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ХудшийЛучший 

УДК 577,118

Турбина Е. С.

Environmental Factors and Children’s Health in the Jewish Autonomous Region (Russia)

Far Eastern State Academy of Humanities

 

Эта работа посвящена изучению влияния экологических факторов на состояние детей дошкольного возраста в Еврейской автономной области (ЕАО). Показано, что постоянное воздействие на детский организм вредных взвешенных веществ, вдыхаемых с атмосферным воздухом, способствует понижению иммунитета, что повышает процент аллергических и респираторных заболеваний, болезней крови, в частности анемии и увеличивает их продолжительность.

Ключевые слова: заболеваемость детей; техногенная нагрузка; загрязнение воздуха; антропогенная нагрузка; взвешенные вещества; заболевании органов дыхания.

The work analyzes the factors of environmental life in the Jewish Autonomous Region (JAR) from the point of their influence on the population’s state of health. The characteristics of sick rate among the most vulnerable group of population – children – are presented. The survey of ecological conditions in the JAR shows that the constant influence of suspended solids, inhaled with the air can increase the percentage of allergic, respiratory and blood diseases and their duration.

Keywords: children’s morbidity; technogenic load; air contamination; anthropogenic pressure; suspended solids; respiratory diseases.

For environmental contaminants, four important media were identified: outdoor air, drinking water, food, and soil as well as climatic conditions. For each of these media, data available from different sources, including regional environmental and health agencies were reviewed.

This paper has three principal objectives. First, it summarizes concrete, quantifiable data of key factors relevant to the environment and children in Birobidjan (Jewish Autonomous Region, Russia). This data offers a basis for understanding some trends in the impact of the environmental factors on children’s health and for further investigation of others.

Second, the paper can draw attention of the public and local authorities to existing situation and make them take measures to improve it.

Third, the paper can trigger, as the author hopes, similar investigations in the impacts of environmental  contaminants on children’s health in borderline arias of China and lead, ultimately,  to mutual investigation in order to identify and evaluate ways to minimize environmental impacts on children, thus integrating the environmental health needs of children into the international policy agenda.

Why is it vital to focus on children’s exposure to environmental contaminants?

One of the major reasons for the increase in the morbidity of population, which is observed both in the entire world and in Russia, is the pollution of environment. This common situation is affected by the specific character of climatic conditions and quality of environment in each particular region. Jewish Autonomous Region (JAR) is a compact region, which makes it possible to examine the tendencies and peculiarities in the status of children’s health depending on ecological situation within a small territory. Children’s health, as well as adults’ health, is affected by an elaborate complex of factors such as climate and socio-medical conditions, the main of them being the composition of family, dwelling, income level, and feeding.

However, according to the data of the different authors the pathology, connected with the anthropogenic pollution, comprises up to 50% in the structure of the of children’s morbidity [3].

According to the data presented in America’s Children and the Environment Measures of Contaminants, Body Burdens, and Illnesses, “Environmental contaminants can affect children quite differently than adults, both because children may be more highly exposed to contaminants and because they may be more vulnerable to the toxic effects of contaminants. Children generally eat more food, drink more water, and breathe more air relative to their size than adults do, and consequently may be exposed to relatively higher amounts of contaminants. Children’s normal activities, such as putting their hands in their mouths or playing on the ground, can result in exposures to contaminants that adults do not face. In addition, environmental contaminants may affect children disproportionately because their immune defenses are not fully developed and their growing organs are more easily harmed” [12, p. 13].

Another evidence of the fact that children are more effected by contaminants than adults is given in the research devoted to the dependence of children’s morbidity (respiratory diseases in particular) on environmental contaminants in four Chinese cities. Among other reasons for having respiratory morbidities the authors of the research named certain personal, residential, and family factors, including into the risk factors the following things: “being younger”, “sharing beds”, “room being smoky during cooking”, “eye irritation during cooking”, and “parental smoking” [13].

