The prevalence of diabetes in Central America was somewhat greater than in East Pakistan and Malaya, less
than in Uruguay and Venezuela, and substantially less than in affluent societies such as the United States. Differences in prevalence among Central American countries were modest but probably significant in some instances. In all Central American countries diabetes was more common in females but this difference was probably attributable to the greater adiposity of the women. Age-matched populations from eleven different countries of three continents have now been tested using standardized methods. Prevalence of diabetes varied greatly, and differences were more related to environment than to race. These results support the hypothesis that environmental factors can increase or reduce prevalence by several-fold.
Studies carried out on the occupational exposure to paraquat of plantation workers in Malaysia comprised quantitative estimates of dermal and respiratory exposure of knapsack spray operators, carriers, and rubber tappers operating under their normal working conditions. Spray operators have been shown to be dermally exposed to paraquat by walking through recently sprayed vegetation and into their own spray, regular adjustment and unblocking of spray nozzles and leakage, and overfilling of knapsack spray tanks. Carriers also received measurable dermal exposure from walking through recently sprayed vegetation and accidental spillage when carrying and loading. The infrequent and negligible dermal exposure of tappers resulted from walking through recently sprayed vegetation. Determinations of the total airborne paraquat concentrations in the breathing zone show that spray operators and carriers are exposed to an order of 1% or less of the current TLV for respirable paraquat. No paraquat was detected in the breathing zones of tappers working in simultaneously sprayed blocks. The calculated ranges of dermal and respiratory exposures, when compared with published data on both the exposure to, and the toxicity of, paraquat, indicate that there should be no toxicological risk to any of the three groups studied as a result of using paraquat.
A study was carried out by the Factories and Machinery Department of Malaysia to assess the problem ofoccupational exposure to inorganic lead in Malaysian battery workers. The eight factories studied were divided into two categories: large, multinational subsidiaries with good industrial hygiene measures and small, locally-owned companies with poor hygiene features. A total of 251 workers (221 males and 30 females) were included in the study. Personal air sampling showed that 47% of the samples in the small factories had lead-in-air levels exceeding 150 ug/m3, compared unth. 29% in the larger establishments. The highest air lead levels were found in the cutting, pasting/mixing and battery assembly sections. 86.7% ofthe female workers and 62.2% of the male workers in the smaller factories had blood lead concentrations above the proposed limits of 70 ug/100 ml (males) and 40 ug/100 ml (females). In contrast, only 7.6% of the male workers in the larger factories had blood lead levels exceeding the proposed limits. Three workers also had positive signs or symptoms on clinical examination. Legislation of specific regulations to protect the health of lead-exposed workers in Malaysia is currently being drafted by the government.
In a cross-sectional study of 7-12 year-old primary school children in Kuala Lumpur city, lung function was assessed by spirometric and peak expiratory flow measurements. Spirometric and peak expiratory flow measurements were successfully performed in 1,214 and 1,414 children, respectively. As expected, the main predictors of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25% and 75% of vital capacity (FEF25-75), and peak expiratory flow rate (PEFR) were standing height, weight, age, and sex. In addition, lung function values of Chinese and Malays were generally higher than those of Indians. In multiple regression models which included host and environmental factors, asthma was associated with significant decreases in FEV1, FEF25-75, and PEFR. However, family history of chest illness, history of allergies, low paternal education, and hospitalization during the neonatal period were not independent predictors of lung function. Children sharing rooms with adult smokers had significantly lower levels of FEF25-75. Exposures to wood or kerosene stoves were, but to mosquito repellents were not, associated with decreased lung function.
Processing of by-product heavy minerals (amang) from tin mining involves potential exposure to external and internal sources of radioactivity. The radioactivity arises through the presence of thorium and uranium series radionuclides in the various minerals. Monazite is the most radioactive mineral, containing 3% to 7% thorium by weight, while ilmenite is generally the least radioactive mineral containing typically less than 0.05% thorium. External exposure occurs when workers are in close proximity to accumulations or stockpiles of the radioactive minerals, whereas internal exposure occurs when workers are involved in dusty processes. This paper summarizes the nature of the amang industry in South East Asia and presents the results of preliminary measurements of external radiation and airborne radioactivity in twelve Malaysian and Thai plants. Although constrained by a paucity of exposure data, it is concluded that radiation doses to some amang plant workers may approach or exceed international standards and that appropriate control measures are required as a matter of priority, Radiation doses may approach or exceed 100 mSv in situations where workers are exposed to excessive levels of ambient dust and no protective measures are used. Observations and recommendations are made relating to monitoring and surveillance, instruction and training, and engineering and administrative protection measures.
