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BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic disrupts selfmanagement in diabetic patients in Indonesia. This study aimed to determine the telemedicine usage and factors contributing to glycemic control in type 2 diabetes mellitus (T2DM) patients during the pandemic. METHODS A cross-sectional study was conducted in T2DM patients aged 25–54 years. The questionnaire included general characteristics, diabetes conditions, consultation factors, and self-care management. Glycemic status was evaluated using glycated hemoglobin (HbA1c) levels, which was categorized into poor (HbA1c≥7%) and good glycemic control (HbA1c

Meteorological conditions change substantially during rainstorms, potentially affecting ambient concentrations of fungal spores. Exposure to ambient fungal spores during rainstorm periods may resul...

The study aimed to determine trend of Indonesian local food consumption and its association with body mass index (BMI) among female university students. It was cross-sectional study that involved 217 Indonesian female university students (18-25 years old) in April-May 2021 using conventional sampling by a self-administered online questionnaire in Malang City, East Java, Indonesia. Sociodemographic and dietary habits were collected along with body BMI data. Descriptive and Ordinal Logistic Regression were applied to analyze the data. The results showed the average BMI of 217 participants was 21.28+3.30 kg/m2. From 167 local Indonesian food that were identified, local cuisine with high carbohydrates and sugar such as fried noodles, meatballs, mixed vegetable soup, biscuits/pastry, fritters with topping, and iced milk tea with topping had a positive impact on overnutrition. Interestingly, chicken porridge had an inverse association with overnutrition. The ordinal regression results depicted the length of stay in study area had a significant association with BMI. However, meal frequency and snack time consumption also affected BMI. The preferred high-carbohydrate food is significantly associated with overnutrition (p

Human biomarkers were used to evaluate the lead (Pb) and arsenic (As) exposure of local people who lived in an agricultural area with intense agrochemical usage and who consumed groundwater. Although the heavy metals/metalloids in the groundwater were at low concentrations, they could cause adverse effects due to a high daily water intake rate over the long term. Biomarkers (hair, fingernails and urine) were collected from 100 subjects along with the local shallow groundwater and tap water, which is the treated deep groundwater, and investigated for the concentrations of As and Pb. Shallow groundwater had an average pH of 5.21 ± 1.90, ranging from 3.77 to 8.34, with average concentrations of As and Pb of 1.311 µg/L and 6.882 µg/L, respectively. Tap water had an average pH of 5.24 ± 1.63, ranging from 3.86 to 8.89, with the average concentrations of As and Pb of 0.77 µg/L and 0.004 µg/L, respectively. The levels of both As and Pb in the hair, fingernails and urine of shallow groundwater-consuming residents were greater than those in the hair, fingernails and urine of tap water-consuming residents. Interestingly, the As level in urine showed a linear relationship with the As concentration in groundwater (R2 = 0.91). The average water consumption rate was approximately two-fold higher than the standard; thus, its consumption posed a health risk even at the low As and Pb levels in the groundwater. The hazard index (HI) ranged from 0.01 to 16.34 (average of 1.20 ± 2.50), which was higher than the acceptable level. Finally, the concomitant factors for As and Pb in the urine, hair and nails from both binary logistic regression and odds ratio (OR) analysis indicated that groundwater consumption was the major concomitant risk factor. This study suggested that direct consumption of this groundwater should be avoided and that the groundwater should be treated, especially before consumption. In conclusion, urine is suggested to be a biomarker of daily exposure to As and Pb, while for long-term exposure to these metals, fingernails are suggested as a better biomarker than hair.

