Status of Human Health at The Eloor Industrial Belt, Kerala, India: A Cross-sectional Epidemiological Study
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Status of Human Health
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The Eloor Industrial Belt, Kerala, India:
A Cross-sectional Epidemiological Study - extracted text
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Status of Human Health
at
The Eloor Industrial Belt, Kerala, India:
A Cross-sectional Epidemiological Study
Supported by Occupational Health and Safety Centre- Mumbai
(SfiSeHTfACf
September, 2003
Status of Human Health
at the
Eloor Industrial Belt, Kerala- India 1
Greenpeace India
Assisted by the Occupational Health and Safety Centre-Mumbai.
September. 2003
First Level Report
Principal Investigators:
Research Coordinator:
Community Relations:
Collaborators:
Manu Gopalan with onsite inputs from Dr. Murlidhar/ Vijay Kanhere (OHSC)
Thangamma Monnappa
VJ Jose, Periyar Riverkeeper.
Vijay Kanhere; P Malwadkar; (of OHSC-Mumbai)
Dr. Vidula Bhole; Dr. Aasawari Talwelkar; (of LTM Medical College);
Sanjiv Gopal; Bidhan Chandra Singh, Vinuta Gopal, Rajendran and
Ananthapadmanabhan (of Greenpeace)
Team Advisory:
Dr.Thelma Narayan / Dr. Rajan Patil of the Community Health Cell, Bangalore.
Dr.Mohan Isaac / Dr. Girish Rao of NIMHANS, Bangalore.
Dr.Swarna Rekha / Dr. Elizabeth Vallikkad / AS Mohammed / Dr. Mario Vaz
of St. Johns Medical College Bangalore.
Jayakumar C, of Thanal Conservation and Action Network, Trivandrum.
Prof. Dr. Peter Orris, School of Public Health- Illinois.
Jayaram MB, Anson BA, Liju PP, Sanju Govind, Smigy Mathew, Snimy
Mathew, Julie Antony, Divya TM , Darshana TM, Benedict George.
External Peer Group:
Interviewers:
1 This report may be found on the web site of Greenpeace Indig: http.7/www.greenpeaceindia.org/
For more information on this project, please contact: Manu Gopalan, Principal Investigator/Phone: +91-98455 35409/
E-mail: manu.gopalan@diaib.greenpeace.org
or Dr. Murlidhar V, Principal Investigator/E-mail: murlidharv@vsnl.com, Ph:+91-22-2761 4098.
Status of Human Health- Eioor Industrial Belt, Kerala, India- First Level Report
I.
MAIN RESEARCH FINDINGS:
Contrary to the expectations based on the initial literature survey about possible increases in
particular types of diseases due to air and water pollution; this health assessment has discovered that
there is an overwhelming increase in most types of systemic diseases across Eloor (target village)
when compared to Pindimana (reference village). Broadly one can say that the cocktail of poisons in
the air and water of Eloor affects all body-systems adversely. Potentially the immune system seems
to be affected too.2 Increased prevalence and incidence of diseases and symptoms at Eloor have been
observed from the database of health information of the community and workers at Eloor and
Pindimana generated by the Field Investigation based on an exploratory format questionnaire.
A Stratified Random Sample of the Eloor4 (target) population when compared with those at
Pindimana5 (reference) shows a significant increased disease incidence in many body systems. The
key systems that are affected are the Neoplasm6 (2.5 times odds7), Blood & blood forming organs8
(2.1 times odds). Endocrine, nutritional and metabolic system’ (1.17 times relative risk). Mental and
behavioural10 (3.03 times odds), The Nervous system" (1.59 times odds). The eye & adnexa'2 (1.21
times odds). The Ear & mastoid process13 (1.49 times odds), The Circulatory system14 (1.59 times
odds), The Respiratory system15 (1.29 times odds). The Digestive system16 (1.69 times odds). Skin &
subcutaneous tissue17 (1.69 times odds), the Musculo-skeletal system & connective tissue18(1.17
times odds), the Genitourinary system19 1.09 times odds). Congenital malformations, deformations &
chromosomal20 (2.63 times odds). Injury, poisoning & certain other consequences of external
causes21 (2.65 times odds). External causes of morbidity & mortality22 (1.36 times odds). All
systemic classification was based on the International Classification of Diseases-10 (ICD-10).'3
Clinically confirmed24 Cancer Incidence is greater in Eloor at a statistically significant rate. When 13
cases of incidence were reported in the Eloor set, only one was reported in the sampling set at
Pindimana. The combined odds ratio across Eloor and Pindimana is (2.85:1). This is alarming to say
the least. One of the body systems worst hit seemed to be the nervous system when combined with
the mental and behavioral effects (odds- 1.59:1 & 3.03:1). Congenital malformations, deformations
and chromosomal aberrations follow (odds- 2.63:1). Accidental injury and poisonings are leading
2 Despite the fact that Pindimana, the reference village, was going through an epidemic of Leptospirosis and Dengue Fever, the rate of
occurrence of infectious diseases under Category-1 of the ICDflntemational Classification of Diseases) in Eloor Section A and Eloor Section B,
two target areas within Eloorfwhich was not facing an epidemic) was slightly more than the rate at the reference! This clearly shows that there is
an ongoing live epidemic in Eloor which is not being perceived as one that requires attention as it is on all the time.
3 Please see Appendix I for details.
4 Sampling Ratio was 1:4
5 Sampling Ratio was 1:7
Chapter-2 of the International Classification of Diseases, the ICD, Version-10, http://www.wellcool.demon.co.uk/ltmhi/PBarkgrlCDI O.htm
7 Odds and risk.The "odds” or “risk” of an event is the ratio of the probability that the event occurs to the probability that the event does not
occur. In other words, the odds of an event that has a probability p of occurring is given by p/(l 2 p), and ranges from zero to infinity. For
example, an event with probability of 0.8 of occurring has an odds of 0.8/(l 2 0.8) 5 4 (or 4 to 1 “on/for” in bookmaker’s jargon). Odds and
probability/chance differ because of the denominator, which becomes important for more frequent events. An interesting property of odds is that
the odds for the complement of an event (i.e., not the event) is the reciprocal of the odds for the event. For example, an event with probability of
0.2 5 I 2 0.8 of occurring has an odds of 0.2/(l 2 0.2) 5 % (or 4 to 1 "against” in bookmaker’s jargon). From the paper: “Use Of The "Odds
Ratio” For Diagnosing Forecast Skill’’ David B. Stephenson, Laboratoire De Statistiques Et Probabilite'S, Universite' Paul Sabatier, Toulouse,
France: http://www.met.rdg.ac.uk/cag/publications/wf2000.pdf
x ibid Chapter-3
9 ibid Chapter-4
10 ibid Chapter-5
11 ibid Chapter-6
12 ibid Chapter-7
13 ibid Chapter-8
14 ibid Chapter-9
13 ibid Chapter-10
16 ibid Chapter-11
17 ibid Chapter-12
"ibid Chapter-13
19 Md Chapter-14
20 ibid Chapter-17
21 ibid Chapter-19
22 ibid Chapter-20
All confidence intervals for relative risk/odds calculations would be elaborated in the second level report.
24 Clinical Confirmations were obtained by follow-up house visits with a team of doctors from the Occupational Health and Safety CentreMumbai using Spirometry for Respiratory Illness (Chapter-10, ICD-IO) and examinations of medical records (Chapter-10,1CD-10) for
ascertaining Cancer Incidence.
2
of - .mar Health- Eloor Industrial Belt, Kerala, India- First Level Report
causes of mortality (Odds- 2.65:1). Diseases affecting the Neoplasms (2.5:1) and Blood and blood
forming organs (2.1:1) are significantly great Eloor.
Medical Verifications were performed using the lung function tests (Spirometry) on a random sample
of the reference and target populations. These confirmed high rates of actual incidence.25 The
increases Lung-function of people at Eloor when compared to Pindimana revealed statistically
significant
DISEASE CONDITION
RELATIVE RATE OF
OCCURANCE
THYROID
215.36%
DEPRESSION
484.01%
Mental Disease
67.07%
MEMORY LOSS
113.39%
EPILEPSY
151.31%
MIGRAINE
233.44%
Paralysis and Paralytic Stroke
105.58%
Vision Loss
Hearing Loss
142.43%
90.49%
Heart Disease
171.37%
DEATH
BRONCHITIS
DEATH
ASTHMA
335.51%
223.18%
STOMACH ULCERS
2553.72%
ALLERGIC DERMATITIS
202.46%
Lumps on Body and Skin Disease
202.46%
ARTHRITIS
473.81%
RHEUMATISM
428.95%
FIBROID
260.84%
Hysterectomy
51.85%
Infertility
211.59%
BIRTH DEFECTS
379.40%
RESULT
DEATH
DEATH
DEATH
DEATH
DEATH
DEATH
CANCER
285.00%
Fiaure I: Table showing DEATH and DISEASE potentially due to pollution. The Relative Qccurance of
215.36% for Thyroid diseases means that Thyroid diseases are found at an increased rate of 2.15 times in
Eloor when compared to the reference village.
In the above analysis notice the high rates of death at Floor due to Cancer, Birth Defects, Bronchitis,
Asthma and Depression. Notice the high prevalence of Allergic Dermatitis, Arthritis, Rheumatism,
Infertility, Migraine, Epilepsy, Thyroid, Fibroids and Lumps on the body.
25
For Eloor the figure was 10- severely affected under FEV1 or FVC or both below 60% of the predicted values, the expected
values in healthy persons. 7 are moderately affected and 9 showed that their values for lung function are just below the 80% of
predicted values. Totally 26 out of 45 tested for lung function are affected ie 57.8% confirmed respiratory illness rates. Lung
function lest could be administered to 43 persons. Three persons were obviously affected and could not perform the test. Eight
had reported respiratory problems but did not want to go through the lung function test. Four persons were in good health with
no problems so tests were not administered. Totally 28 persons interviewed (and tested or only checked) have respiratory system
affected.
Status of Human Health- Eloor Industrial Belt Kerala, India- Hrst Leves Report
IL
EXECUTIVE SUMMARY
An Introduction to Eloor:
Eloor is a river island on the river Periyar around 17 kms from its mouth at the Arabian Sea near the
city of Cochin, the commercial capital of Kerala. It occupies an area of 11.21 square kilometres.
Eloor supports the largest industrial belt in Kerala with over 247 chemical industries. The industries
make a range of chemicals- petrochemical products, pesticides, rare-earth elements, rubber
processing chemicals, fertilizers, zinc/chrome products and leather products. Most of these industries
are over 50 years old and employ the most polluting of technologies. The industries take in large
amounts of fresh-water from the River Periyar and in-tum discharge concentrated effluent with
nominal treatment. This leads to the large-scale devastation of aquatic life in the river and the
farmlands in the region. There are more than 30 effluent pipes spewing toxins into the river directly
from the industry.26Air emissions range from acid mist to sulphur dioxide. Hydrogen Sulphide,
Ammonia and Chlorine gas.27 Air pollution within industrial environment was noted. We do not have
specific data but workers do complain about the foul atmosphere.28
There are close to 40,000 people living and working on the island, 29,064 of whom are part of the
village community not employed by the industries. The rest are employees and stay in the company
quarters. The Woman to Man ratio is 1000:1054.29 Some of the residents work for industries in Eloor
and do not stay in quarters; some are working in industries outside Eloor. What we need to note is the
direct and indirect dependence on industries of a lot of people in Eloor.
Blatant Violations of existing norms prevalent in Eloor:
Information regarding pollutants, chronic and acute effects of pollutants is not given to local the
residents, the local authority-the village Panchayat, workers and the doctors in Eloor as envisaged by
the Factories Act and the rules under the EP Act.
The plan for ‘Disaster Control’ inclusive of information on products, storage of hazardous
substances, effects and antidotes and proper health services is not made public, as it should be. The
health services available to the people seemed inadequate. The medical fraternity of the ESI hospital,
of the local area is not oriented for diagnosing and treating health problems due to environmental
pollution.30
The Final Research Question: ““W/iar are the Health Problems faced by the resident community
of Eloor Industrial Estate, due to increased pollution of the air and water by chemical industries?'"
The Background to the Community Health Assessment:
Despite the fact that the pollution of the River Periyar and the land has been established in sampling
missions by the Kerala State Pollution Control Board, research Universities and Greenpeace, there
has been little action by regulatory authorities.31 It seemed to us at the beginning of the research like
there needs to be stronger arguments and actions from the community that backs up the new research.
We decided to back our existing research on contamination due to the local pesticide industry,
Hindustan Insecticides Ltd and Merchem Ltd32 with further studies focussing on the River Periyar the
26 From a joint assessment done by the Periyar Malineekarana Virudha Samithi, KSSP and the Kerala State Pollution Control
Board. The pollution control board is still defaulting on a white paper it was to prepare to stop these pipes.
27 There are many unidentified chemicals that are in the plumes of the industries of the area. The Pollution Control Board has not
comprehensively monitored these.
2X Interview of workers by Vijay Kanhere- OHSC Mumbai.
29 14,144 women and 14.920 men. Most people are employed in the services industry—serving the government or private
industry. Many run local businesses. Traditional occupations including fishing and farming have been entirely wiped out by
polluting industry. There is a section of people that are migrant and are involved in illegal sand-mining from the bed of the river.
A small population on the island is unemployed..
30 Observations made by the team of legal and medical professionals from OHSC-Mumbai in June,2003.
31 The local pollution control board has been entirely ineffective in ‘controlling pollution’ if not preventing it. Therefore the
local community agitations have more often focused on the pollution control board to initiate immediate action against polluting
bodies Refer the Kerala Pollution Control Board Website for developments: http.7/www.kspcb.nic.in
32 After the Greenpeace Sampling mission of 1999 when it was established that a large amount of polluting chemicals have been
released by certain specific industries (Hindustan Insecticides ltd, Merchem Ltd), the local community took direct action against
the polluting agencies by damming the polluting stream-Kuzhikkandam Thodu. The companies have ever since been forced to
September, 2003
. .... ,
-
Boor Inaustnai BeiL Keraia, India- First Level Report.
final sink of all the run-off from the factories. A resident of Eloor was appointed by Greenpeace as
the Riverkeeper for the Periyar to monitor water quality of the river on a weekly basis and alert local
government, regulatory authorities and the pollution control boards of the need to take immediate
action to stop pollution.33
Over the last two years the communities affected by toxics and radiation pollution, the organisations
that support them and the academic/activist health fraternity convened in two meetings which
discussed the need for performing common-sense health surveys in toxics/radiation hotspots across
the country. These original vision for these studies was that they would create a prima facea link
between pollution and health problems and take the struggle of communities ahead to the remediation
and compensation plank. These meetings were cordial and strategic at the same time and were
dubbed CHESS-1 and CHESS-2.34 The collective energy drawn from both meetings gave rise to new
alliances like CAPE,35 and fuelled new health investigations like the one you are reading right now.
Greenpeace is performing another six health studies elsewhere in the country, which seeks to
strengthen the objectives of CAPE. Lay Epidemiology is the scientific arena, which all these studies
seek to create and address.36
The fact that the Community Health Problems of Eloor were quite apparent and that a similar reality
was observed across the country along the 24 hotspots identified by Greenpeace India prompted us
to go for a health assessment that shall establish prima facea the problem.38 Greenpeace initiated an
alliance with Occupational Health and Safety Cell- Mumbai, which has prior experience in the matter
of Epidemiological Research. The broad framework was of OHSC taking the lead with Medical
Verifications of the primary data collected using a questionnaire research was arrived at jointly, with
Greenpeace taking the primary role in the field based research and the survey.
The Ethical
Social
Science
Research
in Health
Guidelines developed by the National Committee for Ethics in
(NCESSRH/39_were strictly adhered to throughout the study.
The Health Assessment Method:
The Greenpeace team stared active field based work in on the health assessment in April, 2003 and
continued the field investigations till JULY 2003. The OHSC team joined the field-study in two
phases for Medical Verifications of Respiratory Illness in Eloor and Pindimana respectively.
The first step was to obtain Community Consent to do the assessment and ensure participation and
cooperation from the local Panchayat and local community leaders. Next came a comprehensive
literature survey of all available material on health status of the community. All available maps
cnicr into a dialogue with the panchayat and local people to come up with a plan to clean up the mess along the stream. They
have failed to come up with a safe protocol for doing so. Their current plan involves dredging the sludge and dumping it in a
nearby wetland permanently destroying the water table. There is currently a court injunction on any such action.
" I le has also addressed the people of Cochin city with the dangers of using the polluted river water for drinking purposes.
u CHESS stands for Community Health Environmental Survey Skillshare. It is an open collective of organisations and
individuals together building a health platform to fight Toxics and Radiation pollution in the country.
35 CAPE stands for Community Action for Pesticide Elimination. The Secretariat of CAPE is at Thanal Conservation and
Action Network (http://www.thanal.org/). The Coordinator is Kavitha Kuruganti (kkurugan@dialb.greenpeace.prg )
36 Refer the “Manual of Lay Epidemiology” produced by The Community Health Cell at Bangalore(http.//www..sochara.org/)
Details in Appendix-7.
37 On the “1000 Bhopals Jatha” which was a bus-tour across these hotspots listening to distressing stories of people caught
between the wheels of company fortune and taking direct action against criminal companies.
3K The local people have been complaining of large-scale health problems on the island. These include respiratory disorders,
cancels, congenital problems like mentally/ physically challenged children, chronic depression and reproductive problems.
3*' Ethical Guidelines for Social Science Research in Health: By National Committee for Ethics in Social Science Research m
Health (NCESSRH).
www.cehat.org/publications/ethical 1 .html
Also see , Notes on Qualitative Research and Ethics of Research On Disaster and Complex Political Emergencies by
Fatima Alvarez-Castillo, Profcssor.University of the Philippines Manila, Email: fatima.castino@up.edu...ph
•" Several one-to-one meetings with the local panchayat (its president and secretary) and local community leaders (Purushan
Floor of PM VS and Prasad/ Adv.Rajesh of JAV) ensured that the objectives were met.
11 'Hie following were the sources for the secondary literature survey1) 'Hie Integrated Child Development Programme- A Compilation of the whereabouts of people with disease in the village.
2) 'Hie Eloor Village Panchayat- The Death Register
3) 'Hie Regional Cancer Detection Centre- The statistical averages of incidence of cancer in patients that approach the center.
4) The Union Christian College, Aluva—An Environmental Impact Assessment of the Alwaye Industrial Belt, dept of
Economics, August 1993.
5
September.2003
?rarus of Human Health" Boor Industrial Belt, Kerala, India- First Level Report
were digitised to produce one comprehensive map that would capture all the data from secondary
sources on it. (See the Map in Appendix-5)
After plotting of people with ill health and cases of death (morbidity and mortality) due to diseases
with environmental factors on this detailed map, we made the decisions on identification of the
Target and Reference Groups. We also looked at the available state averages could have been used to
supplement the data from the reference group. A shortlist of five reference villages were examined
Maaradi, Aavoli, Puthenvelikkara, Koovappady and Pindimana of which the last one was chosen for
reasons of similarity in “Determinants” and “Processes” of the “Indicators that Count” framework.42
Pindimana is roughly 40 kms distant from Eloor as the crow flies and is upstream of the same River
Periyar in the part least populated by Industries. The only exposure people have to chemicals there is
pesticide drift. Therefore we designated it as a reference and not a control. We arranged for a visit of
the partners in research, the OHSC-Mumbai to Eloor and Pindimana to observe the reality of the
island and its reference and help us with developing the medical aspects of the study.
In setting the criteria to develop the study questionnaire, we concluded that it is in the best interest of
the study to increase the study power to assess the maximum possible number of people by
eliminating as many questions as possible from the study questionnaire. We assume that the studies
that would be done in follow-up possibly by the institutions of the Govt of India and the WHO would
ensure a comprehensive, cause-effect look at all the health problems.
The Proposed Research Question in the first round of discussions was: “What is the prevalence of
Chronic Respiratory Illness and Cancer in the affected community around Eloor Industrial Estate?”
This evolved into the more broad and exploratory research question later as we interacted with the
advisory board: What are the Health Problems faced by the resident community of Eloor Industrial
Estate, due to increased pollution of the air and water by chemical industries?” The meetings with
the advisory board also discussed and thrashed out issues like scientific biases, sampling sizes/ratios,
training module for interviewers, ethics and statistical analysis.
The Training of the interviewers43, a community sampling exercise44 and Pilot Surveys45 to identify
practical difficulties in the working of the Field Investigation were performed. This effectively
launched the team of 10 interviewers for 45 days of data collection at the end of which we have
information about 9122 individuals across Eloor and Pindimana.
Throughout the investigation involving respondents all basic ethical norms were strictly followed.
Voluntary Prior Informed Written Consent was obtained from each participant after giving a brief
introduction to the study and organisational nature of Greenpeace.
The Analysis: We restricted our analysis to simple percentage analysis and lead it to the calculation
of Odds-Ratios under the International Classification of Diseases (ICD-lO).(Refer Appendix 6 for
detailed graphs which shows prevalence of the diseases and disease-sets) Simple Office software was
coupled with Manual Computation techniques to reach the figures on prevalence percentages,
incidence, statistical significance and overall patterns. Most of these were projected into graphs for
easy reading
The Findings: The one basic finding is that we observed without exception, all body systems are
adversely affected in Eloor as opposed to Pindimana. This shows that the cocktail of poisons in the
air and water of Eloor as opposed to Pindimana is exerting synergistic effects on the health and well
being of the local population and these effects seem to be unpredictable especially across particular
age groups.
5) The Vi 1 lage& the Taluk Office: Census Data and Demographic information.
1999^ TablC 2 01 th'S repOrl Wh’Ch l’SlS ’n delaH lhC * Indicators thal Count” framework of developed by Hancock et al. (1998 and
43 Inhouse, for 3 days with the help of local doctors and the Community Health Cell in remote contact.
44 With ail the important people in the local community, the Panchayat Officials, the Community Leaders and youth.
One day events that ended in another day of one-to-one review and amendments in the questions.
6
September,2003
r-js J7 -‘..nan Health- Eloor Industrial Belt, Keraia, India- First Levei Report
The mortality due to Pollution-related illnesses like Cancer, Birth Defects, Asthma and Bronchitis is
very high. There is a statistically significant increase in confirmed cases of Respiratory Illness46.
