Distribution of maternal risk factors for orofacial cleft in infants in Indonesia: a multicenter prospective study.

BACKGROUND: The pathogenesis of orofacial cleft (OFC) is multifactorial, involving both genetic and non-genetic factors, the latter of which play a key role in the development of these anomalies. This paper addresses the incidence of OFC in Indonesia, with a focus on identifying and examining the distribution of contributory factors, including parental medical history, pregnancy history, and environmental influences. METHODS: The study was conducted through the collection of primary data. An interdisciplinary research team from Indonesia administered a standardized questionnaire to parents who had children with OFC and who had provided informed consent. The case group comprised 133 children born with cleft lip and/or palate, and the control was 133 noncleft children born full-term. The risk factors associated with OFC anomalies were analyzed using the chi-square test and logistic regression. All statistical analyses were performed using SPSS version 25. A p-value of 0.05 or less was considered to indicate statistical significance. RESULTS: The study comprised 138 children, of whom 82 were boys (59.4%) and 56 were girls (40.6%). Among them, 45 patients (32.6%) presented with both cleft lip and cleft palate, 25 individuals (18.1%) had a cleft palate only, and 28 patients (20.3%) had a cleft lip only. OFC was found to be significantly associated with a maternal family history of congenital birth defects (p< 0.05), complications during the first trimester (p< 0.05), consumption of local fish (p< 0.05), caffeine intake (p< 0.05), prolonged medication use (p< 0.05), immunization history (p< 0.05), passive smoking (p< 0.05), and X-ray exposure during pregnancy (p< 0.05). CONCLUSION: The findings indicate close relationships between the incidence of OFC and maternal medical history, prenatal factors, and environmental influences.

Risk factors of occupational skin diseases among traditional batik manufacturing workers in Yogyakarta, Indonesia.

OBJECTIVE: Batik is one of the Indonesian traditional arts made by decorating fabric using the resist dyeing technique. Currently, batik manufacturing serves as an important source of livelihood in Indonesia. However, the production process of traditional batik involves a range of chemicals and some repetitive physical movements, making batik production inseparable from physical and chemical hazards which increase the risk of developing occupational skin diseases (OSD). This study aimed to identify the risk factors related to OSD, including occupational contact dermatitis (OCD), among traditional batik manufacturing workers in Yogyakarta, Indonesia. RESULTS: The study demonstrated that working duration (≥ 8 h daily) and type of work (wet process only) were statistically significant as risk factors for developing OSD. While for OCD, our results found that gender (male), history of atopy, and type of work (all and wet phase only) were risk factors for OCD development among traditional batik manufacturing workers.

Hazard identification and the prevalence of occupational skin disease in Indonesian Batik workers.

Batik, a resist-dyeing technique to decorate a special cotton fabric, has been practiced for centuries in Indonesia. Unfortunately, as an informal enterprise, batik industry activities lack work safety and health regulations. This study aimed to identify potential health hazards, including inventorying the chemicals to which the workers are exposed, the PPE profile, and investigating the prevalence of occupational skin diseases (OSD) in the batik industry. A cross-sectional study and an inventory of exposure to the chemicals were done in traditional batik workplaces in 5 districts in Yogyakarta province, Indonesia. The chemicals were classified as potential sensitizers/irritants, and the workers were examined and interviewed using the Nordic Occupational Skin Questionnaire-2002/LONG. Of 222 traditional batik workers, OSD were diagnosed in 61 (27.5%) workers, with occupational contact dermatitis was the most common OSD encountered (n = 23/61; 37.7%) (allergic contact dermatitis n = 7/23; irritant contact dermatitis n = 16/23). A smaller portion of other OSD was also encountered including callus, miliaria, and nail disorder (9%, 6.3%, and 5.9%, respectively). During each step of the traditional batik manufacturing process, the workers are exposed to substances that act as irritants and/or as potential contact allergens. However, only one-fourth of the workers used PPE regularly, particularly during the coloring process and wax removal (wet processes). Traditional batik manufacturing process exposes the worker to various physical and chemical hazards, resulting in a high prevalence of occupational skin diseases, especially contact dermatitis among the employees.

