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English version: PREVALENCE OF SYSTEM VASCULITIS AND ECOLOGY*
Syniachienko O.V., GerasymenkoA.M., LiventsovaK.V.
M. Gorkiy National Medical University, Donetsk
Information about prevalence of systemic vascuiitis (Henoch-Schoniein purpura, cryogiobuiinemic vascuiitis, knot polyarteritis, Takayasu's arteritis, Wegener's granulomatosis et a) in different ecological regions, cities and rural districts is presented; influence on the medical statistical indexes of development degree of separate industry branches, transport and agriculture, contamination in the environment of atmospheric air, soil and waters by different xenobiotics, including toxic and by essential microelements are also presented.
Key words: systemic vasculitis, prevalence, environment.
For last three years the distinct increase of patients with systemic vasculitis(SV)[14] was observed, this fact being considered in the context with worsening of ecolo-gic situation in different regions of the planet. The unfavourable environment rises the prevalence of SV in people genetically predisposed to the diseases [2,12], that is much caused by the formation of antineurophilic cyto-plastic antibodies in the organism - one of the main factors in pathogenic construction of such diseases [4]. SV is noticed occur more frequently in highly urbanized regions [10,18]. It is necessary to underline that the parameters of the prevalence of SV are unknown in cities and counry-sides depending on separate factors of pollution of the atmosphere, soil, drinking water and subsoil water with xenobiotics.
Purpose and the tasks of the work are to study the prevalence of SV and analyze these indexes in different ecologic regions of Donetsk district depending on unfavourable factors of the environment (air, soil, water) and the degree of the influence on this statistic medical index of the development separate branches of industry, transport and agriculture.
Materials and methods
Hygienic estimation of antropogenic pollution of the environment was carried out on the basis of the determination of xenobiotics in four of its objects - atmospheric air, soil, drinking water and underground water sources. The findings were received in consequence of investigations of sanitary - hygienic stations, regional departments of State Committees on hydrometeorology, the control of natural environment and ecological safety. We estimated: 1) the distribution of emissions in the atmosphere of 17 urban and country-side regions of Donetsk district by metallurgical, coal, chemical, engineering industry, the production of building materials, energetics, motor transport and agriculture; 2) the level of emissions in the atmosphere and accumulation of industrial wastes in it for a year per territorial area and a human-being; 3) the contents of ammonia, 3,4-benzpiren, dioxides of nitrogen, sulfur and carbon, carbon oxide, hydrogen sulfide and phenol; 4) mineralization of drinking water of different regions, the contents of chlorides, sulfates, nitrates and phosphates in it;5) the levels of Ba, Be, Bi, Ci, Cr, Cu, Hg, Li, Mn, Mo, Ni, Pb, Sn, TV and Zn in soil, Ba, Cu, Li, Mn, Ni, Pb, Ti and Zn in undersoil water.
The index of emissions in the atmosphere per the area of the territory for a year is 9.7 + 0.59 t3/km2, and the parameters of industrial waste accumulation per a
man - 0.7+ 0.03 tons. The frequency of the distribution of emissions of the average structure in the atmosphere of the Donetsk region is following : metallurgy industry - 8.9 + 0.53%, coal industry - 25.2 + 6.45%, chemical industry
