The consequences of blast wave action on young Kyiv residents (students): preliminary data

Background. The current russian aggression against Ukraine is characterized by the extraordinary intensity of different explosives use. The primary blast injury is an explosive wave combined of acoustic and infrasound components, among which 5 Hz was the fastest and the most powerful frequency. The explosion of a russian subsonic air-launched cruise missile, which attacked Kyiv as well, resulted in an off-scale irritation with the formation of vestibular disorder. The purpose was to evaluate the vestibular condition in the young civilian population of Kyiv (second-third year students) during the war. Materials and methods. The examination of the vestibular condition has been conducted in 38 students, 9 males and 29 females with an average age of 21.27 ± 4.45 years (only three persons were over 30 years), height of 169.11 cm, weight of 65.14 ± 11.30 kg. There was no control group, because an attempt to conduct such survey among students in 2018 find no one with similar complaints, so epidemiological data of the corresponding symptoms were taken as a comparison. The function of the vestibular organ was determined by the questionnaire “Types of dizziness”. Results. Complaints of dizziness/vertigo were found in 49.99 % of our students, and if one adds kinetosis, then it will be 68.41 %, while the epidemiological data of Germany showed the prevalence of 22.9 % among people aged 20–60 years, not 21 years, as in our examinees. In other words, vestibular disorders in Kyiv students are much more widespread than in Germany, which can be due to vestibular injury by the blast wave. Coordination disturbances in our students were found in 15.79 % (n = 6) of cases, while in Spain, in 2.2 %. Orthostatics was registered in 50.00 % (n = 19), while in the United States, its prevalence is 5 % in people under 50 years. Among our students, 42.11 % (n = 16) had complaints of migrainous headaches, while according to the WHO, migraine prevalence in the world is 18 %. Optokinetic nystagmus or flickering disease among students of Kyiv was detected in 2.63 % (n = 1). At the same time, the prevalence of this problem ranges from 1 per 100,000 to 1 per 4,000 (1 out of 4,000 is 0.025 %). Nausea in our students was registered in 18.42 % (n = 7) of cases, and in the United States, its prevalence reaches 12 %. Vomiting was noted in 2.63 % (n = 1), while in the United States, its prevalence is greater than in Canada or UK (3, 1.9 and 1.8 %, respectively). Blackout in our students was recorded in 44.74 % (n = 17) people, while in the Framingham study, the prevalence of this symptom was 10.5 %. Tinnitus was revealed in 23.68 % (n = 9) of our students, mainly type III, while among 222.1 ± 3.4 million American adults, 21.4 ± 3.4 million (9.6 ± 0.3 %) experienced tinnitus (all types). Hyperacusis was found in 23.68 % (n = 9) of our students. For comparison, in the United States, 775 (15.2 %) out of 5,107 participants reported hyperacusis. These data indicate that it is the infrasound explosive wave that led to the formation of vestibular disorder, which, in turn, resulted in the appearance of these symptoms. Spatial disorientation belongs to psychiatric problems. In this case, the influence of blast wave on an increase in the prevalence of spatial disorientation in Kyiv population is not clear. In particular, acrophobia was observed in 26.32 % (n = 10) of our students, while approximately 2–5 % of the global population complains of it. Agoraphobia was detected in 10.53 % (n = 4) of our students, while in Europe, a 12-month prevalence of panic disorder and agoraphobia without a history of panic was 1.8 (0.7–2.2) and 1.3 % (0.7–2.0), respectively, in all studies. Nyctophobia was found in 15.79 % (n = 6) of our students, and the literature shows that 8.20 % of people named dark as their main fear. 36.84 % (n = 14) of examinees complained of anxiety attacks, while 4.05 % of the world’s population suffer from anxiety disorder. Depression in the students examined was registered in 18.42 % (n = 14) of cases. At the same time, according to the WHO data, about 3.8 % of the world’s population had depression. Aggression was called the problem in 42.11 % (n = 16) of our students, and among the global population, 11.19 %. Accepting a certain number of psychiatric problems with anxiety, depression and aggression, we see a significant number of people with this symptom that is caused by vestibular disorder due to the action of the blast wave. Conclusions. The primary blast injury has infrasound and acoustic components, with frequency of 5 Hz being the most powerful, the fastest one, and in case of a cruise missile attack, it covers the terrain of Kyiv and surroundings. Our students have the consequences of the effect of blast wave infrasound component in the form of vestibular disorder and mild traumatic brain injury. Additional symptoms include anxious syndrome, depression, hyperacusis and aggression, which also occur as a result of vestibular disorder. The civilian population of Ukraine requires specific therapy and prevention of the consequences of russian aggression. Ukraine needs to create a center for studying the sequelae of blast trauma and national register for long-term monitoring of the casualties.

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