Chapter 16: Community Health, Safety and Security
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Table of Contents
16 Community Health, Safety and Security ...... 16-1 16.1 Introduction ...... 16-1 16.2 Scoping ...... 16-1 16.2.1 Issues and Population Groups Scoped In ...... 16-2 16.2.2 Issues Scoped Out During the Assessment Stage ...... 16-4 16.2.3 Differences in Scope between EIA and ESIA ...... 16-6 16.3 Spatial and Temporal Boundaries ...... 16-10 16.3.1 Project Description ...... 16-10 16.3.2 Project Location ...... 16-12 16.3.3 Study Area ...... 16-12 16.3.4 Survey of Sites Subject to Health Protection ...... 16-12 16.4 Methodology and Data...... 16-15 16.4.1 Primary Data and Surveys ...... 16-15 16.4.2 Secondary Data ...... 16-16 16.4.3 Stakeholder Engagement ...... 16-16 16.4.4 Data Assumptions, Limitations and Gaps ...... 16-19 16.5 Community Health, Safety and Security Baseline ...... 16-20 16.5.1 Demographic Community Profile ...... 16-20 16.5.2 Morbidity, Incidence and Prevalence of Disease ...... 16-20 16.5.3 Mental Health ...... 16-25 16.5.4 Baseline Data by Determinant of Health ...... 16-26 16.5.5 Emergency and Disaster Response ...... 16-34 16.6 Legal and Policy Context ...... 16-34 16.6.1 IFC Performance Standards ...... 16-34 16.6.2 National Legislation ...... 16-36 16.7 Impact Assessment Methodology ...... 16-40 16.7.1 Methodology ...... 16-40 16.7.2 Determinants of Health ...... 16-41 16.7.3 Receptor Sensitivity ...... 16-41 16.7.4 Impact Magnitude ...... 16-43 16.7.5 Impact Significance Criteria ...... 16-44 16.7.6 Impact Mitigation ...... 16-45 16.8 Assessment of Potential Impact: Community Health, Safety and Security ...... 16-46 16.8.1 Impact Assessment: Construction and Pre-Commissioning Phase ...... 16-49 16.8.2 Impact Assessment: Operational Phase ...... 16-79 16.8.3 Impact Assessment: Decommissioning Phase ...... 16-83 16.9 Unplanned Events ...... 16-84 16.10 Cumulative Impacts ...... 16-84 16.11 Conclusion ...... 16-84
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Tables
Table 16.1 Mortality and Health Indicators, Selected Years ...... 16-21
Table 16.2 Adult and Infant Mortality Rates (Per 1,000 People) for Bulgaria and Varna Region, 2005-2011 ...... 16-21
Table 16.3 Main Causes Of Mortality in Bulgaria and Varna Region (Per 100,000 People per Year), 2011 ...... 16-22
Table 16.4 Incidence of Sexually Transmitted Infections (Cases per 100,000 People), 2008-2010 ...... 16-24
Table 16.5 Number of Physicians per 10,000 Residents in District Varna Municipality Asparuhovo (Data from RHI-Varna on 26.08.2013) ...... 16-32
Table 16.6 Determinants of Health ...... 16-41
Table 16.7 Receptor Sensitivity Criteria for Community Health and Safety ...... 16-42
Table 16.8 Impact Magnitude Criteria ...... 16-44
Table 16.9 Significance Matrix ...... 16-45
Table 16.10 The Mitigation Hierarchy Defined for Community Health and Safety ...... 16-45
Table 16.11 Potential Impacts Discussed in Other ESIA Chapters and Scoped Out the of the Community Health, Safety and Security Assessment ...... 16-47
Table 16.12 Noise Levels Generated by Transport Noise from New Access Road ...... 16-55
Table 16.13 Pre-Commissioning Phase of South Stream Offshore Pipeline Residual Levels with Barrier ...... 16-57
Table 16.14 Noise Levels Generated by Marshalling Yard Activity (Varna East) ...... 16-60
Table 16.15 Noise Levels Generated by Construction Activities (Including Microtunnelling) . 16-60
Table 16.16 Summary –of Residual Impacts during Construction and Pre-Commissioning Phase ...... 16-74
Table 16.17 Summary of Residual Impacts during Operational Phase ...... 16-82
Figures
Figure 16.1 National, Regional, Municipal and Local Community Context of the Project ...... 16-13
Figure 16.2 Survey to Identify Health Protected Sites ...... 16-17
Figure 16.3 Bathing Water Quality Test Sites and Data for 2012 ...... 16-31
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Figure 16.4 View from New Access Road Route (Left) to Nearest Residential Receptors at Priseltsi VZ (right) ...... 16-56
Figure 16.5 Transport Hospital Varna Location Relative to ESIA Noise and Vibration Assessment Receptors around Varna East Marshalling Yard ...... 16-59
Figure 16.6 Junction of (Currently Unsurfaced) Access Road and Krushkite Road ...... 16-63
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16 Community Health, Safety and Security
16.1 Introduction This chapter presents the potential health and safety impacts arising from Project-related activities, as well as Project security as it pertains to communities. This chapter forms part of the Environmental and Social Impact Assessment (ESIA) Report of the Bulgarian Sector of the South Stream Pipeline that will deliver natural gas from Russia to the countries of central and south-eastern Europe (‘the Project’).
The community health, safety and security chapter considers the potential health impacts to national, regional and local population groups, including particularly vulnerable groups who may be disproportionately affected. The occupational health and safety assessment is included as Appendix 16.1: Occupational Health and Safety and considers the potential health impacts to the Project’s workforce and the regulatory framework that governs safe working practices.
The approach has been guided by relevant legislative and policy requirements; including the International Finance Corporation (IFC) guidance on Health Impact Assessment (HIA) (Ref. 16.1). For example the approach addresses the two key characteristics required by the IFC guidance, namely: predicting the consequences of Project-related actions; and providing information that can help decision makers prioritize prevention and control strategies throughout the Project cycle. This has been achieved through: a scoping exercise examining the potential impacts of Project activities; a review of existing baseline health and safety conditions and key trends; evaluation of community views from stakeholder engagement; and a health assessment to classify potential health risks before and after the application of mitigation measures. This chapter has been prepared alongside other assessments that make up the ESIA Report. Where appropriate, this assessment has used relevant data or modelling from other ESIA chapters, as well as information from consultation findings as described in Section 16.4.3.
The consideration of the potential health impacts to the Project’s workforce and the regulatory framework that governs safe working practices is assessed in Appendix 16.1. An alternative approach has been taken for occupation health and safety which recognises that throughout the Project the workforce will be exposed to a number of different hazards and associated risks. The occupational health and safety issues identified in the scoping stage have been grouped against global accident data categorisations. The occupational health and safety assessment in Appendix 16.1 discusses these categories with Project-specific links where appropriate. Occupational health and safety mitigation considers the due diligence requirements that the Project will need to meet. This more strategic approach for occupational health and safety reflects that the detailed occupational health and safety regulatory regimes will properly be addressed through Project and contractor management plans and systems.
16.2 Scoping A general Scoping Report for the international ESIA process for the Project was disclosed in Bulgaria in December 2012 and January 2013. Disclosure of the report was followed by a series of meetings with a range of stakeholders January to March 2013 including Local Communities,
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non-governmental organisations and local authorities. A number of comments regarding community health and safety were made during this period (Section 16.4.3) and these informed the subsequent health studies and the content of this chapter.
An internal Health and Safety Scoping Assessment Report (Ref. 16.2) was prepared in 2013 to focus on community health, safety and security issues which, following IFC Performance Standards (PS) and guidance, more specifically identified sources of exposure and risk for communities and workers during the various phases of the Project. A discussion of the issues considered and the scoping rationale for including or excluding each issue from the main assessment are contained in the Health and Safety Scoping Assessment Report, which has informed this chapter. An outline of the issues which are referred to in other chapters is summarised in Section 16.8 and described in Table 16.11. The issues scoped in are discussed throughout the remainder of this chapter.
16.2.1 Issues and Population Groups Scoped In
The Scoping Stage examined the ways in which the Construction and Pre-Commissioning, Operational and Decommissioning Phases of the Project may affect health and safety. Issues identified as having the potential to give rise to community- and population-level health impacts have been taken forward for further assessments. The scoping exercise also reviewed the input of key stakeholders and relevant health authorities. Key activities of this stage included:
• Identifying legislative requirements; • Gathering and reviewing relevant project information; • Evaluating health context, including consideration of: location; climate; endemic diseases and influx;
• Reviewing project design, including consideration of: water bodies; roadways; pipelines; construction camps; operational facilities; sources of potential exposure; and transmission- line corridors;
• Identifying potentially impacted geographic areas and potentially affected communities; • Identifying key stakeholders; • Setting the geographical, time scale, and population boundaries of the assessment; • Determining the assessment approach; and • Collecting baseline data including:
o Evaluation of existing Bulgarian publication data; o Evaluation of data from key stakeholders; and o Evaluation of data from other ESIA Report chapters. In determining the potential health impacts of the Project, the scoping exercise used the World Health Organization’s (WHO) definition of health: ‘Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’ (Ref. 16.3). Factors that affect health are called the ‘determinants of health’. The IFC defines these as: ‘individual; social
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and environmental; and institutional factors, which are directly, indirectly, or cumulatively affected by the proposed project’ (Ref. 16.1).
The scoping exercise uses the four ‘determinants of health’ themes (individual, social, environmental and institutional factors) to provide a practical framework in which to summarise the areas scoped in for further assessment. Populations with the potential to be disproportionately affected were considered under the ‘individual’ heading during the scoping exercise. Such ‘vulnerable groups’ are discussed where relevant as part of the assessment of the issues listed under the other determinate headings. For this reason the ‘individual’ heading does not form a separate category. The issues scoped in for further assessment are listed below under the remaining headings. These are the issues that form the focus of the community health, safety and security assessment (see Section 16.8). The brackets after each issue identify whether the effect falls primarily during the Construction and Pre-Commissioning Phase [construction], Operational Phase [operation] or Decommissioning Phase [decommissioning].
16.2.1.1 Social Factors • Conduct of workforce in the community [construction]; • Spread of sexually transmitted infections (STIs) due to in-migration of non-local workers [construction];
• Employment opportunities for the local population [construction]; and • Public anxiety over large volumes of gas close to local communities [operation].
16.2.1.2 Environmental Factors • Construction noise impacts from vehicles, plant and vessels [construction]; • Road transport impacts, particularly heavy goods vehicles (HGVs) [construction]; and • Mobilisation of historic seabed pollutants during trenching and microtunnelling [construction].
16.2.1.3 Institutional Factors • Local health and emergency service resources due to in-migration of non-local workers [construction].
16.2.1.4 Unplanned Events • Uncontrolled gas release from pipeline or onshore facilities [operation].
The assessment uses the following population age categories when scoping potential health impacts:
• Children and infants < 5 years (childhood illnesses); • Children ages 5 to 14 years (older childhood and adolescent health effects); • Women of reproductive age; • Adults ages 15 to 64 (working adults); and
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• Elderly > 65 years.
16.2.2 Issues Scoped Out During the Assessment Stage
In addition to the issues which have been addressed in other chapters (Section 16.8), two issues (air quality and historic ground contamination) were initially scoped in to the health assessment but were later scoped out on the basis that no significant impacts were expected at the pre-mitigation stage. The following paragraphs summarise the scoping rationale for this decision.
16.2.2.1 Air Quality Impacts from Vehicles, Plant and Vessels
Air quality emissions from construction plant, vehicles and materials (including activities related to the construction of the landfall section of the Project and to the marshalling yards) have the potential to impact human health.
The baseline notes that air quality is poor in areas of the municipality of Varna, especially urban areas and transport routes, and that transport and the widespread use of solid fuels for domestic heating are the main sources of emissions. There is no baseline information about Priseltsi VZ (Municipality of Avren) but it can be assumed that there will be emissions arising from use of solid fuel for domestic heating.
Chapter 9 Air Quality concluded that road movements during construction will not give rise to significant impacts on nearby community dwellings. The assessment includes consideration of the residential receptors along the new access road at Priseltsi VZ. That assessment predicts an 3 estimated contribution from the access road to be approximately <0.7 μg/m for long term NO2 3 and <0.1 μg/m for long term PM10 concentrations. These values are below thresholds where significant health effects would be expected.
Chapter 9 Air Quality concluded that for all Construction and Pre-Commissioning Phase impacts on air quality, the impact significance is ‘Not Significant’ for human receptors. The assessment also concludes that it is not anticipated that any significant impacts to the ambient air quality conditions will arise from the Operational Phase (including commissioning) of the Project. Based on these findings, community health impacts are not expected as a result.
Nitrogen Dioxide
Health impacts associated with oxides of nitrogen may be delayed for one to five hours after inhalation and brief exposure to low concentrations can cause adverse health impacts. However, as determined by the air quality assessment (Chapter 9 Air Quality) the total predicted maximum permissible nitrogen dioxide concentration, including baseline, at the worst affected sensitive receptor (Pasha Dere Beach), is 15 µg/m3. This value is well below the reported threshold for adverse health impacts. The highest concentration at the closest residential receptor (a residential dwelling located approximately 1 km north of the Pipeline) is 0.9 µg/m3 for NO2). This is 2.2% of the long term national, European Union (EU) or IFC limits, which according to the Impact Magnitude criteria, is considered to be negligible in Magnitude. Furthermore, the modelling suggests a very low frequency of such events and a temporary
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duration. Based on these assessment findings, impacts from nitrogen dioxide have been scoped out.
Sulphur Dioxide
The air quality assessment (Chapter 9 Air Quality) concludes that the maximum predicted short-term impact magnitude at long-term susceptible receptors from certain pollutants, including sulphur dioxide, is less than 5% and therefore negligible. From the air quality assessment, the highest predicted sulphur dioxide concentration, including baseline, over a one hour period is a maximum concentration of 20.7 µg/m3. This is less than the concentration required to elicit an adverse health impact (even for a vulnerable individual, such as someone with asthma). Furthermore, the modelling suggests a very low frequency of such events and a temporary duration. Based on these assessment findings, impacts from sulphur dioxide have been scoped out.
16.2.2.2 Mobilisation of Historic Ground Contaminants during Site Clearance and Trenching
Chapter 8 Soils, Groundwater and Surface Water reports potential impacts and mitigations for occupational exposure to ground contaminants during site clearance and ground works. This chapter considers the potential for community exposure to ground contaminants from these activities. The exposure dose will generally be less than that of the workforce due to increased distance from the site of contamination; however, population sensitivities may be higher. Two issues were assessed before being scoped out: background radiation levels and soil contamination. These are discussed in the following paragraphs.
Background Radiation
Chapter 7 Physical and Geophysical Environment notes that background radiation levels associated with the terrestrial Survey Area were assessed during radiation surveys which indicate that background radiation levels within the terrestrial Survey Area meet the requirements of the Bulgarian Standards on radiation protection. Radiation levels measured in the soils do not pose a risk to human health in terms of radiation exposure. Based on these assessment findings, impacts on the community from radiation have been scoped out.
Soil Contamination
There is the potential for onshore site clearance and ground works to mobilise existing pollutants. Chapter 8 Soils, Groundwater and Surface Water states that elevated concentrations of contaminants that exceed published standards are known to occur in the soil within the soils Study Area albeit at comparatively low levels. The contaminants locally present in the soil may be harmful to human health under certain exposure scenarios. Chapter 8 Soils, Groundwater and Surface Water has concluded that with the following mitigation, which includes undertaking additional desk studies and intrusive investigations, residual impact on human health from soil-bound contamination is Not Significant. The assessment includes the provision that:
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• In the event that previously unidentified contamination is observed during construction, works in the affected area will cease, the area will be demarcated, material tested and appropriate mitigation measures designed in accordance with the Project Health, Safety, Security and Environmental Integrated Management System (HSSE-IMS) or an appropriate disposal process identified.
Based on these assessment findings, the mitigation related to soil contamination includes appropriate dust control measures (Chapter 9 Air Quality), it is unlikely that community impacts would arise. This issue has therefore been scoped out of further assessment in this chapter.
Chapter 5 Project Description sets out the modifications that are likely to be required at the marshalling yards. The preference to use existing port facilities for the marshalling yards means that minimal modifications to the port areas are required to prepare them for use as marshalling yards during pipeline installation. Chapter 8 Soils, Groundwater and Surface Water concludes that although the historic industrial use of the port area would indicate the potential for historic contamination, the absence of improvements requiring ground disturbance greatly reduces the potential for mobilisation of existing contamination at the marshalling yards. This issue is therefore not considered further. Should the situation change and ground disturbance be required for modifications to the port areas, further assessment will need to be undertaken Section 16.8.1.2).
16.2.3 Differences in Scope between EIA and ESIA
Some community health and safety issues were considered as part of the Bulgarian national EIA which have subsequently been scoped out of the Bulgarian ESIA community health, safety and security assessment. This partially reflects the slightly different methodology used to produce the two Reports, and partially the benefit of additional information to inform the scoping decisions for the ESIA Report. The methodological difference arises from the Bulgarian EIA considering the unmitigated impacts of other assessments and then providing conclusions based upon the residual impacts reported in those assessments. In contrast, the Bulgarian ESIA takes as its starting point the residual impacts of other assessments, and concludes with only new mitigation to supplement those mitigations, monitoring and design controls already identified by other assessments. This latter approach was adopted to reduce the repetition of mitigation measures already reported in other assessments. The following paragraphs identify and explain the specific variations in scope.
16.2.3.1 Waste and Fuel Leaks Scoped Out
Based on professional judgement, the mitigation measures already adopted by the Project adequately address the risks of potential contamination of soils or waters from waste or fuel leaks arising from the Project both on land and at sea. As further mitigation measures were considered unnecessary, this issue was scoped out of further assessment in this chapter. This outcome is consistent with the findings of the assessment included in the Bulgarian EIA Report.
• There are a number of activities during the Construction and Pre-Commissioning Phase of the landfall section that have the potential to generate waste. All wastes will be collected, stored and transported off-site in appropriate bins and containers in accordance with
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applicable European and Bulgarian waste policy. Only appropriately licenced companies will be employed for the transportation, recycling and disposal of waste. Spillage prevention, bunding and restrictions near drains, sensitive soils and water bodies will be implemented to avoid potential impacts. Material will be stored away from sensitive soils and water bodies where possible, with secondary containment;
• There will be dedicated plant and vehicle refuelling areas within the construction sites, which will be situated away from surface waters, groundwater and surface water drains. Fuel tanks will be double skinned. Secondary containment will be provided by forming an impermeable bund (i.e. a wall) around the refuelling area to provide containment in the event of a spill or rupture. Both storage tank and secondary bundling will have capacity to contain 110% of the volume of fuel being stored. Spill kits shall be kept in accessible locations at all times during construction, and employees trained in their use and disposal;
• Strict procedures will be followed when refuelling to minimise the risk of spills to the environment. All refuelling activities will be undertaken in line with requirements set out in the Bulgarian Landfall Construction Management Plan (CMP), which will be developed as part of South Stream Transport’s Environmental and Social Management Plan (ESMP). The requirements of the CMP need to be met by both South Stream Transport and the appointed contractors (and sub-contractors); and
• The Project will comply with the International Convention for the Prevention of Pollution from Ships (MARPOL), which includes waste management requirements, as well as the national requirements of the recipient country and, in addition, will ensure that all hazardous waste is disposed of at licenced facilities.
16.2.3.2 Excavation Fall Hazards Scoped Out
Based on professional judgement, the following existing provisions for fencing and warning signs already adopted by the Project adequately address the risks of potential injuries or fatalities to the general population arising from falls and excavation collapse. As further mitigation measures were considered unnecessary, this issue was scoped out of further assessment in this chapter. This outcome is consistent with the findings of the assessment included in the Bulgarian EIA.
• A temporary security fence will be installed around the perimeter of the temporary facilities. Signs will be erected to raise awareness of the hazards. Fencing may also be required at certain locations along the perimeter of the construction corridor to prevent the entry of unauthorised persons (Chapter 5 Project Description).
16.2.3.3 Marine Collisions between Vessels Scoped Out
Based on professional judgement, the following mitigation measures already adopted by the Project adequately address the risks of potential increases in collisions and sinkings between marine vessels. As further mitigation measures were considered unnecessary, this issue was scoped out of further assessment in this chapter. This outcome is consistent with the findings of the assessment included in the Bulgarian EIA Report.
• For the Construction and Pre-Commissioning Phase in the nearshore and offshore sections a safety exclusion zone will be enforced around the pipe-lay vessel during pipe-laying. For
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dynamic positioning (DP) 1 vessels, a safety exclusion zone of approximately 2 km (1.1 nautical miles (NM)) radius from the pipe-lay vessel will be enforced. For an anchoring pipe-lay vessel operating in water depths of between approximately 14 m and 370 m, an exclusion zone of approximately 3 km (1.6 NM) radius around the pipe-lay vessel (depending on the water depth and anchor spread) will be enforced. For water depths shallower than 36 m, an exclusion zone of approximately 2 km radius around the pipe-lay vessel will be enforced;
• Information on restricted areas will be provided to the relevant authorities to inform navigation charts for marine stakeholders identifying marine exclusion zones through the Construction and Pre-Commissioning Phase;
• The pipe-laying spreads (pipe-laying and supporting vessels) will move at very low speeds, (i.e., around two nautical miles a day). This means that they can be considered stationary objects rather than ordinary vessels and other vessels can be notified of their daily position to minimise the risk of vessel collisions; and
• The Project will comply with all international mandatory requirements (e.g. MARPOL), including the following measures: prior to and during construction will liaise with the appropriate marine authorities and ports to ensure suitable navigational warnings are issued; and use of lights, radio communications and other safety devices to communicate the location and extent of the restriction zone around the Project construction activities.
Furthermore, agreement with the appropriate marine authorities shall be obtained regarding the exact exclusion distance to be adopted during pipe-laying to avoid incidents with marine traffic. Unauthorised vessels including fishing vessels will not be permitted access to the safety exclusion zone. The pipe-lay vessel will be equipped with navigation lights, radar and radio communications. Due to the construction spread advancing along the pipeline route as the pipe is laid, constant (at least daily) consultation will be undertaken by the pipe-lay contractor with the appropriate marine authorities to inform them of the location of the construction spread. The marine authorities will then be responsible for informing marine traffic of the location of the pipe-laying activities and the associated exclusion zones. Further details on the Vessels and Marine Transport CMP and South Stream Transport’s ESMP can be found in Chapter 23 Environmental and Social Management.
