[ARTERIAL HYPERTENSION AMONG WORKERS OF A URANIUM PROCESSING ENTERPRISE OF THE REPUBLIC OF KAZAKHSTAN: PREVALENCE, RELATIVE RISKS AND PREDICTORS OF THE DEVELOPMENT].

The aim of this study was to establish the prevalence, relative risks, and predictive factors of the development of arterial hypertension (AH) in workers of a uranium processing enterprise (UPE). An open cross-sectional comparative study of 809 UPE workers was conducted. The compared them to the 696 workers of the bearing plant, located at a distance of 10 km from UPE. Stratification was performed and odds ratios (OR), gross (RR) and standardized relative (SRR) risks of hypertension were calculated. Our results revealed a high prevalence of hypertension among UPE workers (24.8%), as well as greater risk of development of hypertension among workers of UPE in comparison to the personnel of the non-uranium enterprise: RR=2.4 and SRR=2.9. The most significant predictors of hypertension were burdened heredity (OR = 13.6), total radiation dose (OR=1.5), overweight (OR=1.1), high anxiety (OR=0.5) and systematic use of alcohol (OR=0.5). Thus, among workers chronically exposed to radiation toxicity, high prevalence of hypertension, excessive RR and SRR of developing hypertension and the presence of risk factors for hypertension were established.

[Ecological-hygienic evaluation of the environment of territories being adjacent to decultivated uranium mines].

On the territory of Kazakhstan there are uranium deposits, many ofwhich are in mothballed since times of perestroika. Often, the mines are flooded and represent a "time-delay bomb". Inside of mines various there are accumulated gases of both organic and inorganic nature, periodically thrown out and adversely affecting on the health of local populations. The aim of the study was the investigation of the state of the environment of Esilsky district of the Akmola region by common pollutants and chemicals. As the basic variable for the investigation of ambient air there was accepted the maximum one-time concentration of suspended substances, phenol, nitrogen dioxide, sulfur dioxide. The results were evaluated in relation to the MPC for the analyzed substance in the air according to maximal single MPC (MPCms) and daily average MPC (MPCda). The content of metals in the water was determined with the use of spectrophotometer PD-303S. Evaluation of the results was executed in relation of the MPC of substances in water, by means of the comparison with the requirements of Federal standards for drinking water, samples from drinking water sources. There were executed calculations of the overall index of water pollution (IWVgen), the index of water pollution by heavy metals (IWVhm). Chemical analysis of soil was carried out with the use of spectrophotometer PD- 303S (Japan), the photometer expert-003 "Ekoniks". Evaluation of the results was carried out with the respect to the MPC in the soil, the toxicity of all components. Summarizing soil pollution index was evaluated for metals contained in the soil at the level of more than or equal to 1 MAC. The settlement Krasnogorskiy and the village of Kalachi were found to be characterized by a low level of air pollution, increased rigidity of drinking water exceeded the maximum permissible concentrations of copper by 3.45 times and chloride by 1.17 times in the soil cover.

[Microelement profile of Aral region adult population].

Nowadays, environmental pollution has become a global, stable and constant hazard, in some regions consistent totality of pollutants determine toxic situation. In recent years, much attention in Kazakhstan is paid to Aral region. Despite multiple studies, problem connected with chemical influence on public health in Kazakhstan, Aral region, remains unsolved. Special place is taken by microelement state in the population. Microelements were studied in serum of the adult population residing in polluted area of Aral region. Findings are microelements dysbalances manifested by increased copper content and decreased zincum, selenium and iodine contents. Serum microelements disorders are objective criteria for various ecologically induced diseases.

Date of birth and hay fever risk in children and adolescents of Kazakhstan.

