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State of Community Health
at
MEDAK DISTRICT
Jif/
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Supported by
WeaicatCcCtye, Mumbai
Community JCeaftfi Celt, (Sar^ahre
St. Jo fin's MedicalCollege, (Bangalore
JUmfians, (Bangalore
OccupationalJlealtCi andSafety Centre, Mumbai
August 2004
O’
(J8635
State of Community Health
at
MEDAK DISTRICT1
Principal Investigators
Bidhan Chandra Singh with onsite inputs from Dr. Murlidhar (LTM Medical College)/Vijay
Kanhere (OHSC)
Research Coordinator
Thangamma Monnappa
Community Relations
Ankgalla Pochayya, Syed Iqbal
Collaborators
Vijay Kanhere,. P Malwatkar, Dyanesh (OHSC-Mumbai)
Dr Aparna Hegde, Dr Ashwini, Dr Deepali, Dr Archana, (LTM Medical college, Mumbai)
Sanjiv Copal, Ananthpadmanabham, Shailendra Yashwant (Greenpeace)
Team Advisory
Dr. Thelma Narayan/Dr. Francis (Community Health Cell, Bangalore.
Dr. Mohan Issac/Dr. Girish Rao (NIMHANS, Bangalore)
Dr. Swarna Rekha/Dr. Elizabeth Vallikad/AS Mohammed/Dr. Mario Vaz (St. Johns' Medical
College, Bangalore)
External Peer Group
Interviewers: Meerige Vijaya Prakash, D. Sunitha, Gundiathoti Malleshwari, Sarvadeva Bhatia
Ramcharan, Bindu Kodati, Talasila Shravanti, Chandrashekhar, Kalpana Vallabhaneni, Aruna
Sa mu drala, Damera Vidya
1 The report can be downloaded iron
please contact : Bidhan Chandra Sin;
this project
Community Health Cell
Library and Information Centre
tt SO?, “Srinivasa Nilaya”
Jakkasandra 1st Main,
1st Block, Koramangala,
BANGALORE - 560 034.
Phone : 553 15 18 / 552 53 72
e-mail : chc@sochara.org
ACKNOWLEGEMENTS
Members of Greenpeace India team along with experts from LTM Medical College &
OHSC, Mumbai and friends from Patancheru - came together to produce this Health
Report. Community of Medak District, researchers, volunteers, activists, NGO’s, donors,
administrative support, local leaders, and lawyers all deserve our sincere thanks.
Our special thanks to the Key informants in the villages who took time out to share their
experiences. The community in Sultanpur, Kazipally, Gaddapotaram, Bonthapally,
Digwal, Ramojipally, Veerojipally, Musapet and Uthloor deserve special thanks for their
generous gift of time to the researchers. It would have been difficult to collect the data
without the enthusiastic support of the Sarpanch of the Grampanchayats, the President
and Members of the Grampanchayat.
The efforts of the data collection would have been of no use if the Greenpeace team
would have not come forward to put it together. We value the effort of the team, Ms.
Thangamma Monnappa, Sanjiv Gopal and others who worked hard to collate and analyze
the data as per stipulated guidelines.
We would particularly like to acknowledge the help we received from the advisory
committee; They were always there with their response and feedback. We are grateful for
their patience with last minute rushed requests from us. Thanks to Dr. Thelma Narayan
and Ravi Narayan and staffs of CHC for extending their support by providing space for
meetings and presentations. The inspired advice at the premises of CHC and the inputs
ensured that the findings are accurate and clearly communicated.
The very first trip that we made for investigation will go a long way with Mr. Narasimha
Reddy constantly sharing his experience and contacts.
We appreciate the support given by Dr. Kishan Rao and Mr. Niroop Reedy for letting us
go through the files, reports, films, media reports and other relevant informations. Their
patience and knowledge gave our research a strong sense of direction to set our own path.
We would also like to convey our hearty thanks to hundreds of individuals, which also
includes the district collector, the local MLA, Ex - industries minister, health officers at
Osmania Medical College, environmentalists who helped us with their valuable input
before setting out for the data collection process.
We are also grateful to the growing numbers of individual donors who support our work
and their strong committement to Greenpeace and its efforts to contribute to stop the
. abuse of the earth.
The researchers data collection process is augmented by library research and web
research. Thanks to Salil Mukhia, Imran Khan and Jai Krishna of Greenpeace India to
contribute in this process of research.
3
I
respiratory disorders such as asthma and bronchitis, the incidence is 4 times higher in the
study group in comparison to the control group.
A stratified random sample of the study group (9 villages) when compared with those
from the Control group (4 villages) shows a significant increased disease incidence in
many body systems. These include
presence of Diseases of skin and subcutaneous tissue in the study group is at
1. The
r
least two times higher than the control group.
2. One in every eleven, in the study group is afflicted with Diseases of the
musculoskeletal system and connective tissue.
3. Ali systemic classification was based on the International Classification of
Diseases-10 (ICD-10). In at least 15 out of 20 of the ICD 10, the Study group
showed higher rates of incidence in almost all the age groups.
4. Clinically confirmed cancer incidence and respiratory disorders are greater in the
study group at a statistically significant rate. While 1 leases of incidence were
reported in the study group, no such case was reported in the sampling set in the
control group. The occurrence of Asthma and Bronchitis is 4 times highei in tne
study group.
5. There is absolutely no incidence of Heart Disease in the Control Group unlike in
the Study group.
This report, further, uses available and existing research to demonstrate: o The presence of a wide range of chemicals in the land, air and water in Medak.
o The ways in which the local community are being exposed to these toxins.
o The increased exposure has increased the potential for detrimental health impacts
The implications of these findings, amongst others, are serious. In brief, the study
demonstrates that serious damage is being done to the health of the residents of Medak at
current levels of Industrial activity, and this damage potentially correlates with location, a
measure of exposure to Industrial activity-generated pollution. It is incumbent on State
regulatory authorities responsible for the public health to investigate this matter, to
further define the scope and severity of the problem, and initiate processes which will
return the community to the state of health enjoyed by them prior to this reckless
industrialization era and pressurize industries to follow all environmental and ethical
norms and implement clean production and closed-loop systems in their production cycle.
The evidence presented here contributes to a growing repository of research that
reinforces the conclusion of this report that serious damage is afflicted upon the local
community potentially through the pollution stemming out of reckless industrial activity
and necessitates the need to ensure that Industrial estates of the nature of Patancheru, not
be replicated elsewhere.
8
I
<■
Map of Patancheru Industrial Development Area: Survey of India Toposheet
9
uwni
INTRODUCTION
Medak - A Brief Description
Patancheru and the adjoining study areas are located at 17° 31' N latitude and 78° 15' E
longitude on the northeastern part of Andhra Pradesh, which is on the southeastern coast
of India. It covers an area of 222 Sq. Kms in Medak district and is 40 km away from the
capital of Andhra Pradesh, Hyderabad. Many villages in the area are situated on alluvium
and weathered bedrock. Amidst the Granite terrain, the Nakkavagu stream has been
identified as a paleo-channel that is composed of clay-silt-sand. It was predominantly an
agricultural landmass located on the banks of river Manjira, a major tributary' of River
Godavari, one of the lengthiest rivers of south India, but transformed into an industrial
area as part of the governments’ drive on industrialization.
The region experiences a semi-arid tropical climate with persistent drought, unpredictable
weather, limited and erratic rainfall. The area gets two monsoons in varying degrees,
southwest monsoon from end of June till August and Northeast monsoon from September
till November. May is the hottest month with the mean daily temperature of about 40
degree C. December is the coldest month with a mean daily temperature of about 29
degree C.
The Community
As per the 2001 census. Patancheru’s population is 1,17,214. The population density is
234 persons/Sq.km and the sex ratio is (56,267 female, 60947 male). Population of
Medak district, in which Patancheru falls, is about 22, lakhs persons of whom. A
prdominat section of the resident community were traditional farmers and agricultural
labourers cultivating jowar, paddy, ground-nut, chillies, tomato, cotton and wheat till the
industrialization process started in 1975. Affected by aggression of industrialization, most
of them moved into jobs in industries and a large number of them are taken up indirect
jobs created by the industrialization. Today, agriculture continues to be the sustenance for
a few. The inception of Industrialization witnessed the influx of a migratory' population
from other parts of the country' to take up jobs in the industries.
The problem
The Patancheru Industrial Estate was set up in 1975 as part of the government initiative
to bring in more industries to the state of Andhra Pradesh. Over a period of 29 years,
about 320 industries that are manufacturing pesticides, chemicals, pharmaceutical and
steel rolls have come up in this area. Ln the year 1989, 110 of these industries joined
hands and set up a common effluent treatment plant (CETP) in a nearby location. These
industries transport their effluent in tankers to the CETP for treatment. After treating
these effluents, wastewater is discharged into peddavagu water stream, which meets the
main stream Nakkavagu flowing through Patancheru area. The Nakkavagu finally meets
the river manjira that is one of the main potable water sources in the area. In this context,
it is interesting to note that the people of Medak and the twin cities of Secunderabad and
10
Hyderabad are dependent on the Manjira for their requirements. The Manjira further
flows to join the river Godavari, which is one of the longest rivers of South India.
As per conservative estimates, the industries of the Patancheru and Bolaram area generate
cumulative 8 x 106 1/day effluents which are being directly discharged on to surrounding
land, irrigation fields, and surface water bodies that finally enter into the Nakkavagu
stream a tributary of the Manjira river. Studies on abundance and distribution pattern of
toxic trace elements indicated the quantitative aspect of pollution in the Nakkavagu
Basin. Migration patterns indicate that the pollutants discharged by the industries are
entering the surface and groundwater systein (aquifers) and are also migrating towards
the Manjira further deteriorating the entire hydrological structure of the area. A National
Geophysical Research Institute (NGRI) study sponsored by the Central Pollution Control
Board covering an area of about 160 sq km where more than 400 big and small
pharmaceutical and chemical industries operate has found high levels of heavy metals
such as Arsenic, Strontium, Barium, Selenium, Boron, Manganese and Nickel and
residual pesticides of Aldrin and Endosulphan in the groundwater as well as surface
water in the area.
Complaints pertinent to health have-become common-place at Medak, which include
respiratory disorders, cancers, congenital problems like mentally/ physically challenged
children, chronic depression and reproductive problems.
Concerned with the growing indiscriminate discharge of effluents into the open areas and
the consequent large scale pollution, Hyderabad-based Indian Council for Enviro Legal
Action filed a Writ Petition in 1990 in the Supreme Court. The apex court moved the
petition to the High Court of Andhra Pradesh in, 2001 and directed it to monitor
implementation of order passed by the Supreme Court of India on stricter measures with
regard to Common Effluent Treatment Plants (CETP). A High Court appointed expert
committee in March 2004 submitted that 18 of the 23 lakes in the area are polluted at
various degrees and suggested a detailed health study on the people in that area to assess
the impact of the pollution.
pfclhExpostmnRgttowaih? Q?'
adjoining
■Will
□
11
iG^sancCfacies^ tHe
S^/day.^
.2/ddy.MQ^
TOXIC
CONTAMirS
Wide Range of Industries
including Pesticide Units,
Irrigating soil
with polluted
water has
resulted in
toxins entering
the soil and
thereby the
food cycle.
Rnlk Hnia Industries etc
Mercaptans, Particulate
Matter, Chlorine and other
bulk intermediaries,
Hydrogen Sulphide
9
COCKTAILS
^oeioison:
LIVESTOCK
Alarming number
of Livestock
deaths. Humans
dependent on the
produce
Community has been exposed to a cocktai'
of poisons for 20 years. Health complaints
reported from public - still bom and neo
natal deaths, respiratory disorders, cancers,
paraplegia...
n
Underground Water
High concehtrations of
heavy metals, chemicals,
phenols, pesticides, were
found in the Patancheru
Mandal
I I Lakes and the >
I streams
High concentrations of
I heavy metals and
\
f
\
Bore Well
Abnormally high levels
of BOD/IDS/COD
and Toxic Chemicals
toxic chemicals.
I
WATER |
CHEMICALS
OUT OF CONTRA
12
A
Methodology
The survey in Medak district was on nine study villages and four reference
villages totaling a sample size of 10874 persons.
The survey has its need arising out of he following - suspected rampant
pollution of the water bodies in the area-lakes in the and also the prevalent air
pollution in the vicinity.
Also together is the fact that there has been a long struggle of the people in he
area both by legal and public demonstrations.
•
»
The primary aim is the identification of the need for a detailed health analysis in
the area to bring about any understanding of the poisons present in the water
and air and the way people are affected by their presence.
The Proposed Research Question for the study was "What are the health
problems faced by the resident community of the nine villages in Medak district
which comprised the study group, due to increased pollution of the air and
water by industries?"
The answer was researched involving four strategies:
1) A Review of literature from around the area
2) A questionnaire based survey of people in villages of the mandal
3) Ethnographic interviews of people and
4) Focus group discussions
Preceding the study:
The first step was to obtain community consent to do the assessment and ensure
participation and cooperation from the local panchayats and community leaders.
Next came a comprehensive literature survey of all available material on health
status of the community. One map was used to capture all the data from
secondary sources on it. After plotting the cases of ill health and death due to
diseases with environmental causes on this detailed map, decisions were made
on identification of the target and reference group. A visit of the partners in
research, the Occupational Health & Safety Centre-Mumbai was arranged to
examine the conditions at Medak and help us with developing the medical
aspects of the study.
Consulting individuals and like minded groups, sarpanches of villages,
Villages were chosen after deep research of their social standards, location,
occupation, their acceptance for the survey, and various other parameters.
The advisory board consisted of ... and their inputs were implemented on
drafts, training procedures, on sample size selections and other scientific and
statistical analysis.
The details of the study villages are:
13
Village
Bonthapally
Chitkul_______
Digwal_______
Guddapotaram
Khazipally____
Kistareddypet
Pashamilaram
Pocharam___ _
Sultanpur
Sample
size
1322
1574
1404
509
670
628
672____
987
1159
Total
8925
The details of the control villages are:
Village
Musapet
Ramojipally
Uthloor ___
Veerojipally
L
Sample
size___
707 ~~
349___
508
385___
Total
1949
Training of interviewers:
The training of interviewers, a team of 10 people was done in November
2OO3.They were introduced to the problems of people living in the industrial area
with introductions to Greenpeace and its activities in the environmental front.
During the second day of this session, fundamental overviews of epidemiology,
with the example of a survey done on the impacts of industries on public health
by Greenpeace at Floor, Kerala was discussed.
Finally the questionnaire was also discussed and model exercises were held to
keep the interviewers familiar with the questions and procedures.
Sampling exercise:
It is random sampling method followed and the randomisation was executed in
picking lots at a public gathering in the village panchayat as to which house is to
be sampled. It was chosen so that we get a comfortable sampling ratio of 1:3. It
was followed by interaction with villagers as to why the study was conducted.
14
Pilot survey:
This was done in all villages on the first day of sampling. Its aim was to
understand the field difficulties involved and to serve as an experience to the
interviewer. It also was useful in learning the cooperativeness of the people,
whether they were comfortable in disclosing personal information and to
understand manners and customs of the people which was required to make this
survey a pleasant exercise.
It as a whole served as a review of the whole process.
The questionnaire:
The questionnaire was exhaustive one prepared with the recommendations of
our advisory board.
Each sample would be identified with an identification number which is actually
a combination of a area code, interviewer code, and the house number combined
to form a six character code no.
The date, time, address and contact no.s were all recorded.
The questions were wall designed to be open-ended questions. In each of the
house the procedure of zkey informant' was followed.
This is the oldest surviving female of the house who would be telling the
interviewer the information required about the other members and also the last
two deceased members.
After recording basic information like the age, education, two different health
problems were documented. They were diseases that the member of the house
perceived of being affected and those, which were diagnosed by doctors to be
present. Personal information like presence of habits of chewing
tobacco/smoking/ drinking/ snuff was also documented.
Finally related information like pesticides used in home, their frequency of use,
practice of burning of house hold wastes at home, presence of protected water
supply, if no, appearance and details of water available, their sources were all
collected.
Appropriate codes for the'various diseases, for rating of overall health were used
to make the documentation and analysis easier at the later stage.
Throughout the investigation involving the respondents all basic ethical norms
were strictly followed. Prior informed voluntary written consent was obtained
from each participant.
The information gathered was entered on a day-to-day basis onto a computer
and collated in a database. The database was later searched for various diseases
and disease sets as recommended by the International Classification of Diseases,
ICD-10.
15
Follow up medical verification:
The team of doctors from the OHSC and Sion hospital in Mumbai, were
involved in the follow up and verification of the diagnosed illnesses of the
people documented. Though the persons were identified after referring to the
complaints of diagnosed illness they were further classified into cases where
there is no personal habit, which may be responsible for the illness. The team of
doctors visited these persons and tests were done verifying their illnesses in
respiratory system, reproductive system disorders, examined medical records of
cancer symptoms, allergies of skin, and birth defects. These investigations served
as a confirmation to the study and added reliability to its findings.
Ethnographic survey
Ethnographic information were collected from individuals classified according to
age and occupation using open questionnaires.
Limitations:
One of the limitations of the study is that it might not examine in detail the range
of health problems faced by the workers working in the polluting industries who
mostly reside outside villages that fall under the purview of the field
investigations.
Another limitation is that the health study too place during the harvest season
and so a segment of the population could not be interviewed as they were out in
the fields. A certain section of the sampled population was relatively new to the
area and so that too was a seen as a limitation.
Also were the problems of migrating and drifting sections of population, which
makes the study in a way incomplete with respect to the idea of a completely
random sample.
Similar were the cases where personal information like monthly income was not
revealed.
Analysis:
The analysis was classified into three. First the data was classified under six age
groups from 0 to 61 and above. Then there are classifications on sex, and
percentage of illnesses. This data thus grouped into three was then analysed for
individual diseases based on the ICD-10 scale. There was an analysis done on
mortality rates based on the data accumulated in the study.
Once these divisions were made the data was tested for consistency and
significance using the x2 tests and odds ratio tests. These give a direct ratio
between ill health of the people to industrial pollution.
Then based on the results of these tests the graphs were plotted and analysis
was done.
16
The health related responses of the respondents traversing a wide spectrum were
recorded, stored and sorted using a customized software management system.
This involved segregating raw data in an order prescribed in the disease index
(refer to disease index annexure).
The sorted data was then further categorized under the International
Classification of Diseases (ICD 10). (Refer to annexure on International
Classification of Diseases)
Analysed data was then projected in a graphical format for easy understanding,
which was done with simple office software coupled with Manual Computation
techniques.
The validation of this analysed and processed data was further substantiated by
performing the Chi square test to determine their statistical significance. (Refer
table 2452.. .insert table Of few dieases n their statistics)
Findings:
All body systems without exception are adversely affected in the Study areas as
opposed to the control locations. It is amply evident that this is the result of a
cocktail of poisons in the water and air of the study villages, which has had
considerable effects on the health and well being of the local population.
Brief Summary of the Health Study conducted at Medak District.
The Analysis of the data collected at Medak District has shown that there is an
overwhelming difference in incidence of many systemic maladies across the
Exposed group when compared to the Less Exposed group as detailed below:
Cancer Incidence is greater in the Exposed group at a statistically significant rate.
While llcases of incidence were reported in this group, no such case was
reported in the sampling set in the Less Exposed group.
There is absolutely no incidence of Heart Disease in the less exposed group unlike
in the exposed group.
The occurrence of Asthma and Bronchitis is 4 times higher in the exposed group.
