PRACA ORYGINALNA / ORIGINAL ARTICLE

PROBLEMY ZWIĄZANE Z ZANIECZYSZCZENIEM WODY AZOTANAMI W REGIONIE POŁTAWY

Kateryna V. Pikul, Lyudmyla E. Bobyreva, Tatiana M. Kotelevska, Natalia О. Pryimenko, Konstantin V. Tarasenko

HIGHER STATE EDUCATIONAL INSTITUTION OF UKRAINE, UKRAINIAN MEDICAL STOMATOLOGICAL ACADEMY, POLTAVA, UKRAINE

ABSTRACT

Introduction: The topicality is determined bypriority and importance of researches that have preventive referral directed on provision of harmonious growth and early childhood development, children’s resistance to the infection’s effects and other unfavorable external factors. There are problems about the role of permanent nitrate load in the formation of children health issues, especially children who live in the area with high nitrate levels in drinking well water.

The aim is to evaluate the physical development of children who live in nitrate-contaminated areas.

Materials and methods: Object of study – children living in nitrate-polluted locality. Subject of study – violation of physical development and morbidity of children in interrelation of factors that determined. Methods – clinical, biochemical, instrumental, sanitary-hygienic, statistical.

Results: When studying the content of methemoglobin among adult population in village areas, where well water with a high concentration of nitrates is consumed and in the city where centralized water supply is used, it was observed that rural people have a higher level of methemoglobin. Parents who lived in nitrates-polluted territories have a chronic pathology formed in childhood that affects the morbidity of their children, which affects the health of the nation.

Conclusions: centralized water supply was conducted many locations over the years, but parents who lived in nitrates-polluted territories have a chronic pathology formed in childhood that affects the morbidity of their children.

 

Wiad Lek 2018, 71, 4, -842

 

INTRODUCTION

The topicality is determined bypriority and importance of researches that have preventive referral directed on provision of harmonious growth and early childhood development, children’s resistance to the infection’s effects and other unfavorable external factors. Rapid development of molecular and cell biology has significantly expanded our understanding of biochemical, physiological, molecular, and other processes in the healthy human body and allowed us to draw conclusions regarding subtle pathogenic mechanisms of particular clinical symptoms and diseases [1].

There are problems about the role of permanent nitrate [2] load in the formation of children health issues, especially children who live in the area with high nitrate levels in drinking well water. These problems exist on the background of widespread environmental pollution by chemical and radioactive substances and their unfavorable impact on the health of Ukrainian population. According to the “Unified hygienic control of the content of nitrates in food and water,” which was introduced in Ukraine, the limit of allowable concentration of nitrate in drinking water is 45mg/L in the acidic residue and 10 mg / l of nitrogen, while there should not be any nitrites. The maximum safe nitrate dose in the human body is 5mg/kg. There is 0.5-0.75% methemoglobin in the body under normal circumstances. Even at the nitrate concentration of 100mg/L in drinking water an acute poisoning in infants can occur[3]. When studying the content of methemoglobin in an adult population in rural areas, where well water with a high concentration of nitrates is consumed, there is a higher level observed than in a city where centralized water supply is used. There is evidence that the concentration of methemoglobin in the blood of pregnant women who live in the village is also higher. Nitrates from the body of a nursing woman are withdrawn in concentration up to 6mg/L. A lot of attention in the scientific literature is devoted to the issue of drinking water connection and methemoglobinemia [4]. It is proven that the movement of nitrates occurs when the vertical migration of water is up to 10m and with horizontal – at a depth of 5m. With a content of nitrates in water 51-100mg/L, the level of methemoglobin increases up to 3.5%.

The study is done by the author within the GDR, is a fragment of the theme “Current issues of prevention, diagnosis, treatment and rehabilitation of alimentary-dependent diseases in children and the impact of adverse environmental factors on these diseases», (state registration number 000 134 0198U).

THE AIM

The aim of study is to evaluate the physical development of children who live in nitrate-contaminated areas.