During the Operational Phase of the Project a 0.5 km offshore exclusion zone will be implemented in the nearshore and offshore sections the Project (from the centreline of the outermost pipelines) above the subsea pipelines extending from the shoreline to a water depth of approximately 100 m (Chapter 5 Project Description). Furthermore, the Black Sea Commission plans and organises emergency responses, including search and rescue, jointly for all countries bordering the sea. This is likely to include evacuation procedures for medical emergencies by helicopter or ship. South Stream Transport will ensure that contractor Emergency Response Plans appropriately integrate with the Disaster Management Plan for Varna municipality and the National Disaster Management with regard to command and control
1 DP is a computer controlled system that drives the vessels thrusters (directional propellers) to maintain position without the use of anchors.
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systems, points of first contact during emergencies, local capabilities and capacity (Chapter 20 Unplanned Events).
16.2.3.4 Controlled Releases of Natural Gas Scoped Out
Based on the findings of Chapter 9 Air Quality the existing Project mitigation measures already adopted into the Project adequately address the risks of controlled venting of natural gas from the vent stack at the landfall facilities during a planned shutdown procedure for maintenance or repair works. As the mitigation included allows dispersion to safe levels for onsite maintenance personnel (occupational exposure), there is not expected to be a risk to community receptors, which are situated at a greater distance (and therefore benefit from even greater dispersion effects). As further mitigation measures were considered unnecessary, this issue was scoped out of further assessment in this chapter. This outcome is consistent with the findings of the assessment included in the Bulgarian EIA Report.
The venting system is designed to vent the gaseous inventory of the pipework within the landfall facilities to the atmosphere (to depressurise) via four local 3-inch vent pipes in cases of planned shutdown of the pipelines or in cases of emergency shutdown. Each of the vent pipes will be mounted to a single 30 m high vent stack (Chapter 5 Project Description). The stack height has been pre-determined based on safety requirements in the workplace, to protect workers at the facility from asphyxiation and from the unlikely event that the vented gas might ignite. It is not expected that emergency venting would pose a concern to air quality at nearby receptors given their distance from the vent (a minimum 1.1 km) (Chapter 9 Air Quality). The methane emission during venting is not predicted to exceed limits set for the protection of human health (Chapter 9 Air Quality). The uncontrolled release of natural gas is included in the scope of the Bulgarian ESIA and is discussed in Section 16.9.
16.2.3.5 Competition for Fresh Water Scoped Out
Clean drinking water is a finite resource and one which is critical to the maintenance of good health. The industrial construction and pre-commissioning activities of the Project will require large volumes of fresh water to be locally sourced for construction of the microtunnel, general construction activities and hydrotesting of the landfall facilities. The nearshore and landfall section pipelines will be hydrotested with seawater.
Based on professional judgement the following mitigation measures already adopted into the Project adequately address the need for further investigation of water competition issues. As further mitigation measures were considered unnecessary, this issue was scoped out of further assessment in this chapter. This outcome is consistent with the findings of the assessment included in the Bulgarian EIA Report.
During construction of the landfall section, water will be required for domestic purposes (drinking water, mess and welfare facilities) and industrial use (for example microtunnel construction and wheel washing, dust suppression, etc.). Water for domestic purposes will be brought to site by road tanker and bottled water will be provided for drinking purposes.
As outlined in Chapter 5 Project Description, the source of industrial water supply for the Project is currently being investigated by South Stream Transport. South Stream Transport will
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carry out all the necessary consultations and studies required during the process to secure the supply of water for the Project in a good and environmentally friendly manner and in compliance with existing regulatory requirements and best practices.
16.2.3.6 Reduction in Leisure Opportunities Due To Restrictions in Beach Access Scoped Out
Access to leisure opportunities is an important component of physical activity and mental wellbeing.
It is anticipated that Pasha Dere Beach will remain accessible to the public throughout the construction of the microtunnels. The microtunnel will install the pipelines at a depth of approximately 20 m under the beach area using tunnels. Therefore, there will be no expected disturbance of the beach area by the construction activities. However, access will be restricted to a section of the beach area (including behind the cliff and the adjacent nearshore) as a conservative precautionary measure. The section that would be closed off would be approximately 150 m wide. The closure would be for a short period whilst the tunnel boring machine (TBM) passes completely underneath, and during the pipeline pull-in process. The restricted area would be indicated via clear signage.
After construction under the beach area is completed, there will be no further restriction on the use of the beach for the remaining construction activities, pre-commissioning activities and the Operational Phase.
Based on professional judgement the following mitigation measures already adopted by the Project adequately address the temporary reduction in leisure opportunities due to restrictions in beach access during the construction period. As further mitigation measures were considered unnecessary, this issue was scoped out of further assessment in this chapter. This outcome is consistent with the findings of the assessment included in the Bulgarian EIA Report.
• Where practicable, South Stream Transport will schedule construction activities with the intention of minimising both the overall duration of temporary access restrictions at the beach and camping ground and picnicking area, as well as the timing of these activities during the peak summer season; and
• Notice of the restriction will be advertised as far in advance as practicable, and communicated to the relevant authorities and posted at the beach and camp/picnic site.
16.3 Spatial and Temporal Boundaries
16.3.1 Project Description
A detailed description of the Project is provided in Chapter 5 Project Description. A brief description of the elements of the Project relevant to this community health, safety and security impact assessment is provided in this section.
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16.3.1.1 Construction and Pre-Commissioning Phase
The Construction and Pre-commissioning Phase will involve construction activities and a number of activities, known as pre-commissioning activities, which will be undertaken after each of the four pipelines has been installed to ensure that the pipelines meet operational requirements. Key features and activities include:
• Establishment of marshalling yards; • Increase in non-local labour (i.e. in-migration from outside the area); • Temporary and permanent land take within the construction corridor; • Construction plant and vehicles operating within the landfall section; • Access routes between marshalling yards and the landfall section, including heavy goods vehicles passing through Local Communities;
• The construction of microtunnels for the shore crossing of Pasha Dere Beach; • Pre-commissioning tests of the pipelines and landfall facilities using multiple large compressors;
• Vessels in nearshore waters, including an exclusion zone; and • Dredging and seabed disturbance in nearshore waters.
Works within the landfall section of the Project are expected to last two years, works within the nearshore section are also expected to last for up to 18 months, and works within the offshore section are expected to last for approximately 3.5 years. The marshalling yards will be required for approximately four years.
16.3.1.2 Operational Phase
The Project will have an operational design life of 50 years. Key features and activities include:
• Permanent, usually unstaffed, landfall facilities with the capacity for occasional gas venting during a planned shutdown for maintenance or repairs;
• Permanent Right-of-Way (RoW) over the pipeline land route; • Permanent access road to the landfall facilities; • Reinstatement of other areas to their former uses, but with development restrictions based on the established safety exclusion zones; and
• At sea, the establishment of a safety exclusion zone 500 m either side of the outermost pipelines to restrict activities of third parties that could come into contact with the pipelines (e.g. dragged anchors, fishing gear, etc.) and thereby damage the pipelines or place themselves at risk.
16.3.1.3 Decommissioning Phase
The approach to decommissioning, including whether the pipeline will be removed will be determined nearer to the time of decommissioning when more is known about the technologies
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available to undertaken the works and any changes in the sensitivity of surrounding communities. Decommissioning activities will be undertaken in accordance with the international and national legislation and regulations prevailing at that time, and in liaison with the relevant regulatory authorities. See Section 16.8.3 for further discussion.
16.3.2 Project Location
The Project comprises three sections – offshore, nearshore and landfall. The Project also includes marshalling yard(s) that will be used for storage of pipe and equipment. Further information explaining the extent and nature of each section is given in Chapter 1 Introduction. The Project phase timeframes are set out in Chapter 1 Introduction and an indicative construction schedule is provided in Chapter 5 Project Description.
Figure 16.1 shows the boundary of the Bulgarian national level; the Varna and Burgas regional level; Varna and Avren municipality level; and the location of surrounding communities including the city of Varna; Asparuhovo; Borovets; Galata and Zelenika; Rakitnika; Priboj and Fichoza; Priseltsi; and Priseltsi VZ.
Chapter 15 Socio-Economics provides descriptions of these communities.
16.3.3 Study Area
The Study Area for the purposes of the community health, safety and security assessment encompasses the areas described in Chapter 15 Socio-Economics. The Study Area definition provided a frame of reference to consider the potential impacts arising as a result of the Project on its immediate surroundings. In summary, on land, the Study Area included the area within 2 km of the landfall section of the Project and also within a 300 m zone either side of existing transport access routes, overlapping with the communities of Kantara and Rakitnika. In addition, a survey of sites subject to health protection was conducted to ensure that this process did not miss any important receptors (see Section 16.3.4).
The exception is where the Study Area is extended to that adopted in other chapters of the ESIA Report where those assessments and their respective receptors are discussed.
16.3.4 Survey of Sites Subject to Health Protection
The assessment of potential effects on Community Health and Safety for the EIA involved a survey to ensure that sites subject to health protection under Bulgarian regulations were identified and adequate design controls and mitigation measures were included to protect such sites from potential impacts. This survey also addressed requests made by the Ministry of Health to South Stream Transport (Ref. 16.4) regarding this issue.
16-12 URS-EIA-REP-202375 LEGEND 0 25 50 km Local Communities Other communities Ada Bacha fishing community Varna Region Fishing businesses A5 Motorway VARNA MUNICIPALITY Route 9 Krushkite Road AVREN Municipality boundary MUNICIPALITY Varna Mayoralty boundary Bulgarian Sector of South Beloslav B l a c k S e a Varna Beach Fishing Stream Offshore Pipeline businesses Proposed offshore pipelines BurgasVarna Bay L a k e V a r n a Proposed microtunnels Port of Varna Proposed landfall section (Varna East Port) pipelines V a r n a B a y Landfall facilities 0 100 200 km Asparuhovo Right-of-Way Microtunnel entry point Microtunnel exit point VARNA MUNICIPALITY Asparuhovo Mayoralty Permanent access road to be constructed by SSTTBV Zelenika Galata Pipeline Infrastructure Bulgaria Varna Existing Galata gas pipeline Galata Region Existing Galata gas Zvezditsa processing plant B l a c k South Stream Pipeline System on the S e a Borovets A5 Motorway Territory of the Republic of Bulgaria Priboj and Varna compressor station Fichoza Pasha Dere receiving terminal Route 9 SSBAD pipelines Kantara Permanent access road to be constructed by SSBAD
Krushkite Road Projection: Lambert Conformal Conic Priseltsi VZ Rakitnika
Check Ada Bacha Revision Details By Suffix Check Date fishing Purpose of Issue community For Information Priseltsi Mayoralty Client AVREN MUNICIPALITY Chernomorets Beach
Priseltsi Project Title SOUTH STREAM OFFSHORE PIPELINE Pasha Dere Beach Drawing Title NATIONAL, REGIONAL, MUNICIPAL AND LOCAL COMMUNITY CONTEXT OF THE PROJECT Route 9 Drawn Checked Approved Date AH VS VS 01/05/2014 URS Internal Project No. Scale @ A3 46369082 1:65,000
This document has been prepared in accordance with the scope of URS' appointment with its client and is subject to the terms of that appointment. URS accepts no liability for any use of this document other than by its client and only for the purposes for which it was prepared and provided. Only written dimensions shall be used. © URS Infrastructure & Environment UK Limited
URS Infrastructure & Environment UK Limited Scott House Alencon Link, Basingstoke Hampshire, RG21 7PP Telephone (01256) 310200 Fax (01256) 310201 www.ursglobal.com 0 1 2 3 Drawing Number Rev km Figure 16.1 PlotDate: 02Sep 2013 FileName:I:\5004 - InformationSystems\46369082_South_Stream\MXDs\Report Maps - Bulgaria\Bulgarian EIA\Chapter15\Figure 15.1 NationalRegional Municipal district andlocal community contextof the project.mxd
EIA Ordinance Article 3 defines “Sites Subject to Health Protection”. These include the following types of facilities (Ref. 16.5):
• Residential buildings; • Health care establishments; • Schools; • Kindergartens; • Child care centres; • Higher education institutions; • Sports facilities; • Temporary housing facilities (hotels, motels, hostels, recreation centres, vacation settlements, camping sites, huts, etc.);
• Recreation and entertainment locations (swimming pools, beaches, and swimming sites, parks and recreation garden, attraction parts, aqua parks, etc.); and
• Food manufacturing sites.
Following a desk-based review, a field survey was conducted to identify the existence of these sites. The geographical scope of the survey was informed by the routes that construction and operational traffic will take to and from the construction site and by the route of the pipeline. The survey covered the route for construction traffic between the Varna marshalling yards (East and West) and the landfall facility construction site. Burgas marshalling yard was not considered as the level of traffic associated with the Project-related traffic travelling to and from Burgas to the construction site is expected to be low and to pose no burden on the road network irrespective of the time of year. Further assessment will be conducted if this situation changes; for example, if construction materials are brought by road from Burgas or if fill material is imported from the quarry to the south west of Sadovo and is brought north along the E87 road (Appendix 9.4).
The findings of the survey of sites subject to health protection sites are presented in Figure 16.2.
16.4 Methodology and Data The baseline has drawn on a variety of sources, including published scientific literature, international health and safety organizations, and general literature searches using Internet search engines and standard textbooks of public health. А variety of secondary health status data sources were used for the: Bulgarian; Varna and Burgas Regions; and Varna and Avren Municipalities.
16.4.1 Primary Data and Surveys
Primary baseline data collection was undertaken to inform the socio-economic impact assessment (see Chapter 15 Socio-Economics) and the information gathered was analysed
URS-EIA-REP-202375 16-15 Chapter 16 Community Health, Safety and Security
to ensure that any health-related issues were captured and included in this community health, safety and security impact assessment. In addition, specific meetings were held with both the National Commission for Combating Trafficking in Human Beings and SOS Families at Risk to obtain further information on Commercial Sex Workers (CSWs) and with VIK Varna and the Regional Inspectorate of Environment and Water (RIEW) for information on water sources, quality and use in the surrounding area (Chapter 6 Stakeholder Engagement).
A meeting was held with the Varna Police Department to source data on traffic and related issues. Data on existing traffic levels was obtained through surveys of potential access roads. An explanation of the survey methodology, access roads, locations of traffic surveys and the survey results are contained in Appendix 9.4.
16.4.2 Secondary Data
The main sources of secondary information are:
• Dimova A, Rohova M, et al. Bulgaria Health System Review, Vol.14 No.3. 2012. European Observatory on Health Systems and Policies. Health Systems in Transition. Available at http://bit.ly/16V6STC (Ref. 16.6);
• National Institute of Statistics, Bulgaria. (Ref. 16.7); • National Institute of Statistics, Bulgaria, National Centre for Public Health and Analysis (NCPHA) Healthcare Statistics Handbooks, 2010 and 2011 and Healthcare Bulletins, 2011 and 2012 http://bit.ly/1c77Hci (Ref. 16.8); and
• Regional Health Inspectorate (RHI) – Varna, www. rzi-varna.com (Ref. 16.9).
16.4.3 Stakeholder Engagement
Stakeholders are persons or groups who are directly or indirectly affected by a project, as well as those who may have interests in a project or the ability to influence its outcome, either positively or negatively. Stakeholder engagement provides one part of the process for identifying a list of health concerns for analysis. These concerns were combined with other sources, such as consultation with the Bulgarian Ministry of Health and other stakeholders.
16-16 URS-EIA-REP-202375 LEGEND Cemetery 46 Church
69 Health care establishment 47 Kindergarten 48 49 50 18 51 Port 52 2008 Recreation and entertainment Varna West location 12 19 34 Residential building Varna East Sanitary protection zone School 25 55 20 Sports facility 7 54 13 Temporary housing facility 21 56 60 Treatment plant 8 57 Bulgarian Sector of South Stream Offshore Pipeline A5 Cherno More 62 9 Highway 24 1 Proposed offshore pipelines 22 6 23 2 Proposed microtunnels 17 44 58 Proposed landfall section 36 pipelines Landfall facilities Indicative marshalling yard boundary 53 38 Right-of-Way 37 39 40 63 Temporary construction sites 33 45 65 64 Temporary construction site 5 66 42 70 for permanent access road 43 to be constructed by SSTTBV 16 Microtunnel entry point 61 11 67 30 Microtunnel exit point 15 41 32 31 53 68 Access Roads 59 38 4 35 Permanent access road to be 37 constructed by SSTTBV Permanent access road to be 40 39 63 constructed by SSBAD 64 Existing main road 45 65 66 42 70 43
Projection: Lambert Conformal Conic Purpose of Issue 3 29 For Information 27 26 Client
67 14 10 41 Project Title 28 68 SOUTH STREAM OFFSHORE PIPELINE
Drawing Title 35 SURVEY TO IDENTIFY HEALTH PROTECTED SITES
Drawn Checked Approved Date AH RW MW 16/06/2014 URS Internal Project No. Scale @ A3 46369082 1:90,000 This document has been prepared in accordance with the scope of URS' appointment with its client and is subject to the terms of that appointment. URS accepts no liability for any use of this document other than by its client and only for the purposes for which E87 it was prepared and provided. Only written dimensions shall be used. © URS Infrastructure & Environment UK Limited Route 9 0 500 1,000 1,500 URS Infrastructure & Environment UK Limited Scott House m Alencon Link, Basingstoke Hampshire, RG21 7PP Telephone (01256) 310200 Fax (01256) 310201 www.ursglobal.com 0 2 4 6 8 10 Drawing Number Rev km
PlotDate: 16Jun 2014 FileName:I:\5004 - Information Systems\46369082_South_Stream\MXDs\Report Maps- Bulgaria\Bulgarian ESIA\Chapter16\Figure 16.2 HealthProtected Sites.mxd Figure 16.2
Consultation was initiated with the Ministry of Health in January 2013 and subsequent written comments were received on the Project’s Scoping Report / Terms of Reference. In April 2013, a further meeting was held with the Ministry of Health to discuss public health and risk assessment. The main recommendations provided relate to the identification and analyses of the:
• Potentially affected existing residential areas and future developments; • Risk factors for human health during construction, operation and in the case of unplanned events;
• Quality of the Pasha Dere Beach and bathing water; • Quality of the water sources used for water supply in the Project Area; • Cumulative impacts on the communities and workers due to the simultaneous operation of the facilities of the South Stream Transport together with the existing Galata Pipeline and South Stream Bulgaria AD’s (SSB) facilities (Pasha Dere receiving terminal (RT) and Varna compressor station (CS)) to be located adjacent to the landfall facilities; and
• Risk assessment of the human health damages shall be carried out, and measures shall be proposed for health protection and risk management, including in possible emergency situations.
During consultations with local communities and authorities, stakeholders raised issues related to protection of water sources on site, the provision of water to local contractors during construction and impacts on bathing water quality. Concerns about noise impacts from construction of the Project and the operation of the SSB Pasha Dere RT and Varna CS were also raised, along with issues related to safety and risks associated with a high pressure gas pipeline (e.g. gas leaks or explosions) and potential health risks regarding an increase in CSW.
Further details of the Project stakeholder engagement are set out in Chapter 6 Stakeholder Engagement.
16.4.4 Data Assumptions, Limitations and Gaps
The data used in the community health, safety and security baseline has not been assessed for bias or other limitations in its primary collection methodology. For some indicators there are no exact definitions which make the interpretation of the data difficult.
It is noted that in all countries (not just Bulgaria) there is frequent underreporting and misreporting of disease burdens. Very limited or no data was available for the individual communities located near to the landfall section of the Project. It has therefore been assumed for the purposes of this assessment that the health status in these communities is similar to Varna Municipality or to the Varna Region. It is also assumed for the purposes of this assessment that the non-local Project workforce will be housed in the city of Varna. This is based on the consideration that it is the city of Varna, rather than the other smaller Local Communities (including those within the broader Varna Municipality), that is most likely to have a sufficient supply of suitable accommodation options available for requirements.
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Given the lack of available local data on health and the lack of specifics at the time of writing in relation to Project workforce accommodation options, the Project has required its contractor to undertake a Rapid Health Appraisal in the pre-Construction and Pre-Commissioning Phase to further understand health conditions (such as disease prevalence) in the Local Communities and including the quality and quantity of local health services. The appraisal will assess the preferred option for the landfall section workforce accommodation, once it is known, as well as potential health impacts relating to the offshore workforce interactions with the city of Varna and the Local Communities during transit periods. The purpose of this appraisal is to avoid significant adverse impacts on Local Communities by identifying potential impacts and appropriate mitigation/management measures before the start of construction. The appraisal will include consultation with applicable local and regional authorities, including health and social service providers.
16.5 Community Health, Safety and Security Baseline This section provides a summary of the baseline community health characteristics of the Project Area.
16.5.1 Demographic Community Profile
At the end of 2009, Bulgaria had a population of 7.6 million: 51.7% of the population was female and 49.3% male. According to the latest population census from 2011, 84.8% of Bulgarian citizens are ethnic Bulgarians. Turks comprise 8.8% of the population, Roma 4.9%, and other traditional ethnic minorities (Armenian, Greek, Jewish, Russian, Tatar and others) 1.5%. The share of people living in urban areas has been steadily increasing and in 2009 it was 71.4%. The population density is 70.2 people per square km (Ref. 16.6).
16.5.2 Morbidity, Incidence and Prevalence of Disease
Bulgaria lags behind European Union (EU) 27 2 averages in most mortality and morbidity indicators. In 2008, life expectancy was six years below the EU-27 average (79.5), almost seven years below the EU-15 average (80.7), and slightly more than a year below the EU-12 average (75.0), but comparable to Hungary (74.0) and Romania (73.4) and only slightly lower than that of Poland (75.5) (Ref. 16.6).
An analysis of the causes of mortality in Bulgaria shows that, similar to many other European countries, the main causes of death are the diseases of the circulatory system. This unfavourable trend can be attributed to prevailing unhealthy habits and behaviour (unbalanced diet, high rate of smoking and low physical activity), psychosocial factors, and insufficient health promotion, prevention and treatment of risk factors (Ref. 16.6).
2 European Union of 12 member states (EU-12): Belgium, Denmark, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, United Kingdom. EU-15 is the EU-12 plus Austria, Finland, Sweden. EU- 27 is the EU-15 plus Czech Republic, Cyprus, Estonia, Hungary, Latvia, Lithuania, Malta, Poland, Slovakia, Slovenia, Bulgaria, Romania.
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Malignant neoplasms (cancer) have been the second most common cause of mortality in the last couple of decades. Deaths attributable to external causes (injury or poisoning) and respiratory diseases are at a comparable level with other EU countries (Ref. 16.6).
