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Title: Chornobyl and reproductive health of a female rural population (an epidemiological study).
Author: Kundiev YI, Chernyuk VI, Karakashyan AN, Martynovskaya TY.
Journal: Probl Radiac Med Radiobiol; 2013; (18):102-18. PubMed ID: 25191715.
Abstract:
OBJECTIVE: To study the combined effect of radioactive and chemical factors on the reproductive health of a female rural population residing and working on territories contaminated after the Chornobyl accident. MATERIALS AND METHODS: The sociological questioning and gynecological examination of 1850 women have been made including the evaluation of 29520 medical reports of deliveries, 19502 medical reports of newborns, 1694 medical reports of women with spontaneous abortions as well as the state of menstrual function in 480 girls-adolescents residing on the contaminated territories. The radioactive contamination of the studied territories as well as the total effective dose of radiation for the population was evaluated by the results of the general dosimetric dose established for settlements of Ukraine. Factors of the work environment (noise, microclimate, dust, bacterial air pollution, work intensity and strain) were studied by the common hygienic methods and assessed by the criteria of the "Hygienic Classification of Work..." # 4137-86. The residues of pesticides, their isomers and products of transformation in biological fluids (blood, breast milk, cord blood) were assayed by gas-liquid chromatography method and electron capture detector with the device "Kristallux 4000" and the model M-3700. Correlative, regression, and discriminative analyses were used for mathematical processing of the data. RESULTS: It is proved that the reproductive health of rural women has become significantly worse after the Chornobyl accident, the most expressed disorders are seen in young women aged under 30. Worsening of reproductive health is found being the result of a combined effect of factors of radioactive and nonradioactive nature, specific for territories of residence, occupational activity and style of life. In particular, the effect of pesticides at the background of the radioactive contamination is likely to be an additional risk factor of disorders of the reproductive health of women. According to the biomonitoring data the content of organochlorine pesticides in biological fluids of women with reproductive health disorders was significantly higher (p<0.05) vs. with healthy ones. It is established that women of the childbearing age residing on territories with the density of contamination of more than 5 Ci/km and with rates of pesticide load over 5 kg/ha should be referred to a high risk group of the reproductive health disorders. CONCLUSION: The perspectives of epidemiological studies on the reproductive health are related on the use of the combination of many-aspect healthcare and biological approaches. It is equally important to assess adequately the factors of environment and work-related conditions, and their combined effect with dwelling load. Cel'. Izuchit' sochetannoe dejstvie radiacionnogo i himicheskogo faktorov na reproduktivnoe zdorov'e sel'skih zhenshhin, prozhivajushhih i rabotajushhih na zagrjaznennyh posle avarii na ChAJeS territorijah. Material i metody. Proveden sociologicheskij opros i ginekologicheskij osmotr 1874 zhenshhin, izucheny 29 520 istorij rodov, 19 502 istorij novorozhdennyh, 1694 istorij boleznej zhenshhin so spontannymi abortami, a takzhe sostojanie menstrual'noj funkcii u 480 devochek-podrostkov, prozhivajushhih na radioaktivno zagrjaznennyh territorijah. Radioaktivnoe zagrjaznenie obsledovannyh territorij, a takzhe summarnuju jeffektivnuju dozu obluchenija ocenivali po rezul'tatam obshhedozimetricheskoj pasportizacii naselennyh punktov Ukrainy. Faktory proizvodstvennoj sredy (shum, mikroklimat, pyl', bakterial'naja obsemenennost' vozduha, tjazhest' i naprjazhennost' truda) izuchali obshheprinjatymi gigienicheskimi metodami i ocenivali po kriterijam „Gigienicheskoj klassifikacii truda…” #4137-86. Ostatochnoe kolichestvo hlororganicheskih pesticidov, ih izomerov i produktov transformacii v biosredah (krov', grudnoe moloko, pupovinnaja krov') opredeljali metodom gazozhidkostnoj hromatografii s detektorom po zahvatu jelektronov na priborah „Kristalljuks 4000” i modeli M-3700. Pri matematicheskoj obrabotke dannyh ispol'zovalis' korreljacionnyj, regressionnyj, diskriminantnyj analizy. Rezul'taty. Dokazano, chto posle avarii na ChAJeS reproduktivnoe zdorov'e sel'skih zhenshhin znachitel'no uhudshilos', naibolee vyrazhennye narushenija nabljudajutsja u molodyh zhenshhin v vozraste do 30 let. Pokazano, chto uhudshenie zdorov'ja javljaetsja rezul'tatom kompleksnogo vozdejstvija faktorov radiacionnoj i neradiacionnoj prirody, harakternyh dlja territorij prozhivanija, professional'noj dejatel'nosti, uslovij byta. V chastnosti, vozdejstvie pesticidov na fone radioaktivnogo zagrjaznenija javljaetsja dopolnitel'nym faktorom riska narushenij reproduktivnogo zdorov'ja zhenshhin. Po dannym biomonitoringa u zhenshhin s narushenijami reproduktivnogo zdorov'ja soderzhanie hlororganicheskih pesticidov v biosredah okazalos' dostoverno vyshe (r<0,05) po sravneniju so zdorovymi. Ustanovleno, chto zhenshhiny detorodnogo vozrasta, prozhivajushhie na territorijah s plotnost'ju zagrjaznenija radionuklidami bolee 5 Ku/km2 i s urovnjami pesticidnyh nagruzok bolee 5 kg/ga pashni, dolzhny byt' otneseny k gruppe povyshennogo riska narushenij reproduktivnogo zdorov'ja. Vyvody. Perspektivy jepidemiologicheskogo issledovanija reproduktivnogo zdorov'ja svjazany s primeneniem kompleksnyh mnogoaspektnyh mediko-biologicheskih podhodov. Ne menee vazhna adekvatnaja ocenka faktorov okruzhajushhej i proizvodstvennoj sredy, ih kombinirovannogo vozdejstvija v sochetanii s bytovoj nagruzkoj.

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