Sanitary Protection Zones

SANITARY PROTECTION ZONES are defined, limited territories where enhanced sanitary supervision is introduced, mandatory health-improvement measures are carried out, and known restrictions on the population's activities are established (for the purpose of raising the sanitary condition of the given territory and preventing the possibility of its pollution). Sanitary protection zones are introduced: a) for the protection of water sources serving as central water supplies for populated areas, b) for the protection of areas serving as places for public recreation and sanitary-resort treatment, c) for the protection of medical-preventive institutions. Sanitary protection of water sources. The pollution of water sources serving as central water supplies for populated areas (water mains), which intensifies significantly with the growth of populated areas and the development of industry and the economic activity of the population, the necessity due to this of introducing complex and expensive facilities for the purification of water supplied to the population, the impossibility of obtaining satisfactory water in a sanitary sense, sometimes even after such purification, and in view of this the appearance of gastrointestinal and acute infectious diseases of waterborne origin—all this requires the strengthening of sanitary supervision and the introduction of special sanitary protection of water sources from pollution. Sanitary protection of water sources, carried out according to a developed plan constantly and on a defined territory, i.e., a sanitary protection zone, has the goal of protecting these sources from pollution and the deterioration of their qualitative and quantitative composition, as well as the sanitary protection of special water facilities and the surrounding terrain from changes and disturbances that could harmfully affect the water sources and the water supplied to the population. A sanitary protection zone thus protects the population from the appearance of waterborne diseases—"water epidemics"—and facilitates the purification of water supplied to the population, which in turn also provides a definite economic effect: the saving of funds spent on the treatment of the sick, on the operation and construction of complex purification facilities, etc. A sanitary protection zone is introduced in all cities, industrial, resort, and summer cottage settlements, and other large populated areas that have a central water supply or are building and designing one, as well as for water sources feeding the water mains of factories, plants, and railway and water transport, if they serve for the drinking and household purposes of the population in addition to serving technical needs; it is established for each water main separately. The sanitary protection zone must include water sources serving for central water supply, all other water sources having a connection with them and an influence on them, all water main facilities, and the terrain surrounding and connected with the water sources and water main facilities. Depending on the nature of the measures carried out and the degree of sanitary supervision, the sanitary protection zone is divided into separate parts: a) a "strict regime" zone, b) a "restricted" zone, and c) an "observation" zone. The strict regime zone extends to the water source at the place of water intake for the water main, to all water facilities (pumping stations, purification facilities, installations for coagulation and chlorination, clean water reservoirs, reserve reservoirs, and pressure towers) with the territory directly adjacent to them. The restricted zone encompasses the water source feeding the water main, other water sources having an influence on the qualitative and quantitative composition of this water source, and the territory surrounding them and influencing these water sources in this regard, at such a distance where harmful influence may also manifest at the place of water intake by the water main. The observation zone includes the territory adjacent to the restricted zone and having a connection both with it and with the strict regime zone; the harmful influence of the observation zone can manifest on the protected water source, water main facilities, and the population of the restricted and strict regime zones only under certain unfavorable conditions (the emergence of epidemics, the introduction of infectious diseases, etc.). The mentioned parts of the sanitary protection zone are established in full for all water mains using water from both surface and underground sources, whereby the dimensions of the territories of the individual parts of the sanitary protection zone will be different depending on the character and origin of the water source, its capacity and natural protection, the speed and direction of flow, the size and quality of the use of the water source and the surrounding territory, population density, development of industry, occupations of the population, transport routes, and other types of human activity. The entire territory included within the boundaries of the strict regime zone must be fenced off. Within its boundaries, any