In 2009, the main three causes of death in Bulgaria were diseases of the circulatory system (66.0% of all cases), malignant neoplasms (15.9%) and diseases of the respiratory system (3.8%) (Ref. 16.6).
Life expectancy at birth has been increasing in all EU countries (Ref. 16.6). The same is true for Bulgaria where average life expectancy at birth has been increasing since 1970, with the exception of a small dip between 1989 and 1997. In 1980, it was 71.2 years, while in 2008, it became 73.3 years. The discrepancy between men and women is substantial. Between 2007 and 2009, life expectancy for men was 69.8 and that for women was 77.0 (see Ta ble 16.1).
Table 16.1 Mortality and Health Indicators, Selected Years
1980 1990 1995 2000 2005 2008
Life expectancy at birth, total (years) 71.2 71.6 71.1 71.7 72.5 73.3
Life expectancy at birth, male (years) 68.5 68.3 67.4 68.2 69.0 69.8
Life expectancy at birth, female (years) 74.0 75.2 74.9 71.3 76.2 77.0
Total mortality rate, adult, male (per 1,000 male 189.9 219.3 245.3 224.9 220.6 213.0 adults)
Total mortality rate, adult, female (per 1,000 98.6 98.0 99.9 98.8 92.1 90.6 female adults)
Source: Ref. 16.10
In Varna Region, the Adult Mortality Rate and the Infant Mortality Rate for the period 2005 to 2011 were lower than the national average (Table 16.2) (Ref. 16.7).
Table 16.2 Adult and Infant Mortality Rates (Per 1,000 People) for Bulgaria and Varna Region, 2005-2011
Republic of Bulgaria Varna Region
AMR IMR AMR IMR
Total M F Total M F Total M F Total M F
2005 14.6 16.2 13.2 10.4 11.8 9.0 12.5 14.0 11.0 8.9 9.0 8.8
2006 14.7 16.2 13.3 9.7 9.7 9.7 12.8 14.5 11.1 9.5 9.9 9.1
Continued...
URS-EIA-REP-202375 16-21 Chapter 16 Community Health, Safety and Security
Republic of Bulgaria Varna Region
AMR IMR AMR IMR
Total M F Total M F Total M F Total M F
2007 14.8 16.1 13.5 9.2 10.0 8.3 12.6 13.9 11.3 8.1 10.8 5.3
2008 14.5 15.8 13.3 8.6 9.1 8.0 12.5 13.9 11.2 7.5 9.5 5.3
2009 14.2 15.5 13.1 9.0 10.2 7.7 12.2 13.5 11.0 6.3 7.0 5.5
2010 14.6 15.8 13.5 9.4 10.6 8.1 12.6 13.5 11.8 10.1 13.4 6.5
2011 14.7 15.8 13.7 8.5 9.6 7.3 11.9 12.9 10.9 8.1 7.9 8.3
AMR: Adult Mortality Rate; IMR: Infant Mortality Rate Complete. Source: Ref. 16.6
In rural areas, mortality rates are higher than in urban areas. Rural communities have a higher average age than urban populations. They may also be remote and have poorer access to medical care than populations in towns and cities. The five leading causes of death (in descending order) in Bulgaria and the Varna Region are shown in Table 16.3. Cardiovascular disease accounts for almost two thirds of deaths (66%). Some 16% of deaths are attributed to cancer, followed by pulmonary diseases (non- communicable) which account for approximately 4%. Varna Region has lower mortality rates for cardiovascular diseases, compared to Bulgaria, but the rates are similar for the other main causes of mortality.
Table 16.3 Main Causes Of Mortality in Bulgaria and Varna Region (Per 100,000 People per Year), 2011
Diseases Bulgaria Varna Region
Cardiovascular diseases 987.7 768.7
Cancers 230.7 210.5
Pulmonary diseases 54.6 48.5
Diseases of digestive system 44.4 44.5
Trauma, poisoning 38.4 38.1
Endocrine diseases 22.3 24.0
Genito-urinary diseases 15.9 14.1
Continued...
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Diseases Bulgaria Varna Region
Intentional injury 10.4 11.4
Infectious diseases 7.1 2.3
Others 48.0 14.5
Total 1473.2 1187.2
Source: Ref. 16.11 Complete.
16.5.2.1 Communicable Diseases
Data from the National Center for Public Health and Analyses (NCPHA) (2005 to 2011) show that health indicators in the Varna Region as a whole are good with some indicators being better than average (Ref. 16.8 and Ref. 16.12).
The most common infectious diseases (per 100,000 people) in both Bulgaria and Varna Region for the period 2006 to 2011 were (Ref. 16.8 and Ref. 16.12):
• Chicken pox; • Scarlet fever; • Acute viral hepatitis; and • Dysentery.
The incidence of infectious diseases varies, by area and by time, and is determined by factors operating at national and local levels. In the period 2006 to 2011, the incidence of most infectious diseases declined. Measles increased, significantly, in 2010 and then declined sharply in 2011. No cases of typhoid and tetanus were reported.
The incident rates of infectious diseases specific to Local Communities were not available for this assessment. However, available information on the incidence of disease at the local level, particularly as it relates to STIs, will be collected as part of the Rapid Health Appraisal.
Tuberculosis
In Bulgaria, in recent years, there has been a gradual reduction of tuberculosis (TB) morbidity, from 40.1 new cases per 100,000 in 2005 to 27.9 per 100,000 in 2010 (Ref. 16.6).
In Varna Region in 2010 and 2011 both the total number of cases, and the number of new cases, per 100,000 was higher than the national level. This indicates a reversal of the preceding trend, over the period 2005 to 2009, when the total number of cases, annually, were lower in Varna Region compared to the national figures. Tuberculosis is more prevalent in urban than rural areas.
URS-EIA-REP-202375 16-23 Chapter 16 Community Health, Safety and Security
Sexually Transmitted Infections
HIV / AIDS
Bulgaria is located at the junction between Western and Central Europe (c. 900,000 people living with HIV) and Eastern Europe and Central Asia (c. 1.4 million people living with HIV) (Ref. 16.13). The major route of transmission of infection in Central and Western Europe is unsafe sex between men. In Eastern Europe and Central Asia the main route of transmission is through injecting drug use (Ref. 16.13). There is a higher rate of new cases in Eastern Europe and Central Asia than in Western and Central Europe. Bulgaria has a relatively low HIV prevalence among the general population. The incidence of new cases of HIV in the EU is 5.7 cases per 100,000 population. The incidence of new cases of HIV in Bulgaria is 2.7 cases per 100,000 (Ref. 16.13). The total number of people officially registered with the Ministry of Health as living with HIV/AIDS on 14 November 2013 was 1,809 people (Ref. 16.13). HIV-positive cases are mainly in the major regions of the country (Ref. 16.13).
In Bulgaria, the number of new male cases is four times larger than the number of new female cases. The upper age limit for men is 73 years and for women is 59 years (Ref. 16.13). There are two particularly vulnerable groups: men who have sex with men (MSM) (38.5%) and injecting drug users (IDU) (15.6%) (Ref. 16.15). The tendency is for an increase in the share of the first group (Ref. 16.13).
Syphilis and Gonorrhoea
Reported cases show no important differences in the period 2008 to 2010 in Bulgaria (Table 16.4), although the incidence of gonorrhoea increased slightly (Ref. 16.8).
Table 16.4 Incidence of Sexually Transmitted Infections (Cases per 100,000 People), 2008-2010
Disease 2008 cases 2009 cases 2010 cases
Syphilis 43.6 44.7 43.9
Gonorrhoea 2.6 2.7 2.8
Source: Ref. 16.11
In Varna Region in 2011, an increase in the number of reported cases of syphilis and STIs was reported comparable to 2010 (Ref. 16.8).
16.5.2.2 Non–Communicable Diseases
Chronic non-communicable diseases are an issue in Bulgaria. In 2008, the morbidity rate for diseases of the respiratory system accounted for 38% of all diseases, followed by diseases of the nervous system, diseases of the circulatory system, injuries and poisoning (Ref. 16.6).
The prevalence of long-term illness and disability is an important indicator of the population’s health status. The number of new invalidity/disability cases per 100,000 has been at a high level since the early 2000s (Ref. 16.6).
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The overall incidence of non-communicable diseases in Varna Region corresponds to the country average in 2010 and 2011 (Ref. 16.8). The incidence in Varna Region is lower than the national average in terms of:
• Cancer; • Diseases of the urinary system; • Diseases of the nervous system; and • Respiratory diseases.
Conversely, in the Varna Region a higher incidence of cardiovascular and endocrine disorders is noted relative to their frequency in the country (Ref. 16.8).
Cardiovascular Diseases
Hypertension is the most common chronic disease. It affects 18.3% of men and 24.4% of women, and it is estimated that there is approximately 3% hidden incidence of hypertension (Ref. 16.8).
Heart attacks (myocardial infarction) are also common. 41.6% of people experiencing myocardial infarction were aged 45 to 64, and 37.5% were aged 65 to 74. Men are struck by heart attack two times more than women (Ref. 16.8).
The percentage of people affected by stroke increased slightly over the past four years, from 2.0% in 2005 to 2.7% in 2011 (Ref. 16.8).
Cancers
The prevalence rate of malignant tumours, or cancers, is increasing. During the period 2005 to 2011, at the national level, prevalence rate increased from 3,069.9 to 3,602.7 per 100,000 people (Ref. 16.8).
The incidence of cancer both nationally and in the Varna Region increased from 2007 to 2011, but the rate in Varna Region was consistently lower than the national average. In Varna Region, in recent years, there was an increase in newly diagnosed cases of cancer, and the rate was higher than the national average. Increases in diagnoses of cancer can reflect improved availability of diagnostic testing methods and better reporting (Ref. 16.8).
16.5.3 Mental Health
16.5.3.1 Mental and Behavioural Disorders
Published statistics (Ref. 16.8) show the following numbers for patients under observation in psychiatric facilities in Bulgaria
• 2009: 2,270.3 per 100,000 population; and • 2010: 2,075.2 per 100,000 population.
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Hospitalized cases of Mental and Behavioural Disorders from 2005 to 2010 maintained almost the same level: between 600 and 700 cases per 100,000, which is about 2.5% of all hospital admissions. There are no reported significant differences in Varna Region (2.6%) compared with data for the country as a whole (2.6%) (Ref. 16.8).
16.5.3.2 Suicide
Age standardised suicide mortality rates, for 2010 were 9.3 per 100,000 for the total population and 4.0 and 15.3 per 100,000 for women and men respectively. Between 1995 and 2010 suicide rates decreased in Bulgaria by 40% (Ref. 16.14).
16.5.4 Baseline Data by Determinant of Health
16.5.4.1 Individual Factors
Drug Use
The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) report that a national representative study among the general population was conducted in Bulgaria in 2008. This was a repeat of a previous survey and it asked people aged 15 to 64 about their use of and attitudes towards different psychoactive substances (Ref. 16.15). With regard to cannabis the data indicated the following:
• Lifetime prevalence of cannabis use: 7.3%; • Last year prevalence: 2.7%; and • Last month prevalence: 1.4%.
In 2005, lifetime prevalence of cannabis was 4.4% and in 2007 it was 5.6%. The 2008 survey also showed the lifetime prevalence of ecstasy was 1.7%, cocaine 1.7% and amphetamines 2.1% (Ref. 16.15).
Among young adults aged 15 to 34, lifetime prevalence of cannabis was higher than for other substances: 14.3% reported they had used cannabis at least once, 3.6% had used ecstasy, 4.4% amphetamines and 3.0% cocaine. For the same age group, prevalence of cannabis use was 6.0% and of ecstasy was 1.6% (Ref. 16.15).
Smoking
In 2010, 29.2% of Bulgaria’s adult population smoked daily (Ref. 16.14). This compares to an average for EU-27 Member States of 23%. On average, smoking rates decreased across EU-27 by about 5 percentage points since 2000, with a higher decline among men than women, but this decrease was not found in Bulgaria.
Alcohol
In Bulgaria, adult per capita consumption of alcohol is mainly characterised by consumption of spirits (Ref. 16.16). Beer and wine are also consumed, but to a lesser extent. Recorded adult per capita consumption is around 11.2 litres of pure alcohol annually and has remained stable in
16-26 URS-EIA-REP-202375
recent years. Some unrecorded alcohol production is also seen in the country, adding around 1.2 litres to recorded consumption (Ref. 16.16) Total adult per capita consumption of pure alcohol in Bulgaria is around 12.4 litres.
Beer includes malt beers. Wine includes wine made from grapes. Spirits include all distilled beverages. Other includes one or several other alcoholic beverages, such as fermented beverages made from sorghum, maize, millet, rice, or cider, fruit wine, fortified wine, etc. Traditional and local beverages in Bulgaria include rakia and mastika. There are problems from the use of surrogate alcohol (i.e. alcohol which is not intended for human consumption such as industrial alcohol, aftershave, or antifreeze) (Ref. 16.16).
Data from the 1994 Sofia Heart Study found that spirits (e.g. rakia) accounted for around 50% of alcohol consumed, beer for around 30%, and wine for around 20%. Men reported an average of less than three drinking days per week and an average consumption of 65 g alcohol on these days (g/day); 17% of men reported excess alcohol consumption of 40 g/day and 12% of 60 g/day. The percentages and thresholds for excess alcohol consumption in women were 5% (20 g/day) and 2% (40 g/day). In relation to the increased risk of ischaemic heart disease from non-drinking causes, 30% of men and 67% of women aged over 45 reported themselves as non-drinkers (Ref. 16.17).
In 1998, 18% of Bulgarian men were drinking at a level that equated to 80 g/day, which is associated with a greatly increased risk of many of the manifestations of physical harm due to drinking (Ref. 16.17).
Male death rates from cirrhosis in Bulgaria more than tripled between 1970 and 1998 (9.8/100,000 and 33.6/100,000 respectively). Although alcohol is only one of the factors accounting for the high level of premature mortality of the Bulgarian population, it is an important factor (Ref. 16.17).
16.5.4.2 Social Factors
Varna Region
The Municipal Development Plan of Varna Municipality provides the following summary of the population across the municipality of Varna (Ref. 16.18):
• 97.5% of the population of Varna Region live within Varna Municipality and the rural community is very small;
• Population density in the Varna Municipality is high and significantly higher than the national average;
• In 2012, the population was comprised of 51.37% women and 48.63 % men; • 74% of the population of working age live in Varna Municipality; • The population is ageing; and • There are few ethnic minorities; the largest is the Turkish minority group representing 3.56% of the population.
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Varna Region is located in North-Eastern Bulgaria and it covers 12 municipalities with 158 populated areas. The other municipalities in addition to the Municipality of Varna are Avren, Aksakovo, Beloslav, Vetrino, Valchidol, Devnya, Dolni Chiflik, Dalgopol, Provadiya and Suvorovo. Varna Region is one of the better developing areas in the country (Ref. 16.19).
The education system in Varna Region is considered good and above the national average. This is due mostly to the good rate of higher education coverage. There are five universities and three colleges in Varna. The district has the second-highest proportion of university graduates in the population aged between 15 and 64 years (after Sofia). Educational challenges seem to be the relatively small number of schools per capita and the number of teachers per 1,000 students, which is among the lowest rate in the country (Ref. 16.19).
Besides tourism, Varna also benefits from a well-established chemical industry, machine building, textiles, ship repair yards, and transport industry. The most rapidly developing sector in the district over the past several years was agriculture; 60% of the region’s area is farmland. Development in the region is highly polarised. It is characterised by large differences between Varna Municipality and other municipalities. The Varna Municipality holds over three quarters of enterprises and fixed assets, thus contributing a large portion of business revenues in the district (Ref. 16.19).
The population of the Varna Region is mostly dissatisfied with its current employment and local infrastructure. A serious problem seems to be the crime rate, which is eight points above the national average (Ref. 16.19).
Commercial Sex Workers in Varna Region
Bulgaria is ranked third in the world for the trafficking of women as victims of sexual exploitation. The country is a point of both origin and transit for trafficking and, to a lesser extent, it is also a point of destination for trafficking. Most victims are trafficked for sexual exploitation (Ref. 16.20). In the autumn of 2009, Mediana carried out a nationally representative study, which included Varna, entitled “Trafficking in human beings: emigration and sexual exploitation” (Ref. 16.21 cited in Ref. 16.13). The research found a change in the methods and mechanisms of recruiting young women for sexual exploitation, with violence ceding its place to coercion and deception, and force being substituted by a “negotiated relationship” or “advance payment”. Varna Municipality is a sea resort and the region has several ports; activities concerning CSW in Varna Region continue to be strongly linked with violence and an organised hierarchical structure for recruiting (see Chapter 15 Socio- Economics for more details on specifics pertaining to CSW activity in Local Communities).
Police measures and actions are primarily targeting street-based prostitution. Women belonging to this group are usually detained for 24 hours (Ref. 16.14). A report on commercial sex work in eleven countries, including Bulgaria, found that violence (including police violence) is widespread against male and female CSWs (Ref. 16.15). CSWs can be distinguished by the venues in which they work (Ref. 16.13):
• Street-based CSWs; • In clubs and in brothels; • Elite VIP; and
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• Resort oriented and sex tourism.
The CSWs who work in clubs experience the highest level of control and the elite CSWs have the highest level of education and income. The street based CSW group in Bulgaria have the lowest status and least control. Street-based CSWs consist mainly of representatives of minority and some vulnerable communities, some of them are transsexual, with: low levels of education; poor income; and limited access to health care and social services (Ref. 16.13). Because commercial sex work is, and CSWs are, stigmatised, non-governmental organisations (NGO) and other civil society activities to support CSWs are unpopular.
Representatives from the Varna Local Commission for Combating Trafficking in Human beings (LCCTHB) (a local branch of the National Commission for Combating Trafficking in Human Beings), the NGO Families at Risk, the Municipality of Varna and the Ministry of the Interior have identified links between organised crime and trafficking in Varna and assess that the influx of a sizable construction workforce would be seen as a potential market for commercial sex work (Ref. 16.14).
There is also a presence of CSWs close to the landfall construction site on part of the access route to be used by Project construction traffic. The women working here tend to be low status and marginalised, may come from the Roma community and can be supporting their families (Ref. 16.14). It is likely that there are higher levels of unprotected sex amongst the CSWs in this area as the presence of many CSWs means that the women need to compete for clients in the services that they offer (e.g. by offering unprotected sex). In addition, many of the clients are regulars who are known to the women and therefore may also expect unprotected sex (Ref. 16.14 and Ref. 16.16).
Burgas Region
The Region of Burgas is located in South-Eastern Bulgaria and it covers the largest area in the country. The district comprises 13 municipalities, with 254 populated areas. The other municipalities in addition to the Municipality of Burgas are Aytos, Kameno, Karnobat, Malko Tarnovo, Nesebar, Pomorie, Primorsko, Ruen, Sozopol, Sredets, Sungurlare and Tsarevo (Ref. 16.17).
The Burgas Region suffers from a lack of sufficient numbers of qualified medical staff. On all three indicators: general practitioners, cardiologists and specialists in Internal Medicine per capita, Burgas is well below the national average. Hospital infrastructure, however, is not insufficient, quite the opposite. The district has a high number of hospitals per capita. In recent years, two new private hospitals were opened (Ref. 16.17).
The Burgas Region is among the most highly urbanised areas in the country. The proportion of urban population is 74.8%, and has increased rapidly between 2008 and 2011. Throughout the district, there is a large gap in development between coastal communities and those further inland. The former are much richer and there is a relatively low unemployment rate, while the latter's population relies heavily on income from pensions and social benefits (Ref. 16.17).
The quality of education in Burgas Region received scores slightly below the national average. A major problem seems to be the small number of teachers per 1,000 students, and the relatively low number of schools per capita. Despite the presence of three universities, the district lags
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behind in the number of students per population. Burgas ranks within the bottom half also according to the percentage of university graduates among working age population: 15.6% against an average of 23.3% for the country (Ref. 16.17).
The economy of the district is characterised by low diversification. Oil processing is the most important industry, making up for about 70% of industrial production. It is followed by the food and beverage industry and machine building. Also, well-developed sectors include transport, logistics, and agriculture. The two key sectors of the local economy, however, are tourism and trade (Ref. 16.17).
One third of the population of Burgas Region lives in deprivation that, although being a substantial proportion, is well below the average. The share of people falling below the poverty line in the district is 21.3%. At the other extreme are nearly 30% of local residents who perceive their standard of living as satisfactory or very satisfactory, suggesting a pronounced social stratification (Ref. 16.17).
Nearly half of local residents are satisfied with their jobs. Crime rate is a major problem in the district: the second highest in the country, after Sofia (capital city) (Ref. 16.17).
16.5.4.3 Environmental Factors
Varna Region
Air pollution by PM10 is a problem for the quality of air in winter in Varna, Belevo, and Devnya municipalities. Transport and the widespread use of solid fuels for domestic heating are the main sources of emissions (Ref. 16.18). Harmful emissions to the atmosphere are five times higher in Varna than the national average. Emissions have been steadily increasing since 2005, and only in 2010 was a slight decline registered (Ref. 16.19).
Relatively high noise levels were found in areas exposed to heavy traffic. This is attributed to freight transport (Ref. 16.18). The Varna Municipality Plan for the Promotion, Prevention and Rehabilitation for Public Heath provides measures to reduce environmental noise (Ref. 16.19).
Varna Region scores ahead of other areas for the capacity of waste water treatment plants and the proportion of the population in towns and villages with public sewerage systems. A treatment plant for potable water is currently under construction in Provadia, while wastewater treatment plants are being built in Aksakovo and Vetrino (Ref. 16.19).
Figure 16.3 shows baseline coastal water monitoring locations and quality indicators for the Project Area in Varna Region. The waters around Pasha Dere Beach are classified as being of sufficient water quality or compliant with the mandatory values, but not guideline values (Ref. 16.20).
Burgas Region
The environmental indicators reported for Burgas Region indicate a score of "good", and is 6.7% above the national average. However, it only partly corresponds to citizens' perceptions. The advantages in the district come from a relatively low level of harmful emissions into the atmosphere. Treatment plants could be part of the explanation behind the disparity between
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objective data and public perceptions of the environment. In many coastal municipalities that are active tourist destinations, the capacity of water treatment plants is far below the required levels. Efforts are being made to find a solution to this issue. As of 2012, the construction or expansion of wastewater treatment plants was underway in Primorsko, Ravda, Slanchev Bryag (Sunny Beach), Tsarevo and other populated areas in the district. As in many other locations, the lack of sewage facilities negatively affects villages the most (Ref. 16.17).
