200
State of the environment report of Bosnia and Herzegovina 2012
Number of cases
5000 4500 4000 3500 3000 2500 2000 1500 1000 500
TOTAL
New cases pulmonary MTB positive
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
New cases pulmonary MTB negative
New cases with unknown/undetermined MTB finding
4.5.6
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
0
1986
Figure 144: Number of tuberculosis cases by year and by smear-positive status in BiH from 1985 – 2010 (Source: WHO, BiH Country data, 2012)
Other new cases
New cases with extrapulmonary TB
Respiratory diseases caused by polluted air
Although air pollution has been monitored for many years, correlation between any assumed increase in the number of affected people and increased pollution (increase in SO2, NO2 and smoke in the air, particularly in the three most polluted cities in BiH – Sarajevo, Tuzla and Zenica) was not calculated. The main reason is unreliable statistical data on the number of affected persons and on population at risk. Standard diagnostic classification of diseases that are being monitored is carried out in all three administrative units in BiH in line with the regulations on combating infectious diseases (common regulations at BiH level are missing), which means that all other diseases and conditions are monitored in public health reports. The network of public health data collection systems is not functional enough, so relevant data collecting is often difficult or data are not available for analysis to administrative units in the country. Only estimates can be given instead. Because of that, air pollutants as causative agents cannot be linked with respiratory diseases, although many factors indicate that the number of such cases is high.
4.5.7 Diseases caused by radiation or any other environmental risk factor Unfortunately, the health system does not recognize the diseases and conditions which belong to this group. A register of malignant diseases exist only partially in the RS, while the FBiH has only just started establishing it. However, even if the register existed, proving the change in frequency compared to the pre-war period would be very complicated because of three main facts: International Classification of Disease was changed at the beginning of 1990s (ICD 10 replaced ICD 9), and 10th revision has been in use in BiH since 1995; Significant processes of migration occurred in BiH – immigration, internal displacement and emigration significantly changed all demographic categories; The last census in BiH was carried out in 1991, and there has not been one since.