ARSENIC IN DRINKING WATER AND URINE AND ITS RELATIONSHIP WITH MALIGNANT TUMORS OF URINARY TRACT IN OSIJEK-BARANJA COUNTY, CROATIA.

Increased values of arsenic in potable water in eastern Croatia has been a matter of scientific interest for the past two decades due to numerous health effects, including carcinogenic ones. This study investigated whether prolonged exposure to increased arsenic from water could be detectable through increased arsenic in urine, and whether it influenced the incidence of kidney and bladder cancer in Osijek-Baranja County. Inductively coupled plasma mass spectrometry (ICP-MS) was used for analysis of water samples from available water sources (wells, aqueducts). In addition, examinees from Osijek, Nasice, Vladislavci, Cepin and Dalj gave their urine samples for analysis. Data on cancer incidence were obtained from the Institute for Public Health Registry and cumulative incidence of kidney and bladder cancer was calculated for the period between January 1, 2000 and December 31, 2018. Elevated arsenic concentration in drinking water was recorded in Vladislavci, Cepin and Osijek area with values above the allowed maximum according to the EU standards (10 µg L-1) and as a result, arsenic levels in urine of the inhabitants were also elevated. Cumulative incidence for bladder cancer showed correlation between increased arsenic in water and urine in the areas affected by increased arsenic in water. Epidemiologic data suggest a conclusion that elevated arsenic could be considered at least as a cofounding factor for urinary tract cancer.

Determinations of uranium concentrations in soil, water, vegetables and biological samples from inhabitants of war affected areas in eastern Croatia (ICP-MS method).

The occurrence of elevated uranium levels in post-war areas raise concerns among populations, especially in areas affected by heavy bombardment and potential use of depleted uranium weapons. The aim of this study was to assess public exposure to the uranium Water, soil, vegetables, urine, serum and hair samples were collected for the first time in eastern Croatia and analysed using an inductively coupled plasma mass spectrometry (ICP-MS) method, in order to try to explain the possible origins of uranium in the population and environment. Urine, serum and hair samples were collected from 389 inhabitants. A large variation of uranium concentrations in urine, serum and hair samples was found in this study. The majority of urine, serum and hair samples from our study had uranium concentrations below the reference literature values. A higher uranium concentration in the hair of 4% of inhabitants, mostly from rural areas, could not be explained at this stage of research. A further, extended epidemiological study should be made of uranium in the region.

SOME INDICATORS OF HEALTH CARE STATUS IN CROATIA.

The article presents the basic principles of health care, health care measures and strategic objectives of these measures in Croatia. The health of the population does not depend solely on the activities of the health care system but also on various demographic indicators. Our success in implementing health care depends largely on the structure of health facilities and health workers. The Croatian health system in late 2013 had permanently employed 74,489 workers. Out of these, 77% were health care workers. Most health care workers had only secondary school education (37.7%); physicians represented 17.4% of the workforce. On assessing the health of the population, certain health indicators are of utmost importance. The leading cause of deaths were circulatory diseases (in 2012, 24,988 persons died, 585.5/100,000). Neoplasms were the cause of death in 13,940 persons (326.6/100,000), then injuries and poisoning (69.1/100,000), diseases of the gastrointestinal system (53.1/100,000), and respiratory diseases (50.4/100,000). Data are presented on the basis of diseases reported from several national registries (cancer, psychoactive drug abuse, the disabled, diabetes, and suicides). The importance of vaccination for the control of infectious diseases in Croatia is especially emphasized, as well as the experience and excellent results achieved in this area. The epidemiological situation in Croatia in terms of infectious diseases can be assessed as favorable. This is due to the general living conditions, which contributed to the entire health system, making Croatia equal to other developed countries of Europe and throughout the world.

[CHARACTERISTICS AND INCIDENCE OF HEAD AND NECK SKIN MALIGNANT NEOPLASMS IN THE POPULATION OF THE OSIJEK-BARANYA COUNTY 2004-2012]. / UCESTALOST I KARAKTERISTIKE POJAVNOSTI MALIGNIH NEOPLAZMI KOZE GLAVE I VRATA STANOVNIKA OSJECKO-BARANJSKE ZUPANIJE U RAZDOBLJU OD 2004. DO 2012. GODINE.