A study on lead exposure among school children aged between 7 and 12 years from Kajang and Sepang in the state of Selangor, Malaysia was carried out using delta-aminolevulinic acid (delta-ALA) levels in the urine as an index. The delta-ALA levels in urine were linked to variables which could contribute to lead exposure. Out of 1628 school children studied [Kajang (43.5%) and Sepang (56.5%)], only 194 subjects (16 and 8.8% from Kajang and Sepang, respectively) had urinary delta-ALA levels between 0.6 and 2.0 mg/100 ml. However, chi 2 analysis demonstrated significant association between delta-ALA of this group to some of the variables. The strongest association was found in the habit of biting fingernails (P < 0.025). Other statistically significant correlations were found between delta-ALA and father's occupation (P < 0.05) and the amount of time spent playing in the field (P < 0.01). Generally, this study indicates that school children in Kajang and Sepang are still relatively safe from excessively high lead exposure. However, a more sensitive indicator, which is based on a lower tolerable lead limits, such as lead in blood, are necessary to affirm this finding.
Soil-transmitted helminthiasis is a common problem in communities with poor socio-environmental conditions. This study was undertaken to identify important socio-environmental predictors of soil-transmitted helminthiasis in Bachok, a rural community in Kelantan for the development and implementation of an effective prevention and control program. Of 363 children randomly sampled, 38.8% were infected with soil-transmitted helminthiasis. Risk predictors of soil-transmitted helminthiasis found to be significant after adjustment included poor household hygiene score and large household size. The probability of being infected was 0.58 amongst children with both of these risk factors.
Public concern about the adverse environmental and human health impacts of organochlorine contaminants led to strict regulations on their use in developed nations two decades ago. Nevertheless, DDT and several other organochlorine insecticides are still being used for agriculture and public health programs in developing countries in Asia and the South Pacific. As a consequence, humans in this region are exposed to greater dietary levels of organochlorines. In this review, published information on organochlorine concentrations in foodstuffs from South and Southeast Asia and Oceanic countries has been compiled. Foodstuffs that contribute to human exposures and dietary intakes of organochlorines were examined, and the data compared with those reported from more developed nations. Among various developing countries in Asia, considerable information on organochlorines in foodstuffs has been available from India since the late 1960s. DDT and HCH were the major insecticides in Indian foodstuffs. Concentrations of these insecticides have declined more than two orders of magnitude in farm products, such as food grains and vegetables, in two decades. Milk and milk products are the major sources of dietary exposure to DDT and HCH in India. The residues of these insecticides in dairy products were close to or above the MRLs of the FAO/WHO. Dietary intake of DDT and HCH by Indians was > 100 fold that in more developed nations. Sporadic incidences of greater concentrations (> 1 microgram/g) of aldrin, dieldrin, and heptachlor have been measured in Indian vegetables. Untreated surface waters could be a potential source of DDT and HCH exposure. In most Southeast Asian countries DDT was the common contaminant in animal origin foodstuffs. The higher percentage of p,p'-DDT in meat and fish from Southeast Asian countries, except Japan and Korea, indicated the recent use of DDt in vector control operations. Dietary intakes of DDt and HCH in Southeast Asia were an order of magnitude less than those of Indians but 5- to 10 fold greater than in more developed nations. In addition to DDT, aldrin and dieldrin were prominent in meat collected from Thailand and Malaysia. Aquatic food products from more industrialized countries, such as Japan, South Korea, Hong Kong, and Taiwan, contained significant levels of PCBs. In South Pacific countries, particularly in Australia and New Zealand, chlordanes and PCBs were the most prevalent organochlorines in foodstuffs. Food contamination by DDT, HCH, aldrin, and dieldrin was less than in developing countries in Asia but greater than in the U.S. and Japan. Intake of PCBs in Australia was greater than in the U.S. Meat and fish were the major sources of organochlorine exposure by Australians. Human dietary intake of organochlorines has been declining more slowly in developing countries in Asia. Current intakes were at least 5- to 100 fold greater than those in more developed nations, suggesting a greater risk from organochlorine exposure. Factors such as malnutrition, common among rural poor in developing nations, can increase these risks. Of greatest concern is the magnitude of exposure to organochlorines to which infants and children are subjected through human and dairy milk. The estimated intake of DDT by infants was at least 100 fold greater than the ADI of the FAO/WHO. In addition to DDT, excessive exposures to HCH and dieldrin may cause potential health effects in infants because they are more vulnerable to toxic effects. The design and implementation of appropriate epidemiological studies and their integration with monitoring of human, food, and environmental samples would be a major step in assessing the risks of organochlorine residues in foods and controlling or eliminating them. With the continued globalization of trade in food products, and the concomitant risk that food contaminated through point-source pollution may be widely distributed, identification of sources and their control should be matters of
A study was conducted to compare the blood lead levels of 97 pregnant women warded at the Kuala Lumpur Hospital, according to their ethnicity, residence and place of work. The lead content of venous blood samples was determined with a graphic furnace atomic absorption spectrometer. Blood lead levels of Klang Valley women seem to have decreased from 17.3 micrograms/dl in 1982 to 7.71 micrograms/dl in the present study most probably attributed to the phasing out of leaded gasoline. This level is below the 10 micrograms/dl recommended by the United States Environmental Protection Agency for the public, even though 27.8% of them still have blood lead levels that are equal to or in excess of 10 micrograms/dl. The study shows that certain segments of the population such as Indians (geometric mean = 9.35 micrograms/dl) and housewives (geometric mean = 9.55 micrograms/dl) may still experience blood lead levels that are slightly elevated than the rest of the population.