The direct relationship between soil pollution and health effects is difficult to individuate because the traditional approach of analysing a single variable in isolation does not take into account other influences. Many issues that affect human health involve complex and synergistic relationships (Science Communication Unit, University of the West of and England, Bristol, 2013). In addition, the public’s perception is that most adverse impacts on human health derive from poor water and air quality. In Ukraine they do not consider soil pollution to be a risk (Tsiborovsky, 2015). After the Chernobyl accident, the impact of radioactive contamination on human health was not assessed, and therefore no Ukrainian organizations were held accountable for the damage to health and the environment. The extensive increase in illnesses related to radioactive contamination, for example blood and lung diseases, nervous and endocrine disorder, has often been officially linked to other causes or has not been officially reported (Yablokov et al, 2009; Yablokov et al, 2016).
Data on the impact of past intensive uranium mining, nuclear weapon testing, military activities on human health are very limited. In the main the only reliable data is available in literature published by international researchers (87 percent of data), primarily from Germany (30 percent). In Turkmenistan, the monitoring of radioactive soil pollution was stopped in 1998, and since then there is a complete absence of data. Soil are not monitored for petroleum pollution (United Nations Economic Commission for Europe, 2012). A consequence is that there is a total lack of data on the impact of these soil contaminants on human health.
The most significant impact on human health in countries of Eastern Europe was the radioactive pollution after the Chernobyl accident, which directly affected 3.5 million people.
An example was reported by Baranovsky and Baranovska (2016), for the Chernigiv and Semenivskyi regions in Ukraine. The concentration of caesium-137 recorded in soils after the Chernobyl accident was about 45 kBq/m2 in 2001, decreasing to 29 kBq/m2 in 2011. The number of children with thyroid disease between 1986 and 1998 was 562.5 cases/1 000 children in the Semenovskyi region and 352.9 cases/1 000 children in the Chernigiv region. The average number of children with thyroid disease in Ukraine was 47 cases/1 000 children before the accident. After the accident, the population was advised to leave the radioactive regions for 6-8 weeks. In the 1990s, families in Western Europe (mainly from France, Spain and Germany) voluntarily took in children from the most affected regions.
The impact of soil pollution caused by agricultural activities (inappropriate use of pesticides, fertilizers, new unexplored pesticides, or antibiotics) also needs to be considered for this region. Unfortunately, the health effects are usually only reported locally so no national data is available.
One example is the agricultural area of Osh in Kyrgyzstan, where women are often exposed to organochlorine pesticides. Severe health problems in mothers and new-born infants have been detected, including low birth weight, congenital malformations, infections and stillbirths in cases where the mothers had been exposed to OCPs. Many also suffered from pre-eclampsia/gestosis and there was a high frequency of hospitalizations following delivery (Toichuev et al., 2018b).
In Kveto Kartli, Georgia, an incident of pesticide poisoning was reported to the Rotterdam Convention under Article VI. Twenty three percent of local farmers complained of constant poisoning incidents and sought medical assistance, and 37 incidents of livestock poisoning were reported, including cattle, sheep, chickens and dogs (Claydon, 2017).
The most serious impact of industrial activities on human health in the region was reported in the Apsheron region of Azerbaijan. There, long-term intensive manufacturing of oil products to nearly 150 years and the transportation of petroleum products have released a significant amount of contaminants into the environment. In accordance with the World Bank, some 30 000 ha were contaminated, 15 000 of which were heavily polluted and of primary environmental concern (World Bank, 2008a). Oil production on the peninsula had also affected the Caspian Sea through the discharge of contaminated water; and generated radioactive waste from natural radio-nuclides (Vandergraaf et al., 2011). The health surveillance studies reported in 2006 a considerable higher incidence of diseases in the Apsheron region compared to the national average, which was mainly caused by industrial contamination (Table 4) (Ibrahimov et al., 2010; World Bank, 2008b).
