Diseases of the upper respiratory tract and their pathogenetic mechanisms in children living under conditions of chronic exposure to aldehydes and aromatic hydrocarbons

Abstract

Introduction. The problem of diseases of the respiratory system in children in regions with technogenic atmospheric pollution by chemical agents is relevant. 
 The aim of the study was to study the features of the formation of the pathology of the upper respiratory tract, their pathogenetic mechanisms, and causal relationships of clinical, instrumental, and immunological disorders with toxic load in children living under conditions of chronic exposure to phenols and aromatic hydrocarbons of the industrial origin. 
 Materials and methods. one thousand one hundred fifty one 4–13 years children were examined, 883 people made up the observation group and lived in the territory with excess of hygienic standards in the air of phenol, formaldehyde, acrolein, o-xylene. The comparison group consisted of 268 children living in the territory of ecological well-being. The prevalence of pathology of the upper respiratory tract (URT), rhinomanometry, laboratory parameters were assessed, correlation-regression relationships of clinical and laboratory parameters and the concentration of chemicals in the blood were determined. 
 Results. The study established for the first time the relationship between the concentration of chemical compounds in the blood, laboratory and instrumental indicators in children with URT pathology, living in the territory with excess levels of phenol, formaldehyde, acrolein. The total nasal airflow in the observation group was 10-15% lower than in the comparison group and inversely related to the blood concentration of acrolein, o-xylene, phenol, formaldehyde, and the content of IgG specific to phenol, myelopyroxidase, total number of lymphocytes, subpopulations of CD3+CD25+ and CD3+CD95+, integral index of proliferation and frequency of cells with apoptotic bodies and circular notches of the nucleus. 
 Limitations. The results of the study can be extrapolated to 4-13 years children, boys and girls. The study did not include young children or adults. 
 Conclusion. Characteristic features of the pathology of the upper respiratory tract associated with increased levels of acrolein, o-xylene, phenol and formaldehyde in the blood are a decrease in nasal airflow against the background of specific immune-dependent and non-specific inflammation. To reduce the incidence of URT in children, it is necessary to develop programs that include measures aimed at improving the quality of the environment, therapeutic and preventive measures that increase adaptive capacity.