The specific features of the biogeochemical province are associated with the production of phosphorous mineral fertilizers. A significant amount of organophosphate compounds enters the atmospheric air, soil and surface waters . Analysis of the state of environmental objects shows that since 2000 There was no significant decrease in the amount of total emissions of pollutants from stationary sources during the year. In the emissions of phosphorous enterprises of the city Taraz contains more than 55 chemicals and compounds, of which 9 belong to hazard class I and II. They cause the development of environmentally dependent pathologies (1-2).

In the pathogenesis of these diseases , both a high degree of environmental pollution and disorders of the sympathetic-adrenal system developing against this background play a significant role. Complex and constant exposure to the body of a large number of phosphorus compounds in concentrations several times higher than the MPC, high concentrations of fluoride anhydride can lead to chronic stress. There is a risk of occurrence and exacerbation of "stress-dependent" diseases, including neurocirculatory dystonia, for example, it is even considered to be a pre-stage of diffuse toxic goiter. Thus, even a cursory examination of the properties of a complex of heavy metals polluting soil, water, agricultural products in the Taraz area proves the existence of opportunities for the realization of their toxic, mutagenic, teratogenic and carcinogenic properties, which cannot but affect the health indicators of the adult and child population.

However, for a final judgment on the impact of these heavy metals and other environmental factors on human health, it is necessary to have documentary evidence.

We have analyzed the documents of the automated public service "Health" for the period under study. Data on the morbidity of children and adults related to the beginning of our work in the region (2002-2007) show that the leading place in the overall structure of pathology was occupied by environmentally dependent diseases. Thus, in children , diseases of the upper respiratory tract accounted for 72%, and diseases of other respiratory organs (trachea, bronchi, lung) - 16.01%. The next most important types of pathologies are diseases of the endocrine system (4.35%), which is understandable, since the organs of the endocrine system, especially the thyroid gland, are indicators of environmental distress (Table 1).

Table 1 - Morbidity of children (0-14 years old) in Taraz (n/1000)

In adults, among the typical types of pathology , diseases of the upper respiratory tract were also in the first place, accounting for 53.5% of all types of diseases, and diseases of the trachea, bronchi and lung accounted for 15.2% of the total amount of diseases. The second place was occupied by ischemic and hypertensive diseases (10.8%), and the third - diseases of the gastrointestinal tract (10.0%). It is these types of pathology that have become the subject of close attention of specialists of our academy in the process of implementing a program to improve the skills of medical personnel and improve the health of the population of Taraz.

A retrospective analysis of data on the dynamics and structure of morbidity of adults and children in 2002-2007 shows that against the background of the continued prevalence of environmentally dependent types of pathology , the overall picture of morbidity is characterized by certain changes. It has been established that in Taraz there continues, albeit a slight decrease in the birth rate (in 2002 - 11.1%, in 2007 - 8.6%) and an increase in total mortality (6.7%o and 7.8%o, respectively). The number of premature births continues to increase (40% and 45%), the infant mortality rate is also growing (from 9.9 in 2002 to 12.8/1000 in 2007).At the same time, a comparison of the indicators of the general morbidity of children (Table 2) shows that the number of cases (n/1000) of diseases of the endocrine system, upper respiratory tract, respiratory organs has decreased (trachea, bronchi, lungs), skin diseases in children for 2002-2007.

Attention is also drawn to the fact that for the period In 2002-2007, the number of children with chronic types of pathology registered at the dispensary decreased (peptic ulcer, chronic tonsillitis, chronic skin diseases, chronic pneumonia). On the other hand, the list of types of pathology requiring dispensary supervision has expanded. It introduced such types of pathology as respiratory allergoses (7.6/1000 children were registered in 2007), bronchial asthma (2.4/1000), diabetes mellitus (0.3/1000) and congenital malformations (4.7/1000).

The reduction of morbidity for the listed types of pathology can be regarded as a positive effect of the ongoing therapeutic and preventive work, improvement of diagnostic methods within the framework of the ongoing program. However, the incidence of blood and eye diseases continues to remain at a relatively constant level, and the number of cases of diseases of the gastrointestinal tract and genitourinary system has increased by more than 2 times. The leading place in the overall structure of morbidity of children is still occupied by diseases of the respiratory tract, gastrointestinal tract and eyes (Table 2).

The analysis of the general morbidity and its structure in the adult population (Table 3) shows that over the studied period of time (from 2002-2007), the incidence of several types of pathology also decreased (diseases of the blood, eyes, ischemic and hypertensive diseases, diseases of the upper respiratory tract and respiratory organs, gastrointestinal tract and skin). The number of neoplasms has increased. Against this background , respiratory diseases continue to occupy a leading place in the overall structure of morbidity (Table 4) in adults, as well as in children . Hypertension and ischemic disease are in second place , diseases of the gastrointestinal tract are on the 3rd, skin diseases are on the 4th, i.e. types of pathology, which, as already noted, are considered to be environmentally dependent.

Thus, the above allows us to draw the following conclusions: - in Taraz, as a result of the intensive development of the industry for the production of phosphoric mineral fertilizers, a specific environment has been formed, characterized by the presence in the air in increased amounts of industrial dust (settling on the landscape), the permanent components of which are organophosphorus compounds, phosphoric anhydride, hydrogen fluoride are found in drinking water.

- ecological distress is, among other reasons, the basis for the emergence and spread of environmentally dependent types of pathology. Among them, the leading place is occupied by respiratory diseases, diseases of the endocrine system in children, respiratory diseases, ischemic and hypertensive diseases, diseases of the gastrointestinal tract, genitourinary system and eyes in adults.

During the period from 2002 to 2007, there was a positive trend in the prevalence of a number of diseases. The number of children with diseases of the endocrine system, skin, upper respiratory tract, trachea, bronchi and lungs has decreased. In adults, the incidence of such types of pathology as eye diseases, ischemic and hypertensive diseases, diseases of the respiratory system, gastrointestinal tract and skin has decreased. The reduction of morbidity can be considered as an indicator of the effectiveness of organizational, diagnostic, therapeutic and preventive measures carried out within the framework of the ongoing program.

Along with the marked decrease in the prevalence of environmentally dependent diseases, the overall incidence of them remains high, and even an increase has been noted for some types of pathology (gastrointestinal and eye diseases, oncological diseases). The ego serves as the basis for continuing intensive work in a given direction.