One in every eleven is afflicted with Diseases of the muscoskeletal system and connective
tissue .
The presence of Diseases of skin and subcutaneous tissue in the exposed group
is atleast two times higher than the less exposed group.
The number of people in the Study group suffering from headaches is 25 times
more than those suffering from headaches in the Control group.
17
Medical Verifications were performed using the lung function tests (Spirometry)
on a random sample of the reference and target populations. These confirmed
our findings.
73.6% of the people tested were found to have affected lungs when compared to
the control group where only 32.5% were affected. The chi square test proves that
this difference is highly statistically significant as well.
In atleast 75 out of 20 of the ICD 10 ( International Classification of Diseases), the
Study group showed higher rates of incidence in almost all the age groups.
Conclusion:
The study population is in grave danger of chemical crisis which might seem
only invisible now; the aquifers, the lakes and the streams around the area is
being target of the callous attitude of the industries. Now they have reached to
the human population. The pollution control board with crores of Rs of
investment to function in two decades have failed to intervene and come up with
strategy which protects the community and the ecosystem, from toxic
contamination. They have posed a question to their very existence using public
money with total lack of transparency.
Though it is essential to control damage already inflicted, and to protect the
community and the ecosystems from the poison fallout. But given what is
already known - that damage done to aquifers is mostly irreversible, that it can
take years before groundwater pollution reveals itself, that chemicals react
synergistically and often in unanticipated ways - it is equally clear that a
patchwork response will not be effective Given how much this pollution inflicts
on public health, the environment, and the economy once it gets into the water, it
is critical that emphasis shift from filtering out toxins to not using them in the
first place. Andrew Skinner, who heads the international Association of
Hydrogeologists puts it this way: "Prevention is the only credible strategy"
There have been large scale environmental crime going on in the region, we
suggest the regulators and the polluters take up immediate interventions.
The project demands that:
1 Declare a state of Chemical crisis in the region
2. /em Discharge in Land, Lakes, Nakkavagu, Pamalavagu, Pedavagu
stream
3 Compensate and Medically rehabilitate the affected coomunitv It has to
be long term medical rehabilitation
4. Mop illegal dumping and injection < r diluents directly into ground
is
5. Implement immediate and concrete steps towards clean production at
Patancheru, pashamailram and khazippaly and bollaram IDA now.
6. Clean up all contaminated sites immediately
7. The companies and government must Make all information Public
regarding pollution, health risks, emergency preparedness and related
dangers to local communities. Companies must ensure that all workers
have access to medical records
8. The Companies must accept complete responsibility and liability for their
past actions
9. Complete enforcement of the environmental laws must happen in letter
and spirit.
10. Time bound commitment to phase out from deadly chemicals and toxins
The evidence found Patancheru, Jinnaram and Kohir Mandal clearly shows that
the synergistic effects of cocktail of chemicals (a few score heavy metals a few
hundred organic chemicals) are far more alarming than expected.
Waiting for further solid evidence of chemical effects on health will mean risking
irreversible damage to the health further, especially of children.
The reality today is that we are exposed to tens of thousands of chemicals which
simply didn't exist on planet until a few decades ago. We have no tools for
analyzing the toxicity of the complex mixture to which we are exposed (Howard,
1997; Lang, 1995). Most toxicology is performed on chemicals one at a time. We
have difficulty comparing chemicals even in combinations of pairs (Axelrad et
al., 2002 and 2003). When we consider combinations of hundreds or thousands of
chemicals, it is clear that we have not yet developed any methods that will allow
for their rigorous toxicological analysis. There is no indication of any imminent
major breakthrough to this testing problem. That leaves us with only a
generalized approach to. safety through hazard reduction, i.e. reduction in
exposure, using a precautionary approach... There are simply no other rational
options available.
19
Appendix 1. Copy of Questionnaire
PATANCHERH FIELD INVESTIGATION
E•UESTIONNAIRE
Identification Number (Area Code+ Inte
DATE
TIME
Number of Family Members
Address-Phone Number:
What is the total monthly income of the family?
)F
A
G
S
E
AMII Y MEMBER
E
X
.AME
Ky
Infm
t
EDUCAT1
OCCUPATION
ON
Over all
Health
Perceived Healtl
DOCTOR-DIAGNOSED
HEALTH PROBLEM
# of yrs
Y/
1
2
3
4
1
2
N
vil)
12)
13)
.44)
'.15)
• 1 b)
M7)
M8)
a
S
e
Deceased Member:
se
Year of
Death
Occupation
Educat- ■
ion
Over-all
Health
Cause of death ?
)l >
)2)
HN/Y
Do you spray pesticides in the home? If yes what is the number of rounds of spraying in a year?
HN/Y
Do you bum your house-hold wastes at the home? If yes how many times do you bum it in a year?
2N/Y
Protected water supply?
If ‘N’ source a) Well b) Borewell c) Tank d) Stream / River
A)
Colour of water Normal / Change of colour
B)
Odour • Less / Smelly
C)
Turbidity : Normal / Above
[E N ' Y
Do you cultivate your own vegetables?
If ‘N’ source a) Village Shops b) Nearby Market c) City
___
Ventilation : Adequate Inadequate
[DISEASE INDEX FOK INTERVIEWEI
20
Any chronic dis<
A: Asthma. AL: Allergies, AD: Allergic Dermatitis, ATD: Attention
Defects. ADR: Allergic to Drugs, ART: Arthritis, ANM: Anemia, ACR: Accident Road. AC-F: Accident Factory.
B: Bronchitis, BD: Blood Disease, BRD: Birth Defects,
BS: Breathlessness sudden, LBP: Blood Pressure, HBP:
High Blood Pressure, BR: Breathlessness regular, BP:
Back Pain. ___________________ ______________
C: Cancer, CB: Cancer of the Breast, CT: Cancer ofthe testicles,
CPR: Cancer of the Prostrate, CL: Cancer of the Lungs, CBL:
Cancer ofthe Bladder, CUDT: Cancer of the Upper Digestive Tract,
CLDT: Cancer of the lower Digestive Tract, CST: Soft Tissue, CAS:
Angiosarcoma, CA: Cardiac Arrest, CP: Chest Pain, CNT:
Contraceptive Pills/ implants /injections, CC: Cervical Cancer, CNF:
Confusion, CS: Severe Cough,
CCS: Severe Cough & Cold_____________________________
E: Endometriosis, EP: Early onset of Puberty, ED: Erectile
Dysfunction, EL: Epilepsy, EFL: Early Foetal Loss. EP: Eye Pain,
EO: Eye Operation, G: Gall Bladder Stone
D: Diabetes, DP: Depression, DZ: Dizziness. DH:
Diarrhea, DNP: Dental Problem
I: Infection, IE: Infection of the Ear, IT: Infection of the throat, IL:
Infection of the Lungs, IC: Infection-Common Cold, 10: Other
infection, INF: Infertility, IRT: Irritation, IA: Induced Abortions,
!MN: Immunisation, ID: Indigestion.___________________________
F: Fibroid in the Uterus, FR: Fever recurring, FCR: Cold & Fever
recurring
J: Jaundice, K: Kidney Failure. KS: Kidney Stone
M: Migraine, MP: Menstrual Problems, ML: Memory Loss, MN:
Menhorragea, MA; Missed Abortions, MD: Mental Disease
O: Obesity, OP: Osteoporosis
R: Rheumatism, RP: Reproductive illness, RTI: Reproductive
Tract Infection
T: Thyroid problem, TB: Tuberculosis, TH: True Hermaphrodite
VDE: Vomiting with direct exposure, VL: Vision Loss, V: Varicose
Vein Dysfunction_________________________________________
HL: Hearing Loss, HR: Headaches Recurring, H:
Headaches,
HD: Heart Disease, HP.’Hepatitis
L: Leukemia, LD: Liver Disease, LGY: Lethargy, LSC:
Low Sperm count: LGS: Lymph Gland Swelling, LP: Leg
Pain_____________________________________________
N: Nasal Septum Perforation, NS: Nausea
P: Paralysis, PS: Paralysis-Stroke. PCOS: Poly-cystic
Ovarian Syndrome, PLS: Piles, PM: Psychiatric
Morbidity, PU: Prolapse Uterus
SD: Skin Disease, SW: Shuffling when walking, STD:
Sexually Transmitted Diseases, SU: Suicide Urge, STU:
Stomach Ulcers, SNS: Sinusitis, SI: Stress Incontinence,
SP: Surgical Procedures? SPN: Stomach Pain
U: Urinary Tract Dysfunction, UMM: Uncontrolled
Muscle Movements, UT: Undescended Testis
W: Weakness, WZ: Wheezing
[Questions to be asked to the Key informant about himself and other people in the family:|
Q How would you rate your overall Health?
A: Excellent, seldom if ever, sick. B: Good, occasionally sick, no major health problems but not ideal health, C: Fair, sick more
than most people; limited in a few activities,
D: Poor, gets sick often, illness limits many activities. E: Very poor or bad, always sick, Chronic Illness limits all activities.
Have you been diagnosed for any disease/health problem by a doctor? Any other perceived diseases and symptoms?
Q What are your current or past habits?
S (n)/(y): Smoking n=number of cigarettes/bidis per day/ y= number of years of smoking,
D (n)/(p): Drinking n= number of days per week/p= number of pegs in one session
CT (n)/(y): Chewing Tobacco, n=no of times a day/ y= no of years of chewing;
SN (n)/(y): Snuff; n=no of times a day/ y= no of years of use
TP (n)/(y): Tobacco Paste: n=no of times a day/ y= no of years of use
21
Appendix 2
Study of effect on Lung Function in villages exposed to industrial pollution
It is known fact that air pollution from industries affect lung function (respiratory
systems).Lung function tests are a good tool to study this effect. Lung function tests
measure the volume of air forcefully exhaled by a person in the mouthpiece of a lung
function test meter after inhaling air initially. Forced expiratory volume in the first
second (FEV1) means the volume of air exhaled forcefully in the first second after
exhalation starts. This parameter is known to get affected mainly due to air pollution
Some dusts cause fibrosis in lungs
lungs (e.g.
(e.g. asbestos,
asbestos, silica).
silica). These
These dusts
dusts have
have more
more effect
effect on
on
the total capacity of lungs than effect on FEV1.
/e studied effect on FEV1 in exposed villages and in non-exposed villages. A portable
yentilometer (SPIRO DOC) was used. Dr. S. R. Kamat's equations and tables were used
for the predicted values of FEV1. Sex and age, two important variables are considered
in the equations themselves. Separate stratification on the basis of age and sex is not
needed to see the effect on FEV1, if height is within the normal range.
We have labelled persons having FEV1 below the 60% of predicted values as being
severely affected. Persons having FEV1 in the range of 60 to 80% of the predicted values
were labelled as affected but not severely. All the persons having FEV1 above 80% of
the predicted values were labelled as being non-affected.
Smoking also affects FEV1. To neutralize effect of smoking for sake of comparison of
exposed villages to unexposed villages, smokers were subtracted from affected as well
as unaffected. We see the effect in Table 4. We see that actually percentage of affected
persons increases in the exposed villages among the non-smokers. There are smokers
who are yet not affected in both types of villages. These figures we see in Table 3.
Environmental asthma is known to be present in polluted areas. For suspected
asthmatic persons, the lung function test was repeated after administering broncho
dilator asthelin pump.
iricrease m FEV1 equal or more than 15% was used as a criteria for asthama, as given by
-arl Zenz. Family history was probed. One person reported that mother is known to
lave su ered in her youth. This was labelled as familial asthma. Even in this case it is
jgssiole that even mother ^tartedsuffering after industrialization. To be conservative
ye labelled it as familial_asthrna
Sample:
or testing for lung function 44 persons from exposed villages and 35 persons from
mexposed villages were randomly selected among persons who complained of some
espiratory problem. In field studies due to problems of communication, in grasping
nstructions and also genuine respiratory problem some persons cannot perform the
22
test fully satisfactorily. The ratio of exposed to unexposed in the range of 1.15 to 1 was
decided to be acceptable. Even though in many persons it was clear that they could not
perform the test also due to respiratory problem but with a mixture of problem of
communication; such tests (6 from exposed and 1 from unexposed) were not considered
for analysis. Where doctor has clearly commented problem of incapacity due to
respiratory problem it was accepted for analysis as severely affected. One instance of
report of pleural effusion and non-performance was also not taken for analysis (one of
the six above).
The following tables list the findings. Results of test of si; ificance (chi-square) are
given at the end.
Tables of lung function test in Patancheru area:
Table 1. Lung function affected in exposed and unexposed villages:
Villages
Total lung Total
FEV1
FEV1
Severely
Affected, function
non
(FEV1)
Affected
but not
affected
affected
severely
Exposed
Males
08
09
11______ 19
Females
03
06______ 09_______ 01
Total
11
28
17
10
(73.6%)
Unexposed Males
04
06
10
16
02
Females
02
00
06
Total
12
06
22
06
(35.2%)
Total
40
32
Odds ratio=2.08>2
ASTHMA:
Increase in FEV1 equal or more than 15% after broncho-dilator.
Table 2.
Familial
Environmental No asthma
asthma
asthma_______
Exposed
01 (smoker)
07(18.4%);
31
(3 smokers)
Unexposed
00
01(2.9%);
33
(Non-smoker)
Total
08
64
23
Total
38
34
72
Total
tested for
lung
function
28
10_______
38
26
08
34
72
Smokers:
Table 3.
All smokers are males.
Affected
smokers
Non
Heavy
Heavy
0306
Exposed
Villages
02
03
UnExposed
Villages
Total 27
Affected
Smokers
Total
Unaffected
Smokers
Heavy
09
02
NonHeavy
04~
05
05
02
Unaffected
Smokers
Total
06
07
13
14
Number of affected and non-affected smokers is almost the same.
Effect among non- smokers.
Table 4.
FEV1
Villages
Severely
Affected
FEV1
Affected,
but not
severely
Males
Females
Total
02
03
11
08
06
17
Unexposed Males
Females
Total
01
02
05
04
00
06
Exposed
Total
Total
Lung
function
(FEV1)
affected
10 .
09_____
19
(82.6%)
05_____
02_____
07
(31.8%)
26
Total
non
affected
Total
tested for
Lung
function
03
01
04
13
10
23
09
06
15
14
19
45
08
22
Odds ratio= 2.5>2
Significance:
Ghisquare test shows that number of affected persons is significantly higher in exposed
villages (PO.Ol) (Tablel).
The difference is significant also among non smokers at P<0.01 ( Fable 4)
24
Appendix 3:
FOLLOW UP MEDICAL INVESTIGATION OF CARCINOMA QUESTIONNAIRE:
------------------------------identification Number (Area Code+ Interviewer code+
Ward Number+ House Number+ follow up 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
11. Senior doctor in a major hospital
12. Pathology confirmation
13. Was surgery performed?
14. Was chemotherapy administered?
15. Was radiotherapy administered?
16. Is there pain at present?
17. Is there bleeding from the site?
Appendix 4:
FOLLOW UP INVESTIGATION OF RESPIRATORY DISABILITY USING PULMONARY
FUNCTION TESTING QUESTIONNAIRE
1. -------------------------- Identification Number (Area Code+ Interviewer code+
Ward Number+ House Number* follow up 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 2 months?
9. Y/N Is the problem for more than 2 years?
10. Is 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 asthmatic?
14. Y/N Is there a family history of asthma?
25
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 staire
20. Walking at usual speed
21. Walking for even 100 steps/performing activities of daily living
22. Even at rest
23. GRADE OF BREATHLESSNESS:
READINGS OF LUNG FUNCTION TEST
Sr. No.
1~
2
FEV1
FVC
PEFR
MEFR
Selected
PEFR
MEFR
Selected
3.
4.
AFTER BRONCHODILATOR:
Sr. No.
L____
2.
3. ____
4.
FEV1
24. FEV1_____
FVC
J°/o of predicted; 25. FVC
26. COMMENTS
26
% of predicted
!
I
Appendix 5: List of Charts transcribed into Graphs: Mental disease
Age
total pop
total pop
Group Male male
male%
Female female
female% Male
1 -5
years
0
493
0
0
487
0
6-12
years
1
732
0.1366
1
688 0.145349
13- 19
years
2
668 0.2994
3
721 0.416089
20-35
years
6
1503 0.3992
1
1446 0.069156
36-60
years
3
896 0.3348
1
821 0.121803
61 +
years
0
248
0
2
222 0.900901
Male
0.5
0.4
0.3
0.2
0.1
o 4
^EiCT1I
J
■
:
r=i
■
1 - 5 6- 12 13- 19 20- 35 36-60 61 +
years years years years years years
total pop male male%
total
POP
female female%
Female
0
116
0
1
122 0.819672
0
157
0
0
149
0
130
0
1
134 0.746269
1
287 0.348432
0
334
0
0
220
0
0
201
0
0
56
0
0
43
0
Female
□ Study
■ Control
1
0.8
. 0.6
0.4
0.2
0
, 4All
■
□ Study
JI
1 -5 6- 12 13- 19 20-35 36-60 61 +
years years years years years years
■ Control
0
Epilepsy
total
Age
total pop
POP
Group Male male
female% Male
male%
Female female
1 -5
6
487 0.616016
years
493 1.217039
3
6- 12
4
688 0.581395
years
4
732 0.546448
13- 19
2
years
1
721 0.138696
668 0.299401
20-35
1446 0.207469
7
3
years
1503 0.465733
36-60
0
years
0
2
821 0.243605
896
61 +
years
1
222 0.45045
3
248 1.209677
0
116
0
0
122
0
0
157
0
0
149
0
0
130
0
0
134
0
3
287 1.0453
0
334
0
0
220
0
0
201
0
56
0
o
43
0
n
□ Study
□ Control
Female
Male
! 1.4 r
I 1-2
1
0.8 4
0.6 -4
| 0.4 -4
I 0.2 -4
o -U
--
0.7 -j-----
-•
□ Study
1 PI—
1-5 6-12
years years
total pop
female
female%
total pop
male
male% Female
61 +
132036years
35
60
19
years years years
■ Control
o.6 -ri
0.5 -0.4 -0.3 -- 3
0.2 -0.1 --
0 -P
r~
I' I :
5I
I____ _n Jt
n -I —
1-5 6-12
years years
28
'
13- 20- 36- 61 +
19
35
60 years
years years years
Paralysis:
Age Group iMale
1 - 5 years
6-12 years _
13-19 years____
20 - 35 years____
36 - 60 years____
61 +years
total pop
male
_1
0
2
J2
5
total pop
male%
Female
Ifemale__ female% Male
493 0 20284 _____ P_
487 ________ 0
732 ______ 0 ________ 1_
688 0.145349
668 0.149701 ________ 1_
721 0.138696
1503 0.133067 ________ 1_
1446 0.069156
896 1.339286 ________ 5_
821 0.609013
248’ 2.016129
4
222 1.801802
Male
total pop
total pop
male
imale%
Female
female
female%
0
116 _______ 0 _______ 0
122 ________0
0
157 _______ 0 _______ 0
149 _______ 0
0
130
.
