Ataniyazova O A, Baumann R A, Liem A K, Mukhopadhyay U A, Vogelaar E F, Boersma E R
Karakalpak Center for Reproductive Health and Environment, Perzent, Uzbekistan.
Acta Paediatr. 2001 Jul;90(7):801-8.
Since the 1960s a massive decline in the volume of the Aral Sea has occurred as a result of the diversion of the supplying rivers to cotton irrigation schemes. The contaminated sediment of the former seabed has been disseminated over the surrounding area by strong winds. This deterioration of the ecosystem has created a hazardous situation for the health of approximately 3.5 million people. This pilot study was undertaken to assist Karakalpak health workers in investigating the degree of exposure to metals, persistent organochlorine pesticides (OCPs) and dioxins during the most vulnerable prenatal and postnatal period and to provide guidelines for future research. All subjects came from areas located within 200 km of the southern border of the Aral Sea. Blood was obtained from 18 pregnant women and 28 newborns (cord blood) to determine the levels of metals, lead, cadmium, zinc and selenium and the OCPs alpha-, beta- and gamma-hexachlorocyclohexane (HCH; lindane is the product name of gamma-hexachlorocyclohexane), hexachlorobenzene (HCB), and isomers and metabolites of dichlorodiphenyltrichloroethane (DDT), i.e. op-DDT, pp-DDT, pp-DDE and pp-TDE. Levels of metals were also determined in blood from 28 non-pregnant women. In addition, levels of 17 dioxins were determined in 41 human milk samples and 1batch of formula. Information about possible dietary sources of the fat-soluble OCPs and dioxins was obtained from a pooled sample of butter and from seven cottonseed oil samples. A mass-selective detector coupled to a gas chromatograph equipped with a large volume injector was used to analyse the selected OCPs, whereas the dioxins were determined by gas chromatography with high-resolution mass spectrometry. The levels of metals in cord and maternal blood were consistent with concentrations observed in European countries. Only three women (7%) had lead levels greater than 100 ppb. The most notable pollutants in maternal and cord blood were the OCPs, notably HCB, beta-HCH, pp-DDE and the most toxic dioxin, 2,3,7,8-TCDD, when calculated as TEQs. A similar pattern was observed in human milk: beta-HCH and pp-DDE levels of more than 1,000 ng g(-1) fat were found in 68 and 43% of the subjects, respectively. Levels of 2,3,7,8-TCDD were six times higher than those observed in Western Europe. Traces of pp-DDE were detected in the batch of formula milk. Contaminated animal fat, but not cottonseed oil, is the most likely dietary source of OCPs and dioxins.
Further epidemiological research is needed to elucidate the health implications of these pollutants on perinatal and maternal health, including lactation. More importantly, an investigation should be initiated to identify the emission sources of persistent organic pollutants in Karakalpakstan and adjacent regions.
自20世纪60年代以来,由于供应河流被改道用于棉花灌溉计划,咸海的水量大幅下降。以前海底受污染的沉积物被强风散布到周边地区。生态系统的这种恶化给大约350万人的健康造成了危险状况。开展这项试点研究是为了帮助卡拉卡尔帕克斯坦的卫生工作者调查在最脆弱的产前和产后时期接触金属、持久性有机氯农药(OCPs)和二噁英的程度,并为未来研究提供指导方针。所有受试者均来自咸海南部边界200公里范围内的地区。采集了18名孕妇和28名新生儿(脐带血)的血液,以测定金属、铅、镉、锌和硒以及OCPs(α-、β-和γ-六氯环己烷(HCH;林丹是γ-六氯环己烷的商品名)、六氯苯(HCB)以及二氯二苯基三氯乙烷(DDT)的异构体和代谢物,即邻-滴滴涕、对-滴滴涕、对-滴滴伊和对-滴滴滴)的水平。还测定了28名非孕妇血液中的金属水平。此外,测定了41份母乳样本和1批配方奶中17种二噁英的水平。从一份黄油样本和7份棉籽油样本中获取了关于脂溶性OCPs和二噁英可能的饮食来源的信息。使用与配备大体积进样器的气相色谱仪相连的质量选择检测器分析选定的OCPs,而二噁英则通过气相色谱-高分辨率质谱法测定。脐带血和母体血液中的金属水平与欧洲国家观察到的浓度一致。只有三名女性(7%)的铅水平高于100 ppb。母体血液和脐带血中最显著的污染物是OCPs,尤其是HCB、β-HCH、对-滴滴伊以及毒性最大的二噁英2,3,7,8-四氯二苯并对二噁英(以毒性当量计)。在母乳中也观察到了类似模式:分别在68%和43%的受试者中发现β-HCH和对-滴滴伊的水平超过1000 ng g⁻¹脂肪。2,3,7,8-四氯二苯并对二噁英的水平比西欧观察到的水平高六倍。在那批配方奶中检测到了微量的对-滴滴伊。受污染的动物脂肪而非棉籽油是OCPs和二噁英最可能的饮食来源。
需要进一步开展流行病学研究,以阐明这些污染物对围产期和孕产妇健康(包括哺乳)的健康影响。更重要的是,应启动一项调查,以确定卡拉卡尔帕克斯坦及邻近地区持久性有机污染物的排放源。