School screening in the heavily industrialized area--Is there any role of industrial environmental factors in idiopathic scoliosis prevalence?

ABSTRACT

INTRODUCTION: School-screening programs contributed greatly to the study of idiopathic scoliosis (IS) prevalence. A similar program confined to a highly industrialized area is being performed in our Department. Thus the comparison of the findings of IS prevalence of this program with those of programs performed in non-industrialized areas of the same country could imply the significance of special industrial environmental factors on IS aetiology. MATERIALS AND METHODS: 3039 schoolchildren (1506 boys, 1533 girls), aged 5,5 to 17,5 years, have been screened for IS. These children comprise 20% of a total population of 20000 schoolchildren, who live in the region. The detection of the scoliotic children was attained utilizing the criterion of the angle of trunk inclination (ATI). The Prujis scoliometer was used to assess ATI. A cut off point of > or = 7 degrees ATI was used as a criterion for children's referral to hospital. 262 (8,6%) were referred for further evaluation, whereas 118 (3,9%) among these children underwent radiological examination. RESULTS: 90 children were found to have a Cobb angle of > or = 10 degrees at their standing PA spinal radiographs (2,9 % of the screened population). A Cobb angle of 10 degrees -20 degrees was found in 74 (2,4%) children. Sixteen (0,5%) children, who had scoliotic curves with a Cobb angle of > or = 20 degrees, underwent conservative treatment by means of spinal orthosis. Relatively to their location on the vertebral column, 20% of the scoliotic curves were thoracic, 26,7% thoracolumbar, 20% lumbar, 24,4% double and 8,9% miscellaneous. DISCUSSION: The screened area represents a place of particular interest because it experienced considerable environmental pollution during the past decades without any improvement of the available Health Services. A quite diverse population in relation to its occupation and its origin inhabits this area as well. The scoliosis incidence found in this area is similar to the incidence observed (2,9%) at other non-industrialized geographical departments of this country (2,6%). This implies that industrial environmental factors probably do not significantly influence the prevalence of AIS.