Assessment of the Health Status of Children Exposed to Industrial Toxicants in the Towns with Developed Non-Ferrous Metallurgy of the Sverdlovsk Region

Introduction: In the Sverdlovsk Region, the risks posed by cadmium, arsenic and lead exposures account for higher disease rates in the most sensitive groups of population. Recent studies have shown that these toxicants have an effect on mineral metabolism, damage to liver cells, kidneys, immunity indicators, and the nervous system.
Objective: To assess the levels of cadmium, lead and arsenic in biological fluids of preschool children aged 3–6 years, living in towns with developed non-ferrous metallurgy, and possible changes in the health status at the detected level of toxicity.
Materials and methods: The study was conducted in six towns of the Sverdlovsk Region with developed non-ferrous metallurgy. Environmental pollution in the study areas was assessed based on data of socio-hygienic monitoring. Biological monitoring was carried out to establish the levels of toxicants in blood and urine of children. A descriptive analysis of chronic morbidity in preschool children was performed, and the results of a special health examination of children (including that by a pediatrician and a neurologist) were presented. Mathematical modeling using decision trees was carried out.
Results: Health monitoring data indicate an excess of the average regional prevalence rates in the studied preschoolers in nine disease categories. According to the results of an in-depth examination of the preschool children, diseases of the skin and subcutaneous tissue, diseases of the respiratory system, blood diseases and individual disorders involving the immune mechanism, and digestive diseases prevailed. Among concomitant diseases, the most prevalent were diseases of the digestive, nervous, and respiratory systems. Assessment of the neurological status showed that the largest percentage of children had residual cerebral insufficiency, attention deficit hyperactivity disorder, and cerebrastenic syndrome. Biomonitoring results indicated a higher level of lead, arsenic and cadmium in the biological fluids of those children. Mathematical modeling demonstrated statistically significant correlations between lead, cadmium, and arsenic concentrations in environmental objects, biomonitoring results, and clinical and laboratory examination data of children (the blood levels of alanine aminotransferase, zinc, total protein, phagocytic index, and the carrier of the marker of apoptosis CD95+).
Conclusions: The results of biological monitoring were consistent with data on chronic morbidity in preschool children. Modeling data provided the body burden of toxicants, above which deviations of clinical and laboratory parameters from the reference values may occur. The findings can be used in implementation of targeted measures for disease prevention.

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