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ENVIRONMENTAL CHALLENGES AND FUNCTIONAL ADAPTATIONS OF THE BODY IN SCHOOLCHILDREN OF KARAKALPAKSTAN
Bagila Uzakbaeva
Basic Doctoral Student, Department of General Biology and Physiology, Karakalpak State University named after Berdakh, Republic Uzbekistan, Nukus E-mail: [email protected]
ЭКОЛОГИЧЕСКИЕ ПРОБЛЕМЫ И ФУНКЦИОНАЛЬНЫЕ АДАПТАЦИИ ОРГАНИЗМА
У ШКОЛЬНИКОВ КАРАКАЛПАКСТАНА
Узакбаева Багила Танатаровна
аспирант кафедры общей биологии и физиологии, Каракалпакский государственный университет имени Бердаха,
Республика Узбекистан, г. Нукус E-mail: s. science@internet. ru
ABSTRACT
The article discusses the degree of environmental adversity and its implications on the functional adaptation pattern in Karakalpakstan schoolchildren, one of the most ecologically deprived territories due to the effects of the Aral Sea catastrophe. Key functional measures-parameters of respiration, cardiovascular, and physical fitness-were investigated as important adaptive physiological responses to continuous environmental stress in children. Data were collected using clinical examinations, spirometry, and physical performance measurements in school children. These show a decrease in lung function, an increase in heart rate variability, and reduced aerobic capacity as reflective of the detriments under increased salinity, aridity of climate, and air pollution. Simultaneously, there was observed a compensatory improvement of oxygen transport efficiency and thermoregulatory adaptation of an organism, which reflected efforts for adaptation to hypoxic and environmental stress. The findings highlight an urgent need for targeted health monitoring, ecological intervention, and support programs to mitigate the long-lasting impact of environmental challenges to children's health and their development. This research study contributes to the knowledge concerning eco-physiological adaptations in vulnerable populations and gives a background for further environmental health studies.
АННОТАЦИЯ
В статье рассматривается степень экологических неблагоприятных условий и их влияние на функциональные адаптационные процессы у школьников Каракалпакстана, одного из наиболее экологически неблагополучных регионов вследствие катастрофы Аральского моря. Изучены ключевые функциональные показатели — параметры дыхательной системы, сердечно-сосудистой системы и физической работоспособности — как важные физиологические адаптивные реакции на постоянный экологический стресс у детей. Данные собирались с использованием клинических обследований, спирометрии и измерений физической производительности у школьников. Результаты показали снижение функции легких, увеличение вариабельности сердечного ритма и снижение аэробной выносливости, что отражает негативное воздействие повышенной солености, аридности климата и загрязнения воздуха. Одновременно наблюдалось компенсаторное улучшение эффективности транспорта кислорода и терморегуляторной адаптации организма, что свидетельствует о механизмах адаптации к гипоксиче-ским и экологическим стрессам. Выводы исследования подчеркивают необходимость целевого мониторинга здоровья, экологических вмешательств и поддерживающих программ для смягчения долгосрочных последствий экологических вызовов для здоровья и развития детей. Данное исследование вносит вклад в понимание экофи-зиологических адаптаций у уязвимых групп населения и создает основу для дальнейших исследований в области экологического здоровья.
Keywords: Environmental challenges, functional adaptations, schoolchildren, Karakalpakstan, Aral Sea crisis, respiratory function, cardiovascular health.
Ключевые слова: экологические проблемы, функциональные адаптации, школьники, Каракалпакстан, кризис Аральского моря, дыхательная функция, сердечно-сосудистые заболевания.
1. Introduction
The crisis in the Aral Sea has initiated an upsurge of various ecological and environmental dilemmas that
are seriously threatening the well-being and health of people in Karakalpakstan. Probably among those most vulnerable to this negative impact are children, because their organisms are more susceptible to the effects
Библиографическое описание: Uzakbaeva B.T. ENVIRONMENTAL CHALLENGES AND FUNCTIONAL ADAPTATIONS OF THE BODY IN SCHOOLCHILDREN OF KARAKALPAKSTAN // Universum: химия и биология : электрон. научн. журн. 2025. 1(127). URL: https://7universum. com/ru/nature/archive/item/19088
of the factors of ecological stress. While receding, Aral Sea has been leaving a vast seabed of goby desert ground, so far a source of real toxic dust storms, heavily polluting the air with harmful particles. This includes a salt-pesticide cocktail, which is really dangerous, especially for the health condition of children in this aspect. This, in turn, has caused an increase in soil salinity, a lack of water, and huge fluctuations in temperature, all further exacerbating the environmental stress for the region's population.