Occupational lead exposure health risk assessment and heme biosynthesis: A study on batik artisans in yogyakarta, Indonesia.

This study aims to assess dermal and inhalation lead exposure levels among batik industry workers and evaluate noncarcinogenic and carcinogenic health risks associated with lead exposure. We investigate potential relationships between lead exposure (dermal average daily dose and inhalation exposure concentration) and the workers' blood hemoglobin levels (Hb), as well as their urinary ALA (u-ALA) concentrations. Additionally, we explore any possible associations between Hb and u-ALA levels among the workers and identify various factors influencing lead exposure levels. A total of 30 workers were recruited for the study. Interviews and exposure sampling were conducted to measure dermal and inhaled lead exposure. Sample analysis methods include XRF for exposure samples, spectrophotometry for u-ALA, and HiCN colorimetric for Hb. Carcinogenic and noncarcinogenic risk assessments, correlation analysis, as well as ANOVA for factors analysis, were performed. The average dermal exposure dose and inhalation exposure concentration of lead were 6.53 ± 3.2 ng/kg/day and 0.021 ± 0.015 µg/m3, respectively. Hazard Index (HI) values for all workers were below 1 (average: 0.372 ± 0.155), indicating no expected noncarcinogenic health effects due to lead exposure. The average Excess Lifetime Cancer Risk (ELCR) was (5.18 ± 3.84) × 10-8, significantly below acceptable limits. Correlation analysis revealed a significant negative correlation between Hb and u-ALA (r = -0.519, p = 0.058 for male workers and r = -0.531, p = 0.034 for female workers), supporting their use as lead exposure biomarkers. The factors analysis demonstrated a significant impact of working conditions on inhalation exposure (p = 0.018), with outdoor workers experiencing lower lead inhalation. This research provides crucial insights into potential dangers faced by batik workers due to lead exposure, emphasizing the importance of targeted interventions. The strong correlation between Hb and u-ALA indicates their combined effectiveness in detecting lead exposure, even at low levels. The study underscores the significance of outdoor work as a protective measure against inhaling heavy metals, such as lead, present in the air. The assessment of health risks associated with lead exposure in the batik industry lays the groundwork for informed decision-making and interventions to protect workers' well-being, particularly in informal sectors workplaces where health risks are often overlooked.

Investigation of exposure to heavy metals (Hg, Pb, Cd, Co, and Cr) as the cause of congenital anomaly cases (orofacial cleft) in infants.

Orofacial cleft (OFC) is one of the most common congenital defects, with worldwide cases occurring in approximately 1:700 to 1:1000 births. This incidence is among the highest birth defects in Indonesia, and the incidence rate in Bandung Regency (14.69%) is the second-highest in West Java province. The purpose of this study was to analyze the association of heavy metal factors that accumulate in infants to the risk of OFC in Bandung Regency. The method was used by testing heavy metals Hg, Pb, Cd, Co, and Cr in infant blood. The total sample were 54 samples, where the case respondent of 32 and 22 respondents as the control group. Blood samples were analyzed using ICP-MS Agilent 7900. The correlation using statistic analyze namely chi-square analysis (bivariate) and multiple logistic regression (multivariate). The results showed that there was a significant difference in the concentration of heavy metals Hg, Pb, and Cd as well as an increase in Pb and Cd in the infant's blood which was thought to be significantly associated with the risk of OFC.

Distribution of organochlorine pesticide pollution in water, sediment, mollusk, and fish at Saguling Dam, West Java, Indonesia.