It is child’s constitution that is the most sensitive evaluation indicator of the environment effect on the health, because child’s body reactions to the action of anthropogenic factors differ considerably from the reactions of the adult in the range of increased, but subthreshold concentrations of harmful substances (which are not overall toxic).

Outdoor Air Pollutants and Drinking Water Contaminants

Different forms of industry and also motor transport serve as the source of the pollution of medium by - xenobiotics - the compounds, absolutely alien to the organism.

Due to prolonged influence of xenobiotics even in small doses the functioning of organs and systems of the organism, including the immune system, is disrupted which creates conditions for the development of virus-bacterial and parasitic infections. Many xenobiotics act as irritants, causing irritation of mucous membranes of the respiratory tract and leading to the oppression of the system of local immunity [3].

The contamination of air is one of the leading health risk factors. In the first place air pollutants influence the resistibility of organism. In comparison with other sources containing contaminants (food, drinking water), air presents special danger, since there is no barrier on its way similar to liver, which protects organism during the penetration of the pollutants through the gastrointestinal tract. It is established that the effect of poison, admitted with inhaling, is frequently 80-100 times stronger than admitted through the gastrointestinal tract.

Statistically reliable dependence on air contamination is established for falling ill with bronchitis, pneumonia, emphysema of lungs, and also getting acute respiratory diseases [10]. 

Water is the most vulnerable medium of environment. According to the World Health Organization conclusion, the frequency of the diseases, which agents are transferred by water, is highest. The Ministry of Public Health of Russia carried out an official investigation on the influence of the unsatisfactory quality of drinking water on the statuses of the health of the populations in a number of the cities.

The results of this investigation revealed the correlation between the morbidity of population and the quality of the drinking water that does not meet health-based standards for harmful pollutants on one or more indices. The reliable connection between the following water contaminants and deceases is established:

  • iron and gastrointestinal tract and liver deceases;
  • chlorides and ischemic heart disease, the deceases of pancreas,  urolithiasis;
  • sulfates and ischemic heart disease, the diseases of bile tracts;
  • zinc and blood diseases, the diseases of gastrointestinal tract, hypertention, the ischemic heart disease;
  • fluorine and fluorosis, dental caries [11].

A new class of diseases - microelementosis, is singled out and systematized at present. They are caused by the deficiency or surplus (unbalance) of the vitally necessary elements entering the organism. The content of microcells in the organism depends directly on their content in the different environmental media. Of 92 existing elements in nature 81 are found in the human organism. 15 of them (iron, iodine, molybdenum, zinc, cobalt, chromium, nickel, vanadium, selenium, manganese, arsenic, fluorine, silicon, lithium) are essential, that is - vitally necessary. The insufficient or excess receiving of these elements can prove to be extremely dangerous for health [1].

Environmental Factors in the JAR

Studies, dedicated to the evaluation of complex influence of the environmental factors on children’s health in Jewish Autonomous Region (JAR) have not been carried out yet. Meanwhile there exists a number of specific environmental factor, which cannot help effecting people’s health and first of all children’s health.

JAR is a subject of Russian Federation, located in the southern part of the Russian Far East. The population of its capital Birobidjan is 76 thousand people.

A number of studies on the influence of JAR climate on the health of people were carried out. The results showed that the high day-to-day and intradiurnal fluctuations of temperature during winter that are common for the entire territory of region, aggravate the hardness of climatic conditions. According to the data presented by E.A. Grigoryeva heat loss by the respiratory organs in the JAR in winter exceed physiological standard by 2 to 7 times, which causes organism’s supercooling and is one of the important factors in the development of respiratory diseases [6].

Furthermore, the natural climatic and geochemical special features of the JAR (mountainous relief, monsoon climate, being remote and screened from the ocean by mountain ranges, over moist and the acidity of soils, the swampiness of territory, the lack of mineralized water) form biogeochemical province with Iodine deficiency. The misbalance of manganese and the deficiency in cobalt and copper have been revealed in agricultural soil. According to the data presented by M.S. Antonova, with the iodine deficiency of medium degree of gravity in the territory of autonomy over 80% population has an iodine deficiency in the organism [2].