16.5.4.4 Institutional Factors
Varna Region has more than 20 hospitals including emergency medical services, specialist healthcare, teaching hospitals, general hospitals, private hospitals. clinics and more than 160 outpatient units, including dental practices (Ref. 16.21).
Figure 16.3 Bathing Water Quality Test Sites and Data for 2012
Source: Ref. 16.20
Varna Region is divided into 12 health districts, the boundaries of which coincide with the boundaries of the municipalities (Ref. 16.21):
• Avren; • Aksakovo;
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• Beloslav; • Byala; • Varna; • Vetrino Valchi Dol; • Devnia; • Dolni Chiflik; • Dylgopol; • Provadija; and • Suvorovo.
Primary Care
The Regional Health Inspectorate of Varna regulates the basic medical care for the population to be carried out by over 320 physicians in general medicine and around 300 dentists working in medical practices evenly distributed in the region (Ref. 16.9 and Ref. 16.21). The average population served by one doctor is 1,500 people (Table 16.5). The average distance between the centres of medical practice and the outermost of these places does not exceed 20 km.
There are eight GP practices in Avren Municipality. Currently, pre-hospital assistance is provided by these surgeries (Ref. 16.21).
Table 16.5 Number of Physicians per 10,000 Residents in District Varna Municipality Asparuhovo (Data from RHI-Varna on 26.08.2013)
Varna Per 10,000 Municipality Per 10,000 Medical Staff to 1 Jan 2013 Region Residents Asparuhovo Residents
Doctors (physicians) 2139 45.20 64 1.86
Dentists 479 10.12 - -
Other medical health care professionals 3014 63.69 116 3.38
Source: Ref. 16.9
Specialised outpatient medical care is provided by around 300 physicians, including specialists in various medical specialties, which is approximately 28 physicians per 10,000 population. In Avren, there is no hospital, so the people of this community receive the medical assistance of the hospitals in the district town or in close communities. A problem is the uneven distribution and concentration of specialists in the district centre. For example, there are 413 healthcare units and dispensaries in Varna Municipality and 11 in the Asparuhovo mayoralty (Ref. 16.9).
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Hospital Medical Care
The structure of medical establishments for hospital support is as follows: one University multi- profile hospital for active treatment; five multi-profile hospitals for active treatment; six specialized hospitals; two regional dispensaries; one multi-profile transportation hospital; one Military Medical Academy (a multi-profile hospital for active treatment); one home for medical and social care for children; and one specialised hospital for rehabilitation. Hospital beds coverage for Varna Region is 45 per 10,000 population and is lower compared to the national average of 64.7 per 10,000 people for Bulgaria (Ref. 16.12).
In 2013, there were 2,593 hospital beds in Varna Municipality (75 per 10,000). In Asparuhovo, mayoralty, which is within the Municipality of Varna, there were 4 per 10,000.
HIV/AIDS and other STIs
Regional Health Inspectorates, NGOs and municipalities deliver outreach activities and campaigns to prevent HIV and other STIs. These include (Ref. 16.13):
• Condom distribution: since the program's inception in 2009 until the first half of 2013 a total of 8,660,362 free condoms were distributed among the target groups;
• Outreach activities and campaigns:
o In 2012 50,862 people from the most vulnerable groups and 158,541 children and young people were involved; and o Between January 2013 and the end of June 2013, over 30,000 people from the most vulnerable groups and nearly 67,000 institutionalized children and young people at risk were involved.
• Healthcare: 5 sectors have been opened to treat patients with HIV at Clinics for Infectious Diseases in Sofia, Plovdiv, Varna, Pleven and Stara Zagora.
Mental Health
Varna Region implements activities in fulfilment of the National Programme for Suicide Prevention at the regional level. A Regional Council for Mental Health has been created to coordinate the programme across the region. Health-education materials are disseminated for suicide prevention among those working with persons from risk groups. In addition, training courses are planned for various suicide prevention groups – general practitioners, medical specialists from schools, social workers, journalists and prevention work at a younger age – children, pupils and students (Ref. 16.19).
Emergency Medical Care
There is a Centre for Emergency Medical Care (CEMC) in Varna municipality which has opened branches for emergency medical services in the territory of Varna Region in the following locations:
• Devnia; • Provadiia;
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• Dolni Chiflik; • Aksakovo; • Beloslav; • Valchi dol; • Dylgopol; and • Byala.
First level emergency rooms for both adults and children are located at Hospital St. Marina PLC, located in Varna.
Second level emergency rooms are located at Hospital St. Anna-Varna.
Access to emergency healthcare is poor in Avren, Vetrino and Suvorovo because there are no branches for emergency healthcare, and transport to nearest branches is difficult due to the distance and road infrastructure especially in the winter period (Ref. 16.21).
16.5.5 Emergency and Disaster Response
Emergency and Disaster Response is discussed in Chapter 20 Unplanned Events. Specifically, South Stream Transport will ensure that contractor’s Emergency Response Plan appropriately integrates with the relevant local, regional and national disaster management plans with regard to command and control systems, points of first contact during emergencies, local capabilities and capacity.
16.6 Legal and Policy Context The community health, safety and security assessment has considered relevant Bulgarian national and regional legislation, applicable standards and guidelines for international finance, and international agreements to which Bulgaria is a signatory. All applicable standards relevant to the ESIA are presented in Chapter 2 Policy, Regulatory, and Administrative Framework, with those of particular relevance to health, safety and security summarised below.
16.6.1 IFC Performance Standards
16.6.1.1 Performance Standard 1
PS1 is addressed across the entire ESIA (see Chapter 2 Policy, Regulatory, and Administrative Framework); however, the following points are noted with regard to the health, safety and security assessment. The methodology includes stakeholder engagement and assessment of vulnerable groups who may be disproportionately affected (Section 16.4.3). In adopting mitigation measures the mitigation hierarchy has been used (Section 16.7.6). Emergency response planning is discussed as part of the assessment of resource demands on health and other emergency services (Sections 16.8 and 16.9).
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16.6.1.2 Performance Standard 2
PS2 (Ref. 16.22) recognises that the pursuit of economic growth through employment creation and income generation should be accompanied by protection of the fundamental rights of workers.
The aspects of PS2 most relevant to occupational health are linked to discussions in the socio- economic assessment which can be found in Chapter 15 Socio-Economic. Chapter 23 Environmental and Social Management also discusses the Grievance Procedure, an important aspect of the management of occupational health and safety issues. Appendix 16.1 assesses the requirements for a safe and healthy work environment and occupational health issues are discussed further within that Appendix 16.1 and are not addressed further within this cha p t e r.
16.6.1.3 Performance Standard 3
PS3 (Ref. 16.23) recognises that increased economic activity and urbanization often generate increased levels of pollution to air, water, and land, and consume finite resources in a manner that may threaten people and the environment at the local, regional, and global levels.
The following points are noted with regard to the health, safety and security assessment. The health and safety assessments take into consideration the current baseline conditions of affected areas and populations such that impact significance and mitigation requirements are sensitive to the level of current environmental degradation. The assessment sections review the potential for pollution, disturbance and resource use to impact human health and where appropriate include technically and financially feasible mitigation measures which aim to avoid (and where this is not possible, minimise) such adverse impacts (Sections 16.8).
16.6.1.4 Performance Standard 4
PS4 (Ref. 16.24) recognises that project activities, equipment, and infrastructure can increase community exposure to risks and impacts and recognizes the responsibility of the Project to avoid or minimize the risks and impacts to community health, safety, and security that may arise from Project-related activities, with particular attention to vulnerable groups.
The following points are noted with regard to the health, safety, and security assessment. The assessment evaluates risks and impacts to the health and safety of Local Communities throughout the Project life-cycle and where appropriate outlines preventive and control measures consistent with good international industry practice (GIIP) (Sections 16.8 and 16.9). The mitigation measures specified in this chapter are commensurate with the nature and magnitude of the impacts that they aim to avoid (or where this is not possible, minimize). The assessments and Chapter 20 Unplanned Events consider community exposure to hazards. Where considered necessary, mitigation measures have been included to minimize exposure (Sections 16.8 and 16.9). The assessment has included consideration of disease associated with water and communicable diseases (including vulnerable groups) (See 16.2 and Section 16.8).
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16.6.2 National Legislation
16.6.2.1 Health Policy
Bulgarian Law of Health (Ref. 16.10) Article 2 states that the preservation of the health of the citizens of the state (complete physical, psychic and social welfare) is a national priority and shall be guaranteed by the state through applying the following principles:
• Equality in using health services; • Providing accessible and qualitative health care, with priority for children, pregnant women and mothers of children up to one year;
• Priority of health promotion and the integrated prophylactics of diseases; • Prevention and reduction of the risk for the health of the citizens from the unfavourable effect of the factors of the living environment;
• Special health protection of children, pregnant women and mothers of children up to one year of age and handicapped and mentally disordered persons; and
• State participation in financing activities aimed at preservation of the health of citizens.
In Bulgaria, the Ministry of Health is responsible for national health policy and the overall organization and functioning of the health system and coordinates with all ministries with relevance to public health (Ref. 16.6). The Health Insurance Act of 1998 (Ref. 16.25) reformed the Bulgarian health system into a health insurance system with compulsory and voluntary health insurance. Health care is financed from compulsory health insurance contributions, taxes, out-of-pocket (OOP) payments, voluntary health insurance (VHI) premiums, corporate payments, donations, and external funding (Ref. 16.6).
As of 2011, the private sector encompasses primary care, much of the specialised outpatient medical and dental care, pharmacies and some hospitals. Emergency care as well as public health services are organized and financed by the Ministry of Health. There are 28 regional centres for emergency care, one in each district, which have branches in the smaller towns in the district (Ref. 16.6).
Health policy priorities are determined by the Ministry of Health through the National Health Strategy (NHS). At the district level, state health policy is organised and implemented by the Regional Health Inspections (RHI) (Ref. 16.6). In 1999, the public health system was restructured to 28 Regional Centres for Protection and Control of Public Health (RCPCPH). At the beginning of 2011, the RCPCPH merged with the Ministry of Health’s representative bodies at the district level – the Regional Health Centres (RHC) – forming the new RHI. The RHI combine functions of the former two institutions. The public health network also includes the National Centre of Radiobiology and Radiation Protection, the National Centre for Infectious Diseases, the National Centre of Drug Addictions, the National Centre of Health Informatics and the National Centre of Public Health Protection. The latter two merged in 2011 (Ref. 16.6).
Environmental factors that affect public health are controlled by the Ministry of Health and the Ministry of Environment and Water through their regional inspectorates. The Minister of Health is responsible for the organization of epidemiological studies examining the relationship
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between environmental pollution and health status and assessing related health risks. The RHI monitor, analyse and evaluate influencing factors at a district level and suggest measures to reduce their impact (Ref. 16.6). A national action plan for environmental health (2008 to 2013) aims to reduce and prevent public health risks due to the impact of environmental factors as well as improve the environment and quality of life. Priority is given to primary prevention aimed at improving the environment and reducing population exposure (air, water, soil, noise, electromagnetic fields, air in living quarters, etc.). The national action plan also envisions actions to support health prevention and mitigate environmental threats (Ref. 16.6).
At a national level, health promotion is supervised by the Department of Public Health of the Ministry of Health, while at a district level, activities are coordinated by the departments of health promotion of the RHI. The National Centre of Public Health and Analysis is responsible for the coordination, implementation and evaluation of many national health promotion and education programmes. NGOs are very active in the field of health promotion as well.
The constitution guarantees equal rights to health care for all insured citizens; nevertheless, certain population groups (people at social disadvantage, unemployed or disabled individuals or those with other particular needs) experience problems accessing services, a fact that adversely affects their health status (Ref. 16.6).
The Government of Bulgaria has adopted measures aimed at overcoming access barriers for the Roma population and promoting Roma health. The National Plan “Decade of Roma Inclusion 2005–2015” and the Strategy against Poverty and Social Exclusion have been established and implemented. The Government has also adopted a Health Strategy for Disadvantaged Ethnic Minorities in order to solve the health problems of specific populations, including the Roma community (Ref. 16.6).
The Ministry of Health’s strategy for people with disabilities and for people from ethnic minorities (Ref. 16.26) is an integral part of the national health strategy aimed at ensuring better health for the Bulgarian population. It aims to achieve a high level of health for Bulgarian citizens with disabilities, ethnic minorities and to stop some of the negative trends in the health of the nation.
The key policy document for management of STIs in Bulgaria is the National Programme for Prevention and Control of HIV and Sexually Transmitted Infections in Bulgaria 2008-2015 (Ref. 16.27). The main goals of the national programme are to extend work on prevention and improve the quality of life of people living with HIV. The national programme (Ref. 16.27) identifies the following high risk groups:
• Injecting drug users (IDU); • Men who have sex with men (MSM); • Roma people (approximately 5% of the population); and • Commerical Sex Workers (CSW) (estimated nationally at 12,000 to 15,000 people).
The national programme (Ref. 16.27) aims to achieve a HIV prevalence rate among CSW of less than 5%. The same target prevalence rate is set for MSM and Roma people. A target prevalence rate of 10% or less is set for IDU.
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16.6.2.2 Emergency Planning
The Bulgarian legislation seeks to ensure the safety of the public and workers during natural disasters, accidents, incidents and other unplanned events. Systems for disaster response under the Disaster Protection Act 2006 (Ref. 16.28) govern the protection of life and health, and the environment and property in case of a disaster. Planning for disaster protection is done at the municipal, regional and national level. The Provisions of the Disaster Protection Act (Ref. 16.28) includes a requirement to develop an emergency plan. This should cover:
• Maximum possible impact on personnel, population and environment from an accident at the site;
• Measures to reduce and mitigate the consequences of an accident at the site; • Measures for the protection of personnel; • Segregation of duties and responsible bodies and individuals to implement the measures; • The tools and resources needed to implement the measures; • Standby time response of structures and persons; and • Procedures for informing the executive authorities of the need to introduce plans for disaster protection.
16.6.2.3 Environmental Impact Assessment of Plans and Programs
The procedure for the performance of environmental impact assessment of plans and programs is regulated in Chapter 6, Section 2 of the Law on Environment Protection (Ref. 16.29) and the Ordinance on the conditions and order for the performance of Environmental Impact Assessment (EIA) of plans and programs (EIA Ordinance).
The 2010 amendment to the EIA Ordinance includes the mandatory involvement of the health authorities in the EIA procedure. Additional amendments to the EIA Ordinance as of January 2011 mainly concern coordination with the relevant health authorities within the EIA procedures (Ref. 16.30).
The assessment of risk for the health of the population in urban areas was moved to the general process of EIA which also ensures health protection. Risk assessment methodology should be applied to determine significance of impact and the health risk for the population from potential sources of negative impact (objects, facilities, installations) and adequate mitigation measures should be suggested based on the risk assessment. Legislation on air quality, noise etc. should also be taken into account.
EIA Ordinance Article 3 defines “Sites Subject to Health Protection” (Ref. 16.5). Sites subject to health protection are residential buildings, health care establishments, schools, kindergartens, child care centres, higher education institutions, sports facilities, temporary housing facilities (hotels, motels, hostels, recreation centres, vacation settlements, camping sites, huts, etc.), recreation and entertainment locations (swimming pools, beaches, and swimming sites, parks and recreation garden, attraction parts, aqua parks, etc.), as well as food manufacturing sites according to § 1, Cl. 37 of the final provisions of the Foods, Goods Exchanges, and Food Markets Act.
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16.6.2.4 Water
The EC Water Framework Directive (WFD) (Ref. 16.31) establishes a framework for a Europe- wide approach to action in the field of water policy. This directive is implemented in the Bulgarian Water Act (Ref. 16.32), which sets the framework for classification of water bodies depending on their biological and chemical status. It aims to ensure all nearshore water bodies are of ‘Good’ status, in terms of ecological, chemical, biological and physical parameters, by the year 2015. Therefore, any activities or developments that could cause detriment to a nearby water resource, or prevent the water resource from reaching its future potential status, must be mitigated so as to reduce the potential for harm and allow the aims of the WFD to be realised. Bulgarian legislation in this area includes:
• Ordinance No. 11 of 25.02.2002 of the Ministry of Health for the quality of bathing water (valid until 31.12.2014); this sets physical, chemical and microbiological standards for quality; and
• Ordinance 5 (30.05.2008) for Monitoring Quality of Bathing Water (Ministry of Health and Ministry of Economics), classification, quality control and public information. Ministry of Health of Bulgaria presents continuous data on the state of bathing water in accordance with the European Information System on the basis of established common criteria. Two basic microbiological indicators adopted are - Intestinal enterococci and Escherichia coli in MPN/100 cm3.
Regarding the risk of short-term pollution of bathing waters, the Directive requires the municipalities to provide and implement management measures - such as warnings, bathing prohibition or measures to reduce pollution. These measures are intended to avoid the risk to bathers and for the prevention, reduction or elimination of the causes of contamination. Information about short-term pollution of bathing waters should be made available to the public on the website of Ministry of Health and/or Regional Health Inspectorate, as well as in the media.
16.6.2.5 Human Trafficking
Prostitution is not specifically addressed in Bulgarian law; however, a variety of activities associated with prostitution, such as procuring persons for sexual exploitation, are illegal. Forced prostitution is illegal and remains a serious problem (Ref. 16.12). Legislative measures against trafficking in persons are in two levels:
• The first level is The Law on Combating Trafficking in Human Beings (obn.v SG. 46 of 20.05.2003, last revision SG.84 from 27 September 2013) containing administrative and penalty norms; and
• The second level consists of amendments to the Criminal Code of 13 September 2002 by adding a new section of Chapter Two of the special part (art. 159a - 159g ) entitled "Human Trafficking." Changes were made in accordance with the requirements of the Protocol on Trafficking in Persons, especially Women and Children (known as katoprotokola Palermo), which supplements the UN Convention against the Transnational Organized Crime of 2000 (ratifitsirana. SG. 42, 2001).
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16.7 Impact Assessment Methodology The following sections set out the methodology for the community health, safety and security impact assessment. Information within Chapter 5 Project Description (along with other chapters as relevant) and the baseline characteristics provided above have been used to assist the evaluation of the potential impacts and their significance.
16.7.1 Methodology
The impact assessment methodology follows the IFC Guidance on HIA (Ref. 16.24). The IFC guidance stresses that ‘the level of effort to assess health impacts should be proportional to the potential health impacts and risks. It is vital to get a good balance that allows health issues to be integrated into project planning and implementation in a timely and cost-effective manner’.
Most of the guidance provided by IFC is applicable and consistent with GIIP. The main exception is the categorisation of environmental health areas which were designed for developing, non-Organisation for Economic Co-operation and Development (OECD) countries. For example, it emphasises vector borne diseases which have a high prevalence rate in Africa but do not have a high prevalence rate in Bulgaria. The categories of environmental health areas mix health outcomes and health determinants. However, the revised guidance does offer an alternative to distinguish environmental, social and institutional determinants of health. This preferred method of categorization has been adopted for this assessment.
The method of prioritisation proposed by IFC and which follows GIIP is based on combining probability and severity to assess significance. By contrast, the methodology utilised for this ESIA combines sensitivity and magnitude to determine significance. In practice, neither method is entirely suitable for assigning significance to health impacts and both are difficult to use consistently across all health issues. In many cases, significance is a judgement made explicitly by the assessor and justified with supporting text. It highlights the issues which are priorities for mitigation. The choice of prioritisation method does not change that judgement. The use of sensitivity and magnitude to determine significance is therefore seen as an acceptable departure from the IFC guidance on HIA (Ref. 16.1).
The health and safety assessment forms part of a prospective process, which means that it is undertaken in advance of the implementation of the Project, thereby providing sufficient opportunity to enable ‘constructive modifications’ to be made to the Project should negative potential effects be identified and mitigations required. The presumption has been to draw up a wide scope of the potential health issues and potentially affected population groups. This wide scope was then narrowed to those health issues and population groups that are most affected by the Project. These issues and population groups have been assessed, including a classification of the significance of their potential impacts.
The health and safety assessment has included consideration of direct, indirect, and cumulative changes in community exposures to environment-based health risks, such as communicable diseases, equipment incidents, and exposure to hazardous materials or conditions.
The health, safety and security assessment has been framed and informed by work undertaken for other parts of the overall Project impact assessment (e.g. air quality and noise modelling)
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and has taken into account the findings of other chapters to inform the assessment of impacts on human receptors; including but not limited to, Chapter 9 Air Quality, Chapter 10 Noise and Vibration, Chapter 14 Landscape and Visual and Chapter 15 Socio-Economics.
The findings of this chapter are also supported by several appendices including Appendix 9.4 and Appendix 15.1: Fisheries Study. Additionally, this chapter has also referred to Appendix 12.1: Sediment Dispersion Study.
16.7.2 Determinants of Health
As described in Section 16.2, the Project has the potential to affect a broad range of environmental, social and institutional determinants of health either positively or negatively, examples are illustrated in Table 16.6.
Table 16.6 Determinants of Health
Categories of Determinants of Health Examples of Specific Health Determinants
Individual factors: genetic, biological, Gender; age; dietary intake; level of physical activity; lifestyle/behavioural and/or circumstantial. tobacco use; alcohol intake; personal safety; sense of Some of these factors can be influenced control over own life; employment status; educational by proposals and plans, others cannot attainment; self-esteem; life skills; stress levels; etc.
Social factors: community and/or Access to services and community (health, shopping, economic/financial conditions support, etc.); social support or isolation; housing; income; distribution of wealth; sexual customs and tolerance; racism; attitudes to disability; trust; sites of cultural and spiritual significance; local transport options available; etc.
Environmental factors: physical Quality of air, water and soil; access to safe drinking water and adequate sanitation; disease vector breeding places; land use and urban design.
Institutional factors: the capacity, Availability of services, including health, transport and capabilities and jurisdiction of public communication networks; educational and employment; sector services environmental and public health legislation; environmental and health monitoring systems; laboratory facilities; etc.
Source: Ref. 16.12
16.7.3 Receptor Sensitivity
Table 16.7 describes the criteria used to assess the sensitivity of community receptors.
As health impacts may or may not be evenly distributed across the population, the assessment has considered the equity of impacts. Vulnerability is a key consideration within the general discussion of social, environmental, and institutional determinants of health. In many cases, certain subgroups (for example, children, women and the elderly) may be disproportionately affected.