This study aims to determine the distribution of organochlorine pesticide pollution in water, sediments, mollusks, and fish at Saguling Dam as baseline data of organochlorine pollution. Samples were obtained from 12 locations, with 9 and 3 sampling points inside and outside the dam, respectively. Measurement of organochlorine residues was carried out using methods of extraction, purification, evaporation, and gas chromatography. Results showed the presence of several types of organochlorine compounds, namely, lindane, aldrin, dieldrin, heptachlor, dichlorodiphenyltrichloroethane (DDT), and endosulfan. Aldrin was dominant in water (2-37 µg/L) and sediments (2-1438 µg/L), while DDT and heptachlor were dominant organochlorine compounds in mollusks (13-2758 µg/L) and fish (11-104 µg/L), respectively. Sediments demonstrated higher organochlorine concentrations than water, mollusk, and fish. The distribution of organochlorine was affected by land use around the Citarum watershed and pollutant input from tributaries.

Investigation of dermal exposure to heavy metals (Cu, Zn, Ni, Al, Fe and Pb) in traditional batik industry workers.

Batik is an Indonesian cultural heritage that has been designated by UNESCO. Batik industry is one of the industries that applies the synthetic dyes, beside natural ones which have long been used in producing Batik particularly in the modern production. The purpose of this research investigated heavy metals on workers in batik industry, which focuses on dermal detection as portal of entry. Samples of dermal intake of workers were examined with cross-sectional approach, while non-worker samples of resident living surrounding the industry were used as control. Dermal intake on workers and non-workers were examined using Patch Filter. Heavy metals content of the synthetic dyes used in the batik production and those in the patch filter which was attached to worker's skin during sampling period were analyzed using X-Ray Fluorescence (XRF) method. The XRF measurement result of the synthetic dyes shows a detection of several heavy metals including Cu and Zn as the highest detected concentration, while the XRF measurement of the patch filter detects several heavy metal contents, which include Cu, Zn, Ni, Al, Fe and Pb. The highest detected heavy metal concentration found in the patch filter were Cu, Zn and Ni. Meanwhile, the highest detected heavy metal concentration of Pb was found in workers in the stamping process. The result indicates that highest Hazard Quotient (HQ) values for Cu, Zn, Mn, and Fe were found in workers of dyeing process compared to those in other processing stages.

Profile of Transepidermal Water Loss (TEWL), Skin Hydration, and Skin Acidity (pH) in Indonesian Batik Workers.

Chemical substances used during batik processing may affect the physiological function of the batik worker's skin barrier. This study assessed the level of transepidermal water loss (TEWL), skin hydration, and skin acidity in 61 batik workers from the batik center in Paseseh village, Tanjung Bumi subdistrict, Madura Island, Indonesia. Forty-five batik workers involved in dry work including drawing patterns on the cloth with wax and sixteen batik workers involved in wet work including dyeing the cloth with a dye bath were included in this study. The mean TEWL level in the dry work section was 59.87 ± 11.94 g/m2/h on the palmar and 29.00 ± 13.09 g/m2/h on the dorsal side of the hand, while the mean TEWL in the wet work section were 47.39 ± 9.66 g/m2/h on the palmar and 37.07 ± 10.00 g/m2/h on the dorsal side of the hand. The mean skin hydration level in the dry work section was 49.80 ± 19.16 arbitrary units (a.u.) for the palmar side and 52.77 ± 16.21 a.u. for the dorsal side of the hand, while the mean levels of skin hydration in the wet work section were 47 ± 12.73 a.u. and 62.94 ± 10.09 a.u. for palmar and dorsal side, respectively. The mean levels of skin acidity in the dry work section were 5.45 ± 0.19 for the palmar side and 5.30 ± 0.20 for the dorsal side of the hand, while the wet work section had 5.30 ± 0.19 and 5.10 ± 0.19 for the palmar and dorsal side of the hand, respectively. The TEWL levels were found to be higher on the palmar side of the hand in both the dry work and wet work sections, which was consistent with the measurement of skin hydration levels that were lower on the palmar side of the hand. The mean skin pH levels for both work sections were considered within the normal range.

Risk analysis of inhaled hexavalent chromium (Cr6+) exposure on blacksmiths from industrial area.