0 _____ g ____ 134
0
0
287 _______ 0 ________i
334 0.299401
_1
220 0.454545 _____ g
201 _____ g
56'
0
0
o
43 __ 0
Female
2.5
2 -
2 T
1.5
1.5 1 -
E Study
@ Control
0.5
0J
1 -5
years
6- 12 13- 19 20-3536 -60 61 +
years years years years years
_____________
1
0.5
B
0 -1
1 -5
years
29
p
11
6-12 13-19 20-35 36-60 61 +
years years years years years
□ Study
■ Control
Vision loss:
total pop
female female%
I
Male
487 ________ 0
493 _____ 0 ________ 0
688 _______ 0
732 0.136612 _____ 2
668 _____ 0 ________ 2
721 0.277393
0.532269
_______
10
1446
0.691563
1503
821 5.968331
896 3.348214 _______49
222 10.36036
248 9.274194
23
total pop
male
male%
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
_0
_1
0
8
30
23
total pop
Female
female
female%
____ 0 ________0
122 _____ 2
total pop
male
male%
Female
116
157 ____ 0 _____ 2
130
2 _____ o
287 ___ 2 ________2
220 ___ 2 ________2
3
56 1.785714
0
0
0
p
p.
1
149 _____ 2
134 _____ p
334 0.598802
201 0.995025
43 6.976744
Female
Male
10
a
8
'
■
6
4
2
-
■.
‘
1___________.»J
__ ______________ [R_
I Zj ■
0 4
1 -5
years
—---
15
□ Study
10
■ Control
5
.
.■
0 -1
1 -5
years
6 - 12 13 - 19 20-35 36 -60 61 +
years years years years years
30
0 Study
............. n<
,-^nL
I
6 - 12 13- 19 20-35 36 -60 61 +
years years years years years
■ Control
Hearing loss:
Age Group Male
Il - 5 years
female% Male
Female female
487
________ 0
493 _______0 ______ 0
688 0.145349
732 ______ 0 ______ 1
721 0.277393
668 0.149701 ______ 2
0.069156
1446
______
1
0.199601
1503
821 0.852619
896 0.446429 ______ 7
222 0.45045
1
248 0.403226
0)
0i
_1
3I
4
1
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
total pop
female%
Female female
0
122 _____ g
116 ______0
149 _____ g
157 ______0 ______ 0
134 _____ o
130 ______0 ______ 0
334 _____ o
287 _______ 0 ______ 0
total pop
male%
male
total pop
total pop
male
male%
0
0
0
0
2
220 0.454545 ______ 1
1
56 1.785714
1
Female
Male
2
1.5
1
0.5
0
■
' y
■
□ Study
_________________ .
_________ m
;i crral
1 -5
years
201 0.4975124
43 2.3255814
I
■ Control
2i-h
-t
°d
___
Bl
__________
1-5 6-12
years years
6 - 12 13 - 19 20-35 36 -60 61 +
years years years years years
31
□ Study
rM
13-
20-
35
19
years years
61 +
3660
years
years
■ Control
Heart Disease:
Age Group Male
1 - 5 years
6-12 years
13-19 years
;20 - 35 years
^36 - 60 years
61 + years
total pop
female% Male
female
487 _______ 0
493 _____ 0 ________ 0
total pop
male%
male
0
1
p
2
5
1
total pop
male%
male
Female
732 0.136612 ________ 1
668 0.149701 ________0
1503 0.133067 ________ 2
896 0.558036 ________ 3
0
248 0.403226
688 0.145349
721
1446 0.138313
821 0.365408
0
222
3ZHZ°
0
0
0
0
0
0
116
157
130
287
220
56
0.6
0.2
0
■/m
1 -5
years
TZIZI2
0
0 _____ o
0 ________0
0 ________0
0
0
2ZZ2ZZZI2
149
134 ________0
334 ________0
201 ________0
0
43
Female
Male
0.4
total pop
female%
female
122 _______ 0
0 ________0
Female
1
r”
lOI
□ Study
■ Control
0.4
0.3
0.2
0.1
0 4------- :------------, irrJ.l.------- ,----- s-
_____ J
B
...
P
' gpm 01W ii
1 -5
years
6 - 12 13 - 19 20 -35 36 -60 61 +
years years years years years
32
t/*'ItfklIP*| '
6 - 12 13- 19 20 -35 36 -60 61 +
years years years years years
□ Study
■ Control
Bronchitis:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
total pop
male
male%
1
_8
W
10
1
total pop
female
female% Male
493 0.20284 ________ 1
487 0.205339
732 0.273224 ________ 4
688 0.581395
668 0.299401 ________ 0
721 _______ 0
1503
0.532269 ________ 7
1446 0.484094
896 1.785714 _______ 12
821 1.461632
248 4.032258
2
222 0.900901
Female
total pop
total pop
male
male%
Female
femala
female%
0
116 _______ 0 _______ 0
122 _______ 0
0
157 _______ 0 _______ 0
149 _______ 0
0
130 _______ 0 _______ 0
134 _______ 0
2
287 0.696864 J_______0
334 _______ 0
0
220 _______ 0 _______ 0
201 _ ______ 0
1
56 1.785714
0
0
43
Male
5
4
3
2
Female
2
_
___ ________________
_________ bi ftr—i,
r~M i-i
1
0
1 -5
years
6 -12
years
□ Study
■ Control
■
RM
13 - 19 20-35 36 -60
61 +
years years years
years
ft
1.5
□ Study
1 -
0.5 -
0 4
_
m
‘1-5
years
kl
♦
,
hl
;■
IE
6 - 12 13 - 19 20-35 36-60 61 +
years years years years years
■ Control
Asthma:
I
Age Group Mais
|1 - 5 years
|6 - 12 years
|13~-19 years
20 - 35 years
^36 - 60 years
<61+ years
total pop
male____ male%
Female
2
493 0.40568 ________ 1
5
732 0.68306 ________ 0
_4 ____ 668 0.598802 _______ 2
14
1503 0.93147 _______ 11
_!6
896 1.785714 _______ 14
18
248 7.258065
5
total pop
female
female% Male
487 0.205339
688 ________ 0
721 0.277393
1446 0.760719
821 1.705238
222 2.252252
total pop
male
ma!e%
1
2
1
2.5
6 -
E] Study
4
2
0 -
■ Control
years
13 - 19 20-35 36-60
years years years
122
149 0.67114ll
134
334
201
43
Female
81
5 - 12
total pop female% j
Ifemale
116 _______ C
g
4
157 _______ 0
130 _______ 0
0
287 0.348432 ______o'
220 0.909091 __________ o’
o’
"^6[ 1.785714
0
0
0
Male
1 -5
years
Female
.
,
■
-
■
1.1:
1 0.5 0 - f-n
61 +
years
1 -5
years
34
i □ Study
SOS
■ |£
c Wi f
■ Control
IflSTl 31
—
•
- ' rn
ran
I"!
6- 12 13 - 19 20-35 36 -60 61 +
years years years years years
Allergic Dermatitis:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61 + years
total pop
male
male%
_2
_4
_3
]3
_6
4
total pop
!Female
female
female% Male
0.40568 ________5
487 1.026694
493
732 0.546448 ________4
688 0.581395
668 0.449102'________3 _____ 721 0.416089
1503 0.864937 ________3
1446 0.207469
896 0.669643 ________4
321 0.487211
222 0.45045
248 1.612903
1
1
0
1
1
■i
0
Female
Male
2
1.5
1
0.5
0
total pop
female%
Female
female
116 0.862069 _______ 0
122 _______ 0
149 _______ 0
157 _______ 0 _______ 0
130 0.769231 _______ 0 _____ 134 _______ 0
334 _______ 0
287 0.348432 _______ 0
201 _______ 0
220 0.454545 _______ 0
0
43
56
0
0
total pop
male
ma!e%
□ Study
El Study
0 Control
■ Control
0 4
1 -5
years
1 -5
years
6 - 12 13 - 19 20 - 35 36 - 60 61 +
years years years years years
35
6 - 12 13 - 19 20-35 36-60 61 +
years years years years years
Stomach Ulcers:
total pop
male___ male%
^Age Group Male
|1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
Female
493 _______ 0 ________ p’
0
732 _____ 0________ 0
0
_1 ___ 668 0.149701 _______ 0
1503 0.199601
896 0.892857
0
248
3
8
0
total pop
male%
male
total pop
female% Male
Ifemale
0
487
688 ________0
721 \ _____ 0
1 ___1446 0.345781
7__
821 0.121803
1|
222 0.45045
0
0
0
116
157
130
p
287^
0
220
56j
pi
i 8:2
-
•
■ -
•:
i
-.i
3661 +
2060
years
35
19
years years years
13-
0 ______ 0
0.5 7
.■ -.Vi
■
6
1-5 6-12
years years
•- .
p
Female
Male
~ I •-
total pop
Ifemale%
Ifemale
122 _______ 0
0 _____o'
0 _______ 0 _____ 149 ______ 0
__________ O’
134 _______ 0
0
334 _______ 0
0 ______ 0
201 _______ 0
______ 0
Female
□ Study
■ Control
0.4 -
i
8:1:
°d
1-5 6-12
years years
36
1319
years
2035
years
36-
61 +
60
years
years
□ Study
■ Control
43i
0
Arthritis:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
total pop
male
male%
__1
_ 5
13
95
212
80
total pop
female
female% Male
Female
493 0.20284 ________2
732 0.68306 ________7
668 1.946108 _______ 14
1503 6.320692 ______ 119
896 23.66071
257
248 32.25806
75
487 0.410678
688 1.017442
721 1.941748
1446 8.229599
821 31.30329
222 33.78378
total pop
male
male%
total pop
Female
female
female%
116 _____ 0 ________0
122 _______ 0
_0
0
_1
157 _____ 0 ________ 1
149 0.671141
130 0.769231 ________0 _____ 134 _______ 0
287 0.696864 ________9
334 2.694611
220 _____ 5 _____ 22
201 10.94527
56 14.28571
8
43 18.60465
_2
11
8
Male
Female
40
40
30
20
L
10
0 4
El Study '
■ Control
30
________________
20
10
_________________________
0 4
1 -5
years
6 - 12 13 - 19 20 - 35 36 -60 61 +
years years years years years
1 -5
years
37
' r-,
;
6 - 12
years
r-'J
■w
1
13 - 19 20 -35 36 -60
years years years
I fl
61 +
years
® Study
■ Control
Skin Disease:
I
Age Group Male
1 - 5 years______
6-12 years_____
13-19 years____
20 - 35 years _
36 - 60 years____
61+ years
total pop
male
male%
total pop
Female_ female
Ifemale % Male
493 1.217039 _______ 4
487 0.821355
732 0.546448 ________9 ___
1.30814
6
4
5 ______668’ 0.748503 ________ 4 ______721^ 0.554785
7
1503 0.465735 ________ 6
1446 0.414938
7
896 0.78125 ________ 3
821 0.365408
3
248 M .209677
0
222
0
total pop
total pop
male
male%
Female
female
female%
0
116 _______ 0 ________0
122 _______ 0
157 0.636943 ________0
149 _______ 0
130 0.769231 _______ 0 ______134 _______ 0
287 0.348432 _______ 0
220 0.454545
1
56
0
0
0
Male
334 _______ 0
201 0.497512
43
0
Female
4
1.5 -
1.5
□ Study |
1
i 0.5
i 0
■ Control i
1 -5 6-12
years years
1319
years
2036 61 +
35
60
years
years years
-V- -
1
___
'4
0.5
Ifej
0 4
1 -5
years
3K
6 - 12 13 - 19 20-35 36-60 61 +
years years years years years
EJ Study
■ Control
Uterus Removal:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61 + years
total pop
male
male%
0
0
0
0
0
0
493
732
668
1503
896
248
0
0
0
p
p
102
0 _______ 36
0
1
1446 7.053942
821 4.384896
222 0.45045
total pop
female%
female
0 _______ 0
122 ________0
0 _______ 0
149 _______ 0
134 _______ 0
0 _______ 0
total pop
male
male%
total pop
Female
female
female% Male
0 ________0
487 ________0
0 ________ 0
688 ________0
0 ________ 0
721 ________0
0
0
116
157
130
287
220
56
Female
p _______ 4
p _______ 3
0
0
Female
Male
8
6
1
0.8 0.6 0.4 0.2 0 -
El Study
_a
_'__r _
■ Control
4
2
■-
1 -5
years
6- 12 13- 19 20-35 36-60 61 +
years years years years years
39
El Study
* ■
-
"U-
0
1 -5
years
334 1.197605
201 1.492537
0
43
I
1■
11m
6- 12 13- 19 20-35 36-60 61 +
years years years years years
■ Control
Menstrual Problems:
total pop
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
imale%
male
0 _____ 493
0
732
668
1503
896
248
0
0
0
0
total pop
female% Male
female
Female
487 ________ 0
0 ________0
688 0.290698
0 ________ 2
721 0.693481
0 ________ 5
0.484094
1446
________
7
0
821 0.243605
0 _______ 2
222
0
0
0
total pop
male%
male
0
0
0
0
8:1 °fl
,
___________
-■< -
. ;
■
£
0
1 -5
years
. .r:-:|
______ _____________
6 -12
years
1319
years
2035
years
total pop
female
female%
0
122 _______ 0
0
149 ________0
_l'
2
_1
fl
134 0.746269
334 0.598802
201 0.497512
43
0
Female
Study
9 Control
.
0
0
0
0
0
0
116
157
130
287
220
56
Male
1 r
0.8
Female
0.8 -t
0.6 ________nr
0.4 - __ . : -_______
0.2 —t
0 -1------
i j-Ig
-fl I
1-5 6-12
years years
3661 +
years
60
years
40
■ -'flj ------------ft
• •
fl- m '
|:§j~~ H~~i
£
1319
years
61 +
362060
years
35
years years
E Study
H Control
Birth Defects:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61 + years
total pop
male
total pop
male%
Female
female
female% Male
493 0.20284 ________2
487 0.410678
732 0.136612 ________ 2
688 0.290698
668 0.299401 ________ 1
721 0.138696
1503 0.199601 ________ 6
1446 0.414938
896 ______ 0 _____ g
821 ________ 0
248
0
o
222
0
2
2
3
0
0
total pop
male
male%
total pop
female
female%
116 0.862069 _______ 0
122 _______ 0
157 ________0 _____ g
149 _______ 0
130 ________0 _____ g
134 _______ 0
287 ________ 0 _____ o
334 _______ 0
220 ________ 0 _____ g
201 _ ______ 0
0
56
o
43
0
J
0
0
0
0
0
Male
1
0.8
0.6
0.4
0.2
0
I
1
1 -5
years
Female
-f
m Study
S|
H
i
-
Female
' ■
- I
0.3 -7
0.2 -
9 Control
0.1 J
o -P
6 - 12 13 - 19 20 -35 36 -60 61 +
years years years years years
1 -5
years
41
......
„
-
__
E Study
____
PI:
j-
■■________ r-1________ .
■I :
.
6 - 12 13 - 19 20-35 36 -60 61 +
years years years years years
■ Control
Recurring Headaches:
Age Group Male
1 - 5 years
6-12 years
13 - 19 years
20 - 35 years
36 - 60 years
|61+ years
total pop
male
male%
total pop
Female
female
female% Male
493 ____ o _______ 0
487 ________ 0
732 1.092896 _______ 9
688 1.30814
668 2.844311 ______ 31
721 4.299584
1503 3.32668 ______ 98
1446 6.777317
896 4.129464 ______ 57 ____ _821 6.942753
248 3.629032
222 4.504505
10
0
8
_19
50
pz
9
total pop
total pop
male
male%
Female
female
female%
122 _______ 0
0
116 _______ 0 ________0i
’______ 0
0
157
________0>
149 _______ 0
_1
130 0.769231 ________0
134 _______ 0
2
287 0.696864 ________3
334 0.898204
0 ____ 220 _______ 0 ________5
201 2.487562
0
56
0
0
43
0
Male
Female
4.
i 5 T
' 4 -Is
8
•
3
2
1
0
nT~1
1 -5
years
3
1
.............
ml
was
■_____________________________________________________________________________________________
E Study
□ Study
H Control
■ Control
--n ' -
0 -
1 -5
6 - 12 13 - 19 20 - 35 36 -60 61 +
years years years years years
years
42
6- 12
years
trf
' py- |
|
13 - 19 20 -35 36 -60
years
years
years
61 +
years
Headache:
t
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61 + years
total pop
male
male%
_0
2
_8
13
11
3
total pop
Female
female
female% Male
493 _____ 0 ________ 2
487 0.410678
5
732 0.273224
688 0.726744
668 1.197605
12
1503 0.864937 _______ 32
896 1.227679 _______ 26
248 1.209577
3
721 1.664355
1446 2.213001
821 3.16687
222 1.351351
total pop
male
total pop
male%
Female
female
female%
122 _______ 0
116 0.862069 _______ 0
149 _______ 0
157______ 0 ________0
134 _______ 0
130 _____ 0 _______ 0
334 _______ 0
287 _____ 0 _______ 0
201 _______ 0
220 _____ 0 _____ g
0
43
o
56
0
2
o
o
0
0
0
Male
Female
4
■
-
■
3
El Study
0.5
2
■ Control
__________________
□ i.r~<
i
-nr
1
0 -L
1 -5
years
6- 12
years
13- 19 20 -35 36 -60
years
years
years
61 +
years
1 -5
years
43
|:i| -
6-12 13-19 20-35 36-60 61 +
years years years years years
E Study
■I Control
Vomiting Due to Direct Exposure:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61 + years
total pop
male
male%
total pop
male
male%
total pop
female% Male
Female female
0
487 0.205339
493 _______ 0 ______ 1
688 ________ 0
0 ____ 732 _______ 0 ______ 0
668 0.149701 ______ 0 ____ 721 ________ 0
_1
2
1446 0.207469
1503 _______ 0 ______ 3
0.121803
o ____896 _______ 0 ______ 1 __
o
222
0
0
0
248
P’
0
0
0
0
0
Male
0.2 |j
j °-15 h
L__
1 -5
years
0 ______ 0
122 ________0
0 ________0 _____ 149 ________0
0 ________0
134 ________0
0 ________0
334 ________0
0 ________ 0
201 _______ 0
0
43
0
0
116
157
130
287
220
56
0.25 r
r "
total pop
female___ female%
Female
J:: - ■-v-
0.1 - ___ ___ .
' 0.05 0 -
Female
"-
_____
E Study
E Control
______________
0.2 -4
0.15 10.1 0.05 J-
____ _
o -rJ
J
1 -5
years
6 - 12 13 - 19 20-35 36-60 61 +
years years years years years
44
___
_
-i
r-i
__•'_____ _
6 - 12 13 - 19 20-35 36-60 61 +
years years years years years
□ Study
■ Control
Factory Accident:
ftge Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61 + years
total pop
male
male%
0
0
0
2
total pop
female
female% Male
493 _______ 0 ________0
487 ,_____ 0
732 _______ 0 ________0
688 _______ 0
668 _______ 0 ________ 0
721 _______ 0
1503 0.133067 ________ 0
1446
2
o
896 0.111607 _____ p
248
0
0
total pop
male
male%
Female
_____ p
821 _______ 0
222
0
0
0
0
0
0
0
116
157
130
287
220
56
Male
p
Female
0.15
1 7
•
0.8 _____
_______
0.1
E Study
0.05 w&a
teI
'
•
-• •
1 -5
years
6 - 12 13 - 19 20 -35 36 -60 61 +
years years years years years
45
--
■-
•
-
E Study
■
020
■ Control
0
1 -5
years
total pop
Female
female
female%
0 _______ 0
122 ________0
0 _______ 0
149 ________0
0 _______ 0
134 ________0
0 _______ 0
334 ________0
_______ 0
201 ________0
0
43
iQ
0
6 -12
years
13 19
years
- .