- 5.1 + 1.46%, machine building industry - 6.8 + 2.85%, energetics - 19.6 + 6.19%, building material industry -21.4 + 5.79%, automobile and railway transport - 5.9 + 2.68%, agriculture - 7.2 + 3.5%. The average concentration of ammonia in the atmosphere was 15.4 + 3.94mkg/m3, 3,4 benzpiren - 5.6 + 0.22ng/m3, dioxide of nitrogen - 97.2 + 3.65 mkg/m3, dioxide of sulfur - 178.5 + 6.25 mkg/m3, dioxide of carbon - 2.8 + 1.3 mkg/m3, carbon oxide - 10.5 + o.26 mg/m3, hydrogen sulfate -4.1 + 1.78 mkg/m3 and phenol - 8.6 + 0.24 mkg/m3, the parameters of the mineralization of drinking water were 1.7 + 0.07 g?l, chloride - 183.2 + 9.86 mgxeq/l, sulfate -782.0 + 37.08 mg/l, nitrates - 25.8 + 2.03 mg/l, ammonia phosphates - 0.4 + 0.02 mg/l. The amount of Ba in the soil was 854.2 + 22.29 mg/kg, Be - 180.1 + 12.14 mkg/kg, Bi - 161.0 + 1.04 mkg/kg, Co - 1.9 + 0.02 mg/kg, cr -213.1 + 10.54 mg/kg, Cu - 60.8 + 1.09 mg/kg,Li - 63.5 + 1.16 mg/kg, Mn 0 2191.3 + 161.51 mg/kg, Mo - 2.6 + 0.04 mg/kg, Ni 63.5 + 1.16 mg/kg, Pb
- 93.9 + 6.27 mg/kg, Zn - 8.7 + ).49, V - 102.5 + 1.41 mg/kg, Zn - 227.5 + 10.43 mg/kg, and in subsoil water Ba - 2.86 + 0.438 mg/l, Cu - 0.55 + 0.061 mg/l, Li - 0.81 + 0.061 mg/l, Mn - 1.39 + 0.053 mg/l, Ni - 0.08 + 0.006 mg/l, Pb - 0.12 + 0.010 mg/l, Ti - 2.15 + 0.091 mg/l, Zn -0.49 + 0.045 mg/l.
In Donetsk region among the population the correlation of prevalence of such diseases as osteoarthrosis, chronic rheumatic disease of the heart, gout, rheumatoid arthritis, ankylosing spondilitis, systemic lupus erythematosus and SV(Schonlein-Henoch purpura, essential cryoglobulinemic vasculitis, Churg-Srauss vasculitis, Goodpasture's syndrome and Behcet's syndrome, Wegener"s granulomatosis, nodular polyarthritis, Takyasu's unspecific aortoarthritis) is as 184: 38:16:15:2:1:1. In this case the average prevalence of SV in the regions of the district is 1.29 + 0.179 per 10 000 of population.
Statistic processing 0f received results of investigations was carried out with the help of the computer variation, correlation, regression and dispersion analysis (programs "Microsoft Excel" and "Statistics-Stat-Soft", USA). It was estimated the middle values (M), standard deviations (SD) and mistakes (m) coefficient of correlation (r), criteria of dispersion (D), Student's criteria and trustworthiness of the statistic indexes (p). Taking into considera-
To cite this English version: Syniachenko O.V., Gerasymenko A.M., Liventsova K.V. Prevalence of system vasculitis and ecology / / Problemy ekologii ta medytsyny. - 2013. - Vol 17, № 1-2. - P. 23 -25.
TOM 17. N 1-2 2013 P.
tion maximally possible concentrations of the substances it was counted integral degrees of unfavourable load with xenobiotics on atmospheric air (Q), soil and water (S) in the region.
Results and discussion
As it is known the levels of organic and inorganic xenobiotics in the atmospheric air of cities (especially with highly developed industry) are more higher than in country-sides. According to our one-factor dispersion analysis, trustworthy influence of urban and rural place of living of people on prevalence of SV is absent in these regions.
Dispersion and correlation connections between prevalence of SV and parameters of Q, R,S are absent. If prevalence of SV does not depend on the level of emissions of xenobiotics in the atmosphere, according to ANOVA discussed medical statistic index is closely connected with the accumulation of industrial emissions in
The constant influence of toxic microelements (ME) of the environment is considered to be one of the important ecologically conditioned pathogenic factors of many diseases. It must be noted that according to the findings of the literature the degree of the water source pollution with ME is following: Ni>co>Pb>Cr>V>Zn [9]. The high parameters of heavy metal salts in the environment of people living increase the frequency of the development of SV in these regions [15]. We have established the negative influence of the contents of Pb (D=2.13, p=0.025) in the subsoil water on the prevalence of SV, this is presented in figure 1. This toxic ME belongs to the ecological factors of the environment ( an ecological poison) which influences the development of vascular pathology [20]. There is a connection of the development of skin allergic vasculitis with the affect of Pb on the organism.