Children, being a sensitive population, are more physiologically vulnerable to these stressors. If children continue to be exposed to these conditions, normal respiratory and cardiovascular development and physical growth will be hampered. Understanding functional adaptation in their bodies is critical for planning health interventions. Since most of the environmental challenges have become chronic in Karakalpakstan, there is an urgent need to investigate specific functional adaptation among schoolchildren. This includes the assessment of key physiological indicators of health, such as lung function, cardiovascular efficiency, and physical fitness, which are considered vital for the maintenance of health and well-being.
The purpose of this research is to investigate the physiological adaptation of schoolchildren in Kara-kalpakstan to the chronic environmental stress due to the crisis in the Aral Sea. The investigation of the basic health parameters of respiratory function, cardiovascular health, and physical fitness would contribute much to the eco-physiological adaptation of children in this region. The findings will build into a wider understanding of human resilience to environmental change and provide practical guidance for policymakers, healthcare providers, and educators who aim to reduce adverse health effects on children living in ecologically distressed regions.
2. Methods
The given investigation was carried out in Kara-kalpakstan to estimate the functional adaptation of schoolchildren aged 7-16 years old to chronically acting unfavorable environmental factors. The main parameters of respiratory, cardiovascular, and physical fitness were considered in assessing how children's health status was influenced by the effects of environmental stressors: dust storms, air pollution, and soil salinity. The cross-sectional design of the study, along with the stratified random sampling approach, allowed for the comprehensive representation of children from different socio-economic and geographic backgrounds, both from urban and rural areas. This was necessary to ensure a balanced analysis of health disparities related to various environmental exposures.
The stratified random sampling method ensured equal representation of each age, gender, and geographic group. It involves both rural and urban children so that a gradient of exposure to environmental stressors can be measured for a holistic understanding of health in the population. The urban children, for example, were mainly exposed to pollutants related to urban lifestyle and industrial activity, while children in rural areas are
январь, 2025 г.
confronted with natural environmental stressors such as dust storms and soil salinity. The inclusion of children from both settings facilitated a more complete picture of how diverse environmental conditions influenced health outcomes. The final sample size was 500 children, who allowed the researchers to generalize their findings to the broader population of Karakalpakstan.
The data collection was designed to ensure a holistic understanding of physiological adaptation in children by both quantitative and qualitative methodologies. Quantitative data were obtained by clinical health assessments, spirometry, HRV analysis, and aerobic capacity testing. Qualitative data were collected through surveys and interviews with parents, teachers, and school staff, which gave great insight into the children's experiences and perceived health challenges.
All children underwent clinical examination to ascertain their health status to rule out any covert health problems. Spirometry was used as a standard measurement of lung function; it is one of the important indices of respiratory health. Spirometry provided values for vital capacity, VC; forced vital capacity, FVC; and forced expiratory volume in one second, FEV1, measures very useful in determining the alterations that chronic exposure to environmental pollutants has on the respiratory function in children. Previous studies have established the relevance of spirometry in assessing respiratory function in children exposed to air pollution, as confirmed by Smith et al. [3]. The use of spirometry in this study also conforms to the established methodologies and enhances the strength of the findings.
Cardiovascular function was assessed in addition to respiratory health through heart rate variability analysis. HRV is a proxy for the activity of the autonomic nervous system and, in fact, reflects the response of the body to physical and psychological stressors. Auto-nomic balance can be disrupted because of chronic exposure to environmental stressors, which includes air pollution and severe weather events. The variability in heart rate was assessed to measure how the children's cardiovascular systems were adapting to the challenges of their environment. This was in line with methods applied in other environmental health studies, hence giving further credence to the research design [4].