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There is some geographical variation in community sensitivity. The area surrounding the Project is largely rural, interspersed with several communities containing a mix of permanently occupied and summer vacation homes. The largest community near the Project is the city of Varna (the central urban area of the Varna Municipality), located approximately 11 km to the north of the Project on the north side of Varna Bay and the two shipping channels that lead through to Varna Lake. To the south of Varna Bay, the largest communities are located in a crescent formation along or close to the coast extending from Asparuhovo (located across Varna Bay from Varna city) down to Rakitnika. The community of Borovets and the adjoining agricultural area of Kantara are separate from this crescent of residential development and are located approximately 2 km inland. To the southwest and west of the landfall facilities, are the two small communities of Priseltsi and Priseltsi VZ. The main areas of recreational land use within the Local Communities are several beaches including Pasha Dere Beach, Chernomorets Beach and other beaches stretching up the coast towards Varna Bay located within or adjacent to Fichoza, Galata and Asparuhovo.
Table 16.7 Receptor Sensitivity Criteria for Community Health and Safety
Sensitivity Description
High Community groups who are very vulnerable because they have high sensitivity to the impacts of the Project and very limited coping strategies. Groups who are very young, very old or disabled may have high sensitivity to changes in environmental health determinants, such as air quality and noise levels. Groups who are poorer or who have lower social status have high sensitivity to changes in social health determinants because they have less access to medical care, complaint procedures or political representatives. They may be marginalised. Groups who share resources constantly with the Project may be more sensitive to its impact. This could include users of roads, tracks, wild foods and marine resources. It could also include those who live adjacent to a Project component such as a busy road. It could include cyclists and pedestrians sharing roads with construction vehicles more than twice per day. Some groups may normally engage in high risk behaviours which make them more sensitive to changes in risk. For example, members of the community who drive dangerously along roads used by construction traffic; those who purchase or provide unprotected sex. Some receptors may anticipate risks to their health and wellbeing and express high levels of anxiety. They are likely to be very aware of actual changes. The technical hazards of a project component may be unfamiliar and poorly understood by a community; and this could increase sensitivity.
Continued…
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Sensitivity Description
Moderate Communities with some coping strategies and some vulnerabilities, who are classed as less sensitive than the high sensitivity group. They are likely to experience temporary inconvenience as a result of changes in environmental or social determinants of health. They may share resources occasionally with the Project, such as two peak uses of roads each day. They express some concerns and anxieties of the impact of the Project on their wellbeing. They have some, but far from complete, understanding of the technical hazards associated with project components.
Low Communities with sufficient coping strategies who feel little or no challenge to their wellbeing as a result of Project Activities. They may share resources with the Project occasionally and broadly understand the hazards associated with project components. Most drivers of private vehicles are in this category.
Negligible Communities who do not share resources used by the project and have not raised concerns about potential impacts. They are generally not inconvenienced by Project Activities or exposed to Project-related hazards.
Complete.
The landfall section of the Project is located within a relatively isolated, naturally and semi- naturally vegetated area; however, there are several dwellings and Local Communities within a 2 km radius of the landfall section of the Project. No health protected areas (e.g. hospitals, schools, nursing homes) occur within a 2 km radius of the landfall section of the Project. Pasha Dere Beach (i.e. the shore crossing) is considered a naturally beautiful beach and is used for bathing, sunbathing and other forms of recreation during the warmer months.
The sensitivity of road users varies. Most drivers of private vehicles are considered to have low sensitivity although those who drive dangerously have high sensitivity (i.e. high vulnerability). The sensitivity of pedestrians and cyclists varies with geographic location and road status. On roads with no segregated lanes or paths, the sensitivity of these road users is ‘high’. The exceptions are in Varna, where pedestrians most often have wide grade level separated footways; along the Asparuhovo Bridge, where there is a fully separated (by a barrier) protected footway that can be used by cyclists and pedestrians; and along the A5 Motorway where there are unlikely to be any cyclists or pedestrians (and therefore no non-vehicular receptors). Where such segregation occurs, the sensitivity of pedestrians and cyclists is considered to be ‘low’.
16.7.4 Impact Magnitude
Project Activities can have impacts on the health of receptor groups.
In the case of community health, it is assumed that a wide range of illnesses and disabilities are already present in the population and this is the baseline prevalence rate. There is a risk that the Project causes, or is attributed to cause, an increase in the incidence and hence prevalence rate of some of the existing conditions. As people value their health, even a small increase in
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the prevalence rate of a disease or disability that is attributable to the Project is classed as a high magnitude event. Table 16.8 classifies impact magnitude for the community health, safety and security assessment.
Table 16.8 Impact Magnitude Criteria
Magnitude Examples Magnitude Characteristic Negligible Low Moderate High
Extent (within a No additional illness <1% additional <10% additional >10% additional defined attributable to cases of morbidity morbidity morbidity community) Project
Duration No time lost to Cannot work for Acute illness <1 Chronic disease illness or injury <24 hours month > 1 month or death
Reversibility No illness or injury Minor illness for There is a risk of Irreversible / which full recovery long term Permanent is expected disability
Frequency Never Very rare Rare Occasional
16.7.5 Impact Significance Criteria
In accordance with the methodology adopted for this impact assessment, receptor sensitivity and impact magnitude are combined to assess significance using the matrix shown in Table 16.9. There is no global consensus on the criteria that should be defined and used in community health impact assessments and GIIP consists of seeking consistency and transparency. In some cases, professional judgement of significance has to be made without strict adherence to the magnitude and sensitivity criteria, because the criteria do not apply to the health issue under consideration.
Table 16.9 shows a significance assessment matrix regarding the relationship between Receptor Sensitivity and the Impact Magnitude of Project impact on the receptors in terms of area and time of impact.
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Table 16.9 Significance Matrix
Receptor Sensitivity (vulnerability and value)
Negligible Low Moderate High
Not significant / Negligible Not significant Not significant Not significant Low* (extent, (extent, Low Not significant Low Low / Moderate† Moderate
Moderate Not significant Low / Moderate Moderate High
Impact Magnitude High Low Moderate High High frequency, reversibility, duration) reversibility, frequency, * Allows technical discipline author to decide if important significance is Not Significant or Low. † Allows technical discipline author to decide if impact significance is Low or Moderate.
16.7.6 Impact Mitigation The ESIA Report uses the impact mitigation hierarchy (Chapter 3 Impact Assessment Methodology). The terminology includes avoid, abate, attenuate, remedy and compensate. These terms may not have obvious meanings in a health context. Table 16.10 provides additional clarification and alternative terminology for community health, safety and security. When advocating mitigation, the highest possible level in the hierarchy should be chosen. For example, there should generally be no obligation for the community to change their own behaviour as a result of the Project in order to remain safe and healthy.
Table 16.10 The Mitigation Hierarchy Defined for Community Health and Safety
Hierarchy Examples
Legislation Standards for noise, air/water quality
Avoid or eliminate Design out, e.g. reduce risk of STIs by employing local rather than foreign workers
Reduce through Design in, e.g. provide double glazing to receptor, build bypass engineering controls
Reduce through Prevent night time driving of Project vehicles, condom distribution, management controls grievance mechanisms, training of security personnel
Continued…
URS-EIA-REP-202375 16-45 Chapter 16 Community Health, Safety and Security
Hierarchy Examples
Change community Apply evidence based health and safety promotion techniques behaviour
Repair Medical care
Compensate Financial compensation, rehabilitation
Complete.
In Section 16.8, impacts are assessed and discussed. Mitigation measures identified to address these impacts following the application of which, the significance of any residual impact (i.e. impact remaining after mitigation measures have been implemented) is stated. For beneficial impacts, the beneficial nature of the impact has been noted but the magnitude of the impact and the sensitivity of the receptor has not been explicitly identified.
South Stream Transport has developed a Grievance Procedure for the Project, which will guide the management of grievances throughout the Project lifecycle (Chapter 6 Stakeholder Engagement). The Grievance Procedure will be implemented by South Stream Transport in partnership with its contractors and will ensure that grievances are brought to the attention of the appropriate Project staff and addressed in an appropriate and timely way. The Grievance Procedure describes the process by which a grievance is documented, investigated, and resolved in coordination with the affected stakeholders.
Monitoring measures and the Grievance Procedure have not been listed individually against impacts in the following sections but can be assumed to apply to all potential Project health, safety and security impacts per the HSSE-IMS.
16.8 Assessment of Potential Impact: Community Health, Safety and Security
The assessment takes as its starting point the ‘residual’ impacts and mitigation measures already included in other ESIA chapters. This allows the assessment to focus on any outstanding issues that have a bearing on community and population health, safety and security and avoids duplication and restatement.
The assessment assumes the successful implementation of design controls and mitigation measures described in other ESIA chapters. The design controls and mitigation measures proposed in other ESIA chapters are therefore important to minimising potential impacts. Given the significance rankings of the impacts in the other ESIA chapters, and taking into account the design controls outlined and mitigation measures proposed, a range of potential impacts have been scoped out of further assessment in this Chapter on the basis that the design controls and mitigation measures presented in other chapters adequately address any potential impact to community health, safety and security.
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A brief summary of these potential impacts that have not needed further assessment in this cha p t e r, and the chapters of this ESIA Report where they are discussed, is presented in Table 16.11 for reference. A fuller explanation of these potential impacts, how they relate to community health, safety and security and the basis on which these potential impacts were scoped out of the following assessment is presented in Appendix 16.2: Potential Impacts Discussed in Other ESIA Chapters and Scoped Out the of the Community Health, Safety and Security Assessment.
Table 16.11 Potential Impacts Discussed in Other ESIA Chapters and Scoped Out the of the Community Health, Safety and Security Assessment
Relevant ESIA Potential Impact Chapter
Construction and Pre-Commissioning Phase
Disruption of community third party utilities as a result of accidental damage Chapter 5 – Project during construction. Description Ground excavations, including foundations, trenching and microtunnelling have the potential for injuries or fatalities arising from falls and excavation collapse.
Fuel and oil leaks and spills from construction vehicles / plant (including Chapter 8 – Soils, activities related to both the main onshore facility and marshalling yards). Groundwater and Surface Waters
Release of dust from excavation and construction traffic movements. Chapter 9 – Air Quality Deposition of mud on the local roads from construction vehicles with the potential to cause road accidents leading to personal injury. Air quality emissions from marine vessels engaged in nearshore and offshore survey, dredging, pipe-laying and support activities.
Restriction of access / fragmentation of access due to construction works. Appendix 9.4
Noise and vibration emissions from construction plant and pre-commissioning Chapter 10 – Noise activities, including offshore survey, dredging, pipe-laying and support activity and Vibration engines and on-board plant.
Light pollution from construction works. Chapter 14 – Landscape and Visual Physical presence of construction vessels in nearshore area (within sight from shore) could result in loss of income from tourist industry.
Continued…
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Relevant ESIA Potential Impact Chapter
Pre-construction pipeline route surveys and construction activities causing Chapter 15 – Socio- temporary land loss and/or disturbance. Economics Risk of house price and food price inflation due to influx of non-local workers during Construction and Pre-Commissioning Phase. Unemployment for workforce at the end of the Construction and Pre- Commissioning Phase. Beneficial impact at the national (Bulgarian) level for businesses engaged in the manufacture and supply of goods and services during the Construction and Pre-Commissioning Phase. Adverse impact on local tourism due to disruption and reduced visual appeal and local amenity of the area due to industrial nature of project. Risk of house price devaluation due to proximity of the development. Increase in vessel traffic restricting recreational and commercial uses of nearshore and offshore zone, including ports and any exclusion zones.
Waste generation, storage and disposal, including drilling lubricants and waste Chapter 19 – Waste fluids from construction. Management
Accidental underwater third party utility damage. Chapter 23 – Environmental and Social Management (CMPs/HSSE-IMS)
Operational Phase
Fuel and oil leaks and spills from vehicles / plant engaged in maintenance and Chapter 8 – Soils, repair activities. Groundwater and Surface Waters
Air quality emissions from operational plant, vehicles and materials and marine Chapter 9 – Air Quality vessels engaged in nearshore and offshore pipeline surveys and repairs. Controlled venting of natural gas from a vent stack during a planned shutdown for maintenance or repairs of the landfall facilities.
Noise and vibration emissions from operational plant and marine vessels. Chapter 10 – Noise and Vibration
ROV and ROTV nearshore survey activity and pipeline maintenance activities Chapter 12 – Marine causing the release of sediments to water column. Environment
Visual impact of industrial complex replacing rural setting. Chapter 14 – Landscape and Visual Physical presence of survey and maintenance vessels in nearshore area.
Continued….
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Relevant ESIA Potential Impact Chapter
Local job creation. Chapter 15 – Socio- Economics Adverse impact on local tourism due to disruption and reduced visual appeal of the area due to industrial nature of project. Operational land use change including proposed safety restriction areas. Adverse impact on fisheries-related livelihoods.
Site security enforcement. Chapter 23 – Environmental and Social Management (CMPs/HSSE-IMS)
Construction and Pre-Commissioning and Operational Phases – nearshore and offshore
Local job creation for nearshore and offshore activities has the potential for Chapter 15 – Socio- positive physical and mental health outcomes. Economics
Waste generation, storage and disposal on-board vessels. Chapter 19 – Waste Management
Collision with other vessels during nearshore and offshore activities resulting Chapter 20 – in personal injury or fatalities. Fuel and oil leaks and spills from vessels / plant Unplanned Events engaged in nearshore and offshore activities.
Complete.
It is important to note that the mitigation measures presented in the community health, safety and security assessment in the remaining sections below are in addition to, and not alternatives to, the measures presented in other chapters and all measures work together in order to achieve the impact rankings presented for residual impacts.
16.8.1 Impact Assessment: Construction and Pre-Commissioning Phase
16.8.1.1 Introduction
This section identifies the potential impacts and risks to community health receptors which require further assessment using the community health, safety and security methodology. For those effects where potentially significant pre-mitigation impacts are assessed in Section 16.8.1.2, potential mitigation measures have been identified in Section 16.8.1.3. This is followed by a residual impact assessment, the results of which are set out in Section 16.8.1.4.
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16.8.1.2 Assessment of Potential Impacts (Pre-Mitigation)
Social Factors
An incoming, temporary workforce will be required for Project construction. Construction of the landfall section, including the landfall facilities, will generate approximately 330 temporary jobs in total with the peak employment lasting approximately nine to 12 months within a total landfall section construction period of approximately 27 months.
Marine-based construction (i.e. the nearshore and offshore sections) will generate an estimated maximum of 1,669 temporary jobs in total with a peak of approximately 1,100 jobs required at any one time over a period of approximately six months during each year of the marine section construction period (i.e. over three consecutive years). The construction period for the nearshore section will be approximately 12 months and the construction period for the offshore section (in Bulgarian waters) will be up to 30 months.
Three marshalling yards (to be located at the Varna East, Varna West and Burgas ports) will be required for the duration of the Construction and Pre-Commissioning Phase and will also generate employment during this period. Each marshalling yard will need approximately 80 workers. The third marshalling yard could employ up to 408 full-time equivalent workers (maximum) if a quad jointing facility is required.
The construction workforce will be lodged in local accommodations and for the purposes of the socio-economic and health, safety and security assessments, it is assumed that they will lodge in the city of Varna (and city of Burgas for any non-local workers at the Burgas Port marshalling yard).
It is not yet known where vessel crews will come ashore for onward transit during a shift change, however, if they come ashore in Bulgaria it is likely to be in the ports of Varna and Burgas.
It is anticipated that the workers will be housed within existing facilities in the area and that they will interact with local communities. The extent of this interaction will depend on the living, working and recreational conditions for the workforce. Indeed some workers may originate from the local area having taken up employment opportunities from the Project. The offshore workforce will live aboard the vessels on which they work. The majority of onshore and offshore workers are likely to be adult males.
The following potential impacts resulting from Project activities with community, economic and financial outcomes were identified as potentially giving rise to community and population level health impacts:
• Conduct of workforce in the community; • Spread of sexually transmitted infections; and • Employment opportunities for the local population.
Each of these is discussed in turn in the sections below.
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Conduct of Workforce in the Community
This issue is relevant to the landfall, nearshore and offshore sections of the Project.
Potential for conflict between the local community and the workforce depends on the living, working and recreational conditions for the workforce. For the onshore construction workforce, interactions with the local community are likely to be normalised and they are likely to be regarded as community members. Risks of antisocial behaviour and injury are reduced if normal codes of conduct are followed. During the tourist season the workforce will be small compared to the number of incoming tourists, but outside the tourist season it may be more apparent. Although it is not yet known if offshore workers will interact with the community during transit, the potential for community impacts related to the offshore workforce is greatest during periods of leave, such as shift changes when vessel crews would come ashore for short periods of time.
The baseline indicates that alcohol is routinely consumed in Bulgaria and that workers will enjoy easy access to many types of alcohol including unrecorded alcohol (Ref. 16.16). There is a potential for increased numbers of anti-social incidents if the workforce engages in excessive use of recreational substances (such as alcohol) when visiting local communities outside of working hours.
There is also the potential for conflict between communities and direct or contracted workers who will provide security to safeguard the Project’s personnel and property.
The existing mitigation measures to be implemented by the Project include:
• The intention of South Stream Transport is to require its contractors, where practicable, to provide the opportunity for local people to seek employment opportunities on the Project, which will assist in mitigating the potential for tensions related to unmet employment opportunities; and
• To mitigate further these risks, South Stream Transport will keep communities informed about Project activities through ongoing stakeholder engagement, and implement the grievance mechanism to communicate and resolve any grievances arising from Project activities (see Chapter 6 Stakeholder Engagement for further information).
The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be moderate. If the workforce is housed in smaller communities then it would be harder for the host community to limit proximity to the workforce or to avoid particular venues that are visited by the workforce. Furthermore, if there is a large security workforce, it will be more challenging to limit their exposure to Local Communities. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be moderate. This is because altercations, however unlikely, have the potential for serious injury. Applying the scoring of the Significance Matrix the significance of health impacts arising from this activity, without including any additional mitigation or monitoring requirements, is Moderate.
Spread of STIs Due to In-Migration of Non-Local Workers
This issue is relevant to the landfall, nearshore and offshore sections of the Project.
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The sexual activity of the Project workforce during leave and outside of work hours has potential to introduce or spread infectious diseases, including STIs, particularly where CSW are involved.
It is noted that the size of the workforce will be small relative to the large numbers of tourist visitors that the Varna and Burgas regions receive each year. However, as the majority of workers are expected to be adult males, and as there is scope for a diverse range of countries of origin (particularly for vessel crews), this poses potential risks in terms of transmission of infectious disease. The specific risk identified is the potential for an increase in the local incidence of STIs. The likelihood of this occurring depends on the living, working and recreational conditions for the workforce and their sexual activity with CSWs or other persons in the Varna and Burgas regions.
It is noted in the baseline that Bulgaria maintains a relatively low HIV prevalence among the general population with the incidence of new cases per 100,000 population being roughly half that of the EU as a whole. The baseline also notes that in the Varna Region in 2011, an increase in the number of reported cases of syphilis and STIs was reported comparable to 2010.
CSW can be vulnerable to STIs and can also contribute to the transmission of such infections. The baseline states (and Chapter 16 Socio-Economics further explores) that while the exact number of CSWs in the area is unknown, the influx of a sizable construction workforce could be seen as a potential market for commercial sex work and could elevate the levels of forced prostitution. During stakeholder engagement, the Bulgarian National Commission for Combating Trafficking in Human Beings highlighted that the Project and arrival of new construction workers may expand the market for CSWs in the local area as CSWs appear in response to demand, perceived or real (Ref. 16.14).
CSWs can be found working on a stretch road that will be used as part of the access route to the landfall construction site. It is also observed that due to the nature of their working environment (roadside commercial sex activity) such CSWs may be more likely to engage in unprotected sex (the baseline notes that street based CSW groups in Bulgaria have the lowest status and least control). People who are deprived, addicted to drugs and/or suffer from mental illness are particularly susceptible to sexual exploitation. The high prevalence of HIV among the drug users population makes this group vulnerable to further spread of the disease and increases the risk of sexual transmission to the general population through commercial sex workers.
The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be moderate. This is because of the presence of a structure for procurement of CSWs across the Varna Region and because of the presence of CSWs on part of the access route for the Project landfall section. The CSWs thus have the potential to spread infections and also become infected themselves. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be high. This is because the infection impacts may go beyond the Construction and Pre-commissioning Phase with wider prevalence implications for local communities and health resources. While the majority of the workforce will only transit through the large population centres, the significance of health impacts arising from this activity, without including any additional mitigation or monitoring requirements, is considered to be High.
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Employment Opportunities for the Local Population
This issue is relevant to the landfall section, as the majority of marine construction activities (nearshore and offshore) will likely be undertaken by a specialised and non-local workforce provided by the construction contractor.
The majority of the construction workforce required will be highly skilled and is anticipated to come from outside the local area. However, there is potential for local job creation (including activities related to both the construction of the landfall section and to the marshalling yards). The construction of the landfall section will be led by the construction contractor. Therefore, it is not possible to know the exact amount of local employment, if any, that will be generated, but it is estimated that up to approximately 30% will be unskilled and that the contractor may decide to source some of that workforce locally. Each marshalling yard will need approximately 80 workers. In total, two of the marshalling yards at Varna West, Varna East and Burgas might employ approximately eight to 13 full-time workers between them and the third marshalling yard might employ 408 full-time workers (maximum) if a quad jointing facility is required.
In addition to direct local employment, the Project will require the procurement of materials and equipment from locations in Bulgaria, the EU and outside the EU. The activities will give rise to some direct and indirect employment across a wider area. Overall, Chapter 15 Socio- Economics concludes that employment generation and increased demand for goods and services will be a beneficial (but limited) impact of the Project.
Employment is associated with positive physical and mental health outcomes: the quality of the employment is associated with the health effect (Ref. 16.33), for example the terms and conditions of the contract and the working conditions. Appropriate training has also been found important (Ref. 16.34). Unemployment is associated with increased mortality rates (Ref. 16.35 and Ref. 16.36).
During consultation undertaken as part of the scoping process, creation of local employment (including sub-contractors and secondary industries providing goods and services) was perceived as an anticipated positive benefit of the Project for Local Communities (Ref. 16.37). Local businesses and residents asked if there would be local employment in Varna and Burgas, and opportunities for local companies to supply materials, such as concrete (Ref. 16.37).
Population groups likely to disproportionately benefit from job opportunities created by construction activities include the unemployed and people with high levels of deprivation, particularly those on low incomes.
