ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ БУТИЛИРОВАННОЙ ПИТЬЕВОЙ ВОДЫ ВЫСОЧАЙШЕГО КАЧЕСТВА С ОПТИМАЛЬНЫМ СОДЕРЖАНИЕМ МАКРО - И МИКРОЭЛЕМЕНТОВ, СРЕДИ ШКОЛЬНИКОВ

Беляева Н.Н. ¹, Горелова Ж.Ю. ²

¹Доктор медицинских наук, Профессор, ФГБУ «Научно-исследовательский институт экологии человека и гигиены окружающей среды им. А.Н.Сысина» РАМН

²Доктор медицинских наук, Профессор, НЦЗД «НИИ гигиены и охраны здоровья детей и подростков» РАМН

Москва, Российская Федерация

ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ БУТИЛИРОВАННОЙ ПИТЬЕВОЙ ВОДЫ ВЫСОЧАЙШЕГО КАЧЕСТВА С ОПТИМАЛЬНЫМ СОДЕРЖАНИЕМ МАКРО - И МИКРОЭЛЕМЕНТОВ, СРЕДИ ШКОЛЬНИКОВ

Аннотация

В статье оценивается коррекции состояния здоровья 5-7-летних детей в дошкольных и государственных образовательных учреждений (ОУ) в Москве в зависимости от потребления различных видов воды. Особое внимание уделено вопросам оценки цитологического статуса слизистых оболочек носа и рта (щек), будучи первым барьером для проникновения вредных веществ. Полученные результаты свидетельствуют о положительной тенденции в состоянии здоровья детей в ОУ (показателей острой заболеваемости и цитологического статуса) после введения в рацион бутилированной воды высокого качества.

Ключевые слова: бутилированная вода, школьники, здоровье.

Belyaeva N. N.¹, Gorelova Zh. Yu.²

MD¹, Professor, FGBU A.N. Sysin Research Institute for Human Ecology and Environmental Health of the Russian Academy of Medical Sciences

MD²,Professor, Research Institute of Hygiene and Health Protection of Children and Adolescents, Scientific Center of Children’s Health of RAMS

Moscow, Russian Federation

EFFICIENCY OF THE USE OF BOTTLED DRINKING WATER OF THE HIGHEST QUALITY WITH OPTIMAL CONTENT OF MACRO- AND MICRONUTRIENTS AMONG SCHOOLCHILDREN

Abstract

The article evaluates the correction of health state of 5-7-year-olds in pre-school and state educational institutions (EI) in Moscow at consumption of different kinds of water. Special attention is paid to the assessment of cytological status of the mucous membranes of the nose and mouth (cheek), being the first barrier to the penetration of harmful substances. The findings show a positive trend in the health status of children in EI (in indicators of acute morbidity and cytological status) by the introduction of bottled water of the highest quality into the diet.

Keywords: bottled water, schoolchildren, health. 

There are conditions where adequate provision of the population with good quality drinking water from centralized sources of water supply cannot be implemented for the shortest time. A promising solution of this problem is to review the general concept of the provision of the population with drinking water and the forced more extensive use of local means for deep post-treatment of drinking water in a number of populated areas. In addition, it is necessary a sufficient supply of the population with packaged drinking water of guaranteed high quality. It should be a conscious attitude to drinking water (especially bottled) as a food product. There must be a clear understanding of criteria, indicators and standards for its physiological usefulness. The differentiation of its quality by different age groups and indicators of health, as well as a clear terminological separation of drinking water of constant use from any kind of mineral water limited by regime and volume of drinking consumption will be necessary in the future.

Depending on the water quality improved regarding the hygienic requirements for water of central water supply, as well as additional medical and biological requirements, the packaged water is divided into two categories:

- the first category - drinking water, regardless of the source of its receiving, safe for health regarding epidemiology, harmless on a chemical composition, radiation safety, attractive for its aesthetic properties, steadily keeping its high drinkable properties;

- the highest category - the water which is safe for health and has an optimal quality (from independent, as a rule, underground, preferably spring or artesian water sources, reliably protected against biological and chemical pollution). Maintaining all the criteria for water of the first category, the drinking water of the optimal quality must also meet the criteria of the physiological usefulness on the content of the main biologically necessary macro-and micronutrients and more stringent standards for a number of the organoleptic and sanitary - toxicological indicators. Water of the highest category may be recommended for children, including the first days of their lives, pregnant women, elderly people and people with chronic diseases of liver and kidneys that need the water adjusted to the salt composition and also substantially free of toxic substances.

In view of the urgency of the shortage of biogenic macro- and micronutrients for the population of the Russian Federation, the Chief State Sanitary Doctor of Russia G.G. Onishchenko in  Resolution № 5 from 11.07.2000, "About correction of water quality on the content of the biogenetic elements”, recommended to take measures on the completion of the deficit of  biogenetic elements due to the organization of production and delivery of the bottled water with an optimum content of the biogenetic elements for the people.

In some regions of the Russian Federation such an opportunity has been practically implemented. Currently, the water of the highest quality (SanPiN 2.1.4.1116-02) is produced in the Stavropol region ("Rokadovskaya. Standard of cleanliness "), in the Moscow region ("Living water " , "Trinity" and "Courtois"), in the cities of Samara, Ufa, Naberezhnye Chelny ("Crystalnaya"), Orenburg ("Living water "), Tyumen ("Crystalnaya"), Smolensk ("Lekor" Lux "), Barnaul ("Legend").