As it is seen in figure 1 the prevalence of SV is influenced by Pb but in the soil (D=3.25, p=0.047), and also by the concentration of Hg (D=3.41, p=0.040). I(n addition there is a reverse correlation connection with the
cumulation of industrial emissions and in other ecological zones are different accordingly on 39% and 61%, but the results turned out to be doubtful.
Now it is clearly established unfavourable influence of energetics, building material production, metallurgy, chemical and other branches of industry on the vessels ( in context with ecological pollution of the environment). According to our findings only the development of coal industry in the region has negative influence on prevalence of SV (D=2.84, p=0.042).
According to one-factor dispersion analysis the level of phenol in the atmosphere has the negative influence on prevalence of SV (D=2.73, p=0.047), and according to the results of correlation analysis the direct connection exists with the contents of dioxide of sulfur (r==0.403, p=0.004). It is noted the high concentration of dioxides in inspired air belongs to the risk-factors of the development of Sv [6, 8]. It was established that the prevalence of SV inversely depends on the level of phosphate in water
contents of Zn (r=0.27, p=0.033). Previously it has been shown, that the high level of Hg in the environment contributes to the development of Churg-strouss vasculitis in people [13]. Such metal is considered to be immunotoxic, it is confirmed on the muscles C57B1/6xDBA/2 of those who is genetically susceptible to the action of Hg. In these animals and also in Norweegian brown rats there is the connection of such microelements with high levels of antitoxic antibodies and the development of vasculitis [17,19]. The increased level of exogenous affect of Hg on the human organism takes place in the pathogenical construction of Wegener's granulomatosis [1]. Mercuric intoxication is manifested by the development of Kawasaki SV [3] and Behcet's SV.
Dispersion analysis showed reliable influence on the frequency of the development of separate SV indexes Q (D=3,63, p=0.002), the degrees of the development of the chemical industry (d=17.42, p<0.001) and building material production (D=3.41, p=0.003), the levels of ammonia (D=2.19, p=0.044) in the air, Dioxide of sulfur
the air (D=3.89, p=0.041). The prevalence of SV in the regions with exceeding (>M+SD) of emissions and ac-
(D=3.01, p=0.034, r=-0.311, p=0.041)
0,2 0,4 0,6
0,8
Ba
Zn.
Sn -
Pb-'
..Co
- Cr
*-Cu
Mn
Figure I.Trustworthness of the connections (p) of the prevalence of SLE with the level of ME in subsoil water (light lines- the influence, dark ones -correlation influence, dark ones -correlation)
Figure 2. Trustworthness of the connections (p) of the prevalence of SLEwith the level of ME in the soil (light lines- influence, dark ones-correction)
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(D=3.85, p=0.001), the concentration of sulfate (D=2.32, p=0.033) in drinking water, Parameters of Be (D=2.36, p=0.030), Mo (D=2.56, p=0.019), Ni (D=3.78, p=0.001) and Pb (D=5.47, p<0/001) in the soil, and also the contents of Pb (D=4.44, p<0.001) in the subsoil water. The peculiarities of Takyasu's unspecific aortoarteritis are the dependence of its prevalence in the region on the indexes R (D=4.37, p=0.026) and the degree of the development of coal industry (D=3.57, p=0.048), Wegener's granulomatosis - on the development of metallurgy in- 10. dustry (D=9.88, p<0.001). The absence of the concentrations of the prevalence of essential cryoglobulinemic vas-culitis with the character of drinking and subsoil water is paid attention.
Conclusion
Thus, there is a connection of the prevalence of SV with development of coal industry in the region of people living and with such factors of the environment as the degree of accumulation of industrial emissions in the at- 13. mosphere, the contents of phenol and dioxide of sulfur, concentration of phosphate in drinking water, parameters of Hg, Pb and Zn in the soil and only Pb in subsoil water, the peculiarities of the dependence of epidemiologic in- 14. dex on ecological one in Takyasu's unspecific aortoarteri-tis, Wegener's granulomatosis and essential cryoglobu-linemic vasculitis.
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