- -
20 35
years
■ Control
•3660
years
61 +
years
Anaemia:
Agle Group_ Male
LLz 5 yeai s I____
-6-12 years ~|
jl3 - 19 yearsj ___
[20 - 35 years
I36 - 60 years
161 + years
total pop
male
male%
Female
_0
493
0_____
2
732 0.273224 ____
•1,
668 0.149701_____
__3
1503 0.199601_____
_0
896 _____ 0_____
248 0.403226
1
total pop
female
Ifemale% IMale
0
487 ________0
2
688 0.290698
3 ______721' 0.416089
9
1446 0.622407
2 _____ 821 ’ 0.243605
1
222 0.45045
total pop
male
male%
total pop
female
female%
116 _______ 0 ________0
122 ________0
157 _______ 0 ________0
149 _______ 0
130 _______ 0 ________ 0 _____ 134 _______ 0
287 _______ 0________ 0
334 _______ 0
220 0.454545 ________0 _____ 201 _______ 0
56
0
1
43 2.325581
0
0
0
0
0
I
Male
Female
0.5
. ao - A 0.4 ________ __
0.3
0.2
^ISLa
0.1
___ M
0 4
1 -5 6- 12 13- 19 20-35 36-60 61 +
2il
-2 □ Study
■ I
years
|a|
. . ; IWI : .fe
years
years
years
Female
'ftg
years
•
-
-•
■
■
•
■
•
□ Study
• •~
■ Control
ft
1-5 6-12
years years
years
46
p-.
_
F7|<-.
F~7| .
r~~i
13-
2035
years
3661 +
60
years
years
19
years
■ R-l
■ Control
High Blood Pressure:
Age Group Male
1 - 5 years
6-12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
total pop
male
male%
_0
_0
_0
_4
12
8
total pop
female% Male
female
493 _______ 0 ________ 0
487 ________0
Female
732 _______ 0 ________ 1
668 _______ 0 ________ 0
1503 0.266134 ________ 6
896 1.339286 _______33
248 3.225806
7
688 0.145349
721 ________ 0
1446 0.414938
821 4.019488
222 3.153153
total pop
female%
Female
female
122 _______ 0
0
116 ______ 0 ________0
149 _______ 0
0
157 ______ 0 ________0
134 _______ 0
0 _____ 130 ______ 0 ________0
total pop
male
male%
p
287 ______ _0 ________ 1 _____ 334 0.299401
201 1.492537
220 1.363636 ________3
0
0
43
56 1.785714
3
1
Female
Male
! 4
5 1
. v.. ..
3 ____
2 -
El Study
_
2
■ Control
1
0
1 -5
years
6 - 12
years
■
4 -■
3
13 - 19 20 -35 36 -60
years years years
1 0 -
1
47
■ Control
J"-1 -5
years
61 +
years
□ Study
6 - 12 13 - 19 20 -35 36 -60 61 +
years years years years years
Weakness:
Age Group Male
1 - 5 years
- 12 years
13-19 years
20 - 35 years
36 - 60 years
61+ years
total pop
total pop
male
male%
Female
female
female% Male
;
5
493 1.014199 ________4
487 0.821355
5 ____ 732 0.68306 ________4
688i 0.581395
9
668 1.347305 _______ 10
721 1.386963
27
1503 1.796407 ______ 42
1446i 2.904564
896 2.566964 _______ 13 _____ 821 1.583435
23
5
4
222! 1.801802
248 2.016129
total pop
male
male%
0
0
0
0
Male
___ ____________ Bfn
V i _J|U
nnL—I^U
nnJi r
i Wh &
1
TTTT
II
.3 I
mi1 I;
0
2
•■I
1 -5
6 - 12
years
13 - 19 20 -35 36 -60
years years
years
122 0.819672
0
149 ________0
0 ______134 _______ 0
334 0.299401
2
o
201 ________0
o
43
0
Female
3
years
1
116 _______ 0
157 0.636943
130 _______0
287 _______0
220 ______ 0
56
0
0
J_
total pop
female
female%
Female
61 +
E Study
■ Control
□ Study
□ Control
4
3
El Study
2
1 -
i
r—t
0 -1
1 -5
years
years
48
n
I'
I
t
_
- n
I
6 - 12 13 - 19 20 -35 36 -60 61 +
years years years years years
9 Control
Bronchitis Mortality
Cardiac Arrest Mortality Graph
Year of Death Study Total dec. popn. Percentage Control Total dec. popn. Percentage
1994
1
12 8.33333333
0
9
0
1995
0
18
0
0
2
0
1996
3
38 7.89473684
0
8
0
1997
0
37
0
0
6
0
1998
0
43
0
0
5
0
1999
0
34
0
0
13
0
2000
2
52 3.84615385
0
7
0
2001
1
28 3.57142857
0
7
i
0
2002
4
52 7.69230769
0
15
l0
2003
2
53 3.77358491
0
9
l0
Cardiac Arrest Mortality
1994-2003
10
■■ •
8 6
4
2 ■
04
IO
CD
O)
CO
CD
CD
co
<D
CD
CD
CD
CD
O
O
o
<N
O
O
CM
CM
O
O
CM
CO
o
o
Deaths due
to Cardiac
Arrest in the
Study
—Deaths due
to Cardiac
Arrest in the
Control
Deaths due
to Cardiac
CM
Year of Scrutiny
49
•<
Heart Disease Mortality Graph
Year of Death Study Total dec. popn.
.
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
o
o
12
0
18
0
38 2.63157895
37 2.7027027
0
43
1
1
0
1
1
0
1
0
Total dec. popn. Percentage
Percentage Control
34 2.94117647
52 1.92307692
28
0
52 1.92307692
53
0
9
0
0
2
0
8
0
6
0
5
13 7.69230769
7
0
7 14.2857143
15
0
9
0
0
0
0
0
0
4
0
1
0
0
Heart Disease Mortality 1994-2003
16 V
14121I
XA
8 '
H
I \
A I/ \\
64
2
-I
o
NO)
♦
/ \
10
Ko>
>O>
cP" rpcP1'
rp
Deaths due
to Heart
Disease in
the Study
—^—Deaths due
to Heart
Disease in
the Control
Year of Scrutiny
50
Kidney Failure Mortality Graph
Year of Death Study Total dec. popn. Percentage Control Total dec. popn. Percentage
1994
0
12
0
0
9
0
0
1995
18
2
0
0
0
1996
0
38
0
0
8
0
1997
1
37 2.7027027
0
6
0
1998
0
43
0
0
5
0
0
1999
34
0
0
0
13
2000
0
52
0
0
0
7
2001
0
28
0
0
0
7
0
2002
52
0
0
15
0
2003
1
53 1.88679245
0
9
0
Kidney Failure Mortality 1994-2003
3 -
2.5 J
♦
2
1.5
• 0.5
0
N*
cP
<£>
Deaths due.
to Kidney
Failure in th
Study
Deaths due
to Kidney
Failure in the
Control
Year of Scrutiny
''I
51
O H -16-0
08635
Asthma Mortality Graph
Year of Death
Study Total dec. popn. Percentage Control
1994
12 8.33333333
1
18
0
1995
0
1996
2
38 5.26315789
1997
37
0
0
1998
43
0
0
34
0
1999
0
52 5.76923077
2000
3
2001
28 3.57142857
1
2002
2
52 3.84615385
53 1.88679245
2003
1
Total dec. popn. Percentage
9
2
8
6
0
0
0
0
0
1
0
0
0
0
5
13 7.69230769
7
0
7
0
15
0
0
9
Asthma Mortality 1994-2003
9
8
7 6
5
4
♦
3 2 -
Deaths due to
Asthma in the
Study
B ■■ Deaths due
Asthma in the
Control
1 0 -
0
0
0
0
0
Year of Scrutiny
52
Bronchitis Mortality Graph
Year of Death Study Total dec. popn. Percentage Control Total dec. popn. Percentage
1994
0
12
0
1
9 11.1111111
1995
0
0
18
0
2
0
1996
4
38 10.5263158
0
8
0
1997
1
37 2.7027027
0
6
0
1998
1
43 2.3255814
0
5
0
1999
1
34 2.94117647
0
13
0
2000
1
52 1.92307692
0
7
0
2001
1
28 3.57142857
0
7
0
2002
2
52 3.84615385
1
15 6.66666667
2003
1
53 1.88679245
0
9
0
Bronchitis Mortality 1994-2003
12
10
8
6
2
o
Year of Scrutiny
—Deaths due
to
Bronchitis
in the
Study
1 ■ Deaths due
to
Bronchitis
in the
Control
53
Cancer Mortality Graph
Year of Death
!Study Total dec. popn. Percentage Control
12
0
0
1994
18
5.55555556
,
1
1995
38 2.63157895
1
1996
37 10.8108108
4
1997
43 9.30232558
4
1998 i
1999I
2000:■
2001
2002i
2003I
r-
5
1
■ 1
1
2
34
52
28
52
53
14.7058824
1.92307692
3.57142857
1.92307692
3.77358491
Total dec. popn. Percentage
9 11.1111111
0
2
0
8
0
6
0
5
0
13
0
7
0
7
1
0
0
0
0
0
0
0
0
0
15
9
Cancer Mortality 1994-2003
♦ -Deaths due to
Cancer in the
Study
■ -Deaths due to
Cancer in the
Control
54
0
0
Paralysis and Paralytic Strokes Mortality Graph
Year of Death Study Total dec. popn. Percentage Control Total dec. popn. Percentage
1994
2
12 16.6666667
0
9
0
1995
1
18 5.55555556
0
0
2
1996
2
38 5.26315789
0
0
8
1997
5
37 13.5135135
0
0
6
1998
3
43 6.97674419
1
20
5
1999
34
0
1
0
13 7.69230769
2000
6
52 11.5384615
7
0
0
2001
2
28 7.14285714
1
7 14.2857143
4
2002
52 7.69230769
20
3
15
2003
3
53 5.66037736
1
9 11.1111111
Paralysis Mortality 1994-2003
25
20 -
■■ »
15 10 -
5
Deaths due to
Paralysis in the
Study
—S— Deaths due to
Paralysis in the
Control
0
Year of Scrutiny
55
High Blood Pressure Mortality Graph
Year of Death
Study Tota! dec. popn.
Percentage Control
1994
0
12
0
1995
1
18 5.55555556
1996
0
0
38
1997
1
37 2.7027027
0
43
1998
0
0
34
1999
0
52 3.84615385
2000
2
2001
28
0
0
2002
0
52
0
2003
0
53
0
Total dec. popn. Percentage
0
9
0
2
0
8
0
6
0
5
0
13
0
7
0
7
15 6.66666667
9
0
0
0
0
0
0
0
0
0
1
0
High Blood Pressure Mortality 1994-2003
6
»— Deaths due to
High Blood
Pressure in the
Study
■■■*— Deaths due to
High Blood
Pressure in the
control
5
3
2 -
0
LO
o
CT)
tO
CT
CT
r^-
CT
CT
oo
CT
CT
CT>
CT
CT
O
o
o
CM
O
o
CM
CM
O
O
CM
CO
O
O
CM
Year of Scrutiny
56
CHART - 1: Certain Infectious and parasitic diseases - Chapter 1 ICO-10 (International Classification of Diseases)
[Male
[Total
[Female- [Total
[Male
57
[Total
[Female- [Total
Study
Population-
Study
Population-
Conxrol
Population-
% Female Affected Male
% Male Affected Female
3
0
487 0.6160164
493 0.81136
0
J
732 0.81967
688 0.1453488
0
721 0.8321775
668 0.2994
6
4
_1
1446 0.2766252
1503 0.3992
8
896 0.66964
821 0.9744214
2
o
222 0.4504505
1
248 1.6129
Age Group Affected Male
4
1-5 years
6-12 years
6
13-19 years
2
6
20-35 years
6
36-60 years
4
61+years
Control
% Male Affected
116 _____ 0
157 _____ 0
130 ____ p
287 0.34843
220 0.45455
56
0
Female
Male
| (El Study
S Control
EJ Study
■
61+years
•
1
-
0 Control
73
61+years
-
i
36-60 years
36-60 years
i®
- :■ |
. p .
-1-
20-35 years
i 20-35 years
■
!
PopulationFemale
% Female
0
122 ________ 0
0
149 ________ 0
0
134 ________ 0
0
334 ________ 0
0
201 ________ 0
0
43
0
-
.
■
13-19 years SBfg
6-12 y ears 0487 71
7 '4:; !
13-19 years
■'I-.--
1
1.5
.....................................................................................
0
2
Neoplasms - Chapter 2 ICD - 10 (International Classification of Diseases)
58
■
I
=
1-5 years
0.5
...
■
■
....
6-12 years
1-5 years
0
...
■■
0.2
—
;
■ '>
■
■
•
4 7:....
0-544
I ;7
0.4
0.6
0.8
1
1.2
__________ Male
Total
Female- Total
Male
Total
Female- Total
__________ Study
PopulationStudy
PopulationControl PopulationControl
PopulationAge Group [Affected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female
1 -5 years
0
493 ______ 0 ______ 1
487 0.2053388 _______ 0
116 ______ 0 _______ 0 _______ 122
0
6-12 years
0
732 _ _____ 0 ______ 0______ 688 _________ 0 _______ 0____
157 ______ 0 _______ 0 _______ 149 _________ 0
13-19 years
_1
668 0.1497 ______ 0__ 721 _________ 0 ______ 0____
130 ______ 0 _______ 0 _______ 134 _________ 0
1503' 0.1996 ______ 3_______ 1446 0.2074689
20-35 years
3
_______ 0____
287 ______ 0 _______ 0 _______ 334 _________ 0
36-60 years
896 0.11161'______ 2_____
821 0.2436054 _______ 0____
220 ______ 0 _______ 0 _______ 201
o|
61+years
248|
222
0|
0
0
56
0
0
43
2
p
---- £
Male
0 Study
Female
□ Study
a Control
■ Control
4.
61+years
ei+years J^^IJ
36-60 years
20-35 years
36-60 years
20-35 years
13-19 years
6-12 years
13-19 years
1-5 years
1-5 years
6-12 years
0.05
0.1
0.15
0.2
0.25
0
0.05
0.1
0.15
0.2
0.25
0.3
Diseases of blood and blood forming organs and certain disorders - Chapter 3 ICD - 110 (International Classification of Diseases)
59
_______ Female- Total
Total
Male
__________ [Male
Total
_______ Female- Total
Control Population- _______ Control Population__________ Study
I Population- _______ Study
I Population% Male |Affected [Female
% Female
Age GroupjAffected IMale
% Female Affected Male
% Male Affected^IFemale
122
0.8196721
116
_____
0
0
_5
_4 ______ 487 0.8213552
'1-5 years
493 1.0142
0______ 149 ________ 0
157 0.6369
7!
_7 _______ 688 1,0174419 _______ 1
[6-12 years _
732 0.9563
_1______ 134 0.7462687
130 _____ 0
13-19 years
1.497
10
668
n _______ 721 1.8030513 _______0
3 ______ 334 0.8982036
287 _____ 0
20-35 years
41
1446 4.7717842 _______ 0
1503 2.7279
69
4.0909
5______ 201 2.4875622
220
52
36-60 years
896 5.8036
59 _______ 821 7.1863581 _______ 9
2
18
’
43 2.3255814
1
56 3.5714
222 8.1081081
8.871
61+years
248
__22[
2 ____
Female
Male
□ Study
□ Study
■ Control
61+years
36-60 years
20-35 years
13-19 years
6-12 years
1-5 years
I ■
,
■
i
------- ,
■■
7’^
-
277®7
0
2
4
6
8
10
■ Control
1
61+years
36-60 years
20-35 years
13-19 years
6-12 years
1-5 years
J------ , ..
-agn
•
___
-7 :
0
2
4
6
8
Endocrine, nutritional and metabolic diseases - Chapter 4 ICD 10 ( International Classification of Diseases)
10
Male
Total
Female- Total
Male
Total
Female- Total
Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group |Affected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female____ 1 % Female
1-5 years
1
493 0.20284 ______ _3
487'[ 0.6160164 _______ 2
116 1.72414 _____ g ______ 122 _________ 0
6-12 years
_6
732 0.81967
22 _____ 688 3.1976744 _______ 1
• o ______ 149 _________ 0
157 0.63694
13-19 years
20
668 2.99401 _____ 17 ______ 721 2.3578363 _______ 1
130 0.76923 _______ 3 ______ 134 2.238806
20-35 years
54
1503 3.59281 _____ 51 _____ 1446i 3.526971 _____ 6
287 1.74216 _______ 6 ______ 334 1.7964072
36-60 years
46
896 5.13393 _____ 16 ______ 821 1.9488429
4
220 1.81818 _______ 3 ______ 201 1.4925373
10
61+years
248 4.03226
7
222! 3.1531532
3
Male
Study
Female
Study
■ Control
61+years
ED
SB
36-60 years
I
____
20-35 years
13-19 years
6-12 years
■ Control
61+years
36-60 years
agsaetuw
20-35 years
yI
- •
13-19 years
h1
-
6-12 years
■
1-5 years
1-5 years
0
1
2
3
43 4.6511628
2
56 5.35714
4
5
6
0
1
|
”
2
3
Mental and behavioural disorders - Chapter 5 ICD - 10 ( International Classification of Diseases)
£
4
5
Male
Total
Female- [rotal
Male
Total
Female- Total
Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group (Affected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female ;
1-5 years
_1
493 0.2028
________
487
0.2053388
0
116
_______
_______
0
________
1
________ 122 0.8196721|
.1
6-12 years
_3
732 0.4098
2’________ 688 0.2906977 _____ 1
157 0.63694
0 ________ 149
______ 9
13-19 years
5
668 0.7485
WI
721 1.3869626 _______ 0
130 _______ 0 ________1 ________ 134 0.7462687;
20-35 years
36-60 years
61+years
24
1503 1.5968
896 2.3438
248 3.2258
8
24■_______ 1446 __ 1.659751 _______ 1
22!________ 821
2.679659
2
5i
222 2.2522523
0
287 0.34843 _______ 0 ________334 _________ 0
220 0.90909 _____ 1
201 0.4975124
56
0
2
43 4.6511628
Male
Study
Female
@1 Control
61+years
36-60 years feay**
61+years
36-60 years
20-35 years n—'
13-19 years
6-12 years
20-35 years
13-19 years
1-5 years
0
Control
Study
6-12 years
___
1
1-5 years
2
3
4
0
1
2
Diseases of the nervous system Chapter 6 1CD - IO ( International Classification of Diseases)
3
4
5
Male
Total
Female- Total
Male
Total
Female- Total
Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group |Affected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female
1-5 years
_7
493 1.41988 _______ 3 ______ 487 ’ 0.6160164 _______ 0
116 ______ 0
0 ________ 122 ______ g
6-12 years
_2
732 0.27322 _______ 5 ______ 688I 0.7267442
157 ______ 0
0
0 ________ 149 ______ g
13-19 years
_3
668 0.4491 _______ 3 ______ 721 0.4160888 _____ g
130 ____ g
g ________ 134 ______ o
20-35 years
_9
1503 0.5988 _______ 4 _____ 1446 0.2766252 _______ 3
287 1.0453
________ 334 0.2994012
36-60 years
896 1.45089 _______ 8 ______ 821 0.9744214
i
220 0.4545
0 ________ 201 ______ g
61+years
8
248 3.22581
222: 2.2522523
5
0
0
56
0
43
0
n
“I
Male
□ Study
Female
■ Control
□ Study
H Control
61+years
36-60 years
61+years
36-60 years
i 20-35 years
20-35 years gggf
13-19 years
6-12 years
[ 13-19 years
i 6-12 years
1-5 years
I
1-5 years
0
1
2
3
4
0
0.5
1
Diseases the eye and adnexa - Chapter 7 ICD - 10 ( International Classification of Diseases)
1.5
2
2.5
Male
Total
Female- Total
Male
Total
Female- Total
Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group lAffected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female
1-5 years
_0
493 ______ 0
_0
487 ________ 0 _______ 0
116 _______ 0 _____ 0 ______ 122
6-12 years
1
732 0.1366
_0
688 ________ 0 _____g
157 _______ 0 _____ 0 ______ 149
721
~
13-19 years
_0
668 _______ 0
1
0.1386963 _____o
130 _______ 0 _____ 0 ______ 134
20-35 years
_7
1_503 0.4657
1446 0.7607192 _____g
287 _______ 0 _____ 2 ______ 334 0.5988024
D
_____ g
_____ o
_____ g
36-60 years
61+years
_896
248
36
24
4.0179
9.6774
_ 82 7.0645554 _______ i
222 11.711712
1
58
26
220 0.45455 _____ 3 ______ 201
56 1.78571
Male
□ Study
□ Study
61+years
□ Control
61+years
36-60 years
□
13-19 years
20-35 years
13-19 years
6-12 years
6-12 years
1-5 years
1-5 years
0
2
4
6
43
Female
■ Control
36-60 years
20-35 years
7
8
10
12
a,
I
0
5
Diseases of the ear and mastoid process - Chapter 8 ( International ('lassification of Diseases)
10
15
20
1.4925373
16.27907
Female- Total
Total
_________ .Male
Total
Female- Total
Control Population-.