Exposure to heavy metals in mining activities is a health issue among miners. This study was carried out at three small-scale gold mining sites situated in Banmauk Township, Myanmar and aims to assess the occupational health risks of small-scale gold miners who are exposed to arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) in the soil through the dermal route. Soil samples were analyzed through atomic absorption spectroscopy (AAS). The concentrations of the heavy metals in soils found As, ranged 1.04 mg/kg to 22.17 mg/kg, 0.13 mg/kg to 3.07 mg/kg for Cd, 0.15 mg/kg to 77.44 mg/kg for Hg, and 7.67 mg/kg to 210.00 mg/kg for Pb. In this study, 79% of the participants did not use any form of personal protective equipment (PPE) while working in gold mining processes. Regarding noncancer risk assessment, the results found all hazard quotient were lower than acceptable level (HQ −1 in the amalgamation process. On the other hand, the result found cancer risk ranged from 8.02 × 10−8 to 1.75 × 10−6, and the estimated cancer risks for 9 years ranged from 4.78 × 10−7 to 1.04 × 10−5. Therefore, the cancer risks of the miners were greater than the United State Environmental Protection Agency (U.S. EPA) acceptable cancer risk level, 1 × 10−6, and the miners may be at risk of developing carcinogenic diseases. The suggestion is to educate miners about the health risks of heavy metals and to encourage the use of proper PPE all the time while working in gold mine.

Background. Artisanal and small-scale mining activities are widely practiced globally. Concentrations of heavy metals associated with gold, such as copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) can increase in the environment as a result of mining activities, leading to environmental pollution and pose toxicity risks to humans and animals. Objectives. The aim of the present study was to investigate soil concentrations of toxic heavy metals in placer small-scale gold mining operations in Myanmar. Methods. Soil samples were collected from three placer small-scale gold mining sites: Site A located in the Hmawbon public protected forest, Site B and Site C, situated in the Nant-Kyin reserved forest around Nar Nant Htun village. At each site, soil samples were collected from four gold mining stages (ore processing, sluicing, panning, and amalgamation). Atomic absorption spectroscopy was utilized to examine the concentrations of As, Cd, Pb, and Hg. Results. The highest heavy metal concentrations were generally found in the amalgamation stages across all the gold mining sites. Across the three mining sites, the maximum heavy metal concentrations in the amalgamation stage were 22.170 mg.kg−1 for As, 3.070 mg.kg−1 for Cd, 77.440 mg.kg−1 for Hg, and 210.000 mg.kg−1 for Pb. Conclusions. The present study examined the concentrations of As, Cd, Hg and Pb in the soil of several small-scale gold mining sites in Banmauk Township, Myanmar. The results demonstrated the presence of high concentrations of heavy metals in the soil of the gold mining sites. Miners in this area work without proper personal protective equipment, and frequent exposure to heavy metals in the soil may cause adverse health effects. The present study provides baseline data for future risk assessment studies of heavy metal contamination in gold mines. Competing Interests. The authors declare no competing financial interests

EnvironmentAsia, 13, 1, 99-105

Urine used as a biomarker was collected and compared between two groups of participants: (1) a groundwater-drinking group and (2) a non-groundwater-drinking group in intensively agricultural areas in Ubon Ratchathani province, Thailand. The statistical relationship with the metal concentration in shallow groundwater wells was established with urine data. According to the groundwater data, the health risk assessment results for four metals appeared to be higher for participants who drank groundwater than for the other group. The carcinogenic risk and non-carcinogenic risk of arsenic (As) were found in 25.86 and 31.03% of participants, respectively. For lead (Pb), 13.79% of the participants had a non-carcinogenic risk. Moreover, 30 of the 58 participants in the groundwater-drinking group had As urine higher than the standard, and 26, 2 and 9 of the 58 participants had above-standard levels for cadmium (Cd), Pb and mercury (Hg) in urine, respectively. Both the risk assessment and biomarker level of groundwater-drinking participants were higher than in the other group. The results showed an average drinking rate of approximately 4.21 ± 2.73 L/day, which is twice as high as the standard. Interestingly, the As levels in the groundwater correlated with those in the urine of the groundwater-drinking participants, but not in the non-groundwater-drinking participants, as well as with the As-related cancer and non-carcinogenic risks. The hazard index (HI) of the 100 participants ranged from 0.00 to 25.86, with an average of 1.51 ± 3.63 higher than the acceptable level, revealing that 28 people appeared to have non-carcinogenic risk levels (24 and 4 people for groundwater-drinking participants and non-groundwater-drinking participants, respectively). Finally, the associated factors of heavy metals in urine were the drinking water source, body weight, smoking, sex and use of personal protective equipment.

