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 Table of Contents  
REVIEW ARTICLE
Year : 2017  |  Volume : 2  |  Issue : 3  |  Page : 70-75

Reproductive and health-related hazards of Lindane exposure in Aral sea area


1 Department of Normal and Topographical Anatomy, West Marat Ospanov State Medical University, Aktobe, Kazakhstan
2 Department of Obstetrics and Gynecology, Ain Shams University, Egypt and Ahmadi Hospital, Ahmadi, Kuwait

Date of Submission20-May-2017
Date of Acceptance01-Sep-2017
Date of Web Publication11-Oct-2017

Correspondence Address:
Ibrahim A Abdelazim
Ahmadi Hospital, Kuwait Oil Company, P. O. Box 9758, Ahmadi 61008
Kuwait
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ed.ed_10_17

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  Abstract 

Background: The Aral Sea problem arises after improper regulation of the water from cross-borders river and heavy application of the pesticides over the cotton fields in the area. Objectives: This review article was designed to highlight the reproductive and health-related hazards of Lindane exposure in Aral Sea area. Methods of Literature Research: PubMed search was done for the articles that have been published from January 2007 to December 2015 using the keywords; Lindane and related health hazards in human. Five articles were found and critically analyzed to highlight the reproductive and health-related hazards of Lindane exposure in Aral Sea area. Results: Men of reproductive age were exposed to organochlorine pesticides (including Lindane), which have estrogenic and antiandrogenic activity, and this exposure may affect the male reproductive health. The human maternal and cord blood levels of hexachlorocyclohexane (HCH) isomers, dichlorodiphenyldichloroethylene, and dichlorodiphenyltrichloroethane were higher in preterm labor than full-term labor cases. Exposure of the human farmers to Lindane may be associated with long-term abnormalities that affect sensory nerves, and short-term abnormalities that affect liver, with reduced hepatic enzymes activity and reduced hepatocyte RNA synthesis. The Lindane level of 61 ± 268 pg/g lipid detected in the newborns in Turkey. Recently; Lindane has been restricted in most countries since 2009 under the Stockholm Convention on Persistent Organic Pollutants. The WHOs International Agency for Research on Cancer reported that the large epidemiological studies in the United States and Canada showed a 60% increased risk of non-Hodgkin lymphoma in agricultural workers, and pesticide applicators exposed to Lindane. Conclusion: Organochlorine pesticides, including Lindane have estrogenic and antiandrogenic activity, which may affect the male reproductive health. The human maternal and cord blood levels of HCH were higher in preterm labor than full-term labor cases. Exposure of the human farmers to Lindane may be associated with long-term abnormalities that affect sensory nerves, and short-term abnormalities that affect liver. Further future studies needed, with screening program of blood levels of Lindane in people living in Aral Sea area to confirm the Lindane health-related hazards, and the use of Lindane should be restricted in the Aral Sea area, if such relation proved.

Keywords: Aral Sea, hazards, health, Lindane, reproductive


How to cite this article:
Balmagambetova A, Abdelazim IA, Zhurabekova G, Rakhmanov S, Bekmukhambetov Y, Ismagulova EK. Reproductive and health-related hazards of Lindane exposure in Aral sea area. Environ Dis 2017;2:70-5

How to cite this URL:
Balmagambetova A, Abdelazim IA, Zhurabekova G, Rakhmanov S, Bekmukhambetov Y, Ismagulova EK. Reproductive and health-related hazards of Lindane exposure in Aral sea area. Environ Dis [serial online] 2017 [cited 2022 Aug 20];2:70-5. Available from: http://www.environmentmed.org/text.asp?2017/2/3/70/216532


  Introduction Top


Aral Sea environmental problem has socioeconomic impacts reflected on the health of the people living in the Aral Sea area and on the sustainable development in the central Asia.[1]

The problem of the Aral Sea reflected directly on Kazakhstan, Uzbekistan, and Turkmenistan [2] [Figure 1].
Figure 1: Aral sea region disaster (Turkmenistan-Kazakhstan-Uzbekistan) and the rivers

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The Aral Sea was one of the largest water pools all over the world until 1960 (426 km long, 284 km wide, and 68 meters' depth), producing 30,000–35,000 tons of fish annually.

