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Тужырым
Макалада Шыгыс-^азакстан облысы Риддер каласыныц ауыз суы мен ашык жер 6eTi суы жагдайына ретроспектива талдау жасалды жэне бага бершдг Ауыз судыц ластану индексi (СЛИ) 0,21 с.б. (су сапасы жагынан 2 класты) к¥ра-ды, ол ауыз судыц таза екенш кeрсетедi Жалпы судыц ластану индексi (СЛИ): ашык жер бетi суы бойынша 1,4 с.б., ол судыц орташа ластанганын кeрсетедi (су сапасы жагынан 3 класты).
TYwndi свздер: экология, судыц ластану индексу ашык су коймалары, ауыз су, микроэлементтер
Summary
The article presents retrospective analysis and assessment of the guality drinking water, water open reservoirs Ridder city. Index of pollution of drinking water was 0.21 a.u., which means clear water (water guality class 2). Index of water pollution of open reservoirs was 1.4 a.u., which means moderately polluted water (water guality class 3).
Key words: ecology, Index of water pollution, water of open reservoirs, drinking water, trace elements
UDC 613.1:616-092.12(574.54)
THE INFLUENCE OF UNFAVOURABLE ENVIRONMENTAL FACTORS ON
ARAL SEA REGION POPULATION HEALTH (for example, ARYS)
A.Z. Shadetova, G.K. Alshynbekova, T.F. Mashina, I.A. Kalieva, A.V. Doroshilova, A.S. Shokobaeva, K.E. Sattybaev
Republican State Governmental Enterprise "National center of Industrial hygiene and Occupational diseases" Republic of Kazakhstan Health Ministry, Karaganda
The work describes preclinical evaluation of the influence of unfavourable environmental factors on the functional health status of the population living in the city of Arys. The results indicate poor adaptation group with premorbid health status, which is the result of a surge of the functional system.
Key words: environmental factors, hemodynamic parameters, heart rate variability, preclinical evaluation
Relevance. Human health is a major strategic factor in addressing the adverse impact of environmental factors. The task of medicine is to identify, evaluate and develop the most effective interventions to eliminate those risk factors that can be ISSN 1727-9712 Гигиена труда и медицинская экология. №3 (52), 2016
addressed, as to minimize to a safe, acceptable level of the risk factors, which the company is able to manage [1,2].
One of the adverse climate-ecological and anthropogenic factors having a negative impact on the human body in Kazakhstan is the territory of the Aral sea region [3,4]. The impact of climatic ecological and anthropogenic factors on the human organism, with insufficient health provisions, may lead to violation stability of adaptive and regulatory mechanisms.
Intense and long-lasting impact of environmental factors on the human body causes the preclinical and premorbid states that differ from the norm and pathology. These States arise in the process of adaptation of the organism to environmental conditions, as a result of tension regulation mechanisms and exhaustion of the reserve capacity of the organism [5-7].
Maintaining sufficient adaptive capacity of the organism, i.e. health, is directly dependent on the functional reserves of the organism, its ability to mobilize these reserves to support and maintain homeostasis in a changing environment. The transition from health to disease is through the stress and disruption of adaptation mechanisms, and the sooner provide for such an outcome, the more chances to save health. The problem is to learn to identify (measure) the criteria of tension of regulatory systems of the organism and thus to manage health.
The purpose of the study. Preclinical evaluation of the functional health status of the population living in the city of Arys.
Materials and methods. In the course of performing scientific and technical program of MHSD RK on the theme: "Integrated approaches to the management of the health status of the population of Aral sea region" was carried out functional studies on the health of the population living in the area pre-crisis state of the Aral sea region, in particular the town of Arys.
The level of health of the surveyed population was divided into three groups: -persons with diseases of cardiovascular system (CVS), the second person of preclinical (pre-morbid) condition, the third face having CVS disease (CVD).
In a preclinical study it was surveyed 804 people in the city of Arys, of which 106 people joined the group with pre-morbid condition, 414 people had diseases of the cardiovascular system and 284 do not have the disease (healthy).
For the subsequent calculations of hemodynamic parameters, taking into account the time of ventricular systole, was recorded systolic (SBP) and diastolic (DBP) blood pressure. Measurement of blood pressure was performed according to the method Korotkova gauge of brand "Bio-Press".