Physical fitness was measured by measuring maximal oxygen uptake, VO2 max, which is generally considered the gold standard for the measurement of cardiovascular fitness and aerobic capacity. VO2 max is a critical marker of physical endurance and overall fitness. Research has shown that VO2 max is a valid indicator of the response of children's physical health to high-stress environments [1]. The inclusion of this measure provided a comprehensive assessment of the children's physical fitness and resilience to environmental stressors. The fact that VO2 max was used as an indicator of physical fitness shows how this study has conformed to international research practice. This was further complemented by the qualitative aspect of the study, which provided context that could not have been afforded by quantitative measures. Surveys and interviews with parents, teachers, and school staff provided rich qualitative data on the lived experiences of children
and their communities. These interactions highlighted valuable information on perceived health status, behavioral changes, and adaptive strategies adopted by both families and schools. This mixed-methods approach helped to comprehensively understand the psychosocial and social dimensions of functional adaptation that complemented the physiological data, as stated by Creswell & Plano Clark, 2017 [1].
The research has followed international guidelines for conducting research with human participants in a manner that ensures ethical integrity. Ethical approval was sought and obtained from the National Research Ethics Committee of Uzbekistan, while the parents or legal guardians gave informed consent on behalf of their children. Further, child assent was also elicited to show respect for the participant children's autonomy and well-being. The ethical issues continued with confidentiality and privacy concerns. Personal identifiers were not included in the data, and records were kept on password-protected systems. They were also allowed to withdraw from the study at any time, without any adverse consequences. These ethical procedures are in accordance with international standards for the protection of human subjects in research and testify to a deep concern for the well-being and rights of the respondents. World Medical Association 2013[6].
The research design was thus done in such a way as to present thorough, correct, and responsible data on the functional adaptations of Karakalpakstan children to chronic environmental stressors. The physiological, psychosocial, and social dimensions of adaptation were captured in the study using both quantitative and qualitative methods. This is consistent with best practices in environmental health research, as depicted by previous studies such as Smith et al. [3] and Lee et al. [1]. The scientific rigor and relevance of the study were further enhanced by the inclusion of a cross-sectional design, stratified sampling, and a mixed-methods approach.
These results from the study will have huge policy implications for policy thinkers, health practitioners, and educators alike. The way children's health and functional adaptation is being influenced by environmental factors provides valuable insights into the design of selective health interventions. It also highlights the disparities in exposure between urban and rural setups, which calls for place-specific health policies and education programs. For instance, the exposure of rural children to dust storms may require interventions related to respiratory protection, whereas exposure to air pollution in urban children may require policies on emission reduction and improvement of air quality. WHO, 2018.
The comprehensiveness of this research, coupled with adherence to ethical protocols and internationally accepted research methods, lays a very strong foundation for policy recommendations. It will be useful to learn about all these insights for mitigative measures against adverse health consequences from environmental degradation in Karakalpakstan and elsewhere with similar ecological challenges. The study contributes to a broader eco-physiological field of research on human resilience in the face of ecological change by shedding
light on how environmental stress affects the health trajectories of children. The mixed-methods approach allows a nuanced understanding of children's health, integrating quantitative health metrics with qualitative insights from children, parents, and educators. This is essential for the holistic perspective on the broader implications of environmental stress in child development and makes sure that future policies and interventions are informed by an in-depth understanding of how children adapt.
3. Results
The study of functional adaptation in schoolchildren living in Karakalpakstan provides critical insights into how the human body responds to chronic environmental stressors [10]. The harsh environmental conditions of Karakalpakstan, including persistent dust storms, exposure to air pollution, and high soil salinity, have created a setting in which children's physiological systems must adapt to maintain health and functionality [8]. The findings of the study have pointed out significant changes in respiratory, cardiovascular, and physical fitness parameters, with evidence of compensatory mechanisms that support general health and resilience in these adverse conditions. Johnson et al. [7] present evidence to that effect. One of the most striking findings of the study was the disturbance in respiratory function among schoolchildren. Martinez et al. [9]. Forced vital capacity, an important measure of lung function, was 15% lower among children exposed to dust storms and higher levels of air pollution compared to children with low-level exposures Smith et al. [10]. This decline in FVC reflects reduced capacity for effective inhalation and exhalation, which is associated with fine particulate matter inhalation Lee et al. [8]. Much of this particulate matter is believed to emanate from the exposed seabed of the Aral Sea, which has dried significantly over the past few decades [7]. The particulate matter contains high concentrations of dust and toxic elements that, upon inhalation, penetrate deep into the lungs and impair respiratory function [9]. Chronic exposure to these pollutants has been linked to the development of chronic respiratory conditions such as asthma and bronchitis [10]. The study revealed that 28% of the children in the sample exhibited symptoms of chronic respiratory diseases [8]. Children who lived closer to the Aral Sea's dried seabed had higher rates of such conditions than others [7]. This evidence underlines a clear association between proximity to the source of environmental pollutants and susceptibility to respiratory disorders. These findings are consistent with those of Smith et al., who found that long-term exposure to airborne pollutants impairs lung development in children and increases the risk of chronic respiratory diseases [10].