Chromium (Cr) is used as a mixture to improve strength and corrosion resistance. Milling and welding processes can expose workers to Cr through dermal exposure and inhalation. Cr exposure can be determined by urine testing. The purpose of this study was to analyze the concentration of Cr in urine (UCr) of workers. This study was carried out using a cross-sectional method. Sampling was conducted in the village of Mekarmaju, Bandung, Indonesia. The number of respondents included 30 blacksmiths, and the control group comprised 10 people who were not blacksmiths. Cr6+ exposure was measured using a personal sampling pump placed on the collar of the worker's shirt as a breathing zone and then analyzed using a UV-visible spectrophotometer. UCr was measured with a graphite furnace atomic absorption spectrophotometer. The measured Cr6+ concentration in the exposed working area ranged from 0.03 to 0.63 mg/m3, whereas that in non-exposed area ranged from 0.02 to 0.04 mg/m3. Results showed that 16 out of 30 blacksmiths had a UCr concentration above the biological exposure index (BEI) value, 21 had a higher value than the threshold limit value (TLV), and 22 had hazard index (HI) values > 1, which indicated that Cr has a hazardous potential in the body. The analysis of the exposed and control groups showed a significant difference with a p value of 0.000 for TLV, chronic daily intake, and UCr. These results clearly showed that Cr6+ exposure may harm the health of these workers in the future. The results obtained in this study can be used to promote workers' awareness on the potential health risk caused by Cr6+ exposure in the working environment.

Urinary hippuric acid level as a biological indicator of toluene exposure on batik workers.

Urinary hippuric acid (uHA) is one of the biomonitoring parameters of toxic organic exposure, such as toluene. Repeated exposure to a low concentration of toluene may lead to chronic effects such as central nervous system damage. In the preliminary study, toluene was found in the batik industry's working area in Yogyakarta, Indonesia. This study aims to assess the health condition of batik workers to toluene exposure based on the concentration of uHA. There were 52 respondents divided into 2 groups: the batik workers as the exposed group (30 respondents) and the non-batik workers as the control group (22 respondents). The urine sample was taken from batik workers at the end of the shift, and uHA was measured using spectrophotometry. The uHA value was corrected with urinary creatinine. The results showed that the average uHA concentration of batik workers was higher than that of the control group. The result also showed that workers with more than 2 years working period, writing workers, and stamping workers give an Odds Ratio (OR) of 6.43, 6.75, and 9.00 respectively on having a higher concentration of uHA. Workers with toluene exposure symptoms were also having a higher concentration of uHA than workers without any symptoms.

Toward Sustainable Environmental Quality: Priority Research Questions for Asia.

Environmental and human health challenges are pronounced in Asia, an exceptionally diverse and complex region where influences of global megatrends are extensive and numerous stresses to environmental quality exist. Identifying priorities necessary to engage grand challenges can be facilitated through horizon scanning exercises, and to this end we identified and examined 23 priority research questions needed to advance toward more sustainable environmental quality in Asia, as part of the Global Horizon Scanning Project. Advances in environmental toxicology, environmental chemistry, biological monitoring, and risk-assessment methodologies are necessary to address the adverse impacts of environmental stressors on ecosystem services and biodiversity, with Asia being home to numerous biodiversity hotspots. Intersections of the food-energy-water nexus are profound in Asia; innovative and aggressive technologies are necessary to provide clean water, ensure food safety, and stimulate energy efficiency, while improving ecological integrity and addressing legacy and emerging threats to public health and the environment, particularly with increased aquaculture production. Asia is the largest chemical-producing continent globally. Accordingly, sustainable and green chemistry and engineering present decided opportunities to stimulate innovation and realize a number of the United Nations Sustainable Development Goals. Engaging the priority research questions identified herein will require transdisciplinary coordination through existing and nontraditional partnerships within and among countries and sectors. Answering these questions will not be easy but is necessary to achieve more sustainable environmental quality in Asia. Environ Toxicol Chem 2020;39:1485-1505. © 2020 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.