Discussion:
The fact that there an unpredictable and stressful overload of diseases on the population of Eloor,
potentially due to exposure to the cocktail of chemicals released by the industries, goes a long way to
prove that Industrial Belts like the one in Eloor must be phased out and no new Industrial Belt of this
nature must be planned. Industries must follow all ecological an ethical norms and implement clean
production and closed-loop systems in their production cycle.
Remedial ACTION:
Remedial action must include all possible efforts to block the toxicity exposure routes of the local
population:
1. Zero discharge on the river periyar! We cannot tolerate any more dumping of
effluents into the periyar, the lifeline of the whole of cochin.
2. Implement immediate and concrete steps towards clean production at eloor now.
3. Compensate and medically rehabilitate all people affected by the criminal levels of
pollution.
4. Clean-up all contaminated sites immediately
5. Absolute and complete enforcement of the environmental norms and laws must
happen.
6.
The companies and the government must make public all information regarding
pollution, health risks, emergency preparedness and related dangers to local
communities. Companies must ensure that all workers have access to their medical records.
7.
Immediate punitive action need to be initiated by the government on the companies
that are poisoning the communities and workers in the industrial estate and around.
8. The companies must apologise to the affected people of eloor and cochin and accept
complete responsibility and liability for their past actions.
These events must be taken up by the polluting companies and the Government.
IV
ACKNOWLEDGEMENTS
The authors wish to acknowledge the support of the Community Health Cell, Bangalore for all the
research support and advise. More specifically, we want to thank Dr. Thelma Narayan, Dr. Rajan Patil for
their guidance and help. We also want to recognize the valuable assistance of our Project Advisory
Committee in forming the study design and reviewing its progress. Finally, we want to thank the
representatives of all of the universities and organizations who contributed study material and
information to this project.
46 According to the Lung-Function Analysis performed by Vijay Kanhere of the OHSC-Mumbai across Eloor and Pindimana.
Status of Human Health- Boor Industrial Belt Kerala, India- First Level Report
V
TABLE OF CONTENTS
I
II
in
iv
Main Research Findings
Executive Summary
Acknowledgements
Table of Contents
List of Figures
1. Research Problem/Context
1.1 Floor-A Brief Description
1.1.1
Geography
1.1.2
The Community
1.1.3
The Socio-Political Background
1.1.4
Pollution Problems
1.1.5
The Campaign Context
1.1.6
The Reported Health Problems
2. Methods
2.1 Review of Literature
2.2 Field Questionnaire Survey
2.3 Medical Verifications of Respiratory Illness and Cancer
2.4 Ethnographic Accounts
2.5 Focus Groups
3. Limitations
4. DISCUSSION:
4.1 Implications for Health Action to protect Communities and Workers in Indian
Industrial Estates
4.2 Implications for Policy and Practice
4.3 Dissemination/Knowledge Transfer
v
Page
2
4
7
8
9
9
9
9
9
10
10
10
11
12
13
14
14
14
14
15
15
15
15
16
5 Bibliography:
16
Appendix 1: Copy of Questionnaire Survey
Appendix 2: Follow-up Investigation Of Carcinoma Questionnaire:
Apendix- 3: Follow-up Investigation-Respiratory Disability Questionnaire
Appendix 4: Pulmonary Function Tests at Floor & its confirmation rate
Appendix 5: List of Maps of Floor with Mortality/Morbidity information
Appendix 6: List of Findings transcribed into Charts
Chart 1: ICD-10 Chapter 1/Certain Infectious Diseases
Chart2: ICD-10 Chapter 2/ Neoplasms
Chart3: ICD-10 Chapter 3/ Diseases of the Blood and Blood-forming Organs
Chart4: ICD-10 Chapter 4/ Endocrine, nutritional and metabolic diseases
Chart5: ICD-10 Chapter 5/ Mental and Behavioural Disorders
Chart6: ICD-10 Chapter 6/ Diseases of the nervous system
Chart?: ICD-10 Chapter 7/ Diseases of the eye & adnexa
ChartS: ICD-10 Chapter 8/ Diseases of the ear & mastoid process
Chart9: ICD-10 Chapter 9/ Diseases of the circulatory system
Chart 10: ICD-10 Chapter 10/ Diseases of the respiratory system
Chart 11: ICD-10 Chapter 11/ Diseases of the digestive system
Chart 12: ICD-10 Chapter 12/ Diseases of the skin & subcutaneous tissue
Chart 13: ICD-10 Chapter 13/ Diseases of the musculoskeletal system & connective tissue
Chart 14: ICD-10 Chapter 14/ Diseases of the genitourinary system
Chart 15: ICD-10 Chapter 15/ Pregnancy, childbirth and the puerperium
Chart 16: ICD-10 Chapter 17/ Congenital malformations, deformations &
chromosomal-abnormalities.
Chart 17: ICD-10 Chapter 18/ Symptoms, signs & abnormal clinical and laboratory findings,
not elsewhere classified.
Chart 18: ICD-10 Chapter 19/ Injury, poisoning & certain other consequences of external causes
Chart 19: ICD-10 Chapter 20/ External causes of morbidity & mortality
Chart20: ICD-10 Chapter 21/ Factors influencing health status & contact with health services
Appendix 7: List of Resources for Community and Research groups
Appendix 8: The Abridged Ethnographic Interviews for Floor.
Appendix 9: The Chemicals that are being Used, Produced and released into the environment
at Floor and Edayar and the companies responsible.
Appendix 10: Abstracts of scientific investigations of the water-system in and around Cochin
8
'S eswrfceH 2002
- .Trnd;' ri^aiin*- Eioor Industrial Belt, Keraia, India- First Level Report
V LIST OF FIGURES:
Figure 1: Table showing DEATH and DISEASE potentially due to pollution at Eioor.
Page
3
Figure.2: Map of Eioor Island on the River Periyar.
9
Figure 3: Mortality figures compiled for the period from 1998 to 1999 at Eioor Industrial Belt
12
Figure 4: An early comparative study between the target and the reference village, Pindimana.
12
Figure 5: Health Status in the "Indicators That Count" framework developed by Hancock et al.
13
Figure 6: Indicator Categories and Elements of the "Indicators That Count" Framework
13
ELOOR GRAMA PANCHAYATH
N
IQth FIVE YEAR PLAN
CMERANAUOOR
PANCHAYATH
CHER ANALLOUR
HAW
KALAMA'SERV
municipal town
Figure.2: Map of Eioor Island on the River Periyar. The top branch of the Periyar receives most of the
dumped effluent from Industry.
I, I
Eioor: A Brief Description-
1.1.1 Geography:
Floor is a river island on the river Periyar around 17 kms from its mouth at the Arabian Sea near the city
of Cochin. It occupies an area of 11.21 square kilometers. (See Fig-1) There is one high point on the
island within the industrial estate near FACT and the TCC from where all the drainage originates.
1.1.2 The Community::
There are close to 40,000 people living and working on the island, 29,064 of whom are part of the village
community, mostly not employed by the industries. The rest are employees and stay in the company
quarters. The Woman to Man ratio is 1000:1054. (14,144 women, 14,920 men).
9
September, 2003
heaitr- E;oor industrial Beit Keraia, India- First Levei Reoort
Some of the residents work for industries in Eloor and do not stay in quarters; some are working in
industries outside Eloor. What we need to note is the direct and indirect dependence on industries of a lot
of people in Eloor.
1.1.3 The Socio-Political Background:
Most people are employed in the services industry-serving the government or private industry. Many run
local businesses. Traditional occupations including fishing and farming have been entirely wiped out by
polluting industry. There is a section of people that are migrant and are involved in illegal sand-mining
from the bed of the river. A small population on the island is unemployed too.
The Village of Eloor is governed by the local Pachayat- Eloor Grama Panchayat. The hierarchy of local
self-governance in the ascending order of power is as follows: Eloor Panchayat—Alangad Block
Panchayat—North Paravur Taluk Office-Emakulam Zila Parishad. It comes under the Aluva Assembly
constituency and the Ernakulam Lok Sabha Constituency.
1.1.4 Pollution Problems:
Eloor supports the largest industrial belt in Kerala with over 247 chemical industries some of which are
across the bank of the river at Edayar. The industries make a range of chemicals- petrochemical products,
pesticides, rare-earth elements, rubber processing chemicals, fertilizers, zinc/chrome products and leather
products . Most of these industries are over 50 years old and employ the most polluting of technologies.
The siting of the factories is such that they trap the island community, as the connecting bridges to the
mainland, are off the industrial part of the island, away from community households. In the event of a
chemical accident like the one that happened in Bhopal, they have no choice but to swim across the river
for cover, which could lead to massive injury and loss of life.
The industries take 17 million cusecs of fresh-water from the River Periyar and in turn discharge roughly
1.5 million cusecs of concentrated effluent with very little treatment.48 This leads to the large-scale
devastation of aquatic life in the river and the aquaculture farms in the region. There are 30+ pipes
spewing effluent into the river directly from the industry.
Air emissions range from acid mist to Sulfur dioxide, Particulate matter, Carbon Black, Ammonia and
Chlorine gas49. There are many unidentified chemicals that are in the plumes of the industries of the area.
The Pollution Control Board has not been monitoring these in a comprehensive manner.
1.1.5 The Campaign Context:
The local pollution control board has been entirely ineffective in ‘controlling pollution’ if not preventing
it. Therefore the local community agitations have more often focused on the pollution control board to
initiate immediate action against polluting bodies.
After the Greenpeace Sampling mission of December-1999 when it was established that a large amount
of polluting chemicals50 have been released by a certain specific company (Hindustan Insecticides Ltd),
the local community of Eloor took direct action against the polluting agencies by blocking the polluting
stream-Kuzhikkandam Thodu in 2001.
The companies have ever since been forced to enter into a dialogue with the panchayat and local people
to come up with a plan to clean up the toxic mess along the stream. They have failed to come up with a
safe protocol for doing so. Their current plan involves dredging the sludge and dumping it in a nearby
wetland permanently destroying the water table. Recently the local community near the Kuzhikkandam
Creek has organised as a new group to file another case against the proposed toxic-dumping plans of the
local panchayat.
47
See Appendix 9 for details of pollutants released, used and produced by the key industries in Eloor and Edayar.
Projection by the Periyar Malineekarana Virudha Samithi PMVS and KSSP.
49 See Appendix 9 for details.
Look for the file Hindustan.pdf on the website: http://www.greenpeace.oru to get the complete report. Quite a few heavy
metals and over a hundred organochlorines. Refer Table3, page 10 of the report for a detailed look at the organic chemicals and
Table 4, page 13 for a look at the heavy metals.
10
Se pre m b er.2003
.:nan Health- Hoor Industrial Belt, Kerala, India- Hrst Level Reoort.
Mean while VJ Jose, a resident of Eloor was appointed by Greenpeace as the Riverkeeper for the Periyar
as the 1000 Bhopals Bus Jatha was passing by Eloor. His primary role has been monitoring water
quality of the river and alerting local government, regulatory authorities and the pollution control boards
ol the need to take immediate action to stop pollution. He has also addressed the people of Cochin city
with the dangers of using the potentially polluted river water for drinking purposes.
Gi eenpeace has also made a compilation of all information on the chemicals in raw materials, products,
diluents and emissions, which also enlist, detailed information on potential health problems to workers
and community. This is in continuance with the Community Right to Know Campaign in the area.51
1.1.6 The Health Problems52:
The local people had been complaining of large-scale health problems on the island. These included
icspiratory disorders, cancers, congenital problems like mentally/ physically challenged children, chronic
depression and reproductive problems. It was noted that the time to do a meaningful assessment of the
same had arrived.
The Proposed Research Question for the study was u TWhat
'”
‘ ~
are the
Health Problems faced by
the icsident community of Eloor Industrial Estate, due to increased pollution of the air and
water by chemical industries?”
2. METHODS AND LIMITATIONS
The answer was researched involving five strategies:
2.1 A Review of literature from around the world and Eloor (March-April 2003);
2.2 A questionnaire based survey of people in Eloor and Pindimana (May-July 2003);
2.3 Follow up Medical Verifications for Respiratory Illness and Cancer.(May-July,2003)
2.4 Ethnographic interviews of two subsets of people at Eloor (August, 2003);
2.5 Focus-group discussions (August 2003).
In all strategies involving respondents all basic ethical norms were strictly followed. Voluntary prior
informed written consent was obtained from each participant. The people were informed of the results of
lhe medical examination as soon as it was over. All patients were given medical-advise by the doctors to
the best of the ability and grasp of the patients’ current condition. Some were also given legal advise on
using the Public Liabilities Insurance Act to claim some compensation from the Industries via the State
fhe Iniervtewers had regular working hours and was paid on a monthly basis for their services They had
limited performance incentives so the projections of completion of the survey were met. The projections
were arrived
Here is a detailed account of each of the five strategies:
2.1) A Review of Contamination/Health/Indicators Information Gathered From Secondary Sources
at Eloor and elsewhere:
2.1.1 Literature from Eloor:
The following were the sources for the literature surveya) The Integrated Child Development Programme- A Compilation of the whereabouts
of people with disease in the village.
b) The Eloor Village Panchayat- The Death Register
c) The Regional Cancer Detection Centre- The statistical averages of incidence of
cancer in patients that approach the center.
d) The Union Christian College, Aluva—An Environmental Impact Assessment of the
Alwaye Industrial Belt, Dept of Economics, August 1993.
e) The Village & the Taluk Office: Census Data and Demographic information.
This compilation is available on request. Because of its bulk(3000+ pages) it has not been printed out into a hard edition. It
could be viewed using a computer.
S2 Identified
I
mostly through observational studies done by the local community an . local self Government
I I
September, 2003
Status of Human Health- Eloor Industrial Belt, Kerala, India- First Level ReportNumber of Mentally& Physically Ill in the Overall Population (ICDS Data): 159
Death Register- Death Rate:
4.425 per 1000
Cancer Death Rate
Ashtma Death Rate
Rhuematism DR
Heart Attack DR
Paralysis DR
Renal Failure DR
Others
Death Rate 98-99
0.361272
0.481696
0.275255
0.946188
0.395679
0.240848
1.376273
4.077209
Figure 3: Mortality figures compiled for the period from 1998 to 1999 at Eloor Industrial Beit.
Mortality rates, Socio-economic indicators and other factors that influence the Health of Communities
were considered while taking design decisions for the health survey. The design decisions- including
those of which village to choose as a reference to Eloor (target) and what sampling technique to follow
was taken at the advisory board meetings. The Advisory met three times during the survey and
recommended meaningful amendments in structure and approach which was implemented almost in its
entirety in the field by the Greenpeace and OHSC team. Mapping of Mortality patterns on the detailed
map of Eloor was performed. This graphically portrayed the patterns across the industrial belt in terms of
local geography, wind patterns, water flow and other ecological processes greatly enhancing our capacity
to analyse the data.
THE TARGET VILLAGE- ELOOR
Population:___________ 29,064
Total Area:_______
11.21 sq kms
Male/Female Ratio:
1054:1000
A PROPOSED REFERENCE- PINDIMANA
Population:__________ 15, 729___________
Total Area:___________22.87 sq kms______
Male/Female Ratio:
1003:1000
Occupations: Service sector. Business, Chemical
Factory Based, Ex-Agriculture, Ex-fishing-Fishing
(few fish), Dairy, Tailoring, Animal HusbandryChicken, Pig, Vegetables, Banana (no large scale
farming)___________________________________
Riverine Status: River Island- locked on all sides
Number of Industries: 18 large chemical industries
247 in the vicinity
Occupations: Agriculture-Vegetables, Banana,
Areca nut, Rubber, Pineapple, Tapioca,
Traditional Fishing, Tailoring, Food Processing,
Animal husbandry- Dairy, Chicken, Pig,
Matchstick production______________________
Riverine Status: Locked by the river on one side
Number of Industries: 1 Hollow brick industry
Figure 4: An early comparative study between the target and the reference village, Pindimana.
2.1.2 Literature from Global Sources:
Our understanding of health and the influencing indicators of community health
is based on an existing conceptual framework of characteristics of the health of
communities, the "Indicators That Count" framework developed by Hancock et al. (1998
and 1999) (see Figure 1). 53
The framework presents a logical progression from inputs to processes of change to outputs. The inputs are determinants of health
(environmental viability, liveable built environments, community conviviality, social equity and economic adequacy). Next, education and
governance are related
io processes-of-change which underpin community health. Finally, population health outcomes include measures of both positive health (e.g.,
quality of-life) and negative health (e.g., disability/morbidity/mortality, functional health measures). For the purposes of our research, we
refer to Sustainability, Viability, Livability, etc. as ’’categories" while the sub-levels within these categories are referred to as "elements" (e.g..
energy use, waler consumption, etc.).
12
V
- dius ■ jf H jman Health- Eloor Industrial Belt Kerala, India- First Level Report:
11EALTH STATUS
"
:-------------------------------------------------------
Positive Health and Quality of Life: Well-being/self-reported health; Life satisfaction; Happiness
Mastery/Self-esteem/Coherence
Health-promoting Behaviours
Negative Health: Stress/anxiety; Other morbidity/disability measures; Health utility index
Mortality: Overall mortality rate; Infant mortality rate; Suicide rate; Life expectancy
Health Status in the Indicators That Count" framework developed by Hancock et al (1998 and
1999)
”
-------------------- -----------As you see from the table above the evaluation of community health must take into account a complex
mix ol indicators. Our study strategically chose to explore overall patterns in morbidity and mortality
(hiough an exploratory approach. This was seen as the most inclusive choice available to us given our
limitations.
I he study also looked at determinants of community health other than Contaminated Air/Water/Food.
1 hese determinants were checked across the target (Eloor) and proposed reference villages to reach the
closest match. This helped us narrow ourselves on Pindimana as the reference village.
DETERMINANTS
Sustainability
Water consumption; Renewable resource consurnpiicD; Waste production and reduction; Local
production of resources; Land use (allocation of use); Ecosystem health; Ecological fc-tprim
Viability
Air quality; Water quality; Toxics production and use; Soil contamination; Food chain contamination
Livability
Housing quality; Density and land use in the built-environment; Community
afeiy and sccuruv;
I lanspoitation/automobile dominance; Walkability; Green/open space; Smoke-free space; Noise pollution
Conviviality
bainily safety and security; Sense of neighbourhood/place; Social support networks; Charitable donations;
Commitment to public services; Demographics
Equity
Economic disparity; Housing affordability; Discrimination and exclusion; Access to power and control
Prosperity
Diverse economy; Local control of businesses; Employment/unemployment; Quality of employment; Traditional
economic activity indicators
PROCESSES
Education
Early childhood development; Education attainment/school quality; Adult literacy; Lifelong learning
(Governance
Voluntaiism/associational lite; Citizen action/civic ness; Human and civil rights; Voter turnout; Perception of
political leaders and government services; Healthy public policy
l-iKine 6: Indicator Categories and Elements of the "Indicators That Count" Frameworkftext in black signifies
criiei ia (hat have been observed in the current survey)
When icviewing global research one looked at the existing typologies of research in community health.
Of (he five types of relevant research listed by Frankish et al54 (1- Conceptual53, 2- Needs Assessment56,
3- Tools Development57, 4- Implementation58 and 5- Intervention Outcome Research59); in the area of
5-1
.
Inslilute of Health Promotion Research, University of British Columbia, September 2002- www.ihpr.ubc.ca/pdfs/frankish-cphifinal_v4.pdf
( onccplual research is needed to better articulate the key characteristics of interest as they relate to community health. We need to better
understand how Indians (both lay people and decision leaders) conceptualize health and quality of life at a supra-individual (i.e.,neighbourhood
or community level). We also need research on the values underlying these perceptions and their implications for program and policy
development.
56
Needs assessment research should involve five aspects: identification of users and uses of community-levelindicators; better description of
laigci populations and service environments; more complete description of problems and potential solutions); assessment of the relative
onpoi lance and nature of specific needs; and communication of these needs to decision makers and relevant audiences.
I ool development is needed to develop, validate and test new ways of measuring community-level indicators. At present,
sufficient tools do not exist or they are poorly validated and not rigorously or widely used.
Implementation reseat ch is needed to examine the factors influencing the successful execution of indicator projects. Many
project arc developed with the intent of fostering change in a given jurisdiction. If they "fail”, it is often difficult to ascertain if
lhey were provided sufficient resources (e.g., time, people, money) so as to be successful.
13
Sratus
Hjrnsn Health- Floor Industrial Belt, Kerala, India- First Levei Repor.
Community Health that warrant further attention, future research, and immediate corrective measures
ours would fall under the final category.
Intervention outcome research would in all probability lead to action from the concerned parties in the
direction of affirming the rights of the communities affected.
2: A Questionnaire based Survey was conducted across the target and reference villages:
The Questionnaire was exploratory in nature and observed the prevalence and incidence of various types
of diseases that are normally caused due to toxic pollution. The details of a sample questionnaire are
attached herewith. (See Appendix 1)
The format and the content of the questionnaire was finalised after several rounds of discussions with the
advisory board in Bangalore. Over the course of many meetings with the Advisory board, the
Questionnaire got abridged from four pages to one page; the sampling unit changed from individual to
the household and a key informant was to be chosen by the interviewer using a standard criteria- that the
key informant is the person in the household who is in charge of the family’s health.
The key informant was to report the health status of all the living members of the family and the last two
deceased members. The interviewer would take the family health information down in a table using a set
of codes given to him, which were later classified during analysis under the International Classification
of Diseases.
The questionnaire was administered to the populations sampled out randomly from three strata(A,B,C)
which were distinctly separated geographically by the factories-belt of Eloor(target) and one in
Pindimana (reference). The Sampling ratio for Floor was 1:4 and that of Pindimana was 1:7. Roughly all
the strata (A,B,C) and Pindimana(D) had similar population sizes60. All in all we generated information
about 9122 alive people, both villages put together. The information about deceased has also been
collated.
The method of sampling followed was Stratified Random Sampling. The Sampling exercise was done in
a moderately sized community meeting where all the important and interested people in Floor picked lots
till we arrived at the number of houses required for the health survey.
