ENVIRONMENTAL HEALTH PROMOTION MODEL TO PREVENT DEVELOPMENTAL DISRUPTION OF CHILDREN AS ARESULT OF MERCURY EXPOSURE

Transcription

1 ENVIRONMENTAL HEALTH PROMOTION MODEL TO PREVENT DEVELOPMENTAL DISRUPTION OF CHILDREN AS ARESULT OF MERCURY EXPOSURE Yusniar Hanani Darundiati, Anies, Henna Rya Sunoko, Onny Setiani FACULTY OF PUBLIC HEALTH DIPONEGORO UNIVERSITY SEMARANG INDONESIA

2 INTRODUCTION Mercury exposure Health effects Children development Mental retardation developmental delay Minamata disease Mercury contamination Page 1 AGM (amalgamation) at Jendi since 1993 till now Hg level in dug well water from 50 samples (+) Hg ( ) Hg Mean = 0,0114 mg/l (WHO = 1µg/l) Dinkes Prop Jateng (2010)

3 RESEARCH OBJECTIVE To develop environmental health promotion model to control and prevent developmental disruption of children as a result of mercury exposure fromartisanal gold mining activities

4 METHODS Research site and time Artisanal gold mining area at Jendi Village, Selogiri, Wonogiri, Indonesia Juni 2013 Maret 2014 Research design Observasional, cross sectional 3 stages : exploration of environmental factors, epidemiologic research, planning and developing model Population and samples Children (2 5 yrs old) 54 children (purposive sampling) Hair samples, water samples, soil samples Data analysis Cross tab, Chi square, multiple logistic regression

5 RESEARCH FRAMEWORK STAGE I : EXPLORATION OF ENVIRONMENTAL FACTORS STAGE II : EPIDEMIOLOGIC RESEARCH STAGE III : DEVELOPING MODEL PLANNING TRIAL FOR MODEL FEASIBILITY IMPLEMENTING MODEL EVALUATION

6 RESULT AND DISCUSSION ARTISANAL GOLD MINING PROCESS at Jendi Village, Selogiri, Wonogiri Ores mining Crushing WATER Milling Hg amalgamation TAILING Burning amalgam Hgvapor Gold

7 STAGE I. EKSPLORATION OF ENVIRONMENTAL FACTORS SOIL Hg LEVEL at Jendi Village Min (mg/kg) Max (mg/kg) Mean (mg/kg) Std Deviation Natural Standard Value for Soil Environment Quality I for mercury (NSV) : 150 ng/g (=1,5X 10 4 mg/kg) Fresh water Hg level (ppb) at Jendi Village Th i l f f h t H l l b ( 2 259) The maximum value of fresh water Hg level was ppb (mean = 2.259) WHO guidelines value (2004 ) 1µ/L for total Hg 13 samples (24,1 %) were above the standard level

8 STAGE II. EPIDEMIOLOGIC RESEARCH Children s hair Hg level (ppm) Min Max Mean Standard Samples Deviation size 12, , , ,74 54 Children s level of development

9 Result of logistic regression Step 7 a Category of living area Mother s Level of Education B S.E. Wald df Sig. Exp(B) 1,728 0,668 6, ,010 5,628 1,138 0,666 2, ,088 3,121 Constant -2,099 0,580 13, ,000 0,123 Category of children s living area and mother s level of education influence children s level lof development

10 Environmental health promotionmodel model SOCIAL ENVIRONMENT HAZARD IDENTIFICATION RISK ASSESSMENT PERCEIVED SUSCEPTIBILITY PERCEIVED SEVERITY PERCEIVED THREAT SELF EFFICACY RISK CONTROL CUES TO ACTION PERCEIVED BENEFIT MONITORING AND EVALUATION vs PERCEIVED BARRIER Developed from HBM and HIRARC

11 Environmental health promotion model in ASM PERCEIVED SUSCEPTIBILITY : Children under 5 are vulnerable to toxic effects of Hg PERCEIVED SEVERITY : Hg toxicity may cause CNS damage which is irreversible PERCEIVED THREAT : Local inhabitants are threaten by Hg exposure CUES TO ACTION : communication, information, education through early education program SOCIAL ENVIRONMENT : community engagement SELF EFFICACY : healthy behavior to avoid Hg exposure PERCEIVED BENEFIT : Avoid exposure, prevent and minimise toxic effect of Hg, increase health, normal development vs PERCEIVED BARRIER: Financial limitation, availability of environmental friendly technology to extract gold HAZARD IDENTIFICATION : Hg use in ASM cause env. contamination RISK ASSESSMENT : Children s health & level of development RISK CONTROL: Concentrate amalgamation, communal tailing process, using env.friendly tech MONITORING AND EVALUATION: Monitoring of env. Quality, monitoring children s health and level of development, hair Hg level examination

12 CONCLUSION Category of living area (exposed unexposed) and mother s level of education influence children s level of development. Children living in exposed area had risk 5 times higher to experience developmental disruption than children living in unexposed area. Environmental lhealth promotion model dlare consist itof 12 constructs t : hazard identification, risk assessment, risk control, monitoring and review, perceived susceptibility, perceived severity, perceived threat, perceived benefit, perceived barrier, self efficacy, cues to action, social environment RECOMMENDATION It i ddt l thi dli t th ti l ld It is recommended to apply this model into other artisanal gold mining sites in Indonesia to prevent developmental disruption among children living in exposed area