construction and measures are carried out with the permission and under the supervision of the zone's sanitary physician and the technical personnel of the water main, whereby the erection of buildings and structures is permitted only if they have a direct relation to the water main and its purification facilities. Any residence here of persons not having a direct relation to the water main is prohibited; the residence of workers and employees is permitted in limited numbers. On this territory of the sanitary protection zone, special sanitary rules are introduced, and sanitary and technical supervision and laboratory control are established, ensuring the correct operation of all parts of the water main. In this sanitary protection zone, a "strict regime" is carried out under the supervision and control of the sanitary physician. The boundaries of the restricted zone and its territory are determined after a detailed sanitary and sanitary-technical survey. Here, "restrictions" are introduced, thanks to which the pollution of water sources and soil within the boundaries of the zone and changes in the quality and quantity of water in them are prevented. Pollution of water sources can be direct and indirect. Direct pollution is caused by the discharge of sewage and all kinds of runoff, the dumping of excrement and refuse on the banks of rivers, streams, or on ice, the construction of dams from manure and other rotting refuse, the rinsing of hides, the soaking of hemp, the washing of laundry, the bathing of people, the stabling of livestock, the mooring of vessels, the floating of rafts, the extraction of river sand, the construction of absorption wells, abandoned and unused borehole and artesian wells, the development of the earth's interior, and other violations of the integrity of the water cover. Indirect pollution can depend on many other conditions: pollution of the soil with dumps of excrement and refuse, the fertilization of vegetable gardens and fields with excrement with their runoff into water sources, mass, unregulated settlement without taking necessary measures for the collection, removal, and neutralization of excrement and refuse, the construction of cottage-industry establishments that pollute the soil (glue-boiling, tanning) and warehouses, unregulated destruction of forests, the construction of dams that change the flow of water, incorrect tapping of springs, incorrect drilling and use of artesian wells, the influence of winds on the direction of currents, the backing up of groundwater, etc. In order to prevent all these types of pollution, a special procedure for the approval of local construction projects and all other measures is established in the "restricted" zone, with the preliminary conclusion and permission of sanitary authorities and with subsequent constant sanitary supervision. An accurate record is kept of all places that could be sources of pollution, and strict sanitary and laboratory control is established over facilities for the purification and neutralization of sewage, excrement, and refuse. In the observation zone, primarily enhanced sanitary-epidemiological observation of the populated places of the zone's territory is established, and strict statistical accounting is kept of diseases that can be transmitted through water (cholera, typhoid fever, dysentery), with the urgent implementation of necessary anti-epidemic measures. Here, special attention is paid to the correct organization of medical-sanitary affairs and the connection of medical-sanitary institutions with the zone's sanitary physician. For the implementation of preventive and current sanitary supervision within the boundaries of the entire zone, the study of its sanitary condition, the identification and registration of all sources of pollution, the observation of the activity of sanitary-technical facilities, the collection and development of materials on the morbidity and mortality of the population, the coordination and unification of the activity of all medical-sanitary bodies working in the zone, and the implementation of necessary health-improvement measures, a special permanent sanitary physician of the zone is appointed. Sanitary supervision over the water main itself and the work of all its facilities also lies with him. Local sanitary-bacteriological laboratories and institutes take part in the work of the zone's sanitary physician, and in case of necessity, a special laboratory is organized at the water main. The zone's sanitary physician also makes wide use of the initiative of the population (health and communal services sections, health cells, sanitary representatives of households, etc.). All questions regarding the organization and implementation of the zone, the development of measures, and their implementation on the territory of the zone are worked out by local health departments, jointly with local departments of communal services, with the participation of representatives of other interested departments (transport, council of national economy, military, etc.) and institutions, as well as individual specialists (geologists, hydrogeologists, hydrotechnicians, hygienists, etc.).

