Kontaminacija hrane i agroproizvoda u Republici Makedoniji

The Republic of Macedonia has 662,000 ha of cultivated land with well-organised agricultural production. It is a well known producer of agricultural products. From 1991 to 1999, authorised laboratories conducted systematic control of about 6,500 food samples in 1991 to 36,000 by 1999 which included a whole range of hygienic quality parameters including microbiological and chemical. Microbiological contamination of food was reported to have caused disease outbreaks in 1,578 people in 1995, which dropped to 126 people in 1999. The decreasing trend of samples unfit for human consumption was observed for all food groups. As for the chemical parameters, an increasing trend of contaminated samples was noted only for additives, with peaks reaching 6.9% in 1998 and 4.9% in 1999 of the total number of analysed samples.Republika Makedonija ima 662.000 ha kultiviranih poljoprivrednih površina s dobro organiziranom poljoprivrednom proizvodnjom. Pored brojnog deficitarnog industrijskog izvoza, Makedonija je dobro poznati proizvođač ponajprije poljoprivrednih proizvoda. Tijekom proteklog 10 godišnjeg razdoblja (1991-1999) prehrambeni su proizvodi uključeni u sistematsku kontrolu u autoriziranim laboratorijima te je tako od 6500 proizvoda 1991. godine do 36000 uzoraka analizirano na zdravstvenu ispravnost, mikrobiološke i kemijske parametre. Mikrobiološka kontaminacija hrane uzrokovala je nekoliko akcidenata a objavljeni broj žrtava kretao se od 1578 u 1995. god. do 126 osoba u 1995. god. Uočljiv je trend smanjenja uzoraka hrane koji nisu za ljudsku prehranu u svim vrstama hrane. Od kemijskih parametara jedino je za aditive uočen trend porasta broja uzoraka koji ne zadovoljavaju kriterije za ljudsku prehranu. Najveći broj uzoraka koji nisu bili prihvatljivi, u odnosu na sve analizirane uzorke, zabilježen je 1998. god. (6,9%) i 1999. god. (4,9%)

Climate and weather service provision: Economic appraisal of adaptation to health impacts

Abstract This paper seeks to demonstrate that the value of climate projection information can be used to derive quantitative estimates of both the costs and benefits of information-based measures introduced to reduce climate-related risks. Specifically, information relating to both longer term climate change and weather variability are combined to identify potential resource implications for health service planning when faced with higher frequencies of heatwaves. A range of climate projection-city combinations are explored in order to test the robustness of the economic justification for heatwave warning systems (HWWS) in Europe – London, Madrid and Prague. Our results demonstrate that in most cases the HWWS option can be justified in the current climate – it is therefore a "no/low regret" option. Our results also show that whilst costs increase slightly under climate change scenarios, benefits of HWWS are likely to increase more steeply in European contexts. However, whilst the majority of cost-benefit analysis (CBA) outcomes are found to be positive, (i.e. economic benefits are greater than economic costs), across alternative climate projection-city combinations, in sensitivity analyses it is possible to generate negative results in certain geographical contexts. Indeed, with respect to this climate change risk, this analysis has identified that the analysis of key uncertainties, such as effectiveness of HWWSs and the valuation of health improvements, is critical in strengthening the case for HWWS implementation

Health Impacts and Economic Costs of Air Pollution in the Metropolitan Area of Skopje

Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3) caused an estimated 1199 premature deaths (CI95% 821–1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977) from cardiovascular diseases, and 937 admissions (CI95% 937–1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city

Health Promotion Activities in the Republic of Macedonia

This course covers the following topics: definitions and basic concepts of health promotion, Macedonian health system and health indicators, the new Macedonian public health policy and priorities, health promotion activities regarding 12 key priorities, advantages and weaknesses of the process of health promotion and future developments

Projected heat-related mortality under climate change in the metropolitan area of Skopje

Abstract Background Excessive summer heat is a serious environmental health problem in Skopje, the capital and largest city of the former Yugoslav Republic of Macedonia. This paper attempts to forecast the impact of heat on mortality in Skopje in two future periods under climate change and compare it with a historical baseline period. Methods After ascertaining the relationship between daily mean ambient air temperature and daily mortality in Skopje, we modelled the evolution of ambient temperatures in the city under a Representative Concentration Pathway scenario (RCP8.5) and the evolution of the city population in two future time periods: 2026–2045 and 2081–2100, and in a past time period (1986–2005) to serve as baseline for comparison. We then calculated the projected average annual mortality attributable to heat in the absence of adaptation or acclimatization during those time windows, and evaluated the contribution of each source of uncertainty on the final impact. Results Our estimates suggest that, compared to the baseline period (1986–2005), heat-related mortality in Skopje would more than double in 2026–2045, and more than quadruple in 2081–2100. When considering the impact in 2081–2100, sampling variability around the heat–mortality relationship and climate model explained 40.3 and 46.6 % of total variability. Conclusion These results highlight the importance of a long-term perspective in the public health prevention of heat exposure, particularly in the context of a changing climate

Functional Foods in Macedonia: Consumers’ Perspective and Public Health Policy

Background: The objective of our study was to explore the knowledge, attitudes and practices of Macedonian consumers towards functional foods, to predict future trends and to assess the national public health policies encompassing the functional foods market.Methods: Total of 518 respondents aged 18+, from all regions in the country participated in the study. They were sampled through three-staged national representative sampling procedures. The questionnaire comprised questions regarding the level of information about functional foods, trust in health claims, frequency of consumption and knowledge and attitudes related to those foods. Statistical significance was determined at p<0.05.Results: Respondents aged 18-34 were more informed compared to the total population (22 and 16 % respectively, p<0.05). Most of the consumers consume these products once a day. Employed consumers were willing to increase daily consumption from 3 to 18 % (p<0.05). On average 65.1% of the statements assessing knowledge were answered correctly. On a scale from -3 to +3 functional foods were considered as very healthy (mean=2.03, SD=1.42).Conclusion: On average, Macedonian consumers have a positive attitude and high expectations of functional foods. Public health policies still lag when compared to comprehensive approach of the food industry in market placement of these products

The impact of ambient temperature on mortality among the urban population in Skopje, Macedonia during the period 1996–2000

BACKGROUND: This study assesses the relationship between daily numbers of deaths and variations in ambient temperature within the city of Skopje, R. Macedonia. METHODS: The daily number of deaths from all causes, during the period 1996–2000, as well as those deaths from cardiovascular diseases, occurring within the city of Skopje were related to the average daily temperature on the same day using Multiple Regression statistical analyses. Temperature was measured within the regression model as two complementary variables: 'Warm' and 'Cold'. Excess winter mortality was calculated as winter deaths (deaths occurring in December to March) minus the average of non-winter deaths (April to July of the current year and August to November of the previous year). RESULTS: In this study the average daily total of deaths was 7% and 13% greater in the cold when compared to the whole period and warm period respectively. The same relationship was noticed for deaths caused by cardiovascular diseases. The Regression Beta Coefficient (b = -0.19) for the total mortality as a function of the temperature in Skopje during the period 1996–2000 was statistically significant with negative connotation as was the circulatory mortality due to average temperature (statistically significant regression Beta coefficient (b = -0.24)). A measure of this increase is provided, on an annual basis, in the form of the excess winter mortality figure. CONCLUSION: Mortality with in the city of Skopje displayed a marked seasonality, with peaks in the winter and relative troughs in the summer