UNLABELLED: Introduction the first months of life are the most vulnerable period in allergic disease development and it is not clear enough whether inhalant pollen allergen exposure predisposes the risk of consequent allergic reactions. OBJECTIVE: To study the clinical and epidemiological criteria of hay fever with special emphasis on investigation of the relationship between the date of birth and seasonal allergic rhinitis development in children and adolescents in Kazakhstan. METHODS: The prospective hospital based study was conducted during pollen season from the beginning of May to the end of October in two consequent years 2010 and 2011. 184 children and adolescents at the age of 1--17 years underwent consultations and skin prick tests in the allergological center "Umit" (Astana, Kazakhstan). Special allergological questionnaires were developed and adapted for local residents. The assessment of symptoms severity was performed using a scoring system. Skin prick tests were performed in 112 patients. The number of patients was explained by the age limitations. Correlation analysis between skin prick test results and the month of birth were performed. RESULTS: It was found that in summer months there were the highest number of patients with seasonal allergic rhinitis 68 (36.9%), followed by spring 44 (23.9%), then autumn 37 (20.1%) and the lowest percent of patients 35 (19.1%) was born in winter. Rhinoconjunctival syndrome was diagnosed in 180 (97.8%) patients, pollen induced bronchial asthma in 76 (41.3%) and pollen induced urticaria in 35 (19.0%) patients. Mono sensitization among Kazakhstan children and adolescents was determined only to several species of the plants, mainly to Artemisia Absinthium (68.2%) and Sunflower (25.7%), whereas multiple sensitization to the mix of weeds was determined in 75 (66.9%) patients, to the mix of meadow grass in 33 (29.4%), mix of meadow grass+mix of weeds in 25 (22.3%) and mix of trees in 9 (7.1%) patients. The mean of symptoms severity of total scoring (24) was 15.5. The mean of IgE level in blood tests was 323.2IU/ml. CONCLUSIONS: Our results proved that first months of life are the crucial period and inhalant pollen allergen exposure, particularly to the weeds pollen, predisposes the risk of consequent allergic reactions development in children and adolescents in Kazakhstan. This fact may predetermine the risk of consequent allergic reactions development and the awareness of patients about it helps to prevent following severe clinical manifestations.

[The prevalence of anemia among children and women of reproductive age in Kazakhstan and basis of its prevention].

Results of the study on the prevalence of anemia among women of reproductive age and children, residing in the various regions of Kazakhstan, are presented in the article. Representational sampling which takes into account the divisional principle of medical service of children population in each of the 14th areas, Astana and Almaty cities has been implemented. Research involved participation of 1303 women at the age of 15-49 years, and of 1318 children, 353 (26.8%) of whom were in the age of 6 up to 23 months, and 985 (73.2%) were in the age range of 24-59 months. 89 women were pregnant, which constituted 6.8%. The average hemoglobin level in the blood of pregnant women was 11.1 +/- 1.6 g/dL, which was significantly lower compared to that of non-pregnant women, for whom the figure was 12.1 +/- 1.6 g/dL. The average level of hemoglobin in the blood of children in the age range of 6-23 months was 10.7 +/- 1.4 g/dL, and was significantly lower than that of children in the age range of 24-59 months, for whom the figure was, in average, 11.5 +/- 1.4 g/dL (p < 0.05). The rate of prevalence of iron deficiency anemia among pregnant women was 43.8%, among non-pregnant women--39.0%, among children aged 6-59 months--35.2%. It was found that the prevalence of anemia was significantly higher in children aged 6-23 months (53.3%) compared with children aged 24-59 months (28.8%). As for degree of severity of anemia, mild form prevailed in all of the examined groups: children--53.6%, pregnant women--51.2% and non-pregnant--77.2%. Moderate anemia was mostly diagnosed in children in the age range of 6 to 23 months and in pregnant women (50.5 and 43.6% relatively). Comprehensive program of prevention and control of iron-deficiency anemia among children and women includes food fortification, supplementation of target groups with iron preparation and folic acid, food diversification, monitoring and evaluation of program execution, as well as training of medical students and medical staff with policies and strategies of struggle against iron-deficiency anemia.