For the physiological parameters systolic and diastolic pressure (SBP, DBP), heart rate (HR), age (A) we calculated the following indices: pulse pressure; average dynamic pressure; systolic blood volume; minute volume of blood; peripheral vascular resistance; the index of circulatory failure; vegetative kerdo index; index of tension; the adaptation indicator: AP=0.001*HR+0.014*SBP+0.008*DBP+0.014*A+0.009*P-0.27.
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The functionality of the circulatory system was assessed by calculating the index of functional changes (IFC) by the method of B.A. Berseneva, and Y.P. by Swainy (1987). The calculation was performed according to the following formula: IFI=0.011 HR+0.014 Adsit+0.008 Addict+0.014+MT 0.009-0.009 R-0.27
To determine the body mass index was used the body composition analyzer SC-330 "Tanita". Calculation of body mass index according to the formula: BMI=(m) body weight of person in kilograms / (h2) the man's height in meters. Electrophysiological equipment included: automated complex "Varikard" company "Ramen".
Processing of the obtained databases were conducted in the statistical program "Statistica V.10". Quantitative variables were tested for normality of distribution. Using the data of descriptive statistics (excess and asymmetry of less than 1), Kolmogorov— Smirnov, Lilliefors biomedical data), the histogram and check the line graph normal probability (QQ plot). For quantitative variables with normal distribution were calculated the arithmetic mean, variance, error and 95% confidence interval for quantitative data, not obeying the law of normal distribution - median and 25% and 75% quartiles.
For comparison of groups, analysis of the comparison of mean values of independent variables, with significance level p<0.05.
The results of the study. Comparative analysis of dynamics of changes in hemodynamic parameters among the residents of Arys have shown that in healthy persons the indicators of the GARDEN was 103,310 mm.rt.st., that was significantly lower by 20.42 mm.rt.st. (p>0.05) compared with patients with CVD and 26, 75 mm.rt.st. (p>0.05) from the group with a pre-morbid condition, respectively. Such changes in the systolic blood pressure directly dependent on heart rate (HR) in individuals with pre-morbid condition with high SBP, made up 93,972 heart rate beats per minute.
Medium-dynamic pressure (MDP) describing the level of centralization of regulatory mechanisms of the circulatory system, was in the normal range (82.612 mm.rt.st.) in the group of healthy and was above normal in the other groups. In comparative aspect of MDP in patients with MDP was lower by 4.68 mm.rt.st. (p>0.05) than in persons with a premorbid state which is characterized by the constant tension of the vessels, indicating a high risk of developing hypertension, which is confirmed by indicators MDP (130.06 mm.rt.st.) and DBP (82.2 mm.rt.st.) were in the upper limits of normal. In individuals with pre-morbid condition compared with patients with MDP had a high percentage of the weight, with an average growth 165.7 cm (p>0.05) the average body weight was 81.7 kg, 10.09 kg (p>0.05) higher weight of patients with MDP, which also contributes to the risk of developing hypertension (table 1).
Indicators in minute volume of blood (MVB) was observed exceeding of the normative values in all studied groups, but in patients with CVD compared to healthy 328.77 was lower on the ml and in the group of persons with pre-morbid condition was lower by 731.3 ml (p>0.05). The increase in MVB in individuals with pre-morbid state is due to the increase in heart rate, which is higher by 10.32 heartbeats per min and
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increasing of systolic volume of blood (SBV) compared with patients. One of the most important cardiovascular reflexes, providing an increase in MVB, is the Bainbridge reflex, which is "switched on" by increasing heart rate in response to increased blood volume. This reflex is implemented by the stimulation of mechanoreceptors, localised in the mouth of the hollow and pulmonary veins. Their irritation is transmitted to the Central sympathetic nuclei of the medulla oblongata, resulting in the increase in tonic activity sympathetic link of vegetative nervous system, and develops reflex tachycardia. The Bainbridge reflex is aimed at increasing cardiac output.