In addition, the sea served to protect against sharp weather changes in central Asia.[3],[4] The Aral Sea problem arises in 1960s, after improper regulation of the cross-borders Rivers in the area and heavy application of the pesticides over the cotton fields. Most of the Aral Sea destroyed, converted to lifeless wasteland, and it is estimated that 40,000–60,000 fishermen lost their work [5],[6],[7] [Figure 2].
Figure 2: Aral sea Satellite images (shows Sea reduction in size)

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Cotton field irrigation from the cross-borders Rivers is the main cause behind the Aral Sea destruction with subsequent desertification of the deltas of the cross-borders Rivers.[7]

The heavy application of the pesticides over the cotton fields in the area such as dichlorodiphenyltrichloroethane (DDT) and Lindane (gamma-hexachlorocyclohexane [HCH]) that flew over the workers, and surrounding population brought critical health hazards.[8],[9],[10],[11]

In addition, the Aral Sea area drinking water is below the standards suitable for human consumption.[12],[13] Total dissolved salts and minerals in the Aral Sea water exceed the palatable WHO international standards (1.5 g/L) for the human consumption, and the application of pesticides over the cotton fields in the area is the main cause behind the water contamination.[12],[13]

Due to this environmental disaster, the law of The Republic of Kazakhstan divided the Aral Sea area into the following ecologic.[7]

  1. Area of ecologic catastrophe (Aral, Kazaly, Shalkar)
  2. Area of ecologic crisis (Districts of the Kyzylorda region)
  3. Regions near ecologic crisis (Baiganin, Irgiz, Mugalzhar, Temir).



  Methods Of Literature Research Top


PubMed search was done for the articles that have been published from January 2007 to December 2015 using the keywords; Lindane and related health hazards in human. Five articles were found and critically analyzed to highlight the reproductive and health related hazards of Lindane exposure in Aral Sea area.


  Discussion Top


Toxic substances in pesticides and fertilizers

A lot of toxic chemicals were identified in the pesticides and fertilizers such as organo-phosphate, cadmium, lead, silver, hexachlorobenzene, Dichlorodiphenyldichloroethylene (DDE), polychlorinated biphenyls, Beta-HCH, chlordane, and Aldrin.[14],[15]

In addition, nitrous oxide, carbamate group, Sulfates, DDT, organochlorine, copper, and arsenic residues were detected in the pesticides and fertilizers.[16],[17],[18]

The most toxic chemicals identified in the pesticides and fertilizers are chlorinated hydrocarbons, DDT, DDE, and HCH. Lindane is gamma-hexachlorocyclohexane, and organochlorine pesticide widely applied to the plants or soil as a seed dressing, alone or in combination with fungicides [18] [Figure 3] and [Figure 4].
Figure 3: Chemical composition of Lindane

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Figure 4: Three-dimensional image for chemical composition of Lindane

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Lindane used topically for scabies and ticks' prevention in humans and animals. Lindane is extremely dangerous for humans, exposure to Lindane may occur from eating contaminated food or by breathing contaminated air, then it absorbed from the mucosa of the respiratory and gastrointestinal tracts to the blood, liver, and ovaries.[19],[20]

The reproductive hazards of Lindane

Pagès et al. concluded that Lindane produces irreversible endocrine disruption in rats exposed to residual environmental doses of Lindane during the critical phase of sexual differentiation. Lindane endocrine disruption is induced through alterations of gamete cell membranes such as calcium, potassium exchanges, and free radical-mediated inhibition of steroid-genesis.[21]

Exposure of the developing mice oocytes to Lindane resulted in an irreversible damage and fragmentation of the two-cell stage embryos.[22] Reduced surface area of the endometrium and diminished primordial follicle diameters was observed in pregnant mice exposed to Lindane from 9th to 16th days of gestation.[23]