UNLABELLED: The aim of this study was to investigate the incidence and characteristics of malignant neoplasms of the skin of the head and neck region in the Osijek-Baranya County during the 2004-2012 period according to gender, age, place of residence, place of work, occupation, type and location of the neoplasm, and phenotypic characteristics of patients. SUBJECTS: The study included all subjects with the diagnosis confirmed by histopathology finding and residents of the Osijek-Baranya County. The study included a total of 2952 persons, 1487 (50.4%) male and 1465 (49.6%) female, yielding an approximate annual incidence of 104/100,000. Mean age was 72 years. Respondents were mostly from rural areas (n = 1952, 66.2%). There were 2137 (72.4%) of respondents mostly working outdoors, mainly farmers (n = 907, 42.4%) and construction workers (n = 889, 41.6%). RESULTS: According to the type of neoplasm, the basal cell type was most common with 2160 (73.2%) patients. Ninety-three (3.1 %) patients had malignant melanoma. According to localization, face was the most common site of malignant neoplasms with 839 (28.7%) and nose with 643 (22.0%) patients. Squamous cell carcinoma was significantly more common in men (n = 341, 56.6%) as compared with women (n = 262, (43.4%; p = 0.005). Subjects with malignant melanoma were significantly younger, with median age of 67 years. There were no significant differences according to the type of malignant neoplasms and place of residence, place of business, and occupation with regard to working outdoors or indoors. According to localization, significantly more squamous cell malignancies were found on the ears and lips (p = 0.039 and p < 0.001, respectively), malignant melanomas on the neck, head and eyes (p = 0.004, p < 0.001 and p = 0.026, respectively), and basal cell neoplasms on the nose (p = 0.002). There were no significant differences in the type and frequency of malignant neoplasms according to hair and eye color. CONCLUSION: It is obvious that the disease occurs after a decades-long incubation period and the cumulative effect of exposure to risk factors, with direct sun exposure, seems to have a significant role. Additional research is needed.

Climatic Factors and Epidemiologic Characteristics of Head and Neck Skin Malignancies in Osijek Baranja County, Croatia.

AIM: The aim of this study was to investigate and compare the incidence and epidemiological characteristics of head and/or neck skin malignancies in Osijek-Baranja County, Croatia, and to connect them with relative climatic indicators such as the number and intensity of sunny and cloudy days over a longer period of time. METHODS: The study included patients from Osijek Baranja County with confirmed pathohistological diagnosis of the head and/or neck malignancies from January 1, 2004 to December 31, 2012. The patients were analyzed according to gender, age, residence, occupation, type and location of the neoplasm, and hair and eye colour. The analysis of climatic elements (mean monthly and annual cloudiness values, mean monthly and annual sum values of sunny days) for a period of 50 years (1961-2011) based on the data of the Croatian Meteorological and Hydrological Service for the investigated area was performed. RESULTS: The study included a total of 2,952 patients: 1,487 (50.4%) males and 1,465 (49.6%) females, representing the estimated annual incidence of 104/100,000. The mean age was 72 years. The patients were mostly from rural areas, 1,952 (66.2%); 2,137 (72.4%) worked outdoors: 907 farmers (42.4%) and 889 construction workers (41.6%). Given the type of neoplasm, the most common was a basal cell cancer (BCC) in 2,160 patients (73.2%). Malignant melanoma was found in 93 patients (3.1%). The most common localizations were face (839 cases, 28.7%) and nose (643 cases, 22.0%). Males had a significantly higher number of planocellular malignancies--341 (56.6%) than females--262 (43.4%) (p=0.005). The median age of the patients was 67 years. There were no significant differences in types of malignancies, place of residence, workplace, or occupation (with respect to working outdoors or indoors). It has been shown that the ears and lips are significantly more affected by squamous cell malignancies (p=0.039 and p<0.001) compared to the neck, eye and head with malignant melanoma (p=0.004, p<0.001, and p=0.026) and the nose where basal cell neoplasms (p=0.002) prevail. There were no significant differences in the type and frequency of malignant neoplasms in relation to hair and eye colour of the patients. The last 50 years in Osijek-Baranja County have seen a declining trend in the number of cloudy days and upward trend in the mean annual sum of sunny days. When compared, the increase in sunny days results in a higher number of patients suffering from malignant melanoma (ρ=0.695, p=0.038). CONCLUSION: It is obvious that malignant neoplasms of the skin, head and neck occur after decades of exposure, and as a cumulative effect of exposure to risk factors. A direct exposure to sun seems to play an important role, especially with regard to melanoma. Nevertheless, further research is needed.

