The New Armenian Medical Journal Vol.6 (2012), Nо 3, P

The New Armenian Medical Journal Vol.6 (2012), Nо 3, p. 67-74

Dynamics of Organochlorine Compounds Identifica- tion in Rural Female Population of Armenia and Re- lated Health Issues Tadevosyan N.S.1, Tadevosyan A.E.2 1 Scientific Research Center of Yerevan State Medical University, Yerevan, Armenia 2 Chair of Health Care Organization and Medical Law, Yerevan State Medical University, Yerevan, Armenia

Abstract It is known that women’s reproductive function is highly sensitive to the influence of unfavorable factors of the environment. Persistent organic pollutants, to which the majority of organochlorine pesticides are attributed, may penetrate through the placental barrier and considerably affect the course and termination of pregnancy. In this respect the pollution of the environment by POPs is the major ecological problem closely related to the health issues and needs in-depth study. The sociohygienic and monitoring investigations were done (2008-2010) in Ashtarak district of Aragatsotn marz (province) of Armenia to study the levels of organochlorine pesticides in human organism, as well as their possible unfavorable impact on certain indices of reproductive health and newborns’ physical development. The results of monitoring showed that organochlorine pesticides levels do not decrease and a high constancy of determination in samples of breast milk of rural population is observed. At the same time, the increase in number of samples (77%) with concurrently determined pollutants (DDT, DDE, γ-HCH) was recorded. According to data/ responses of Questionnaires, in a part of respondents (3-17%) the current pregnancy and delivery proceeded with complications, in anamnesis of the parturient women (7-17%) different disorders of reproductive function (miscarriage, preterm delivery) were registered as well. The total number of respondents with reproductive function problems ranged from 13% to 27%. The results of comparative analysis of organochlorine pesticides levels in breast milk samples of fe- males from pre-mountain (Ashtarak district) and valley (Artashat district) regions of Armenia demonstrated that the determination frequency, concentrations, as well as the total amounts of organochlorine pesticides had higher statistical significance in Artashat district. The comparison and analysis of official statistical data (2010) revealed that in Artashat district as compared to Ashtarak district higher values of certain indices were recorded to testify pregnancy/ delivery course disorders. According to the responses, among parturient women of Artashat district the high frequency of pregnancy/delivery complications (53-63%) and different disorders of reproductive function were revealed, as well as calculated odds ratio values were of statistical significance. The content of organochlorine pesticides in breast milk of parturient women with complicated course of pregnancy and delivery was higher in comparison with women recently confined in normal course. The presented study makes a part of a complex sociohygienic, monitoring investigations on environmental quality, and the results obtained would further serve as a platform for working out recommendations on reduction of the environmental pollution and improvement of human health protection issues in Armenia.

Keywords: environment, pollution, pesticides, monitoring, persistent organic pollutants, reproductive function, rural population, risk.

Introduction

Adress for Correspondence: Nowadays the researchers are worried by the Yerevan State Medical University after M. Heratsi steady increase of chemical hazards to the environ- 2 Koryun Street, 0025, Yerevan, Armenia ment and humans. The objective reasons consist in Tel.: (+37410) 26 15 06 E-mail: [email protected] the increase of chemicals production and use, the increased number of newly synthesized chemicals,