PopulationMale Study PopulationPopulation- ________ Control
Study
% Female [Affected Male
1% Female
Age Group Affected
Male
% Male Affected Female
% Male Affected Female
________
122
0
_______
4
116 _______ 0
1-5 years
493 0.81136 _______ 0 _______ 487 _____ 0
0
o!
157 _______ 0 _______ 0 ________149
3
0
6-12 years
732 0.40984 _______ 2 _______ 688 0.2906977
130 _____0 _______ 0 ________134
0
668 0.1497 _______ 4
13-19 years
1
721 0.554785
o
287 _____ 0 ■_________ 0 ________334'
4
20-35 years
1446 0.2766252
0
1503 0.26613 ______4
4
220 0.45455 _______ 1 _______ 201 0.4975124
36-60 years
896 0.44643 _______ 8 _______ 821 0.9744214
i
_____ g
1
61+years
248 0.40323
222 0.4504505
1
56| 1.78571
1
0
43
Female
Male
□ Study
0
□ Study
■ Control
■ Control I
61+years
61+years
36-60 years
36-60 years
20-35 years
20-35 years
13-19 years
13-19 years
6-12 years
6-12 years
1-5 years
1-5 years
0
0.5
1
1.5
2
Diseases of the circulatory system - Chapter() ICD
0
0.2
0.4
0.6
10 ( International Classi fication of Diseases)
0.8
1
1.2
__________ Male
Total
- ----------- Female- Total
Male
Total
Female- Total
__________ Study
Population- ------------- Study
PopulationControl PopulationControl Population- __________ ;
Age Group Affected Male
% Male Affected Female
% Female /Effected Male
% Male Affected Female
% Female j
1 -5 years
0
493 _____ 0
_0 _______ 487 _______ 0
0
116 _______ 0
. 0 ________ 122 _________ 0i
6-12 years
4
732 0.5464
2 ________688 0.2906977
0
157 _______0 _______ 0 ________ 149 ________ 0l
13-19 years
5
668 0.7485
_2 ________721 0.2773925
1
130 0.76923 _______ 0 ________ 134 _________ 0
20-35 years
18
1503 1.1976
18
1446 1.2448133
3
287 1.0453 _______ 1 ________ 334 0.2994012
36-60 years
23
896
2.567
18
821 2.1924482
2
220 0.90909
2 ________ 201 0.9950249
61+years
5
248 2.0161
6
222 2.7027027
43’________ 0
1
56 1.78571
0
Male
Female
Study
Study ■ Control j
_J
61+years
36-60 years
|
20-35 years
61+years
36-60 years
20-35 years
13-19 years
13-19 years
6-12 years
6-12 years
1-5 years
1-5 years
0
0.5
S Control
1
1.5
2
2.5
3
0
0.5
1
I
1
1.5
1
2
2.5
3
Diseases of the respiratory system Chapter 10 ICD - 10 (International Classification of Diseases)
----------------- Male
Total
Female- Total
Male
Total
Female- Total
__________ Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group^Affected |MaIe
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female
1-5 years
23
493 4.66531 ______ 24 _______ 487 4.9281314 _______ 0
rie ______ 0 _____ 2 _______ 122 1.6393443
6-12 years
30____
732 4.09836 _____ 24
688 3.4883721 _______ 0
157 ______ 0 _______ 1 _______ 149 0.6711409
13-19 years
21____
_668 3.14371 ______ 12 _______ 721 1.6643551 _______ 0
130 _______0 _______ 0 _______ 134 ______ 2
20-35 years
75___ 1503 4.99002 ______ 49
1446 3.3886584 _______ 7
287 2.43902 _______ 1 _______ 334 0.2994012
36-60 years
84____
896
9.375 ______ 50 _______ 821
6.090134 _______ 7
220 3.18182 ______ 3 _______ 201 1.4925373
61+years
50
248 20.1613
12
222 5.4054054
4
56 7.14286
1
43 2.3255814
Male
□ Study
Female
S Control
□ Study
□ Control
61+years
36-60 years
61+years
36-60 years
20-35 years
13-19 years
20-35 years
13-19 years
I
I
6-12 years
1-5 years
—|
0
5
10
15
20
25
6-12 years
1 -5 years
0
5
10
Diseases of the digestive system - Chapter 11 ICD - 10 ( International Classification of Diseases)
15
20
25
__________ Male
Total
_______ .Female- Total
Male
Total
Female- Total
__________ Study
Population- _______ Study
PopulationControl PopulationControl PopulationAge Group [Affected Male
% Male Affected^ Female
% Female Affected Male
% Male Affected Female
% Female
1-5 years
493 0.4057
_4 _______ 487 0.8213552 _______ 1
116 0.86207 _______ 0______ 122 _________ 0
6-12 years
732 J.62?3
10 __ _____ 688 1.4534884 _______ 0
1?
157 ______ 0
0______ 149 _________ 0
13-19 years
J3
668 1.9461
_2 _______ 721 0.2773925 _______ 1
130 0.76923 _______ 0______ 134
0
20-35 years
36
1503 2.3952
27
1446 1.8672199 _______ 5
287 1.74216 _______ 5_______ 334 1.497006
36-60 years
32
896 3.5714
21 _______ 821 2.5578563
5
220 2.27273 _______ 1_
201 0.4975124
61+years
7
248 2.8226
6
222 2.7027027
1
56 1.78571
0
43
0
Male
□ Study
Female
□ Study
El Control
M— T~—
61+years
136-60 years
20-35 years
61+years
36-60 years
20-35 years
13-19 years
]
13-19 years
I
1 6-12 years
I
6-12 years
1-5 years
1-5 years
0
1
B Control
2
3
4
0
0.5
1
1.5
2
2.5
Diseases of the skin and subcutaneous tissue - Chapter 12 ICD - 10 (International Classification of Diseases)
68
3
__________ Male
Total
Female- Total
Male
Total
Female- Total
__________ Study
PopulationStudy
PopulationControl PopulationControl
PopulationAge Group Affected Male
% Male Affected Female
% Female Affected Male
%
Male
Affected
Fema
le____ % Female
1-5 years
8
493 1.62272 ______ 10 ________ 487 2.0533881 _______ 1
116
0.86207
_______
0
122 _________ 0
6-12 years
8____
732 1.0929 ______ 12
688
1.744186 _______ 1
157
0.63694
0 ________149 _________ 0
13-19 years
__8____
668 ^1.1976 _______ 6 ________ 721 0.8321775 _______ 2
130
1.53846
_______
0
________134 _________ 0
20-35 years
21_
1503 1.39721 _______ 9 _______ 1446 0.6224066
2
287
_____
0.69686
_______
0
_______ 334 _________ 0
36-60 years
13__
_ 696 J 45089
7
_ J21 0.8526188 _______ 2
220
0.90909
_______ 1 _______ 201 0.4975124
|61+years
7
248| 2.82258
222 0.45045051
0
56
0
0
43
0
I
Male
□ Study
Female
■ Control
61+years
36-60 years
20-35 years
13-19 years
6-12 years
1-5 years
□ Study
o=)
o
1
2
61+years
36-60 years
.
—wm—
20-35 years
13-19 years
6-12 years
,
— —-
1-5 years
—--—
3
0
■ Control
I
I
I
0.5
1
1.5
2
2.5
Diseases of the muscoskeletal system and connective tissue Chapter 13 ICD - 10 (International Classification of Diseases)
69
__________ Male
Total
Female- Total
Male
Total
Female- Total
__________ Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group Affected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female
1-5 years
2
493 0.40568 _____ 4 ______ 487 0.8213552
0
116 _______0
0 ________122 _______ 0
6-12 years
16
732 2.18579 _____ 17 ______ 688 2.4709302
157 0.63694
2 _______ 149 1.3422819
13-19 years
41
668 6.13772 _____ 61 ______ 721 8.4604716
2
130 1.53846 J_____2
20-35 years
________ 134 1.4925373
282
485
7
36-60 years
61+years
1503 18.7625
896 54.1295
248 2.82258
451 _____ 1446 31.189488
572 ______ 821 69.671133
180
222 81.081081
U
37
21
287 4.87805
220 16.8182
56
37.5
Male
□ Study
61+years
□ Control
□ Study
5
□ Control
61+years
36-60 years
20-35 years
a—
■ -....
r,. ,
6-12 years b
13-19 years
6-12 years
—■
■■
I
1-5 years
1-5 years
- ■■
I
0
500
20-35 years
13-19 years
10
20
30
61 _______ 201
20
43
Female
36-60 years
o
46 _______ 334 13.772455
40
50
60
_______
1000
1500
Diseases of the Genitourinary systerm - Chapter 14 1CD - 10 ( International Classification of Diseases)
70
2000
30.348259
46.511628
Male
Total
Female- Total
Male
Total
Female- Total
Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group Effected Male
% Male Affected Female
% Female Affected Male
% Female
% Male Affected Female
1-5 years
_0
493 _______ 0 _____g ______ 487 _______ 0
116
______
g
0
_______0 ____ g _____ 122
6-12 years
_0
732 _______ 0 _______ 3 ______ 688 0.4360465 ____ g
157 ____ g _____o ______ 149 _____ o
13-19 years
1
668 0.1497 _____ io ______ 721 1.3869626 ____ o
130 ____ o _______ 2 _____ 134 1.4925373
20-35 years
36-60 years
J2
_8
2
61+years
□ Study
■ Control 1
___
. _I
1503 0.7984 ______ 15 _____ 1446 1.0373444 ____ g
896 0.89286 _______ 8 ______ 821 0.9744214 _____1
248 0.80645
3
222 1.3513514
o
287 ____ g _______ 2 _____ 334 0.5988024
220 0.45455
1
201 0.4975124
56
0
0
0
43
Male
Female
61+years
36-60 years
20-35 years
13-19 years
L~~
61+years
36-60 years
20-35 years
13-19 years
6-12 years
1 -5 years
■ Control
□ Study
1
6-12 years
1-5 years
0
0.2
0.4
0.6
0.8
1
0
0.5
1
1.5
Pregnancy, childbirth and the pucrperiuni - Chapter 15 ICD -10 ( International Classification of Diseases)
71
2
Female- Total
Total
Male
Female- Total
Male
Total
Control PopulationPopulationControl
PopulationStudy
PopulationStudy
Affected Female
Affected
Male
%
Male
% Female
%
Female
Female
___
% Male Affected
Age Group Affected Male
0 ______ 122 _________ 0
116 ______ 0
0
493 _______ 0 _______ 0 ______ 487 _________ 0 _______ 0
1-5 years
______ 149 ______ oj
157
______
0
0
_______
688
________
0
______
_______
0
0
732 _______ 0
6-12 years
______ 134
______
0
130
0
_______ 0 ______ 721 _________ 0 ______ 0
0
668
13-19 years
______ 334 _________ 0
287 ______ 0
0
1503 _______ 0 _______ 2 _____ 1446 0.1383126 ____ p
20-35 years
____ p
896 _______ 0 _______ 0 ______ 821 _________ 0 ____ p
0
222
0
0
0
248
0
0
36-60 years
61+years
____ p
____ p
____ o
220 ______ 0 ____ p ______201 _________ 0
o
43
0
0
56
Female
Male
I
El Study
□ Study
H Control
g Control
|
61+years
36-60 years
61+years
36-60 years
20-35 years
a
20-35 years
13-19 years
<.'■ W'
13-19 years
6-12 years
1-5 years
6-12 years
1-5 years
0
0.2
0.4
0.6
0.8
0
1
72
0.05
0.1
0.15
Congenital malformations, deformations and chromosomal abnormalities - Chapter 17 ICD - 10 (International Classification of
Diseases)
- ----------------Male
Total
_______ Female- Total
__________ Study
Population- _______ Study
PopulationAge Group Affected [Male
% Male Affected Female
1-5 years
6-12 years
13-19 years
20-35 years
36-60 years
61+years
_1____
2___
2 ____
3 ____
0____
0
Male
Total
Female- Total
Control PopulationControl Population% Female Affected Male
% Male Affected Female
% Female
2 _______ 487 0.4106776 _______1
116 0.8621
0 ______ 122 ________ 0
2 _______ 688 0.2906977 _______ 0
157 ______ 0
0 ______ 149 _____ g
J _______ 721 0.1386963 _____g
130 ______ 0
0 ______ 134 _____ g
6 _______1446 0.4149378 _____ o
287 _____ 0
0 ______ 334 ______ o
0 ________821 _________ 0 _____ o
220 ______ 0
£______ 201 ______ g
0
222
0
0
56
0
o'
43
o
493 0.2028
732 0.1366
668 0.2994
1503 0.1996
896 _____ 0
248
0
I
Male
□ Study
Female
□ Control
□ Study
61+years
0 Control
61+years
36-60 years
36-60 years
20-35 years
13-19 years
6-12 years
1-5 years
0
0.2
0.4
0.6
0.8
20-35 years
13-19 years
—
6-12 years
—>
______
1-5 years
—
ZZ~T
1
.
■
0
73
,
I
—j
0.1
0.2
0.3
0.4
0.5
Symptoms, signs and abnormal clinical and lab.findings not elsewhere classified - Chapter 18 ICD - 10 ( International Classification
of Diseases)
__________ Male
Total
Female- Total
Male
Total
Female- Total
__________ Study
PopulationStudy
PopulationControl PopulationControl PopulationAge Group Affected Male
% Male Affected Female
% Female Affected Male
% Male Affected Female
% Female
1-5 years
28
493 5.67951
23 ______ 487 4.7227926 _____ 1
116 0.86207 _______ 0
122 _________ 0
6-12 years
41
732 5.60109 ______ ______ 688 5.9593023 ____ 1
157 0.63694 _______ 2
149 1.3422819
13-19 years
69
668 10.3293 ______ 57 ______ 721 7.9056865 _____ 3
130 2.30769 _____ 1
134 0.7462687
20-35 years
36-60 years
149
127
61+years
36
1503 9.91351
896 14.1741
248 14.5161
216 _____ 1446 14.937759 _____ 6
174 ______ 821 21.193666 _____ 8
28 ______ 222. 12.612613
1
287 2.09059 ______ 10
220 3.63636 ______ 8
56 1.78571
2
Female
Male
[
□ Study
61+years
36-60 years
20-35 years
13-19 years
H Control
□ Study
SSH________ _
_____
I
HE831
6-12 years
61+years
36-60 years
I
I
I
I
■ 13-19 years
6-12 years
! '
5
10
15
0 Control
J
I
I
20-35 years
1-5 years
0
334 2.994012
201 3.9800995
43 4.6511628
T
1 -5 years
20
0
74
5
10
15
20
25
Injury, poisoning and certain other consequences of external causes - Chapter 19 ICD - 10 ( International Classification of Diseases)
Female- Total
Total
Male
Female- Total
Control IPopulationPopulationControl
PopulationStudy
% Female
Affected Female
%
Male
%
Fema
le
Affected
Male
Fem
a
le
____
Male Affected
______ g
_______
122
0
116 ____ g
0
493 ____ 0 ______ 1 _______ 487 0.205339
157 0.63694 _______ 0 _______ 149
______ 1 ________688 0.145349
732
130 ______0 _______ 0 _______ 134
0
668 0.2994 ______ 2 _______ 721 0.277393
287 0.69686 _______1 _______ 334 ' 0.2994012
2
1503 0.73187 ______ 7 ______ 1446 0,484094
Male
Total
Study
PopulationAge Group [Affected Male
%
1-5 years
___ g
0
6-12 years
13-19 years
20-35 years
J.
11
17
5
36-60 years
61+years
896 1.89732 ______ 3 _______ 821 0.365408
222
0
0
248 2.01613
Male
□ Study
220 ______ 0 _______ 1 _______ 201 0.4975124
2!_________ 43 4.6511628
56 3.57143
Female
□ Control
□ Study
ffl Control
61+years
36-60 years
20-35 years
20-35 years
13-19 years
=■
6-12 years
1 -5 years
1-5 years
0
0
1
61+years
6-12 years
______ o
______ o
2
36-60 years
13-19 years
1
1
2
3
4
' I
□
0
75
1
2
3
4
5
External causes of morbidity and mortality - chapter 20 1CD - 10 ( International Classification of Diseases)
Male
Total
Female- Total
Female- Total
Control PopulationControl PopulationStudy
Population% Male Affected Female
Male Affected Female____ % Female Affected Male
% Female
116 _______ 0 _______ 0 ______ 122
493 ______ 0 ______ 1 _______ 487 0.2053388 _______ 0
__________ Male
Total
__________ Study
PopulationAge Group Affected Male
%
1-5 years
0
6-12 years
13-19 years
0
______ p
732 ______ 0 ______ 0 _______ 688 ________ 0 _______ 0
668
0 ______ 0 _______ 721 ________ 0 _______ 0
1503 0.06653 ______ 6 ______ 1446 0.4149378 _______ 0
896 0.22321
821 ________ 0 _______ 0
0
222 0.4504505
0
248
0
1
0
20-35 years
36-60 years
61+years
2
0
157 _______ 0 _______ 0 ______ 149 ________ 0
130 _______ 0 ______ 0 ______ 134 ______ p
287 ____ 0 ______ 1 ______ 334 0.2994012
220 _____ 0 ______ 0 ______ 201 ________ 0
56
0
0
43
0
Male
□ Study
Female
□ Study
EU Control
l
61+years
36-60 years
20-35 years
El Control
r
61+years
~ 7
36-60 years
_
20-35 years
13-19 years
13-19 years
6-12 years
1-5 years
6-12 years
1-5 years
o
0.05
0.1
0.15
0.2
0.25
0
76
=P=
0.1
..
