Environmental health acti̇on plan studi̇es in Aydin province – environmental risk factors research

Objective: This study was carried out to determine the spatial distribution of cancer cases registered in Aydın Adnan Menderes University (ADU) Application and Research Hospital between 2013 and 2016 and four groups of basic environmental risk factors (air, water, soil, food) with Geographic Information Systems (GIS) supported maps; to examine the relationship between cancer cases and environmental risk factors Method: The study was an ecological study which created a database based on GIS to investigate the spatial distribution of cancer cases registered in Aydın ADU Application and Research Hospital and four groups of basic environmental risk factors (air, water, soil, food) in Aydın and to examine cancer risk in terms of environmental risk factors and the people who lives in the same place where the cancer cases live. The study was conducted between September 2016 and June2018. All of the data related to cancer cases, air, drinking water and surface waters are enrolled. Samples of Incirliova, Söke and Kuyucak were collected to evaluate soil and food quality. Environmental risk factors, awerness about risk factors' association between cancer, attitudes and behaviors related to cancer of people living in the same place as cancer cases were surveyed with a questionnaire in İncirliova and Kuyucak county. Within the scope of the research, visual maps were created with a database based on GIS showing the spatial distribution of cancer cases data which recorded in Aydin ADU Application and Research Hospital and four major environmental risk factor groups in Aydin. Results: Between 2013 and 2016, Efeler was the county where the rate of cancer incidence was the highest in both genders, in women and in men. Cancer cases seen in both gender between 2013 and 2016 have been clustered in Incirliova and cancer cases seen in men have been clustered in Çine. When the environmental risk factors in Aydın were evaluated, between 2007-2016, the annual mean values of PM and SO2 in the air in Aydın province Efeler county are above the limit value according to the "Air Quality Assessment Regulation" Between 2012-2016, all of the annual mean values of drinking water chemical parameters of Aydın province are below the limit value according to the "Regulation on Water for Human Consumption". The mean annual values of zinc, copper, iron, chromium, lead, aluminum and boron in the surface water stations of Aydın province between 2010-2012 are above the limit values according to "Surface Water Quality Regulation". The mean values of nickel, chromium and cobalt in soil samples are above the limit value in İncirliova county, Söke county and Kuyucak county and the mean values of lead and cadmium in fig samples are above the limit value in all of the three counties. When the relationship between cancer cases and environmental risk factors observed between 2013-2016 was evaluated, there was a positive correlation between the cancer incidence rates to the standard of age of the districts and the measured values of arsenic, boron, copper, nitrate, nitrite, epichlorinidine, dichloroethane, manganese, sodium, nickel calcium, lead in air, water, surface water, soil and nutrients. According to the survey, people were no difference between the awareness, attitude and behavior scores of parpicipants who lives in the two counties where the age-standardized incidence rate of cancer. Conclusion: As a result of study, the distribution of cancer cases and the environmental health profile of Aydın were determined through the database and maps created in the study and the relationship between cancer cases and environmental risk factors was examined. Key words: Environment, Environmental Health, Environmental Risk Factors, Cancer, Geographic Information System