To work through all more complex issues regarding the zone, special zone meetings are organized, consisting of the aforementioned representatives, the number of which is determined depending on local conditions. The tasks of the meeting include: a) study of the catchment basin in sanitary, hydrological, and other respects, and the establishment of the boundaries and parts of the zone; b) development and discussion of measures for the implementation and conduct of sanitary protection of water sources and water supply facilities in the zones; c) review and provision of conclusions on all kinds of plans and projects for structures, works, and surveys in the zone; d) unification and coordination of the activities of all bodies working and conducting measures within the boundaries of the zone. The boundaries of the zone, and the measures developed for sanitary protection within it, are approved by local district executive committees, which also issue mandatory decrees on the protection of water sources. -The introduction of Sanitary Protection Zones for water supply sources as a mandatory measure is an achievement of Soviet sanitation. In pre-revolutionary times, Sanitary Protection Zones were noted only in 4 cities: Moscow, Krasnodar, Tula, and Kungur, but with the exception of Moscow, there was effectively no properly developed zone with systematically conducted measures. For the first time, the question of zones was discussed at the VIII Congress of Bacteriologists, Epidemiologists, and Sanitary Physicians in Leningrad in May 1924, where the establishment of Sanitary Protection Zones was recognized as one of the most essential measures for protecting water sources. In August of the same year, the People's Commissariat of Health of the RSFSR, together with the People's Commissariat of Internal Affairs, issued a special decree on sanitary protection zones. From this time on, the implementation of Sanitary Protection Zones was placed into the activity plan of sanitary organizations, and planned and systematic work began on studying and establishing the boundaries of the zones. By 1927, Sanitary Protection Zones had already been introduced for 21.5% of cities with water supply systems (56 cities), whereby cities had Sanitary Protection Zones not only with river water supply (34.5%) but also with groundwater (17.9%). On July 6, 1928, a special decree of the Council of People's Commissars of the RSFSR was issued, "On the Establishment of a Sanitary Protection Zone for Water Sources Serving the Central Water Supply of Cities, Workers' Settlements, and Other Populated Places" (Collection of Laws, 1928, No. 79, Art. 546), by which Sanitary Protection Zones are established as a mandatory measure not only for cities, workers' settlements, and populated places, but also for the water supply systems of factories, plants, railway, and water transport, if their water supply systems, in addition to serving technical needs, serve the drinking and household purposes of the population, whereby the zone is mandatory not only for existing water supply systems but also for those under construction and being designed. For the former, the deadline for introduction was set at 1 year; for the latter, from the moment of selecting the water sources. In development of this decree of the Council of People's Commissars of the RSFSR, the People's Commissariat of Health and the People's Commissariat of Internal Affairs of the RSFSR issued on October 10, 1928, a regulation on the sanitary protection zone of water sources and an instruction for its establishment. With their issuance, Sanitary Protection Zones are being implemented throughout the republic, whereby the first mandatory decree, in which concrete measures of major health-improving significance are carried out, was the decree of the Moscow Soviet on sanitary rules for the protection of the Rublevo water supply system within the limits of the "strict sanitary protection" strip. The new regulation on the zone establishes annual reporting on work in the zone, whereby the registration of all zones, general observation, and guidance of the work of the zones is entrusted to regional and territorial health departments, which report to the People's Commissariat of Health of the RSFSR; they are also entrusted with consultation on issues related to the implementation of the zone. Sanitary Protection Zones, of mineral springs, see Mineral Springs. Sanitary Protection Zones of medical institutions. The establishment of Sanitary Protection Zones for medical and medical-preventative institutions has the goal of preserving and improving the climatic and sanitary-hygienic conditions of the area where these institutions are located, and protection from changes that could harmfully affect this area, in particular, the prevention of the development of infectious diseases. Proper operation of the indicated institutions (rest homes, sanatoriums, clinics for convalescents, infectious disease hospitals, psychiatric colonies, etc.) is possible to the full extent only when also utilizing the therapeutic and health-improving properties of the area where these institutions are located, and creating a proper sanitary-hygienic environment within it. At the disposal of these institutions there must be clean air, water, sun, and sufficient green space for conducting a specific regimen and appropriate physical culture, which is achieved by the introduction of a Sanitary Protection Zone. The Sanitary Protection Zone includes: a) the territory occupied by the institution with all auxiliary and household buildings; b) the territory occupied by parks, gardens, vegetable gardens, and fields necessary for the implementation of medical-preventative measures; c) beaches, water surfaces, and water sources serving the institutions; d) green spaces protecting the institution and the territory surrounding it from unfavorable winds, from smoke, soot, and gases of nearby factories, plants, and in general from all kinds of pollution, drifting sand, snow, etc., and also ensuring the preservation of specific climatic conditions of the area. The boundaries of the Sanitary Protection Zone are established for each institution separately, whereby the dimensions of the territory included in the Sanitary Protection Zone can be different depending on local conditions. When determining the size of the territory and establishing the boundaries of the Sanitary Protection Zone, the following is taken into account: the nature of