Trace metals in the environment and population as possible long term consequence of war in Osijek-Baranja County, Croatia.

War in Croatia resulted with a significant release of contaminants into the environment as a result of the use of combat assets, mainly conventional, mostly aimed at civilian targets. The aim of the study was to investigate the concentration of metals and metalloids in the soils, water, plants (Taraxacum officinale), serum, urine and hair of the inhabitants in eastern Croatia. Overall results show minor abnormalities in presence of some trace metals in soil (As, Hg, Pb, Sb), water (As, Fe) and dandelion leaves (As) in some locations. Compared with soil samples from areas exposed to low intensity combat activity soil samples from areas exposed to heavy fighting had higher concentrations of As, Hg and Pb than allowed by national legislation for ecologic farming. Drinking water with the exceptions of the concentrations of Fe, As and Mn was in accordance with national legislation. Examinees from Dalj had mean hair Sb level 10-19x higher then examinees from any other location. However, when these data are correlated through methods of principal component analysis, presence of trace metals in some war affected areas can be followed from soil, through plants up to population proving that intense combat activities over small area leave metal presence that can be followed even 15 years after the war.

Bus water storage tank as a reservoir of Legionella pneumophila.

Health concerns associated with Legionnaires' disease have been identified as an area of the increasing public and professional interest. Any natural water or man-made water systems worldwide might be reservoirs of Legionellae. We presented a sporadic, community-acquired case of Legionnaires' disease caused by Legionellapneumophila serogroup 1 in a bus driver who used water for hand and face washing from a bus water storage tank. The history of any other usual place of exposure to Legionellae was negative. The water from the tank was dirty, filled with sediment and leaves, at the temperature of 22 degrees C. The water was heavily contaminated with Legionella pneumophila serogroup 1 isolated from each sample with the concentration of 66,000, 16,000, 42,000, 56,000 and 34,000 CFU/L. The disinfection of the bus water storage tank was made using hyperclorination with 50 mg/L of free residual chlorine. The control sampling one week after the disinfection yielded negative results. So far, there are no recommendations on regular management or disinfection of water in bus storage tanks, but it seems to be reasonable to assume that passengers as well as bus drivers may be exposed to Legionella and therefore at risk of acquiring the infection. These recommendations should include regular empting, rinsing and filling the tank with fresh tap water, at least once a week. Finally, we have to be aware that Legionella bacteria are ubiquitous and any potential mode of producing contaminated aerosol should not be overlooked during an epidemiological field investigation and proposed appropriate measures.

The burden of hospitalised carcinoma patients in Osijek-Baranja County, Croatia, 1998-2010.