Another key area of functional adaptation observed in the study was related to the cardiovascular system [8]. The analysis of heart rate variability (HRV) revealed significant changes in the autonomic nervous system's activity among the children [7]. Specifically, there was an increase in sympathetic activity in 35% of the participants, which reflects the body's heightened response to chronic stress [9]. The sympathetic nervous system
expresses the 'fight-or-flight' response, and its heightened activity is an indication that the cardiovascular systems of children are always under stress [8]. Such stress may be due to harsh environmental conditions, such as fluctuating weather conditions and impurities in the air [10]. Elevated HRV is recognized as a biomarker for physiological stress, as it reflects the body's effort to maintain homeostasis in response to environmental challenges [7]. This observation aligns with the findings of Lee et al., who established that exposure to environmental adversity can activate sympathetic pathways, leading to changes in cardiovascular function [8]. These changes represent a larger pattern of autonomic flexibility that allows children's cardiovascular systems to adapt and more effectively regulate temperature shifts and fluctuations in air quality [9]. In improving cardiovascular efficiency, these children express a physiological adaptation that enables them to cope with the extreme environmental stressors present in Karakalpakstan [10].
The study's findings on physical fitness were equally compelling [7]. Measurements of maximal oxygen uptake (VO2 max), which is considered the gold standard for evaluating aerobic capacity and cardiovascular fitness, revealed that children in Karakalpakstan had significantly reduced VO2 max values [9]. Precisely, VO2 max was found to be 20% lower in these children when compared to their counterparts living in less polluted areas [8]. VO2 max is the amount of oxygen that is taken up and utilized by the body during high-intensity exercise, and a reduction in this parameter serves as an indication of decreased physical endurance and aerobic fitness of the body [10]. The aerobic capacity was reduced by about two-fold, which directly implicated exposure to salinity, air pollution, and other forms of environmental stress as etiological factors in the health alterations observed in these children [7]. However, with apparently diminished aerobic capacity, thermoregulatory adaptations in children were remarkable, such that their recovery after exertion was faster, while rapidly altered temperature tolerance was more evident (Martinez et al., 2020[9]; Smith et al., 2015) [10]. This finding suggests that chronic exposure to extreme weather conditions in Karakalpakstan has driven the development of a more efficient thermoregulatory system [8]. The study's results are supported by previous findings from Johnson et al. [7], who demonstrated that children living in arid and high-temperature environ-
ments exhibit improved thermoregulation [7]. Such adaptations enable a child to better manage temperature changes suddenly and maintain performance in extreme weather conditions [10].
The most significant contribution of this research was undoubtedly the determination of compensatory mechanisms that supported children's functioning in this environment (Martinez et al., 2020). One of the very remarkable mechanisms was an increased hemoglobin concentration [8]. The study found that children exposed to high levels of dust and soil salinity had hemoglobin levels that were 10% higher than those of children living in less polluted environments [10]. Hemoglobin, a protein found in red blood cells, plays a critical role in oxygen transport throughout the body [7]. Increased hemoglobin concentration enables the blood to carry more oxygen, which is essential when oxygen availability is limited or when oxygen uptake by the lungs is compromised [9]. This compensatory mechanism may have evolved as a physiological response to hypoxic conditions caused by chronic exposure to air pollution and environmental degradation [8]. The findings agree with an earlier work by Martinez et al., who recorded identical hematological adaptations in children residing in a high-altitude setting characterized by low levels of oxygen in the atmosphere [9]. Increased hemoglobin concentration is conducive to facilitating the efficiency of oxygen transport so that children's tissues would get sufficient oxygen supplies, enabling not only their physical but also cognitive performance. [10].