[The specific features of bacillary excretion and drug sensitivity in Mycobacterium tuberculosis in patients with recurrent pulmonary tuberculosis].

Data on 485 patients with recurrent pulmonary tuberculosis were studied. At the beginning of the study, all the patients underwent a triple sputum smear test and sputum was cultured in 338 cases. Among persons with a negative smear, sputum inoculation yielded Mycobacterium tuberculosis (MBT) in 50%. By taking into account these observations, bacillary excretion was detected in 72.2%. It was established most frequently by both methods (42%), slightly less frequently by the smear test (38%) and inoculation (20%). Drug resistance in MBT was revealed almost equally frequently in bacillary recurrences in patients with positive and negative sputum smear tests (68 and 62.3%, respectively). The bulk of the strains obtained were found to be polyresistant as well as quite often multiresistant. In the group of patients who had received chemotherapy by the WHO standards at primary detection of tuberculosis, polyresistance and multiresistance were encountered significantly more frequently in those who had been treated in previous years. The resistance of MBT to various drugs was also studied. Recommendations are given on the basis of the results of the study.

Plutonium and uranium in human bones from areas surrounding the Semipalatinsk nuclear test site.

To evaluate the present levels of 239,240Pu and U in residents living near the Semipalatinsk nuclear test site, more than 70 bone samples were obtained at autopsy. The subjects ranged in age from 30 to 86 years (mean 59.3+/-12.9). Most of the samples consisted of victims who died of various diseases. Plutonium and U were radiochemically separated and determined by alpha-ray spectrometry. The mean concentrations of 239,240Pu and 238U observed were 0.050+/-0.041 mBq/g-ash (vertebrae 71, long-bones 18) and 0.28+/-0.13 mBq/g-ash (22.8+/-10.6 microg U/kg-ash) (vertebrae 58, long bones 16), respectively. The present 239,240Pu levels were within the range found for human bone samples from other countries due solely to global fallout in the early 1980s. The average U concentration was close to the estimate (mean 22.5 microg U/kg-ash) for the UK, and about 10 times higher than those estimated for residents in New York City and Japan. By assuming that the average concentration of 239,240Pu in bone samples is the value at 45 years after instantaneous inhalation in 1955, the initial total intake and the effective dose for 45 years were estimated as 10 Bq and 0.2 mSv, respectively. The annual intake of total U (234,235,238U) and its effective dose for 60 years were estimated as 30 Bq for adult and 0.1 mSv, respectively, for chronic ingestion.

Anaemia in relation to low bioavailability of dietary iron among school-aged children in the Aral Sea region, Kazakhstan.

This study investigates anaemia related to the sufficiency of dietary iron intake of school-aged children in the Kzyl-Orda region of Kazakhstan. We conducted a cross-sectional study of 97 school-aged children living in Kzyl-Orda. Blood samples were collected for measuring haemoglobin. Dietary intake data were obtained from 24-h dietary recalls. Iron bioavailability was estimated with algorithms adjusting for absorption enhancers (meat, fish and poultry, and vitamin C) and inhibitors (tea and phytates) consumed in the same meal. The median total iron intakes were adequate compared with the median basal iron requirement; however, the median bioavailable iron intakes were well below the median absorbed iron requirement. Available iron was 6.9-7.2% of the total iron intake after adjusting for the absorption enhancers, and was reduced by 3.1-4.4% after adjusting for both enhancers and inhibitors. After adjustment for energy intake, higher iron intake was significantly associated with a decreased prevalence of anaemia (odds ratio, 0.39; 95% confidence interval, 0.16-0.93; P=0.034). Some evidence suggested an association between bioavailable iron intake after adjustment of absorption enhancers and inhibitors (odds ratio, 0.43; 95% confidence interval, 0.18-1.01; P=0.053). In conclusion, low bioavailability of dietary iron seems related to anaemia in the region. Although iron fortification or supplementation programmes can be useful for promoting the anaemia prevention control programme, further efforts for nutritional education suited for family level dietary practice are necessary.