the institution, its size, the wider deployment of the institution in some months of the year, the prospects for its further development (expansion); the geographical location of the area where the institution is located, climatic and soil conditions, the slope of the terrain, the socio-economic and living conditions of the surrounding population, population density, morbidity, etc. For the implementation of necessary sanitary measures, the territory of the Sanitary Protection Zone can be divided into separate parts, in which a stricter regime is established, certain restrictions are introduced, and specific epidemiological observations are conducted. By introducing a specific regime on a known part or the entire territory of the Sanitary Protection Zone, the intention is to create a correspondingly favorable environment for the life of patients, convalescents, and vacationers, the establishment of specific hours for night rest and daytime rest, when a certain silence must be observed, and the introduction of proper sanitary maintenance of the territory of the Sanitary Protection Zone with the establishment of hours for cleaning streets and courtyards, watering them, removing waste, etc. A whole series of restrictions in the Sanitary Protection Zone also has the goal of protecting the territory of the Sanitary Protection Zone from pollution and changes that could harmfully affect the natural factors of the given area and the health of persons using it: prohibition in the Sanitary Protection Zone of the construction of factories and plants, the performance of work causing noise, the emission of gases, smoke, soot, and other waste polluting the soil, water, and air or harmfully affecting vegetation, waterlogging the soil, disturbing its cover, etc.; restriction of places for grazing livestock, which damages green spaces and contributes to the breeding of flies; restriction of amusements that create disturbance, nervous shock, or violate the established regime; restriction of visits by outsiders to the territory of the zone and its use by them for walking, hunting, fishing, etc. Epidemiological observation sets as its task the adoption of preventive measures against the introduction of infectious diseases into the Sanitary Protection Zone and their spread, as well as the elimination of already existing diseases among the population of the Sanitary Protection Zone. As the practice of implementing Sanitary Protection Zones has shown, the average radius of a Sanitary Protection Zone for the above-mentioned medical-preventative institutions should be about 2-3 km, allowing, of course, for fluctuations depending on local conditions. The conduct of preventive and current sanitary supervision within the boundaries of the Sanitary Protection Zone, the study of its sanitary condition, the development of necessary measures for sanitary protection, etc., are entrusted to the local sanitary physician. In the event that there are several medical-preventative institutions in a given area with separate Sanitary Protection Zones, a special sanitary physician for the Sanitary Protection Zone may be appointed. In addition, physicians of medical-preventative institutions within the territory of the Sanitary Protection Zone and the organized population (members of the health section, health cells, etc.) are involved in the work on the Sanitary Protection Zone. -The inclusion in a Sanitary Protection Zone of populated places, state farms, industrial enterprises, etc., on the activities of which the regime and restrictions introduced in the Sanitary Protection Zone can significantly influence, must be carried out with great caution and strict justification. Also, the introduction of a Sanitary Protection Zone may restrict the local population's use of forests, meadows, beaches, water surfaces, and water sources. Therefore, all issues regarding the organization of a Sanitary Protection Zone, the establishment of its boundaries, and the implementation of necessary measures within it are developed by the health department together with the local department of communal services or the land administration, with the participation of representatives of interested departments and institutions. In case of particular complexity in implementing a Sanitary Protection Zone, a special commission on the Sanitary Protection Zone is organized, consisting of representatives of interested departments and institutions with the participation of the local sanitary physician, the physician of the medical-preventative institution, and necessary specialists.

The developed boundaries of sanitary protection zones and the measures for their sanitary protection are approved by the local executive committee and the city council, which also issue mandatory decrees. Sanitary protection zones for therapeutic and prophylactic institutions were first implemented in our country under Soviet power. At the II Prophylactic Congress of Moscow Governorate in 1926, the question of sanitary protection zones received a fundamental resolution, after which, on December 28, 1926, the Presidium of the Moscow Soviet adopted a regulation on protection zones for sanatorium institutions of Moscow Governorate, which entered into force on April 1, 1927. In the Instruction on the planning, improvement, and development of summer cottage settlements, issued by the People's Commissariat for Internal Affairs jointly with the People's Commissariat of Health, the People's Commissariat of Agriculture, and the People's Commissariat of Justice of the RSFSR on August 10, 1928, the question of sanitary protection zones for therapeutic and prophylactic institutions is posed much more broadly and for the entire RSFSR; it draws special attention to the "creation of the most favorable conditions for the activities of therapeutic and sanitary institutions, sanatoriums, rest homes, etc., and the establishment of corresponding sanitary protection zones for them" and indicates the basic conditions for planning a therapeutic and sanitary district. On April 1, 1929, the People's Commissariat of Health and the People's Commissariat for Internal Affairs issued a special circular with an instruction "on the organization of sanitary protection zones for sanatorium institutions and rest homes." With the issuance of this circular, the question of sanitary protection zones already receives a certain legislative formalization and begins to be implemented, beyond Moscow, in other localities of the Union.