In this study, the hair and fingernails of the local people in an intensively cultivated agricultural area in Ubon Ratchathani province, Thailand, were used as biomarkers of exposure to arsenic (As) and heavy metals. The study area has shallow acidic groundwater that is contaminated with As and heavy metals. The local people often consume this shallow groundwater; thus, they are exposed to As and heavy metals. Hair and fingernail samples were collected to characterize the differences between shallow groundwater drinking (SGWD) and tap water drinking (TWD) residents. The concentrations of As and the heavy metals Cd, Pb and Hg were significantly higher in the hair samples from the SGWD group than those from the TWD group, especially for As (0.020-0.571 vs. 0.024-0.359µg/g) and Cd (0.009-0.575 vs. 0.013-0.230µg/g). Similarly, the concentrations of As and the heavy metals in the fingernail samples collected from the SGWD group were larger than those of the TWD group, especially for As (0.039-2.440µg/g vs. 0.049-0.806µg/g). The χ2 statistic and binary logistic regression were used to find the associated factors and assess the associated probabilities. The regression results show that the factors associated with the concentrations of As and the heavy metals in the hair samples were drinking water source, rate of water consumption, gender, bathing water source, education, smoking and underlying disease, whereas the factors associated with the concentrations of these species in the fingernail samples were drinking water source, gender, occupation, work hours per day, alcohol consumption, and the use of pesticides.

The Hua-ruea sub-district has long been a major agricultural area of Thailand. Shallow groundwater from farm wells is a main source of drinking water for most locals. This study assessed the human health hazards associated with consuming groundwater contaminated with heavy metals among adults age 15–60 years and the aging, greater than 60 years. Twelve groundwater wells were sampled in the Hua-ruea agricultural area. The results showed adults’ average groundwater consumption was high at 3.6 ± 2.1 L/day/person and for the aging group was 2.6 ± 1.0 L/day/person. The hazard quotients for As, Cu, Pb, and Zn exceeded 1 among both the adult and aging populations. Residents of the Hua-ruea subdistrict may be at risk of developing diseases from consumption of water contaminated with these four metals at seven of the 12 wells. These wells are located in intensely cultivated chili fields. All non-carcinogenic hazards of all heavy metals were higher in adults than for the aging population due to a higher in...

Most local people in the agricultural areas of Hua-ruea sub-district, Ubon Ratchathani province (Thailand), generally consume shallow groundwater from farm wells. This study aimed to assess the health risk related to heavy metal contamination in that groundwater. Samples were randomly collected from 12 wells twice in each of the rainy and the dry seasons and were analyzed by inductive coupled plasma spectrometry-mass spectrometry (ICP-MS). The concentration of detected metals in each well and the overall mean were below the acceptable groundwater standard limits for As, Cd, Cr, Cu, Hg, Ni and Zn, but Pb levels were higher in four wells with an overall average Pb concentration of 16.66 ± 18.52 μg/l. Exposure questionnaires, completed by face-to-face interviews with 100 local people who drink groundwater from farm wells, were used to evaluate the hazard quotients (HQs) and hazard indices (HIs). The HQs for non-carcinogenic risk for As, Cu, Zn and Pb, with a range of 0.004-2.901, 0.053-54.818, 0.003-6.399 and 0.007-26.80, respectively, and the HI values (range from 0.10 to 88.21) exceeded acceptable limits in 58 % of the wells. The HI results were higher than one for groundwater wells located in intensively cultivated chili fields. The highest cancer risk found was 2.6 × 10(-6) for As in well no. 11. This study suggested that people living in warmer climates are more susceptible to and at greater risk of groundwater contamination because of their increased daily drinking water intake. This may lead to an increased number of cases of non-carcinogenic and carcinogenic health defects among local people exposed to heavy metals by drinking the groundwater.