[Development of a system for the early diagnosis and prevention of children's health changes caused by exposure to heavy metals].

At the moment, the making a diagnosis of an environment-induced disease in Russia is not routine and this is not relied on a rather evidence basis. Nevertheless, the choice of exposure methods from educational and preventive to therapeutic depends on the intensity and pattern of exposure to ecotoxicants and on the magnitude of appropriate specific changes. Epidemiological surveys of 5-7-year-old children from 3 towns of Russia have revealed that 8.3-24.5% of the children have moderate excesses of the allowable levels of lead in blood; 4.6-12.8% have excess hair magnesium levels, and 5.9-33.8% have excess hair copper levels. The real damage to the children's neuropsychic health manifests as a significant reduction in the memory and academic achievement indices, the parameters of fine and gross motor coordination, speech expressiveness, and in the rate of minor successive movements. The prevalence of environment-dependent neuropsychic malformations is 3-7%, as calculated with reference to all the children examined. The children aged 5-7 years are shown not to be in need of therapeutic measures in all the towns compared. At the same time, 61.1-83.2% of the children need neuropsychic health-promoting measures. For this, it is expedient to use informational and educational technologies. About 4.3-17.8 and 11.5 - 21.1% need primary and secondary preventive measures against environment-dependent neuropsychic changes. The authors present approaches to developing measures to promote neuropsychic health and to prevent neuropsychic malformations. There is evidence that primary prevention is more effective for the pediatric population. There is no question that multivariate analysis of the problems associated with childhood neuropsychic development, including environmental, behavioral, sociomedical components, is of importance. These approaches may be realized at the municipal level and taken as the basis for preparing national guidelines for the promotion of health and for the prevention of environment-dependent conditions in children.

[The regional characteristics of the prevalence of elevated arterial pressure in the schoolchildren of Moscow, Tallinn and Novosibirsk (a cooperative study)]. / Regional'nye osobennosti rasprostraneniia povyshennogo arterial'nogo davleniia u shkol'nikov Moskvy, Tallinna i Novosibirska (kooperativenoe issledovanie).

The authors describe the results of a cooperative epidemiological screening of schoolchildren aged 11 to 14 years, living in Moscow, Tallinn and Novosibirsk. 1219 persons underwent screening in Moscow, 923 in Novosibirsk, and 1227 in Tallinn; the screening coverage was 88.3, 92 and 87.2%, respectively. The mean values of systolic and diastolic arterial pressure (AP), the anthropometric parameters, and of the degree of puberty are given with respect to the cities. The structure as well as predictors of high AP in schoolchildren differed with respect to the above-indicated cities. The highest AP values were identified in Moscow schoolchildren whereas the least ones in schoolchildren living in Tallinn. The data obtained were compared to those of the epidemiological screening of the male population aged 20 to 54 years, living in the same cities. A reverse correlation has been established.

[Study of arterial pressure, body weight, motor activity and prevalence of smoking in two independent samples of Moscow schoolchildren 11 and 14 years of age]. / Izuchenie arterial'nogo davleniia, massy tela, dvigatel'noi aktivnosti i rasprostranennosti kureniia na dvukh nezavisimykh vyborkakh Moskovskikh shkol'nikov 11 i 14 let.

The paper treats the results of a comparative 6-year study of arterial blood pressure, body weight, motor activity, and tobacco-smoking prevalence with respect to two representative samples of schoolchildren aged 11 and 14 years living in one of the districts of Moscow. A total of 1999 and 1219 persons were examined. The scope of examination amounted to 88 to 93 percent. From 1978-1980 to 1985-1986 the levels of systolic and diastolic arterial blood pressure increased whereas the physical activity of the schoolchildren of the same age declined. The situation with tobacco-smoking changed towards better. Thus the number of tobacco-smoking boys aged 14 years reduced almost 2-fold in spite of the lack of any prophylactic interventions in that population.

[Epidemiologic characteristics of nutrition of school children at high risk for developing ischemic heart disease and atherosclerosis]. / Epidemiologicheskaia kharakteristika pitaniia shkol'nikov v gruppakh vysokogo riska razvitiia ishemicheskoi bolezni serdtsa i ateroskleroza.

The results of the investigation of a representative sample of Moscow schoolchildren, aged 11-14 years, are described. The investigation included a triple arterial pressure measuring, anthropometry, numerical score of sexual development, assay of cholesterol, triglycerides and high-density lipoprotein cholesterol levels in the blood serum. The character of nutrition of 250 (20% of the sample) schoolchildren was studied by the method of dietary inquiry (daily ration) with the use of food patterns. The data of the multivariative analysis have shown that sexual development, a low educational level of the parents (among them subjects engaged in the manual labor being predominant) influence the development of the risk factors of ischemic heart disease and atherosclerosis. Composition of food is of great importance, especially for boys with dislipoproteinemias (low consumption of starch per 1 kg bw, high consumption of total protein, low consumption of fat in cal %), and for those with excessive body mass and low physical activity (low consumption of total fat, polyunsaturated fat per 1 kg bw, as well as high consumption of total protein in cal %).

[Characteristics of blood pressure in schoolchildren 7-17 years old (based on one-stage and prospective studies)]. / Kharakteristika arterial'nogo davleniia u shkol'nikov 7-17 let (po dannym odnomomentnogo i prospektivnogo issledovanii).

One-stage epidemiological survey permitted one to define the limits of normal blood pressure values in schoolchildren aged 7-17 years for each age-sexual group differentially. Isolated blood pressure elevation was found to be rare, amounting to 4.4% in boys and to 3.1% in girls. The rate of new cases of elevated blood pressure per 100 subjects was equal to 8.2 cases for systolic and 10.3 cases for diastolic blood pressure.

[Physical endurance and various prodromal manifestations of atherosclerosis in 11- to 17-year-old schoolchildren]. / Tolerantnost' k fizicheskoi nagruzke i nekotorye predvestniki ateroskleroza u shkol'nikov 11-17 let.

A single epidemiologic screening of schoolchildren at 11-17 years of age revealed a higher heart performance index during exercise peaks in individuals with one or several atherosclerosis precursors, as compared to that of children showing no precursors of the disease. It is suggested that high heart performance index in schoolchildren with atherosclerosis precursors reflects cardiovascular overstrain rather than high exercise tolerance.