Chapter 16: Community Health, Safety and Security URS-EIA-REP-202375 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 URS-EIA-REP-202375 i Chapter 16 Community Health, Safety and Security 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 ii URS-EIA-REP-202375 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 URS-EIA-REP-202375 iii 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