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The Northern Research Area
Research activity in the Barents region has developed rather recently, and it is still increasing in volume.
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The Russian-Norwegian border is said to represent the largest difference in economic living standards seen in the world between two countries. Many research projects have been launched.
Nickel Research
An initiative was taken by the Ministry of Environment in both countries to explore the possible effects of air pollution from the nickel industry on the Russian side. The Health Group of Norwegian and Russian scientists, headed by the ISM, was founded in 1991, and carried out a health study in the Norwegian-Russian border area. Altogether 3,671 and 3,731 persons from the Norwegian and Russian sides of the border participated, respectively. Human urinary nickel levels were substantially higher on the Russian side, and highest in the vicinity to the nickel smelters. Despite that, the Russian women had a lower prevalence of nickel allergy. Lung function was better than predicted for both groups. No associations between sulphur dioxide concentrations in air and lung function could be verified. The study revealed no major health effects from the nickel and sulphur dioxide pollution on either side of the border.
Pollution and pregnancy outcome
At the same time, a study was initiated at ISM to assess the health condition of 630 pregnant women and the pregnancy outcomes in the Russian-Norwegian Barents area (Finnmark, Kola Peninsula, Arkhangelsk). Maternal blood lead concentrations and placental lead had a negative impact on birth weight, while associations for other toxic elements, like nickel in urine, could not be demonstrated. However, the significantly lower birth weights and child’s body mass index (BMIC) on the Russian side suggested that malnutrition during pregnancy might have occurred. Blood lead concentrations above the level of medical concern were also observed in children living in remote areas of the Kola Peninsula.
The AMAP programme
The study of pregnancy outcome from 1995 on became a core component of AMAP (Arctic Monitoring and Assessment Programme), which involves the cooperation of eight circumpolar countries. Special attention is paid to the indigenous people of the north. The second AMAP phase comprises further studies on the high risk populations defined after the first phase (1995-1998), namely isolated communities in Siberia and the Russian Far East. The study is done in close cooperation with Russian scientific institutions.
Pregnancy outcome and Birth Registries
A comprehensive reproductive study of nickel refinery workers has been initiated in cooperation with Russian and Canadian scientists, as well as the National Institute of Occupational Health, Oslo and the Reproductive Health Assessment Section, National Institute for Occupational Safety and Health, USA. Individual exposure assessments have been completed in support of a pregnancy outcome study, and a birth registry has been set up, including all mother/child pairs retrospectively back to 1973. The registry will be employed to study congenital defects in Monchegorsk, especially in children of nickel refinery workers. It is developing to be an important tool for the assessment of factors influencing pregnancy outcome of the area, and to date includes 22,155 records. The registry design is now adapted by the Russian Federation for implementation in other areas. A Norwegian/Russian intervention study of pregnancy care in Monchegorsk, run by the ISM, is now being evaluated through the birth registry, demonstrating a reduction in perinatal mortality and morbidity over the last five years. Collectively, the ISM/Russian public/environmental/occupational health projects have resulted in over 25 research publications, two completed PhD theses, and two in progress.
Alcohol consumption
Financed by the Research Council of Norway (project title “Alcohol Drinking and its Impact on the Health in the North-West of Russia”) and in cooperation with The Northern State Medical University and The Semashko Policlinic, ISM launched The Archangelsk Study in 2000. Between November 1999 and the end of 2000, 4,089 men and women at all ages participate in a cross-sectional health study. Blood pressure, heart rate and body size were measured, and a six-page questionnaire on several health issues was administered. Blood tests were drawn for parallel laboratory analyses of more than 20 parameters in Arkhangelsk and Tromsø. Some twenty articles from this study have been published, one doctoral thesis has been completed, and another is in progress. A “Death and Disease Register” for this study population is currently in preparation, allowing us to monitor the health situation and to establish valid endpoints for further longitudinal analyses.
Developing Community Medicine
“Development of Community Medicine in Northwest-Russia” is a project funded by the Barents Health Programme. The project has three components: 1) provide primary health care to the target population; 2) provide education in general practice and public health to the doctors providing the service, and; 3) developing practice profiles based on the practice encounters. The Practice Profiles component is serving as bases for the need assessment in education in general practice, and for international comparative studies of performances in practice. The profiles are used to tailor specific clinical courses. The Practice Profiles are registered in Russia, Norway and Armenia, and the first comparative studies from the profiles will be presented in May 2003 in Tromsø.
Sami Health Research
For several decades researchers have raised questions about health and diseases among the Sami population, the Norwegian indigenous people. While settled in Northern Norway, as reindeer breeders they move freely into Sweden and Finland. In 2001 the Minister of health gave the University of Tromsø resources to initiate a Centre for Sami Health Research, which is a multidisciplinary centre. As their first major investigation a health screening study combined with research started January 2003 in collaboration with the National Institute of Public Health. During 18 months altogether 30,000 men and women living in areas of Northern Norway with mixed populations of Sami and Norwegians will be invited. The study focuses on ethnicity in connection with self-reported health and life style factors. By linkage to national registers, follow-up will be performed for cancer incidence and mortality. A bio-bank will be set up at ISM, and a common steering committee with a member also from the Sami parliament will be responsible for the use of all collected material.
Youth Study
In cooperation with The National Institute of Public Health, the Centre for Sami Health Research will conduct The Youth Study of adolescents’ health and living conditions in Northern Norway. The study includes adolescents from the indigenous Sami and the Norwegian population and will include about 5,600 students in junior high school, aged 15 years. The study consists of a questionnaire study, conducted at the schools, and health examinations with blood tests of a random sample. A particular focus of the study is the influence of ethnic and cultural conditions on mental and physical health.
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