Vol. 12 No. 3 (2020): Archives of Public Health
Public Health

Systematic review and comparative analysis of current methodological approach for risk assessment of “Ohis Plant Skopje”

Sandra Kosteska
Institute for Accreditation of the Republic of North Macedonia
Dragan Gjorgjev
Institute of public health of Republic of North Macedonia; Medical Faculty, University Ss Ciril and Methodius, Skopje, Republic of North Macedonia

Published 2020-12-15


  • health impact assessment,
  • health risk assessment,
  • industrially contaminated sites,
  • epidemiological studies,
  • exposure assessment

How to Cite

Kosteska S, Gjorgjev D. Systematic review and comparative analysis of current methodological approach for risk assessment of “Ohis Plant Skopje”. Arch Pub Health [Internet]. 2020 Dec. 15 [cited 2021 Dec. 7];12(3):16-29. Available from: https://id-press.eu/aph/article/view/5654


Considering complicity in ecological health and social aspects of industrial contaminated sites (ICSs), the methodologies and approaches of health impact assessments are very heterogeneous. ICSHNet together with WHO recommend two main methodological approaches: health risk assessments and epidemiological studies. Some countries have necessary experience for impact assessment of ICSs, but others have limited resources and less intensity studies. In the Republic of North Macedonia, 16 ICSs are identified, but one of them, lindane dumpsite in OHIS Plant is characterized as the most ecological and public health risk. The general aim: Systematic review of literature data about methodological approaches for health risk assessment of ICSs on international and national level in order to make comparative analysis of current methodological approaches in the Republic of North Macedonia using the case study of ICS OHIS PLANT SKOPJE. Material and methods: The review of scientific and grey literature was performed. The selected scientific studies were searched in the PubMed and Medline databases from 2000-2017, in English and Macedonian. The selected studies and data were analyzed by required information for identification of hazards, exposure assessment and risk characterization. Additionally, the review was performed on published reports of risk assessment of OHIS Plant. Results: A total of 14 original papers were investigated. Continuous monitoring systems for gathering environmental data related to ICSs were used only in two cases and in other studies the concentrations of contaminants in the source were calculated or several ad hoc monitoring campaigns were performed. Exposure assessment was conducted according to qualitative definition for the presence/absence of a source, distance to a source and biomonitoring in the study. Mortality, cancer incidence, congenital abnormalities and hospitalizations were used health data. The study of risk assessment of OHIS Plant has ecological design and indirect quantitative exposure assessment model was used. Conclusion: All investigated studies used three main methodological approaches for exposure assessment: measurement of hazard concentration, distance from source and biomonitoring. Comparable, conducted risk assessment of OHIS Plant follows the recommendations of US EPA and ATSDR with weakness of no existing continual monitoring process and also deficiency of health data and this is the reason for limitation of health impact assessment and setting up EPHT or other public health surveillance system.


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