The use of the packaged drinking water of the highest quality is essential for the population’s health, prevention of iodine deficiency states and dental caries (especially in children) and improvement of the immune system.

The feature of the growing organism is its large, compared with the adult organism, ability to adjust the arising changes in some cases. Therefore, the measures are being searched to restore gomeorezis of child.

This work is devoted to the evaluation of the correction of health state of children between 5 and 7 years old in preschool educational institutions in Moscow during the consumption of different kinds of water.

In carrying out this work 165 children between 5 and 7 years old have been twice observed in five educational institutions (EI) and three preschool institutions (PSI)  of the North-Western administrative district in Moscow on several methods: before and after 6 months after water consumption. 83 children from PSI № № 1197, 1200, 1192 and EI № 69 were a control group and had Moscow boiled tap water while staying in EI. 82 children from PSI № № 1199, 1397 and EI № № 89, 1302 were an experimental group and had bottled water of the highest quality with a free access to water. The groups were randomized on hygienic characteristics and cytological status of the mucous membranes of the nose and mouth (cheeks).

The health of children has been studied on the basis of questionnaire, analysis of medical records, inspection by specialists and determination of the status of the cytology of the mucous membranes of the nose and cheeks by means of a non-invasive method developed in A.N. Sysin Research Institute for Human Ecology and Environmental Health of the Russian Academy of Medical Sciences [3].

Special attention in this paper is paid to the assessment of the cytological status of the mucous membranes of the nose and mouth (cheek), being the first barrier to the penetration of harmful substances [2]. The informativity of the evaluation of the mucous is associated with the recognition of their coordinating position in the reactions, linking the mechanisms of specific and nonspecific immunity, in the initiation and stabilization of the inflammatory processes that have a central place in the pathology of the respiratory tract [1, 2, 4, 5].

The cytological analysis of the mucous allows to compare different cell populations: epitheliocytes, leycocytes and microflora and exhibit several cytological diagnosis of the mucous [2], and link these states with various factors, as it has been shown earlier that the condition of the mucous membranes of the nose and mouth reflect the body state, depending on the environmental pollution [2, 4].

The findings showed that the children in the control groups in the conditions of usual water use had deteriorated cytological indicators in 6 months: the number of children with the cytological status "norm" in the buccal mucosa significantly reduced from 100+12,5 to 76,4+10,3, 3, and in the nasal mucosa this indicator  significantly reduced from 42,9+9,4 to 11,7 +7,8 (P <0,05). Accordingly, the number of children with the cytological diagnosis "inflammation", "acute inflammation" and "allergic state" increased.

In the experimental groups of the districts there was a quite opposite trend: the number of children with the cytological status "norm" in the buccal mucosa tended to increase from 80,8+5,5 to 100+13,8, and in the nasal mucosa this indicator did not significantly changed in the trend to the reduction of such cytological diagnosis as "inflammation", "acute inflammation" and "allergic state".

In the groups of children who received the bottled water it was marked a significant reduction in the buccal mucosa in the number of the children with an increased number of low differentiated buccal epitheliocytes (LDBE) that was a favorable attribute of the increased resistance of the body. The flora state, assessed as "the risk of pathogenic microflora" ("RPM"), showed the absence of significant changes in the parameters in the buccal mucosa as well as in the nasal mucosa.

The findings of the morbidity after 6 months of water intake showed a significant decrease in the number of cases of acute illness in children attending EI in both the control and experimental groups. However, a significant reduction in acute morbidity in the children of the experimental groups was higher than in the control groups (p <0,01 vs. p <0,05). There was also a downward trend in the average duration of a single case of acute illness in the experimental groups, from 8.5 days to 8.1 days. The rates of chronic morbidity and the distribution of children in health groups before and after the water consumption in both districts were not significantly changed.

It was determined the absence of gender differences on the number of leukocytes in the mucous of the nose and cheeks in the children with normal cytological status who had participated in the study.

Thus, a positive trend was shown in the health status of children in EI (in indicators of the acute morbidity and cytological status) by the introduction of the bottled water of the highest quality into the diet of children, as an example of health-saving technology.

Currently, based on the findings obtained for the optimization of water consumption in children's educational institutions and improvement of the immune properties in children’s body, the packaged drinking water of the highest quality was included in a typical twenty-day diet in PEI .

References

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2. Belyaeva N.N. /V kn.: Neinvazivnye metody v otsenke zdorov'ya    naseleniya. - M.-2006.- Izd-vo: MGU.- S.163.

3. Belyaeva N.N., Sycheva L.P., Zhurkov V.S. i dr. Metodicheskie rekomendatsii. «Otsenka tsitologicheskogo i tsitogeneticheskogo statusa slizistykh obolochek polosti nosa i rta u cheloveka». Moskva - 2005-37s.

4. Belyaeva N.N., Shamarin А.А., Petrova I.V., Malysheva А.G. Svyaz' izmenenij slizistykh obolochek nosa i rta s immunnym statusom pri vozdejstvii faktorov okruzhayushhej sredy // Gigiena i sanitariya –2001-№ 5.- S.62-64.

5. Polito A.J., Proud D. Epithelil cells as regulators of airway inflammation. //J.Allergy Clin Immunolog.- 1998-v.102-P.714-718.