ñòàòò³ ïðèâåäåí³ ðåçóëüòàòè äîñë³äæåíü âîäè äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ çà 2021 ð³ê ç âèçíà÷åííÿì êîíöåíòðàö³¿ í³òðàò³â. Ïîêàçàíî íåãàòèâíèé âïëèâ í³òðàò³â íà ñòàí çäîðîâ’ÿ ä³òåé ðàííüîãî â³êó. Íàì³÷åí³ øëÿõè âèð³øåííÿ ïðîáëåìè çàáðóäíåííÿ äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ í³òðàòàìè.
Ìåòà äîñë³äæåíü: âèâ÷èòè ôàêòè÷íó êîíöåíòðàö³þ í³òðàò³â ïèòíî¿ âîäè äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ ç ìåòîþ âñòàíîâëåííÿ ê³ëüê³ñíî¿ îö³íêè ðèçèêó äëÿ çäîðîâ’ÿ ä³òåé ðàííüîãî â³êó.
Ïåðñïåêòèâíèì ï³äõîäîì âèð³øåííÿ ïðîáëåìè º êîìïëåêñíèé ï³äõ³ä ñòâîðåííÿ åï³äåì³îëîã³÷íî¿ ñèñòåìè (ìîí³òîðèíãó) îõîðîíè çäîðîâ’ÿ ä³òåé ðàííüîãî â³êó â³ä íåãàòèâíîãî âïëèâó í³òðàò³â ïèòíî¿ âîäè äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ, ÿê îñíîâíîãî áàçîâîãî äæåðåëà ¿õ íàäõîäæåííÿ â îðãàí³çì, ³ â ïåðøó ÷åðãó â îðãàí³çì âàã³òíèõ æ³íîê òà ä³òåé äî òðüîõ ðîê³â, à â ïîäàëüøîìó ³ ä³òåé äî 6 ðîê³â.
Îá’ºêò ³ ìåòîäè äîñë³äæåíü. Îá’ºêòîì äîñë³äæåííÿ º ïèòíà âîäà äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ.
Ìåòîäè äîñë³äæåííÿ – çàãàëüíîïðèéíÿò³.
Ðåçóëüòàòè äîñë³äæåííÿ òà ¿õ îáãîâîðåííÿ. Ó 2021 ðîö³ äîñë³äæåíî 925 ïðîá âîäè äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ ç ÿêèõ ó á³ëüøå, ÿê 30% âèÿâëåíà êîíöåíòðàö³ÿ í³òðàò³â âèùå íîðìàòèâó.
³äïîâ³äíî äî âèìîã ÄÑàíÏ³Í 2.2.4-171-10 «Ã³ã³ºí³÷í³ âèìîãè äî âîäè ïèòíî¿, ïðèçíà÷åíî¿ äëÿ ñïîæèâàííÿ ëþäèíîþ» äîïóñòèìà êîíöåíòðàö³ÿ í³òðàò³â â ïèòí³é âîä³ ñòàíîâèòü 50 ìã/äì3. Äîïóñòèìà äîáîâà äîçà (ÄÄÄ) í³òðàò³â äëÿ äîðîñëî¿ ëþäèíè âñòàíîâëåíà íà ð³âí³ 5 ìã/êã/äîáó, à äëÿ ä³òåé ðàííüîãî â³êó â³äïîâ³äíî 2,5 ìã/êã/äîáó [11].
ÄÄÄ äëÿ ä³òåé ìîëîäøèõ â³êîâèõ ãðóï ñòàíîâèòü: íîâîíàðîäæåíèõ ä³òåé – 9,45 ìã/äîáó, ä³òåé 6-12 ì³ñÿö³â – 45ìã/äîáó, ä³òåé 1-3 ðîê³â – 56,88 ìã/äîáó, ä³òåé 4-6 ðîê³â 141,25 ìã/äîáó [1].
Ðàçîì ç òèì, â³äì³÷àºòüñÿ ôàêòè÷íå ïåðåâèùåííÿ äîáîâîãî íàâàíòàæåííÿ í³òðàò³â äëÿ ä³òåé ðàííüîãî â³êó, ùî çíàõîäÿòüñÿ íà øòó÷íîìó ãîäóâàíí³ ïðè êîíöåíòðàö³¿ í³òðàò³â â ïèòí³é âîä³ íà ð³âí³ ã³ã³ºí³÷íîãî íîðìàòèâó, òîáòî 50 ìã/äì3. Íàïðèêëàä, äèòèíà ïåðøîãî ì³ñÿöÿ æèòòÿ ç ñòàíäàðòíîþ âàãîþ 3,5 êã, ÿêà çíàõîäÿòüñÿ íà øòó÷íîìó ãîäóâàíí³, îòðèìóº õàð÷îâèõ ïðîäóêò³â 1/5 ñâ âàãè. Òîáòî, çà äîáó âîíà ñïîæèâຠ700 ìë ïèòíî¿ âîäè, ³ ò³ëüêè ç âîäîþ, îòðèìóº í³òðàòíå äîáîâå íàâàíòàæåííÿ â ê³ëüêîñò³ 35 ìã, ùî ïåðåâèùóº äîïóñòèìå â 3,7 ðàç³â. Îñîáëèâî íåáåçïå÷íå í³òðàòíå íàâàíòàæåííÿ äëÿ íåäîíîøåíèõ ä³òåé, çà ðàõóíîê çìåíøåííÿ âàãè äèòèíè òà ³í.
Âèñíîâêè.
1. Ðîçðîáèòè ìåòîäîëîã³÷í³ ï³äõîäè ñòâîðåííÿ òà ñòâîðèòè ìåäèêî-åï³äåì³îëîã³÷íó ñèñòåìó îõîðîíè çäîðîâ’ÿ äëÿ ä³òåé äî òðüîõ ðîê³â, âàã³òíèõ æ³íîê òà ä³òåé äî 6 ðîê³â â³ä íåãàòèâíîãî âïëèâó í³òðàò³â âîäè äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ.
2. Îòðóºííÿ ä³òåé ðàííüîãî â³êó ñë³ä ðîçãëÿäàòè, ÿê íàäçâè÷àéíó ñèòóàö³þ òà ÿê çàãðîçó äëÿ ¿õ çäîðîâ’ÿ òà æèòòÿ.
3. Ðîçðîáèòè íîðìàòèâ í³òðàò³â ó âîä³ äëÿ ä³òåé ðàííüîãî â³êó.
4. Âèâ÷èòè ïèòàííÿ ùîäî â³äíîøåííÿ äî ä³òåé ðàííüîãî â³êó ä³òåé äî 6 ðîê³â.
5. Âæèòè çàõîäè ùîäî çàáåçïå÷åííÿ ä³òåé ðàííüîãî â³êó, ÿê³ çíàõîäÿòüñÿ íà øòó÷íîìó ãîäóâàíí³ äîáðîÿê³ñíîþ ïèòíîþ âîäîþ,
6. ʳëüê³ñíó îö³íêó ðèçèêó äëÿ çäîðîâ’ÿ ä³òåé ðàííüîãî â³êó íåîáõ³äíî âèâ÷àòè, ÿê íà ïîïóëÿö³éíîìó òàê ³ íà ³íäèâ³äóàëüíîìó ð³âíÿõ.
7. Ïîñò³éíî ïðîâîäèòè ìîí³òîðèíã çà ñòàíîì ï³äçåìíèõ äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ
8. Ïîñò³éíî ïðîâîäèòè ñàí³òàðíî îñâ³òíþ ðîáîòó ç íàñåëåííÿì òåðèòîð³àëüíèõ ãðîìàä, îðãàíàìè âëàäè.

