ABSTRACT
OBJECTIVE: To study the combined effect of radioactive and chemical factors on the reproductive health of a female rural population residing and working on territories contaminated after the Chornobyl accident. MATERIALS AND METHODS: The sociological questioning and gynecological examination of 1850 women have been made including the evaluation of 29520 medical reports of deliveries, 19502 medical reports of newborns, 1694 medical reports of women with spontaneous abortions as well as the state of menstrual function in 480 girls-adolescents residing on the contaminated territories. The radioactive contamination of the studied territories as well as the total effective dose of radiation for the population was evaluated by the results of the general dosimetric dose established for settlements of Ukraine. Factors of the work environment (noise, microclimate, dust, bacterial air pollution, work intensity and strain) were studied by the common hygienic methods and assessed by the criteria of the "Hygienic Classification of Work..." # 4137-86. The residues of pesticides, their isomers and products of transformation in biological fluids (blood, breast milk, cord blood) were assayed by gas-liquid chromatography method and electron capture detector with the device "Kristallux 4000" and the model M-3700. Correlative, regression, and discriminative analyses were used for mathematical processing of the data. RESULTS: It is proved that the reproductive health of rural women has become significantly worse after the Chornobyl accident, the most expressed disorders are seen in young women aged under 30. Worsening of reproductive health is found being the result of a combined effect of factors of radioactive and nonradioactive nature, specific for territories of residence, occupational activity and style of life. In particular, the effect of pesticides at the background of the radioactive contamination is likely to be an additional risk factor of disorders of the reproductive health of women. According to the biomonitoring data the content of organochlorine pesticides in biological fluids of women with reproductive health disorders was significantly higher (p<0.05) vs. with healthy ones. It is established that women of the childbearing age residing on territories with the density of contamination of more than 5 Ci/km and with rates of pesticide load over 5 kg/ha should be referred to a high risk group of the reproductive health disorders. CONCLUSION: The perspectives of epidemiological studies on the reproductive health are related on the use of the combination of many-aspect healthcare and biological approaches. It is equally important to assess adequately the factors of environment and work-related conditions, and their combined effect with dwelling load.