The existing enhancement measures in the ESIA include:
• South Stream Transport will encourage the use of local labour for the Project including by requiring its contractors to advertise suitable available positions in local and regional media, use local recruitment agencies and engage in other similar activities, so as to provide the opportunity for local people to access employment opportunities created by the Project; and
• Where practicable, SST will require its contractors to advertise suitable available contracts for goods and services in local and regional media, establish contacts with the local Chamber of Commerce and business associations and engage in other similar activities.
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Whilst the Project will provide opportunities for local labour to access employment and for local firms to secure contracts for the supply of goods and services, the effects of direct employment are expected to be relatively modest as the majority of the construction workforce required will be highly skilled and is anticipated to come from outside the local area.
For those individual workers that do benefit from employment and service provision opportunities, the impact on the general health of workers and their families is likely to be beneficial.
Positive impacts are not scored using the significance matrix; however, the following points are noted. The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be high. This reflects the potential for the employment benefits to include vulnerable groups, e.g. families with low incomes. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be Beneficial and limited.
Environmental Factors
The following potential impacts resulting from Project activities that affect the physical environment were identified as potentially giving rise to community or population level health impacts.
• Impacts from noise sources; • Road transport impact, particularly from HGVs; and • Mobilisation of historic seabed pollutants.
Each of these is discussed in turn in the sections below.
Impacts from Noise Sources
Each of the noise sources and potential impacts is described below and an overall assessment of the significance of noise impacts can be found at the end of the section.
The document Night Noise Guidelines for Europe (Ref. 16.38), issued by the WHO, quantifies the night-time noise levels at which health effects are reported to occur. This document states that if the external night-time noise level exceeds a level of 42dB, residents may report sleep disturbance. Below this level, no significant health effects are found to occur. The severity of any effect would depend on the individual’s vulnerability, predisposition and the duration of the exposure.
Construction Noise and Vibration Impacts from Vehicles, Plant and Vessels
This issue is relevant to the landfall and nearshore sections of the Project. As there are no human receptors in the offshore section, this impact has not been assessed for that section.
Noise and vibration emissions from construction plant and vehicles include piling; excavation; microtunnelling; HGVs; loading; and unloading activities (including activities related to both the main onshore facility and marshalling yards). These emissions have the potential to adversely affect health by disturbance to residential dwellings and visitors.
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Excessive or persistent noise exposure can have a detrimental effect on health including on cardiovascular disease and on sleep, work or leisure activities. Noisy outdoor environments (commonly traffic noise) can also affect the social inclusion component of social pathology risk factors. For example, intrusive traffic noise can make streets less conducive for social interactions (Ref. 16.39).
Vibrations transmitted from construction activities to residential receptors can cause anxiety as well as annoyance, and can disturb sleep, work or leisure activities (Ref. 16.39).
The baseline notes that noise in urban areas is an existing issue in Varna Municipality.
During consultation in January 2013 some stakeholders raised the issue of noise impacts related to the Project’s landfall construction activities. Many of the concerns expressed related specifically to local noise from the planned SSB Varna CS,3 as there is already an existing facility, between the community of Rakitnika and the proposed Project landfall facilities, which is used for the neighbouring Galata pipeline. There are existing noise impacts associated with the movements of HGVs near residential areas (Ref. 16.37).
Access Road Noise Impacts
The ESIA noise and vibration assessment (see Chapter 10 Noise and Vibration) notes that the minimum distance from the proposed new access road to noise sensitive residential properties in Priseltsi VZ is approximately 50 m (Figure 16.4). Based on the noise modelling described in Chapter 10 Noise and Vibration, the noise level that will be experienced at the nearest residences in Priseltsi VZ will be 29 dB(A) (Table 16.12). Chapter 10 Noise and Vibration concludes that this residual impact to residents in Priseltsi VZ will be Not Significant for construction activities.
Table 16.12 Noise Levels Generated by Transport Noise from New Access Road
Type Receptor dB(A)
Transport noise from Residential properties in Priseltsi VZ (vehicles movements 29 new access road from 7am until 7pm)
Source: URS noise modelling
As vehicle movements will be limited to between 7 am and 7 pm and noise levels will not exceed statutory norms, there will be a low potential for disturbance impacts and no health impacts are anticipated.
3 This is being constructed by SSB, not by South Stream Transport.
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Figure 16.4 View from New Access Road Route (Left) to Nearest Residential Receptors at Priseltsi VZ (right)
Source: Ref. 16.40
Pre-Commissioning Noise Impacts
After each pipeline has been installed, a number of activities, known as pre-commissioning activities, will be undertaken to ensure that the pipelines meet operational requirements. The primary objective of these activities is to verify that the pipeline has been laid without significant defects and that it is in a suitable condition to be filled to transport the gas at the anticipated pressure and to deliver the gas to the required specifications.
As described in Chapter 5 Project Description, there are three separate pre-commissioning elements. Firstly, the nearshore and landfall section (excluding landfall facilities) pipelines will undergo pre-commissioning activities, followed by the pre-commissioning activities of the landfall facilities. Chapter 10 Noise and Vibration concludes that noise impacts from these first two elements will be not significant and based on the predicted noise levels no health impacts are anticipated.
The third element, pre-commissioning of the pipeline from Russia to Bulgaria, involves pre- packing the pipelines with compressed air using a compressor spread at the landfall facilities to control the speed of Pipeline Inspection Gauges (PIGs) inserted to the pipeline at the Russian landfall facilities. This will require approximately 56 combined compressor and booster units, to be located at the Bulgarian landfall facilities, which will operate continuously for approximately 20 days per pipeline. The ESIA noise and vibration assessment modelling has assumed as a worst-case scenario that all 56 compressors are operating continuously at full power and the magnitude of the impact was assessed using the night time criteria as the activities will run during the day and the night. As noted in Chapter 10 Noise and Vibration, it is not clear at this stage in the Project whether all the compressors will be required to run at full power for the entire duration of the pre-packing activity. The calculated noise levels are the maximum noise levels that can be expected at the sensitive receptors throughout the duration of the activity. It
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is likely that, for substantial periods within the activity duration, the noise levels at the sensitive receptors will be within the night-time limit given in the applicable regulation (Ordinance 6/2006). Once more information is known about the required load on the compressors, and the noise levels generated by the compressor at a specified load, it may be apparent that the noise levels that will be generated will be within the norms.
However, if it is determined that mitigation is required due to the noise levels generated, the suggested mitigation measure is the construction of a noise barrier around the compressor spread, as outlined in Chapter 10 Noise and Vibration. The noise levels have been calculated with the barrier described in place, as shown below in Table 16.13. The significance of the impact of the noise generated by the compressors, with this barrier in place, has been found to be high at all identified receptors, as it will still exceed the statutory night time norms. The only exception to this is at Pasha Dere Beach, where significance of the impact will be low, as the activities will not occur during the summer months and hence the beach will be unoccupied. In order to reduce the noise levels at the most exposed receptor (Chernomorets Tourist Resort) to below 35 dB(A) to comply with the Bulgarian night-time noise norms, an overall reduction of 8 dB(A) has been estimated to be required. To achieve such a noise level reduction, it is considered that a combination of measures will need to be implemented including the use of inherently quieter plant in conjunction with the provision of acoustic screens surrounding the plant compound.
Table 16.13 Pre-Commissioning Phase of South Stream Offshore Pipeline Residual Levels with Barrier
Type Receptor Leq (dB(A))
Pre-commissioning Two residential dwellings, located approximately 2 km north- 47 compressors east of the pipeline route and landfall facilities.
Chernomorets Tourist Resort, located approximately 1 km north 43 of the pipeline and 2.5 km east-north-east of the landfall facilities.
At the proposed landfall site on Pasha Dere Beach 50
The south-western residences of the settlement of Rakitnika, 48 located approximately 1.8 km north of the pipeline and 3 km north-east of the landfall facilities.
A residential dwelling on the outskirts of the settlement Priseltsi 50 VZ, approximately 50 m from the proposed construction route.
Source: URS noise modelling (Adapted from Chapter 10 Noise and Vibration)
It can be seen from Table 16.13 that the residual noise levels (including an additional reduction from the values in the Table of 8dB(A), as described above) during pre-commissioning activities are not predicted to exceed a level of 42 dB at any identified receptors. On this basis there is no identified potential for health impacts to occur at any of the five receptors.
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Marshalling Yards
Noise Impacts
To facilitate the offshore and onshore pipe-laying activities three marshalling yards are proposed at existing ports Varna East, Varna West and Burgas. Chapter 5 Project Description notes that it is anticipated that all three marshalling yard locations will be required in order to provide the necessary storage capacity and meet pipe supply demands for the installation of the four offshore pipelines. However, at the time of writing, discussions with the port authorities are on- going. Consequently, final confirmation on the use of each port is yet to be confirmed.
Sources of noise emissions at the ports include: the movement of vehicles around the marshalling yard site; loading and offloading of pipeline sections; and operation plant and equipment. All three ports are existing developed ports and these activities are assumed to be within the scope of normal port activities (Chapter 10 Noise and Vibration). In addition, at all the port locations, the assembly and dispatch activities will be under controlled conditions maintained by the port authorities and the impact of these is not discussed further.
There are peripheral communities outside both Varna East and Burgas ports; however, such peripheral communities are already impacted by port activities. Varna West port does not have a peripheral community subject to impacts. Given this, impacts from activities at the Burgas or Varna West ports have been scoped out of further assessment for noise. Activities at Varna East Port have been assessed for noise impacts due to the existence of a peripheral community outside the port that includes a site subject to health protection – the Varna Transport Hospital although the Bulgarian statutory norms for noise are already being exceeded at this location by existing activities during both the day and the night (Chapter 10 Noise and Vibration).
Chapter 5 Project Description describes a quad-jointing facility which may also be constructed at one of the marshalling yards. Alternatively, quad jointing could be undertaken on-board a pipe-lay vessel moored at one of the three marshalling yards. It will be up to the construction contractor as to whether a facility is constructed or a pipe-lay vessel is used for quad jointing and in which marshalling yard this will be located. Given the limited amount of information available, it is not possible at the time of writing to consider the impact that this may generate, hence the impact of the quad-jointing facility has been scoped out of this assessment. Should it be decided to construct a quad-jointing facility in the marshalling yard of Varna East or Burgas ports, the impact of the noise generated by the facility will need to be assessed. If the activity is undertaken aboard a vessel or the facility is constructed at the Varna West marshalling yards, the impact of the facility will be negligible and further assessment for noise impacts is unlikely to be necessary.
Varna East Marshalling Yard
The ESIA noise and vibration assessment identifies four receptors at approximately equivalent distances around Varna East marshalling yard. Two of these receptors (R10 and R11 in Figure 16.5) are residential receptors and are subject to the statutory norms for such receptors which are 55 Leq dB(A) for day and 45 Leq dB(A) for evening and night. The third r e ce p t o r, the Varna Transport Hospital (R12 in Figure 16.5) is subject to Ordinance 6/2006 (Ref. 16.38) criteria for medical institutions which set the noise threshold of 45 Leq dB(A) (day) and 35 Leq dB(A) (evening and night). This lower statutory threshold (as compared with thresholds for residential
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receptors) reflects the greater potential for adverse health impacts that could result from disturbance of unwell and recovering patients. The fourth receptor, Varna Beach (R9 in Figure 16.5), is subject to the norms for recreational areas.
For the purposes of the noise assessment, the impact magnitude criteria at the Varna Transport Hospital and at Varna Beach, have been chosen to be the same as those for residential areas. It is not considered necessary to meet the more stringent criteria for medical institutions and recreational areas at either of these receptors, as the ambient noise levels at these locations are already in excess of the less stringent norms for residential areas (see Chapter 10 Noise and Vibration).
All four receptors are predicted to experience not significant pre-mitigation daytime noise impacts from marshalling yard activities. Pre-mitigation night time noise impacts are predicted to be High for three receptors and Not Significant for the receptor Varna Beach. Figure 16.5 shows the location of the Varna Transport Hospital (R12 in Figure 16.5) relative to the approximate boundary of the marshalling yard (red line). Table 16.14 shows the noise levels that have been predicted at the Varna Transport Hospital.
Figure 16.5 Transport Hospital Varna Location Relative to ESIA Noise and Vibration Assessment Receptors around Varna East Marshalling Yard
Source: Ref. 16.41
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Table 16.14 Noise Levels Generated by Marshalling Yard Activity (Varna East)
Type Receptor Leq
Marshalling yard activity Varna Transport Hospital – without barrier (i.e. 44 (day) (Varna East) pre-mitigation) 46 (night)
Varna Transport Hospital – with barrier 43 (day) 44 (night)
Source: URS noise modelling
Based on the Night Noise Guidelines for Europe (Ref. 16.38) mentioned above, there is potential for the following effects to occur from the existing ambient noise levels which already exceed the statutory thresholds: self-reported sleep disturbance; environmental insomnia; and adverse impacts on hypertension for patients (and staff) at Varna Transport Hospital. Assuming comparable figures for the other receptors around the marshalling yards, similar impacts could be expected.
Construction Activities (Including Microtunnelling) Noise Impacts
A source of night-time noise impacts is the microtunnelling operation (Table 16.15). This will be undertaken on a 24-hour per day, seven day per week basis. It is anticipated that each microtunnel will take approximately three to four months to excavate. However, the construction schedule to complete all four microtunnels is approximately 8 months as the construction for each tunnel will overlap.
Table 16.15 Noise Levels Generated by Construction Activities (Including Microtunnelling)
Type Receptor Leq
Construction activities Pasha Dere Beach Pre-mitigation 46 (day) (including microtunnelling) 42 (night)
Pasha Dere Beach Residual Impact 39 (day) 35 (night)
Source: URS noise modelling
As the night-time noise levels are not predicted to exceed 42 dB at any of the identified receptors, no adverse health impacts are anticipated due to the noise generated by the construction activities.
Overall Noise Impact Scoring
The mitigation measures to address noise impacts presented elsewhere in this ESIA Report include:
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• Design controls and mitigation measures are set out in Chapter 10 Noise and Vibration which include:
o Selection of plant that gives rise to the lowest feasible noise emissions; o Careful on site location and orientation of plant; o The use of temporary noise barriers and/or soil screening bunds to reduce noise; o The separation plant should include mitigation measures in its design, if necessary, to reduce the overall sound power level of the plant, in order to ensure that the relevant noise norms at the sensitive receptors are not exceeded; o Mitigation measures will be applied at the Varna East marshalling yard to reduce the noise levels generated by the marshalling yards to within the relevant noise norms; and o If it is determined that mitigation is required to reduce pre-commissioning noise, a noise barrier may be constructed around the compressor spread.
The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be high as both night time residential receptors and the Transport Hospital Varna are affected. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be moderate. This is because the level of noise predicted, although within the regulatory limits, is close to or at the limits in some instances. Applying the scoring of the Significance Matrix, the significance of health impacts arising from this activity, without including any additional mitigation or monitoring requirements, is high. However, based on professional judgement (given the short term and temporary nature of some impacts, the existing ambient noise levels in some areas and the fact that in most instances noise levels will not exceed the 42 dB level at which health impacts are predicted to occur) the significance is assessed to be Moderate.
Road Transport Impacts, Particularly Heavy Goods Vehicles
This issue is relevant to the landfall section of the Project.
Materials that are required for the installation of the landfall section of the Project will be delivered from the marshalling yards to the landfall construction sites by road. The Project will require the construction of approximately 1.3 km of new permanent access road to provide access to the landfall facilities.
Potential health impacts arise from the increase in traffic flows and increase of heavy and oversize vehicles on local roads due to construction activities (including activities related to both the main landfall section and marshalling yards). Increases in construction road traffic (movement of materials and personnel) through community areas can result in a number of effects for other road users, such as: • Reduction in real or perceived road safety; • Overload of junction capacity; • Driver delay; • Community severance; • Intimidation and fear; • Reduced pedestrian amenity; and
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• Increase in hazardous loads.
If access routes are poorly conceived, difficult to access, poorly maintained or perceived as unsafe, construction traffic can act as barriers to encouraging the use of active transport (Ref. 16.39). The density of motorised transport can also negatively affect social cohesion within a community though direct community severance due to road construction or through the impact of high levels of heavy motor traffic (Ref. 16.39).
Perceived physical danger posed by motorised traffic has been cited as one of the main barriers to engaging in walking and cycling. For road safety issues children, the elderly, pedestrians and cyclists are considered to be vulnerable population groups.
During consultation, local residents were concerned about the potential impacts associated with a proposed access road near the residential area of Priseltsi VZ (Ref. 16.37). Local community members were concerned about proximity to residential areas and vineyards, increased traffic, noise, safety and general disturbance to wellbeing, as well as whether or not the access road could be used after construction is completed (Appendix 9.4 and Chapter 6 Stakeholder Engagement).
The existing mitigation measures presented elsewhere in this ESIA Report include:
• Workers will be transported to the landfall section construction sites by mini buses if required to reduce traffic movements and routes will be coordinated with local authorities;
• Approved transport routes and potential impacts of traffic travelling to the landfall section construction site will be managed through the Bulgarian Landfall CMP;
• Movement of ‘outsize’ or ‘large/long’ vehicles, or convoys, will be timed, where practicable, to avoid busy traffic periods;
• Strict enforcement of speed limits for employees driving company vehicles and adherence to driving and health and safety guidelines during both work and non-work hours;
• Drivers will be briefed to maintain vehicular access to all existing properties and relevant safety measures to be applied along the designated construction access route;
• Training and enforcement to ensure that all South Stream Transport / contractors drivers adhere to all Bulgarian driving rules;
• All drivers will be trained in ‘well driven’ principles and guidance; and • Driving performance will be assessed and monitored with additional training provided, if necessary.
Appendix 9.4 concludes that flows on the sections of the highway network that will carry significant volumes of construction traffic are within the capacity of the networks. The calculated level of construction traffic when spread over the duration of the works and the working day results in relatively low additional volumes of traffic. The only section of the highway where there will be a material increase in traffic is the section of Route 9 between the southern end of the A5 Motorway and the permanent access road that will run along the edge of Priseltsi VZ (Figure 16.6). Route 9 was formerly part of the strategic route between Varna and Burgas and is therefore fully capable of catering for the additional traffic. However, this
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section of the highway is used by CSWs and their clients who are considered as sensitive receptors. This section of the road also passes through a wooded area where there is no pavement adjoining the road and in some places the trees are close to the road itself.
In addition, in order to access the landfall facilities, South Stream Transport will utilise an access road to be constructed by SSB for the SSB Pasha Dere RT and Varna CS (Appendix 9.4). This SSB road will be built along the single track (currently unsurfaced) road that extends from the junction on Krushkite Rd (Figure 16.6). South Stream Transport will utilise this SSB road for access during both construction and operations. In addition, South Stream Transport will also construct a new section of road extending from the end of the SSB access road to the South Stream Transport landfall facilities. Appendix 9.4 assesses that there will only be 51 daily construction related traffic movements along the new access road. As the road runs through an agricultural area and along the edge of the Priseltsi VZ community with few surrounding residences, impacts from traffic increases are unlikely to have an impact on the surrounding community in terms of road safety, community severance or reduced pedestrian amenity.
Figure 16.6 Junction of (Currently Unsurfaced) Access Road and Krushkite Road
For road safety, the sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be high. This reflects a precautionary approach since certain vulnerable sub-populations are known to be present e.g. CSWs and their clients, children, the elderly, pedestrians and/or cyclists. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be high. This is because although temporary, there are periods of intense activity during the construction period when large
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numbers of HGV and other vehicle movements will occur. Applying the scoring of the Significance Matrix the significance of health impacts arising from this activity, without including any additional mitigation or monitoring requirements is High.
Mobilisation of Historic Seabed Pollutants during Dredging and Tunnelling
This issue is relevant to the nearshore section, where microtunnelling exit pits and dredging will occur.
The EC WFD (Ref. 16.42) establishes a framework for a Europe-wide approach to action in the field of water policy. This directive is implemented in the Bulgarian Water Act (Ref. 16.43), which sets the framework for classification of water bodies depending on their biological and chemical status. It aims to ensure all nearshore water bodies are of ‘Good’ status, in terms of ecological, chemical, biological and physical parameters, by the year 2015. Therefore, any activities or developments that could cause detriment to a nearby water resource, or prevent the water resource from reaching its future potential status, must be mitigated so as to reduce the potential for harm and allow the aims of the WFD to be realised.
It is noted that the presence of inert sediment in the water is not anticipated to result in any direct health impacts, although it could cause anxiety and reductions in leisure activities. Direct health impacts may, however, arise from the disturbance of historic seabed pollutants. There is potential for nearshore dredging and pipe-laying activities to disturb and mobilize existing toxins or pollutants (including chemicals from unexploded munitions (UXO)) within the seabed. Chapter 5 Project Description notes that post-lay trenching methods can be grouped into three main categories: jetting, mechanical cutters and ploughs. The final decision on which method to be employed will depend on the appointed installation contractor and further detailed design.
The microtunnelling activities also have the potential to mobilise historic ground pollutants into the drilling fluid as the tunnel is excavated. The drilling fluid will be a mixture of drill cuttings and slurry made of water and bentonite (a natural, inert, non-toxic clay) that is pumped through the drill string to the drill head to lubricate the drilling equipment. If present, such pollutants have the potential to escape to the marine environment at the tunnel exit pit then migrate to bathing waters.
Toxins from these activities have the potential to enter the human food chain either directly, if consumed whist engaging in marine leisure activities, or indirectly if consumed following assimilation (and potentially accumulation) in fish, mollusc or crustacean intermediates. Children and young people’s developmental processes are particularly sensitive to exposure to contaminants. As well as the potential for illness, there could also be economic loss for businesses reliant on coastal waters. People with high levels of deprivation, particularly those on low incomes, would be more sensitive to loss of income due to reduced tourism or commercial marine activity.
The main recreational beach that has the potential to be affected by seabed disturbance is Pasha Dere Beach, which lies immediately onshore of the microtunnel exit pit (the pipeline route crosses underneath the beach). To the north there are other recreationally active beaches, the nearest of which is Chernomorets Beach. To the south there are also beaches but
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these are limited in their recreational use due to poor vehicle access. The next accessible recreational beach to the south is approximately 9 km away.
