"Biological prophylaxis" - one of the ways to proceed from the analytical environmental epidemiology to the population health protection.

Population (and especially children’s) health in industrialized urban areas of the Middle Urals, Russia is generally rather poor, and our epi studies demonstrated that some diseases and sub-clinical conditions could be conclusively associated with environmental exposures to toxic metals and to some organic chemicals emitted by industries characteristic of this region. Theoretically sound and tested in a lot of animal toxicological experiments is a concept of “the biological prophylaxis” (BP) meaning a complex of methods aimed at the increase in the effectiveness of general and specific host’s biological protective mechanisms. The system of the BP that is functioning in our region comprises 4 stages. Stage 1. This stage involves analytical epidemiological studies and prognostic risk assessment projects with the purpose of characterizing the real significance of certain problems of environmental medicine in the context of our region and, thus, setting specific tasks for biological prophylaxis. Stage 2. Based on theoretical premises, we propose a complex consisting of innocuous bio-protectors with expected beneficial influence on the toxico-kinetics and toxico-dynamics of certain chemicals acting either separately or in combinations characteristic of a particular urban area. Then we test this complex for its protective efficacy on an animal experimental model of the individual or combined toxicity of those chemicals. Stage 3. Bio-protective complexes (BPC) which proved effective in animal experiments are subject to controlled field trials on limited groups of individuals exposed to a particular health risk (mostly of children aged 4-7) under well-qualified medical and laboratory supervision. When the protective effectiveness and the absence of adverse side-effects of a BPC is proved, it is recommended for the prophylactic practice. Stage 4. Based on available data on environmental contamination, areas of the highest potential health risks are determined and then subpopulations of these areas’ residents who need a protective treatment the most are singled out. For example, preschool children residing and attending kindergartens in such an area and having some explicit disease are hospitalized for clinical treatment including elimination therapy, whilst the rest of the selected children population is being given a course of presumably effective BPCs for 4-5 weeks once or twice a year through kindergarten’s or school’s medical personnel under the supervision of local pediatricians. About 10% of the children receiving BPCs at the 4th stage are chosen each year by local pediatricians and examined before and after this treatment as to check their general health status which proved bettered in 70%-80% of the examined children. The experience gained when implementing the project has been used to expand its scope within the Middle Urals region. Thus if in 2002 only 253 children in 2 towns received the BPCs, in 2003 they were received by 2915 children in 5 towns, and so on – up to 8389 children in 11 cities and towns in 2006 and 8096 children in 2007. Conclusion. We believe that experience gained when implementing the project of biological prophylaxis should be used to expand its scope both within and outside Russia.

Contribution proposed for:   oral presentation