3) Follow up Medical Verifications for Respiratory Illness and Cancer.(May-July,2003)
These were planned and conducted by the Occupational Health and Safety Centre- Mumbai. The follow
up medical verification was done using house-calls and primarily relied on Spirometry for verification of
Respiratory Illness cases and examination of medical records for cancer verification. Conducted by
doctors of the Occupational Health and Safety Centre, under the leadership of Dr. Murlidhar V and Vijay
Kanhere, this was a 6-day event in June when they diagnosed the degree of disability in communities.
This information was used to objectively verify and qualify some of the observations of the questionnaire
survey.
4) Ethnographic interviews of two subsets of people at Floor (August, 2003):
Collecting Ethnographic Information from Various Individuals classified according to age and
occupation using open questionnaires (Refer Appendix-7 for abridged version of each interview) These
interviews were done by VJ Jose, the Periyar Riverkeeper asking a series of common-sense open
questions to a group of people who were present in Floor before the factories were set up and another
group of parents of affected children in the neighborhood.
5) Focus group discussions (August 2003):
The focus groups were held as the community sampling exercise was being conducted before the field
survey and later as the final debrief was being conducted within the community after the survey. Both
sessions confirmed our earlier understanding from individual interviews. They also confirmed the
common sense understanding of the findings of the preliminary literature survey.
59 Intervention outcome research is needed. Many indicator projects are developed with the goal of launching some form of
"intervention'’ and linking indicators of "community health" to important outcomes such as changes in health behaviours, health
status and use of health or social services. At present, we lack sufficient knowledge to say which interventions are effective and
to elucidate the causal pathways between community-level factors and the outcomes of interest.
60 A=Target 617 houses/ completed 516: B=Target 562/complete 462: C=792/632
14
September. 2003
.
oi Human Health- Eloor Industrial Beit, Kerala, India- First Level Report
3. PHE LIMITATIONS:
The health problems of contract and permanent workers due to degradation of environment within
polluting units were not specifically considered, as access to them was limited. We could only approach
woikers at the residences in Eloor. So the drifting population got excluded.
Especially at certain worker households, the interviewers made an observation that visibly obvious
illnesses were not being reported. So it is possible that generally illnesses have been underreported and
figures arrived at from the database would be conservative at the least.
I he resources and time at our disposal was limited. Therefore we could not go ahead with a
comprehensive census and had to limit ourselves to a Stratified Random Sample as recommended by the
advisory group.
4 DISCUSSION:
4.1 Implications For Remedial Health Action To Protect Communities And Workers In Indian
Industrial Estates:
1 he Routes of Exposure of the people to the chemical-cocktail are Water, Air and Food. The Water route
is shaied by the people of Eloor with the whole of Cochin. The Air however is shared with select distant
liscilolks villages. The food route is shared by all communities downstream which grow vegetables
using the polluted effluent water. The common-sense strategy to stop the health problems would be to
cap the tap from the top: plug these exposure routes.
The immediate iinterventions that this project would suggest regulators and criminal parties take
up:
1 Zero Discharge on the River Periyar!
2. Implement immediate and concrete steps towards Clean Production at Eloor now.
3. Compensate and Medically Rehabilitate for life, all people affected by the criminal
levels of pollution.
4. Clean-up all contaminated sites (Kuzhikkandam Creek, the large wetlands in A,B,C)
immediately.
5. Absolute and complete enforcement of the environmental norms and laws must happen.
6. The companies and the government must Make Public All Information regarding
pollution, health risks, emergency preparedness and related dangers to local
communities. Companies must ensure that all workers have access to their medical records.
7- Immediate punitive action needs to be initiated by the government on the companies
that are poisoning the communities and workers in the industrial estate and around.
8. The companies must apologise to the affected people of Eloor and Cochin and accept
complete responsibility and liability for their past actions.
4.2 Implications For Policy And Practice:
It is clear that the nature of illness spreads across practically all body systems in an almost unpredictable
manner. This is clearly due to the fact that it is a cocktail of chemicals (a few score heavy metals a few
hundred organic chemicals) and that are in the air and water of Eloor. There is very little medical
research globally that accounts or synergistic effects of synthetic chemicals in human beings. The
evidence that one finds at Eloor clearly shows that the synergistic effects of these chemicals are more
devastating than expected.
These findings have implications on industrial planning policy globally. The paradigm of designing
industrial estates recklessly with no regard for the effects on public health needs to change. The chemical
cocktail that are released into the air and water needs to be stopped. When there are a complex group of
chemicals in your air and water it becomes almost impossible to predict and remedy the human diseases
that may be caused by them, not to mention the near impossibility of treatment and clean-up of the
contaminated air and water.
61
www.our.stolcnfu(urc.org/NcwScience/svnergv/synergy.htm
Also LV-U^www.health.siate.mn.us/divs/eh/groundwater/hrlmix.html for some new action on groundwater contamination and
synergisiic effects.
A*so hlip://www.nmenv.state.nrn.us/aQb/Droiects/Corra!es/ DOH Synergistic Effects.pdf
September,2003
-tiS (?’■ Hernan Health- Eloor Industrial Belt; Kerala, India- First Lever Report
Industrial Estates must be allowed to exist only in the rare exception, when they are planned like
ecological neighborhoods where all the chemicals used within the estates are self contained using closed
loop systems and zero-discharge is effectively implemented by online regulation.62
62 The new planning
paradigm must accommodate clean production technology as its integral part. 63
4.3 Dissemination/Knowledge Transfer
We have adopted a participatory approach in all our research activities.64 The Dissemination plan is also
based on an understanding of the needs and concerns of our audience, the community, workers, scientists,
media-persons, policymakers, politicians and the medical community.
The report will be produced in three levels. The first level report would sum up
i all the broad findings and
give an overview of the community health picture of the Industrial Belt for regulators to take immediate
action under the Precautionary Principle. It would be shared with the community, the regulators and the
media. This would set the ball rolling on a community consultative actions agenda.
The second level report would be a detailed account with in-depth analysis with all the technical detail
required for publication. Greenpeace would publish it for the global audience. The third level report
would be in the form of a brief article, which would be sent to a reputed international journal of
medicine/environmental health for publication.
5. BIBLIOGRAPHY
Antony Prof. (August 1993) An Environmental Impact Assessment of the Alwaye Industrial
Belt, The Union Christian College, Aluva-Dept of Economics, Alwaye, Kerala.
Castillo, Fatima Alvarez, Notes on Qualitative Research and Ethics of Research On Disaster and
Complex Political Emergencies. Professor, University of the Philippines Manila, Email:
fatima.castillo@up.edu.ph
Census Data and Demographic information( 1990-2000): The Village& the Taluk Office
‘Clean Production techniques and success stories from around the world’.http://www.cleanproduction.org
‘Cornell Work and Environment Initiative’ http://www.cfe.comelLedii/wei/ Eco-industrial roundtable
newsletters and proceedings, case profiles, and papers on eco-industrial parks and networks.
Community Health Survey. Report for the Policy Development & Coordination Division,
Health Canada.
The Death Register( 1993-2003) The Eloor Village Panchayat.
Erkman, Suren, Ramaswamy, Ramesh.( 2000). Industrial Ecology as a Tool for Development PlanningTwinning Industrial Ecology and Cleaner Production. UNEP's 6th International High-level Seminar on
Cleaner Production, Montreal, Canada. http://www.agrifood-forum.net/db/cp6/Tnput to CP6.doc
Ethical Guidelines for Social Science Research in Health: By National Committee for Ethics in Social
Science Research in Health (NCESSRH): http://www.cehat.org/publications/ethical 1 .html
Frankish J. (1999) Background Paper on Community Health Indicators for the Canadian
6’
See http://www.indigodev.com/ADBHBCh2Foundations.doc
Also Erkman. Suren and Ramaswamy, Ramesh. 2000. Industrial Ecology as a Tool for Development Planning—Twinning Industrial
Ecology and Cleaner
Production. UNEP’s 6th International High-level Seminar on Cleaner Production. Montreal.
Canada. http://www.agrifood-lbrum.net/dh/cp6/Input to CP6.doc
>VVyw eleanproduction.org for details of clean production techniques and success stories from around the world.
See Cornell Work and Environment Initiative http://www.cfe.comell.edu/wei/ Includes eco-industrial roundtable newsletters and
proceedings, case profiles, and papers on eco-industrial parks and networks.
64
We define participatory research as "systematic inquiry, with collaboration of those affected by the issue being studied, for purposes of
cducatio and taking action or effecting social change." As such, our work was designed to make our research questions more relevant to our
community people, our methods more acceptable, and our results more useful to decision makers.
16
September, 2003
. .atus of Human Health- Eloor Industrial Belt, Kerala, India- First Level Report
‘Groundwater contamination and synergistic effects’
hiip://www.health.state.mn.us/divs/eh/groundwater/hrimix.html
Hancock T, Labonte R and Edwards R (1998). Indicators That Count! - Measuring Population
Health at the Community Level. [Report]
Hancock T. Labonte R and Edwards R (1999). Indicators That Count! Measuring population
health al the community level. Canadian Journal of Public Health 90 (Suppl 1):S22S26.
Institute of Health Promotion Research, University of British Columbia, September 2002
11up.://www.ihpr.ubc.ca/pdfs/frankish-cphifinal v4.pdf
International Classification of Diseases, the ICD, Version-10
hit p://www.wel lcool.demon.co.uk/ltmhi/PBarkerICD10.htm
lnip://wvvw.indigodev.coTTi/ADBHBCh2Foundations.doc
The Integrated Child Development Programme- A Compilation of the whereabouts of people with
disease in the village.
“Our Stolen Future” http://www.ourstolenfuture.org/NewScience/svnergv/synergy.htm
The statistical averages of incidence of cancer in patients(2OO3)._77ze Regional Cancer Detection
Centre. Ernakulam, Kerala.
Shiell, A. & Hawe, P. (1996). Health promotion, community development and the tyranny of
individualism. Health Economics 5(3):241-247.
Synergistic Effects:
liup://www.nmenv.state.nm.us/aqb/projects/Corrales/ DOH Synergistic Effects.pdf
Stephenson, David B. (April, 2000). Use of the “Odds Ratio’’ for Diagnosing Forecast Skill
Laboratoire de Statistiques et Probabilite's, Universite'Paul Sabatier, Toulouse, France'. 221-225
hit pV/www.met.rdg.ac.uk/cag/Dublications/wf2000.pdf
17
Appendix 1: COPY OF THE QUESTIONAIRRE SURVEY
003 HEALTH SURVEYS’ - FIELD INVESTIGATION QUESTIONNAIRE
Identification Number (Area Code+ Interviewer code+ Ward Numberf- House Number)
DATE
TIME
Number of Family Members
Address+ Phone Number (H/PP):
NAME
OF
FAMILY
MEMBER
A S Ky
G E Inf
E X mt
OCCUPATION
EDUC
ATION
# of yrs
Over
all
Health
Y/
N
DOCTOR-DIAGNOSED
HEALTH PROBLEM
1
2
3
4
Perceived Health
Problem
Habits? Smoking/
Drinking/ Chewingtobacco- CT n/y / SnuffSN iVy /
Tobacco-paste- TP n/y
1
S n/y
2
Ml)
3
D n/p
CTn/ySN n/yTP n/y
M2)
M3)
M4)
M5)
M6)
M7)
M8)
Deceased Member:
DI)
D2)
a
S
e
s
e
x
Year
of
Deat
h
Occupatio
n
Educat
- -ion
Over
all
Healt
h
Cause of death?
Any chronic
disease?
Any addictive habits?
Status of Human Health- Eloor Industrial Belt, Kerala. India- First Level Report
Appendix 2: FOLLOWUP MEDICAL INVESTIGATION OF CARCINOMA QUESTIONNAIRE:
I---------------------- Identification Number (Area Code+ Interviewer code+ Ward Number+ House
Number+ followup number-(two digits)
2.
date:
3.
AGE
4. Male/Female
SEX
5. Type of cancer
6. Organ affected.
7. TNM Stage
8.In which year was it detected?
9.How was it detected?
10.local doctor
1 I .Senior doctor in a major hospital
12. Pathology confirmation
13. Was surgery performed?
14. Was chemotherapy administered?
15. Was radiotherapy administered?
16.1s there pain at present?
17.1s there bleeding from the site?
Appendix 3: FOLLOWUP INVESTIGATION OF RESPIRATORY DISABILITY USING
PULMENORY FUNCTION TESTING- QUESTIONNAIRE:
’ ■ ---------------------- Identification Number (Area Code+ Interviewer code+ Ward Number+ House
Number* FOLLOWUP NUMBER-(TWO DIGITS)
2.
.DATE:
3.
AGE
4. Male/Female
.SEX
5. Y/N
Do you smoke? Y/N Did you smoke earlier?
6.
S (n)/(y): Smoking n=number of cigarettes/bidis per day/ y= number of
years of smoking
7. Y/N Do you get up due to cough?
8. Y/N is the problem for more than two months?
9. Y/N is the problem for more than two years?
10.1s there a particular season when the problem is faced?
11 - Y/N is the cough with expectoration?
12. Y/N are you suffering due to asthma?
13. Y/N are you diagnosed to be asthamatic?
14. Y/N is there a family history of asthma?
15. Y/N.have you associated this problem with any cause?
16. what is the cause you have identified?
_______________
17. What is the medication you take for asthma? ______________
18. what is the frequency of medication?
BREATHLESSNESS:
Do you become breathless while:
19. climbing stairs
20. walking at usual speed
21. walking foreven 100 steps/performing activities of daily living
22. even at rest
23. GRADE OF BREATHLESSNESS:
READINGS OF LUNG FUNCTION TEST
Sr. No.
FEV1
FVC
PEFR
MEFR
Selected
_L____
1____
3.
September. 2003
.vrarus cf Human Health- Floor Industrial Belt, Kerala, India- First Level Report
A FEER BRONCHODILATOR:
FEV1
Sr. No.
_L____
FVC
MEFR
PEFR
Selected
2.____
X__
4.
24. FEV1 _____
26. COMMENTS
% of predicted;
% of predicted ; 25. FVC
APPENDIX 4: PULMONARY FUNCTION TESTS AT ELOOR AND ITS CONFIRMATION
RATES
Qi
Sr
No
9
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
2___
Code
2
F
Y
Y
xY
Y
Y
Y
x
x
xY
1_
Y
1_
Y
y
Y
y
Y
y
Y
y
Y
y
Y
1_
Y
y
Y
N
n
4
M
5____
PFT
done?
N
N
N
N
N
N
N
N
N
N
Y
Y
Y
Y
Y
Y
Y
N
Y
y
N
xN
N
n
N
n
N
n
N
n
N
n
N
n
N
n
N
n
N
n
N
n
x
y
y
Y
y
Y
y
Y
y
Y
n
N
r
Y
y
N
n
Y
y
X
y
6___
FEV1
<60%
7____
FEV1
<80%
8____
FVC
<60%
9____
FVC
<80%
10_____
Breath
lessness
grade
3______
J____
N
n
N
n
Y
n
N
Y
n
n
N
n
N
n
N
n
N
N
n
xn
N
n
N
n
N
N
xY
xN
n
n
N
n
N
N
xN
N
N
N
N
N
xN
N
N
N
N
N
N
y
Y
y
N
y
Y
xN
xN
n
N
N
N
N
n
N
n
N
n
N
N
N
N
n
N
n
N
xn
N
n
N
n
N
y
N
n
y
Y
n
Y
0______
0______
j______
j______
j______
0______
J____
nk
0______
1
0
3
2
1
2
2
1
1
0
0
0
1
1
Nk
0
0
4
1
2
11_____
Lung
function
affected
Nk____
Nk____
N_____
x__
xY__
Y
Y
Nk
Y
N
Nk
N
N~
N
Y
Y
N
Y
N
N
Y
Y
N
Nk
N
N
Y
N
N
20
SepTamber..2OO3
Status of Human Health- Eloor Industrial Belt Kerala, India- First Level Report
33
34
35
36
37
38
39
40
41
J__
42
43
44
45
46
47
48
49__
50
51 __
52 __
53 __
54
55 __
56 __
57 __
58 __
Total
Of
2
Y
Y
n_____
____
y
’X_____ Y __
n_____ _v___ y
’_N______
Y __
Y
n_____ _X___ y
'_N_____ Y ___ Y
n_____ _X___ y
*_N_____ Y ___ Y
'2___ J__ 5
n
_X___ y
____
Y ___ N
n_____ J
y
Y
N_____ Y
Y
N_____ Y ___ Y
N___ _ Y ___
N_____ Y __ Y
N_____ Y ___ Y
N_____ Y ___ N
N_____ Y ___ N
N_____ Y ___ Y
Y _____ N___ Y
N_____ Y ___ N
N_____ Y ___ Y
Y _____ N___ Y
Y _____ N___ N
33
25
45
Females Males
____
'x__
N
Y
Y
N
N
y
N
N
Y
N
n
N_
6_
y
Y
N
N
7
EN
n
N
Y
n
N
Y
N
Y
N
Y
n
N
n
x
A
x
N
8
N
Y
Y
n
Y
n
N
9
y
A
X
A
N
N
N
N
N
N
N
N
Y
N
N
Y
N
10
10
9
17
n
Y
n
Y
Y
N
Y
Y
Y
N
N
11
A
n
Y
N
Y
1
nk
0
0
2
1
1
0
0
10
1
2
_o
2
2
2
2
2
2
2
2
2
2
o
N
Y
Y
N
Y
Y
Y
N
N
N
N
Y
N
Y
N
28
yeses
Total
13
25
of
nos
Total
03
05
of
nks
Nk=not known
10 tested are severely affected with FEV1 or FVC or both below 60% of the predicted values
(the expected values in healthy persons). 7 are moderately affected and 9 showed that their
values for lung function are just below the 80% of predicted values.
Totally 26 out of 45 tested for lung function are affected. Lung function test could be
administered to 43 persons. Three persons were obviously affected and could not perform the
test. Eight had reported respiratory problems but did not want to go through the lung function
test. Four persons were in good health with no problems so tests were not administered.
Totally 28 persons interviewed (and tested or only checked) have respiratory system affected.
21
Septem her, 2003
APPENDIX 6: LIST OF FINDINGS TRANSCRIBED INTO CHARTS
CHART-1: Certain infectious and parasitic diseases- Chapter 1 ICD-10 (International Classification of Diseases)
Male
Female
□ Pindimana aEloor
□ Pindimana ■ Floor
61 +years
20-35 years
6-12 years
16.00
14.00
12.00
Age Group
10.00
8.00
A
male
0-12 months __ J
' '3
1 -5 years
5-12 years
> f-6
12-19 years
■ "8
19-35 years
35-60 years
34
^6
60+ years
18
B
female
6.00
B
C
C
male female male female
o
_5
4
_8
10 ‘
'
■
' 4 - . 1
o
W-o
.-.3
-- -'0
_5 W.9 ■ ■ '.6 >•.»; ■ ■ • 2
- 4
J6 :n^38 ' 16
'16
^4 : > 42
57
30 ,<^7
felS
15
0-12 months
—I----
—i—
28
27
'^^5
4.00
2.00
A+B+C
A+B+C
male
female
_____ 3 ______0
_____ 8 ______9
____ 19 _____ 14
____ 19 _____ 15
____ 87 ____ 48
118
118
54
47
0.00
0.00
(A+B+C)
(A+B+C)
Total
Population Male
Total
Population
Female
2.00
Affected
4.00
Affected
6.00
8.00
10.00
Affected
Population D
12.00
14.00
16.00
Total
Population D Affected Male
Affected
Female
(A+B+C)
(A+B+C)
(D)
Population (%) Population
Population (D) Population
male
(%) female male female nale female
(%)
(%)
77 _________ 71 ________ 3.90 _______ 0.00
_____ 0 _J8I_____ 14
12.50 _________ 0.00
256 ______ 225 _________ 3.13 _______ 4.00 W2
___ 58 _____ 43 _______ 3.45 _________ 4.65
314 ______ 318 _________ 6.05 _______ 4,40
85 _____ 67 _______ 5.88 _________5.97
356 ______ 355 _________ 5.34 _______ 4.23
___ 70 _____ 88 _______ 7.14 ________ 14.77
1212 _____ 1104 _________ 7.18 _______ 4.35 «5
217
233 _______ 6.91 _________8.58
1168 _____ 1206 ________ 10.10 _______ 9.78 %&4
249
248
13.65 _________ 9.68
376
418
14.36
11.24
129
126
10.85 _________ 8.73
BSE
23
t yq-i f-;. K ’ » v' 4 «
CHART-2: Neoplasms- Chapter 2 ICD-10 (International Classification of Diseases)
Male
Female
□ Pindimana ■Eloor
□ Pindimana ■Eloor
61+ years
20-35 years
6-12 years
1.80
1.60
Hr—
1.40
Age Group
0-12 months
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
0-12 months
1.20
1.00
A
0.80
B
0.60
C
0.40
A+B+C
0.20
0.00
(A+B+C)
0.00
(A+B+C)
Total
Total
Population - Population
male|female| Male I female male female male female
Male
Female
HQ ,<~0-'-Q
__ g ____ g
77 __________ 71
•<.. -C -'-\o ' Wo ___ 1 _____ 0
256 _________225
0 ___ 1 ____ g
314 ________ 318
So
W$o _jg ____ g
356 ________ 355
\l| /T -2|-~0
___ 2 _____ 2
1212 _______ 1104
■
•- ■ 4
'•?k2 . : 4
8
18
1168 _______ 1206
2
l| ~4
*■ 4
0 -1
6
6
376
418
^o^QolOi
&To
0.20
0.40
0.60
Affected
Affected
(A+B+C)
Population
(%) male
(A+B+C)
Population (%)
female
0.80
1.20
1.40
Affected
Total
Population D|Population D| Affected Male
1.60
1.80
Affected
Female
(D) Population (D) Population
male female male female
s
i•o
________ 0.00 I i
________ 0.0C __________ 0.00
________ 0.39 __________ 0.00 t________ 0.32 __________ 0.00
________ 0.00
________ 0.17 __________ 0.18
________ 0,68
k49
1.60
1.44
1.00
,
0
J
2
.