67 Tadevosyan N.S., Tadevosyan A.E. The New Armenian Medical Journal, Vol.6 (2012), No 3, p. 67-74 extension of human activity spheres, in which dif- press adaptation mechanisms of an organism [Kuzmin ferent chemical compounds are widely applied, as D., 2007]. Pesticides and fertilizers are also considered well as the raise of chemicals availability, includ- among known agents contributing to development of ing those with high biological activity. As a result, malignant neoplasms, including those of female repro- the abovementioned factors contribute to increase ductive system [Shikhnabieva N. et al., 2008]. In of the anthropogenic burdens on the environment women settled at territories polluted by pesticides the and human organism [Topical problems on toxicol- reproductive health disorders such as late menarche, ogy and radiobiology, 2011]. monthly period disorders, miscarriages, as well as the The variety of conditions for chemicals impact gynecological, obstetrical and perinatal pathologies of to humans contribute to manifestation of different high frequency, abnormalities in terms and rates of forms of the toxic process such as development of physical and sexual development of girls are more fre- acute, subacute and chronic forms of intoxication, quently registered [Panina N., 2010]. reproductive function disorders and carcinogene- Persistent organic pollutants (POPs), among sis initiation, changes in organism reactivity to- which the majority of organochlorine pesticides wards the impact of both numerous man-caused are considered, may have the adverse influence on and environmental agents [Topical problems on human organism producing a wide range of toxic toxicology and radiobiology, 2011]. effects, may penetrate through the placental barrier It is mentioned that the deterioration of human and considerably affect the course and termination health observed during the last decades is associ- of pregnancy [Saxena M. et al., 1980; Pavlov A. et ated namely with the negative influence of chemi- al., 1991; Longnecker M. et al., 2001; Fenster L. cal factors of the environment. The researchers et al., 2006]. In this respect the pollution of the consider that registered peculiarities of disease environment by POPs is the major ecological prob- course, chronic nature and pathomorphism, as well lem closely related to the health issues and needs as changes in structure and nature of pathologies to in-depth study [Revich B., Shelepchikov A., 2008]. a greater extent are formed due to anthropogenic Based on the abovementioned, the investigations ecological misbalances and intensive pollution of aimed at the study of organochlorine pesticides lev- the human habitat. The environmental factors els in human organism and their possible unfavor- rarely act as the initial cause of health disorders; able impact on reproductive health and newborn mostly the diseases develop under the effect of a child’s physical development were conducted. bulk of low-intensive factors characterized by modifying effect as well. Material and Methods It is proved that non-specific changes may prevail According to the posed aims, the sociohygienic over the specific ones caused by the impact of chemi- and monitoring investigations among rural popula- cal factors of the environment [Belyaeva N. et al., tion of Ashtarak district in Aragatsotn marz (prov- 2007; Kurlyandskiy B. et al., 2007; Dunaev V. et al., ince) of Armenia were done in 2008-2010 to study 2008; Mudryi I., 2008]. Various effects of pesticides to the possible unfavorable impact of organochlorine human health are developed onto common widely pesticides carriage on certain indices of reproduc- spread pathologies characterized by the increased fre- tive health (course and termination of pregnancy) quency of agrochemical burdens prevalence. Their im- and newborn child’s physical development. pact on human health is considered as chemical com- Face-to-face interviews by a specially devel- ponent of anthropogenic origin that is enhancing the oped Questionnaire were conducted among rural effect of other etiological agents [Pavlov A. et al., female population from different villages (Dzorap, 1991; Borisenko N., Khizhnyak I., 1992; Panina N., Aragatsotn, Karbi, Parpi, Mugni, etc.). Randomly 2010]. It is known that women’s reproductive function selected thirty recently confined women (for each is highly sensitive to the influence of unfavorable fac- year) participated in interviews. During investiga- tors of the environment. To a sufficient extent, the tions, the female population from 31 villages were changes in reproductive health indices may represent questioned that makes approximately 30% of total the environment status characterizing mutagenicity rural communities of the marz. The Questionnaire and embryotoxicity of agents and their ability to de- embraced issues related to personal information,

