment and Nature ProtectionCentre is important as well. For more than twentyyears this centre has been organizing programmes atdifferent schools on environment topics.

Several NGOs deal with education and informa-tion. The task of these organizations is first of allpractical activities in the field of environment andhealth.

The media have an important role in informingand educating the public about positive attitudesand behaviour. Radio and television have broad-cast many programmes of this kind in recent yearswhich seems to have a positive impact on publicopinion.

In the environmental health education pro-gramme, journals and books play an importantrole as well. Ministries and different organizationssupport such publications but the choice of teach-ing material is not yet satisfactory.


Education is one of the preventive tools showingresults only in a long term perspective. Changingpublic attitudes, customs and behaviour in a positivedirection is the ultimate aim of health promotion.

The following table outlines future tasks.

96

Education and Training 9. 5

97

9. 5 Education and Training

Prac

tical

task

s(o

rgan

izat

ion,

con

trol

)

Spec

ial f

urth

er tr

aini

ng fo

r sch

ool

and

kind

erga

rten

teac

hers

;Sp

read

ing

info

rmat

ion

in s

peci

aljo

urna

ls,

info

rmin

g as

soci

atio

nsan

d ex

pert

grou

ps;

Impr

ovem

ent

of

info

rmat

ion

syst

em a

nd m

etho

ds o

n to

pics

rela

ting

to e

nviro

nmen

tal h

ealth

;D

eman

d fo

r th

e m

edia

to ta

ke a

grea

ter

part

in i

nfor

min

g th

epu

blic

to im

prov

e pu

blic

aw

are-

ness

;A

genc

ies f

or re

gula

r inf

orm

atio

nof

the

publ

ic;

Proj

ects

invo

lvin

g lo

cal p

opul

a-tio

n, N

GO

s, sc

hool

s an

d lo

cal

auth

oriti

es;

Invo

lvem

ent

of f

amily

doc

tors

,pr

ovid

ing

them

with

lite

ratu

re.

Info

rmat

ion,

edu

catio

n,

publ

ic a

war

enes

s

Educ

atio

n sh

ould

inc

lude

soc

ial

fact

ors

as w

ell p

layi

ng a

sig

nifi-

cant

role

in e

nviro

nmen

tal h

ealth

issu

es;

Educ

atio

n is

one

of

the

long

-te

rm m

etho

ds. P

ublic

aw

aren

ess

is

impo

rtant

to

fo

rm

prop

erbe

havi

our a

s the

bas

ic e

lem

ent i

nth

e pr

even

tion

of d

isea

ses;

Task

s of

ed

ucat

ion

can

beac

com

plis

hed

only

with

wid

e-sp

read

coo

pera

tion.

Adm

inis

trat

ive

mea

sure

s(te

chni

cal,

legi

slat

ive)

Clo

se c

oope

ratio

n am

ong

go-

vern

men

tal

agen

cies

an

dN

GO

s,

educ

atio

nal

and

rese

arch

ins

titut

ions

and

the

med

ia in

volv

ing

the

publ

ic;

Wid

espr

ead

info

rmat

ion

for t

hepu

blic

abo

ut t

he r

esul

ts o

f th

esu

cces

sful

loca

l ini

tiativ

es;

Educ

atio

n on

env

ironm

enta

lhe

alth

topi

cs s

houl

d be

incl

ud-

ed i

n th

e ed

ucat

iona

l pr

og-

ram

mes

at a

ll le

vels

;A

dvis

ory

syst

em

is

need

edin

volv

ing

the

loca

l Pu

blic

Hea

lth S

ervi

ces

for

info

rmin

gth

e pu

blic

;Su

ppor

t of

dis

able

d pe

ople

is

spec

ially

impo

rtant

bas

ed o

n th

etra

ditio

nally

goo

d pr

actic

e in

Hun

gary

(e.g

. Pet

ô In

stitu

te).

Inth

e sa

me

time

the

who

le p

opu-

latio

n is

to b

e ed

ucat

ed fo

r tol

-er

ance

.

Stud

y, su

rvey

, dat

a co

llect

ion

Prom

otio

n of

loca

l edu

catio

nal

sche

mes

com

plyi

ng w

ith t

hena

tiona

l sc

hedu

le.