(%)
___ 8 _____ 14 ________ 0.00
0
58 ____ 43 ________ 0.00
85
67 ________ 0.00
___ 70 _____ 88 _________ 0.00
217
233 _________0.00
0 249
248 _________0.00
2 129
126 _________ 1.55
(%)____
0.00
0.00
0.00
0.00
0.00
0.00
____ 159
24
CHART-3: Diseases of blood & blood forming organs & certain disorders- Chapter 3 ICD-10 (International Classification of Diseases)
Male
Female
□ Pindimana aEloor
□ Pindimana ■Eloor
61 +years
36-60 yeai
20-35 yeai
J 13-19 year
6-12 years
1-5 years
0-12 montt
15.00
40.00
30.00
35.00
Age Group
25.00
A
20.00
B
15.00
C
10.00
5.00
A+B+C
male female male female male female male female
0-12 months
0
0
0
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
3
:r: •oB
0
0
4
1
0
1
6 0
17'.-. 18 21
72
91 61
35- | 62 63
0 ;
98 11 r 118
82 50
77
0.00
0.00
10.00
(A+B+C)
(A+B+C)
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
20.00
Affected
30.00
Affected
Population D
(A+B+C)
Population (%)
female
male
0
77
71
0.00
0.00
5
6
3
256
225
1.95
1.33 i
3
314
318
1.91
3
10
356
355
0.84
52
57
1212
1104
244
307
1168
148
221
376
50.00
Total
Population D Affected Male
60.00
Affected
Female
(D) Population (D) Population
female male female
r. -o|%
0
40.00
(%)
(%)
8
14 ________ 0.00
0.00
0
_g
58
43
0.00
0.00
0.94
M-0
67
0.00
1.49
__1
j
_2
85
2.82
70
88
1.43
2.27
4.29
5.16
3
217
233
1.38
1.29
1206
20.89
25.46
249
248
7.23
12.90
418
39.36
52.87
18
'• 33
129
126
25.58
23.81
PS'32
WEWso
25
CHART-4: Endocrine, nutritional and metabolic diseases- Chapter 4 ICD-10 (International Classification of Diseases)
Female
Male
□ Pindimana BEIoor
□ Pindimana ■ Floor
61 +years
i _______________
|
,
.
~
?
.
.■
.. .
.
;.-■■■•
I
I
I
36-60 years
-
—-
I
20-35 years
-_
.T"^
I
I
I
I
J
1.00
2.00
13-19 years
I
I
6-12 years
1-5 years
0-12 months
00
8.00
7.00
6.00
Age Group
0-12 months
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
4.00
5.00
3.00
B
A
C
2.00
1.00
A+B+C
0.00
(A+B+C)
0.00
(A+B+C)
Affected
Affected
4.00
3.00
5.00
Affected
Total
Population Population Affected
D
D
Male
6.00
7.00
Affected
Female
Total
Total
(A+B+C)
(A+B+C)
(D)
(D)
PopulationlPopulation Population Population (%)
Population Population
Female
(%) male
female
malejfemalernale female
male female male|female|male|femalehiale|female -Male
(%)
(%)
' -Q
C
77 ____ 71 _______ 0.00 _________ 0.00 ^-0
8
14
0.00
0.00
__2
‘i 03
256
225 _______ 1.95 _______ 0.44 - 0
43
.0 58
0.00
0.00
.'.-0 > 0 ■ 0
gWi ■ 5 _1
1 85
318
7
314
u
3.50 _________ 2.20
0 '
67
1.49
-.1
1
e
0.00
iS?5
figfl
:^7?o
1^4
: 23
32
a
11
.1
•Ci 6
28
ago
Wa
B
27
18 f'!’31 ^^28
9
50
90
_1Z
34
74
356
1212
1168
2.53 _________ 4.79
355
3 'Oa 70
1104 _______ 4,13
3J08 C¥b
. 7 217
1206
7.71
6.14 13
4 249
88
233
248
4.29
3.41
3.69
5.22
3.00
1.61
26
CHART-5: Mental and behavioural disorders- Chapter 5 ICD-10 (International Classification of Diseases)
Male
Female
□ Pindimana BEIoor
□ Pindimana BEIoor
61 +years
20-35 years
6-12 years
0-12 months
5.00
4.50
4.00
3.50
Age Group
1 -5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
2.50
A
male
0-12 months
3.00
2.00
B
female
male
0
0
o|
1,
o
____ 4
____ 7
26
12
3
76
0
____ 16
■
-0
1.50
C
1.00
0.50
A+B+C
female
male_______
female male female
~ o| "
Q
___ 0 _____ 0
o
o
___ 0 _____ 2
o|
o|
J ___ 2 _____ 0
0 !
0 _J5 _____ 3
■
48_ ___ H0_
22
5
6
■
4
0
_1 __ 12 ____ 23
4 __ 34 ____ 62
17|
3
31
0.00
0.00
1.00
2.00
3.00
4.00
(A+B+C)
(A+B+C)
Affected
Affected
Affected
Population D
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
male jernale male
__ 77 _______ 71
256 ______ 225
314 ______ 318
356
355
1212 _____ 1104
1168 _____ 1206
376
418
_______ 0.00 _______ 0.00
_______ 0.00 _______ 0.89
_______ 0.64
_______ 1.40
_______ 0.99
_______ 2.91
4.52
w
Bi
5.00
6.00
Total
Population D Affected Male
'
8.00
Affected
Female
(D) Population (D) Population
female
(%)
8 _____ 14 ________ 0.00
___ 58 _____ 43
0.00
_______ 0.00
___ 85 _____ 67 _________ 0.00
_______ 0.85
___ 70 _____ 88 ________ 0.00
_______ 2.08 ■ .Vc
217
233 ________ 0.00
_______ 5.14 ^'2 : -^2
249
248 ________ 0.80
7.42
129 ____ 126
1.55
w Wig
7.00
(%)
0.00
2.33
0.00
1.14
0.00
0.81
4.76
27
CHART-6: Diseases of the nervous system- Chapter 6 ICD-10 (International Classification of Diseases)
Male
Female
□ Pindimana HEIoor
□ Pindimana ■ Floor
61 +years
36-60 years
L_
20-35 years
r
13-19 years
I
T
6-12 years
1-5 years
0-12 months
6.00
3.00
4.00
5.00
A
Age Group
-0
'/ 1 • 4
/ ’0
0.00
C
A+B+C
(A+B+C)
(A+B+C)
Total
Population Male
Total
Population
Female
0.00
male female male female
1 ___1 ______ 1 _______ 77
1 __ 7 _______ 1 ______ 256
2 - ■ 0 ___ 2 _______ 4 ______ 314
' 2
’ '-3
1 11 _____ 11 ______ 356
11/ 6
6 26 ______ 24 ______ 1212
54
1168
13 _____ 19 34
_16
female
:/o
^'O gff2 __o
.
2
• ‘ 6
Bi
1.00
B
male female male
0-12 months
1 -5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
2.00
9,
7,
1l|
10|
19
11
3
11|
13
9
' 3
= 3
19
23
376
______
71
________ 225
318
________ 355
_______ 1104
Affected
3.00
5.00
1.00
2.00
Affected
Total
Affected
Population D| Population D| Affected Male
4.00
6.00
Affected
Female
(A+B+C)
(D) Population (D) Population
Population (%)
female
male female frnale female
(%)___
(%)
0.00
0
8 _ ___ 14 ________ 0.00
________ 1.30 __________ 1.41 • 0
0.00
58 _____ 43 ________ 1.72
0
1 WK
________ 2.73 __________ 0.44
0.00
85 _____ 67 ________ 1.18
________ 0.64 __________ 1.26
1 7T HO
1.14
70 _____ 88 ________ 1.43
1
________ 3.09 __________ 3.10
’
3
0.86
________
1.38
233
\2 217
________ 2.15 __________ 2.17
(A+B+C)
Population
(%) male
2.91 __________ 4.48 ___ _5
5.50
5.05
2
1206
418
10
5
249
129
248 ________ 2,01
1.55
126
4,03
3.97
CHART-7: Diseases of the eye & adnexa- Chapter 7 ICD-10 (International Classification of Diseases)
M
.r
28
Male
Female
Pindimana oEloor
[□Pindimana BEIoor
61+ years
36-60 years
20-35 years
13-19 years
6-12 years
1-5 years
0-12 months
14.00
12.00
Age Group
0-12 months
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
10.00
8.00
A
6.00
B
4.00
C
2.00
A+B+C
male female male female male female male
female
0"
Q '
C
0[; j 0 ___ 0 _____ 0
o•
2:
Wo
o|
1^1 *■^■0
. 0 _J0 _____ 0
d
3
•W-o ____ 7 ______ 6
4 - / 5
0
#'J6: ' < -^7 Wp4
16 _____ 23 < '20
6
3ll
6
28
21
24
19
17
____ 4 ______ 4
__ 16 ____ 15
^£45 __ 64 ____ 99
• 30
47 _____75
0.00
5.00
10.00
(A+B+C)
(A+B+C)
Affected
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
________ 0.00
_______ 0.00
_______ 1.27
_______ 1.97
_______ 1.32
_______ 0.00
_______ 0.00
_______ 1.26
_______ 1.69
__ 77 _________71
256 _______ 225
314 _______ 318
356 _______ 355
1212 ______ 1104
1168
1206
376
418
_______ 5.48
12.50
15.00
Affected
Total
Population D Population D
Affected
Male
25.00
Affected
Female
(D)
(D)
Population Population
male female ynale female
(%)
(%)
0 __ 8 _____14 ______ 0.00 ______ 0.00
43
2g
__0
58 r
______ 0.00 ______ 0.00
c
_1
85 _____67
0.00
1.49
gw
—
_______ 1.36
_______ 8.21 |
_______17.94
20.00
_1
_2
J3
16
27
70 _____ 88
217
233
249
248
129 __ 126
1.43
0.46
2.81
12.40|
1.14
0.86
5.24
21.43
29
CHART-8: Diseases of the ear & mastoid process- Chapter 8 ICD-10 (International Classification of Diseases)
Female
Male
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61 +years
36-60 years
i
7
20-35 years
13-19 years
6-12 years
1-5 years
0-12 months
4.50
4.00
Age Group
3.50
3.00
2.50
2.00
B
A
1.50
C
1.00
0.50
A+B+C
0.00
0.00
(A+B+C)
(A+B+C)
Affected
1.00
Affected
2.00
3.00
Affected
Population D
6.00
7.00
Total
Population D Affected Male
Affected
Female
4.00
5.00
■!
0-12 months
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
Total
Total
Population - Population
Male
Female
male female male female male female male female
f ~ :0
77 _______ 71
pl
0
0
0 ___ 0 _____ 1
0
0|
~ ____ 1 _____ 1
■ Q 3 , -rQ
256 ______ 225
314 ______ 318
____ 8 _____ 3
lilt?
0
3
l|
4
356 ______ 355
2 2__ 1
_1 ____ 2 _____ 7
1212 ______1104
<2
3
9
5
__ 3 ___ 12 ____ 11
6|
9
i cj / 3
1168 ______1206
10 ___ 16 ____ 25
26
12
376
418
2
9
7
6
11
3
W
Ba
(A+B+C)
Population
(D) Population (D) Population
(%) female male female male female
(%)
(%)
0.00
_______ 0.00 _______ 1.41
_J8 _____ 14 ________ 0,00
___ 58 _____ 43 ________ 0.00
0.00
_______ 0.39 _______ 0.44
________ 2.55 _______ 0.94
0.00
1'4* to ___ 85 ______ 67 _________ 1.18
0
___ 70 ______ 88 ________ 0.00
1.14
________ 0.56 _______ 1.97
________ 0.99 ______ 1.001 fl}-i ______ 0
217
233 ________ 0.46
0.00
4
_______ 1.37 ________ Z07
3
249
248 _________1.20
1.61
3.19
6.22
5
129
126
3.88
3.97
5
(A+B+C)
Population
(%) male
30
CHART-9: Diseases of the circulatory system- Chapter 9 ICO-10 (International Classification of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61+ years
36-60 years
i
••
|
20-35 years
13-19 years
6-12 years
1-5 years
0-12 months
14.00
12.00
10.00
8.00
6.00
Age Group
A
B
C
4.00
A+B+C
1
A
O 0-12 months
o
c*
1 -5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
male female male ______
female male female male
W-o '■rW&o -P-'o
0
V-‘;-1
o
___ 3
17
15
SWo
^o|
0 ____ 0
_J2
1
mg ___ 1
ft • -1 4
0
1
ii
12
13
19
17
22
female
o
0 ____ 0 ______0
0 _____0 _jg ______0
0
0 _J3 ______ 1
0 ■ ; 0 ____ 1 ______0
0 ____ _2 ____ 7 ______3
12 ___ 46 _____36
12
41
9
10
46
2.00
0.00
0.00
2.00
4.00
Affected
Total
Population D Population D Affected Male
(A+B+C)
(A+B+C)
Affected
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
77 _________ 71
256 ________ 225
314 ________ 318
356 ________ 355
1212 _______ 1104
_______ 0.00
_______ 0.00
________ 0.96
________ 0.28
________ 0.58
1168 _______ 1206 ________ 3.94
376
418
12.23
6.00
8.00
10.00
12.00
Affected
Female
(D) Population (D) Population
male______
female nale female
(%)
(%)____
o ___ 8 _____14 _________ 0.00
0.00 ____ o ’■ S
0.00
‘__ 58 ____ 43 _________ 0.00
0.00|
0
0.00
0.31
0.00 ‘
0.27
2.99
9.81 $
0
0
2
6
8
___ 85 ____ 67 _______ 0.00
0 ___ 70 ____ 88 _________ 0.00
217
233 _________ 0.92
>h.4 249
248 _________ 2.41
8 129
126 ____
6.20
0.00
0.00
0.00
1.61
6.35
31
CHART-10: Diseases of the respiratory system- Chapter 10 1CD-10 (International Classification of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61 +years
1
36-60 years
20-35 years
1
13-19 years
6-12 years
1-5 years
30.00
25.00
Age Group
20.00
0-12 months
1-5 years
5-12 years
13-19 years
20-35 years
36-60 years
61 + years
15.00
A
male female
I
0-12 months
——
10.00
B
male
5.00
C
female
A+B+C
male
female _male
female
8~____ 6 _____ 15
. .3
•25|^^Ml6
-P; 23 ___ 50 _____ 44
^117 f 1W6|E-I6|g^i4
24 ' ?
J30____ 57 _____ 60
1s{
11 !
18
40 -1 29____ 73 _____ 59
- 46 : 82|
^69^
48
61_ 199
140
44 -4-183
i.78
75
,78
200
243
26
29
38 H
27
28
35
92
91
/■-
-
5 '
SL
i
J|
0.00
0.00
5.00
(A+B+C)
(A+B+C)
Affected
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
10.00
15.00
I
■■i
20.00
Affected
Total
Population D Population D Affected Male
25.00
Affected
Female
(D) Population (D) Population
male female male [emale (%)
(%)
__ 77 _______ 71 ________ 7.79
21.13I pc-b _ 2
____ 8 ____ 14 ________ 0.00
14.29
256 ______ 225
19.53
19.56 < . 14|_____ 10 ___ 58 _____ 43 _______ 24.14
23.26
314 ______ 318 ______ 18.15 ______ 18.87 - • 11
___ 85 _____ 67 _______ 12.94
14.93
356 ______ 355
20.51
16.62
■ 10
___ 70 _____ 88 ________ 14.29
14.77
1212 _____ 1104
16.42 ______ 12.68
36
26 217
233 ________ 16.59
11.16
1168 _____ 1206
17.12
20,15 J 33
34 249
248 ________ 13.25
13.71
376
418
24.47
21.77
22 ___ J6 129
126 ________17.05
12.70
32
CHART-11: Diseases of the digestive system- Chapter 11 ICD- 10(International Classification of Diseases)
Male
Female
E Pindimana ■ Eloor
□ Pindimana ■ Eloor
■
tt
61 +years
i
36-60 years
20-35 years
13-19 years
■■ 6-12 years
j
1-5 years
I
T"
0-12 months
12.00
10.00
6.00
8.00
Age Group
A
B
4.00
C
A+B+C
male female male female male female
0-12 months
1-5 years
W'o
__ 4 1
6-12 years
13-19 years
' -re
20-35 years
36-60 years
8
16
.'2
Wio
male
1 _J0
3 7^'1 W<M<1
____ 5
2 3 V3
2 ___ 11
'^6 ■
^-2 __ 1
3 ____ 3
h;.22 O&-.'6 Oil
___ 41
Wl3
28 -•ffiS34
26 W'"32
70
i
0.00
'
(A+B+C)
(A+B+C)
Total
Population Male
Total
Population
Female
1.00
2.00
Affected
3.00
4.00
Affected
5.00
6.00
7.00
8.00
Affected
Total
Population D Population D Affected Male
Affected
Female
______ 1
______ 4
______ 4
_J77
256
314
(A+B+C)
(A+B+C)
(D)
Population (%)|Populatlon (%)
(D) Population Population
male
female
male female nale female
(%)
(%)___
_________ 71 _________0.00
1.41 __ 0
____ 8 _____ 14 ________ 0.00
0.00
________ 225 _________ 1.95
1.78 Wgi
2 ___ 58 ____ 43 _________ 1.72
4.65
2 ___ 85 ____ 67 ________ 4,71
________ 318 _________3.50
1.26 ■. ‘'4 ' ?
2.99
______ 7
_____ 23
79
356
1212
1168
________ 355 __________0.84
_______ 1104 __________3.38
_____
1206
5.99
female
1.97
2.08 -^5
6.55
10
___ 70 _____ 88 _________1.43
217
233
2.30
;r'3
249
248
4.02
■ 6
■-
1.14
2.58
1.21
33
CHART-12: Diseases of the skin & subcutaneous tissue- Chapter 12 ICD-10 (International Classification of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61 +years
|
36-60 years
I
I
20-35 years
_ __________L
I
]'
1
13-19 years
T
6-12 years
1-5 years
I
i
-U
10.00
9.00
8.00
7.00
Age Group
6.00
A
5.00
4.00
B
C
3.00
——
T
2.00
1.00
A+B+C
male female male female male female male female
0-12 months
1 -5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+ years
nW 2
13
--
:
Mi? •IMio Bis
11 Wr8|
9
33 ’V ^16 ■F 10 •T
'• 28
35
31
6
7
14
0 Wl
5
5
ft
'6 '■
25 r isi "
35
12
25
8
ko ___ 2 _____ 2
__ 23 ____ 10
___ 27 _____ 21
_5 ___ 26 ____ 16
VI ___ 58 ____ 52
84 _____ 97
27
9
28
28
0-12 months
0.00
0.00
2.00
4.00
6.00
8.00
(A+B+C)
(A+B+C)
Affected
Affected
Total
Affected
Population
Population D
D
Affected Male
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
male female pale female
10.00
Affected
Female
(D) Population (D) Population
Sfcc
77 _______ 71 _______ 2.60 _______ 2.82
256 ______ 225 _______ 8.98 _______ 4,44 ; 3-n-<. 1
314 ______ 318 ________ 8.60 _______ 6.60
1 - - -1
356 ______ 355 ________ 7.30 _______ 4,51
1 '*Au,r’ ^5
1212 ______1104 ________ 4,79 _______ 4.71
7
J2
1168 ______1206 ________ 7.19 _______ 8.04 ____ 6
11
376
418
7.45
6.70
' 5
11
(%)
70
217
14 .________ 0.00
43 _________ 5.17
67
1.18
88 _________ 1.43
233 _________ 3.23
249
129
248 _________ 2.41
126
3.88
__ 8
58
85
(%)___
0.00
2.33
1.49
5.68
5.15
4.44
8.73
34
CHART-13: Diseases of the musculoskeletal system &
connective tissue- Chapter 13 ICD 10 (International Classification of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
r~^
61 +years
J___
36-60 years
20-35 years
I
' i
I
~
!
—"1
-
I
'..
'
45.00
40.00
35.00
Age Group
30.00
25.00
A
20.00
B
C
1-5 years
__7
el
2
6-12 years
12
13-19 years
r~^-
5
3_____ 6
j
8| -
20-35 years
55
36-60 years
126
22
53 __ 42 ___ 39
162
90
145
61+ years
52
54
52
69
3
1
ej
6
52
1
male
____ 9
__ 67
139
199
50
74
149
355
154
.i,:.---------- .
1-5 years
10.0(
female
12
21
21
6-12 years
0-12 months
..................................................................................
'
8
3|
6
:
A+B+C
0-12 months
l|
~|
■
15.00
male female male female male female
~ 2|
0
3l
~T
13-19 years
I______ !