68 The New Armenian Medical Journal, Vol.6 (2012), No 3, p. 67-74 Tadevosyan N.S., Tadevosyan A.E. description of pregnancy and delivery course with quence did not reach the statistical significance. indication of occurred complications, premature The analysis of newborns physical develop- delivery, stillbirth, miscarriage and birth defects, ment indices depending on delivery sequence and as well as newborns physical development data organochlorine pesticides content in the breast (sex, weight, height, head and chest circumfer- milk of their mothers did not reach the statistical ence), respondents’ possible contacts with pesti- significance: physical development of these new- cides or participation in farm works, etc. borns corresponded to the physiological norm. Concurrently, in the same group of respondents According to data obtained in 2010, the residual monitoring of organochlorine pesticides content in amounts of organochlorine pesticides were higher breast milk samples was conducted to study resi- than in earlier years; this latter is an evidence of the due levels of γ-HCH and DDT with its metabolites increasing levels of anthropogenic pollutants bur- (DDE and DDD). den on human organism. Thus, the average concen- To determine the levels of organochlorine pesti- trations of individual organochlorine pesticides de- cides residues during the first 2-3 days after the deliv- tected in 2010 compared with data obtained in 2008 ery the samples of breast milk were taken and kept and 2009 manifold (2-8 times) exceeded: 3.5 and under the appropriate cold conditions until analytical 5.3 times for γ-isomer of HCH, correspondingly; 2 studies. The determination of organochlorine pesti- and 3 times for DDE; 4 and 2.5 times for DDT. Fur- cides in breast milk of nursing mothers was done by Table 1. gas-liquid chromatography methods with electron The levels of organochlorine pesticides in the capture detector on “Tsvet” gas-liquid chromato- breast milk of rural female population, graph [Klisenko М. et al., 1992] at determination sen- Ashtarak district, Armenia (X±Sx) sitivity of 0.0007 mg/l. The findings were processed with the use of standard statistical programs such as Average Determination Years Pesticide concentration, frequency, Biostat and Excel. The obtained data validity was es- μg/l % timated at significance level equal to p≤0.05. γ-HCH 2.96 ± 1.1 83 Results and Discussion DDE 2.75 ± 0.49 80 The results of organochlorine pesticides moni- DDD 1.22 ± 1.0* 10 2008 toring in breast milk samples of women recently DDT 0.18** 3 confined (Ashtarak district) testify to continued Total amount of presence of their residues in biomedia of the stud- organochlorine 5.425 ± 1.291 83 compounds ied cohort. Determination frequency of main contaminants (γ-HCH and DDE) was high and ranged γ-HCH 2.0 ± 0.14 100 from 80 tо 100% (Table 1). DDE 1.8 ± 0.26 100 The analysis of organochlorine pesticides lev- DDD N/D - els in breast milk depending on delivery sequence 2009 DDT 0.32 ± 0.1 43 (primipara – secundipara) was conducted to study Total amount of the dynamics of their accumulation in human or- organochlorine 1.9 ± 0.28 100 ganism (Table 2). As to data obtained in 2010, the compounds levels of organochlorine pesticides content, in- γ-HCH 10.6 ± 1.0 100 cluding DDT, both in primipara and secundipara DDE 5.4 ± 1.3 100 breast milk samples were one order higher. It DDD N/D N/D should be mentioned that the detection frequency 2010 DDT 0.8 ± 0.2 70 of DDT in breast milk of secundipara was higher Total amount of than in primipara: 82.4% and 53.9%, correspond- organochlorine 16.1 ± 1.9 100 ingly. However, revealed differences in the content compounds of individual organochlorine pesticides (DDE, Note: * 3 “positive” samples; γ-isomer of HCH) and in total amount of organo- ** 1 “positive” sample; chlorine compounds depending on delivery se- N/D – not detected.

69 Tadevosyan N.S., Tadevosyan A.E. The New Armenian Medical Journal, Vol.6 (2012), No 3, p. 67-74

Table 2. 100 The organochlorine pesticides content in breast milk 90 DDE/DDT γ-HCH+DDE γ-HCH+DDE+DDT/DDD Not detected of rural female population depending on delivery se- 80 quence, Ashtarak district, Armenia (X±Sx) 70 Years Pesticide Primipara Secundipara 60 μg/l μg/l 50 2.704±11049 40 γ-HCH 3.157±1.821 р>0.05 30 3.062±0.862 20 DDE 2.48±0.559 2008 р>0.05 10 Total amount of 5.766±1.524 0 organochlorine р>0.05 5.175±1.982 2008 2009 2010 compounds Figure 1. Distribution of organochlorine pesticides in breast 2.0±0.2 γ-HCH 2.0±0.16 milk samples of rural female population, Ashtarak р>0.05 district of Aragatsotn marz, Armenia (in %). 1.8±0.35 DDE 1.8±0.37 р>0.05 2009 0.4±0.2 DDT 0.24±0.05 р>0.05 Total amount of 3.9±0.5 100 organochlorine р>0.05 3.9±0.46 90 2008 2009 2010 compounds 80 10.8 ± 1.5 10.5 ± 1.4 70 γ-HCH р>0.05 60 4.4 ± 2.2 5.4 ± 2.2 50 DDE р>0.05 40 2010 1.1 ± 0.5 0.6 ± 0.15 DDT 30 р>0.05 20 Total amount of 15.8 ± 3.3 16.4 ± 2.4 10 organochlorine р>0.05 0 compounds γ-HCH DDE DDD DDT thermore, the total amount of organochlorine com- Figure 2. The frequency of organochlorine pesticides detection in breast milk samples of rural female pounds exceeded 3- and 8-fold, correspondingly. At population, Ashtarak district of Aragatsotn the same time, the quantity of samples (77%) con- marz, Armenia (in %). taining concurrently determined several pollutants (DDT, DDE, γ-HCH) increased and in one sample the residues of four organochlorine compounds 30 2008 2009 2010 were detected in parallel: γ-isomer of HCH, DDT, DDE and DDD (traces) (Figure 1). It should be 25 mentioned that in three samples the traces of DDT 20 were determined. In comparison with earlier years 15 of investigations, the frequency of DDT detection considerably increased (70%) (Figure 2). The ob- 10 tained data testify to impairment of the environment 5 in terms of its pollution by organochlorine com- 0 Current Problems in Reproductive func- pounds considered as persistent organic pollutants. pregnancy/delivery anamnesis tion problems The interviews were conducted in the same complectations groups of respondents, parturient women of Ashta- Figure 3. Certain indices of reproductive function of rak district, to study the possible unfavorable ef- rural female population, Ashtarak district of fect of organochlorine pesticides on reproductive Aragatsotn marz, Armenia (in %).