Table 1 - Hemodynamic parameters among residents of Arys with diseases of the cardiovascular system, with pre-morbid condition and healthy
Middle sick Middle premorbid Middle healthy t-meaning p
Growth, cm. 163.548 165.717 166.778 -2.391 0.017150
Weight, kg. 71.681 81.775 64.283 -2.895 0.003949
BMI, kg/m2 26.843 27.716 23.257 -1.492 0.136227
SBP, mm Hg 123.725 130.066 103.310 -2.389 0.017260
DBP, mm Hg 78.722 82.209 67.623 -2.270 0.023642
RR, cycle/min 19.314 19.736 18.810 -0.673 0501058
PP, mm Hg 45.003 47.857 35.687 -1.493 0.136075
ADP, mm Hg 97.623 102.309 82.612 -2.527 0.011804
SVB, ml 75.268 74.603 77.269 0.552 0.581113
MVB, ml 6290.200 7021.516 6618.970 -4.291 0.000021
PVR, din*c/sm5 1304.347 1275.319 1043.625 0.673 0.501184
VKI, % 3.388 7.976 18.788 -1.813 0.070398
AC, y.e. 2.185 2.487 1.735 -5.219 0.000000
HRR, beats per min. 83.652 93.972 85.475 -5.816 0.000000
IFC, y.e. 2.185 2.487 1.735 -5.219 0.000000
Increased values of the studied parameters are associated with high ambient temperature, and are a compensatory reaction of the body, because the studies were conducted in warm period of the year.
The settings up of the body of the inhabitants of Arys in the studied groups were above guideline values and were at the level of 1.73 (satisfactory adaptation (norm)) in healthy, 2.18 (the degree of stress in patients and to 2.48.e. (unsatisfactory degree) in the group with pre-morbid condition that talk about reducing the adaptive capacity of the organism and is a poor prognostic sign and one of the leading causes of occurrence and development of diseases.
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The degree of stress in patients with CVD due to the inclusion of a self-regulatory, protective and compensatory reactions, representing a physiological measure of the body's defense against disease, when there is maximum mobilization of the mechanisms of short-term and long-term adaptation carried out on the verge of the ability of the body.
The index of functional changes (IPR), showed that the inhabitants of Arys functionality of the circulatory system good (of 1.73 to 2.48.e).
The modern idea of the cardiovascular system as indicator of adaptation reactions of the whole organism can be obtained on the analysis of heart rate variability (HRV).
The results showed that the increase in slow-frequency waves of the order of 1 (LF-waves) in the groups studied exceeded the normative values at 3.78%, and 5.86% and 9% (p>0.05), respectively (table 2).
Table 2 - Indicators of heart rate variability in residents of Arys town, with diseases of the cardiovascular system, with pre-morbid condition and healthy
Middle sick Middle preclinical Middle healthy t-meaning p
TI, у.е. 132.226 151.064 131.961 -5.047 0.000001
ICF, у.е. 1.520 1.460 1240 1.399 0.162328
Мо, мс 737.737 676.547 722.380 4.133 0.000042
АМо, % 107.296 95.699 67.148 1.577 0.115439
CV,% 9.897 10.570 12.081 -0.288 0.773103
IC, % 4.162 4.589 3.538 -0.735 0.462474
HF, % 35.134 33.471 37.904 0.673 0.501187
LF, % 43.786 49.672 45.864 -2.873 0.004232
VLF, % 21.093 17.422 15.627 1.954 0.051215
LF/HF, у.е. 2.971 3.483 - -0.712 0.476762
SI, у.е. 1082.543 971.107 469.761 0.559 0.576141
RSAI, у.е. 5.732 6.406 5.683 -3.223 0.001350
Strengthening of LF slow waves is the response of the body to increase blood pressure, cardiac output and vascular resistance and indicates the activation of subcortical nervous centers, and, possibly, the predominance of activity cardiostimulators centre, providing the regulation of blood pressure, cardiac output and vascular resistance through sympathetic vagal inhibitory and excitatory fibers.
The activity of the sympathetic regulation mechanisms, as Central regulation is characterized by the index of tension of regulatory systems (TI). This increased in the healthy group was 131.96.e. patients - 132.22.e. that became normative values in the group with a pre-morbid condition, an increase of 1.06.e. (151.06.e.). The higher the
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tension index (TI), the higher the "price of adaptation" of the organism to environmental conditions, that is, the more effort an organism expends on maintenance of homeostasis in vital systems.
According to table 2 a high index of regulatory systems tension (stress index, SI) was observed in patients with CVD, which is equal to 1082.543.e. in the group with premorbid condition - 971.107.e. and the lowest values were observed in healthy group 469.761.e. The gain of this indicator in the group of patients with CVD characterizes activity of sympathetic regulation mechanisms and the prevalence of Central regulation over the Autonomous.