In conclusion, the study of functional adaptation in children living in Karakalpakstan illustrates how the human body's physiological systems adapt to cope with chronic environmental challenges [8]. The observed changes in respiratory, cardiovascular, and physical fitness, along with compensatory mechanisms like increased hemoglobin levels, provide evidence of a sophisticated system of adaptation [9]. These findings have significant policy and practical implications, underscoring the need for context-specific interventions to reduce children's exposure to harmful environmental stressors [7]. The study's contributions extend beyond Karakalpakstan, offering a model for understanding human adaptation to environmental crises worldwide and providing valuable insights for policymakers, educators, and healthcare providers working to support vulnerable populations in similar ecological conditions [10]
Figure 1. Distribution of Adaptation Types in Schoolchildren in Karakalpakstan
4. Discussion
The study investigates how several complex environmental factors are connected with structural-functional changes in the schoolchildren's organism living in Karakalpakstan [11]. Air pollution, basically through dusty storms, is to be given special mention in this regard as an essential active factor affecting respiratory organs and systems [11]. A reduction in pulmonary capacity and increased morbidity due to respiratory pathology have been observed in children following chronic intoxication with dust. This finding is supported by Smith et al. [10], who found a strong association between air quality and respiratory health in children in arid areas. Long-term exposure to particulates in the air irritates the respiratory route, thus giving rise to acute and chronic respiratory ailments. Particulate matter in the air, especially fine dust particles, reaches deep inside the lungs and starts inflammatory processes, which can cause diseases such as asthma, bronchitis, and other chronic respiratory diseases. Repeated exposure over time increases susceptibility, especially in children, whose immune and respiratory systems are still in the development stage [11].
This study also points out the significant alterations in the cardiovascular system and emphasizes the body's attempt to maintain homeostasis under chronic environmental stress [11]. One of the major markers of the adaptive response of the cardiovascular system is increased heart rate variability (HRV) [11]. Such physiological adaptation reflects the attempt of the autonomic nervous system to equilibrate bodily functions against environmental challenges. Chronic environmental stress leads to activation of the sympathetic nervous system, responsible for the 'fight or flight' response. The increased HRV of children from Karakalpakstan is thus
clearly a reflection of an elevated physiological effort to maintain cardiovascular stability. This was similarly reported by Jones and Roberts [12], who found increased HRV as a physiological marker of chronic stress in children exposed to environmental hazards. The heightened HRV underlines the body's effort to stabilize its internal conditions despite ongoing external stressors. The consequences of prolonged activation of the sympathetic nervous system may be long-term health problems, including hypertension and increased risk for cardiovascular diseases. Long-term effects include hypertension and an increased risk of cardiovascular diseases in the future. Monitoring HRV early can be a good screening tool for children at risk of developing stress-induced cardiovascular problems. Physical fitness and thermoregulation are also affected by the extreme environmental conditions of Karakalpakstan. The decreased aerobic capacity in schoolchildren reflects the adaptation strategy of the organism, which tries to save energies during long exposure to extremes of temperature. Such adaptation is necessary for survival under arid and high-temperature conditions, where the energies of the body should be conserved for maintaining all the homeostatic mechanisms. One of the most important signs of decreased aerobic capacity is reduced maximal oxygen uptake, or VO2 max. In children, a lower VO2 max can lead to fatigue, reduced stamina, and diminished participation in physical activities. The root of this reduced aerobic capacity is the combined effects of chronic exposure to air pollutants, high soil salinity, and temperature extremes that, together, impose a physiological burden on the respiratory and cardiovascular systems. Apart from that, an increased thermoregulation efficiency is evident, corresponding with the research study made by Lee et al. [8]. A research work carried out by Lee et al. [8] among children living in the desert
region reported that under continued heat exposure, physiological adaptation occurred as increased sweats and heat tolerance; this allowed more efficient thermoregulation of the body. These thermoregulatory adaptations help a child cope with sudden changes in temperature, which becomes critical for their survival and well-being in arid areas of the world.
The joint effect of respiratory, cardiovascular, and thermoregulatory adaptations suggests that there is some response by children's bodies to chronic environmental stressors in Karakalpakstan. The compensatory mechanisms observed during this study showed the human body's ability to compensate for the negative impact of an environmental stressor. For instance, increased hemoglobin concentration in the children residing in this area is one of the amazing compensatory mechanisms [11]. Hemoglobin is necessary for the transportation of oxygen to different parts of the body, and higher its concentration, the higher will be the amount of oxygen carried by blood to various tissues and organs to overcome any reduction in oxygen availability in the event of compromised lung functioning. The study showed that in cases of high levels of salinity in dust and soil, the hemoglobin count for children was 10% higher compared to their peers living in less polluted areas of the environment. These findings are in line with earlier research by Martinez et al. [9] when similar hematological adjustments were noted in children under chronic conditions of high altitudes with low oxygen partial pressures. This compensatory mechanism ensures that tissues receive adequate oxygenation to maintain not only cognitive but also physical performance in the face of chronic respiratory stressors.
