Associations between urinary heavy metal concentrations and blood pressure in residents of Asian countries.

BACKGROUND: Previous studies have suggested that exposures to heavy metals (arsenic, cadmium, lead, and selenium) may be associated with differences in blood pressure. However, the findings of these studies have been inconsistent. This study was performed to examine the associations between urinary heavy metal concentrations and blood pressure among residents of four Asian countries (Bangladesh, Indonesia, Nepal, and Vietnam). METHODS: This cross-sectional study examined 1899 adults in four Asian countries. Urinary concentrations of heavy metals were measured by inductively coupled plasma mass spectrometry. A questionnaire survey was administered regarding individual characteristics. Anthropometric measurements (height and weight) were performed. Systolic and diastolic blood pressures were measured after a short rest. Multiple linear regression models were applied to investigate associations between urinary heavy metal concentrations and blood pressure after adjustments for age, sex, and body mass index. RESULTS: The geometric means of the urinary concentrations of arsenic, cadmium, lead, and selenium were 84.6, 0.885, 2.09, and 16.5 µg/g creatinine, respectively. The urinary arsenic concentrations were slightly higher than those typically reported in non-polluted populations, while urinary cadmium, lead, and selenium concentrations were equivalent or slightly lower. The urinary lead concentrations were positively associated with both systolic and diastolic blood pressure, but urinary selenium concentrations were negatively associated with them. CONCLUSIONS: Variations in the urinary concentrations of lead and selenium were associated with blood pressure at low levels of exposure/intake.

Urban-rural difference in the determinants of dietary and energy intake patterns: A case study in West Java, Indonesia.

BACKGROUND: Few studies have explored differences in the determinants of individual dietary/energy intake patterns between urban and rural areas. OBJECTIVE: To examine whether the associations between individual characteristics and dietary/energy intake patterns differ between urban and rural areas in West Java, Indonesia. METHODS: A 3-day weighed food record, interviews, and anthropometric measurements were conducted in Bandung (urban area; n = 85) and Sumedang (rural area; n = 201). Total energy intake and intake from protein, fat, and carbohydrates were calculated. Food items were grouped into dietary categories based on the main ingredients to calculate their share of total energy intake. The associations between individual characteristics and dietary/energy intake were examined by fitting regression models. Models that also included education and body mass index (BMI) were fitted to adult samples only. RESULTS: In Sumedang, the total energy intake and energy intake from carbohydrates, fat, and grain/tubers were significantly associated with age and occupation. In Bandung, energy intake from grain/tubers and vegetables/legumes was related to sex and occupation, while other indicators showed no associations. Among adults, BMI was associated with the total energy intake and educational level was associated with energy intake from vegetables/legumes (both only in Sumedang). CONCLUSIONS: The relationship between demographic and socioeconomic factors and dietary/energy intake patterns differs in rural versus urban areas in West Java. These results suggest that different strategies are needed in rural and urban areas to identify and aid populations at risk of diet-related diseases.

Pesticide usage and its association with health symptoms among farmers in rural villages in West Java, Indonesia.

The improper handling of pesticides in agriculture has caused serious health problems in many developing countries. In this study, we report the pesticide usage condition among Indonesian farmers and its association with symptoms of pesticide toxicity. A questionnaire survey on personal history regarding agricultural labor, pesticide storage and disposal, pesticide use and health history was conducted using a structured questionnaire in rural Sundanese villages in West Java, Indonesia. The most frequently used pesticides included dithiocarbamates, pyrethroids and organophosphates. In approximately 80% of sprayings, category II pesticides (World Health Organization (WHO) categorization; "moderately hazardous") were used. Many of the subject farmers worked in a highly unsafe occupational environment; protective measures and safe handling were rarely observed, whereas smoking and drinking during spraying were frequently practiced. Correlation analysis revealed that farmers who wore a long sleeve shirt and headgear showed health symptoms less frequently. Moreover, farmers who had skin contact with the spray solution during measuring or mixing (excluding the hands), who wore wet clothing (skin exposure to pesticide), and who smoked and rubbed their eyes during spraying showed more symptoms. Among these factors, headgear use, wearing wet clothing (skin exposure to pesticide), and smoking during spraying were the significant determining factors for developing health symptoms. Preventing such behaviors will be an effective method of reducing health problems among the subject farmers.

Double Burden of Malnutrition in Rural West Java: Household-Level Analysis for Father-Child and Mother-Child Pairs and the Association with Dietary Intake.

Indonesia is facing household-level double burden malnutrition. This study aimed at examining (1) household-level double burden for the mother-child and father-child pairs; (2) risk of adiposity of double burden households; and (3) associated dietary factors. Subjects were 5th and 6th grade elementary school children (n = 242), their mothers (n = 242), and their fathers (n = 225) in five communities (1 = urban, 4 = rural) in the Bandung District. Questionnaires on socioeconomic factors, blood hemoglobin measurements, and anthropometric measurements were administered. For adults, body fat percentage (BF%) was estimated by bioelectrical impedance (BF%-BI) and by converting skinfold thickness (ST) data using Durnin and Womersley's (1974) formula (BF%-ST). Food frequency questionnaires were also completed. Double burden was defined as coexistence of maternal or paternal overweight (Body mass index (BMI) ≥ 23) and child stunting (height-for-age z-score <-2) within households. Maternal-child double burden occurred in 30.6% of total households, whereas paternal-child double burden was only in 8.4%. Mothers from double burden households showed high adiposity; 87.3% with BF%-BI and 66.2% with BF%-ST had BF% >35%, and 60.6% had waists >80 cm. The major dietary patterns identified were "Modern" and "High-animal products". After controlling for confounding factors, children in the highest quartile of the "High-animal products" dietary pattern had a lower risk of maternal-child double burden (Adjusted OR: 0.46, 95% CI: 0.21-1.04) than those in the lowest quartile. Given that the "High-animal products" dietary pattern was associated with the decreased risk of maternal-child double burden through a strong negative correlation with child stunting, improving child stunting through adequate intake of animal products is critical to solve the problem of maternal-child double burden in Indonesia.