Alterations in the first meiotic spindle in mice were observed after in vitro exposure to Lindane, decreased maturation rate, and increased degeneration was also observed after bovine in vitro exposure to Lindane.[24],[25]

In addition, exposure to Lindane inhibits the formation of the gap junction between the oocytes and the granulosa cells.[26]

Unfavorable toxic environmental condition adversely affects the women's reproductive ability.[27],[28] Several studies concluded that the chemical pollutants increase the spontaneous abortion rate in women, and high levels of HCH found in women with recurrent miscarriages and birth defects.[29],[30]

Pathak et al. concluded that the human maternal and cord blood levels of HCH isomers, DDE, and DDT were higher in preterm labor than full-term labor cases.[31]

In addition, Balmagambetova et al. concluded decreased ovarian parameters as antral follicle count, ovarian volume, and ovarian blood flow in women living in Shalkar group (ecologic catastrophe area) compared to controls.[27],[28]

Lindane administration in mice at various stages of pregnancy associated with poor endometrium for implantation and fetal death.[32]

Elevated toxic chemicals in the environment associated with reduced ovarian volume, increased follicles atresia, and disturbed gonadotropins secretion.[33],[34],[35],[36]

Carreño et al. determined 14 organochlorine pesticides in the blood of 220 young males in Southern Spain including Lindane. They concluded that men of reproductive age were exposed to organochlorine pesticides (including Lindane), which have estrogenic and antiandrogenic activity, and this exposure may affect the male reproductive health.[37]

The hepatotoxic hazards of Lindane

Zucchini-Pascal et al. found that the experimental rats' exposure to Lindane associated with formation of acidic vesicles in the liver, inhibition of apoptosis, and induction of carcinogenesis.[20]

Vijaya et al. concluded that Lindane induces hepatic and renal cells damage, and this damage was detected by the elevated liver and renal markers (aspartate transaminase and creatinine, respectively) and by the histopathological examination.[38]

Devendra et al. found that the isocitrate dehydrogenase, succinate dehydrogenase, and malate dehydrogenase enzymatic activity declined 2 months after exposure to Lindane. In addition, they found that the neoplastic nodules and tumors developed 4–6 months in mice after of exposure to Lindane.[39]

Ruifa et al. concluded that exposure of the human farmers to Lindane may be associated with long-term abnormalities that affect sensory nerves, and short-term abnormalities that affect liver, with reduced hepatic enzymes activity, reduced hepatocyte RNA synthesis, and renal functions.[40]

Sauviat et al. found that Lindane exerts immunologic, teratogenic, and/or carcinogenic effects. High doses of Lindane are toxic to the human nervous system and reproductive systems. Lindane disturbs the metabolic pathway in the mitochondria of the liver and the nerve cells' inositol phosphate pathway and produces endocrine disruption.[41] Lindane inhibits the intercellular gap junctions and produces electrocardiogram changes such as those produced by hyperkalemia.[41]

The effect of the toxins on children health

Jensen et al. found elevated DDT concentration 20 times with high concentration of beta-isomer of HCH in the child's blood referred from Aral Sea area.[36]

Zetterström found that long-term exposure and presence of high concentration of pesticides in the breast milk associated with child's chronic disorders and physical retardation.[42]

Crighton et al. studied the effect of environmental perceptions on the human health in Aral Sea area and reported that the environmental concern is one of the factors, which negatively associated with retarded human health in the Areal Sea area.[43]

Erdinger et al. found that the DDE contamination of the children from Aral Sea cities (Aralsk [2.48 mg/L] and Akchi [1.35 mg/L]) was significantly higher than the German reference value (0.7 mg/L).[44]

As results of poor environmental conditions, anemia, tuberculosis, and infectious respiratory tract diseases are prevalent in Aral Sea area.[45]

Eighty-Seven percent of newborns in Uzbekistan are anemic with subsequent risk for weak immune systems and brain hypoxia following untreated anemia.[44]