1
0.00
5.00
I j
10.00
20.00
(A+B+C)
(A+B+C)
Affected
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
1
77
13
17
39
159
256
314
356
1212
1168
225
4.69
318 ________ 6.69
355 ________ 5.90
1104
12.29
1206
30,39
376
418
40.96
506
197
15.00
_ 71
10.39 _______ 1.41
5.78
5-35
25.00
-J
30.00
35.00
40.00
Affected
Total
Population D Population D Affected Male
male female
2
to
21
10.99 i 9
14.40 44
41.96 71
47.13 54
nale female
45.00
50.00
Affected
Female
(D)
Population
(D) Population
(%)
(%)
8 ____ 14
25.00 ________ 14.29
58
j43
8 __ 85
17 70
26 217
27 249
26 129
67
25.86
24,71
12.86
|0
88
233
248
126
23,26
11.94
19.32
20.28
11.16
28.51 ________ 10.89
41,86 ________ 20,63
35
CHART-14: Diseases of the genitourinary system - Chapter 14 ICD-10 (International Classification of Diseases)
Female
Male
□ Rndimana ■ Boor I
□ Hndimana ■ Boor
61 +years
36-60 years
|
20-35 years
I
13-19 years
6-12 years
1-5 years
0-12 months
8.00
7.00
6.00
Age Group
4.00
5.00
A
male
3.00
B
2.00
C
A+B+C
female male female male female male
0.00
1.00
female
1.00
2.00
3.00
(A+B+C)
(A+B+C)
Affected
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
4.00
5.00
6.00
7.00
8.00
Affected
Total
Population D Population D Affected Male
9.00
Affected
Female
(D)
(D) Population Population
male_______
female nale female
(%)
(%)
0-12 months
0
0
0
0
1
0
1
77
71
0.00
1.41
0
0
8
14
0.00
0.00
1-5 years
0
1
1
1
0
4
2
256
225
1.56
0.89
0.00
2.33
1
1
i ■ 2
1
4
3
314
318
1.27
0.94
1
0
43
1
0
1
58
6-12 years
85
67
1.18
0.00
13-19 years
1
2
2
2
r-’a S
S-8
6
12
356
355
1.69
3.38
3
70
88
4.29
3.41
20-35 years
24
26
24
20
22
21
70
67
1212
1104
5.78
6.07
233
3.69
5.15
20
4
25
19
42
23
-r/29
62
96
1168
1206
5.31
7.96
249
248
6.83
5.24
4
5
9
6
S9
15
22
376
418
3.99
5.26
8
17
9
217
36-60 years
3
12
13
9
129
126
6.98
7.14
61 + years
36
CHART-15: Pregnancy, childbirth and the puerperium - Chapter 15 ICD-10 (International Classification of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61+ years
36-60 years
20-35 years
13-19 years
6-12 years
1-5 years
0-12 months
1.00
0.90
0.80
0.70
Age Group
0.60
0.50
A
0.40
B
0.30
C
0-12 months
1 -5 years
0
0
S-12 years
13-19 years
M-' 0
0
61+ years
c
I-"o
___ 0
c'
20-35 years
36-60 years
d
c|
2
c ____
0
LS'
0 ■•j-’o
0
Wo •'
2
_g
o
0.10
A+B+C
male female male female male female
■
0.20
male
female
0.00
0.05
0.10
0.15
0.20
0.25
0.30
(A+B+C)
(A+B+C)
Affected
Affected
Affected
Population D
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
male female male
0.35
Total
Population D
0.40
0.45
Affected Male
0.50
Affected
Female
(D) Population |(D) Population
[emale
(%)____
(%)___
cj
o ____ 0
0
77
71
0.00 _______ 0.00
0
0
0
o
8
14
0
0.00
256
314
356
1212
1168
376
0.00
225
0.00
0
0
58
43
0.00
0.00
0
_____ 0.00 I 0
0.45
0
0.08
0
_____ oog
0
.0
0
0
0
85
67
88
233
248
126
0.00
0.00
0.00
0.00
' '0
0
0
0
0
0
IB
c
1
0
5
_c
i
0
1
0
0
c
0
0
0.00
318
0.00 _______ 0.00 >1
355
0.00
1104
0.00
1206
0.00
418
0.00
4
70
217
249
129
0.00
0.00
0.00
0.00
0.00
0.00
37
CHART-16: Congenital malformations,deformations & chromosomal abnormal
- Chapter 17 ICD-10 (International Classification of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61+years
■
36-60 years
1
20-35 years
i
i
13-19 years
6-12 years
1-5 years
I
I
0.90
0.80
0-12 months
0.70
0.60
Age Group
0-12 months
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
0.50
A
0.40
B
0.30
C
0.20
0.10
A+B+C
male female male female male female male female
Ol
0
C
0 ___ _C
_J0 ______ 0
4 '-‘o f
o •
0 •'2
0 ____ 2 ______ 0
0
• -
0 '
0
____ 2_
•
c /
0
____ 1_____ 3_ 3
5
2
3
0.00
0.10
0.20
0.30
Affected
Affected
Total
Population D Population D Affected Male
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
male_______
female nale emale
77
71 _______ 0.00
0.00 -'b 0
256
225 ________ 0.78
0.00
314
318 ________ 0.00
0.63
0.84
0.56
1212
1104
0J5C
0.54
1
1168
1206
0.77
0.50|
9
6
0.70
Affected
355
3
0.60
(A+B+C)
356
1
0.50
(A+B+C)
0 —_ J ____ 0 ______ 2
1 _J3 ______2
1_ J '
1 __ 2
. .2 ____ 6 ______ 6
1
0.40
.ft
■T
0
0
0
0
0
0.80
0.90
Affected
Female
(D) Population (D) Population
____ (%)
____
0 ____ 8
14 ________ 0.00
0 ___ 58
43 ________ 0.00
0 ___ 85 _____ 67 ________ 0.00
0
70
88 _________0.00
1 217
233 _________0.00
2[ 249
248 _______ aoo
0.00
0.00
0.00
0.00
0.43
0J31
38
CHART-17: Symptoms, signs & abnormal clinical and lab. findings, not elsewhere classified
- Chapter 18 ICD-10 (International Classification of
Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
r
61 + years
36-60 years
i
H
^5
13-19 years
i
c
50.00
40.00
Age Group
1-5 years
I
r
60.00
6-12 years
1
I
0-12 months
30.00
A
20.00
B
C
10.00
A+B+C
male female male female male female male
0-12 months
__ 4[
1-5 years
29
6-12 years
__ 41_
5.00
(A+B+C)
(A+B+C)
Total
Population Male
Total
Population
Female
10.00
Affected
15.00
20.00
Affected
4
_8
11 ____ 24
77
30 __18
19
20
2Z
67 _____ 76
256
225
26.17
33.78
105
125
314
318
33.44
39.31
48 _ __ 44
110
133
356
355
30.90
37.46
141 ___ 139
366
377
1212
1104
30.20
34,15
129
330
403
1168
1206
28.25
33.42
42
24
40
52
22
119
135
106
145
91
W __ 40 ____ 44
37
<03
in
147
25.00
30.00
35.00
40.00
45.00
Affected
Total
Population D Population D Affected Male
50.00
Affected
Female
(A+B+C)
(A+B+C)
Population (%) Population (%)
(D) Population (D) Population
male
female
male female male female
(%)
(%)_____
71
14.29
33.80
4
____
8
____ 14
50.00
6
42.86
e
13-19 years
110
female
0.00
al
io|
20-35 years
36-60 years
20-35 years
24
39
22
18 ___ 58
31 ___ 85
39 7C
43
41,38
41.86
67
45.88
46.27
88
31.43
44.32
61
75
81
217
233
28.11
34.76
97
249
248
30.12
39.11
39
CHART-18: Injury, poisoning & certain other consequences of external causes- Chapter 19 ICD 10 (International Classification of Diseases)
Male
Female
□ Pindimana ■Eloor I
□ Pindimana ■ Boor
6 W years
36-60 years
i—i
20-35 years
B-19 years
6-12 years
VS years
0-12 months
3.50
3.00
Age Group
0-12 months
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
2.50
2.00
A
150
too
B
0.50
0.00
0.00
C
A+B+C
(A+B+C)
(A+B+C)
0.50
Affected
1.00
1.50
Affected
2.00
2.50
3.00
Affected
Total
Population Population Affected
D
D
Male
Affected
Female
Total
Total
(A+B+C)
(A+B+C)
(D)
(D)
PopulatlonlPopulation Population (%)
Population
Population Population
male
female
male female male female iiale|female - Male
Female
male
(%) female maleffemale nalgfemale
(%)__
(%)
0
0
0
0 ___ 0_ 0
c
0
77
71
0.00 _______ 0.00
0
0 8
14
0.00
0.00
0
0
0
o ___ 1_ 1
1
1
256
225
0.39
0.44 ft 0 ' . 0 58
43
0.00
0.00
2
4
o
2
3
7
5
314
318
2.23
1.57
0 85
1
67
1.18
0.00
3 42
2
1
Q
_____ 0
5
4
356
355
1.40
1.13
0
0 7C
88
0.00
0.00
7 JL
4
12
8
1
5 28
10
1212
1104
2.31
0.91
1
2 217 233
0.46
0.86
16
12
9
4
12
7 38
23
1168
1206
3.25
1.91
2
1 249 248
0.80
0.40
40
CHART-19: External causes of morbidity & mortality- Chapter 20 (International Code of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61 + years
36-60 years
20-35 years
13-19 years
■
6-12 years
1-5 years
0-12 months
4.00
3.50
3.00
2.50
2.00
1.50
1.00
0.50
0.00
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
A.
Age Group
A
B
C
A+B+C
male female male female male female male
0-12 months
1-5 years
S-12 years
13-19 years
20-35 years
36-60 years
51+ years
;io
J) 5
0 n o
J
____ 0 & o
1 ______ 1_
1
2
9 _____ 8_
8
2
2
____ 1
J
j
_J0
3
J.
4
4
2
Affected
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
Affected
77
71
0
o
256
225
0.00
o.oo
1
2
314
318
0.32
0.63
1
j
356
355
0.28
0.28
4
5
1212
1104
Ha
0.33
0.45
13
J5
1168
1206
1.11
1.24
.■■11
13
5
376
418
3.46
1.20
■'• ■ o
Affected
Total
Population D Population D Affected Male
Affected
Female
(A+B+C)
Population (%)
(D) Population (D) Population
female
male female nale female
(%)
(%)
0.00
0.00
0
0
8
14
0.00
0.00
0
0
- -
(A+B+C)
0
0
0
o|
female
(A+B+C)
0
1
0
2
3
1
0
0
0
1
1
1
.£8
43
0.00
0.00
85
67
1.18
o.oc
70
88
000
0.00
217
233
0.92
0.43
249
248
1.20
0.4C
129
126
0.78
0.79
41
CHART-20: Factors influencing hcaltl, status & contact with health services- Chapter 21 ICD-10 (International Classincation of Diseases)
Male
Female
□ Rndimana ■ Boor
□ Rndimana ■ Boor
61 +years
36-60 years
20-35 years
13-19 years
6-12 years
!
1-5 years
0-12 months
1.40
1.20
1.00
Age Group
0.80
A
0.60
B
0.40
C
jg
o
■ 13
13-19 years
___ 1
cl
o|
g
20-35 years
0
0
1 -5 years
6-12 years
36-60 years
61+ years
0
0
0
1
0
i
0
0
.00
0.02
0.04
0.06
0.12
0.14
0.16
Affected
Affected
Affected
Total
Population D Population D Affected Male
female
Total
Population Male
Total
Population
Female
(A+B+C)
Population
(%) male
(A+B+C)
Population
(%) female
male female Tiale female
0
0
1
0
77
71
1.30 ______ 0.00
0
0
0
C
0
0
256
225
0.00
0.00
_0
0
0
314
318
0.00
0.00
0
0
0
0
0
0
0
0
1
0
356
355
___ c
0 j__ g
0.28
0.00
S-
2
0
2
1212
1104
0.00
0.18
0
0
0
1
1168
1206
0.00
0.08
0
0
0
0
0
376
418
0.00
0.00
0.18
0.20
Affected
Female
(D) Population (D) Population
0
C
0
0.10
0.08
(A+B+C)
J2
o
0
■
0.00
(A+B+C)
A+B+C
male female male female male female male
0-12 months
0.20
0
0
0
0
0
0
0
(%)
(%)___
8
14
ooo
58
43
0.00
0.00
85
67
0.00
0.00
70
88
0.00
0.00
217
233
0.00
0.00
249
248
0.00
0.00
129
126
0.00
0.00
____ 0.00
42
CHART-21: Mortality figures
Asthma Mortality - Hoor/Pindimana 1994-2003
5 -j
4
3
2
1 0 —
- Deaths due
to Asthma at
Floor
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003
Year of Scrutiny
Deaths due
to Asthma at
Pindimana
Blood disease Mortality- Eloor/Pindimana 1994-2003
12 1
1
0.8
0.6
0.4
0.2
0
-♦—Deaths due to
Blood disease
-■-Deaths due to
Blood disease
Year of Scrutiny
43
Cardiac Arrest Mortality - Eloor/Pindimana 1994-2003
3.5 i
3
2.5
2
—♦—Deaths due to Cardiac
Arrest at Eloor
1.5
1
—Deaths due to Cardiac
Arrest at Pindimana
0.5
0 19C4
1995
1996
1997
1998
1999
2000
2001
2002
2003
Year of Scrutiny
Heart Disease Mortality - Hoor/Pindimana 1994-2003
12 1
Kidney Failure Mortality - Eloor/Pindimana 1994-2003
2.5
10
8
6
4 2
0
" ♦
2
—♦
-■
//////////
Year of Scrutiny
Deaths due to
Heart Disease
at Eloor
Deaths due to
Heart Disease
at Pindimana
deaths due to
Kidney Failure
1.5
at Eloor
1
—■—Deaths due to
0.5
Kidney Failure
at Pindimana
0
/ / // / ///
Year of Scrutiny
44
Paralysis Mortality - Eloor/Pindimana 1994-2003
5
Deaths due to
Paralysis at
Eloor
4
3
2
1
Deaths due to
Paralysis at
Pindimana
0
^////////
Tuberculosis Mortality - Boor/Pindimana 1994-2003
2.5
/1
15
▲
0.5
/ \
/’
jL
\
/
/
\
/
0 B M Ml ■ M M ■ B Ml
—♦ Deaths due to
Tuberculosis
at Eloor
■ M Deaths due to
Tuberculosis
at Pindimana
Year of Scrutiny
Y««r of Scrutiny
A
Sudden Breathlessness Mortality - Eloor/Pindimana 19942003
" ♦
3 1
2
1
0
///#/////
Year of Scrutiny
Deaths due to
Sudden
breathlessness
at Eloor
Deaths due to
Sudden
breathlessness
at Pindimana
45
Cancer Mortality- Eloor/Pindimana 1994-2003
15
10
5
0
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
—♦— Deaths
due to
Cancer at
Eloor
' ■ Deaths due
to Cancer
at
Pindimana |
Year of Scrutiny
46
Thyroid
Depression
Thyroid Morbidity
Depression Mortality
60+ years
--1-
60+ years
.r
35-60 years
35-60 years
19-35 years
19-35 years
—
12-19 years
n.
£
12-19 years
□ Rndimana
r
5-12 years
□ Boor
51
1-5 years
r-
r
■■
~~i
5-12 years
-■
OB
1-5 years
‘iXy,'
0-12 months
1 xy~. ‘r *j
X -
0-12 months
0.00
0.00
Age Group
1.00
A
B
0-12 month§
1~
9
11
3.00
4.00
Affected ELOOR
Population (%)
C
c
/ c:
1-5 years
5-12 years
12-19 years
19-35 years
35-60 years
60+ years
2.00
0 __________ 0.00 j
•1 __________ 0.52 ~
2
2
2
2.31|
16.61
Increased risk at Eloor
6.00
9.00
12.00
15.00
5.00
Affected
Population In
Pindimana (%)
Age Group
J _ ________ 0
0-12 months
D
—J __________ 2,92
___ 0_ __ 2 _____4.74
4
4 __________ 2.13 _
7
14 _________ 3.99
3.00
□ Pindimana
□ Eloor
I-
__ __________ 0
1-5 years
__________ c
5-12 years
2
4
1.265822785
0.888888889
0 ___ _________ 0
1
0.390625
2.545336674
Affected
Population
in
Pindimana
Affected
ELOOR
Population
A
C
_cy_
0
IL i|
0 _______ c
_0
1.54
J
J.
0.54
19-35 years
18
35-60 years
63 ■j ■
10
60+ years
28
3.
5
1
-
0 _______ 0
0
- 5 X.
0
■ ■ 6 -
2.25 •
3.56
10.24
13.62|
31.76
6.526522877
Increased risk at Eloor
(%)
0.00
0
12-19 years
D
_0 _________ 0
-
_1
0.6329114
c ________ C
—1
3
0.2008032
1.171875
2.00559
15.83538
47
Mental Disease
Memory Loss
Mental Disease
Memory Loss Morbidity
n
60+ years
35-60 years
19-35 years
12-19 years
5-12 years
1-5 years
0-12 months
■ : -Kf?.
L
I
19-35 years
□ Pindimana
12-19 years
□ Eloor
□ Eloor
■
5-12 years
1-5 years
0-12 months
0.50
1.00
2.00
1.50
0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00
Affected
Population
in
Pindimana
Affected
ELOOR
Population
A
B
C
0-12 months
’0
___ 0
1-5 years
J
__ g
g
g
5-12 years
n-
35-60 years
□ Pindimana
0.00
Age Group
j
60+ years
■1 ' ^7.
______ 1
19-35 years
2
12-19 years
35-60 years
9
60+ years
1
i
■ J/
(%)
D
o ______ 0.00
o-oop"
__ o
Age Group
o
0
0.990099
1 -5 years
0
0.00
0
5-12 years
.0
0.45
0
0
12-19 years
3
0.91
0
0
19-35 years
-F
A
B
0-12 months
_1
0
<
c
•: ' O C
■
■ h
3
2
4
1.93
3
0.6024096
35-60 years
.5
1
C
0.73
1
0.390625
60+ years
9
4.02
Increased risk at Eloor
(%)
Affected
Population
in
Pindimana
Affected
ELOOR
Population
C
0
0
1
0
1
3
6
(%)
0
0
0
1
0
1
2
D
0.00
0.00
0.50
0.79
0.55
1.19
6.48
9.51
1.983134
(%)
0
1
0
0
0
1
4
0
0.990099
0
0
0
0.2008032
1.5625
2.7534022
2.025745
Increased risk at Eloor
3.455678
48
Epilepsy
Migraine
F“
Epilepsy Morbidity
60+ years
35-60 years
19-35 years
12-19 years
5-12 years
1-5 years
0-12 months
Migraine at Death
2^
60+ years
.......
35-60 years
□ Pindimana
□ Eloor
19-35 years
5-12 years
- |.
0-12 months
- I
0.00
~ ■
1
'W
1
r. 1
A
!
■ 2
i
5-12 years
_ 2 -UF ;
l|
12-19 years
r ;2 W-
_3
1
2.74
6___
2
1.58
4
1.39
■
o
19-35 years
C
35-60 years
60+ years
Bi
C
__ (%)
5.76
4,82
1.98
0
(%)
D
0.83
19.12
Increased risk at Eloor
Affected
Population
In
Pindimana
Affected
ELOOR
Population
B
1 -5 years
“T"
:—i
□ B_OOR
1-5 years
A
0-12 months
□ PINDIMANA
12-19 years
0.00 1.00 2.00 3.00 4.00 5.00 6.00
Age Group
~~ r
4.8533023
:
0 ____
0.00
i
0.99
2
____ 1
0.66
1.27
0.22
4 _______ 0.80
0
A
0-12 months
■■
i
Age Group
1 -5 years
2.00
•r
0
'C
X?'.
6.00
8.00
10.00
Affected
Population
in
Pindimana
Affected
ELOOR
Population
B
o
5-12 years
4.00
C
__(%)
D
(%)
0_^
0
’
1
1 it
i
___ 2
5.84
0 _________ _0
0
0.00
0
_____ 0
0.52
1
0.990099
0.90
0
0
12-19 years
~''d
7
19-35 years
-
12
13
___ 9
4.46
4
0.8888889
35-60 years
23
17
26
8.31
7
60+ years
1.4056225
1
7
1
3.05
0 _________ 0
23.08
3.2846104
0.00
3.9392516
Increased risk at Eloor
7.0253247
49
Paralysis and Paralytic Stroke
Vision Loss
Paralysis/Paralytic stroke
Vision Loss at Death
60+ years
19-35 years
I
60+ years
35-60 years
__ _
35-60 years
□
12-19 years to if
19-35 years
□ Pindimana
: -..J
12-19 years
□ Eloor
5-12 years
‘ ]_____
it
-:
■
h
■
1-5 years
0-12 months
3
0-12 months
0.00
2.00
4.00
6.00
8.00
10.00
□ Eloor
i
1
5-12 years
1 -5 years
□ Pindimana
0
Age Group ____ A
1-5 years
5-12 years
1 >_o
12-19 years
1
19-35 years
0
35-60 years
___ U
8
60+ years
'
(%)
T
__ g
__ g
__ g
0.45
___ 2
0.37
J
4
14
4
_0
J
■j
Age Group
0
0
0-12 months
0
0
A
B
0
(%)
C
___ g
i
ig
.___ c
0
1
0.77
2,02
1
_____ 2
1.82
i
0.6329114
3.17
3
0.6666667
12
27
2.4096386
1-5 years
_J—J
0
12-19 years
• •
: 3
/ -.J r (3
■■Q
_________ 0
19-35 years
_______ _ig
8
6
1.26
5
1.0040161
35-60 years
________ 28
42
____ 55
15.63
9,44
1
2.734375
60+ years
28
36
35
37.78
3.0808499
'io
■
3.7383911
:
■
61.19
Increased risk at Eloor
_(%)
D
0.00
5-12 years
;c
Affected
Population
In
Pindimana
■_____ C
._______ o
■
0.00
0
Affected
ELOOR
Population
_________ g
0.00
11.52
Increased risk at Eloor
(%)
D
0.00 _____
Ji
0
0
Affected
Population
In
Pindimana
Affected
ELOOR
Population
c
______ B
iBBi (J
W" c
0-12 months
*
0.00 5.00 10.0 15.0 20.0 25.0 30.0 35.0 40.0
_______ g ________ 0
o
g
g _______ _g
/
10.546875
14.256092
4.2919149
50
Hearing Loss Mortality
Heart Disease
Hearing Loss Mortality
Heart Disease Mortality
60+ years
60+ years
35-60 years
r
1;
19-35 years
* 12-19 years
5-12 years
(
19-35 years
□ Pindimana
■
■
■
l~~
35-60 years
Z3
□ Pindimana
12-19 years
□ Eloor
-
5-12 years
1-5 years
-
□ Boor
"I;
1-5 years
J:
0-12 months
0-12 months
__________________________________■
0.00
2.00
4.00
8.00
6.00
0.00 3.00 6.00 9.00 12.0 15.0 18.0 21.0 24.0 27.0 30.0
10.00 12.00
0
0
t
c?
c
[I
o
Age Group
0-12 months
1 -5 years
Affected
Population
in
Pindimana
Affected
ELOOR
Population
T
A
B
0
5-12 years
.J
-J.