MATERIALS AND METHODS

Object of study – children living in nitrate-polluted locality. Subject of study violation of physical development and morbidity of children in interrelation of factors that determineit. Methods – clinical, biochemical, instrumental, sanitary-hygienic, statistical. The study followed official statistics on the digestive organs morbidity among children of nitrate-polluted Khorolsky region (n = 7133) and environmentally friendly Myrhorod city (n = 7719) for the period 1999-2002. We have studied the results of general clinical examination of 148 pupils aged 7 to 16 years old. 80 of them lived in nitrate-polluted area in the village, used well water with elevated levels of nitrates (main group) and 66 children who lived in the city and used water from centralized water supply (comparison group). A survey of children was conducted at the upper secondary schools, child consultations, sanitary and epidemiological stations of districts (Khorolsky, Semenovsky, Lokhvitsky, Hrebinkivsky; the colleagues from the department of Pediatrics №1 examined children of Chutovsky, Karlovsky, Mashevsky districts) of Poltava region, City Children’s Hospital, Regional Clinical hospital of the city of Poltava, Institute of Ecological Hygiene and Toxicology in Kyiv, CSRL Ukrainian Medical Stomatological Academy. The contain of nitrates in water of individual mine wells ranged from 50 to 2200mh/dm3 in nitrate-polluted areas and up to 45mg/dm3in the areas with centralized water supply. While collecting data the following documentation was used: “Exchange card of pregnant,” “History of birth “(to study the anamnesis vitae of infants),” Individual card of child development “, books of registration of medical examination [4].

RESULTS AND DISCUSSION

During the long-term chemical nitrate pollution of the environment there are preconditions for the formation of chronic nitrate load; in these conditions (on the basis of chronic hypoxia) not only chronic pathology, but also violations of physical development of children may develop. The undoubtedly increased morbidity of the children of the main group led to an increase of disharmonious physical development of schoolchildren because of children who had a height above the average and circumvention of the chest below the average age standard 2 times more compared with the comparison group (p<0.05). During the examination of schoolchildren who lived for a long time in nitrate-polluted area, it was discovered that children from 7 to 12 had more harmonious physical development than children aged 13 to 16. It means that increasing nitrate load on the child’s body in the time aspect also increases the percentage of children with disharmonious physical development (p<0.01). Analyzing the distribution of the harmonious development of schoolchildren by gender, it was noted that this relative index in boys was slightly lower in the main group and was 35% versus 79.3% with the accuracy of the difference (p<0.01). Harmonious physical development in girls was 43.2% in the main group and 59% in the comparison group (p>0.05).

Among the examined children [4], the pathology of the urinary organs was confirmed. The percentage of the urinary system disorders in the main group was 3 times higher than in the comparison group. At the age of 7 to 12 years abnormality met only among the surveyed students from nitrate-polluted area – 27.1%. The percentage of school children from 13 to 16 years with various disorders of urinal system was 32.6% versus 16.3% (p<0.05). Deficiency anemia was found to be 4 times more common in children from the main group than in the comparison group (p<0.01). Frequency of deficiency anemia was higher in girls than in boys of nitrate-polluted areas and was 21.6% compared to 5.1% of high school girls who lived in ecologically clean area (p<0.05). In the main group the studied digestive organs morbidity among male schoolchildren was 2.3 times higher than in the comparison group (p<0.05). Among girls of the main group, the percentage of digestive disorders was 2.9 times higher versus the comparison group (p<0.01).

Must attmitted that about our methodcal, we put methemoglobin , the normal which about WHO should not increase above 2.5g/l. Result of the main group where we did exactly (р<٠,٠١) content of methohemoglubin in 2,05 time or in 105% responsible control were very good conditions (tabl.I). According to the data of professional literature, scientists who investigated the problem of nitrates pollution of drinking water on the child’s body, also found possible correlation bonds of average strength between blood nitrogen oxide and free radicals NO- and indicators that characterize the state of enzymatic liver exchange, namely those that reflect the level of intoxication of the organism, hepatocyte cytolysis and the development of cholestasis [5]. In parallel with the formation of NO with chronic nitrate loading in the blood of children and the formation of methemoglobinemia. For a comprehensive assessment of the influence of nitrate contamination of drinking water on the health of children, in particular on the studied blood parameters, between them and methemoglobin and nitrates, correlation bonds were investigated. Between the level of total bilirubin and NO blood, an average dependence was observed in children who consumed water with an excess of nitrates r = 0.46 (p<0.05). The strong correlation between the level of nitrates and the alanin-transferase reflected [6] the dependence of the functioning of the liver and the bile-excreting system on the excessive intake of nitrates to the body in the schoolchildren of the main group r = 0.72 (p<0.01).In determining the presence of a connection between renal blood samples, the probability was established only in children who used water from wells with high nitrogen content. Connections between urea and blood nitrates were observed for medium force – r= 0.46; residual nitrogen – r = 0.49; creatinine r = 0.49 (p <0.05). Correlations between the level of total protein and blood nitrates were unlikely.

When we compared the long-term consequences of chronic nitrate intoxication as a result of the overall morbidity of children whose parents had been exposed to permanent effects of nitrates on their bodies since their childhood, they noted that the issue is relevant today.