Surveys and analysis of the sediment (Appendix 12.1) to be disturbed by the dredging and seabed intervention works did not indicate the presence of environmentally significant contamination thus no potentially harmful substances will be released or redistributed during the dredging works. Within 1.1 km of the shore the sediments are sandy, and disturbance during the works will not cause turbidity (suspended mud) or nutrient release. Dredging, temporary storage and backfilling of the mud deposits within the zone 1.1 to 2 km from the shore will potentially release nutrients and cause a turbidity plume. The dispersion patterns have been modelled, and whereas diffusion and current eddying can cause slight landward movement of the plumes, most movement is parallel to the shore (north or south, depending on the prevailing current). The worst-case situation predicts turbidity levels just exceeding 5mg/l along a 1 to 2 km section of shore to the north of the northern headland bounding Pasha Dere Beach. The predictions are therefore for a very low level of impact (~5 mg/l is expected to be typically the highest level of inshore water turbidity created by natural conditions).
The presence of inert sediment in the water is not anticipated to result in any direct health impacts, but could cause anxiety and reductions in leisure activities including those undertaken by guests of the local tourism businesses. To mitigate against any potential effects from turbidity or nutrient release, the methodology and timing of the trenching operations through the mud zone will be optimised so as to cause minimum plume development. Importantly, two monitoring buoys are being installed in the nearshore waters off Pasha Dere Beach (sites at 12 m and 8 m water depths). Data will be collected on turbidity and algal content of the water column until which time as construction commences, and based on these data levels of acceptable impact from dredging will be defined. Monitoring through the dredging operations will allow control of operations in order to stop any excessive turbidity or algal bloom affecting bathing waters.
Regarding historic seabed pollution, Chapter 12 Marine Environment concludes that based on the results of sampling undertaken for the Project, the inshore sediments in the area of the landfall are not significantly contaminated by heavy metals, hydrocarbons or organic pollutants. The detail of Chapter 12 Marine Environment reports that surveys did however identify a number of elevated concentrations of organic pollutants. While petroleum hydrocarbon concentrations were frequently below detectable limits, especially in spring, phenols were detected in higher concentrations (17 μg/l in 2009 and up to 11 μg/l in 2011), levels which exceed the Bulgarian regulatory limit of 5 μg/l. That assessment also reports that although concentrations of total petroleum hydrocarbons (TPH) were generally low, higher concentrations were observed at some sampling locations during the 2011 survey (up to 100 μg/l in nearshore waters and up to 850 μg/l in offshore waters). These higher TPH concentrations are linked to the proximity of a navigation route. Based on these findings this assessment considers the potential impacts of elevated phenol and TPH levels on the health of bathing water users and this is discussed below.
In terms of coastal water quality, Chapter 12 Marine Environment reports that the Black Sea Basin Directorate (BSBD) performed monitoring of water quality in 2005 within Varna Bay and at the mouth of the Kamchiya River. The data suggested possible exceedances of the European Standards for cadmium. Surveys undertaken for the Project in 2009 identified
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generally low concentrations of heavy metals within the Project Area. Surveys conducted in 2011 indicated the maximum Mercury concentration in coastal waters (1 μg/l) exceeded the EU Environmental Quality Standards (EQS) of 0.07 μg/l, as defined by 2008/105/EC. Chapter 12 Marine Environment considers that this peak concentration exceedance for Mercury is likely to reflect pollution associated with industrial activity in Varna. Based on these findings this assessment concludes that whilst there may be some existing water quality issues that may be of concern to human health, such exceedances are not expected to change as a result of the Project and are therefore not discussed further in this Report.
The existing mitigation measures in the ESIA Report include:
• UXO surveys will be carried out along the Pipeline route in Bulgarian waters to identify potential UXO in advance of the pre-lay surveys. Identified UXOs will either be avoided through re-routing or cleared. A UXO clearance plan (if required) will be developed by South Stream Transport in close conjunction with relevant national authorities. However, a final check for the presence of UXOs will be undertaken during pre-lay surveys ahead of the pipe-lay spread;
• Detailed mitigations are set out in Chapter 12 Marine Environment; • All contractors involved with the Project will be contractually bound to developing and implementing an Oil Spill Prevention and Response Plan. The plan will include specific measures to carry out immediate spill response activities at the shore approach location on Pasha Dere beach;
• Water quality, including suspended solids concentrations, will be monitored in sensitive protected areas. Development and application of a Dredging Management Plan, with mitigation of the higher concentration of the suspended solids by means to be recommended by the contractor and based on the local conditions. The mitigation measures will be reviewed and agreed by South Stream Transport prior to adoption. The Dredging Management Plan will specify the mitigation measures once the dredging contractor has been appointed and the dredging plant identified. This will be developed in collaboration with the regulatory authority;
• Temporary sediment storage will be avoided during the season of maximum storm waves (taken for this purpose as 1 October to 15 March); and
• The Project will avoid dredging during high wave conditions, where possible.
The results of the marine water and sediment surveys showed that in the nearshore and offshore areas there may be areas with high concentrations of phenol and TPH. Chapter 12 Marine Environment presents information on levels of contamination, but does not assess receptor sensitivity. The following sections therefore consider the potential health impacts of these pollutants.
Phenol
Acute effects of phenol exposure are only expected from contact or ingestion (or inhalation) of concentrated quantities of phenol. Such exposure would only be expected in an occupational setting and is not discussed further in this section.
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Non-occupational exposure to phenol may occur by drinking contaminated water. The threshold for exposure via ingestion is 1 to 32 g. Phenol in marine sediments samples for 2010 to 2011 in Shallow Water Coastal Areas occurred in the range of 0.05 to 0.40 mg/kg. Phenol in Sea Water samples for 2010 to 2011 occurred in the range of <0.1 to 6.1 µg/L. As phenol readily dissolves in water, the dilution effect makes it very unlikely that disturbance of recorded concentrations of phenol in the seabed and seawater will affect bathing water quality to the extent required to produce a detectable human health effect. It is very unlikely therefore that the general population will be exposed to a level of phenol high enough to cause adverse health effects (Ref. 16.44).
Petroleum Products
TPH is a term used to describe a large family of several hundred chemical compounds that originally come from crude oil. Crude oil is used to make petroleum products, which can contaminate the environment. Because there are so many different chemicals in crude oil and in other petroleum products, it is not practical to measure each one separately. The collective term of TPH is therefore applied.
The extent of absorption of TPH by dermal routes varies because of the wide range of physical/chemical properties observed for these chemicals. The extent of absorption depends on the volatility, solubility, lipophilicity, and other properties of the specific chemical or mixture. (Ref. 16.45). However, it would generally be expected that dermal exposure (e.g. skin contact when swimming) would produce less severe symptoms or toxicity than ingestion. As the contamination would be in seawater, ingestion in any significant quantity can be ruled out. Where petroleum products are dissolved or in suspension within the seawater the potential for high exposure concentrations is considerably reduced by dilution. However, where Project activities disturb concentrations of seabed petroleum products, TPHs may congregate as a film on the water’s surface, resulting in higher exposure doses to recreational marine users.
Due to the diversity of potential chemical components it is not practical to consider particular exposure concentration thresholds. However, the concentrations detected by marine sediment samples do not give rise to obvious concerns, with the highest detected concentration being 407 mg/kg.
Overall Historic Seabed Pollutant Impact
The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be high. This reflects a precautionary approach since certain vulnerable sub- populations may occur, e.g. children. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be low. This is because although the sample concentration levels indicate a low level, there is the potential for extensive or concentrated contamination to be encountered (e.g. petroleum products) which could either concentrate at the surface or be transported in sediment plumes. Applying the scoring of the Significance Matrix the significance of health impacts arising from this activity, without including any additional mitigation or monitoring requirements, is Low.
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Institutional Factors
Local Health and Emergency Service Resources due to Presence of Workers
This issue is relevant to the landfall section of the Project.
The Construction and Pre-Commissioning Phase may impact on local health and emergency response service providers, as the Project may affect demand for their resources, particularly in the event of an unplanned event that affects large numbers of the construction workforce.
Lack of availability and accessibility of municipal services such as health facilities, doctors’ surgeries, schools and social support can have a negative social impact on communities and affect both physical and mental health (Ref. 16.39). There is also a possibility that the increase in road traffic may restrict access to medical facilities.
The baseline suggests that access to primary healthcare in Varna and close to the landfall facility will not be affected by the presence of workers. The baseline also notes that access to emergency healthcare is less than average in Avren compared to other regions. No specific mitigation measures to manage potential periods of high demand on local health and emergency service resources have been identified as being included from other ESIA chapters or assessments. The existing mitigation measures in the ESIA include:
• The contractor will ensure that sufficient first-aid or medical staff and equipment are located at the construction site to meet the identified risks and in compliance with the Bulgarian Ordinance on occupational health services;
• A designated hospital or accident and emergency centre will be identified, in collaboration with local health authorities, together with all contact details, times of operation, distance and expected travel times;
• The location and capability of ambulance stations will be identified (and mapped) together with all contact details, times of operation, distance and travel times. Both public and private ambulance services will be identified. A qualified occupational physician will inspect and report on the capacity and capability of these services; and
• In the event of an off-site medical emergency in the vicinity of the Project, members of the public may request assistance from the construction site medical staff or manager in the event of a medical emergency. A clear protocol will be developed by South Stream Transport informing staff on how to handle such requests.
The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be high as it concerns people seeking medical care. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be low. This is because the resource demands of the construction workforce are expected to be small in the context of the local population, particularly when seasonal tourism is considered. Applying the scoring of the Significance Matrix the significance of health impacts arising from this issue, without including any additional mitigation or monitoring requirements, is Moderate.
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16.8.1.3 Mitigation and Enhancement
The mitigation measures recommended in relation to each of the significant adverse impacts are set out below. Enhancement measures, which have the potential to enhance beneficial outcomes of the Project, are also outlined.
A Community Health Construction Management Plan (CHCMP) will form part of the ESMPs for the Project. The CHCMP will establish the proposed actions needed to mitigate identified impacts and promote health opportunities in the Project. The CHCMP will assign actions, timeframes, resources, responsibilities and collaborating organizations to the mitigation and enhancement measures identified in this assessment. It will include a monitoring system designed to track implementation progress and selected outcomes. The monitoring system will include appropriate key performance indicators and an early-warning system for any problems occurring at the community level. Evaluation and Verification protocols will also be included to determine when successful implementation has been accomplished. The CHCMP will be reviewed by key stakeholders prior to construction activities commencing. It will incorporate key findings from the Rapid Health Appraisal which will provide additional baseline data and set further parameters for mitigation during the Construction and Pre-Commissioning Phase.
Social factors
Conduct of Workforce in the Community
• All workers contracted or sub-contracted for this Project will be required to comply with a code of conduct, to the extent that contractual requirements governing periods of leave and out of work hours allow;
• South Stream Transport will be guided by the principles of proportionality and good international practice in relation to hiring, rules of conduct, training, equipping, and monitoring of security forces, and by applicable law;
• Residents and visitors in Local Communities will be able to contact the Project at any time and utilize the Grievance Procedure if there are any concerns regarding security arrangements and acts of security personnel;
• As part of the HSSE-IMS, a Security Plan will be developed for each phase of the Project per GIIP; and
• If government security personnel are deployed for Project security, South Stream Transport will make every effort to ensure training, due diligence, and monitoring adhering to GIIP are also employed.
Spread of Sexually Transmitted Infections (STIs) Due To In-Migration of Non-Local Workers
• All workers contracted or sub-contracted for the Project will be required to attend an awareness and education programme that covers the risks associated with STIs, CSWs, alcohol and drugs;
• Specific sexual health testing and clinic facilities will be identified for this Project; • Condoms will be made freely available to the workforce;
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• South Stream Transport will have a policy statement regarding STIs including HIV/AIDS and this policy will be communicated internally to staff, and externally to Contractors; and
• Any work concerning CSWs will be carried out in consultation with a local provider.
Employment Opportunities for the Local Population
• No further enhancements required.
Environmental Factors
Construction noise impacts from vehicles, plant and vessels
• South Stream Transport will adopt appropriate mitigation measures in order to ensure that statutory noise thresholds are not exceeded by Project activities at occupied residential properties along the new access route passing through Priseltsi VZ. Such mitigation may include the erection of barriers or other measure noise reducing measures; however, this will not involve rerouting past other sensitive receptors;
• For the pre-commissioning tests, South Stream Transport will adopt appropriate mitigation measures in order to ensure that the relevant statutory noise thresholds are not exceeded by Project activities at occupied residential properties in the surrounding Local Communities. Such mitigation may include: compressor specifications; maximum operating protocols; and/or noise barriers;
• Should the contractor decide to locate a quad-jointing facility in a marshalling yard in Varna East or Burgas, or should other ground disturbing works be planned that may mobilise historic pollutants in the soil, further impact assessment work will be undertaken and, if appropriate, mitigation measures will be implemented; and
• Should night time train movements be required for the Project, further impact assessment work will be undertaken and, if appropriate, mitigation measures will be implemented.
Road Transport Impacts, Particularly Heavy Goods Vehicles
• Preparation and implementation of a Traffic Management component of the Bulgarian Landfall CMP to manage and coordinate the transport and logistics requirements of the Project. The Logistics Plan will identify agreed access routes, as well as measures and safeguards to minimise interference with local transportation and routes; and
• As part of the contractor's Traffic Management Plan, all drivers contracted or sub-contracted for this Project will be required to attend an awareness and education programme that covers road safety and emphasises the vulnerability of cyclists and pedestrians, particularly around Priseltsi VZ.
Mobilisation of Historic Seabed Pollutants during Dredging and Microtunnelling
• If the Project uses a jetting process for post-lay trenching, South Stream Transport will undertake additional dispersion modelling to enable an assessment to be undertaken by the Contractor. If the assessment identifies any significant impacts, required mitigation will be identified and included to ensure that significant sediment plume effects do not occur at Pasha Dere Beach;
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• Protocols similar to those that will be used in the event of marine fuel spills will be prepared and followed to deal with any disturbance of petroleum products in the marine sediment that result in a significant oil film at the surface; and
• The use of bentonite mud for microtunnelling (an inert, heavy and sticky substance which pools on seabed and doesn’t disperse) will be carefully planned and monitored to avoid deposits migrating into bathing waters.
Institutional Factors
Local Health and Emergency Service Resources Due to In-Migration of Non-Local Workers
• The location of hospitals, clinics, doctors’ surgeries and pharmacies will be identified to ensure that access to and from them is not restricted by Project activities or that alternative access is in place and has been agreed with the local health authorities;
• Prior to construction activities commencing, agreement will be reached with local health services as part of the Rapid Health Appraisal (see below) to confirm how the healthcare needs of the construction workforce, including non-Russian workers, will be met. Such consultation will include a solution that avoids any adverse impact to local populations due to resource demands of the Project being greatest at the nearest healthcare facilities;
• Prior to construction activities commencing, agreement will be reached with local health services on how the healthcare needs of non-Bulgarian workers will be met;
• Prior to construction activities commencing, agreement will be reached with local health services and other authorities on how demand for health and other emergency response services will be met in the event of an unplanned event that affected both local communities and the construction workforce;
• The location of hospitals, clinics, doctors’ surgeries and pharmacies will be identified to ensure that access to and from them is not restricted by Project activities or that alternative access is in place and has been agreed with the local health authorities;
• The construction contractor will undertake a Rapid Health Appraisal of the potential socio- economic and health impacts related to the preferred option(s) for workforce accommodation during the Construction and Pre-Commissioning Phase of the Project. The purpose of this appraisal is to avoid significant adverse impacts on the town of Anapa and the Local Communities by identifying potential impacts and appropriate mitigation and management measures prior to the start of construction and to confirm appropriate housing and health provision is in place prior to making accommodation arrangements for the onshore workforce. The appraisal will include consultation with applicable local and regional authorities, including health and social service providers and will include an assessment of local health conditions and services. The assessment will also include a review of the accommodation, conduct, sexual health and general health service resource requirements of the estimated offshore workforce, employed to work aboard Project vessels, during periods of shore based transit to and from their vessels.
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16.8.1.4 Residual Impacts
Table 16.16 presents a summary of the potential Construction and Pre-Commissioning Phase residual community health, safety and security impacts arising from the Project following application of the identified mitigation measures.
Social Factors
Conduct of Workforce in the Community
Subject to the full adoption of the mitigation measures set out in this chapter and elsewhere in the ESIA; the residual significance of potential community/population health impacts arising from the conduct of workforce, including offshore workforce, if any and security personnel, in the city of Varna and the Local Communities during the Construction and Pre-Commissioning Phases are considered to be Low.
Spread of STIs due to In-Migration of Non-Local Workers
Subject to the full adoption of the mitigation measures set out in this chapter and elsewhere in the ESIA; and assuming the Rapid Health Appraisal determines that the assumptions made for sexually transmitted diseases due to lack of baseline data are accurate, the residual significance of potential community and population health impacts arising from the spread of STIs during the Construction and Pre-Commissioning Phases are considered to be Low.
Employment Opportunities for the Local Population
Subject to the full adoption of the enhancement measures set out in the ESIA; the residual significance of potential community/population health impacts arising from employment opportunities during the Construction and Pre-Commissioning Phases is considered to be limited and beneficial.
Environmental Factors
Construction Noise Impacts From Vehicles, Plant and Vessels
Subject to the full adoption of the mitigation measures set out in this chapter and elsewhere in the ESIA; the residual significance of potential community and population health impacts arising from construction noise impacts during the Construction and Pre-Commissioning Phases is considered to be Low.
Road Transport Impacts, Particularly Heavy Goods Vehicles
Subject to the full adoption of the mitigation measures set out in this chapter and elsewhere in the ESIA; the residual significance of potential community and population health impacts arising from road transport impacts during the Construction and Pre-Commissioning Phases is considered to be Low.
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Mobilisation of Historic Seabed Pollutants during Trenching and Microtunnelling
Subject to the full adoption of the mitigation measures set out in this chapter and elsewhere in the ESIA; the residual significance of potential community and population health impacts arising from mobilisation of historic seabed pollutants during the Construction and Pre-Commissioning Phases is considered to be Not Significant.
Institutional Factors
Local Health and Emergency Service Resources due to Presence of Workers
At this point in time, and based on the information collected to date, the approximately 330 landfall construction workers are not likely to have a significant impact on the health care infrastructure of Varna Region and are not likely to place serious pressure on existing health facilities. However, until which time as additional information is obtained during the Rapid Health Appraisal and through continuous engagement with local health authorities, the residual significance of potential community and population health impacts arising to local health and emergency service resources during the Construction and Pre-Commissioning Phases is considered to be Low.
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Table 16.16 Summary –of Residual Impacts during Construction and Pre-Commissioning Phase
Activity Impact Receptor Sensitivity of Magnitude Pre-mitigation Mitigation Measures Residual Receptor of Impact Significance Impact Significance
Social Factors
Conduct of Anti-social incidents Local communities Moderate Moderate Moderate Stakeholder Engagement Plan Low workforce in and excessive use of and Grievance Procedure; the community recreational and social Workers Code of Conduct; infrastructure (e.g., Appropriate Living, working and schools, hospitals) recreational conditions for the workforce -Rapid socio-economic appraisal to identify workforce accommodation
Conduct of Spread of STIs due to Local communities Moderate High High Workers Code of Conduct; Low workforce in influx of workers awareness and education the community programme; sexual health testing; provision of condoms; SSTT policy statement on STIs
Landfall and Employment Local communities Not identified Not identified Beneficial Not applicable Beneficial Nearshore opportunities for the (limited) construction local population activities
Continued…
Activity Impact Receptor Sensitivity of Magnitude Pre-mitigation Mitigation Measures Residual Receptor of Impact Significance Impact Significance
Environmental Factors
Construction Impacts on receptors Varna Hospital; High Moderate Moderate Erection of barriers and other Low Noise Impacts from construction at Pasha Dere beach measure noise reducing from Vehicles, access roads, users measures; adherence to national Plant and marshalling yards, and noise limits Vessels microtunnelling
Traffic flows Impacts on road safety Local communities High High High Logistics Plan to manage and Low due to due to construction and Vulnerable coordinate the transport and movement of traffic, particularly groups (children, logistics. Temporary bypass materials and heavy goods vehicles elderly, roads; Construction Traffic personnel pedestrians and Management Plan (CTMP); cyclists) implementation of safe driving procedure protocols
Mobilisation of Overall historic seabed The environment High Low Low/Moderate UXO survey; Storage of dredged Not Significant historic seabed pollutant impact spoil; Appropriate dredger to pollutants (Phenol, Petroleum minimise sediment re-suspension during Products) (within engineering constraints); trenching and use of bentonite mud for tunnelling microtunnelling
Continued…
Activity Impact Receptor Sensitivity of Magnitude Pre-mitigation Mitigation Measures Residual Receptor of Impact Significance Impact Significance
Institutional Factors
Presence of Impact on local health Local Communities High Low Moderate Emergency Response Plans Low Workers during and emergency and Workforce First-aid or medical staff and Landfall and response service equipment at the construction Nearshore resources site construction activities Mapping and report on the capacity of local ambulance stations capability- Rapid Health Appraisal to identify appropriate housing and health provision
Complete.
16.8.1.5 Monitoring
South Stream Transport will develop an Environmental and Social Monitoring Programme for the Project which will detail all monitoring requirements applicable to the Project regardless of associated phase, topic or location. Chapter 23 Environmental and Social Management discusses the monitoring programme based on the monitoring requirements across the ESIA. This section briefly outlines the key issues, receptors and monitoring activities for community health, safety and security during the Construction and Pre-commissioning Phase of the Project.
Social Factors
Conduct of Workforce in the Community
The monitoring programme will record any issues of poor conduct by the Project’s workforce (including contractors and sub-contractors) both in Local Communities and in the city of Burgas. It will cover offshore workforce interaction, if any, with the local population (residents and visitors). Additional mitigation measures will be adopted and consultation will be undertaken with local law enforcement, and health and social service providers, especially as it pertains to potential impacts to CSWs, as necessary and indicated by monitoring results.
This will include monitoring the number of grievances raised by local residents via the Grievance Procedure relating to the workforce and its interaction with the community, including the number of anti-social incidents involving workforce recorded by police, and monitoring of health statistics (e.g. of STIs and HIV/AIDs) recorded by local health officials, and record of incidents where the worker code of conduct has been violated and whether this has triggered local health/emergency response.
Spread of STIs due to Presence of Workers
South Stream Transport will work with local public health and CSW support organisations to monitor any adverse effects attributable to the Project workforce or Project activities. If significant adverse impacts are indicated then additional mitigation measures will be adopted in collaboration with those organisations.
Employment Opportunities for the Local Population
The monitoring programme will record the number of employment opportunities advertised in and taken up by Local Communities.
