Abstract
BACKGROUND: Mercury is a toxic metal with effects on human health ranging from acute to chronic in a very short time of exposure. Artisanal and small-scale gold mining (ASGM) is the main source of direct human exposure to mercury. Human exposure to mercury (Hg) can occur through both direct inhalation of mercury vapor and consumption of material taken from contaminated areas. To protect the health of ASGM workers and surrounding communities, a health assessment of mercury exposure and its effects is urgently needed. However, analysis of hair and urine samples as a proof test for mercury toxicity is very expensive. Therefore other tests must be considered to identify the first symptoms of mercury toxicity in miners and the surrounding community. OBJECTIVES: The present study aimed to determine the effects of mercury exposure on renal function along with the hematological parameters of gold miners and the community as a first indication of mercury exposure symptoms. METHODS: The study was designed as a purposive field sampling study and was conducted in 3 main villages in Sekotong District, West Lombok Regency, West Nusa Tenggara Province, Indonesia. The 100 subjects were miners that have been exposed to mercury for at least 5 years and their wives and children (non-miners) who lived around the gold processing area. Blood and urine samples were then obtained from the subjects. The miners and non-miners were questioned about their mercury exposure over the previous 5 years, duration of exposure, and how mercury was handled in their daily life. Blood and urine samples were collected at the time of the study, around 10 ml of urine and 0.1 ml of blood (2 drops) were collected per subject. In order to determine the parallel results between the blood-urine and hair results, hair from the miners was collected at a different time for analysis. RESULTS: The results showed that the subjects had low proteinuria, hemoglobin and hematocrit concentrations as a consequence of chronic mercury intoxication. This finding was parallel with results of high mercury concentrations in urine (>7 - 273.3 μg/l) and miners' hair (>1 - 12.93 μg/g). Miners and non-miners in the exposure area were found to have proteinuria levels of more than 0.3 g/L. Proteinuria (≥0.3 g/L) was observed in 92.6% of miners and 72.4% of non-miners. CONCLUSIONS: The results of the present study suggest that urinalysis of proteinuria and hemoglobin values can be used as a screening test to detect renal impairment due to mercury intoxication.