Living in the Aral Sea area has detrimental consequences for fertility, both in people growing up in the area and for adult immigrants (23, 24). Furthermore, in the late 1990s infant mortality was between 60 – 110/1000, a figure far higher than in Uzbekistan (48/1000) and Russia (24/1000) (25). At the same time, body mass index (BMI) was inversely correlated with blood concentration of PCBs, DDTs and DDEs in children between 7 and 17 years, advocated as an effect of malabsorption. Values of insulin-like growth factor type 1 (IGF-1) tended to correlate with a reduction in body mass index (26). It is known that low IGF-1 values may be associated with high concentrations of DDT or DDT metabolites in the body (27).
In the late 1990s, Kazakh children believed to be harmed by Aral Sea pollution were sent to a rehabilitation centre in Almaty. Clinical findings included skin lesions, heart and kidney disease. Growth retardation and late sexual maturation were common (28). Further, anaemia was related to settlement near the lake (29) and local children had impaired renal tubular function. Chronic heavy-metal exposure has been shown to cause such damage, and polluted water could be causative (30). Hypercalciuria in children (31) could possibly be related to intake of saline-rich water, food and dust, or renal tubular dysfunction, associated with toxic damage after exposure to substances such as lead and cadmium (29).
Studies conducted in 2000 examined the respiratory function of local children. In an area within 200 kilometres of the Aral Sea, schoolchildren had low vital capacity and a high cough rate (32). Surprisingly, dust exposure appeared unrelated to the prevalence of asthma (33). Therefore, it is still uncertain whether the environmental disaster has had a direct impact on the frequency of respiratory disease (29).
Compared with far eastern Kazakhstan, the Aral Sea population seems more prone to develop cancer (34, 35). During the 1980s, the occurrence of liver cancer doubled (36), while the incidence of oesophageal, lung and stomach cancer appear highest (37). Inhabitants of the Uzbek part of the Aral Sea area subjectively experience their own health as poor, correlating with concerns about the environmental disaster. A large percentage of residents wish to emigrate (25, 38).