Environment&Health (Dovkillia ta zdorovia)

4-10

Authors: CЕРДЮК А.М., КАРТАШОВА С.С.

Objective: We improved the application of the methodology for the evaluation of the health of the population of Ukraine in terms of PLYPL in medico-demographic and financial-and-economic aspects, ranking of the regions of Ukraine by the standardized parameter of premature death risk. Materials and methods: The data on gender and age structure of the population and the forms of state statistical reporting were used as a source of primary information. Results and conclusions: In the population of Ukraine, the average annual number of the lost years of potential life of all causes of death (A00-Y99) amounted to 3098840 person-years during 2015-2016, in particular, by three leading classes of the causes of death, these losses made up 909848 person-years of the disease of circulatory system, 523139 person- years of tumors, 670169 person-years of external causes. The results of the ranking of the regions of the state by the standardized attitude of PLYPL indicated that the worst situation with the losses from premature mortality (all causes of death) was in Dnipropetrovsk and Zhytomyr regions, the best - in Vinnytsia, Ternopil, and Ivano-Frankivsk regions where the maximum relative risk in comparison with the other state territories did not exceed 0.8 at 5 % significance level. The lost profit of the state for 2015 - 2016 as a result of premature mortality of the population (all causes of death) in monetary terms made up 433838 million UAH, while the total contribution of three main classes of causes of death (I00-I99, C00-D48, V01-Y99) didn’t exceed 68 %, although in the classical structure of mortality, it is approximately equal 87 %. The latter indicates that a proper attention isn’t paid to premature mortality due to such reasons as infectious and parasitic diseases (A00-B99), respiratory diseases (J00-J99) and diseases of digestive organs (K00-K93), certain states, arising in the perinatal period (P00-P96), congenital malformations, deformities and chromosomal abnormalities (Q00-Q99).

17-22

Authors: СТЕПАНОВА Є.І., БАЗИКА Д.А., ПОЛЬКА Н.С., ПОЗНИШ В.А., КОЛПАКОВ І.Є., ВДОВЕНКО В.Ю.

Objective: We assessed the psychoemotional state and determined the typological personality traits of the children – the forced migrants from the zone of armed conflict in the south-east of Ukraine. Methods and scope of research: Psychological testing of 179 children - forced migrants from the zone of armed conflict in the south-east of Ukraine, was carried out. The age of the children ranged from 10 to 17 years, 92 boys and 87 girls were among them. As a basic tool for the assessment of the psychoemotional sphere of the child, we used the provocative method of “non-existent animal” test. The test was evaluated according to generally accepted criteria in psychology. Results: The assessment of the psychoemotional sphere of children - forced migrants from the combat zone, with the help of the test "non-existent animal" revealed the presence of anxiety, aggressiveness, and exhaustion in the overwhelming majority of them. Based on the prevalence of a high level of symptoms of the symptom complex or their combination, 5 observation groups were formed and typological personality traits of children were determined. The group of the children with a predominance of the high level of anxiety signs (43.01%) was the most numerous. By number, the group of the children with a combination of high rates of two symptom complexes — anxiety and aggressiveness (23.46%) was at the second place. The third group consisted of children with a predominance of the signs of aggressiveness (16.2%). Group four (12.29%) included the children with the combination of the signs of exhaustion and anxiety. Group five (5.02%) was characterized by the low rates for all three symptom complexes. An assessment of the gender characteristics of the psychoemotional state of the children showed that the girls were more prone to the manifestations of anxiety, while the boys were characterized by the manifestations of aggressiveness, which can be accompanied with a high level of anxiety. Exhaustion symptom complex was found with the same frequency both in boys and girls.

28-30

Authors: КОРОЛЬОВА Н.Д., ЧОРНА В.В., ГУМЕНЮК Н.І., АНГЕЛЬСЬКА В.Ю., ХЛЄСТОВА С.С.

Objective: We revealed the prevalence of smoking among students of higher medical institution during educational process. Materials and methods: We performed a survey with the help of our own questionnaire "Prevalence of smoking among students", studied the causes of smoking; age of the beginning of smoking; duration; and frequency of smoking; whether the malicious habit caused somatic diseases and what exactly. 487 students of the I-V years of study were the respondents. Results: At the moment of survey, 38.8% of the students were smoking, 51.7% of them were not smoking. The average age when the respondents tried to smoke first was 16-18 years. 60.4% of our respondents had started smoking until they reached the age of 18. The main causes of the prevalence of smoking among students are: stress relief - 17.9%; difficult learning -9.4%; for pleasure - 8.2%; to keep company - 3.3%; of idleness – 2.5%; it's fashionable - 0.8%. Duration of smoking was: 6 months - 7.2%; 1 year – 6.4%; 2 years – 6.6%; 3 years – 3.5%; 4 years – 2.3%; 5 years – 3.0 % The question "Did your smoking cause somatic diseases?", the most of the students answered "no" (32.6%), which could be attributed to a short term of smoking, but 2.1% of the respondents noted that smoking caused cardiovascular diseases in them, 1.2% - a chronic bronchitis, and 0.6% - a chronic obstructive pulmonary disease. Regarding the digestive system, 1.2% of the respondents indicated that they had gastroesophageal reflux disease, and 0.6% complained of gastric and duodenum ulcer. Conclusions: The average age of smoking beginning among medical students is 18 years, the prevalence of smoking is 38.8%. The main causes of smoking prevalence are stress and difficult learning.