Almost 15 years later, we decided to compare the overall incidence in our study areas (Hrebinkivsky, Karlivsky, Lokhvitskiy, Mashivsky, Pyryatynsky districts) inhabited by people with permanently high levels of nitrates in the water with a relatively safe Myrhorodsky district (comparsion group). We noted increased rates in these areas as indicated in the table II.

CONCLUSIONS

Centralized water supply was conducted many locations over the years, but parents who lived in nitrates-polluted territories have a chronic pathology formed in childhood that affects the morbidity of their children.

REFERENCES

1. Vesnina L., Kaidashev I. English Version: Creating A Genetic Database As A Strategic Challenge Of Modern Medical Researches. Problems ecology and medicine. 2014; 1-2 (18): 8-12.

2. Salyha N.O. Antioxidant defence system indices or rat treated by sodium nitrite and their correction by L-glutamic acid. World of medicine and biology. 2016; 2(56): 145-148.

3. Kholod D., Shkurupii D., Sonnik E. Immune changes in newborn infants with gastrointestinal failure requiring intensive care. Georgian medical news. 2016; 7-8: 62-66.

4. Pikul K.V. State of health of children who live in nitrate-polluted areas and reasoning of rehabilitation methods. Poltava: 2004; 175.

5. Bohadelnykov Y. Differential diagnosis of children infectious diseases. Simferopol: 2009; 390: 242.

6. Kryuchko T.O., Nesina I.M., Tkachenko O.Ya. Diagnostic algorithm and peculiarities of monitoring for infants with disorders of the gastrointestinal tract. Wiadomości Lekarskie. 2017; 70(2, cz. II): 275-281.

7. Materials reports of the regional Health Department. Poltava. 2000-2016.

The study is done by the author within the GDR, is a fragment of the theme “Current issues of prevention, diagnosis, treatment and rehabilitation of alimentary-dependent diseases in children and the impact of adverse environmental factors on these diseases», (state registration number 000 134 0198U).

Conflict of interest:

The Authors declare no conflict of interest

ADDRESS FOR CORRESPONDENCE

Lyudmyla E. Bobyreva

Higher State Educational Institution of Ukraine,

Ukrainian Medical Stomatological Academy,

23 Shevchenko str, 36000 Poltava, Ukraine

tel: +380955614138

e-mail: ekateryna.pikul@gmail.com

Received: 26.12.2017

Accepted: 19.05.2018

Table I. Level of methemoglobin in blood of examined children who lived in the territory of high level of nitrates and clean ecologic territory

Tittle

Statics

Groups of children

р

main group

n=22

diffrential group

n=22

Methemoglobin

g/L

М±m

Trust interval

4,61±0,35

3,95-5,3

2,08±0,07

1,99-2,16

р<0,001

Table II. Morbidity among children aged 0-16years in1000 children (2016) [7]

Rayon

The total incidence

For 1000 us.

In the first life

For 1000 us.

1

V. Bahachansky

5 104

1581.2

3 506

1086.1

2

Gadyatsky

9 363

1348.0

6860

987.6

3

Globinsky

10 600

1653.2

8 564

1335.6

4

Hrebinkivsky

6 097

1847.0

4 775

1446.5

5

Dykansky

4 002

1483.3

2 851

1056.7

6

Zinkivsky

6 513

1493.1

4984

1142.6

7

Karlivsky

9 405

1922.5

6 287

1285.2

8

Kobelyatsky

9 201

1570.9

6 854

1170.2

9

Kozelshchynsky

3 741

1530.1

2 559

1046.6

10

Kotelevsky

3,734

1308.8

2 686

941.5

11

Kremenchutsky

8 097

1315.3

6 148

998.7

12

Lokhvytsky

10 877

1989.9

8 804

1610.7

13.

Lubensky

18 723

1717.1

10 919

1001.4

14

Mashivsky

4 570

1852.5

2 945

1193.8

15

Myrhorodsky

13 753

1503.9

9732

1064.2

16

N.Sanzharsky

6 705

1509.8

4 536

1021.4

17

Orzhytsky

4 262

1358.2

3 440

1096.2

18

Pyryatynsky

7 965

1827.7

5,939

1362.8

19

Poltavsky

13 997

1566.7

11 333

1268.5

20

Reshetylivsky

6,660

1784.1

3 922

1050.6

22

Semenivsky

5 195

1922.6

3 856

1427.1

23

Khorolsky

8 409

1935.8

5 864

1349.9

24

Chornukhynsky

1 788

1337.3

1 207

902.8

25

Chutivsky

8 564

2654.7

6 758

2094.9

26

Shyshatsky

4 577

1657.1

3 267

1182.8