The purpose of this paper was to determine the number and trend of hospitalisations caused by carcinoma in the Osijek-Baranja County, to to determine the proportion of these hospitalizations compared to all other hospitalization, as well as to determine the burden put on the hospitals by external patients (those not residing in the Osijek-Baranja County area). There has been an average of 10.1% of hospitalisations caused by carcinoma in the Osijek-Baranja County from 1998 to 2010. In the aforementioned period there have been an average 15.9% days of hospitalisation caused by carcinoma. Patients hospitalised due to carcinoma stay in hospital 5.3 days longer than other patients. The number of hospitalisations as a whole, as well as those due to carcinoma, is rising, while the number of days of hospitalisation per patient is decreasing. The number of hospitalisations which refer to men is slightly higher than for women (51.2%:48.8%). Almost one third of patients hospitalised are not residents of the Osijek-Baranja County due to a gravitational hospitalisation instance. Residents of northern Bosnia and Herzegovina are the most common patients being treated in our county. This burden has to be taken in to account when planning our health care due to the geographically, economically and politically specific situation of Osijek-Baranya County. This data has to be taken in to account when further planning our health care, as to relieve the acute medical situation hospitals of some of their burden, as well as to provide adequate care to patients suffering chronically from carcinoma. It is especially important to stress out that our county does not have a palliative care facility, nor a hospice for the terminally ill.

Malignant neoplasms of digestive organs (C15-C26) in the Osijek-Baranja County, Croatia.

The Institute of Public Health for the Osjek-Baranja County (OBC) has processed the data on cancer patients that were collected from mandatory county hospitals data reports, county bureaus of statistics and the County Register of Deaths. The cancers were defined according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), codes of malignant neoplasms of digestive organs (C15-C26). The aim of this article is to show the size of the problem and the burden of the health care system caused by cancers of the digestive system (C15-C26) in the OBC in the period 2001-2006. This article deals with cancer incidence and mortality data, appertaining age distribution, cancer survival, median age at diagnosis and at death and length of stay in hospitals. The overall incidence and mortality rate from cancer group C15-C26 (101.1 and 80/100,000, respectively, EU standard population) declined in all age groups, comparing the data originating from the 2001-2003 period to the data referring to the 2004-2006 period. The median age at diagnosis of cancer was 67.8 years with a shift of 0.91 year up in second period (the median age in the first period was 67.3 years and in the second one 68.2 years). The median age at diagnosis of cancer in females was 69.7 years while in males was 66.3 years, which represents a difference of 2.9 years in favour of females. The overall relative survival rate of all ages was 23.6%. This figure was slightly bigger for females (24.3%) than for males (23.1%). Concerning all age groups, the number of hospital admissions of males increased during the observation period while the number of hospital admissions of women decreased at the same time. The average length of stay over the six years did not changed significantly. Group of cancer C15-C26 was the most common group of cancers regarding both genders. The five-year relative survival as one of the reliable benchmarks of the quality of the health care system needs to be raised to a great extent in order to come nearer to the EU average within a short period of time.

First six years of implementing colorectal cancer screening in the Osijek-Baranja County, Croatia--can we do better?

The primary goal of this paper is to evaluate the efficiency of the Colorectal Cancer Screening Program in the Osijek-Baranja County. The screening method for early detection of colorectal cancer was the guaiac Faecal Occult Blood Test (gFOBT) and colonoscopy for gFOBT positive finding. The target population were asymptomatic subjects at average risk, aged 50-74. The responding rate was 20.3% (14.9% of men and 19.3% of women). The percentage of gFOBT positive tests was 8.5% (11.2% of men and 6.6% of women). From the 1,657 individuals who were invited to further assessment (884 men and 773 women), 1,157 underwent a colonoscopy exam (649 men and 508 women). We can conclude that the response to FOBT in our county was extremely poor. 83 carcinomas were found, with almost double findings among men than among women. Our population has a significantly higher number of men with malignant and premalignant changes when compared with women. Considering the higher incidence among men, as well as an increase in incidence in the entire population, we have to take care that our public health programmes are being created with this taken into account, as to increase the response rate, especially among those with a higher risk of developing a disease.

Heavy metals and metalloid content in vegetables and soil collected from the gardens of Zagreb, Croatia.

