Serum iron levels in tuberculosis patients and household contacts and its association with natural resistance-associated macrophage protein 1 polymorphism and expression.

BACKGROUND: Iron deficiency can impair immune function, increasing tuberculosis (TB) susceptibility and severity. The research aimed to investigate iron deficiency anemia in TB patients and household contacts and its association with natural resistance-associated macrophage protein 1 (NRAMP1) polymorphism and expression. METHODS: The levels of iron, ferritin, and transferrin were measured in the serum by ELISA (Enzyme-Linked Immunosorbent Assay). NRAMP1 polymorphisms were determined by polymerase chain reaction (PCR) and sequencing. NRAMP1 gene expression was measured by real-time PCR. Interferon-gamma release assay (IGRA) checked on household contacts to screen household contacts with positive IGRA as the control. RESULTS: This study involved 35 TB cases and 35 TB contacts. The results showed that the serum Fe levels were found to be lower in the TB case group (median 149.6 µmol/L) than in the positive IGRA household contacts group (median 628.53 µmol/L) with a p-value <0.001. Meanwhile, ferritin levels in TB cases tended to be higher, in contrast to transferrin, which was found to tend to be lower in TB cases than household contacts but did not show a significant difference. This study found no association between the polymorphism of exon 15 D543 and active TB. However, NRAMP1 gene expression was lower in TB cases than in positive IGRA household contacts (p = 0.011). Besides, there was a positive correlation between NRAMP1 gene expression and serum Fe levels (r = 0.367, p = 0.006). TB was associated with decreased NRAMP1 gene expression (OR 0.086 95% CI 0.02-0.366, p = 0.001). Besides, TB was associated with low Fe levels (OR 0.533 95% CI 0.453-0.629, p < 0.001). CONCLUSION: Comparing the TB case to the household contacts group, decreased serum Fe levels were discovered in the TB case group. This study also shows a correlation of NRAMP1 gene expression to Fe levels in TB patients and household contacts and describes that TB may lead to decreased Fe levels by downregulating NRAMP1 expression.

Potentially Toxic Element Levels in Atmospheric Particulates and Health Risk Estimation around Industrial Areas of Maros, Indonesia.

Air quality deterioration is a major environmental problem in Indonesia. This study evaluated the levels and health risks of potentially toxic elements (PTEs) in Maros Regency, Indonesia. Total suspended particulate matter was collected from industrial areas for PTE (Al, Pb, Cr, Cu, Ni, As and Zn) analysis using inductively coupled plasma optical emission spectrometry (ICP-OES). Samples were collected from six critical areas in the Bantimurung region as that is where marble, cement and limestone industries are located. A calculation of the non-carcinogenic and cancer risks was performed to determine the potential health exposures in adults and children. A Monte Carlo simulation with 10,000 iterations and a sensitivity analysis was carried out to identify the risk probability and the most sensitive variable contributing to cancer risk from PTE exposure in humans. The results showed that the concentration of PTEs decreased in the order of Zn > Al > Cr > Pb > Cu > Ni > As in the wet season, and Zn > Al > Pb > As > Cr > Cu > Ni in the dry season. The hazard index (HI) value for children was 2.12, indicating a high non-carcinogenic risk for children. The total cancer risk (TCR) values in adults and children were 3.11 × 10-5 and 1.32 × 10-4, respectively, implying that both are at risk for developing cancer. The variables with the most contribution to cancer risk from As, Cr and Pb exposure in adults and children were As concentration (33.9% and 41.0%); exposure duration (ED) (34.3%) and SA (40.7%); and SA (98.7 % and 45.4%), respectively. These findings could be used as the scientific basis for public health intervention and to raise awareness of the harmful health effects of particulate bound PTEs.

Community Health Risk Assessment of Total Suspended Particulates near a Cement Plant in Maros Regency, Indonesia.

BACKGROUND: Cement plants generate particulate matter (PM) across processes from raw material preparation to packaging. The presence of total suspended particulates (TSP) coming out of the stack causes a high accumulation of dust in residential areas. Human exposure to TSP could affect human health and wellbeing. OBJECTIVES: The present study aims to evaluate concentrations of TSP and to estimate the health risks of TSP exposure through the inhalation pathway in communities surrounding a private cement industry in Maros regency, Indonesia. METHODS: Total suspended particulates were collected using a high-volume air sampler (HVAS) at five locations. Samples were taken by grab sampling for 24 hours. The SCREEN3 program was used to view the maximum range and distribution of pollutants based on the geographical, stack profiles and meteorological factors in the study area. Hazard quotient (HQ) was used to estimate non-carcinogenic risks of TSP in surrounding communities. RESULTS: Total suspended particulate concentrations were measured with a maximum value of 133.24 µg/m3 and a minimum value of 18.48 µg/m3. This maximum value exceeds the minimum acceptable level from Canadian National Ambient Air Quality Objectives (C-NAAQOs). The non-carcinogenic risks from the inhalation pathway were low except for location 3 (HQ>1) across all locations. CONCLUSIONS: The cement plant may significantly contribute to total TSP concentrations in air and may potentially have adverse effects on human health. Communities near the cement plant are vulnerable to TSP exposure and measures are needed to reduce TSP in Maros regency, Indonesia. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: This study was approved by the Health Research Ethics Committee of Hasanuddin University with protocol number 28920093022. COMPETING INTERESTS: The authors declare no competing financial interests.