12-19 years
0
C
g
0
i
0.00
0.54
0 ______ 0.00
19-35 years
2
_2
___ 1
35-60 years
4
d
•__ 6
60+ years
7
10
11
0.66
1.62
10.71
13.53
Increased risk at Eloor
(%)
0
o ______ 0.00
o
0
D
(%)
2.7433386
0
£ •-0
B ro
.i
: 1
4
10
0
0
0
0
0.2222222
0.8032129
3.90625
Age Group
A
0-12 months
1 -5 years
5-12 years
■■
0
_1
0
_____ C
0 ___
■
0
0
0
0
Affected
Population
In
Pindimana
Affected
ELOOR
Population
B
0
>
0
(%)
D
(%)
0
0.00
0
0
0|
_c
0.00
||g
0
J
_0
2.04
c
0
o __________0
12-19 years
0
1 ______
0
0.50
19-35 years
3
4
_0
0.95
2
0.4444444
35-60 years
24
25
11
7.84
d; ‘ 9
1.8072289
60+ years
23
40
17
29.37
14
40.70
4.9316851
Increased risk at Eloor
5.46875
7.7204234
5.2723343
51
Bronchitis
Asthma
Bronchitis Mortality
"T------- r '
60+ years
I
~T—T
35-60 years
60+ years
—i
--i
F’
|
■■
19-35 years
□ Rndimana
|
5-12 years
5
=2
■
:
1-5 years
0
0
0
0.0
0
A
B
8 •'r y
1-5 years
5-12 years
12-19 years
___ io
19-35 years
15
yf >
(%)
C
Q
0
J2
1
2
6.0
9.0 12.0 15.0 18.0 21.0 24.0 27.0 30.0
D
(%)
Age Group
___ A
0-12 months
V'.' •
B
C
2X1 _____
1.59
o
0
y-Mb
12.56
2
1.980198
1 -5 years
10
10.46
1
0.6578947
5-12 years
i
6
13
9.97 _________ 1
0.6329114
12-19 years
J
31
5.79
_______ 0
19-35 years
8
2___ i
28
42
_______53
18
31
‘
22
3
45
8.40
5
1.0040161
35-60 years
60+ years
11
0
26
15.53
5
1.953125
60+ years
64.32
10.326668
6.2281452
Affected
Population
in
Pindimana
Affected
ELOOR
Population
35-60 years
Increased risk at Eloor
3.0
Affected
Population
in
Pindimana
Affected
ELOOR
Population
0-12 months
»
0-12 months
0
□ Boor
5 r
5-12 years
3
0.00 2.00 4.00 6.00 8.00 10.0 12.0 14.0 16.0 18.0
Age Group
□ Ptndimana
12-19 years
□ Boor
1-5 years
0-12 months
! -
35-60 years
19-35 years
12-19 years
Asthma Mortality
-
V."
(%)
(%)
D
. gy ' i
2.17
c __J?
12
2.36
y
0
6.75
1
0.6578947
3.01
5.61
2
.1
0.2222222
15.85
9
1.8072289
26.14
____ 15
‘ o|
2L2?
2^127
61.90
Increased risk at Eloor
0
0.6329114
5.859375
9.1796323
6.7430415
52
Wheezing
Sinusitis
Sinusitis at Death
60+ years
35-60 years
19-35 years
12-19 years
5-12 years
1-5 years
0-12 months
Wheezing at Death
60+ years
<
i-J'!
□ Pindimana
19-35 years
□ Eloor
12-19 years
□ Pindimana
5-12 years
□ Boor
1-5 years
c
Age Group
A
0-12 months
_____ 0
1-5 years
1
5-12 years
2
12-19 years
2
>:•
4
(%)
Affected
Population
in
Pindimana
D
35-60 years
4
J;
_2
30+ years
0
0
Age Group
A
2.00
0
1.38 ________ 0
0
1 -5 years
_____ 0_
0_
c
0
5-12 years
_____ 0_
c
1.93 _________ 0
0
2.32
<
0
0
1.30 _________ 0
0.32|
0
0
9.24
0
3.00
0
4.00
0.00
J
0.00
Jj ______ 0.00
12-19 years
0
0
0___ _
0
J
J
0.00
35-60 years
J
0
2
0.36
0
0
3
1.27
I
Affected
Population
In
Pindimana
D
(%)
I!
19-35 years
60+ years
5.00
Affected
ELOOR
Population
c
B
0-12 months
1.98
J
(%)
1.00
0
0.00
.0
____
0.00
Affected
ELOOR
Population
,
Ip
0-12 months
0. 0. 0. 0. 0. 1. 1. 1. 1. 1. 2. 2. 2. 2. 2. 3.
00 20 40 60 80 00 20 40 60 80 00 20 40 60 80 00
19-35 years
II''
35-60 years
0.00
(%)
0
0
0
0
0
0
0
0
0
J
0
0
0
Increased risk at Eloor
53
Stomach Ulcers
Allergy Dermatitis
Stomach Ulcer
Allergy Dermatitis
60+ years
I
,
I
19-35 years
~
12-19 years =3— :t
12-19 years
□ Rndimana
5-12 years
□ Boor
"i
5-12 years
1 -5 years — 1 ~ ~T~
0-12 months —— ~T~
1-5 years
0-12 months
0.00
1.00
A
2.00
3.00
1-5 years
J':
j
J-
o
c
1
19-35 years
0________ 11
35-60 years
5
3
13
7.00
(%)
_____ 0
. h
■
6.00
0
1
__Z
(%)
w
Age Group
0
0 _________ 0
0.54
0.84 j
2.26^
g _________ 0
MO
'^0
0
J
O Pindimana
i
□ Boor
4.0
8.0
12.0
A
___ B
C
1 -5 years
17_ .__
5-12 years
24_
D
7.59
?4
17
1.3157895
____ 2
1.2658228
____ is
ic
is
2.0080321
29
1?
11.73
52
.3^
18.43
60+ years
10
21
12
"i
2.970297
15.06
53
15.86
107.99
Increased risk at Eloor
"s
..2
35-60 years
0.2008032
■
(%)
______ 0
12
42
4
■
19.88 L
19-35 years
7.05 y" '■ ; 7'o ______ g
C
19.44
0.2008032
3.81 j___
Affected
Population
In
Pindimana
(%)
c
..
20.0
Affected
ELOOR
Population
0-12 months
12-19 years
16.0
_________0
ii
74.78257
1
Affected
Population
In
Pindimana
0.52
15.02
Increased risk at Eloor
0.0
____ D
0.00
I ~
, I
i
—t
8.00
Affected
ELOOR
Population
c
0
5-12 years
60+ years
4.00 *5.00
B
g
0-12 months
12-19 years
L
35-60 years
19-35 years
Age Group
]------... I
60+ years
35-60 years
3.3333333
5.859375
16.75265
6.4462183
54
Lumps on Body and Skin Disease
Arthritis
Lumps and skin disease at Death
J
60+ years
t
'
I
35-60 years
I
19-35 years
- ' L.... !
12-19 years
I
|•
| :
|
Arthritis
~i
|~~~
60+ years
-
□ Rndimana
□ Boor
' • • :[ h
5-12 years
1-5 years
19-35 years
□ Pindimana
5-12 years
0-12 months
0.0
1.0
2.0
3.0
4.0
*
Age Group
4'9-
J: •
0-12 months
□ Boor
5.0
0.0
6.0
Affected
Population
in
Pindimana
Affected
ELOOR
Population
A
B
C
0-12 months
0
fio
1-5 years
2
3
5-12 years
5
12-19 years
2
(%)
D
(%)
c
0
3 _______ 4.93
1
2
2
4.51
2
• ■■ M-:4
3.28
0.00 J:.
0
Age Group
3.0
6.0
9.0
12.0 15.0 18.0 21.0 24.0 27.0
Affected
Population
in
Pindimana
Affected
ELOOR
Population
A
0-12 months
0
0.990099
1-5 years
0
o
4
B
J
C
(%)
D
(%)
0
0
0,00
c
0
0
0
v?C
0.00
0
0
5-12 years
1
_____ 2
0
1.54
0
0
2.5316456
12-19 years
1
____ 4
3.14
0
________ 0
19-35 years
10
9
9
3.65
4
0.8888889
19-35 years
6
18
12
4.61
35-60 years
0.8032129
35-60 years
J
4
20
74
48
18.12
5
1.0040161
6
12
3
4.31
60+ years
JO
?4
0.2222222
12
5.02
1
0.390625
60+ years
8
36
25
25.26
6
25.70
Increased risk at Eloor
4.5857298
5.6044713
52.67
Increased risk at Eloor
2.34375
3.5699883
14.754066
55
Rheumatism
Fibroid at Death
Rheumatism
.. r7r~n. 7
T. .....
60+ years
Fibroid at Death
35-60 years
19-35 years
I
35-60 years
19-35 years
!o
12-19 years
I
60+ years
I.
—
-■
]
? i-h:
5-12 years
■
□ Pindimana
12-19 years
□ Floor
5-12 years
□ Pindimana
□ Eloor
=
1 -5 years
1-5 years
Mt
0-12 months
0-12 months
—t
1.00
0.00
3.00
2.00
0.00 4.00 8.00 12.0 16.0 20.0 24.0 28.0
0
0
0
0
0
Affected
ELOOR
Population
Age Group
A
B
60+ years
A
c
B
?•
D
(%)
(%)
____c___
0
0.00
0
5-12 years
0.40
0
c
0.00
o
1
_____ 0_____
0
12-19 years
0
o
0.00
__ c
0
_____ 0
0
0.45
__±_o
g
0
19-35 years
2
3
5
1.27
6
54
36
0
4
1.40
\ F F 1
0
0.2222222
35-60 years
3
10
2.33
26
11.86
■t 6
^2
60+ years
1
5
26.46
2.43
10.28
1
18
gw 4
1.2048193
______
0.390625
1.380724
W
X
0-12 months
g
1-5 years
35-60 years
Age Group
(%)
Affected
Population
in
Pindimana
Affected
ELOOR
Population
0
■■■'____________ 0_
12-19 years __
19-35 years __
(%)
*
5.00
c
0 'k 1
2
_________ 0 1___ LC
0-12 months
5-12 years
___C
Affected
Population
in
Pindimana
4.00
1
12
18
C
D
0 ______ 0.00
40.16
0
a. c
0
1-5 years
_C r-
*
0
I
1.5625
13.43509
0
0
2
2.26
1
0.990099
0
2.989541
Increased risk at Eloor
Increased risk at Eloor
J ______ 1.59
7.4434971
56
Hysterectomy
D&C
Hysterectomy
D&C Mortality
60+ years
60+ years
35-60 years
35-60 years
19-35 years
12-19 years
5-12 years
□ Rndimana
19-35 years
□ Boor
12-19 years
□ Rndimana
□ Boor
5-12 years
1-5 years
J-’: .
0-12 months
1-5 years
•
0-12 months
0.00
1.00
2.00
3.00
4.00
5.00
0.00
Age Group
A
B
(%)
C
D
(%)
Age Group
0
c
0.00
0
0
0-12 months
0
j___ _g
g
0.00
0
0
1 -5 years
5-12 years
c
c
0.00
0
0
5-12 years
12-19 years
0
0
0.00
0
0
12-19 years
19-35 years
0
___ c
c
o
0
0.00
0
0
19-35 years
35-60 years
3
10
10
2.88
4
0.8032129
35-60 years
60+ years
0
0
2
0.84
4
1.5625
■
3.73
Increased risk at Eloor
2.00
3.00
4.00
5.00
Affected
Population
in
Pindimana
Affected
ELOOR
Population
c
0-12 months
1.00
Affected
Population
in
Pindimana
Affected
ELOOR
Population
1-5 years
s
60+ years
A
B
•;/
7
’■
C
0
0
(%)
c
0
0
0
0
0
0
0.00
0
0
0.00
0
_ ___ g
' <' o
0
0.00
j
c
0
3
8
1
1.58
j
g
0
2
7
0
1.22
■
0
0
0
1
0
0.32
■
c
_0
2.3657129
3.12
1.5752201
(%)
D
0 _____ apo
0
;
0
Increased risk at Eloor
■.
/
57
Infertility
Infertility
60+ years
35-60 years
19-35 years
12-19 years
5-12 years
1-5 years
0-12 months
□ Plndimana
□ Boor
0.00
1.00
2.00
3.00
4.00
5.00
J
Age Group
A
B
0-12 months
.0
1 -5 years
...I1
5-12 years
_0
12-19 years
Affected
Population
In
Plndimana
Affected
ELOOR
Population
(%)
D
(%)
__ g ______ 0.00 f_____ 0
0
_c__
o ______ 0.00 f___ 0 _________0
_____ g
0.00 ft^0 ________ 0
c__
o
■
.0
0.00
______ c
C
C___
19-35 years
.J:
3___
0.91 ■I
35-60 years
60+ years
I
i
2___
0.52
o
0
0
0.2222222
0.00 _________ 0 ________ 0
1.43
Increased risk at Eloor
1
jj____ g ________ 0
0.2222222
6.4274339
58
t-e./.. ?
Icdia- Frsi Lew •
APPENDIX 7: LIST OF RESOURCES FOR COMMUNITY AND RESEARCH GROUPS
(Community Health Assessment Guidebooks)
India:
Title: The Manual of Lay Epidemiology
Contact: The Community Health Cell
Address: # 367, Srinivasa Nilaya,
Jakkasandra 1th Main????
Koramangla Block 1
Bangalore-560034
Tel: +91 -80-5525372/ 5531518
Website: www.sochara.org , www.phmindia.org
Description: The Community Health Cell is a group of Organised Health Professionals based in
Bangalore, India dedicated to the cause of “Health for All” and the paradigm shift from ‘disease
treatment’ to ‘health-preservation’. Their Library is a fabulous collection of rare manuscripts
from around the world, most of them original works.
Canada
Title: Community Sustainability Auditing Resource Kit
Contact: University of Victoria
Address: PO Box 1700 STN CSC,
Victoria, BC V8W 2Y2
Canada
Tel: 250-721-7211
Web site: http.7/web.uvic.ca/-’csap/frbc/reskit/menu.html
Description: An online resource for sustainable community auditing. This kit is mainly intended
for communities with a threatened resource-based economy and has useful information about the
development and use of sustainability auditing protocols.
Title: Environment and Sustainable Development Indicators (ESDI)
Initiative
Contact: National Roundtable on Environment and the Economy
Address: National Round Table on the Environment and the Economy
344 Slater Street, Suite 200
Ottawa, Ontario KIR 7Y3
Canada
Tel: 613-992-7189
E-mail: admin@nrtee-tmee.ca
Web site: http://www.nrteetmee.
ca/eng/programs/Current_Programs/SDIndicators/Approach_toJndi
cators/SDIndicators_Approach_e.htm
Description: A three-year project aimed at developing and testing indicators. Workshops are
available for training in indicator selection and data gathering.
Title: Pilot Project to Develop a Community Health Measure for Small and
Rural Communities
Contact: The Canadian Federation of Agriculture and Federation of Canadian
Municipalities
Address: Federation of Canadian Municipalities
24 Clarence Street
Ottawa, Ontario KIN 5P3
Canada
Tel: 613-241-5221
E-mai I: federati on @ fcm.ca
59
India-
Web site: htlp://www.fcin.ca/english/national/ruralhealth-e.pdf
Description: This web site provides a description of a 1999 pilot project in three small Canadian
communities. The report presents suggestions to be used as tools for small and rural communities
to undertake future community discussion and action.
Title: Signs of Progress, Signs of Caution
Contact: Ontario Healthy Communities Coalition
Address: 1202-415 Yonge Street
Toronto, Ontario M5B 2E7
1-800-766-3418
Web site: http.7/www.opc.on.ca/ohcc/publications/signs/signspdf.htm
Description: The goal of this guidebook is to help the user(s) make “communities healthier and
more sustainable’’. A number of steps necessary for developing health and sustainability
indicators are described and worksheets to accompany each step are provided. A useful listing of
potential indicators of health and sustainability is also included.
Title: Sustainable Community Indicators Program - User’s Manual
Contact: CMHC and Environment Canada
Address: scip-pidd@ec.gc.ca
Web site: http://www.ec.gc.ca/scip-pidd/EngIish/indicators.cfm
Description: Detailed manual and guide to conceptualizing sustainability, identifying target
markets, choosing a framework and developing and evaluating indicators. The manual
accompanies the Sustainable Community
Indicators Program database. A copy of the database and manual can be downloaded from the
address listed above.
Title: Sustainable Community Resource Package
Contact: Ontario Roundtable on Environment and Economy
Address: The Ontario Roundtable was disbanded in 1995, but the resource can found at the web
site listed below.
Web site: http://www.law.ntu.edu.tw/sustain/intro/ortee/
Description: A resource package on sustainable communities featuring case studies of community
sustainability initiatives in Ontario. This package also provides a step-by-step guide to profiling a
community including methods for looking at community activities in terms of four quadrants:
environmental,
economic, social and health. The package also outlines action plans and evaluation processes for
healthy community development as well as literature about models of sustainable community
living.
United States
Title: Check Your Success. A Guide to Developing Indicators for
Community Based Environmental Projects.
Contact: Department of Urban Affairs and Planning, Virginia Tech, US. EPA
Address: Dr. JoAnne Carmin
Department of Urban Affairs and Planning
105 Architecture Annex, MC 0113
Virginia Polytechnic Institute and State University
Blacksburg, VA 24061
USA
Tel: 540-231-5426
Web site: http://www.uap.vt.edu/checkyoursuccess
Description: Although the primary focus of this guide is environmental, the authors adopt a broad
vision of environment (social, economic, environmental, social and organizational). The first part
of the manual provides information on the benefits of developing and measuring indicators and
then leads into a number of case studies. One of the most useful sections of this book is the
60
■
Hf-arr'
. . ■: ter. • e'aia..
-
"Indicator Workshop” which is presented in the appendices. This section is easy to follow and
contains a number of useful worksheets and exercises.
Title: Community Based Environmental Protection: A Resource Book for
Protecting Ecosystems and Communities.
Contact: US EPA
Address: Community Based Environmental Protection
1200 Pennsylvania Avenue, NW
Mail Code 1807T
Washington, DC 20460
USA
Tel: 202-566-2182
Web site: http://www.epa.gov/ecocommunity/tools/resourcebook.htm
Description: This resource book includes sections on how and why to select and use community
indicators. It also includes discussion of how the ecosystem is integrally linked to the economy
and to the quality of life and social aspects of each community. The guide is available in PDF
format on the US Environmental Protection Agency web site.
Title: The Community Health Indicators Handbook
Contact: Redefining Progress
Address: One Kearny Street
Fourth Floor
San Francisco, CA 94108
USA
Tel: 415-481-1191
Toll Free: 1-800-896-2100
Web site: www.rprogress.org
Description: A detailed handbook for creating measures of community health, wellbeing and
sustainability progress toward community sustainability. The handbook contains extensive
information on community indicators including a step-by-step guide to developing an indicator
project, a glossary, case studies, resources and a national directory of indicator projects.
Title: Community Outcomes Toolkit
Web site: http://ag.arizona.edu/fcr/fs/nowg/prodev_newlinks.html
Description: This toolkit is part of the University of Arizona’s web site for Evaluating National
Outcomes. It contains a step-by-step plan for identifying and evaluating community building
indicators. The web site provides examples of indicators and lists tools and resources available to
help communities set goals and develop, measure and evaluate community indicators.
Title: The Community Toolbox
Contact: ToolBox@ukans.edu
Web site: http://ctb.lsi.ukans.edu/tools/EN/tools_toc.htm
Description: This web site was created by the University of Kansas Work Group on Health
Promotion and Community Development in Lawrence, Kansas. The core of the Tool Box is the
"how-to tools.” The how-to sections use simple language to explain how to do the different tasks
necessary for community health and development. There are sections on developing indicators,
leadership, strategic planning, community assessment, advocacy, grant writing and evaluation.
Each section includes a description of the task, advantages of doing it, step-by-step guidelines,
examples, checklists of points to review and training materials.
Title: Community Visioning and Strategic Planning Handbook
Web site: The handbook is available at
www.scs.unt.edu/classes/CSAG/5790/001/CmtyVisioning/com_visioning_
handbookl.htm
Description: The University of North Texas has posted this community visioning and strategic
planning handbook on its student web site. The handbook was developed through a grant from the
61
uman Heaiw Boor I Kiustna; ce ’ Kerala, India- Hrst .. .
Ford Foundation and the Carnegie Corporation of New York and produced by the Alliance for
National Renewal and the National Civic League. It presents steps toward developing a
“community vision” and includes sections on selecting and evaluating key performance areas.
Title: Green Communities Assistance Kit
Contact: r3green@epa.gov
Web site: http://www.epa.g0v/greenkit/indicat0r.htm#select
Description: The US Environmental Protection agency has a Green Communities
Project Web site that details how to select, use, evaluate and report on community indicators..
68
Title: Guide to Sustainable Community Indicators
Contact: Maureen Hart
Address: Sustainable Measures
P.O. Box 361
North Andover, MA 01845
USA
Tel: 978-975-1988
Web site: http://www.sustainablemeasures.com/
Description: This comprehensive guide covers all the steps necessary for developing indicators. It
begins with a description of the issues associated with sustainability, and then leads the reader
through the necessary steps for organizing and measuring sustainability indicators. The
appendices contain helpful information such as: a listing of community indicators used by other
projects, resources and examples of other community indicator
projects.
Title: Measuring Community Success and Sustainability: An Interactive
Workbook
Contact: Northern Central Regional Center for Rural Development
Address: Iowa State University
108 Curtiss Hall
Ames, IA 50011-1050
USA
Tel: 515-294-8321
Web site: http://www.ncrcrd.iastate.edu
Description: This guide was developed to help communities learn how to measure the effects of
rural development and conservation efforts. The focus of the guide is on five key outcomes that
were developed by rural communities. The outcomes range from “increase in knowledge, skills
and ability of local people” to “appropriately diverse and healthy economics”. The guide begins
with a general introduction to measuring indicators and then outlines a measurement plan and
year-end assessment for each of the five outcomes stated.
Title: Monitoring Community Sustainability
Contact: Izaak Walton League
Address: 707 Conservation Lane
Gaithersburg, MD 20878
USA
Tel: (301) 548-0150
Toll-Free: (800) IKE-LINE (453-5463)
E-Mail: general@iwla.org or sustain@iwla.org
Web site: http://www.iwla.org/sep/pubs/monitor.html
Description: This 23-page workshop guide, published in 1998, provides directions for identifying
and measuring indicators that reflect a community’s progress toward goals that promote
sustainability.
Title: Neighborhood Sustainability Indicators Guidebook
62
/■jn rcalth- Boor : .aLSinai ce-.*-,
India- Frsi: Len
Ford Foundation and the Carnegie Corporation of New York and produced by the Alliance for
National Renewal and the National Civic League. It presents steps toward developing a
‘community vision” and includes sections on selecting and evaluating key performance areas.
Title: Green Communities Assistance Kit
Contact: r3green@epa.gov
Web site: http://www.epa.g0v/greenkit/indicat0r.htm#select
Description: The US Environmental Protection agency has a Green Communities
Project Web site that details how to select, use, evaluate and report on community indicators..
