health issues in upper citarum: obesity and agrochemicals filehealth issues in upper citarum:...
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Health issues in upper Citarum: obesity and (agro)chemicals
Chiho Watanabe Dept Human Ecology
Graduate Sch of Medicine U Tokyo
Interlinkage meeting; May 27, 2014
Profile of ENVrionmental REsearch in Rural Asia 2006-2009
• Bangladesh, China, Indonesia, Nepal, PNG, Vietnam approx. 5,500 participants from 32 rural communities (some “urban” included as the “control”) • focus: - Impact of the changing lifestyle (changing subsistence) on health (and environment) in rural Asia > communities were so selected to reflect different lifestyle within each area. - Exposure to (Agro)chemical, industrial chemicals, and metals among villagers. - nutritional status (including lean/overweight) among adults (“Double burden”) • household survey in Upper Citarum. -5 villages: 50 households/village with schoolchildren - Sampling of biological media (blood, urine, saliva) - Interview: demographic, socioeconomic status, food consumption, physical activity (GPS/accelerometer).
* Collaboration with Institute of Ecology, UNPAD for West Java survey.
Pop. In Asian developing countries: total/rural (3.6/2.2 bil) (FAO, 2000)
Subsistence transition and life/health
Self-consuming, sustainable, domestic slush-and-burn (tuber), paddy field
Market-dependent, risk-taking Adopting new technology, incld chemicals
Vegetables/coffee/tropical fruits banana/rubber
Traditional agriculture
Cash crop-oriented agriculture
subsistence transition
Effects on life/health ・chemical exposures⇒ biomarkers of effects ・shortened ? Labor hours ・improved food, nutrition
Effects on local environment ・introduction of chemicals⇒ water quality, products, ・changes in the land usage (forest converted into cultivating field)
Chemicals: pesticides, Fertilizers, food additives, Plastics, undegradables
2008
B= agri culture to pisciculture (Sagulin 1985) pop 8,034 HH 2,133 (2001) Agriculture activity = low
P= paddy-field & cash-crop 950-1,450 m ASL Pop. 9,555 HH 3,200 (2002)
C= vegetable & dairy farming 1,200-1,600 m ASL pop 5,070 HH1,300 (2002 ) Agriculture activity = high
Study sites
P (control)
C (agricultural)
B (pisciculture)
B C T P S 1way ANOVA
Hb [g/dL] (NOT adjusted for
altitude)
♂ 13.9 14.2 15.0 13.9 14.2 **
♀ 12.8 13.2 13.5 12.7 12.2 ***
Uinrary Zn [μg/gCre]
♂ 721 433 632 645 409 *
♀ 499 484 430 389 298 ns
Urinary Se [μg/gCre]
♂ 34 21 30 25 21 ***
♀ 35 25 30 21 22 ***
Height [cm] ♂ 159.7 159.8 161.2 159.6 160.7 ns
♀ 149.3 147.6 150.9 149.1 150.0 *
BMI ♂ 21.3 20.8 21.3 20.5 21.7 ns
♀ 24.1 23.2 24.8 22.6 24.2 *
%fat ♂ 17.3 16.5 17.0 16.8 19.4 ns
♀ 35.4 33.8 35.4 32.9 35.8 ns
MUAC ♂ 25.5 25.7 26.7 24.8 26.6 ns
♀ 27.8 25.8 28.0 25.1 27.0 *
Salivary cortisol
[ng/mL]
♂ 1.3 1.9 1.4 1.6 1.4 *
♀ 1.4 2.1 1.9 1.7 1.3 *
Examples of the Effect variables (Z) nutritional status and stress
B C T P S ANOVA
Spraying Pesticides
% (Q42)
♂ 4 65 31 10 4 ***
♀ 2 0 0 0 5 ns
AchE/Hb ♂ 3.9 4.0 4.4 4.3 4.1 ***
♀ 3.4 3.6 3.9 3.6 3.5 **
Urinary DAP [% detected]
♂ 50 57 64 31 56 *
♀ 38 31 49 23 49 ns
Urinary As [ng/mgCre]
♂ 75 80 83 81 61 ns
♀ 88 101 76 76 63 ns
Urinary Cd [ng/mgCre]
♂ 0.93 0.41 0.68 0.83 0.65 *
♀ 1.61 1.06 0.94 0.70 0.69 ***
Urinary Pb [ng/mgCre]
♂ 5.5 2.9 3.8 1.5 1.5 ***
♀ 5.5 2.3 3.7 1.2 1.6 ***
Exposure to chemicals
Relationship between effect (Z) and descriptor (Y) “nutritional status” domain – PC1 = “high energy” status
MALES = high only in S (urban) FEMALES =high in B,T in addition to S. PC1 load: females >males (partly due to higher %fat). non-farming, & chem-dep farming were associated with “high energy”
P(paddy)
S(urban)
B(fish) T(dairy)
C(vege)
MALES FEMALES S(urban)
Effects (Z) and descriptors (Y): stress (physical/psychological)
Saslivary cortisol concentration; would reflect both physiological psychological stresses. Both non-farming¥chem-dep farming >> lower stress
males females
P(paddy)
S(urban)
B(fish) T(dairy) C(vege)
Obesity (risk for chronic dis.)
ESA Human Ecology: SYMP-19 @Pittsiburge 100805
BMI males BMI females
N mean Under (<18.5)
Over (>25)
N mean Under (<18.5)
Over (>25)
West Java, Indonesia
Vairous area, Nepal
11
GPS/accerelometer plot of an individual
ENVRERA West Java lifestyle change and health; findings
• Most of the health-associated variables showed inter-community difference, some (e.g. nutrition) were positively and others (e.g., stress) were negatively associated with “urban” characteristics. • Substantial proportion of lean and overweight individuals were observed within each community. “Fat females and lean males” was the predominating pattern; a feature of West Java population (among the six countries surveyed). This indicated the impacts of “lifestyle change” may not be identical on males and females. • Exposure of children to agrochemical (organophosphate pestides) were less extensive compared to that of children living in a rural area in Japan, and the levels were not associated with the intensity of agricultural activity. While exposure to metal elements like Cd and Pb did not seem extensive, the level of As was somewhat elevated.