—t—
0.2
0.3
0.4
0.5
Factors influencing health status and contact with health services - Chapter 21 ( International Classification of Diseases)
Female- Total
Total
Male
Female- Total
Total
Male
Control PopulationI
PopulationControl
I
PopulationStudy
I
PopulationStudy
% Female
Female
Affected
I
%
Male
i
Male
Affected
I
1% Female
% Male Affected Female
Age Group Affected Male
■____ 0I_______ 122 ________ 0
116 _______ 0
0
493 _______ 0 _______ 0 _______ 487 _________ 0 _______ 0
1-5 years
l_______U9 ________ 0
157 _______ 0
732 _____ 0 _______ 0 _______ 688 _________ 0 _______ 0
0
6-12 years
130 _______ 0 ______ 0)_______134 ________0
0
668 _____ 0 _______ 0 _______ 721 _______ 0 _______ 0
13-19 years
287 ______ 0 ______ 2>’______ 334' 0.5988024
0
1503 _______0 _______ 4;1446 0.2766252 _______ 0
20-35 years
201'0
l______ 0f
220 __ 0
0
0I________ 821 _________ 0
0
896 _______ 0
36-60 years
43
0
0I
56
0
222:
o
0i
0I
0
248
61+years
____ p
;
Female
Male
■ Control
□ Study
-•
61+years
□ Study
L
■ Control
61+years
36-60 years
20-35 years
36-60 years
13-19 years
13-19 years
6-12 years
20-35 years
6-12 years
1-5 years
1-5 years
J
0
0.2
0.4
0.6
0.8
1
'o
J
77
0.2
0.4
0.6
0.8
o
Appendix 6: Disease Investigation : Cattle Death; Poster Mortem Certificate
(Source: Veterinary Hospital, Jinnaram Mandal) Dated: 20.08.2003
Disease Suspected : Chemical Toxicity
POSTEM CERTIFICATE: She Buffalo
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We got similar reports of livestock deaths; from the same veterinary hospital the
reason stated in the laboratory report is suspected insecticide poisoning and
chemical toxicity.
Appendix 7: Who's document is it?
We had to walk into the office of the MRO Jinnaram to get the voters list after
several phone calls and visits.
The MRO, Jinnaram cooperated with us after getting a phone call from the
District Collectors' office.
xi
)
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pi’
io
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MandaJ Revenue Officer
^JWWAaAM.
79
Appendix 8
Lawyers Speak
M.C.Mehta (Senior Advocate, Supreme Court)
Patancheru is really a sad story, nothing much has changed on the ground, even
after courts' intervention. In 1988, when I visited the place I was shocked to see
the state of toxicity in the region. The prime necessity and the source of life,
water was taken away from people. The lakes and streams were full of toxic
wastes. Agricultural crops were withering away.
The people of Patancheru got some relief after courts' intervention, in the name
of drinking water, compensation. The court has done what it can in its own
capacity. Now it's for the government machinery to enforce the courts order and
look after the implementation; they have failed in their duty. They lack
responsibility. The pollution control board along with the industry is the cause of
suffering for the people of Patancheru.
So many thesis have been written, PhD's done about the state of the region, but
the plight of the people are same as 1988. Eco-restoration should take place in
Patancheru. The concerned authorities and agencies should act.
Niroop Reddy - Supreme Court Lawyer
"Patancheru Industrial pollution by major export oriented pharmaceutical units
is a classic example of corporate social irresponsibility and a symptom of a faulty
development model, where farmers have being displaced from their traditional
habitat and livelihood without any alternative resettlement.
If industrial activity is not to have an adverse impact on the ecology - Land,
Water and Air & Human Health than the standard prescribed in the rules under
Environment Protection Act, 1986 have to be of such an order so as to contain the
effluent and emission standard in a comprehensive manner.
The criteria for effluent pollutant in USEPA is 85 in number; where as in India it
is 13 and for emission pollutant the USEPA is about 55 and in India it is 5.
The court orders are derived under such limitations and ultimately the people
are on the receiving end and the industries who gain.
(the classic example is of coke where it can clearly get away because there is no
national standard for potable water)"
80
(
Appendix 9
Doctors Speak:
I still shudder at the thought of the nasty chemical smell that pervaded the air in Khazipally, like
a sickening miasma, sucking all cheer from the lives of the hapless villagers. Not a day goes by
when I don't feel a twinge of regret and guilt over the strong urge that overwhelmed me when I
first set foot into Sultanpur: the urge to run away, the urge to return back to the familiar environs
of Hyderabad, full of modern flyovers, steel and chrome towers which, for long I had deluded
myself, where testament to the relentless "progress" India was making towards becoming a
"developed" nation. I am glad I didn't act on the urge. The next five days were a revelation for
me in more ways than one. Those five days of walking door to door, meeting people, sharing
their pain and looking into their hopeful eyes have transformed me irrevocably. I realized, albeit
with a great degree of embarrassment, that we, the aware, opinionated, extremely educated
young citizens of the country are completely blind to the greatest criminal activity of all that is
going on right under our very noses: the rape and the destruction of our land, our rivers and our
groundwater because of the greed and the irresponsibility of a few rogue companies.
And what pains me the most is the realization that somewhere each one of us is responsible for
this relentless destruction of our environment. We choose to keep quiet and turn a blind eye just
because it suits our pockets to do so. In our myopic viewpoint of the world and conventional
notions of success, we do not care about sustainable development because that would mean
bringing about a sea change in the ideology of the very companies, which we have upheld all our
lives as role models of entrepreneurial zeal, good corporate governance and as sources of great
jobs which will help us "arrive" in society. And in a company whichls the true beacon of the
new, mint-fresh globalized capitalist India and its remarkably effervescent pharmaceutical sector,
any efforts spent on proper waste disposal and treatment of toxic effluents are perfectly
dispensable. After all, this great Indian "economic war" is being fought solely on the
underpinning of low costs of production. Sustainable development means greater costs, lower
profit margins, higher prices and lower salaries. Drug companies can iU-afford to waste money
on processes that would make even a minor dent on profit margins. So what if the surrounding
fields have fallen fallow and a few thousand people have lost their source of livelihood and so
what if a few people have "allegedly" contracted chronic illnesses- (the reports of illnesses
anyways never get validated). All this is just "collateral damage", a necessary price that has to be
paid in the path towards "growth" and a thriving economy. Anyways, the managerial cadre of
these companies and the rest of us (the middle class citizens of the country who, in our eyes, are
the only ones who truly matter) live in cities where there are great supermarkets in which we can
buy the best of organic farm produce and where we have easy access to bottled pure, mineral
water completely free of the arsenic, barium and the rest of the many chemicals which the drug
companies in Medak district expel with complete and unabashed impunity into the river waters.
And many of these drug companies are actually so "socially responsible." There are so many
beautiful and moving articles in the Bombay Times and similar supplements that sing paeans
about the many charitable acts of the Piramals, the Reddy's etc.
But this distorted reasoning misses the very crux of the matter, the very crux of the point being
made by environmentalists all over: any economic victory that rides piggy back on the
destruction of our environment, the destruction of the habitat and source of livelihood of many is
necessarily pyrrhic. How long will it take for our apathy to rebound on us? How long will it take
for the great Manjira waters, which supply the whole of Hyderabad to get polluted? How long
will it take for the groundwater and the pure streams of our country, which form the source of all
our bottled water to get irreparably polluted? We choose to ignore the warning signs only at our
own peril. What kind of India have we created in which poor villagers (like the ones in Digwal)
have to fight a court battle for two years only to earn the right to get clean drinking water: water
81
J
which is the fundamental right of all and not the preserve of a few. What kind of people are we
that we cannot empathize with the plight of the poor farm labourers who are being squeezed
from all sides. It was heartbreaking to hear the same stories being repeated in every village I
visited: barren fields forcing farm labourers to search.for odd jobs in the city. Not only was there
no security of a .steady income, most families I visited had a string of health complaints ranging
from headaches to major illnesses, adding greatly to their financial burden. The insensitive public
health system had also forced many to visit private doctors and to take crippling loans from
moneylenders to pay for their medical bills. There was a feeling of desperation which was very
difficult for even me, a doctor who has seen a great deal of pain, illness and death in her line of
work, to take. And the irony of the entire situation was that the root cause of the illnesses was the
apathy and the lack of accountability of the very drug companies whose function it is to
manufacture’ drugs, ostensibly to help people recover from illnesses. How can the corporate
bigwigs of these companies resolve this irony in their minds and function with a clear conscience:
the irony of saving lives on the one hand and destroying others in the process of doing so.
What kind of a lesson are we teaching our children: that it is okay to steal from the environment
and strip poor people of their livelihood for the development of the already developed. What
kind of a world are we, the present generation, leaving behind for them? A world, in which
global warmingzaind polluted rivers and deforestation will wreak havoc and ruin countless lives.
Why should they .be made to pay a heavy price for our apathy and callousness? It is time to act
before it is too late. It is time to wake up and smell the bacon. It is time to take responsibility and
learn to value the beauty and life sustaining nature of Mother Earth. Each one of us can make a
difference and the time to do so is now, before it is too late.
Dr. Aparna
Ex-Lecturer, Department of Obstetrics and Gynecology,
Gynecology Endoscopic Surgeon
Lokmanya Tilak Municipal college and general Hospital
82
1.
Incidence of cancer in the affected area is significantly higher than in the
control area. The incidence of cancer was validated by senior surgeons from
Mumbai. This is an underestimation because; we did not add the cancer
incidences which was detected in hospitals and nursing homes and autopsy data.
It was based on house to house survey with validation of pathology reports of all
cancer detections in a year.
2.
Lung function tests were affected significantly (p<0.01), both Fevl and Fvc of
the affected population as compared with the control group.
3.
Environmental Asthma was validated in a few cases but due to logistic
problems, could not be confirmed by Lung Function tests in a.larger population.
4.
Allergic Contact dermatitis, which was validated by doctors from Mumbai, was
significantly more in the affected group.
5.
The other medical conditions like mental health, gastrointestinal conditions
etc... showed a pointer to a possible higher incidence in the affected population,
but a medically validated comment cannot be made, at present, hence there is a
need for a more elaborate and validated study preferably with the governmental
health infrastructure.
6.
Local medical facilities are very inadequate and people spend a sizable percent
of their income on private,
]
mostly irrational treatment. Only when it comes to the
final advanced stages,- they
. are shifted to> a major hospital in big cities like
Hyderabad.
7. It is urgently required to upgrade local government medical facilities and provide
free medical treatment to people of the affected communities.
Dr Murlidhar V
Dr Ashwini
Dr Deepali
Dr Archana
Lokmanya Tilak Municipal college and general Hospital, Mumbai
83
Appendix 10
Officials Speak:
The District Judge, Medak at Sangareddy
In his Report submitted to Supreme Court through the High court dated 27.01.96
"It is unfortunate that the State owned A.P.I.I.C which is incharge of day to day
operations of CETP (Common Effluent Treatment Plant), in utter disregard of the
provisions-contained in the Environment (Protection) Act, 1986 and its Rules, is
discharging such partially treatment effluent into the stream Nakkavagu. The
industrialists have very cleverly entrusted the management to the State owned
A.P Industrial Infrastructure Corporation in order escape themselves from the
penal provisions of the Environment (Protection) act, 1986and its Rules."
Deputy Director, Ground Water Department at Sangareddy, Medak district
In a report submitted on 24.01.1996 to Director Ground Water Department,
Hyderabad (Memo No. 12-4-92/ Hd. 6/93. dt. 15.7.1993)
"My survey confirms that Nakkavagu and Pamulavagu catchment areas are
polluted and level of pollution are very high causing danger to lives of man,
animals and agricultural activity."
Tishya Chatterjee
Member secretary
AP Pollution Control Board (APPCB)
In an article published in Down to Earth 31st August 1999.
It is common knowledge in Patancheru that most of the 400
industrial units cannot treat effluents properly and that they dump
them in the open or inject them directly into the ground.
"We caught Paks Trade, a Patancheru-based company, for pumping arseniclaced effluents into borewells," says Tishya Chatterjee, member secretary, AP
Pollution Control Board (APPCB). "We have also found high levels of cadmium
in the groundwater samples in AP's industrial areas," he adds. Chatterjee points
out that there are several other industrial units that also indulge in such
practices, but there are no clear-cut rules to stop such polluters.
An NGRI study found high levels of strontium in the groundwater.
84
ITW Signode, another Patancheru-based company, was discharging toxic,
strontium-laced effluents into a nearby drain. "We located this industry and
closed it," says Chatterjee." A study by the groundwater department of the state
government confirms that the pollution level is very high and has endangered
human
lives,
animals
and
agricultural
activity.
"The common effluent treatment plants (CETPs) at Patancheru and Bollaram do
not work up to the required efficiency. So, effluents with TDS levels of more than
20,000 mg/1 are only treated up to 8,000-9,000 mg/1 levels. And many a time,
these CETPs discharge the effluents in the nearby streams without treatment,"
Chatterjee reveals. (Down to Earth,)
85
Appendix 11
Ethnography
Name:Gangamma:
Age: 75 years
Address: Sultanpur
Earlier crops used to grow well but after the factory came in, the yield reduced
considerably. For the last 15 years, fields have not been providing any substantial
yield for the farmer's consumption. She says that it is a common fact that
children are born with defects and illnesses and adolescents suffer body aches
and bone related problems unlike in the earlier days. Respiratory illnesses like
asthma are common. Now there are no fields to go back to and youngsters do not
have as much strength to do any work.
Name:Sailu:
Age: 60 years
Address: Khazipally
Sailu who works as a labor in a paddy field says that 20 years back there was
good water and the fields were flourishing now there is no such produce and
the young boys are not in a position to do any proper work. The industries
around Kazhipally lake has been dumping effluents into the lake and the lake is
now unrecognizable. You cant stand the foul smell.
NameiSyed Razzak:
Age: 80 years
Address: Khazipally
Razzak was born in Kazhipally and has been living here ever since. For the last
15 years, the tamarind tree growing opposite his house does not produce any
tamarinds. Kazhipally Lake has been polluted completely and that was the areas
main source of water for the irrigating fields. Earlier, he used to get about 30
bags of paddy from 1 acre and so in 2 seasons he used to get around 60 bags.
That number has now come down to about half now. There were different kinds
of fish in the lake. The whole village was self - sufficient. They were able to sell
around about 20 bags, apart from keeping enough for their consumption. There
is no water in the wells now. Their livestock have also perished because of the
contaminated water. The trees in the forest near by have dried up because of the
concentration of chemicals in the soil and very few animals are now found.
Name:G.Saraswati
Age:(32 years)
86
Village: Gandigudam; Farmer
The Gandigudam cheruvu used to be our main source of daily life. The drinking
water for villagers as well the livestock, the fishermen's fish. The Washermen,
the quality time spent by children, the irrigation of 100 acres of land, everything
is gone by the contamination done by industrial effluents. The main source of
contamination is Khazipally industrial area, where the effluent is released, which
joins Khazipally lake which links to Gandigudam cheruvu. Before the industries
came, we used to have healthy crop yield. We used to grow sufficient rice for our
family. The entire field is barren now. We are not getting anything since 12 years.
Now the bore water is also contaminated. In past few years, we have seen
livestock deaths, which has severely affected the livelihood of the villagers. The
tank is full of chemicals now. The foul smell has brought constant unknown
diseases in the area. We suffer continuously from headache, burns in eyes, body
ache, weakness, and water release from eyes, skin disease. We did protest at
different points of time. We carried the dead buffalo to the district collector's
office in the lorry last month. We have been complaining to the PCB for years.
But nothing has changed. Things have to change now. Our demands are:
• The company's effluent should not come in Gandigudam cheruvu.
• Give back our lake. (Remediation)
If we stop contaminating further, we will get back our fields in 2-3 years,
Saraswati said when asked about the use of land which got contaminated by the
industrial effluents. When asked if the company gets closed, what about the
livelihood of the workers inside? She said: The land, which are barren now, and
the lake that is dead now will bring back livelihood to them, which will be
healthy and more sustaining.
Name : Puli Raju
Age: (21 years)
Village : Gandigudam
The village of Gandi Gudda where Puli Raju age 21 lives is among the worst
polluted regions of Andhra Pradesh. I used to be a farmer till about five years
back, effluents from the nearby industrial area contaminated my land, degraded
the water used for irrigation, and this area has lost its fertility. The Gandicheru (a
tank) used to provide drinking water to four nearby villages - Gandi Guda,
Dayara, Sultanpur, and Kistareddypet. Now the tank's water is so polluted that if
anyone consumes its water he or she is sure to fall sick immediately. Many of us
suffer from chronic diseases, many have weak vision, and stomach problems are
also very common.
Name: Mallaiah
Age: 80
87
Address:Pocharam
Mallaiah aged 80; a resident of Pocharam said that their health has been
adversely affected after the establishment of the industries. They are suffering
from arthritis, stomach pains and mouth ulcers. They cannot walk properly.
Their fields are also affected due to the chemical water. The crop yield has
reduced. Chemicals polluted underground water at the depth of 30 feet.
Mosquitoes are also developed due to the smells. In one bore only chemical
water comes, the color of the water is black. During the nights at around 11
p.m. the industries release smoke, due to which they get severe headaches
and coughs. The water has also affected their livestock, there have been
deaths reported.
Name: Geetamma
Age : 65
Address: Pocharam,Patancheru
Geetamma a resident of pocharam feels the establishment of the industries
had affected their health. They now suffer from skin diseases, stomach pains,
arthritis and tumors in the stomach. Crop yields have also reduced. Winds
bring along with them the smoke, which has been released by the industries,
which has been responsible for frequent headaches. The villagers fought with
the government, for which the government had sanctioned money for lands
affected.
In her house, Kumar aged one and half years old has been suffering from
vomiting and diarrhea since he was born, and Pentaiah who is 25 yrs old
suffers from stomach pain and associated breathlessness.
Name:Mallaiah
Age :60
Address: Pocharam
Mallaiah a resident of Pocharam says that they had excellent health until the
industries where established. With the establishment of the industries, their
health has been deteriorating especially since the last 15 yrs. They now suffer
from bronchitis, back pain, arthritis and skin diseases. Crop yields have
reduced drastically. The chemicals from the industries pollute underground
water that may be tapped within 30 feet.
In the night between 6 p.m. and 10 p.m. industries release smoke causing
severe headaches and vomiting to the people around here.
Name: S.K. Sahib Hussain
88
Age^70
Address: Pocharam
According to Hussain when he came to Pocharam in 1995 with his family
there was little development. He used to drink water from the bore, which
was beside his home. The general health of the people and cattle was good.
Vegetables were available cheap.
Now he feels that the pollution levels have increased and this he has
attributed to the factories. He feels the high levels of pollution to be the cause
for the diseases they suffer from. Visits to the doctor are frequent.
The underground water is polluted with the chemicals used by the
industries.
He also adds that though the incidence of serious diseases is. low, many
people suffer from general diseases such as blood pressure, body pains,
stomach pains, arthritis and so on.
Name: Durgaiah
Age: 82
Address: Ganpathiguda, Patancheru.
In those days there was a huge growth in the crops. There was tremendous
cultivation and we used to make nice profits. Seasons were on time.
There was little development in the village. There were very few houses,
people stayed in their farms.
The major source of water for the village was the Nakka vagu (stream),
Pamula vagu, Kuntla bavi (well) and nadim bavi. Water from these sources
was used for drinking and bathing purpose.
After the factories were established the water has become dirty, the color of
the water is black and the fish in the water are also dying. Cattle that drank
this water also died.
With pollution people suffer from many diseases, diseases which don't get
cured even after frequent visits to the doctor.
I don t know when we will get salvation from this pollution and diseases.