There are 68 sources of centralized water supply and 489 sources which are not centralized. With this 30% of sources of the centralized water supply do not meet health-based standards and rules. According to the chemical hygiene indices the unsatisfactory quality of water sources is mainly caused in essence by the increased content of iron, manganese and others the microcells of natural origin. The quality of water in the water-conducting network remains unsatisfactorily despite the fact that10 deironing stations have been launched in the region in recent years. Furthermore, the reduced content of fluorine in the water is noted. The entire population of region lives under conditions of fluorine scarcity in the water. This leads to the fact that 95% of the region’s population suffer from dental caries.

The river Bira and its ducts, running through the territory of the JAR undergo the greatest anthropogenic pressure. It has been noted in recent years that the quality of water according to the chemical hygiene and microbiological indices, has worsened, which leads to an increase of lambliasis, hepatitis and different helminthiases among population [5].

Furthermore, one of the urgent problems for the JAR remains the sphere of the rotation of production and consumption wastes. The basic sources of the pollution of soil of the residential areas’ soil are the unsanctioned dumps of liquid and solid household trash, ashes and slag from the boiler rooms, ejections during the combustion of fuel, exhaust gases of motor transport. The system of sanitary cleaning of the populated areas in the JAR does not ensure rational collection, reliable neutralization and the rapid removal of household trash [4, 5].

In view of the reasons pointed out above, the level of  soil pollution in the JAR remains high, and as to the microbiological indices and the contamination of soil by helminthes’ eggs it considerably exceeds average indices for the Russian Federation [5].

Among the socio-ecological factors, which can, both strengthen and weaken the negative influence of environmental factors, special attention is paid to the nourishment of population. Last years were characterized by the damage in the structure of population feeding in the JAR; however, a gradual increase in the consumption of meat, fish, vegetables and vegetable oil is noted. At the same time the cost of the minimum collection of food products in recent years increased by 20%. It is one of highest in the Far-Eastern territory [4, 5]. S. I. Krokhaleva calculated penetrating of nitrates into the human organism with water and food in the course of twenty-four hours. It was established that daily nitrate load per each Birobidjan citizen comprises in 241 mg summer time and 249 mg in winter, which does not exceed the affirmed standard in Russia; however, it does not meet the norms and permissible doses accepted in the majority of the European countries and exceeds them by 2-3 times [8]. In this case it is necessary to remember that the conventional hygienic norms are developed taking into account the reactions of an adult organism or even experimental animals. They do not provide for the variations in the sensitivity dependent on age.

About 40% of population of region lives in Birobidjan. City does not belong to large industrial centers. However, in 1995 and 1996 it entered into the number of 45 cities of the Russian Federation with the high level of air pollution, which is mainly connected with air contamination caused by pollutants from heat and power plant, heating boiler rooms and, up to 40%, caused by emissions of diesel pollutants from trucks and buses. For a long time automobiles were the source of polluting the medium by lead. They continue to vent to the atmosphere solids, oxides, carbon, nitrogen oxides, hydrocarbons, sulfurous anhydride.

Different city districts have different anthropogenic load. According to the data of V.P. Makarenko the city air is ventilated poorly and has low capability for self-purification, which contributes to xenobiotics accumulation in some regions [9]. As E.O. Klinskaya states there is high contamination by lead and exceeding maximum permissible concentration of zinc in some stations for soil sampling, located in different city districts [7].

Children’s Environmental Health Research in the JAR

Children’s status of health is one of the most sensitive indices, reflecting the quality of environment. Using data of sanitary-epidemiologic supervision, we analyzed the children’s state of health in the JAR. It has been revealed, that the morbidity of children and adolescents in recent years has a tendency toward the increase on the majority of the disease classes and prevalence of chronic pathology. Infantile mortality remains very high; it exceeds approximately 1.5 times the data for the Far-Eastern region and for Russia as a whole. There is an increase in the number of innate anomalies (1.7 within the last 5 years). The indices of morbidity by anemia among children are also increasing (almost 2 times since 2001 to 2003). General morbidity in children has grown by more than 20% in comparison with average long-standing data (1995 -2002). This increase is mainly caused by the diseases of the respiratory organs.