Recently, UlutaŞ et al. stated that the first exposure to organic pollutants (OPs) takes place in utero and/or with mothers' milk after delivery, and a Lindane level of 61 ± 268 pg/g lipid detected in the newborns in Turkey.[46]

Lindane and cancers

Recently, Lindane has been restricted in most countries since 2009 under the Stockholm Convention on Persistent Organic Pollutants.[47] The WHO's International Agency for Research on Cancer (IARC) reported that the large epidemiological studies in the United States and Canada showed a 60% increased risk of non-Hodgkin lymphoma in agricultural workers, and pesticide applicators exposed to Lindane.[47]

International projects in Aral Sea area

Several projects were carried out to protect the Aral Sea environment and to prevent health-related hazards. The Aral Sea Project for Environmental and Regional Assistance program implemented by the Turkish Administration of Cooperation and Development, which was carried out in Kazakhstan (Kyzlorda region), Turkmenistan, and Uzbekistan and directed toward mother and children's health, nourishment, primary education, water supply, and sanitation.

From 1996 to 1999, a World Bank project was directed to the water supplied to the people living in the Aral Sea area; similarly, the projects of Kazakhstan Canadian Security Identification Display Area were directed to the water supplied to the people living in Aralsk and Kyzlorda.[48]

A recent program was implemented by International Fund of Aral Saving together with United Nation Organizations and World Bank from 2011 to 2015 to solve common socioeconomic problems in the regions of Aral Sea disaster.[48]

The only limitation faced during conduction of this article was the limited number of human studies on Lindane-related health hazards. To the best of our knowledge, this is the first review article done to highlight the human health-related consequence of using Lindane in Aral Sea area, and further future studies needed with screening program of blood levels of Lindane in people living in Aral Sea area including the newborns and children to confirm the Lindane health-related hazards, and the use of Lindane should be restricted in the Aral Sea area, if such relation proved.


  Results Top


Men of reproductive age were exposed to organochlorine pesticides (including Lindane), which have estrogenic and antiandrogenic activity, and this exposure may affect the male reproductive health. The human maternal and cord blood levels of hexachlorocyclohexane (HCH) isomers, dichlorodiphenyldichloroethylene, and dichlorodiphenyltrichloroethane were higher in preterm labor than full-term labor cases. Exposure of the human farmers to Lindane may be associated with long-term abnormalities that affect sensory nerves, and short-term abnormalities that affect liver, with reduced hepatic enzymes activity and reduced hepatocyte RNA synthesis. The Lindane level of 61 ± 268 pg/g lipid detected in the newborns in Turkey. Recently; Lindane has been restricted in most countries since 2009 under the Stockholm Convention on Persistent Organic Pollutants. The WHOs International Agency for Research on Cancer reported that the large epidemiological studies in the United States and Canada showed a 60% increased risk of non-Hodgkin lymphoma in agricultural workers, and pesticide applicators exposed to Lindane.


  Summary and Conclusion Top


Organochlorine pesticides, including Lindane, have estrogenic and antiandrogenic activity, which may affect the male reproductive health. The human maternal and cord blood levels of HCH were higher in preterm labor than full-term labor cases. Exposure of the human farmers to Lindane may be associated with long-term abnormalities that affect sensory nerves and short-term abnormalities that affect liver. Recently, Lindane has been restricted in most countries since 2009 under the Stockholm Convention on Persistent Organic Pollutants. The WHO's IARC reported that the large epidemiological studies in the United States and Canada showed a 60% increased risk of non-Hodgkin lymphoma in agricultural workers, and pesticide applicators exposed to Lindane.

Further future studies needed with screening program of blood levels of Lindane in people living in Aral Sea area including the newborns and children to confirm the Lindane health-related hazards, and the use of Lindane should be restricted in the Aral Sea area, if such relation proved.

Acknowledgment

Authors are grateful to West Kazakhstan Medical University for the continuous support during production of this report.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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