Expe

rtssh

ould

take

par

t in

the

elab

ora-

tion

of to

pics

on

envi

ronm

enta

lhe

alth

.

Task

s lis

ted

acco

rdin

g to

type

s of a

ctio

n

The occurrence and negative effects of environ-ment problems frequently extend across nationalborders so that countries are not able to find solu-tions in isolation.

The Helsinki Conference stated, that the Euro-pean Environmental Health Action Programmeshould be established as a result of a widespreadinternational cooperative effort. This process hasbeen confirmed by the initiation of the “PilotProject Programme” in which Hungary is one ofthe participants.

1. Present cooperation

Hungary is actively engaged in international coop-eration is several environmental health field.Among the many different forms of cooperation,participation in several WHO programmes – relat-ed to environmental hazards with an impact onhealth – should particularly be mentioned.

WHO

EUROHEALTH. Extensive research hasbeen going on in the frame of WHO pro-grammes, not only in the field of environ-mental health, but also prevention in generaland primary health care;National Integrated Programme on En-vironment and Health (NIPEH) has been themost important programme during the pastthree years. Although it has been terminated,some of its subprograms – like improvementof information systems – will be continued inthe coming years;Environmental health education – coopera-tion to set up a programme for a school ofpublic health;Extending the Basic Environmental HealthTraining course.

98

International Relations 10.

10. International Relations

Hungarian Environmental Health Action Programme (NEHAP)

Abbreviations

NPHS National Public Health Service (Hun.)MoIA Ministry of Internal Affairs (Hun.)BTX Benzene, Toluene, XyleneCET Concern for Europe’s Tomorrow.

(Health and the Environment in the WHO European Region, 1995)CINDI Countrywide Integrated Noncommunicable Disease InterventionDADA Programme agaist tobacco, drog, alcohol and AIDSDDT Dichlor-diphenyl-trichloroethaneECEH European Centre on Environment and HealthEEC European Economic CommunityEHAPE Environmental Health Action Plan for EuropeEHIS Environmental Health Information SystemÉM or ÉVM Ministry responsible for constructions work (Hun.)EPI Extended Programme of ImmunizationEU European UnionEUROHEALTH WHO Regional committee programme supporting Central-Eastern European CountriesMoA Ministry of Agriculture (Hun.)GERMON Network operated by the WHO for exchanging dataGIS Geographic Information SystemGLP Good Laboratory PracticeHCB HexachlorobenzeneHCH Hexachloro-cyclohexaneHEHAP Hungarian Environmental Health Action ProgrammeHFA Health for All by the Year 2000HM Ministry of Defence (Hun.) HPLC High Pressure Liquid ChromatographyIKIM Ministry of Industry, Trade and Tourism (Hun.)ILO International Labour OfficeKHVM Ministry for Transport, Communication and Water Management (Hun.)KKA Central Environmental Protection Fund (Hun.)KÖFE: Environmental Inspectorates (Hun.)KÖRLÁNC “Chain circle” project (Hun.)KTM Ministry for Environment and Regional Policy (Hun.)MM Ministry of Labour (Hun.)MMMF Manmade Mineral FibresNAK Agrochemical and Plant Protection Stations (Hun.)NEP National Environmental Programme (Hun.)NEXT Nationwide Evaluation of X-ray TrendsNGO Non-Governmental OrganizationNIPEH National Integrated Programme of Environment and HealthMÜM Ministry of Welfare (Hun.)OECD Organization of Economic Cooperation and DevelopmentOKSER National Radiation Control System (Hun.)PAHs Polycyclic aromatic hydrocarbonsPCBs Polychlorinated biphenylsPHARE Polish and Hungarian Assistance for the Reconstruction of EconomyPIC Prior Informed Consent

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PVC Polyvinyl chlorideSPLUS Statistical Programme for Spatial AnalysisUN/ECE United Nations Economic Commission for EuropeUNCED United Nations Conference on Environment and DevelopmentVIZIG Water management Directorates (Hun.)VOC Volatile Organic CompoundsWHO World Health Organization

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