The structure of children’s morbidity within the age group from 0 to 14 years runs as follows: the diseases of respiratory organs occupy the first rank place, infectious and parasitic diseases are at the second place, injuries and poisonings go for the third place, the diseases of the skin and subcutaneous cellular tissue – the fourth rank place, and the disease of the organs of digestion have the fifth place.

Morbidity among the children with the diseases of blood exceeds average for the Far-Eastern region 1.3 times, endocrine system – 1.4 times, systems of blood circulation - 1.7 times. Within JAR the maximum morbidity of the children is noted in Birobidjan (both within general and practically in all nosologic groups) [4, 5].

In order to reveal the role of the anthropogenic pollution of medium in children’s morbidity in the JAR, we have studied the records of children development within the age group from 3 to 6 years. These children attend Birobidjan pre-school establishments, which are located in the ecologically different regions. For this purpose 8 kindergartens were selected and divided into five groups according to the level of technogenic contamination of the district they were located. On the whole 781 records of child’s development child in the pre-school establishment were analyzed. They were compared: The general morbidity of children during 2007, morbidity within different nosologic groups, the average duration of one case of disease, the number of frequently and prolongedly sick children, the number of cases of the complications of sharp respiratory virus infections, anamnesis data of children and their health when they start attending kindergarten were compared.

The first group was comprised by children’s pre-school establishments № 11 and 21 located in Bumagina – Naberezhnaya district. According to the data of the map of the mutual imposition of the areas of air pollution in Birobidjan and stationary sources, and taking into account the direction of wind-rose and area relief this district can be referred to the regions with the minimum level of technogenic influence. The basic considered indices in children attending these establishments are rather similar and majority of them are lower than the average data on all investigated kindergartens; therefore average indices on these two establishments were used as estimated figures. Kindergartens № 28 and 39 made the second group. They are located in Pionerskaya Street, the area of city with the moderate level of technogenic load. Kindergarten of № 15 situated Lenin's street - the area of city with a weak level of technogenic load made the third group. The fourth group was presented by- kindergarten № 32, which is located in the settlement Sopka (according to the data of E.O. Klinskaya this region is characterized by a high level of soil contamination by heavy metals). The fifth group consists of kindergarten № 37, located in Chapaeva Street, and kindergarten № 43 along Millera Street. They are located in the city district with the maximum level of technogenic influence.

The greatest difference in the indices in comparison with the estimated/control figures is observed in the establishments, which comprise the fifth 5 group. Only 26 % of children, when they started attending the kindergarten, were healthy. It is 1.4 times less in comparison with the estimated figures. 44% of children had 2-3 and more diagnoses (2 times more). In anamnesis (from birth until 2007) 46% of children had a diagnosis of anemia (2.3 times more); allergic diseases, including postvaccinal allergy - 63% of children (2.7 times more); the disturbance of physical development - 12%, which is 1.2 times more in comparison with the estimated figures. An average number of cases of the upper respiratory tract diseases per child in 2007 was 3.8, which is 1.6 times more than in the relatively clean region. Average duration of upper respiratory tract disease is 14 days, which is 1.9 times more in comparison with the estimated figures.

Percentage of the frequently and prolongedly sick children rises up to 23 (1.3 times higher in comparison with the estimated figures). Sharp respiratory virus infections were complicated by the bacterial infection in 20% of cases, which is 1.3 higher than control indices.

Conclusion

This study showed that a constant influence of even a moderate technogenic load on the organism of pre-school age child causes worsening in the state of his health. The most sensitive indices of this inspection proved to be the anemia and allergic diseases in children’s anamnesis, and also the average duration of one case of the upper respiratory tract disease.

Thus, based on the example of the JAR and Birobidjan we can trace the influence of medium factors on the health state of the most sensitive population group of the region and prove that even slight deviations in different indices of environment, provided they are total and permanent, can perceptibly and sufficiently influence children’s health.

 

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