Aim of this study was to determine concentration of Pb, Cd, As and Hg in green leafy vegetables and soil in the urban area of Zagreb, Croatia and to determine if there is a connection between the contamination of soil and vegetables. Green leafy vegetables and soil samples were taken from the gardens located in the outskirts of the city. Concentrations of Pb, Cd, As and Hg were determined by atomic absorption spectrometry; showing that average concentrations of metals and metalloids in vegetables and in soil, regardless of the location of sampling were below the maximum allowed concentration (MAC). The analysis determined that metal concentrations in only nine vegetable samples (9%) were above maximum allowed values prescribed by national and European legislation (three with higher concentrations of Pb, one with a higher concentration of Cd and five with higher concentrations of Hg). Concentrations of contaminants present in the analysed samples, in general, are lower than the ones published in similar studies. The final distribution and concentration of contaminants in vegetables of Zagreb, besides industry and traffic, is affected by the dominant wind direction.

Effects of magnesium, chromium, iron and zinc from food supplements on selected aquatic organisms.

The aim of this study was to determine the effect of uncontrolled environmental disposal of food supplements containing magnesium (Mg), chromium (Cr), iron (Fe) and zinc (Zn) on selected aquatic organisms including freshwater algae Scenedesmus subspicatus and Raphidocelis subcapitata, water flea Daphnia magna and duckweed Lemna minor. Thirty different food supplements containing Mg, Cr, Fe and Zn were analyzed. Results were expressed as effective concentration 50 (EC50), i.e. growth inhibiting Mg, Cr, Fe and Zn (mg/L) concentration immobilizing 50% of treated organisms. Particular metal EC50 differed significantly (p < 0.001) among study organisms, as follows (in ascending order): Scenedesmus subspicatus EC50 Fe (median 46.9 mg/L) < Zn (59.8 mg/L) < Mg (73.0 mg/L) < Cr (88.1 mg/L) (KW-H(3;120) = 36.856; p < 0.001); Raphidocelis subcapitata EC50 Fe (median 44.9 mg/L) < Zn (52.6 mg/L) < Mg (62.2 mg/L) < Cr (76.8 mg/L) (KW-H(3;120) = 44.0936; p < 0.001); Daphnia magna EC50 Zn (median 59.4 mg/L) < Cr (79.2 mg/L) < Fe (80.8 mg/L) Mg (82.0 mg/L) (KW-H(3;120) = 39.2637; p < 0.001); and Lemna minor EC50 Zn (median 131.0 mg/L) < Fe (186.8 mg/L) < Mg (192.5 mg/L) < Cr (240.4 mg/L) (KW-H(3;120) = 58.6567; p < 0.001). Uncontrolled environmental disposal of food supplements containing Mg, Cr, Fe and Zn exerts adverse effects on aquatic organisms. Therefore, legal provisions should regulate both the utilization and disposal of food supplements into the environment.

Detection of thallium and uranium in well water and biological specimens of an eastern Croatian population.

Abstract Using inductively-coupled plasma mass spectrometry (ICP-MS), we measured the concentrations of thallium and uranium in local water resources from three villages (Celije, Draz, and Potnjani) in eastern Croatia, with the aim to determine if they were associated with the levels of these same elements in the serum, urine, and hair collected from the residents of this area. The exposure of the local population to thallium and uranium through drinking water was generally low. ICP-MS was capable of measuring the levels of both of the elements in almost all of the analysed samples. Although there were differences in the concentrations of both elements in water samples and biological specimens taken from the residents, they did not reach the maximum contaminant level in any of the four sample types studied. Although hair was previously reported as an excellent indicator of occupational and environmental exposure to various elements, our study did not confirm it as a reliable biological material for tracing thallium and uranium levels, mainly due to the very low concentrations of these elements, often well below the detection limit. However, our results have shown that the concentration of thallium and uranium in drinking water can be effectively traced in urine samples.

Chemometric analysis of groundwater quality data around municipal landfill and paper factory and their potential influence on population's health.