68
Title: Guide to Sustainable Community Indicators
Contact: Maureen Hart
Address: Sustainable Measures
P.O. Box 361
North Andover, MA 01845
USA
Tel: 978-975-1988
Web site: http://www.sustainablemeasures.com/
Description: This comprehensive guide covers all the steps necessary for developing indicators. It
begins with a description of the issues associated with sustainability, and then leads the reader
through the necessary steps for organizing and measuring sustainability indicators. The
appendices contain helpful information such as: a listing of community indicators used by other
projects, resources and examples of other community indicator
projects.
Title: Measuring Community Success and Sustainability: An Interactive
Workbook
Contact: Northern Central Regional Center for Rural Development
Address: Iowa State University
108 Curtiss Hall
Ames, IA 50011-1050
USA
Tel: 515-294-8321
Web site: http://www.ncrcrd.iastate.edu
Description: This guide was developed to help communities learn how to measure the effects of
rural development and conservation efforts. The focus of the guide is on five key outcomes that
were developed by rural communities. The outcomes range from ‘‘increase in knowledge, skills
and ability of local people” to ‘‘appropriately diverse and healthy economics”. The guide begins
with a general introduction to measuring indicators and then outlines a measurement plan and
year-end assessment for each of the five outcomes stated.
Title: Monitoring Community Sustainability
Contact: Izaak Walton League
Address: 707 Conservation Lane
Gaithersburg, MD 20878
USA
Tel: (301) 548-0150
Toll-Free: (800) IKE-LINE (453-5463)
E-Mail: general@iwla.org or sustain@iwla.org
Web site: http://www.iwla.org/sep/pubs/monitor.html
Description: This 23-page workshop guide, published in 1998, provides directions for identifying
and measuring indicators that reflect a community's progress toward goals that promote
sustainability.
Title: Neighborhood Sustainability Indicators Guidebook
62
ealth -
tidustria! 8e^;. Keraia, India- First Lave- ?
Contact: Crossroads Resource Center
Address: P.O. Box 7423
Minneapolis, Minnesota 55407
USA
Tel: 612-869-8664
kmeter@crcworks.org
Web site: http://www.crcworks.org/guide.pdf
Description: This guidebook was produced for the Urban Ecology Coalition of Minneapolis. It is
aimed at building “strong, self-determined, sustainable communities.” The guidebook defines
“neighborhood sustainability indicators” and provides a guide to developing and refining
indicators.
Title: Outcomes Toolkit: The Results Oriented System for Community
Improvement
Contact: Michael Bilton, Director, ACT National Outcomes Network
Address: The Healthcare Forum Foundation
180 Montgomery St. Suite 1520
San Francisco, CA 94104
USA
Tel: 415-248-8411
Fax: 415-248-0411
E-mail: mbiiton@healthfoi-um.com
Web site: www.act-toolkit.com
Description: Web-based application for developing and tracking community indicators. On this
web site, stakeholders can develop a community profile, receive technical assistance in
developing indicators and share information.
Title: Sustainability Starts in your Community
Contact: earthday@eailhday.net.
Address: Earthday Washington, D.C., USA
1616 P Street NW, Suite 200
Washington, D.C. 20036 USA
Tel: 202-518-0044
Fax: 202-518-8794
Earthday Seattle, USA
811 First Avenue, Suite 466
Seattle, WA 98104 USA
Tel: 206-876-2000
Fax: 206-876-2015
Web site: http://www.earthday.net/pdf/goals/Sustainability_Guide.pdf
Description: This community indicator guide was produced in April 2002 by Redefining Progress
and Earth Day Network. It is a step-by-step guide to developing and reviewing community
indicators. The guide also provides suggestions for ways to involve the larger community in
indicator projects.
Title: Sustainable Community Indicators: a Review of National Methods
and Suggestions
Contact: Long Island University, Institute for Sustainable Development
Web site: www.luinet.edu/sustain/si.html
Description: Review and comparison of ten leading indicator projects, definitions of sustainability
and indicators and discussion of how to start an indicator project. Online tools are also available
toward developing and maintaining community indicator projects.
Title: The Sustainable Development Toolkit
Contact: John Lambie, Director, Florida House, Institute for Sustainable
63
C: d: bC:r.. r -rC’d'" f'
Developinentjl@i4sd.org
Address: Florida House Institute for Sustainable Development, Inc.
4600 Beneva Road
Sarasota, Florida 34233
USA
Tel: 941-927-2020
Web site: http://www.i4sd.org/toolkit.htm
Description: A toolkit of process and design tools to support citizen-based sustainable community
development planning processes. One of the sections in the toolkit is aimed at helping citizens
and other stakeholders develop sustainable community indicators.
Europe
Title: Cities Environment Reports On the Internet (CEROI)
Contact: CEROI Secretariat
Address: UNEP/GRID-Arendal
Longum Park
Service Box 706
N-4808 Arendal
Norway
Fax: +47 37 03 50 50
E-mail:ceroi @ grida.no
Web site: http://www.ceroi.net/ind/index.htm
Description: This project follows up on Chapter 40 of Agenda 21. CEROI provides a template
and software including an Encyclopedia of Indicators for member cities wishing to create and use
indicator data on the Internet.
71
Title: Communities Count: The LITMUS Test
Contact: New Economics Foundation
Address: Cinnamon House
6-8 Cole Street
London SEI 4YH
UK
Tel: 020-7407 7447
Web site: http://www.neweconomics.org/uploadstore/pubs
Description: This useful guidebook describes the necessary steps to develop and monitor
indicators. It also describes the approach taken and lessons learned from the LITMUS project
(local indicators to monitor urban
sustainability). The guide is user friendly and easy to follow.
Title: The Dashboard of Sustainability
Contact: Consultative Group on Sustainable Development Indicators (CGSDI)
Address: CGSDI Secretariat
International Institute for Sustainable Development
161 Portage Avenue East, 6th Floor
Winnipeg, Manitoba R3B 0Y4
Canada
Tel: +1-204-958-7700
E-mail: phardi@iisd.ca
Web site: http://www.iisd.org/cgsdi/intro_dashboard.htm
Description: The Dashboard of Sustainability is an online tool designed to be understood by
experts, the media, policy-makers and the general public. Using the metaphor of a vehicle's
instrument panel, it displays countryspecific assessments of economic, environmental, social and
institutional performance toward (or away from) sustainability.
64
S^are
■iLman Health- Sncr ihcustrial Beit, Kera’a, India- F>st Le - "-
Title: Local Quality of Life Counts
Contact: Mark Jeffcote, Sustainable Development Advisor
Address: Department of the Environment, Transport and the Regions
Free Literature
PO Box 236
Wetherby LS23 7NB
UK
Tel: 0870 1226 236
Web site: http://www.defra.gov.uk/environment/sustainable/index.htm
Or http://www. 1 a21 -uk.org.uk
Description: A handbook offering a guide for measuring sustainable development and quality of
life in local communities. It presents a menu of 29 indicators, guidance for preparing community
strategies and developing indicators, suggested methodologies for collecting data, a checklist of
issues to stimulate discussion and a list of eight “best value'’ performance indicators
72
Title: Local Sustainability: Campaign Interactive.
Contact: European Commission
Mr. Anthony Payne
Campaign Co-ordinator & Head of Office
E-mail: campaign.anthony@skynet.be
Address: European Sustainable Cities & Towns Campaign
Rue de Treves/Trierstraat 49-51
box 3
B - 1040
Brussels
Phone:+32 2 230 53 51
E-mail: campaign.ofrice@skynet.be
Web site: http://www.sustainable-cities.org/subl2a.html
Description: The European good practices Information Service and Best Practices Database.
Contains examples of good practices and policy documents on sustainability and the urban
environment.
Title: Towards a Local Sustainability Profile
Contact: Ambiente Italia
Address: Institute di Ricerche (responsabile del coordinamento scientifco)
all’attenzione di Claudia Semenza
Via Poerio 39
20129 Milano, Italy
Tel: 0039 02 277441
E-mail: ecip@ambienteitaria.it.
Web site: http://www.sustainable-cities.org/indicators/index2.htm
Description: The European Common Indicators is a monitoring initiative focused on
sustainability at the local level. The project is ongoing and accepting new participants. Support
services are provided to participating authorities during the testing phase: technical support
(scientific expertise, helpdesk, workshops, etc.), methodological development, pilot activities on
the Ecological Footprint, good practice collection and exchange, dissemination activities, and
evaluation, reporting, recommendations and guidelines.
Title: Urban Indicators Toolkit
Contact: United Nations Center for Human Settlements (Habitat)
Address: Global Urban Observatory and Statistics
Urban Secretariat, UNCHS (Habitat)
PO Box 30030
65
Nairobi
Kenya
Tel: 254-2-623119
Fax: 254-2-623050
E-mail: guo@unchs.org
Web site: www.urbanobservatory.org/indicators>
Description: UNCHS offers a toolkit and guide for cities participating in the implementation of
the Habitat Agenda. The guide includes detailed indicator methodology sheets and examples of
toolkit spreadsheets for
reporting.
Title: WHO Healthy Cities Project
Contact: WHO Center for Urban Health
WHO Regional Office for Europe, Healthy Cities Project
Address: 8 Scherfigsvej
DK-2100 Copenhagen
Denmark
Tel: 45 39 17 12 24
Web site: http://www.who.dk/healthy-cities/hcp.htm
Description: Worksheets for 32 urban health indicators are presented in this booklet. The
indicators listed have been developed from the data collected from the European Healthy Cities
project. The worksheets provide definitions, methods of calculation, unit of measurement and a
number of other descriptors.
APPENDIX 8: THE ABRIDGED ETHNOGRAPHIC INTERVIEWS AT ELOOR.
A8.1 TESTIMONIES OF SENIOR CITIZENS:
(the addresses of the respondents have been altered in the interest of their safety and
confidentiality)
Name: SP Sadananda Pillai
Age: 75
Address: Eloor
He is a resident of the locality for the past 75 years. An employee of Ogale Glass Factory,
he retired from there.
Pollution in Eloor is a serious problem. Water is a major cause for concern here. None of
the ground wells have any amount of water and they all are forced to depend on the water
authority. This distribution is far from regular.
He still remembers the time before all the companies came. There were a number of
houses here in this area. On an average, each coconut tree yielded 40 coconuts then. This
was also a major source of the local people’s livelihood. Nowadays they hardly can get
good coconuts and they are far from sufficient even for a single family. Then again a lot
of medicinal plants seen then are hardly to be seen nowadays.
The pollution in the area has made him Asthmatic. There a lot of people like him here.
The people living here have a lot of allergic complaints; some of them have skin allergies
while others have various scalp infections etc.
66
Ll incHa- *::-rsr L
A8.2 Name: EM Sundareshan
Address: The Cooperative Bank, Eloor
As told by the person himself. He has always been here. Going down memory lane he
remembers the existence of just two factories way back then. They were FACT and TCC.
There was a small rubber plantation near these factories. He still remembers bathing in
the penyar when he was very small. Just 25 years ago this became impossible because of
irritation that it caused to the skin and eyes.
He strongly feels that it was with the coming of Merchem Factory that people began
complaining of breathing difficulties and chest pain, and other respiratory illnesses For
years the mercury that flows out of TCC has killed almost all fish in the river. But the
mercury does not go away. It is entering all the bodies of people living in and around the
river who come in contact with the water here.
A8.3 Name: VS Suitan
Address: Eloor south
Age: 70 years
He has been living here all his life. The China nets and toddy shops have been his chief
source of income and livelihood. That was sufficient to look after his family well. Then
he got a job in the Indian Aluminium Company and worked there for 32 years. Looking
back on yester years he feels people never ever went to English doctors. The medicinal
plants were all that was required to heal then of their little ailments. Whereas his coconut
trees yielded 700 coconuts then today he can hardly get 100 coconuts. His brother had
serious Asthma problems, which he feels is largely due to the pollution in the area. Both
his brother and his son died due to severe asthma attacks. Even the domestic animals that
flourished in these parts no more can be seen living healthily here if at all they manage to
survive.
A8.4 Name: Ali Raj
Address: Manamthuruthu
Age: 75 years.
He has been in the fishing business for the past 60 years. During his early days he still
remembers the bounty of fish that had always his pocket full of money. But all that has
changed now. For the past two years he has been unable to go out fishing due to his
Asthma. Before the coming in of companies, there was no shortage of water and the
ground well was sufficient for every household. Domestic animals have also slowly
vanished. It’s been nearly 20 years that the company wastes have caused serious damage
to the fauna here. In a river that had innumerable china nets to catch fish, now you hardly
see them; the river itself has become murky.
A8.5 Name: Jacob VM
Address: Eloor
67
n
Efcor Ineustriai Bert, Kgnfe India- First teSei Renor3"
Age: 53 years
For the past 70 years he has been a resident of Eloor. His father was an employee of a
nearby mill. He has 10 children of which three are no more. Fishing had always been the
family’s chief livelihood. He still remembers that before the companies came, each day’s
catch came to up to 750 kgs of fish. None of the kind of illnesses was even known to
them then.
When the companies started dumping their wastes into the river (which he feels was
when he was 15 years old or so) all the fish began mysteriously dying. Apart from
fishing, they also had a lot of domestic animals. But today none of them can be seen in
this part of Kerala. Whereas in his youth they used to get around 40 healthy bunches full
of coconuts per tree, today they hardly manage two nuts per tree.
When the factories came, a lot of people started coming in with their families. But he
feels the locals per se hardly found any employment in these factories. The river could
boast of various kinds of prawns and shrimp but sadly none of the catches today manage
even one of its kind. Equally distressing is this water shortage in the area. He does know
that all these are direct outcomes of the pollution of the river and surrounding areas.
A8.6 Name: Prema
Address: Eloor South.
As told by herself. It was in 1961 that her parents returned to their ancestral home in
fr°m ?°'Tlbayk S,^ was a student of dassl then. The only factory in the area was
FALI She had no health problems whatsoever when she came here. It was their father’s
death that had brought them to Eloor where they had an own house and some property to
ca their own. When she was in class 8 there was a chlorine leak from the TCC factory,
ecollecting memories of that day, she says she remembers running to school and falling
faint m the school corridors. The school authorities admitted her in JNM hospital and she
regained consciousness three days later. Her health woes have started ever since then,
bhe gets breathing difficulty and bouts of unconsciousness whenever the fumes are very
strong. Chronic Cough has been with her ever since then. She spends around 400 rupees
every month on barely keeping away from the major bouts of breathlessness and cough
None of the doctors have conclusively told her that her health will see a fine day Her
husband too suffers from breathlessness.
Talking of her surroundings, she still can remember the number of domestic animals that
were seen m and around Eloor in those days. She does not believe that the local
community has benefited from all the factories. A few that got jobs carried on in their
jobs and hence traditional livelihoods have totally been wiped out. The factories and the
pollution have also led to a serious water shortage. The ground well in their house no
longer can be used for the quality of water it has. But she cannot use the water supplied
by the authonties for its chlorine content. So she manages with the well water available.
Factories have led to varied problems not I*the mention the
_ spate of health complaints it
has caused to the people living here. She wonders
how _..j
she can inch forward her difficult
-----------life.
68
-rditn -.z: uc/' I. 'Gusina; Beft Kerala, India- First Leve- Ren.:r-
A9 TESTIMONIES OF PARENTS ABOUT AFFECTED CHILDREN:
(the names and addresses of the respondents have been altered in the interest of their safety
and confidentiality)
A9.1 Name of Child: Bidhan
Age: 2 years
Address: Eloor
Father’s name: Ananthapadmanabhan
Mothers name: Kavitha
As Told by the father. It was in 1965 that the family settled down in Eloor. The wife’s
maternal home is in the district of Alleppey. They had a baby boy by tubular pregnancy
the delivery of which was by caesarean section. The baby, Bidhan was diagnosed as 40%
mentally retarded. Two years old now, he still has difficulty in walking. There are
occasional attacks of fits in between. Doctors in Amrita Hospital, Cochin are treating the
baby. He has speech difficulties as well. The medicines being administered are Norma
Brain and Digital2.5mg.
Others in the family do complain of severe headaches and bouts of breathing difficulty.
They have already spent around 2 lakhs on the child’s treatment. Though Physiotherapy
was also advised they have discontinued the same due to its high costs.
The child’s aunty ,Sarasamma has been in Eloor for the past six months. She is pregnant
now and ever since she has been here she has acute headaches and breathing problems.
Previously a resident of Cherthallai locality, Sarasamma admits that she has never ever
had such health complaints. Living in the vicinity of the Leather factory and inhaling the
ammonia fumes has led to a major deterioration of their health, they family avers.
A9.2. NAME OF baby: Gopal
Age: 7 months
Address: Aluppuram
As told by the baby’s mother, Vinuta.
Marriage brought her to Eloor three years ago from her home in trivendrum. Pollution in
Eloor has caused a whole lot of problems in her health. Consuming the water in this
locality has led to discoloration of her teeth during her pregnancy, her sugar levels shot
up which had to be checked with Insulin shots. The baby was delivered by Caesarean
section and weighed 3.250kgs at birth. Since the time of her birth, the baby has had
respiratory problems. Chronic Cough is one of the many that keep surfacing. An unusual
skin problem seems to be troubling the baby as well. A normal bath gives rise to redness
and rashes all over the body of the baby that has then to be treated. (Each treatment costs
5000-6000 Rupees.) unable to afford this they are now consulting a homeopath in
Cherthallai regularly. She feels that the poisonous fumes are more during the monsoon.
The fumes are almost always coupled with a stinking smell. When she goes to her
maternal home in Trivandrum, she does not have any of the health complaints that she
has here. The present house they are staying is slightly better than their previous
residence in the staff quarters. It was the unbearable pollution that compelled the shift to
69
4
htm-
realth- Eloc'
Beit., Keraia, India- First Level Repjr
their present place of residence. But they sadly have realized that nowhere around Eloor
can be really safe from pollution.
A9.3 Name of the child: Tito
Age: 2 1/2 years
Address: Eloor South
As told by the mother, Aditi. She is from Chirayil. Marriage brought her to Eloor four
years back. Her husband works in Saudi Arabia. She was also in Saudi Arabia for a
while. That was where the baby was conceived and delivered. Medical history during
pregnancy was uneventful. The baby weighed 2.800 kgs at birth. All the regular
vaccinations were administered on time. When the baby was a year old, they returned to
Eloor. Ever since there has been a spate of health problems. They stay hardly 200 meters
away from the Merchem factory and HIL factory yards. The baby has had chronic cough
and phlegm since his stay here. Every time antibiotics have been administered. If the
fumes are unbearable, there is also a bate of cough. Doctor visits have now become a
regular routine affair for this family. Not to mention the drain of money associated with
every visit. They can hardly bare to bathe the baby for fear of it falling ill. A couple of
times they have had to rush him to the hospital at night. Febrile temperatures are many a
time over the 100 mark. Smitha also says that none of these bother them when they are
away form this place. Before marriage she has never had serious health problems. Ever
since she has been here, she has had frequent bouts of headaches. Whenever the fumes
are let out from the adjoining companies she gets acute feelings of Nausea as well.
A9.4 Name of infant: Sanjiv
Age: 1 1/2 years
Address: Eloor North
As told by the mother, Nina. It’s been ten years since she came here from her maternal
home in Pookattupadiyil. Her husband is an Autorickshaw driver. She feels it’s at night
that the fumes are unbearable. This does cause a fair amount of breathing difficulty as
well. It also causes strange rashes in the baby’s body with a lot of redness and itching. At
nights this is fairly severe too. It has been traced to the water available in the area. They
have totally stopped using the ground water available in their well making them fully
dependant on the public distribution system. The baby had been very normal at birth and
they had given him all the normal vaccination. A fever triggered off a seizure and
required hospital stay and treatment for a month. The temperature has gone up to around
104 degrees during these fever bouts.
The fumes cause a lot of discomfort for everyone in the family. Cough and breathing
difficulty are very common. She finds none of these complaints in her home in
Pookattupadiyil. The baby is being administered Valium 2.5 mg every time for the
seizures. During monsoons the rainwater that clogs and wells up creates rashes in their
legs.
A9.5 Name of the children: Divya, (5) Ashesh (3)
Address: Manjummil
70
blhL- /• Human Health - Soor Industrial Belt, Kerala, India- First Level R.er-or
Name: Kavitha Gubra
Kavitha says they have been in Floor for the past one year. Before this they were in
Palanvattom, Cochin. Divya was born in the Lissy hospital. Cochin and weighed 3.100
kgs at birth and the younger one Sneha, was born in the Medical Center, Cochin. She
weighed 3.250 at the time of birth. They have both been given all the stipulated
vaccination shots. They have had a lot of health complaints ever since they have been in
Floor. The elder daughter has had a lot of respiratory troubles along with headaches.
They frequently have been falling ill because of which a fair amount of money goes into
medical treatment alone. There have been times when they have had to shell out 150
rupees per day. They had always been healthy in Palarivattom. Their illnesses seem to be
more during the monsoons when there are more fumes and then the whole family suffers
from headaches and nausea. The brief stay of a year in this vicinity has caused so much
of health related discomfort to the children as well as everyone in the family.
A9.6 Name of Child : Sameera
Age: 3 years
Address: Manjummel.
They have been residents of this locality for many generations. Adarshan, the child's
father has been married for three years now. The baby was delivered in MAJ hospital
and weighed 2.900 kgs. The mother had taken proper care and followed all doctoral
advice during her pregnancy. However the baby has severe cough, fever and breathing
difficulty. They have been incurring huge costs over the child’s treatment alone. Over
10,000 rupees were spent in the Medical Center, Cochin alone.
It is during the dusk that obnoxious fumes and the strong smells fill the place. In fact the
family feels that over the past four or five years this has increased manifold. They have
switched over from Allopathy to homeopathy treatment for the child. The main reason for
the witch was the monetary one. In spite of this they end up spending over 200 rupees
each visit.
A9.7 Name of the infant: Ramapati
Address: Manjummel
As told by the grandfather, Shailendra Pannikar
The family has been living here since the 70s. Shailendra Panikkar was working in FACT
in the Product Issue Department as Supervisor. He retired in 1989 and has had a lot of
health problems since. He has sever joint pain and a nagging back problem. His younger
daughter, Jayasri stays with him. She has a daughter by name, Reshma. She is three years
old. The child has already had three heart surgeries done on her. There was a problem of
insufficient blood circulation from the heart to the lungs. This was the reason for the first
operation. Then the second surgery was to correct a hole in her heart. After these two
medical interventions she had a severe digestion problem that necessitated a third
surgery.