Since 2008, the World Bank has supported the ecological rehabilitation of Apsheron peninsula, including the clean-up of two of the most polluted sites: Sabunchu and Surakhani, affected by low-level iodine radioactive waste using “dig-and-dump” technology (Ministry of Economic Development of Azerbaijan., 2012; World Bank, 2008a). The remediation included removal, repackaging and transportation of low-level iodine radioactive waste to the dedicated waste storage facility located in Govan Mountains.
The cleaning of 1 000-2 000 ha of oil-polluted land at the area close to Mashtagha, Zugulba, and Buzovna villages implied the removal of hydrocarbons by washing and/or scrubbing with hot water, steam and / or additive detergents and chemical agents. These techniques were combined with the application of alternative technologies such as off-site bioremediation in heaps, separate removal and direct use of heavy bitumen fractions and mazut as additive for asphalt production or alternative fuel in the cement industry (World Bank, 2008b).
Soil pollution with trace elements (cadmium, copper, manganese, lead, and zinc) from industrial activities in the Lugansk region, in Ukraine, has also affected the local population. The concentration of trace elements in hair samples of people living in the industrial zone was 2.9 times higher than in the control zone. In comparison to non-polluted areas, concentrations in urine samples were also higher for the following: copper - 10.7 times; manganese - 9.1 times; nickel – 3.7 times; and lead - 2.4 times (Zdanov, 2009).
Another case was reported in the mining area of Akhtala, Armenia, where soils are heavily polluted with lead and arsenic. Blood from 84.6 percent of children aged 4-6 years exceeded permitted levels for lead, while in the control group in Yerevan it was only 57.4 percent. In this case, no remedial measures were taken to address the soil pollution (Petrosyan et al., 2004).
The influence of past and present military activities on soil pollution should also be highlighted, in particular for countries where the military conflicts have either occurred in the past (Azerbaijan, Georgia, Republic of Moldova, and Tajikistan) or are still ongoing (Ukraine). The soils of areas that were used for training and those subject to armed conflicts contain a wide variety of contaminants, in particular oil-products, trace elements, radionuclides, and, sometimes, unknown chemicals. In addition, access to these areas and to information on pollution levels is very limited. It is therefore difficult to assess the impact of these polluted areas on the surrounding population.
EPL (2015) reported a 13 percent increase in nervous diseases in 2014 in the local population of Mariinka, Ukraine, that had been affected by the bombing in 2014 as result of the Russian-Ukrainian war. In the study conducted by Kenesariyev et al. (2008), in the former nuclear military base of Azgyr, Kazakhstan, the morbidity rate was higher than in the reference locality. Ingestion of contaminated sediment from the lakebed was via dust and water cycle. In comparison to average natural background levels, the soil of the inhabited localities had elevated levels of cadmium (6 times), cobalt (21 times), and lead (10 times). The local inhabitants mainly eat the meat produced from the local animals fitted by grasses grown at suburb of Azgyr, as a result metals bioaccumulated to the humans through the food chain. Lead concentration in human blood was 1.6 times higher than the permissible level (0.23-0.33 mg/litre). Cobalt concentrations in the organs (liver, kidneys) of calves and in cow’s milk were respectively, 2.5 and 5 times the permitted levels.
The Aral Sea disaster (see Section 7.2.3) impacted the health of approximately 70 million people in Kazakhstan and Uzbekistan (Encyclopedia Britannica, 2019). It resulted in significant increases in the incidence of kidney and liver diseases (thirtyfold), arthritic diseases (sixtyfold), endocrine diseases (thirtyfold) and hepatitis (sevenfold) (Ataniyazova et al., 2001a, 2001b). A study of mothers and new-born infants of Karakalpakstan, Uzbekistan, observed elevated levels of trace elements, HCH and DDT and its metabolites in blood, umbilical cords and breast milk (Ataniyazova et al., 2001b). Average life expectancy has declined from 64 to 51 years in the Kzyl-Orda region in Kazakhstan. Ninety-nine percent of pregnant women and 87 percent of adolescents suffered from anaemia. Eighty seven percent of new-born infants were anaemic and one in twenty babies was born with abnormalities (Hamidov, Helming and Balla, 2016).