AIM: To assess the level of 15 groundwater quality parameters in groundwater samples collected around municipal landfill and paper factory in order to evaluate usefulness of the groundwater and its possible implication on the human health. METHODS: Obtained data have been analyzed by principal component analysis (PCA) technique, in order to differentiate the groundwater samples on the basis of their compositional differences and origin. RESULTS: Wastes and effluents from municipal landfill did not contribute significantly to the pollution of the aquatic medium. Groundwater degradation caused by high contents of nitrate, mineral oils, organic and inorganic matters was particularly expressed in the narrow area of the city centre, near the paper factory and most likely it has occurred over a long period of time. The results have shown that the concentrations of the most measured parameters (NO3-N, NH4-N, oils, organic matter, Fe, Pb, Ni and Cr) were above allowed limits for drinking and domestic purposes. CONCLUSIONS: This study has provided important information on ecological status of the groundwater systems and for identification of groundwater quality parameters with concentrations above allowable limits for human consumption. The results generally revealed that groundwater assessed in this study mainly does not satisfy safe limits for drinking water and domestic use. As a consequence, contaminated groundwater becomes a large hygienic and toxicological problem, since it considerably impedes groundwater utilization. Even though, all of these contaminants have not yet reached toxic levels, they still represent long term risk for health of the population.

Objective identification of sexual risk behavior among blood donors in Croatia: is it reality?

BACKGROUND: The objective of this study is to determine the prevalence of blood donors positive for herpes simplex virus type 2 (HSV-2), to identify the patterns of sexual risk behavior responsible for HSV-2 positivity and to assess the reliability of HSV-2 positivity as a marker of sexual risk behavior in the study population. METHODS: This cross-sectional study included 423 blood donors of both sexes from eastern Croatia. Their blood samples were tested by ELISA IgG test kit for HSV-2 IgG and Western blot. Data on sexual risk behavior were collected by use of an anonymous questionnaire. RESULTS: Western blot testing showed HSV-2 IgG antibodies in 14 of 423 (3.3%) donor blood samples. The most common patterns of sexual risk behavior potentially associated with test positivity were irregular condom use during sexual intercourse with new partners (294/423; 69.5%) and > or = 5 sexual partners during lifetime (213/423; 50.4%). CONCLUSIONS: The population of blood donors from eastern Croatia included subgroups of subjects characterized by sexual risk behavior. Study results pointed to a relationship between various forms of sexual risk behavior and HSV-2 positivity, which could therefore serve as a reliable marker of sexual risk behavior in the study population.

Changes in the lower Drava River water quality parameters over 24 years.

The goal of this study was to analyse 13 physico-chemical and microbiological parameters of the Drava River water at three sampling sites in the lower Drava region (eastern Croatia) over two distinct periods: the pre-war period between 1985 and 1992 and the post-war period between 1993 and 2008. Over both periods, most parameters kept within the tolerable water quality limits, while NO3-N, NH4-N and BOD5 were higher. The lower Drava showed slight organic pollution with high concentrations of dissolved oxygen. High levels of total coliforms and heterotrophic bacteria in the post-war period were only found downstream of the town of Osijek. Upstream of Osijek, the river showed a tendency for improvement.

Sexual behaviour of Croatian blood donors as a threat to the health of blood recipients.

BACKGROUND: In this cross-sectional study we assessed the prevalence of the various blood safety sexual risk behaviours among blood donors from East Croatia and the possibilities for improving the present blood donor screening procedure. MATERIALS AND METHODS: The study included 423 blood donors of both sexes who completed a specially designed anonymous questionnaire immediately after their blood donations. The questionnaire contained questions on demographic data, sexual preferences, and possible sexual risk behaviours in the period before the blood donation. RESULTS: The study revealed that the most common forms of sexual risk behaviour among Croatian blood donors had been irregular condom use during sexual contacts with new partners (294/423; 69.5%) and five or more sexual partners during the lifetime (213/423; 50.4%). More male than female subjects had had five or more sexual partners during their lifetime (p<0.0001). Compared to married donors, single subjects more frequently reported sexual contacts without using a condom with their new partners in the period from the last blood donation (p<0.0001) and also in the period of 1 month before current blood donation (p=0.0060). A larger number of younger than older subjects had practiced different types of sexual intercourses during the lifetime (p=0.0002) but more older than younger subjects reported irregular use of condom on sexual contacts with a new partner during their lifetime (p=0.0231). CONCLUSION: Blood donors who were involved in various forms of sexual risk behaviour represent a serious threat to the health of blood recipients. In this respect a new approach to blood donor screening procedure with additional questions on sexual behaviour in anonymous donor questionnaires would improve the safety of transfusion treatment in East Croatia.

