Integral assessment of thyroid disorders in children, consuming drinking water with elevated levels of nitrate

A hygienic and epidemiological study of the Perm region's territories with unfavorable health indicators was carried out. The areas with poor quality of drinking water due to the content of nitrates and increased prevalence of thyroid diseases in children and adolescents were identified. Clinical and laboratory study of the peculiarities of thyroid pathology in children drinking water with deviant (49.5-141.3 mg/l) nitrate content was performed. The list of marker indicators of disruption of thyroid function in children living under unfavorable environmental conditions was identified. The algorithm of integrated assessment of thyroid disorders. In conditions of the oral nitrate exposure, the integral index of thyroid disorders was 1.2 times higher than in the territory of comparison and 1.13 times higher comparing to the average level in the Perm region (p = 0.016-0.05). The main marker indicators of nitrates negative impact in drinking water are: the reduction of free T4, changes in the thyroid ultrasound structure and the presence of antibodies to TPO, in 1.6-7.0 times higher than the levels on the territory of the comparison.