70 The New Armenian Medical Journal, Vol.6 (2012), No 3, p. 67-74 Tadevosyan N.S., Tadevosyan A.E. function of human organism. Data of sociohy- cantly higher in comparison with those in Ashta- gienic study on the course of pregnancy and deliv- rak district (р=0.02; 0.007 and 0.004, correspond- ery was summarized and presented as Figure 3. ingly). In 2009, the frequency of DDT determina- As to responses, the number of parturient tion in Artashat district was also significantly women with complications of current pregnancy/ higher (70%) versus the same results obtained in delivery ranged from 3% to 17%. Moreover, in a Ashtarak district (43%). Represented findings part of respondents (7-17%) different disorders of confirm the evidence of intensive and wide ap- reproductive function (miscarriage, preterm deliv- plication of agrochemicals in farms of Ararat val- ery) were registered in anamnesis as well. The ley, as well as the anxiety on continuous applica- total number of respondents with any problem(s) tion of organochlorine pesticides in plant cultiva- of reproductive health was in the range of 13-27%. tion, poultry farming, and cattle breeding. It should be added that according to conducted FY 2010 data of administrative statistical re- interviews, none of the respondents had profes- ports on delivered medical care to pregnant and sional contact with pesticides. However, a part of parturient women in observed districts (Artashat rural female population (50-63%) indicated appli- and Ashtarak) and their comparison were summa- cation of different pesticide formulations on home- rized as well (Figure 5). stead land and truck farms (Figure 4), among According to findings obtained in Artashat which were the respondents (21-47%), who men- district versus Ashtarak district, the higher values tioned trade names of applied pesticides (bayleton, of certain indices of pregnancy/delivery course dimethoate, arrivo, chloriphos, karate); persons, were registered (per 1000 deliveries): the higher who used personal protection means during pesti- figures of total cases of complicated labors (471.6 cides application, formed 47%-60% of this group. and 214.0, correspondingly); difficult labors In order to study the levels of environmental pollu- (156.8 and 7.0); disorders/anomalies of labor ac- tion in different regions of the Republic of Armenia the tivity (98.61 and 83.72); miscarriages number, comparative analysis of organochlorine pesticides including those due to abnormality of fetus devel-

70 500 2008 2009 2010 Ashtarak region Artashat region 60 450 400

50 350

40 300 250

30 200 20 150 100

10 50 0 0 Households Used protective Non used Mentioned Complicated Difficult Labor activity Miscarriages, due to abnormality used pesticides means protective means pesticides name labors labors anomalies including of fetus

Figure 4. Pesticides application in truck farms and use Figure 5. Statistical indices on pregnancy and delivery of personal protection means, Ashtarak district course in certain districts of Armenia (per 1000 of Aragatsotn marz, Armenia (in %). deliveries, 2010). content in breast milk samples of rural female popula- opment (110.0/8.9 and 62.8/2.3). The obtained re- tion from Ashtarak district (Aragatsotn marz) was sults confirm the anxiety over problems relevant to done versus results of the same research conducted in pregnancy and delivery issues. These findings Artashat district (Ararat marz) (Table 3). comply with literature data and testify that the car- Data presented in Table 3 testify that concentra- riage of organochlorine pesticides may pose an ad- tions of both DDE and DDT, as well as their sum ditional risk of the negative impact on human re- values obtained in Artashat district were signifi- productive function.