Haemoglobin status of adult non-pregnant Kazakh women living in Kzyl-Orda region, Kazakhstan.

OBJECTIVE: To estimate the prevalence of anaemia among adult non-pregnant women in the Kzyl-Orda region of Kazakhstan, and to determine the association between haemoglobin concentration and anthropometric, socioeconomic, reproductive and dietary factors. DESIGN: A cross-sectional study using a randomly selected sample. Subjects were interviewed, and finger-prick blood samples and anthropometric measurements were collected. Associations between haemoglobin concentration and anthropometric and questionnaire data were evaluated by sequential linear regression analysis. SETTING: Health centres in Kazalinsk, Djalagash and Zhanakorgan districts of Kzyl-Orda region, Kazakhstan. SUBJECTS: Three-thousand six-hundred and twenty-five non-pregnant women aged 18-45 y randomly selected from health centre records. RESULTS: Iron deficiency anaemia, as reflected by low haemoglobin levels (Hb<12 g/dl), was detected in 40.2% of the total sample. There was a significant curvilinear relationship between haemoglobin concentration and age, with the nadir of the curve in the 30-40 y age-group. Haemoglobin concentration was found to be positively associated with body mass index (BMI) and socioeconomic factors. Significant negative associations were found between haemoglobin concentration and duration of menses, use of the intra-uterine contraceptive device and the consumption of tea. CONCLUSIONS: This study demonstrates that iron deficiency anaemia is present at considerable levels among adult women living in Kzyl-Orda region, Kazakhstan, and provides important baseline information for future research and public health interventions. SPONSORSHIP: Funding was provided by the United States Agency for International Development, Office of Nutrition, the United Kingdom Department for International Development, and the Polden-Puckham Trust.

Blood lead and erythrocyte protoporphyrin levels in Kazakhstan.

A pilot study was conducted to examine the extent of lead exposure and prevalence of iron deficiency in 3 major cities of Kazakhstan. Blood lead (B-Pb.) and erythrocyte protoporphyrin (ZnPP) levels of 475 children, age range 6 months to 7 yeas were measured. The mean B-Pb. levels in the different cities ranged from 4-7 micrograms/dl (minimum 1 to max 29 micrograms/dl) and similarly the mean ZnPP levels ranged from 26-32 micrograms/dl (minimum 12 and maximum 95 micrograms/dl), thus confirming low level lead poisoning of children at some sites. One to four year olds had greater than 10 micrograms/dl B-Pb in 18-27% cases compared with 3-7% cases in five to seven year olds. Prevalence of iron deficiency in 6 months to 4 year old children was the highest ranging from 28-86% compared with 4 to 15% in 4-7 year olds. However, there was remarkably low prevalence (4%) of iron deficiency in a group of 5-6 years olds. This study suggests that a targeted B-Pb and ZnPP monitoring together with an iron supplementation programme in the 3 cities of Kazakhstan is essential. Environmental education appears to have had a positive impact in lowering B-Pb at one site and should thus be expanded nationwide.

[Staphylococcal contamination of the upper respiratory tract mucosa in children exposed to air pollution]. / Stafilokokkovaia obsemenennost' slizistykh verkhnikh dykhatel'nykh putei u detei v razlichnykh usloviiakh zagriazneniia atmosfernogo vozdukha.

The carriership of staphylococci, specifically, of the resident type, is highly prevalent among children living near gas industry plants. The authors characterize the relationships of the level of resident staphylococcal carriership in children with the intensity of chemical pollution of the atmosphere and with the incidence of respiratory diseases. They estimate the gradations of coefficients of resident carriership of staphylococci corresponding to certain levels of air pollution, which served the basis for spatial microbiological monitoring of atmospheric contamination in regions with gas industry plants.