71
CHEMICALS RELEASED, used and produced by the key
Effe^ts)ICAL INDUSTR'ES ^Extracted from Greenpeace Compilation on Toxicity and Health
4.1 Hindustan Insecticides Ltd, Udyogamandal Industrial Estate,Kerala.
4.1.1. Greenpeace Investigation of December, 1999.
4.1.2 HIL Raw Materials/Intermediates
4.1.2. a Benzene
4 1.2 h Chlorine
4.1.2 c Carbon Tetra Chloride
4.1.2. d Hexachlorocyclopentadiene(HCCP)
4.1.2. eThionyl Chloride
4.1.2. f Hydrochloric Acid
4.1.2. g Sulfuric Acid
4.1.2. h Toluene
4.1.2.i Epichlorohydrine
4.1.2. J Oleum
4.1.3 HIL Products
4.1.3. a DDT
4.1.3. b Endosulfan
4.1.3. C Dicofol
4.1.3. d Hydrochloric Acid
4.1.3. eSulfuric Acid
4.1.4 HIL Effluent
4.1.4. a DDT
4.1.4. b Endosulfan
4.1.4. C BHC
4.1.4. d Chlorides
4.1.4. e Sulfates
4.1.5 HIL Air Emissions
4.1.5. a Chlorine
4.1.5. bSulfur Dioxide
4.1.5. c Carbon Monoxide
4.1.5. d Hydrochloric Acid Mist
4.2 Merchem Ltd,Udyogamandal Industrial Estate,Kerala.
4.2.1 ML Raw Materials/Intermediates’
4.2. La Aniline
4.2. Lb Carbon Disulfide
4.2.1. c Toluene
4.2.1 .d Zinc Sulfate
4.2.1 e Chlorine
4.2.1. f Dicyclohexyl Amine
4.2. l.g Morpholine
4.2.1 .h Sodium Sulfate
4.2.1 .i Hydrochloric Acid
4.2.1 ,j Sulfuric Acid
4.2.1 .k Hexachlorobenzene
4.2.2 ML Products
4.2.2. a Mercaptobenzothiazole(MBT)
4.2.2. bDibenzothiazyldisulphide
4.2.2. C N-cyclohexyl 1,2benzothiazyl sulfanamide
4.2.2. d ZMBT
4.2.3 ML Effluent
4.2.3. a Zinc
4.2.3. b Sulfides
c
4.2.4 ML Air Emissions
4.2.4. a Sulphur Dioxide
72
4.3 FACT, Udyogamandal Industrial Estate,Kerala
4.3.1 FACT-AMMONIA PLANT
4.3.1.1 FACT Raw Materials/Intermediates’
4.2.1.1 .a Naphtha
4.3.1.2 FACT Products
4.3.1.2. a Ammonia
4.3.1.2. b Carbon Dioxide
4.3.1.2. C Synthetic Gas
4.3.1.3 FACT Effluent
4.3.1.3. a Ammonium Nitrate
4.3.1.3. b Nitrates
4.3.1.4 FACT Air Emissions
4.3.1.4. a Sulphur Dioxide
4.3.2 FACT-PETROCHEMICAL PLANT
4.3.2.1 FACT Raw Materials/Intermediates’
4.3.2.1. a Benzene
4.3.2.1. b Hydrogen
4.3.2.1. c Oleum
4.3.2.1 .d Ammonia
4.3.2.1. e Carbon Dioxide
4.3.2.1. f Caustic Soda
4.3.2.2 FACT Products
4.3.2.2. a Caprolactum
4.3.2.2. b Soda Ash
4.3.2.2. C Nitric Acid
4.3.2.2. d Ammonium Sulphate solution
4.3.2.3 FACT Effluent
4.3.2.3. a Free Ammonia
4.3.2.3. b.Ammonium Nitrate
4.3.2.3. c Nitrates
4.3.2.3. d Phenolic
4.3.2.4 FACT Air Emissions
4.3.2.4. a Sulphur Dioxide
4.3.2.4. b Ammonia
4.3.2.4. C Carbon Monoxide
4.3.3 FACT-Ltd.-Udyogamandal Division
4.3.3.1 FACT Raw Materials/Intermediates’ Toxicity and Health Data Sheets
4.3.3.1. a Naphtha
4.3.3.1. b Sulphur
4.3.3.1 .c Rock Phosphate
4.3.3.2 FACT Products
4.3.3.2. a Ammonium Phosphate
4.3.3.2. b Ammonium Sulphate
4.3.3.2. C Sulphuric Acid
4.3.3.2. d Phosphoric Acid
4.3.3.2. e Ammonia
4.3.3.3 FACT Effluent
4.3.3.3. a Ammonium Nitrate
4.3.3.3. b Free Ammonia
4.3.3.3. C Nitrate
4.3.3.3. d Cyanide
4.3.3.3. e Vanadium
4.3.3.3. f Arsenic
4.3.3.3. g Phosphate
4.3.3.3. h Flouride
4.3.3.3J Hexavalent Chromiunv
4.3.3.3 j Chromium
4.3.3.4 FACT Air Emissions
73
Status of Human Health- Eioor Industrial Belt, Kerala,. India- First Level Repor
The baby weighs 9.5 kgs while she weighed 2.450 kgs at the time of her birth. For her
age she should weigh 12.250kgs, the doctors say. The mother, Jayasri has sever
headaches and congestion related health problems. The grandmother has a skin disease
for the past 25 years and has severe ear pain too. She has had an operation done on her
ear, but that has hardly helped. The whole family seems to be suffering form various
health problems.
A9.8.Name: Ameer
Age: 2 .5 years.
Address: Kuttikattukara
The mother, Thankamma says the following. She is a resident of Perumabavoor near
Alwaye. She came here when she got married. Her husband has always suffered from
breathing problems since his childhood. Their second child was hardly six months old
when the first bout of respiratory trouble surfaced. The baby was normal at birth,
weighed 3 kgs and was given all the vaccinations on time. He is constantly under medical
treatment under Dr. Varma’s care for a long time now. He has been in the hospital for
fairly long periods. Each visit incurred around 2000 rupees in costs alone. The child gets
fever bouts when temperatures shoot over 102 degrees. Sometimes the fever persists
beyond the normal time. The child has shown symptoms of asphyxia too. The mother and
the child have none of these problems when they are in her home in Perambavoor. The
grandmother has something interesting to say. She used a lot of medicinal plants
abundantly available in her courtyard during her children’s childhood. All these plants
are no longer to be found in the area now.
A9.8 Name of child: Keerthi
Age: 2.5 years.
Address: Manjummel
As told by the mother, Namrata. She has been here since her marriage. Her in-laws,
husband, and two children comprise her family. Anakha was born in KMK hospital in
Alwaye. She weighed 3.800 kgs at the time of birth. The air pollution in this area is
primarily the reason for the kind of cough and fever it causes in children like Keerthi.
There is a fair amount of breathing difficulty as well. Of late, she has been suffering from
severe cough too. The elder son, Antony is comparatively healthier but they have had
limes when his health costs alone cost them 5000 rupees. She also finds that none of
these illnesses raise their heads in her maternal home in Pookattupally. Everybody in the
family suffers from some amount of breathing and respiratory troubles.
A9.9 Name of children: Mathew(3) Sarah( 1)
Address: Pathalam
As told by the mother, Julie
Both her children keep getting bouts of fever. They are always under treatment of Dr.
Somasundaram of JNM hospital. They require medical treatment thrice every month.
Each visit demands 300 rupees each. The parents live in a one-room home and both of
them too suffer from headaches and breathing difficulty. They have been in Eioor for six
72
; h.nij- health- Eloc-r l^dustridi Beit, Kerala, India- First. Leves Rl-t <;
Years now. Before when they were in Coimbatore none of them had any health problems.
They are aware that it is the nearby factories and their fumes that are playing havoc with
their health.
A9.10 Name of the children: Bidhana.(9); Sanjiva(6); Rama(3)
Address: Majumel.
As per the mother, Kavitha. They have been residents of eloor for the past 45 years. They
have all had varied health problems varying from headaches to cough, breathing
difficulty, joint pains and cramping of the legs. The eldest daughter, Bidhana has been
suffering form Easnophilia for the past five months. She also gets headaches and cold
very often. She had a heart valve complication when she was three years old. Now she
does not have that. Now 9 years old, she has a gland growing under her ears near the
neck. The second daughter, Sanjiva complains of leg pains and cramps very often. The
youngest one suffers from cold and fever very often that requires hospitalization too. The
oldest member in the family , Sicily has rashes in her leg and Kavitha herself has severe
headache and other discomforts as well.
A9.ll Name of twins: Archana and Kiran
Age: 15 years
Address:Eloor North.
Aditi the mother gives this account. She is a native of the neighboring Cheranalloor. Ever
since her marriage 16 years ago she has been living in Eloor. Her husband is a daily
wages laborer and they find it very difficult to meet their daily ends with the work he
gets. They live in a three-room house provided by the Panchayat. They have twins,
Archana and Kiran both of whom are paralyzed down the hips. Their delivery was before
the eighth month. They have gone to the school upto the third standard. Archana likes to
write and read but they could no longer afford their studies. In the evenings the fumes
horn the factories fill the whole surrounding region. They often lead to skin irritations
and breathing difficulty. They incur an expenditure of 1400 rupees every month on
medicines alone. The children have been shown to an Aired doctor in Coimbatore. The
charges there have come to 30,000 rupees. The daughter is slightly better than the son.
They believe that their disability should be overcome by good medical treatment.
73
4.3.3.4. a Ammonia
4.3.3.4. b Sulphur Dioxide
4.3.3.4. C Carbon Monoxide
4.4 Indian Rare Earths,Udyogamandal Industrial Estate,Kerala.
4.4.1 IRE Raw Materials/Intermediates’
4.4.1 .a Monazite
4.4.1 .b Caustic Soda Lye
4.4.1 .c Hydrochloric Acid
4.4.1. d Sulphuric Acid
4.4.1 ,e Nitric Acid
4.4.1 ,e Sodium Chloride
4.4.1 .f Sodium Sulphate
4.4.1 .g Sodium Sulphide
4.4.1. h Soda Ash
4.4.1.1 Sodium Silicoflouride
4.4.1 .j Sodium Hypochlorite
4.4.1. k Oxalic Acid
4.4.1.1 Magnesium Sulphate
4.4.1 .m Hydrogen Peroxide
4.4.2 IRE Products
4.4.2. a Trisodium Phosphate
4.4.2. b Rare Earths Chloride
4.4.3. C Rare Earths Flouride
4.4.3. d Cerium oxide
4.4.3. e Thorium hydroxide
4.4.3 f Cerium Nitrate and other Rare Earths
4.4.3 IRE Effluent
4.4.3. aFlourides
4.4.3. b Ammonium Nitrate
4.4.3. c Phosphates
4.4.3. d Lead
4.4.3. e Zinc
4.4.3. f Sulphide
4.4.4 IRE Air Emissions
4.4.4. a Chlorine
4.4.4. b Hydrogen Sulphide
4.4.4. C Sulphur Dioxide
4.5 Binani Zinc,Binanipuram, Edayar,Kerala.
4.5.1 BZ Raw Materials/Intermediates’
4.5.1 .a Zinc Concentrate
4.5.1 .b Trisodium Phosphate
4.5.1 .c Sodium Sulphate
4.5.1 .d Sodium Silicate
4.5. l.e Ammonium Chloride
4.5.1 .f Manganese Dioxide
4.5.2 BZ Products
4.5.2. a Zinc
4.5.2. b Cadmium
4.5.2. c Sulphuric Acid
4.5.3 BZ Effluent
4.5.3. a Cadmium
4.5.3. b Zinc
4.5.3. C Sulphuric Acid
4.5.3. d Mercury
4.5.3. e Copper
4.5.3. f Sulphide
c
4.5.3. g Flouride
4.5.3. h Sulphate
74
4.5.4 BZ Air Emissions
4..5.4.a Acid Mist
4.5.4.b Sulphur Dioxide
4.6 Travancore Cochin Chemicals Ltd,Udyogamandal Industrial Estate,Kerala.
4.6.1 TCCL Raw Materials/Intermediates’
4.6.1 .a Barium Carbonate
4.6.1 .b Soda Ash
4.6.1 .c Common Salt
4.6.1 .d Sulphuric Acid
4.6. Le Lime
4.6.2 TCCLProducts
4.6.2. a Caustic Soda
4.6.2. b Liquid Chlorine
4.6.2. C Hydrochloric Acid
4.6.2. d Soda bleach
4.6.3 TCCL Effluent
4.6.3. a Sulphide
4.6.3. b Mercury
4.6.3. C Chlorine
4.6.4 TCCL Air Emissions
4.6.4. a Hydrochloric acid fumes
4.6.4. b Chlorine
4.6.4. C Mercury
4.7 Cochin Minerals and Rutiles Ltd.,IDA, Edayar.
4.7.1 CMRL Raw Materials/Intermediates’ \
4.7.1 .a Ilmenite
4.7. Lb Hydrogen chloride
4.7.1. c Chlorine
4.7.2 CMRLProducts
4.7.2. a Synthetic Rutile
4.7.2b Ferric Chloride
4.7.3 CMRL Effluent
4.7.3. a Hexavalent Chromium
4.7.3. bChromium
4.7.3. C Manganese
4.7.3. d Nickel
4.7.3. e Copper
4.7.3. fZinc
4.7.3. g Cadmium
4.7.3. h Mercury
4.7.3.1 Lead
4.7.3. j Cyanide
4.7.3. k Titanium
4.7.4 CMRL Emissions
4.7.4. aSulphur Dioxide
4.7.4. b Carbon Dioxide
4.7.4. C Chlorine
4.7.4. d Hydrochloric acid vapour and mist.
APPENDIX 10: STUDY ABSTRACTS OF THE WATER SYSTEM OF COCHIN AND PERIYAR
10.1 Determination and distribution of Endosulfan and Malathion in an Indian estuary.
Authors:
SUJATHA CH
NAIRSM
CHACKO J
Author Address: Dep. Chem. Oceanography, Cochin Univ. Sci. TechnoL, Cochin-682 016, India.
75
Source: WATER RESEARCH; 33 (1). 1999. 109-114.
Abstract:
BIOSIS COPYRIGHT: BIOL ABS. A field survey was conducted to determine the spatial and seasonal
distribution of two very common pesticides. Endosulfan and Malathion, in Cochin estuary, India. Six
sampling stations along the estuary were identified and analyses were carried out during premonsoon,
monsoon and postmonsoon seasons. Pesticide levels were higher during the premonsoon period than
during the postmonsoon season. Throughout the monsoon season, the estuary remained largely free of
(he pesticides except at the mid- estuarine region which was characterized by prominent agricultural
runoff. One of the sampling sites located in the riverine area was designated as "pesticide-loading site"
in view of its proximity to the pesticide-manufacturing unit.
Medical Subject Headings (MeSH):
CONSERVATION OF NATURAL RESOURCES
ECOLOGY
MARINE BIOLOGY
AIR POLLUTION
SOIL POLLUTANTS
WATER POLLUTION
Keywords:
Ecology
Public Health: Environmental Health-Air
CAS Registry Numbers:
121-75-5
121-75-5
115-29-7
Language: English
Coden:
WATRA
Entry Month: April, 1999
Year of Publication: 1999
Secondary Source ID: BIOSIS/99/04291
10.2 Dissolved and particulate trace metals in the Cochin estuary.
Authors: OUSEPH PP
Author Address: Cent. Earth Sci. Studies, Trivandrum-31, India.
Source: MAR POLLUT BULL; 24 (4). 1992. 186-192.
Abstract:
BIOSIS COPYRIGHT: BIOL ABS. The Cochin estuary located at 9e58'N latitude and 76el5’E
longitude is subjected to various types of effluents discharged from the Eloor and Chitrapuzha
industrial belts. The present study reports the concentrations of dissolved and particulate copper,
zinc, cadmium, lead, nickel, and iron based on three consecutive surveys conducted during July
(monsoon), November (post-monsoon) 1985 and April (premonsoon) 1986. The concentrations
of dissolved and particulate copper, zinc and cadmium showed high seasonal variation. Seasonal
variation in the concentrations of nickel and lead was negligible. Iron was found to be removed
from the disolved state. Surface water samples contained higher concentrations as compared to
the bottom. The study revealed that salinity plays an important role in the precipitation of
particulate manner and heavy metals with respect to^estuarine mixing.
Medical Subject Headings (MeSH):
76
CLIMATE
ECOLOGY
METEOROLOGICAL FACTORS
ECOLOGY
OCEANOGRAPHY
FRESH WATER
MINERALS
Keywords:
Ecology
Ecology
Biochemical Studies-Mi nerals
Movement (1971- )
CAS Registry Numbers:
7440-66-6
7440-66-6
7440-50-8
7440-43-9
7440-02-0
7439-92-1
7439-89-6
Language; English
Coden:
MPNBA
Entry Month: September, 1992
Year of Publication: 1992
Secondary Source ID: BIOSIS/92/20320
10.3 Heavy metals in fishes from coastal waters of Cochin, southwest coast of India.
Authors:
NAIR M
BALACHANDRAN KK
SANKARANARAYANAN V
JOSEPH T
Author Address: Natl. Inst. Oceanography, Regional Centre, PB No 1913, Cochin 682 018, India.
Source: INDIAN JOURNAL OF MARINE SCIENCES; 26 (1). 1997. 98-100.
Abstract:
BIOSIS COPYRIGHT: BIOL ABS. The concentration levels of copper, zinc, manganese and iron have
been determined in marine fishes from Cochin area which is one of the major fishing zones along the
west coast of India. The concentration of heavy metals varied from species to species. Copper, Zn, Fe
and Mn showed increased levels in the gills and alimentary4canal compared to the muscle. Difference in
heavy metal concentration in various species studied is attributed to the varying feeding habits. The
observed levels were below the toxic limit.
77
Medical Subject Headings (MeSH);
ANIMALS
ECOLOGY
ECOLOGY
OCEANOGRAPHY
NUTRITION
NUTRITIONAL STATUS
DIGESTIVE SYSTEM/PHYSIOLOGY
DIGESTIVE SYSTEM/METABOLISM
RESPIRATORY FUNCTION TESTS
RESPIRATORY SYSTEM/PHYSIOLOGY
RESPIRATORY SYSTEM/METABOLISM
MUSCLES/PHYSIOLOGY
MUSCLES/METABOLISM
EN VIRONMENTAL POLLUTANTS/POISONING
OCCUPATIONAL DISEASES
Keywords:
Ecology
Ecology
Nutrition-General Studies
Digestive System-Physiology and Biochemistry
Respiratory System-Physiology and Biochemistry
Muscle-Physiology and Biochemistry
Toxicology-Environmental and Industrial Toxicology
CAS Registry Numbers:
7440-66-6
7440-66-6
7440-50-8
7439-96-5
7439-89-6
Language: English
Coden:
IJMNB
Entry Month: November, 1997
Year of Publication: 1997
Secondary Source ID: BIOSIS/97/27595
HU Effect of waste disposal on water quality in parts of Cochin, Kerala.
Authors:
KHURSHID S
BASHEERA
ZAHEERUDD1N
SHABEER MU
Author Address: Dep. Geology, Aligarh Muslim University, Aligarh, India.
Source: INDIAN JOURNAL OF ENVIRONMENTAL HEALTH; 40 (1). 1998. 45-50.
Abstract:
78
SIS COPYRIGHT: BIOL ABS. The successively increasing amount of chemicals in rivers
and other water bodies, resulting from the enhanced discharge of industrial effluents and
municipal waste water, has become the major problem affecting water quality. Study area covers
an estuary at south-western part of Kerala which is bound by three important rivers namely
Periyar in the north, Pumba in south and Muvattu puzha in the east. In the present study, an
attempt has been made to evaluate the water pollution caused by existing industries in parts or
Cochin. A systematic study of the chemical nature of the surface water bodies from Floor to
Cochin harbour has been made with a view to assess the extent of pollution of various trace
elements. The study revealed that the concentration of trace elements around Floor industrial
belt is higher than the vembanad lake, which may be attributed to steady discharge of effluents in
Floor region. In most of the samples, concentration or trace elements exceed the max
Medical Subject Headings (MeSH):
ECOLOGY
AIR POLLUTION
SOIL POLLUTANTS
WATER POLLUTION
Keywords:
Ecology
Public Health: Environmental Health-Air
Language: English Coden: IJEHB Entry Month: May, 1999 Year of Publication: 1998 Secondary
Source ID: BIOSIS/99/04916
10.5 Trace elements in the surface waters of Cochin harbour.
Authors:
MEENAKUMARI B
NAIR NB
Author Address: Central Inst. Fish. Toxicol., Cochin 682 029, India.
Source: JOURNAL OF ENVIRONMENTAL BIOLOGY; 17 (1). 1996. 33-37.
Abstract:
BIOSIS COPYRIGHT: BIOL ABS. The concentration of Cu, Fe Mn, Zn, Co, Ni, Cd and Pb present in
the Cochin Harbour waters was studied at monthly intervals during the period 1982- 83. The
concentration in mug I-1 varied from 2.1-25 forZn, 0.75-5.4 for Ni, 11.0-31 for Mn and 7.2-113.0 for
Fe with an average value of 11.88, 2.50, 20.23 and 23.74 respectively. The values for toxic elements
ranged from 0-1.5 for Pb, 0.2-13 for Cu, 0-25-28 for Cd and 0-3 for Co with respective means of 0.48,
4.64, 8-37 and 1.1 mug 1-1. The average concentration of all the elements except Zn and Cd were
highest in the monsoon period. The mean values for Zn increased from premonsoon to post-monsoon
period, but the reverse was found for Cd. No interdependancy could be noticed for the presence of trace
elements for the period studied.
Medical Subject Headings (MeSH):
ECOLOGY
OCEANOGRAPHY
FRESH WATER
MINERALS
AIR POLLUTION
SOIL POLLUTANTS
WATER POLLUTION
Keywords;
79
Ecology
Biochemical Studies-Minerals
Public Health: Environmental Health-Air
Language: English
Coden:
JEBID
Entry Month: June, 1996
Year of Publication: 1996
Secondary Source ID: BIOSIS/96/12683
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