38-41

Authors: БОНДАРЕНКО Ю.Г., ДЖУЛАЙ О.С., РЯБОВОЛ В.М., НІКІТЮК С.С.

Objective: to carry out an epidemiological assessment of the effect of nitrates of drinking water from decentralized sources of water supply on the health of young children and pregnant women of Cherkasy region. Materials and methods. Determination of the concentration of nitrates in drinking water of decentralized and centralized sources of water supply was carried out in accordance with the State Standard of Ukraine ISO 7890-1: 2003. Water quality. Determination of nitrates. Part 1. Spectrometric method using distilled 4-fluorophenol (ISO7890-1 1986. IDT) and GOST 18826-73 Drinking water. Methods for the determination of nitrates. In addition, statistical, hygienic, epidemiological, bibliographic, analytical research methods were used. Results. In 2018, the State Institution "Cherkassy Regional Laboratory Center of the Ministry of Health of Ukraine" investigated 8173 food samples (vegetables and fruits), water from centralized and decentralized sources of water supply, of which 2579 are foodstuffs, 2390 are decentralized water and 3204 – centralized water sources. In food products in 0,5% of samples, the content of nitrates was higher than the maximum permissible, and in water of centralized sources - in 4%, decentralized sources - in 30%. Conclusions. It has been established that the main source of nitrates in the human body is drinking water from decentralized sources of water supply. The occurrence of nitrate poisoning in young children should be regarded as a threat to their health and life.

47-52

Authors: ОРЄХОВА О.В., ПАВЛЕНКО О.І.

Objective: We harmonized the method for the analysis and evaluation of the morbidity associated with the conditions of work, with international standards. Materials and methods: We used hygienic, epidemiological, mathematical and statistical methods in the study. The main group was represented by 19 033 workers of 8 leading mining and smelting enterprises. Control group included 6270 persons who were not exposed to harmful production factors during the course of their work. The study of the incidence of temporary disability was conducted on the basis of the analytical treatment of the disability letters and the report on the causes of temporary disability (form TN-23) for 5 years (2010-2014). Results: We proposed an approach to the estimation of the risk of morbidity with a temporary disability, which, unlike the current one, allows not only to assess the level of the morbidity but also to identify the causes of its change and give a quantitative assessment of the factors affecting it: industrial harmful factors, medical care, quality of professional selection, etc. The quantitative correlation between these factors is a solid ground for the development of preventive measures which allow reducing the level of professional pathology by 7-15 % and preserve from 7 to 40 years of labour losses for the state and enterprises. According to the results of our research, the risk of the development of general diseases is higher in the main group in the workers of the underground mining of iron ore (RR=0.127), open mining of iron ore (RR=0.173), and metallurgical production (RR=0.161) than in the control group, and the ratio of the chances to have an occupational disease (OR) is 0.0516, 0.041, and 0.0061, respectively. The workers of main professions have a high relative risk (RR) of development the incidence of TBV which varies from 9.5 to 52.1. The etiological part of the professional factors in the development of diseases with TBP is 94.7-98.1 %, which indicates a high degree of connection of the morbidity with the conditions of work and a very high professional risk factor for the development of the risk of morbidity with a temporary disability at the workplace. Conclusions: Obtained parameters of morbidity, calculated on the basis of the analysis of the incidence of temporary disability, are necessary for the assessment of the risk of the development of professional and professionally determined pathology, while integral parameters, taking into account the incidence of diseases and the severity of the consequences, are crucial.

61-68

Authors: КОРЗУН В.Н., ВОРОНЦОВА Т.О.

Analysis of the scientific publications confirmed a significant influence of medico-social, hygienic, and environmental factors on the epidemiology of iodine deficiency diseases and as well as an absence of the direct dependence of thyroid pathology on the degree of iodine deficiency. Ecological factors (pollution of air, water, and soil with heavy metals, pesticides, fertilizers, radioactive isotopes) significantly affect the occurence and prevalence of thyroid gland diseases. The long-term effect of the factors, exhibiting the goitrogenic effect, increases the iodine deficiency, significantly affects the iodine-thyroid state and functioning of thyroid gland, and leads to an increase in the incidence of thyroid pathology, especially in goiter endemic areas. However, the growth of morbidity in the iodine deficiency non-endemic regions of Ukraine shows that iodine deficiency is not a prior factor in the genesis of diffuse nontoxic goiter, and the cause of the disorders is in a numerical imbalance of microelements. Both natural and anthropogenic environmental factors were established to affect the occurence and course of thyroid disease, but none of these factors is isolated, they operate in a complex, accumulating on the social and hereditary factors. The occurrence and prevalence of goiter is a result of the complex interaction of endogenous and numerous exogenous factors, including those related to human activity. Goiter is a multifactorial disease and can be an indicator of the environmental disadvantage of the settlements. To understand the problem of iodine deficiency and to develop more effective approaches to the treatment of the patients with iodine deficiency, the doctors and the scientists should conduct a systematic analysis of the relationships between iodine metabolism, thyroid function and some microelements on the basis of the data of physiology, biochemistry, molecular biology, pharmacology, food hygiene, and evidence-based medicine.