The difference in the number of complaints from patient health services using national health insurance at regional general hospitals.

OBJECTIVE: Health services can cause different perceptions of each patient as recipients of health services. This study aims to determine the difference in the number of complaints in several regional general hospitals in Gorontalo Province. METHOD: The method used in this research is interviewing and collecting data in situ at the Gorontalo provincial health office. Data analysis used a one-way analysis of variance. The research sample consisted of seven regional public hospitals in Gorontalo Province. RESULTS: The results showed that the average number of complaints was 15-22 complaints per month in seven hospitals in Gorontalo Province. The average number of health services complaints in several Gorontalo Provincial Hospitals is at the Aloe Saboe Regional General Hospital, 22 complaints per month. CONCLUSIONS: The results showed significant differences in the number of complaints about health services at seven regional general hospitals in Gorontalo Province.

Ecological risk assessment of hexavalent chromium and silicon dioxide in well water in Maros Regency, Indonesia.

OBJECTIVE: This paper assesses the potential ecological risk of hexavalent chromium (Cr(VI)) and silicon dioxide/silica (SiO2) in well water. Both of pollutants have been classified as carcinogenic compound. The ecological risk assessment of drinking water is an effective tool to evaluate drinking water quality to reduce further risk. METHOD: Fourteen well water samples were collected around the residential area near cement industrial activity and karst mining area. Estimating the ecological risk of well water which consumed daily evaluated based on Hazard Quotient (HQ) ratio. RESULTS: The mean values of Cr(VI) and SiO2 in well water samples were 0.0017mg/L and 12.94mg/L, respectively. Drinking water in this area are unacceptable. HQ values for SiO2 at all stations are more than 1 (moderate level). CONCLUSIONS: Cr(VI) and SiO2 are discoverable within well water surrounding the research location. This finding is used as scientific data and references for ecological protection of drinking water in Maros.

The relationship of mercury exposure with neurological problems in artisanal gold in Makassar city.

Objectives This research aims to analyse the relationship between urine mercury levels and neurological problems. Methods This research is an observational study with a cross-sectional approach. There are 44 goldsmiths in the gold jewellery small scale industry involved in this study. Urine mercury levels were measured using an atomic absorption spectrophotometer. Neurological problems were assessed by a medician. Data collected includes age, time of exposure, work duration, smoking behaviour and nutrition status of the goldsmiths which were obtained by interview. Results The results showed that the concentration of mercury in the goldsmith's urine was around 0.93-64.59 µg/L. The analysis showed that there were 63% of goldsmiths experiencing neurological problems, such as tremors (9.1%) and knee pass reflex (6.8%). The bivariate analysis showed that there is no significant relationship between the concentration of mercury (p=0.133), age (p=0.155), time of exposure (p=0.702), time of working (p=0.354), smoking behaviour (p=0.169) and nutrition status (p=0.541) with neurological problems. Conclusions The goldsmiths who had high levels of mercury in urine samples were diagnosed with at least one of the neurological symptoms. It is recommended that the goldsmith use personal protective equipment during work such as mask, glasses and gloves.

Human health risk assessment of heavy metals via consumption of fish from Kao Bay.

Water pollution by heavy metals due to discharge from gold mining activity has threatened the aquatic environment and human health of the community around Kao Bay. This report review explores the level of mercury and arsenic in the fish and the health risk of fish consumption within the community around Kao Bay. Fish from 10 spots in the bay were analyzed for mercury and arsenic using Atomic Absorption Spectrophotometry. Community members around Kao Bay were interviewed for details of their fish consumption. Daily intake of metals and health risk level were also calculated. All of the fish caught contained mercury (mean of 0.2110 ug/g) and arsenic (mean of 0.422 ug/g). This heavy metal concentration exceeds the allowable level for food standard. The human health risk assessment showed that the fish caught from Kao Bay were not safe for human consumption (RQ>1). The hazard risk quotient based on cancer and non-cancer was more than one. As many as 49 of 52 people living around Kao Bay have a risk from mercury and arsenic exposure via fish consumption. The magnitude of HQ and ECR values for most fish indicates that it is not safe for consumption.