ͳòðàòè, âîäà ïèòíà, çäîðîâ’ÿ, ä³òè ðàííüîãî â³êó, ñèñòåìè.

1. Chornyy VI, Sherman BS, Grebnyak NP, Kolesnikov AN., Fedorenko AYu. [Prophylaxis and intensive therapy of acute intoxications of children and adolescents]. Kyiv-Donetsk; 2007. 1010 p. Russian.

2. Samotuha VV, Bondarenko YuH. [Ecological-hygienic assessment of the total intake of nitrates from drinking water and food products into the human body]. In: [Actual Issues of Hygiene and Ecological Safety of Ukraine. Collection of Report Abstracts]. Kyiv; 2010:120-3. Ukrainian.

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5. Samotuha VV, Bondarenko YuH, Papach VV, Tyshchuk MM, Khomenko IV, Tereshchenko VH. [Medical and ecological characteristics of the source of water supply in Cherkasy]. In: [XIII Congress of the World Federation of Ukrainian Medical Societies. Collection of Report Abstracts]. Lviv; 2010:657-8. Ukrainian.

6. Bondarenko YuH. [Hygienic assessment of the total intake of nitrates with food products and drinking water in the body of young children]. [Abstract of the Dissertation]. Kyiv: Institute of Occupational Medicine of the Medical Academy of Ukraine; 1994. 23 p. Ukrainian.

7. Bondarenko YuH, Khomenko IV, Bilyk LI, Zahoruiko NV. [Medical-ecological assessment of the centralized source of water supply in Cherkasy]. Environment and Health, 2010;3:30-5. Ukrainian.

8. [National Standard of Ukraine. Water quality. Determination of nitrate Part 1. Spectrometric method using 2,6 dimethylphenol]. (ISO 7890-1:1986, IDT) DSTU ISO 7890-1:2003. Ukrainian.

9. [National Standard of Ukraine. Water quality. Determination of nitrate Part 2. Spectrometric method using distilled 4-fluorophenol]. (ISO 7890-2:1986, IDT) DSTU ISO 7890-2:2003. Ukrainian.

10. [National standard of Ukraine. Water quality. Determination of nitrate Part 3. Spectrometric method using sulphacylic acid]. (ISO 7890-3:1988, MOD) DSTU 4078-2001. Ukrainian.

11. [State sanitary norms and rules 2.2.4-171-10 «Hygienic requirements for drinking water intended for human consumption»]. Kyiv: Ministry of Health of Ukraine, Pub. L. No. 400-99 (May 12 2010). Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/z0452-10#Text

Áîíäàðåíêî Þ.Ã., Òèùóê Ì.Ì. Ìåäèêî-åêîëîã³÷íà îö³íêà âïëèâó í³òðàò³â âîäè äåöåíòðàë³çîâàíèõ äæåðåë âîäîïîñòà÷àííÿ íà ñòàí çäîðîâ’ÿ ä³òåé ðàííüîãî â³êó â ×åðêàñüê³é îáëàñò³ çà 2021 ð³ê. ó㳺íà íàñåëåíèõ ì³ñöü : çá. íàóê. ïð. Ê., 2022. Âèï. 72. Ñ. 23-29.