Environmental Factors
Construction Noise Impacts from Vehicles, Plant and Vessels
Noise monitoring will be undertaken at the following locations to ensure that the noise thresholds discussed in this assessment are not exceeded during the Construction and Pre- commissioning Phase:
• The two residential dwellings, located approximately 2 km northeast of the pipeline route and landfall facilities;
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• Pasha Dere Beach; • Residential properties in Rakitnika; • Residential properties in Priseltsi VZ including those nearest to the access road; and • Varna Transport Hospital.
If monitoring indicates that the relevant thresholds are exceeded then further mitigation will be implemented to achieve these thresholds.
Road Transport Impacts, particularly Heavy Goods Vehicles
The monitoring programme will record the impact of construction transport along the new access road on road safety and access to Priseltsi VZ. Monitoring will include vehicle counts and consultation with residents of Priseltsi VZ. If the monitoring indicates that road safety or access becomes a significant concern for the local community then further mitigation measure will be adopted. Monitoring of vehicles based on construction site vehicle entry and exit data will be undertaken. Perception monitoring in regards to traffic and other potential issues will be undertaken as part of regular stakeholder engagement with communities – including with schools, shop owners, and local community leaders.
Mobilisation of Historic Seabed Pollutants during Trenching and Tunnelling
During dredging, backfilling and microtunnelling activities water quality will be monitored to ensure that national bathing water quality standards are maintained in surrounding coastal areas, particularly at popular beach locations such as Pasha Dere Beach and Chernomorets Beach. If monitoring indicates that bathing water quality is affected by the Project’s activities then further mitigation measures may be required.
Institutional Factors
Local Health and Emergency Service Resources due to Increase of Non-Local Workers
South Stream Transport will work with local health and other emergency response service providers to monitor local service resource use by the Project’s workforce. If monitoring indicates that service demand as a result of the Project is causing resource shortages further mitigation measures will be investigated to ensure that Local Communities are not adversely affected.
Monitoring of potential changes in the demand and capacity for accommodation, local health and emergency services will be primarily undertaken through direct engagement with local officials, and health and emergency response service providers to discuss whether or not the Project has had increased demands on local health and emergency service resources.
The first such engagement will be undertaken through a face-to-face meeting, and regular engagement will be established (e.g. quarterly or semi-annually) to review the use of health and emergency services related to the Project’s workforce and activities. Carrying out engagement with local officials and service providers will also enable South Stream Transport to
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identify any trends or qualitative changes. South Stream Transport will also monitor their own records (such as Human Resource data, the Grievance Procedure) for any workplace incidents that may require a response from local officials, health and emergency providers. Open lines of communication will also be established between South Stream Transport, the Contractor, and local service providers.
16.8.2 Impact Assessment: Operational Phase
16.8.2.1 Introduction
This section identifies the potential impacts and risks to community health, safety and security receptors during the Operational Phase of the Project. For those effects where potentially significant pre-mitigation impacts are assessed in Section 16.8.2.2, potential mitigation measures have been identified in Section 16.8.2.3. This is followed by a residual impact assessment, the results of which are set out in Section 16.8.2.4.
16.8.2.2 Assessment of Potential Impacts (Pre-Mitigation)
Social Factors
The following potential impacts resulting from Project activities with community, economic, and financial outcomes were identified as potentially giving rise to community or population level health impacts.
Public Anxiety over Large Volumes of Gas Close to Local Communities
This issue is relevant to the landfall section of the Project.
Perceptions of fear arising from risks of controlled or uncontrolled natural gas releases may give rise to public anxiety.
Concern about the existence and safety of the Project, whether founded or not, may lead to stress, anxiety and depression. Fear of an environmental hazard, itself, may give rise to anxiety attacks and these may manifest as headaches, hypertension, and other low grade illnesses (Ref. 16.46). People with high levels of deprivation or with existing mental health conditions are more likely to be sensitive to issues that could affect mental wellbeing.
It is not possible to draw conclusions about this effect from the baseline for mental health as the effects will likely be low level but during consultation stakeholders did raise the issue of safety and risk of explosion from hydrogen sulphide or a gas leak. In consultation meetings, stakeholders were concerned about the risk of gas explosion or fire and enquired about the safety measures that would be put in place (Ref. 16.37). The existing mitigation measures in the ESIA include:
• Consultation with stakeholders, including the residents of Local Communities has been ongoing and will continue, including for disclosure of the ESMPs, as outlined in Chapter 6 Stakeholder Engagement; and
URS-EIA-REP-202375 16-79 Chapter 16 Community Health, Safety and Security
• South Stream Transport has developed a Stakeholder Engagement Plan which identifies stakeholders and their interests, describes the consultation undertaken and that planned as part of the Project’s ESIA process, and establishes a framework for stakeholder engagement activities to be undertaken as the Project progresses beyond the ESIA phase.
Due to the presence of hydrogen sulphide and mercaptans (sulphur containing organic compound) in the gas being transported by the pipeline, perceptible odour impacts may be expected to occur on a short-term infrequent basis during occasional venting of gas during a planned shutdown for maintenance or repairs. Although the odour would not represent a risk to health, it could serve as a reminder and possibly a trigger for sustained anxiety.
Public anxiety can reasonably be expected to decrease as public understanding develops amongst the local population of the design controls and as the design controls are seen to be effective. For example the air quality assessment notes that the vent stack height has been pre- determined based on safety requirements in the workplace in order to protect workers at the facility from asphyxiation and from the unlikely event that the vented gas might ignite. This level of localised dispersion to safe levels for onsite maintenance personnel, should reassure local residents that there is not expected to be a risk to community receptors, which are far more distant. The continuing success of such alleviation will also depend on good communication between the Project and the local population.
The sensitivity of the local population, including consideration of particular vulnerabilities, is considered to be low. This reflects a precautionary approach since certain vulnerable sub- populations are likely to be concerned about these processes, e.g. people with existing anxiety type disorders. The magnitude of change caused by the Project that has the potential to affect health outcomes is considered to be moderate. This is because an unknown number of people may experience mental ill health, such as increased anxiety and stress, for more than one month as a result of the proposed works. Applying the scoring of the Significance Matrix the significance of health impacts arising from this activity, without including any additional mitigation or monitoring requirements, is considered to be Low.
Environmental Factors
No potential impacts resulting from Project activities that affect the physical environment were identified as potentially giving rise to community or population level health impacts.
Institutional Factors
No potential impacts resulting from Project activities that affect institutional factors were identified as potentially giving rise to community or population level health impacts. See Chapter 20 Unplanned Events for issues relating to institutional involvement in the unlikely event of uncontrolled release of gas from the pipeline.
16.8.2.3 Mitigation and Enhancement
The mitigation measures recommended in relation to each of the significant adverse impacts are set out below. Enhancement measures, which have the potential to enhance beneficial outcomes of the Project, are also addressed, where appropriate.
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Social Factors
Public Anxiety over Large Volumes of Gas Close to Local Communities
• Stakeholder engagement will be continued throughout the life of the Project to ensure that appropriate Project information on operations and safety is communicated.
16.8.2.4 Residual Impacts
Table 16.17 presents a summary of the potential residual community health and safety impacts arising from the operational phase of the Project following application of the identified mitigation measures.
Social Factors
Public Anxiety over Large Volumes of Gas Close to Local Communities
Subject to the full adoption of the mitigation measures set out in this chapter and elsewhere in the ESIA; the residual significance of potential community and population health impacts arising from public anxiety during the Operational Phase are considered to be Not Significant.
Environmental Factors
No potential impacts resulting from Project activities that affect the physical environment were identified as potentially giving rise to community or population level health impacts.
Institutional Factors
No potential impacts resulting from Project activities that affect institutional factors were identified as potentially giving rise to community or population level health impacts. See Chapter 20 Unplanned Events for issues relating to institutional involvement in the unlikely event of uncontrolled release of gas from the Pipeline.
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Table 16.17 Summary of Residual Impacts during Operational Phase
Activity Impact Receptor Sensitivity of Magnitude Pre-mitigation Enhancement and Proposed Residual Receptor of Impact Significance Mitigation Measures Impact Significance
Public anxiety Concern about the Nearby communities Low Moderate Low Further consultation with local Not Significant over large Project, whether and recreational communities throughout the life volumes of founded or not, may visitors. of the Project. gas close to lead to stress, anxiety local and depression. Fear communities. of an environmental hazard, itself, may give rise to anxiety attacks.
16.8.2.5 Monitoring
South Stream Transport will develop an Environmental and Social Monitoring Programme for the Project which will detail all monitoring requirements applicable to the Project regardless of associated phase, topic or location. Chapter 23 Environmental and Social Management discusses the monitoring programme based on the monitoring requirements across the ESIA. This section briefly outlines the key issues, receptors and monitoring activities for community health, safety and security during the Operational Phase of the Project.
Social Factors
Public Anxiety over Large Volumes of Gas Close to Local Communities
The monitoring programme will include on-going consultation with Local Communities and local health authorities.
Environmental Factors
No monitoring requirement has been identified.
Institutional Factors
No monitoring requirement has been identified.
16.8.3 Impact Assessment: Decommissioning Phase
The Project will be decommissioned many years into the future 4 and impacts during the Decommissioning Phase depend on the alternatives chosen at that time – preservation of the pipelines in place or complete or partial removal. If the latter option is chosen and construction activities (e.g. excavation, removal of pipeline, land rehabilitation) are carried out or construction equipment is used, then impacts are expected to be similar to those assessed in relation to the Construction and Pre-Commissioning Phase – i.e., generation of employment (beneficial impacts), increased demand for goods and services (beneficial impacts), and impacts on land users (potentially adverse, depending on whether or not productive land uses such as agriculture were disturbed). However, such impacts are likely to be at lower levels and short- term.
A careful record and archive of construction and operation activities will be maintained in a suitable format for future users of such information. It will include any special mitigation measures that were applied retrospectively, in addition to those identified prospectively in this impact assessment. It will also record all unexpected events that occurred during the Construction and Pre-Commissioning and Operational Phases of the Project.
4 The Project Life (i.e. the duration of the Operational Phase) is estimated to be approximately 50 years. As such, decommissioning would take place sometime in the mid to late 2060s.
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16.9 Unplanned Events Unplanned events are discussed in Chapter 20 Unplanned Events, while community perceptions of unplanned events are discussed under the issue of ‘Public Anxiety’ in Section 16.8.1.5.
16.10 Cumulative Impacts The health and safety impacts of the SSB Pasha Dere RT and Varna CS, which will be located directly adjacent to the Project, as well as other cumulative impacts are presented in Chapter 21 Cumulative Impact Assessment and in Appendix 21.1: Environmental Assessment of the Pasha Dere Receiving Terminal and Varna Compressor Station.
16.11 Conclusion This chapter has assessed the potential effects of the Project on Community Health, Safety, and Security and set out the Project approach to Occupational Health and Safety. This assessment has been conducted following the standards and guidelines of financing institutions, as well as national legislation and GIIP.
The Construction and Pre-Commissioning Phase of the Project will bring direct employment opportunities to Local Communities at the landfall facilities and marshalling yards. Procurement of goods and services will also give rise to indirect employment across a wider area. This local employment is relatively small in number and while the effects will also be small they will be beneficial. The people who are employed and their families and dependents may enjoy improvements to their health and well-being if the employment improves the economic situation of the employee and their family.
The infrastructure and logistics requirements of the Project mean that there are inevitably some adverse effects for certain population groups. Large construction sites and busy transport corridors may be disruptive for some residents of Local Communities. These changes may manifest as negative health outcomes. South Stream Transport recognises this risk and will take all appropriate measures to reduce disruption through design controls and mitigation measures that will govern the movement of transport, noise from Project vehicles and emissions to air. The Project will also maintain communication with Local Communities to ensure that any grievances are addressed promptly.
South Stream Transport’s commitment to on-going consultation with Local Communities is expected to provide reassurance regarding Project operations, with potential anxieties decreasing as the Project’s track record for safety becomes established and is publicised.
Overall, although this chapter has identified a number of issues that have the potential to give rise to adverse health impacts, mitigation will be included to reduce the residual impact to an acceptable level for both the community and workforce.
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References
Number Reference
Ref. 16.1 IFC. Introduction to health impact assessment. Washington, DC: International Finance Corporation, 2009. Hereafter the ‘IFC Guidance’.
Ref. 16.2 Health and Safety Scoping Report, Ben Cave Associates, October 2013.
Ref. 16.3 World Health Organization. Preamble to the Constitution of the World Health Organization; signed on 22 July 1946 by the representatives of 61 States and entered into force on 7 April 1948. Official Records of the World Health Organization, no. 2, p.100. 1948 New York. Available at www.who.int/about/definition/en/print.html
Ref. 16.4 Ministry of Health, Written comments on EIA Terms of Reference, Received 1st February 2013.
Ref. 16.5 EIA Ordinance Article 3. (New - SG, issue 3/2011) "Sites Subject to Health Protection”
Ref. 16.6 Dimova A, Rohova M, et al. Bulgaria Health System Review, Vol.14 No.3. 2012. European Observatory on Health Systems and Policies. Health Systems in Transition. Available at http://bit.ly/16V6STC
Ref. 16.7 National Institute of Statistics, Bulgaria. Available at www.nsi.bg
Ref. 16.8 National Institute of Statistics, Bulgaria, National Centre for Public Health and Analysis (NCPHA) Healthcare Statistics Handbooks, 2010 and 2011 and Healthcare BulletinS, 2011 and 2012 http://bit.ly/1c77Hci
Ref. 16.9 Regional Health Inspectorate (RHI) – Varna, www. rzi-varna.com
Ref. 16.10 Law of Health. Prom. SG. 70/10 Aug 2004, amend. SG. 46/3 Jun 2005, amend. SG. 76/20 Sep 2005. In force from 1st of January 2005
Ref. 16.11 National Health Strategy 2008 - 2013 period. Adopted by Resolution adopting the National Health Strategy 2008 - 2013 period and Plan. Available at: http://bit.ly/1fZpzs3
Ref. 16.12 Regional Statistical Office – Varna (Statistics Handbooks and Statistics Collection, Varna Region, 2010, 2011).
Ref. 16.13 Global Fund to Fight AIDS, Tuberculosis and Malaria “Programme for Prevention and Control of HIV / AIDS Latest on AIDS in Bulgaria” Available at http://bit.ly/1jKkXGj Accessed on 27th November 2013
URS-EIA-REP-202375 16-85 Chapter 16 Community Health, Safety and Security
Number Reference
Ref. 16.14 OECD. Health at a glance: Europe 2012. OECD Publishing. 2012. Available at http://dx.doi.org/10.1787/9789264183896-en
Ref. 16.15 EMCDDA. Country overview: Bulgaria. Lisbon, Portugal: European Monitoring Centre for Drugs and Drug Addiction. 2013. Accessed on 07-11-2013. Available at http://bit.ly/1a9qnbn
Ref. 16.16 World Health Organization. Bulgaria. 2009. http://bit.ly/1c1xKBj
Ref. 16.17 D. Balabanova and M. McKee. Patterns of alcohol consumption in Bulgaria. Alcohol and Alcoholism 34 (4):622-628, 1999. Available at http://dx.doi.org/10.1093/alcalc/34.4.622
Ref. 16.18 Varna Municipality. Municipal Development Plan of Varna Municipality 2014-2020 - Summary. Varna, Bulgaria: 2013. Available at http://bit.ly/1bXHqN0
Ref. 16.19 Institute for market economics, Bulgarian non-governmental organisation (NGO). Regional Profiles – indicators of development, Varna Region. Available at: http://bit.ly/1eCMqcD (accessed 11.11.13)
Ref. 16.20 US State department report. 2008. http://bit.ly/I0XoNJ
Ref. 16.21 Mediana Agency. Sociological research trafficking in Human Beings, emigration and sexual exploitation. Bulgaria: 2009.
Ref. 16.22 GRETA. Report concerning the implementation of the Council of Europe Convention on Action against Trafficking in Human Beings by Bulgaria. Strasbourg: Group of Experts on Action against Trafficking in Human Beings (GRETA) for the Council of Europe, Directorate General of Human Rights and Rule of Law. 2013. Available at http://bit.ly/1cEQ3MI
Ref. 16.23 Personal communication with National Commission for Combatting Trafficking in Human Beings Varna; comprised by the NGO Families at Risk, the Municipality of Varna Preventions Department and the Ministry of the Interior (Varna Police). Meeting conducted 21 November 2013 in Varna.
Ref. 16.24 Open Society Institute. Arrest the violence: human rights violations against sex workers in 11 countries in Central and Eastern Europe and Central Asia. Open Society Institute (OSI). 2009. http://bit.ly/HyXw6v
Ref. 16.25 Personal communication with NGO SOS Families at Risk (FAR). Interview conducted 26 February 2014.
Ref. 16.26 Institute for market economics, Bulgarian non-governmental organisation (NGO). Regional Profiles – indicators of development, Burgas Region. Available at: http://bit.ly/1aXLcYP (accessed 11.11.13)
Ref. 16.27 Annual Report of RHI-Varna (2012) http://bit.ly/195I7BS
16-86 URS-EIA-REP-202375
Number Reference
Ref. 16.28 Varna Municipality. Municipal programs for promotion, prevention and rehabilitation of public health. Available at http://bit.ly/18lgzYM (accessed 08.11.13).
Ref. 16.29 EEA, Bathing waters data and coordinates: Member states authorities | Esri, DeLorme, NAVTEQ, USGS, NGA http://bit.ly/19LAnUX
Ref. 16.30 Regional Health Card: Varna Region http://bit.ly/1dlCbw4 2009
Ref. 16.31 IFC. Performance Standard 2, Labor and Working Conditions. January 2012.
Ref. 16.32 IFC. Performance Standard 3, Resource Efficiency and Pollution Prevention. January 2012.
Ref. 16.33 IFC. Performance Standard 4, Community Health, Safety, and Security. January 2012
Ref. 16.34 Health Insurance Act. State Gazette No. 70, 19 June 1998; last amended 10 August 2010.
Ref. 16.35 Ministry of Health (2005). Health strategy for disadvantaged ethnic minorities. Sofia, Ministry of Health (http://bit.ly/1cezIOK)
Ref. 16.36 Ministry of Health (2008). National Programme for prevention and control of HIV and sexually transmitted infections in the Republic of Bulgaria (2008–2015). Sofia, Ministry of Health. Available at http://bit.ly/1bn7Rh8
Ref. 16.37 Disaster Protection Act, 2006. Promulgated, State Gazette, No. 102/19.12.2006, (as amended). Available at http://bit.ly/1fvJNcH
Ref. 16.38 Environmental Protection Act. Promulgated, State Gazette No. 91/25.09.2002, amended and supplemented etc, SG No. 42/3.06.2011. Available at: http://bit.ly/1aJTbaR
Ref. 16.39 Regional Environmental Center. Regional Report on the Implementation of SEA and EIA Laws in Bulgaria, Romania and Turkey. June 2011. Available at: http://bit.ly/I63A73
Ref. 16.40 The European Parliament and the Council of the European Union (2000). Directive 2000/60/EC of the European Parliament and of the Council of 23 October 2000 establishing a framework for Community action in the field of water policy. Official Journal of the European Communities.
Ref. 16.41 Water Act Promulgated, State Gazette No. 67/27.1999 (effective 28.01.2000). Amended and supplemented, SG No. 81/2000 (effective 6.10.2000); SG No. 34/2001; SG No. 41/2001; amended, SG No. 108/2001; SG No. 47/2002 (effective 11.06.2002); SG No. 74/2002; SG No. 91/2002 (effective 1.01.2003).
URS-EIA-REP-202375 16-87 Chapter 16 Community Health, Safety and Security
Number Reference
Ref. 16.42 Graetz B. Health consequences of employment and unemployment: longitudinal evidence for young men and women. Soc.Sci.Med. 1993;36(6):715-24.
Ref. 16.43 NSW Department of Health Australia. Healthy urban development checklist: a guide for health services when commenting on development policies, plans and proposals. 2010. Available at http://www.health.nsw.gov.au/pubs/2010/hud_checklist.html
Ref. 16.44 Clemens T, Boyle P, Popham F. Unemployment, mortality and the problem of health-related selection: evidence from the Scottish and England & Wales (ONS) longitudinal studies. Health Stat.Q. 2009(43):7-13. Available at PM:19774831
Ref. 16.45 Waddell G, Burton K. Is work good for your health and well-being? Norwich: The Stationary Office; 2006. Available at http://bit.ly/19700Af
Ref. 16.46 South Stream Consultation 2012/13 (See section 16.4.3)
Ref. 16.47 Ordinance № 6/2006 on the parameters of noise in the environment, taking into account the degree of discomfort in the various hours of the day and night, the limit values of the parameters of noise in the environment, the methods of assessment of the parameters of noise in the environment, the methods of assessment of the values of the parameters of noise and the harmful effects of noise on the health of the population (Bulgaria)
Ref. 16.48 World Health Organization Regional Office for Europe. Urban planning, environment and health. From evidence to policy action. 2010. Available at: www.euro.who.int/__data/assets/pdf_file/0004/114448/E93987.pdf
Ref. 16.49 © 2013 Google Image Date: June 2012
Ref. 16.50 Imagery ©2013 DigitalGlobe, Map data ©Google
Ref. 16.51 The European Parliament and the Council of the European Union (2000). Directive 2000/60/EC of the European Parliament and of the Council of 23 October 2000 establishing a framework for Community action in the field of water policy. Official Journal of the European Communities.
Ref. 16.52 Water Act Promulgated, State Gazette No. 67/27.1999 (effective 28.01.2000). Amended and supplemented, SG No. 81/2000 (effective 6.10.2000); SG No. 34/2001; SG No. 41/2001; amended, SG No. 108/2001; SG No. 47/2002 (effective 11.06.2002); SG No. 74/2002; SG No. 91/2002 (effective 1.01.2003).
Ref. 16.53 Health Protection Agency. Chemicals & Poisons A-Z and compendium. Viewed 08.10.13 http://www.hpa.org.uk/Topics/ChemicalsAndPoisons/ChemicalsPoisonsAZ/
Ref. 16.54 Centres for Disease Control and Prevention (CDC), Toxicological Profile for Total Petroleum Hydrocarbons (TPH). U.S. Department of Health and Human Services. Septermber 1999 http://www.atsdr.cdc.gov/toxprofiles/tp123.pdf
16-88 URS-EIA-REP-202375
Number Reference
Ref. 16.55 Luria, P., Perkins, C., and Lyons, M. Health risk perceptions and environmental problems: findings from ten case studies in the North West of England. 2009 Health Protection Agency North West and Centre for Public Health, Liverpool John Moore's University. Available at http://bit.ly/ItbCaN
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