In the group with pre-morbid condition compared with the other groups experienced a decline in the fashion that made 676.547 MS.
As the pronounced stress regulatory systems in the group of patients with CVD shows that regulatory systems activity index (RSAI) the average value of 5.73.e. which is associated with the active mobilization of protective mechanisms, including increased activity of the sympathetic-adrenal system and the pituitary - adrenal axis.
For individuals Arys with pre-morbid condition is characterized by a state of overstrain of regulatory systems (PARS=6.4.(e.), which is manifested by failure of protective-adaptive mechanisms, their inability to provide adequate reaction of the organism to the influence of environmental factors. Here excessive activation of the regulatory systems already not underpinned by an appropriate functional reserves.
Thus, the results of the study revealed that the population living in areas of environmental pre-crisis zones, especially in patients premorbid condition, there is a linear increase of the indicators of the SBP, heart rate, ADP, MVB, RR, AC and decrease HRV, all this is due to the presence of these diseases, which affect the functionality of the body. The increase in HRV show that the activation of adrenergic mechanisms of regulation, increased tone of the sympathetic nervous system.
References
1. Basiev V.A., Okazin Z.L. Assessment of the adverse impact of environmental factors on population health // Bioraznoobrazie I racionalnoe ispolzovanie prirodnyh resursov [Biodiversity and rational use of natural resources]. - 2013. - №4. - P.154-155.
2. Tabakaev M.V., Artamonova G.V. The impact of air pollution by suspended solids in rasprostranennosti cardiovascular diseases among the urban population // Vestnik RAMN. - 2014. - №3-4. - P.55-60.
3. Orakbay L.Z., Omarova M.N., Bekshin Z.M., Kalimoldyn MM. Topical problems of the influence of environmental factors on the health of the population and some features of risk assessment methodology // Zdorovie sem'I - 21 vek: materialy 18 mezhdunarodnoy nauchno-prakticheskoy konferencii [Family health - the XXI century: materials of the 18th international scientific-practical conference]. - Netaniya, 2014. -P.127-132.
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4. Kelyna N.Y., Bezruchko N.V. Human ecology. - Rostov na Donu: Phenix, 2009. -394 p.
5. Dusembaeva N.K., Shpakov А.Е., Salimbaeva B.M. and other. The influence of adverse environmental factors on the health status of the population // Gigiena truda i medicinskaya ekologiya [Occupational hygiene and medical ecology]. - 2014. - №2 (43). - P.14-26.
6. Suleymenov E.Z., Hasenova S.K. The modern state of environmental protect-tion in the Republic of Kazakhstan (national profile) // Innovation processes in ICSTI community: Ecological problems and ways of their solution. - M: ICSTI, 2009. - P.55-70.
7. Kelyna N.Y. and other. The urgency of development and testing program to assess the risk factors to human health and the environment in the town of Zarechny in Penza region // Okruzhayushaya sreda I zdorovie: materialy 6 mezhdunarodnaya nauchno-prakticheskaya konferenciya [Environment and health: materials of VI international scientific-practical conference]. - Penza: RIO PGSHA, 2009. - P.5-8.
Тужырым
Бул жумыста колайсыз экологиялы; факторлардьщ Арыс каласында тура-тын халы; денсаулыгыныц функционалды жагдайына эсерi багаланган. Алынган мэлiметтер денсаулыгы преморбидт жагдайдагы топтардыц канагаттанарлыксыз бешмделу^ олардыц функционалды жYЙеtiнщ катты ширыгуыныц нэтижесiнен болып табылады.
TYwndi свздер: экологиялы; фактор, гемодинамикалы; керсетюштер, жYрек ыр-гагыныц тYрленгiштiгi, донозология
Резюме
В работе дана донозологическая оценка влияния неблагоприятных экологических факторов на функциональное состояние здоровья населения проживающего в г. Арысь. Полученные результаты свидетельствуют о неудовлетворительной адаптации групп с преморбидным состоянием здоровья, которое является результатом перенапряжения функциональной системы.
Ключевые слова: экологический фактор, гемодинамические параметры, вариабельность сердечного ритма, донозология
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Гигиена труда и медицинская экология. №3 (52), 2016
