Introduction. At present, incidence of musculoskeletal diseases is growing in children, especially in areas with poor quality of the environment

The purpose of the study was to identify markers of the development of musculoskeletal pathology in children to minimize the risk of health under conditions of exposure to emissions from a non-ferrous metal alloy production plant.

Materials and methods. We performed clinical examination in four hundred ninety five 5 and 7 years children (54.3% boys and 45.7% girls). They lived in a large industrial center where safe standards for chemical in ambient air were violated per aluminum (up to 3.06 average daily MPL) and gaseous fluorides (up to 8.25 average daily MPL). Also, we examined 95 children (57.9% boys and 42.1% girls) who lived in an area where the foregoing chemicals were detected in ambient air in levels not exceeding 0.3–0.54 average daily MPL. The children were examined by pediatrician. Levels of aluminum and fluoride-ion were determined in urine. We examined phosphor-calcium metabolism indices and markers of bone tissue synthesis and resorption. The study also involved performing ultrasound densitometry.

Results. The children form the observation group had aluminum and fluoride-ion levels in their urine up to 3.2 times a higher than their peers from the reference group. Likelihood of musculoskeletal pathology, including deforming dorsopathy, was found to be up to 1.3 times higher for the exposed children. Bone metabolism failure manifested itself in the exposed children through elevated levels of ionized calcium in blood; elevated levels of N-osteocalcin in 25.4% of the exposed children and elevated activity of tartrate-resistant acid phosphatase in 59.3%. Bone marrow resorption was by 9.2 times more likely to be activated in the exposed children from a large industrial center. Impaired bone tissue remodelling was accompanied with lower bone mineral density in 54.7% of the exposed children.

Limitations. The study was conducted on 5–7 years children.

Conclusion. Markers of bone tissue metabolism disorders can be used to implement sanitary-epidemiological and medical-preventive measures to reduce the risk of developing osteopathic conditions in childhood.

Compliance with ethical standards. The clinical examination was performed in accordance with the ethical principles of the Helsinki Declaration of the World Medical Association (as amended in 2013) and the National Standard of the Russian Federation GOST R 52379-2005 “Good Clinical Practice” (ICH E6 GCP), approved by the Ethics Committee of the Federal State Budgetary Institution “FNC MPT URZN” (Protocol No. 2, 2017). Legal representatives signed a voluntary informed consent to the examination of children.

Contribution: Maklakova O.A. – study concept and design, data collection and analysis, statistical analysis, writing and editing the text; Ustinova O.Yu. – study concept and design, editing the text; Valina S.L. – data collection and analysis, editing the text. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: August 12, 2024 / Revised: September 9, 2024 / Accepted: November 19, 2024 / Published: December 17, 2024