Prevalence and significance of vaginal group B streptococcus colonization in pregnant women from Osijek, Croatia.

The aim of the study was to determine the prevalence of vaginal group B streptococcus (GBS) colonization in pregnant women from Osijek area, the possible effect of GBS colonization on pregnancy outcome and neonatal complications and the role of intrapartum prophylaxis in this context. This retrospective case-control study took place at the Department of Gynecology and Obstetrics, Osijek University Hospital Center from December 2003 to June 2006. A total of 118 pregnant women was enrolled in study and divided into two groups: 59 women in 35th-37th week of gestation, free from risk factors for infection (control group); and 59 women in 25th-41st week of gestation with risk factors for infection. Low vaginal swab for GBS isolation and identification on selective and enriched medium was obtained from each woman. GBS colonization was recorded in 29 (24.6%) women: 12 (20.3%) control and 17 (28.8%) women at risk of infection, yielding a statistically non-significant difference (Chi2 = 1.480489; p < 0.48). Early neonatal infection was observed in six (20.7%) neonates born to 29 mothers with GBS colonization, pointing to a correlation between vaginal GBS colonization and early neonatal infection (r(s) = 0.99). Early perinatal infection was found in 22 (18.6%) neonates, including 17 (28.8%) pregnancies with risk factors, pointing to a significant correlation between vaginal GBS colonization, risk factors and early perinatal infection (Chi2 = 88.68; p < 0.001); however, gestational age and pregnancy outcome were not influenced by GBS colonization. In eight (36.4%) newborns, early neonatal infection developed in spite of intrapartum administration of antibiotics; three of these children were born to GBS positive mothers, and perinatal GBS infection was demonstrated in one (0.84%) child. Study results revealed a relatively high rate of GBS colonization in the population of pregnant women in Croatia, occasionally leading to early neonatal infection. Large studies are needed to develop national strategy for the prevention of GBS infection in Croatia.

An analysis of the pollution problem in Slavonski Brod (eastern Croatia).

H2S, PM2.5, O3, NO2, SO2 and meteorological parameters such as temperature, relative humidity, precipitation, wind speed and wind direction were measured simultaneously in an eastern Croatian town called Slavonski Brod during the season winter/spring 2010. Emissions from the nearby cross-border (Bosnia and Herzegovina) oil refinery were identified as sources of temporary elevated concentrations of H2S. The maximum daily averages of PM2.5 concentrations during the winter period were as high as 240 microg m(-3) which is a value 10 times greater than the threshold prescribed by the World Health Organization. It is considered that the heating season, dense traffic, intense industrial activities and temperature inversion during stable weather conditions are prevailing contributors to higher winter concentrations of PM2.5. The results of the principal component analysis technique (PCA) have shown that lower air temperature, lower wind speed and higher relative humidity play a significant role in the winter pollution episodes. From a public health point of view, implementation of measures aimed at reducing the levels of H2S and PM2.5 should be considered.

Enuresis in school children from eastern Croatia.

The aim of this study was to establish the prevalence of nocturnal incontinence (NI) in 6-to-7-year-old children from eastern Croatia, to determine the factors associated with NI and to evaluate parental perception of the problem. From May to September 2004, the parents of 3,011 children were asked to complete an anonymous validated questionnaire. The overall prevalence of reported NI was 1.2% (35/3011). All of the cases were cases of secondary NI. NI was significantly more frequent in boys than in girls. Family history of enuresis was present in 68.6% (24/35) of enuretic children. Only 17.1% (6/35) of parents expressed some concern about the effect of the researched problem on their child's future development. The frequency of NI in this study group is much lower than that reported in other European countries. The reason for this is still not known, although parental perception of this problem is certainly a significant factor. Further investigations are needed.