Name: Veera Swamy Goud
89
Age: 54
Address: Pocharam, Patancheru.
It was the then Prime Minister Indira Gandhi's wish to make Patancheru an
industrial area of Andhra Pradesh.
But before the factories were established the seasons were on time, and the
profits that we could earn from farming was also good.
There were no major diseases; the average health of the villagers was good.
The only prevailing disease was the common cold, which was due to the
change in the seasons.
In 1978 the factories were established, with which started our doom days.
Pollutants were released in the Nakka vagu and Pamula vagu to which loss of
aquatic life maybe attributed.
Crops no longer grow here. The only crop that grows is rice. All other crops
dry due to the polluted underground water. The underground water smells a
lot.
Fruit bearing trees have flowers, which dry due to air pollutants such as ash,
mica and so on. Trees no longer bear fruits or flowers.
He also mentioned that 'Dexo' a factory releases a chemical, which is yellow
in color into the Nakka vagu. Novo pan releases asbestos, ash etc in the air.
He also added that the Effluent Treatment Plant (ETP), where more than 300to500 lorries come, does not treat the chemical waste and in the night releases
the untreated chemical water into the Nakka vagu.
PHR-16
Name: Kishtaiah
Age: 90
Address: Pocharam
Kishtaiah a resident of Pocharam said that until the factories were established
the crop yield was good and groundwater was used for drinking.
With the establishment of the industries the crop yield has reduced. Intact
they have stopped cultivation of crops. The underground water being
polluted is no longer used for drinking purpose. He said if the regular supply
of Manjeeera water was stopped then their condition would worsen.
He said that he is suffering from severe cough, vision loss, swollen legs, pain
in the legs and arthritis.
His son Anthaiah who is working in 'Biological E ltd' is also suffering with
arthritis and pain in the legs.
The livestock has been affected due to the polluted water.
90
Name: Rayagiri Yadi Reddy
Age:
Address: l-85,Bachiguda, Pocharam.
Rayagiri informed of smell during the nights between 6-7 p.m. He says that
the Pamula vagu water is black in color. Before the industries were
established they used that water for drinking purpose. Now they no longer
do so, as they develop skin diseases suddenly. They don't use the water for
their buffalo's either. They no longer cultivate their own lands, infact they
have abandoned their lands because of the polluted water. An industrialist
had come and paid five thousand per acre when Dr. Kishan Rao had filed a
case against them.
He felt that they were healthy before the industries started their work in their
village, now their health has deteriorated. Bollaram, Gandigudam chemicals,
pollutes Nakka vagu. They suffer from many diseases such as psychiatric
morbidity, recurring headaches, asthma and anemia. When they walk in the
water they develop skin diseases. Once they tried to meet the chief minister
Chandra Babu Naidu, he ordered the police to lathi charge. Loss of cattle has
been reported.
Name: Kishtaiah
Age: 53
Address: Bachi guda, Patancheru.
The village environment was goog. The water in the Pamula vagu, the chief
water resource, was used for drinking purpose. The water was also used for
livestock. Before the industries were established they never visited any
doctor, home remedies were resorted to and they were effective.
Since the industries started their work, he feels the villagers' health has been
affected. They suffer from many diseases, which don't get cured even after
frequent visits to doctors and after having followed their prescriptions. Cattle
die after drinking the water from the stream, which is totally black and
sometimes white. A different color could be noted each day.
Bore water anywhere in the village is not without an oil slick
He feels polluted water is the cause for all the diseases they contract.
Name: G. Shankaraiah
Age: 60
Address: Pocharam
91
Shankaraiah a resident of Pocharam says everything is polluted. Crops have
failed, and agriculture being their main source of income their standard of
living is low.
He said the well water was used for drinking purpose, now the water in the
well is acidic and yellow in color. He also added that the water had bad smell.
He says the bore water is also polluted; as a result there is no source of
drinking water except the Manjeeera water, which is supplied by the
government. He said if this water supply were to stop then they would face a
lot of trouble for drinking water.
With regards Manjeeera water supply he said that during the rainy season the
water supplied to them was polluted as the pipe lines get damaged due to the
rains, so people suffered from various diseases.
The smell of the pollutants released by the factories comes during the night.
This problem was much perceptible earlier, until there were protests.
With regards agriculture he says the yield has reduced. They manage to grow
paddy but that paddy when consumed would lead to various diseases, as it is
grown using polluted water.
Other crops don't grow. Rice is another crop which maybe grown but then
quality has reduced.
KST-2
Name: K. Balanarasimha
Age: 39
Address: Kishtareddypet
Occupation: Sarpanch, Kishtareddypet.
Reports: Balanarasimha a resident of the village since 39 years is the Sarpanch of the
village. He says before 1985 that is before the industries had started their
activities in their village, the crop yield was good and the produce was nutritious
and tasted good. The villagers drank the underground water. Cattle and other
livestock were healthy.
After the factories were established, this is no longer the case; most people in the
village have lost their sense of smell.
He says effluents from factories in his village, such as the AP metals engineering,
Dr. Reddys labs etc, got mixed with the groundwater. Their most important
source of water Posamudram was the most affected.
The crop yield has reduced and the size of the seed in the husk has reduced.
Now they no longer use that water.
After the government order, 14 villages of Patancheru are getting their daily
water supply, however Kishtareddypet is not supplied Manjeeera water by the
92
government. The same is done by a social welfare organization, 'Sri Sai Baba
organization' (BHEL)
He says in 1986 the scientists from ICRISAT warned them that the men would
become sterile in the next 20 years when the poison would have entered their
body.
In Kazipally the effect of pollution from the factories is more than in Bollaram as
the villages are on a lower plane and the wastes readily mix with the ground
water.
He says the villagers mostly suffer from arthritis, back pain, loss of memory, and
removal of the uterus, skin diseases, allergies, birth defects, respiratory diseases,
fits and paralysis.
He feels the increase in the number of mosquitoes could be attributed to the
factories and their operations, which has increased the number of malaria cases
in the village.
Name: K. Sattamma
Age: 65
Address: Kishtareddypet
Sattamma says before the industries were established they drank water from the
lakes, well, streams etc. she says they were very strong then. Cow dung was the
only manure they used for their fields. The crop yield was good. Now however
she feels there is no increase in yield even with so many fertilizers and pesticides
available.
She says they used to walk to the Patancheru market, and walk back home.
When the factories were first established, she says everything was normal for the
first few years. Later the aquatic life was lost due to the chemicals released by the
industries in Bollaram.
She says, " paisalu neelala paduthe, paisa kanpichedi kani ippudu
manishi kuda kanupichadu. (if a paisa fell into the water it could be seen, now
however even a human being wouldn't be visible).
The main crop that is grown in her village is rice. Last year due to poor rains the
yield was poor, however this year the crop was good.
She feels the pesticides and other chemicals they use are also responsible for the
diseases they suffer from. She says people were generally strong then, now
however a person is equivalent to a person aged 85 in her time.
Name: Narsimhas
Age: 65
93
I
Address: Kishtareddypet
Narasimha says when he was a teenager the crop yield was good, and to his
knowledge there were only two seasons when the yield would be low. And this
was due to the poor rains. He says in one season they couldn't store a single
grain, and they would eat 'Busa Vadlu' (rice which grows along the banks of the
river). Sometimes they would have nothing to eat. The other season was better,
thought there were no rains they didn't face much problem.
The cattle were healthy. He says they drank water from the lake, and in those
days the water was very clean, so clean that if a paise was dropped it could be
seen. The factories dumped their wastes into the lake and now the color of the
water is black. The crop yield has reduced and so has the income. He says in a
season 75% of the crop is lost. He says ML As and collectors had come to his
village, but they did nothing to improve their lives. He says that they are losing
their lives and doesn't know when god would help them.
Name: Yadaiah
Age: 60
Address: Kishtareddypet
According to Yadaiah he worked as a labourer at Bollaram IDA, he worked in a
private company. In his lifetime he says he worked for 3 companies. Now he
feels weak and hence can't work anymore. He has no income, as both his sons
are dead. The death of his elder son was a case of suicide. He says his son
Srinivas had no option as he was suffering from severe stomach pain. He had
studied up to class 10, and worked as an accountant at the brick maker's house.
He was 27 years old. He says when he was 15 years old, one worked even at the
age of 70. But now, though he is only 60years old he is unable to work because of
the pollution.
94
I
Appendix 12
Status of Water contamination:
a)
□ Effluents of the Industrial Development Areas (IDA) are discharged
partly untreated into streams, underground water and ponds
□ The effluents contain appreciable amounts of inorganic and inorganic
chemicals and their bye-products
□ The CETP in Bolaram and Patancheru lets out their untreated
•effluents in Pamulavagu and Peddavagu polluting Nakkavagu the
main drainage.
The
Cocktail of effluent chemicals Pollutes the Drainage system. □
Hazardous committee in 1997 - asks for Research to deal with the
Cocktails.
□ Irrigation tanks are used for effluent settlement tanks, the spill over
joins Pamulavagu and Peddavagu
□ Dispersal of contamination by interactions between surface water and
the aquifer system
b)
J Six million litres of Water is drawn from Manjeera water supply and
consumed by the industries in Patancheru area. A quantity of 5Mld of
effluents is released into the natural streams without bringing it with the
outlet standards prescribed by the EPA and Rules.
CETP is discharging partially treated effluent into Nakkavagu. Water of
the stream is not useful for irrigation. - District Judge's observation
dated 27.01.1996 submitted to the Hon'ble Supreme Court
PETE & industry major contributor for pollution.. All of them
individually as well as cumulatively are discharging almost untreated
effluents into the stream, the main source of water supply to the
residents of several downstream villages - CRE Report based on study
carried by Ms/.Bhagavathi Ana Labs Limited, Consulting Environmental
Engineers
Pollution around the Patancheru, Bolaram industrial areas has increased
during the past one and half decade due to discharge of effluents into
surface water bodies.
The Polluted surface water is strongly influencing the quality of
groundwater as TDS and elements Cu, Ar, Se and B reaching
concentrations 5 to 10 times the permissible limits
Elements with extremely variable pH interacting with sediments, soil
and rock (chemical weathering) to release heavy metals which add to the
degradation of groundwater quality
95
S
S
S
S
S
S
All the toxic elements (except Fe & B) are migrating in NW direction with
the groundwater down stream significantly affecting the quality of water
in the Manjira River
Arsenic in stream water near CETP as high as 40,000 ppb. Source clearly
from the industrial effluents not natural rocks.
Peddavagu and Nakkavagu streams showing high arsenic concentration
of 5,000 ppb
Groundwater having high concentration of arsenic
Wells with 750 ppb of arsenic concentration, while the permissible limit
is only 50 ppb.
High levels of heavy metals in the ground water around Patancheru
Industrial area was found, which was higher than the permissible WHO
standards. - down to earth 31st Aug 1999.
Toxic Effluents into the aquifers and other surface water streams and
water bodies in an area of 250 sq km thus destroying the crops, flora,
fauna of the surrounding areas admeasuring about 3000 acres
c)
Units in Patancheru and Bollaram discharge about five million litres of effluents
everyday. A major part of the untreated effluents ultimately goes into nearby
tanks and streams. A certain part is clandestinely disposed of in dry borewells.
d)
Names of Lakes Polluted:
1. Khazipally Cheruvu
2. Gandigudam Cheruvu
3. Nagulal Cheruvu
4. Kistareddypet Cheruvu
5. Mukta Kanta Cheruvu
6. Aminpur Cheruvu
7. Bollaram cheruvu
8. Saki Cheruvu
9. Muthangi Cheruvu
10. Isnapur Cheruvu
11. Chitkul Cheruvu
12. Lakadaram Cheruvu
Names of Rivers/Drains Polluted
1. Bollaram near sultanpur village
2. Iskavagu drain
3. Nakkavagu
4. Pamulavagu
5. Peddavagu
6. Manjeera upstream of Nakkavagu Confluence
96
I.
e)
Main Contaminations:
Arsenic - Surface Water and Groundwater up to 0.7 ppm (mg/1)
Selenium - up to 0.038 ppm
Strontium - up to 3.0 ppm
Barium - up to 0.20 ppm
Boron - up to 4.0 ppm
Manganese - up to 1.5 ppm
Nickel - up to 1.0 ppm
Pesticides, Aldrin, Endosulphur, DDT, Phenol were highly concentrated in soil
and water samples.
f)
SAFETY OF FRESH WATER RESERVOIR IN STUDY AREA
Analysis of hazard to fresh water reservoirs in the study area indicated that the
Manjira river and Nizam Sagar located in the northwest of the city are in grave
danger of contamination emanating from Gaddapothram - Bolaram Patancheru industrial axis as they are located within 15 kms of the fresh water
source. In case of Patancheru- Gaddapothram - Bolaram industrial area, the
Nakkavagu river which is one of the principal tributary of Manjira River drains
the area and is located at a distance of 5 kms. from Patancheru IDA . Although
the area has a slope of < 1 % from the industrial area towards Manjira river, the
sediment load and contaminant flow poses a severe hazard to Manjira water
supply system. Similarly, while the two pharmaceutical industries located at
Aroor are situated at a distance of 26 k. ms from Manjira reservoir, the industry
at Digwal is within 13 kms of the reservoir indicating a hazard to source of
drinking water supply to Hyderabad.
REFERENCE:
‘Europe and India Past Present and Future - Austrian Research Center Seibersdorf
‘Toxic trace element pollution in groundwater around Patancheru and Bollaram Indusrial Areas by Shivkumar, Pande
and Biksham in 1996
*'Arsenic Pollution in Ground water' at Patancheru IDA by Pradip K. Govil, NGRI. 2002
* Lakes and Water Bodies have been polluted by the nearby industries. - CPCB, 1998 Report
‘Toxic Metals and Organic compounds: (NGRI Study, 1996-97)
‘Down to Earth, CSE publication; 3151 August 1999.
*GIS FOR ENVIRONMENTAL AUDIT OF HYDERABAD METROPOLITAN REGION, RANGA REDDY & MEDAK
DISTRICTS OF ANDHRA PRADESH, INDIA
Dr.Kausalya Ramachandran, D.Sai kiran, M.Pumend & M.Kalpana
Central Research Institute for Dry land Agriculture
97
Appendix 13. Other Health Studies from the Study area:
Table 1.
Title:
“Assessment of environmental health risk due to inorganic
arsenic in the industrially contaminated areas of
Hyderabad (A.P.), India”
Authors:
Chandra Sekhar K, N. S. Chary, C. T. Kamala, and A.
Kishan Rao
Abstract:
Environment exposure of inorganic arsenic to humans was
assessed by collecting clinical samples from the residents of
the
industrially
contaminated
area,
Patancheru,
Hyderabad. Arsenic levels in the clinical samples like
blood, hair, nails, was measured by means of ICP-MS.
Arsenic content of nails and hair were found to be higher
than urine and blood. The nail concentration of arsenic in
the range of 0.5-1.63 mg/kg and hair 0.3-0.94 mg/kg
indicating longer exposure periods of arsenic. The man
source of arsenic exposure is found to be contaminated
waters (ground and surface) and also through the
consumption of arsenic contaminated vegetables grown on
the contaminated soils. It was further found that people
consuming nutritious rich diet suffered least from the
arsenic contamination than those who were malnourished.
Year of the Study:
Title:
“Status Report - Pollution and Actions Taken at RHC
(Rural Health Centre) Patancheru Area”
Author/Investigator:
Dr. G. Nagaiah, Osmania Medical College, Hyderabad
Submitted to: The Additional Advocate General. A.P.
High Court, Hyderabad
Remarks:
“Morbidity Survey 1998”
The study team came out with the report which showed
25.49% of general sickness rate, the report also showed
more morbidity was due to orthopedic problems, followed
by skin problems. The cause for diseases was to be
established.
“Environmental Pollution and its effect on the health
Nov-Dec 2000”
The study at Sulthanpur village, conducted in Nov-Dec
2000 was taken up in the academic interest and research
oriented, useful for students, and helpful in planning
health intervention. Though the results of the study are in
favour of the fact that heavy metals like arsenic, mercury,
aluminium, etc. are the determinants of the clinical
manifestations and symptoms but the study is insufficient
at this stage as the size of the study population constitutes
only 0.93% of rhe total 32001 population distributed
among 14 villages who are also exposed to environmental
hazards.
98
TtxM-e
Triki-Lt
'b
Title:
Report of Fact Finding Committee
Constituted by the Hon’ble High Court in its order
dated 25,h September 2003 in W.P.No. 19661/02
Index page SI. No. 6 - 1;
(Page no. 13 ; para 6.3) - 2
Submitted to the court in March 2004.
Tide:
Conservation and Management Plans for
remediation of Asanikunta and Kistareddypet
Cheruvu prepared by EPTRI Environment
Protection Training and Research Institute,
Hyderabad. December, 1998
9.0 page 41
The Terms of Reference States:
Study the adverse effect of pollution, caused by
discharge of effluents by industries, on the health of
inhabitants of the effected villages and suggest
remedial measures required to be taken in this
regard as also the proportion in which the cost
thereof, if any, is to.be borne by the polluting
industries 1
Remarks:
The following problems are reported during the
socio economic study in the surrounding of the
Asanikunta and Kistareddipet cheruvu
Remarks:
The Report says that the Chairman and members of
the committee met the inhabitants of the effected
villages and held discussions with them on their
health status. They complained that some of them
have developed skin rashes after handling the water
for washing purposes (Dobhi).
In majorities of the areas visited by the committee,
villagers complained that the medical facilities in the
village are inadequate. Steps have to be taken to
improve medical facilities in these areas. 2
z
99
Morbidity is high in villages around these
lakes
Skin diseases are common
Malarial incidence is high
Respiratory diseases, loss of sight and
digestive problems are prominent
Decrease in soil fertility
It is reported that the livestock population
is reducing day by day and their life span in
these villages is found lesser on an average
Milk yield of these buffaloes is found 2 ’/2
litres per day which is very less when
compared to the average yield
Acqatic life in the water bodies is almost nit
due to pollution
Appendix 14 The Hard Fact
During the past two decades, the industries around Patancheru has managed to
dispose high volumes of chemical pollutants in the environment.
The concentrations of the released pollutants in the region has been reported by
media. Committees set up be the Supreme court and A.P. High Court, APPCB,
and independent authorities and institutions.
The Hard Fact : Report’s & News (in 10 years)
_____________ Title_____________
The impact of paleo-channel on
groundwater contamination
K.Subrahmanyam (Y)
National Geophysical Research
Institute,Hyderabad,
P.Yadaiah
Geology Department.Osmania
University, Hyderabad,__________
Shivkumar K, Pande AK, Biksham
G (Dept Atom Energy, Atom
Mineral Div, Civil Lines, Nagpur
_____Year
Received: 17
November
1999
Accepted: 14
March 2000
Assessment of contaminant
migration in groundwater from an
industrial development area,
Medak District
By V.V.S. Gurunadha Rao,
R.L.Dhar and K. Subrahmanyam
National Geophysical Research
Institute )Council of Scientific
Research), Hyderabad
Received 6 july
1999, accepted
7 june 2000
4
Contamination of soil due to
heavy metals in the Patancheru
industrial development area,
Andhra Pradesh
P.K.Govil, G.L.N.Reddy &c
A. K. Krishna
NGRI, Hyderabad
Springer-Verlag
2001
5
90.85 p-c. units in AP complying
with water standards, says study
By Our Special Correspondent,
Hindu
HYDERABAD
, APRIL 4
2001
No.