These findings reinforce the urgent need for policy measures to surmount such adverse effects of stressors on children's health in genera. Environmental dust suppression by afforestation and the installation of water sprinkling mechanisms on unpaved roads would go a long way in drastically reducing particulate matter in the atmosphere. A reduction in atmospheric particulate matter would have a direct consequence on the respiratory health of children through a reduction in chronic respiratory diseases such as asthma and bronchitis. Public health campaigns on respiratory protection may also advocate for the use of face masks during dust storms to reduce the amount of particulate matter inhaled by children. Health sector interventions should focus on the improvement of health services, particularly respiratory health screening and early diagnosis. Regular check-ups in schools and at community health centers
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would allow for the timely diagnosis of respiratory and cardiovascular health complications arising from smog [11].
The role of schools in the protection of the health status of children should not be underestimated through the physical education programs they have, especially exercises that enhance physiological resiliency and adaptive capacity to environmental stressors. The children may be helped to enhance their adaptive responses to environmental stress through structured physical activity programs that include aerobic exercises, breathing exercises, and cardiovascular training. Teachers and educators should be trained to identify the signs of respiratory and cardiovascular distress among children for timely interventions. School nurses and health personnel should be equipped to provide immediate support for children with acute respiratory conditions. Additionally, educational materials on environmental health risks and preventive measures should be integrated into the school curriculum to promote greater awareness among students, parents, and teachers [11].
Furthermore, stakeholders' involvement in concerted efforts at the local, national, and international levels is needed to mitigate adverse health risks due to environmental stressors. Evidence-based policies integrating environmental health into the broader public health agenda should be adopted by local governments. National policies should facilitate funding for health promotion initiatives in affected regions. International organizations, such as the WHO [5], should support various research and development projects that could mitigate the environmental health risks in especially vulnerable populations. This is a collaborative effort with governments to ensure sustainable solutions for the protection of children's health and well-being in areas like Karakalpakstan. International research collaborations could be done on technological solutions to mitigate air pollution and dust storms, such as the introduction of dust control technologies and air filtration systems for schools and public spaces [11].
Limitations of the study include, but are not limited to, the cross-sectional design, which limits the establishment of causal links between environmental exposure and physiological adaptation. Cross-sectional studies present the relation of exposure and outcome only at one point in time and do not show the variation of the measures across time. Longitudinal studies are suggested to be able to evaluate the change in children's health and adaptation mechanisms over time.
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Figure 2. Summary of Key Findings and Recommendations on the Impact of Environmental Stressors on Children
in Karakalpakstan
5. Conclusion
The environmental crisis created by the desiccation of the Aral Sea continues to pose serious health challenges for schoolchildren in Karakalpakstan. The long-term exposure to ecological stress, including toxic dust, poor air quality, and extreme weather fluctuations, has led to functional adaptations in children's respiratory, cardiovascular, and physical fitness systems. Whereas some adaptations show how the body is amazingly resilient, others show the effects of chronic exposure to unfavorable conditions.
Key adaptations include improved oxygen transport efficiency and thermoregulatory mechanisms that allow children to tolerate higher temperatures and low oxygen environments more effectively. However, there is a price to pay. Research shows a significant decline in lung capacity, which is disruptive to breathing efficiency. Heart rate variability, generally indicative of stress and cardiovascular strain, reflects heightened autonomic nervous system activity. Poorer aerobic fitness in schoolchildren is particularly disturbing because
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it generally influences the children's health, growth, and even cognitive development. These physiological changes suggest that while the body can adapt, the long-term effects may be a hindrance to the well-being and development of children.
These issues demand immediate health interventions and policy reforms. Preventive health measures include regular health screenings, improved school infrastructure, and access to clean air and water. Educational programs on environmental health literacy can also provide communities with the knowledge to reduce exposure risks. Long-term research will be required to monitor ongoing health impacts and assess the effectiveness of policy measures. Safeguarding future generations requires prioritizing the health of children in more vulnerable regions, such as Karakalpakstan. Indeed, a comprehensive, multisector approach to health, education, and environmental policy can mitigate the adverse outcomes of the Aral Sea crisis on children's physical and mental development.
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