71 Tadevosyan N.S., Tadevosyan A.E. The New Armenian Medical Journal, Vol.6 (2012), No 3, p. 67-74

Table 3. The average content of organochlorine pesticides in the breast milk of rural female population, Ar- menia, 2008-2010 (X±Sx) Ashtarak district, Artashat district, Aragatsotn marz Ararat marz Years Pesticide Average Determination Average Determination concentration, μg/l frequency, % concentration, μg/l frequency, % 2008 3.29±0.89 γ-HCH 2.96±1.3 83 97 р>0.05 13.0±2.6* DDE 2.75±0.5 80 100 р=0.00002 Total amount of 22.412 ± 8.3* 5.425±1.3 83 100 organochlorine compounds р=0.00011 2009 2.4±0.3 γ-HCH 2.0±0.1 100 100 р>0.05 4.2±0.7* DDE 1.8±0.26 100 100 р=0.006 0.37±0.09 70* DDT 0.32±0.1 43 р>0.05 р<0.05 4.5±0.85* DDT+DDE 1.9±0.28 100 100 р=0.006 Total amount of 6.8±0.89* 3.9±0.35 100 100 organochlorine compounds р=0.005 2010 14.7 ± 3.0 γ-HCH 10.6 ± 1.0 100 100 р>0.05 11.7 ± 2.0* DDE 5.4 ± 1.3 100 89 р=0.02 3.9 ± 1.0* DDT 0.8 ± 0.2 70 71 р=0.007 13.7 ± 2.2* DDT+DDE 5.5 ± 1.6 100 100 р=0.004 Total amount of 45.1 ± 17.0 16.1 ± 1.9 100 100 organochlorine compounds р>0.05 Note: * differences are statistically significant (р<0.05).

Conclusion The pollution of the environment by organo- taining concurrently determined several pollutants chlorine pesticides considered as persistent or- (DDT, DDE, γ-HCH) increased as well. According to ganic pollutants is the major ecological problem Questionnaire responses, the considerable part of re- closely related to the health issues, because these spondents (50-63%) indicated application of differ- compounds, as it is known, have an unfavorable ent pesticide formulations (bayleton, dimethoate, ar- effect on human organism manifesting the toxic rivo, chloriphos, karate) on homestead land and truck impact of a wide range, including the adverse ef- farms, while individuals, who used personal protec- fect on human reproductive function. tion means during pesticides application formed Monitoring results showed that the levels of or- 47%-60% of questioned groups. However, none of ganochlorine pesticides do not decrease and keep on the respondents mentioned the application of any or- high constancy of determination in the biomedia of ganochlorine pesticides. rural population (Ashtarak district, Aragatsotn marz). In a part of interviewed persons (3-17%) the cur- At the same time the number of samples (77%) con- rent pregnancy and delivery proceeded with compli-

72 The New Armenian Medical Journal, Vol.6 (2012), No 3, p. 67-74 Tadevosyan N.S., Tadevosyan A.E. cations and in anamnesis of the parturient women orders, including those of human reproductive (7-17%) different disorders of reproductive func- function. All these findings give grounds for tion (miscarriage, preterm delivery) were registered strengthening the issues on control and regulation as well. The total number of respondents with repro- of plant protection chemicals application in Arme- ductive function problems ranged 13-27%. nia. In order to improve the current practice and It should be mentioned that in Artashat district manner of agricultural management it would be the determination frequency, concentrations and necessary to implement measures aimed firstly at total amounts of organochlorine pesticides were at awareness raising of individual farmers on rules statistically high levels. Analysis of administrative and regulations related to pesticides safe applica- statistical reports on medical care delivered to tion, issues relevant to hazards of organochlorine pregnant and parturient women revealed the higher compounds, as well as necessity to observe estab- values of certain indices testifying the pregnancy/ lished hygienic norms and regulations. delivery course disorders in Artashat district com- The presented findings confirm the topical na- pared to the same findings obtained for Ashtarak ture of issues relevant to pollution of the environ- district. According to Questionnaire data, among ment by organochlorine pesticides, their carriage, parturient women of the mentioned district the and possible delayed effects of these compounds high frequency of complicated pregnancy and on human organism. The abovementioned empha- labor cases (53-63%) and different disorders of re- size the necessity to proceed with investigations, productive function (miscarriages, premature as no tendency to reduction of residual amounts of labor) were revealed; calculated values of odds these compounds in both the environment and bio- ratio were of statistical significance as well. The media is observed until present. content of organochlorine pesticides in parturient The presented study makes a part of a complex women with complicated course of pregnancy and sociohygienic, monitoring investigations on envi- delivery was higher in comparison with women re- ronmental quality, and the results obtained would cently confined in normal course. further serve as a platform for working out recom- The obtained results correspond to literature mendations on reduction of the environmental pol- data and testify that the presence of organochlorine lution and improvement of human health protec- pesticides in human organism may pose an addi- tion issues in Armenia. tional risk for development of different health dis-

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