Methodical aspects in assessing risks of comorbid pathology occurrence under exposure to chemical environmental factors

Risk assessment methodology is a promising trend in examining effects produced by environmental factors on population health. However, at present little attention has been paid to issues related to comorbid pathologies occurrence under chronic exposure to toxicants. Our research goal was to improve methodic approaches to assessing risks of co-morbid pathology occurrence under exposure to multi-component chemical factors in the environment. Data and methods. To develop an algorithm for establishing a probability that comorbid pathology would occur, we analyzed scientific publications that focused on effects produced by technogenic chemicals on a body and health risk assessment methodology. Methodic approaches were tested with epidemiologic hygienic analysis techniques and statistical processing of data obtained via profound medical and biological examination of children living in Perm region where chemical enterprises were located. Results. We suggested a systemic approach to assessing risks of co-morbid pathologies caused by complex exposure to chemical environmental factors; the approach includes reference groups creation; determining responses in critical organs and systems via stage-by-stage modeling within «chemical factor - exposure marker - marker parameter - disease» system; determining population and individual risks of environmentally induced comorbid diseases. The performed analysis allowed establishing marker parameters of bronchial asthma and comorbid pathologies occurrence in children living on a territory with multi-component contamination of ambient air predominantly with saturated spirits, aldehydes, and particulate matter. It was shown that a number of additional comorbid diseases that were probabilistically related to increased chemicals contents in the examined children’s blood could amount up to 15 ‰, and a contribution made by the examined chemicals into comorbid pathology occurrence would reach 14.2-23.4 %. Implementation of mathematical analysis procedures outlined in the present work will make for higher efficiency of activities aimed at managing and minimizing health risks for people living under combined exposure to chemical environmental factors.