1
2
3
1997
_________________ Abstract_________________
Amidst the granite terrain,the Nakka vagu has
been identified as a paleo-channel (composed of
clay-silt -sand facies);its presence in the area has
immensely increased the spread of groundwater
contamination.The transmissivity of the alluvial
aquifer varies from 750 to 1315 m 2 /day.The
adjoining granite has a transmissivity that varies
from 30 -430 m 2 /day.______________________
Present study on abundance and distr-ibution
pattern of toxic trace elements indicates the
quantitative aspect of pollution in the Nakkavagu
Basin.
The degree of contamination is so intense that in
some parts of the environment has become
unsuitable for human living. The morbidity rate
in the area is a shocking 80%, compared to the
national average of 10%, all directly attributable
to the industrial pollution.
The chemical analysis of the treated effluent from
the CETP was found to contain metals like
arsenic, selenium and manganese (Dhar et al.
1998).
100
The data reveal that soils in the area are
significantly contaminated, showing two to three
times higher levels of toxic elements than normal.
Many heavy metals, such as Cr, V, Fe, As, Cd, Se,
Ba, Zn, Sr, Mo and Cu, are present above the
normal distribution in the soil. The heavy-metal
loads of the soils in the study area are 240 mg/kg
for Cr, 235 mg/kg for V, 1,350 mg/kg for Ba,
200 mg/kg for Cd, and 500 mg/kg for Cu. Most
of the soils should be removed from agricultural
production, and the area needs to be monitored
regularly for heavy metal enrichment.____________
The A P Pollution Control Board (APPCB),
quoting a study done by the Programme
Evaluation Organisation (PEO) at the instance of
the Planning Commission, has claimed that it is
was one of the few PCBs in the country which
controlled pollution in an effective manner.
6
Disaster in the pipeline ?
By K. Venkateshwarlu Hindu
HYDERABAD
, NOV. 13
2000
The State Government's decision to go ahead
with the laying of a 1 8-km-pipelinc to carry
industrial effluents from Patancheru industrial
area to Sewerage Treatment Plant (STP) at
Amberpet, has raised the hackles of city-based
environmentalists who say that it amounts to
"merely shifting pollution problem from one area
to another."
7
Groundwater Polluted :
Government Study on Ground
Waterpollution: In compliance
with Supreme Court order
Survey
conducted on
27-6-1996
There is evidence in the field that the crop yields
are reduced highly and some lands are abandoned
from irrigation and cultivation.
8
Conservation and management
plans for remediation
KHAZIPALLY CHERUVU
Final Technical report , Jawaharlal
Nehru technological university,
Hyderabad
STUDY OF GROUNDWATER
POLLUTION IN
PATANCHERU AND
BOLARAM INDUSTRIAL
DEVELOPMENT AREAS,
MEDAK DIST. ANDHRA
PRADESH,
Sponsored by APPCB, Hyderabad
National Geophysical Research
Institute, Hyderabad
January, 1999
Soil Contamination: In this period of 10 years the
area of the land available for cultivation has come
down from 240 acres to 80 acres a reduction of
66% mainly due to introduction and influence of
industrial effluents into Khazipally lake.
Dec, 1998
The Study area covers about 160 sq km. There are
more than 400 big and small pharmaceutical and
chemical industries. Some observations of the
toxic metals are:
The result shows high values of Arsenic,
Strontium, Barium, Selenium, Boron,
Manganese, Nickel, Residual Pesticides, Aldrin,
Endosulphur in the groundwater as well as surface
water in the area.
9
It is well established that the high concentration
of toxic metals are dangerous to human life and
cause many diseases, which are called geochemical
diseases. High concentrations of arsenic cause
lung cancer, skin cancer and nickel is also a wellknown carcinogen that causes cancer. Lead is
known to increase the blood pressure in human
beings.
10
Down to Earth, Centre for Science
& Environment Publication
11
Government Study on Ground
Waterpollution: In compliance
with Supreme Court order.
Survey
conducted on
27-6-1996
Paks Trade, a Patancheru-based company, was
apprehended for pumping arsenic-laced effluent
into the ground through borewells
The DTE/IIT test conducted on a water sample
from a handpump in Pocharam village of
Patancheru Industrial Area (P1A) in Medak
district of Andhra Pradesh showed that the level of
mercury was 115 times the permissible limit._____
From the samples collected it was clearly
established in the field that groundwater is not
potable in 8 villages. Out of 16 villages, the
groundwater in 11 villages is found to be polluted
and pollution is attributd to industrial activity as
discharge of Nakkavagu and Pamulavagu is
coloured and odoured. The source of pollution to
101
C
•
OH -1 c~t)
08635
•
/•
t■
O'-
groundwater is industrial effluent that is let into
the 2 streams and affects groundwater body
during rainy seasons mostly. On the whole the
pollution areas fall within 100 to 500 ints either
side of Nakkavage and Pamulavagu streams.
There is evidence in the field that the crop yields
are reduced highly and some lands are abandoned
from irrigation and cultivation.
12
Contamination of Urban India
Environment by Hazardous
Industries
Kausalya Ramachandran
Senior ScientistD. Sai Karan
Research Associate
M. Kalpana and M. Purncndu
Project Associates
CRIDA (ICAR), Hyderabad
1997
GISdevelopme
nt.net.
Scattered location of hazardous chemical
industries in urban areas and meager availability of
proper waste management system in Hyderabad,
Banglaore, Chennai and Delhi, are primary cause
of non-poi'nt source pollution in these urban
centres. ARCGIS was used in tandem with
satellite data (IRS - ID - LISS III&: PAN merged
data) to map location of hazardous industries in
these urban areas and estimate the spread and
direction of flow of contaminants. The pattern
and extent of contamination of soil and water was
mapped and quantified to facilitate undertaking of
remediation plans.
1997 GISdevelopment.net.
13
INVESTIGATION REPORT:
Environment pollution caused by
patancheru and Bollaram industrial
Estates in nearby villages of medak
district in Andhra pradesh.
By: National Environmental
Engineering Research Institute,
Nagpur.
October 1991.
A detailed survey has been carried out by NEERI
in patancheru and Bollaram industrial Estates and
in surrounding villages affected by pollution,
which includes the river qualiry of Manjeera after
the confluence with Nakkavagu, which carries
wastewater from both the estates.
Observations:
•
Wastewater is highly polluting and must
be treated.
•
Samudram an irrigation tank at
Kistareddypet has been totally spoiled by
industrial discharge into it and now it
looks like stabilization pond.
•
The analysis of the data reveals that the
wells/bore wells and even Manjeera river
waters have been contaminated.
HEALTH:
The incidence of disease and death has increased
considerably. The data suggests that there is an
increased rate of premature deaths.
NEERI Scientists were informed by the farmers of
the affected villages that:
•
Girls do not attain puberty at the proper
age
•
Married women cannot conceive
•
Pregnant women deliver still born
children
•
There is high rate if infant mortality
•
Death of cattle wealth takes place after
drinking/coming in contact with the
102
high polluted wastewater.
A STUDY ON THE
ENVIRONMENTAL
POLLUTION AND ITS
EFFECTS ON THE HEALTH
STATUS OF PEOPLE AT
SULTANPUR VILLAGE BY
DEPT. OF COMMUNITY
MEDICINE, OSMAN1A
MEDICAL COLLEGE,
HYDERABAD________________
ASSESSMENT OF
ENVIRONMENTAL HEALTH
RISK DUE TO INORGANIC
ARSENIC IN THE
INDUSTRIALLY
CONTAMINATED AREAS OF
HYDERABAD.
BY Analytical Chemistry and
Environment Sciences Division,
Indian Institute of Chemical
Technology and Yashodhara
Hospital, Patancheru
NOV. 2000
STATUS HEALTH REPORT
ON HEALTH PROBLEMS AND
REMEDIAL MEASURES
TAKEN AT PATANCHERU
AREA.
FROM Dr. G. Nagaiah
to The additional advocate general,
high court
Osmania medical college
Morbidity
survey, 1998.
17
EUROPE AND INDIA PAST,
PRESENT AND FUTURE
BY Austrian Research Centre
Seibersdorf.
March 2001
18
CIS FOR ENVIRONMENTAL
AUDIT OF HYDERABAD
METROPOLITAN REGION,
RANGA REDDY & MEDAK
DISTRICTS OF
ANDHRA PRADESH, INDIA
Dr.Kausalya Ramachandran,
D.Sai kiran, M.Purnend &
14
15
16
“2974 people examined and 690 people found to
be suffering from symptoms of toxicity. DR. Rao
in Hell of Earth” .
l/4'h of the population available for medical
examination. Blood sam pies from some
individuals with suspected heavy metal poisoning
were taken.
The main source of arsenic exposure is found to
be the contaminated waters (ground and surface)
and also through the consumption of arsenic
contaminated vegetables grown on contaminated
soils.
Concentration of arsenic in clinical samples clearly
shows that there is a possible association of arsenic
in blood, urine, hair and nail with age, sex and
with concentration of arsenic in soil, water and
vegetables.
Remarks of Chief Investigator.
The report of the sample study in October 1998
showed quantitative values of the health problems.
The study lacked specificity of cause effectivness.
FINDINGS/OBSERVATIONS
•
Morbidity rate in this area showing
increasing number trend which is
evident from past rate of 10.18% in
1991 oct. to present ratio of 25.49%
•
In all the types of the diseases, the female
population is experiencing higher
morbidity.
Status of water contamination sources
•
Effluents of the I DAs are discharged
partly untreated into the streams,
underground and ponds
•
The effluents containing appreciable
amounts of inorganic and organic
chemicals and their bye-products.
SAFETY OF FRESH WATER RESERVOIR IN
STUDY AREA
Analysis of hazard to fresh water reservoirs in the
study area indicated that the Manjira river and
Nizam Sagar located in the northwest of the city
are in grave danger of contamination emanating
from Gaddapothram — Bolaram - Patancheru
industrial axis as they are located within 1 5 k. ms
103
M. Kai pan a
Central Research Institute for Dry
land Agriculture,
Hyderabad —
of the fresh-water source. In case of PatancheruGaddapothram - Bolaram industrial area, the
Nakkavagu river which is one of the principal
tributary of Manjira River drains the area and is
located at a distance of 5 k. ms. from Patancheru
IDA . Although the area has a slope of < 1% from
the industrial area towards Manjira river, the
sediment load and contaminant flow poses a
severe hazard to Manjira water supply system.
Similarly, while the two pharmaceutical industries
located at Aroor are situated at a distance of 26 k.
ms from Manjira reservoir, the industry at Digwal
is within 13 k. ms. of the reservoir indicating a
hazard to source of drinking water supply to
Hyderabad.
14.0 CONCLUSION
Hazardous chemical industries pose serious
problem to soil, surface water body and
groundwater aquifer in the study area. Creating
facilities for safe disposal of hazardous waste is
urgently required if the region has to be saved
from irrevocable damage and decline. Treatment
of solid waste and effluents requires strong efforts,
both from polluters as well as the law enforcing
agencies
104
Appendix: 15
Table . Water consumption and waste water generation by major polluting industries
patancheru industrial complex.
Industry
Raw material
Products
Water
consumpti
on
1
Standard
organics
Acetone, acetic acid, acrylonitrile,
ammonia gas , benzene, caustic soda,
dimethyloxalate, ethyl acetate.
240
2
Nova resins
and
chemicals
Asian paints
Formaldehyde-150T
Helamine-12T
Urea-75T__________
NA
Sulpha
methoxazole
(60T)
Trimethroprim
(15T)
Solbutanamol
sulphate (0.4)
T.H.B.Acid
(10T)_________
Aminoresins
(450T)
Waste
water
genera
tion
130
4.6
1.0
240
50
4
Reliable
paper
50
30
5
Deccan
drugs
Trimethoprim
105T
35
20
6
Sri sai baba
cellulose
Bleached cotton
linters 35T
150
130
7
R.K.Industri
al Chemicals
Waste paper 288T
Bosin 3.6T
Alum 27.6T________________________
Dimethyl oxalate
Acetone, Hydroxylaminesulphate,
Sodium, Sulphuric acid, Ammonia gas,
chlorine, benzene, 3,4,5trimethoxybenzaldehyde, acrylonitrile,
sodium methioxide, Glanidine nitrate
Caustic dye 8T, Sulphuric acid 3T,
common salt IT
Cotton linters 78T___________________
NA
Paints and
enameIs-1250 T
Aerific
Emulsion 67T
Synthetic resins
234 T_________
Craft paper
360T
7
l(recy
cled)
8
National
chemical
industries
Quinn
Chemicals
Barium
carbonate 27T,
Sodium
sulphide 12T
Barium
sulphide 60T
Leather
finishing
chemical 200T
10
4.5
S.N
o
3
I
9
J
NA
Acetone, acrylic acid, aerosol, ammonia,
casein, Caprolactum, cyclohexanol,
castoroil, butyl acetate, butyl acrylate,
ethyl acrylate, 2-E.H.A.,Formate MC
navyblue, Goldex(401),
| Direct Black,etc..
(
105
I
J
10
Sahney paris
rhone
NA
11
Surana
strips
(bhagyanaga
r metals)
Voltas
chemnical
division
NA
12
13
Reliance
cellulose
14
Asrani tubes
15
Novopan
India
16
Hical
pharma
Venkataram
a chemicals
17
Automobile
engg. Goods
(4000 items)
Cold rolled
steel strips
420T
Ortho amino phenol 38 T, urea 25 T,
Formalin 31 T, chlorine 60 T, ethyl
alchohol 60 T, caustic soda , HCL 16.2 T,
mallic anhydride, formaldehyde 47 T,
Ethyl mercaptan 30 T, Methylene bromide
49 T, nitrogen 4.5 T caustic soda 310 T,
alchohol 75 T_________________________
Hosiary cuttings and raw linters 150
T.,Caustic soda 60 T,chlorine gas 150
T,sulphuric acid 60 T,acetic acid and
acetic..
Steel strips, cutting oil,HCL, Zinc
chloride, ammonium chloride, molten
zinc.
Urea- formaldehyde resin, melamine
formaldehyde resin, wood, binders,
adhesives, sizing materials__________
NA
NA
Charminar
papers
ambuja
petro
chemicals
Waste paper 270 T, alum 8T resin 2.5 T,
dye 0.1 Tzchlorine.
o-Xylene 900 T, sulphuric acid 5 T,
sodium hydroxide (NaOH) 3 T.
20
Deccan
leathers
21
Gromor
chemicals
Raw sheep and goat skins, chromium
salts, dyes oil and Grease,acetic
acid,formic acid
NA
22
Ion
exchange
Dexo lab
chemicals
18
19
23
24
Bhaghyana
gar oil
reifneries
NA
Sodium, methanol. Di Ethyl oxalate.
Acetone, Sulphuric acid, Hydroxylamine
sulphate. Ammonia, Caustic soda,
chlorine, ethyl acetate, benzene, pyridine.
Raw groundnut oil and cotton oil 300
T,rice bran oil 60 T, neem oil 30 T, sodium
silicate 15 T, Bleaching earth 7.5 T, salt
3
1
3
1
Phoslone
1009T,
Malathion
125T, phorate
100T,
Ethion 100T.
560
72
MCA 116
T,Bleached
cotton linters
35 T, Cellulose
powder 25 T.
Steel tubes (MS
&GI)
500
400
6
2.5
Chip boards
66
7.0
Analgin 12 T
18
1.5
Chlorophericminimala
te4T_________
Kraft paper
4
3
140
30
Phthalic
325
anhydride 600
T, fumeric acid
45 T.____________
Finished leather
200
Iskin(l lakh hides)
Dextro
propocryhydrochlo
ride 2 T__________
Water treatment
chemicals 15 T.
Sulpha
methaoxazole 15 T.
1
300
190
7
5
10
5
30
20
r
F
Edible refined oil
3.2
2.5
300 T, soaps 150 T
106
i
I
3T.
25
Qu re drugs
26
N.S.L
27
V.B.C ferro
alloys
28
Hindustan
fluoro
carbons
Ferro
insulation
29
p-chloro benzoic acid, thio-urea, thionyl
chloride, acetamilide, nitric acid,
sulphuric acid, ammonia, iron, Dimethyl
sulphate, chloro formate.______________
HR steel strips 5200 T, Hcl 180 T, cutting
and lubricating oils____
Quartz 2100 T, charcoal 1560 T, Iron ore
4800 T,
Limestone 390 T, Coke 1600 T.
Mebendazole 2 T
25
15
MS cold rolled
strips 3500 T.
Ferro silicon 2200
T, pig iron 100 T.
150
100
10
(domes
tic)
20
(coolin
10
£)____
Anhydrous hydrofluoric acid, chloroform
Poly tetra fluoro
ethylene 45 T.
120
NA
Insulation boards
3
Appendix 16 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: vvwvv.sochara.org, wvvw.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:// 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.
107
108
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-trnee.ca
Web site: http:// www.nrteetrnee.
ca/eng/ programs/Current_Programs/SDIndicators/ Approach_to_Indi
ca tors/ SDI nd ica tor s_A pp roach_e. h tm
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-mail: federation@fcm.ca
Web site: http://www.fcm.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://wTww.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/English/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
108
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/or tee/
Description: A resource package on sustainable communities featuring case studies of
community sustainability initiatives in Ontario. This package also provides a step-bystep 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 "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/ecocomnrunity/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.
109
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: w w w. rp rog ress.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, community7
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 /CmtvVisioning/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 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.gov/greenk.it/indicator.htm#select
110
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: 978-9754988
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.
Ill
Title: Neighborhood Sustainability Indicators Guidebook
Contact: Crossroads Resource Center
Address: P.O. Box 7423
Minneapolis, Minnesota 55407
USA
Tel: 612-869-8664
kmeter@crcworks.org
urban Ecology Co^on of
,
Minneapolis. It is aimed at building "strong, self-determmed, ^stainablet
The guidebook defines "neighborhood sustainability indicators and provides gu
developing and refining indicators.
Title: Outcomes Toolkit: The Results Oriented System for Community
SnS: 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: mbilton@healthforum.com
SZuon for developing and backing conbaunity tadicafors.
On this web site, stakeholders can develop a community profile, receive technic
assistance in developing indicators and share information.
Title: Sustainability Starts in your Community
Contact: earthday@eartliday.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
. ,
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Web site: http://www.eartliday.net/pdf/goals/Sustamabihty_Guide pdl
Description: This community indicator guide was produced m April 2002 by Rede mmg
Progress and Earth Day Network. It is a step-by-step guide to developing and review g
community indicators. The guide also provides suggestions for ways to mvolve the
larger community in indicator projects.
,
Title: Sustainable Community Indicators: a Review of National Methods
and Suggestions
Contact: Long Island University, Institute for Sustamable Development
Web site: www.Iuinet.edu/sustain/si.html
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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
De v e 1 o p m e n Ij I @ i 4 sd. o r g
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.
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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/uploadszorc 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)
Addtess: CGSDI Secretariat
International Institute for Sustainable Development
113
161 Portage Avenue East, 6th Floor
Winnipeg, Manitoba R3B 0Y4
Canada
Tel: +1-204-958-7700
E-mail: p h a rd i(«) i i s d. c a
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.
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.la21-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.
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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.office@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: Instituto di Ricerche (responsabile del coordinamento scientifco)
all'attenzione di Claudia Semenza
114
Via Poerio 39
20129 Milano, Italy
Tel: 0039 02 277441
E-ma i 1: eci pl?/!a nib i en tei ta 1 ia. i I.
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
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-citics/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.
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