The Nephrotoxic Effects of Mercury Among Coal Power Plant Workers in Sual Pangasinan

8/12/2019 The Nephrotoxic Effects of Mercury Among Coal Power Plant Workers in Sual Pangasinan

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Panel:

J. Calayo, RMT, MSMTJE Jose, RMT, MSMTCJ Acosta, RPh,MSPharma

Room: Lab 10Time: 10:20 am

UST FACULTY OF PHARMACY

NEPHROTOXIC EFFECTS OF MERCURY AMONG COAL

POWERPLANT WORKERS IN SUAL, PANGASINAN

A Thesis Sbmitte! to the

"aclty o# Pharmacy o# the

$ni%ersity o# Santo Tomas

&e'artment o# Me!ical Technolo(y

Es'a)a, Manila

*n Partial "l#illment

o# the Re+irements #or

achelor o# Science in Me!ical Technolo(y

"erna!e-, Christian oel

/arcia, Romal! Jo-e' &.

/asa'o, Simon *bert /.

/balla, ester *mer S.

Loreto, Allen Ste'hen .

illalobos, Maria Jho(ielyn A.

/MT


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March 201

ACKNOWLEDGEMENT

This thesis 3ol! not ha%e been 'ossible 3ithot the (i!ance an! the hel' o#

se%eral in!i%i!als 3ho in one 3ay or another contribte! an! e4ten!e! their %alable

assistance in the 're'aration an! com'letion o# this st!y.

"irst an! #oremost 3e 3ol! li5e to than5 or research a!%iser, Associate

Pro#essor Ron Sison, 3ho (a%e the moti%ation to 'rse the research an! len! him

time in criti+in( the research 3or56 7e 3ol! also li5e to than5 Associate Pro#essor

8an!ro ieto , #or hel'in( s on or statistical !ata6 7e 3ol! li5e to e4'ress or

(ratit!e to the "aclty an! Sta## o# $ST "aclty o# Pharmacy, #or (i%in( incenti%es

#or the ma5in( o# the st!y.

Thro(h the s''ort, be it emotionally, mentally or #inancially an! assistance

#or or thesis, 3e are (rate#lly than5#l to or 'arents. 7e 3ol! li5e also to e4'ress

or (ratit!e to or #rien!s #or their encora(ement an! s''ort an! abo%e all, to the

Almi(hty /o! #or 9is e%erlastin( 5in!ness an! blessin(s #or the sccess o# this st!y.

"erna!e-, Christian oel






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TABLE OF CONTENTS

Title o# research 1

Ac5no3le!(ement 2

Table o# Contents ;

C9APTER * < *TR=&$CT*= >

1.1 ac5(ron! o# the st!y >

1.2 =b?ecti%es o# the St!y @

1.; Si(ni#icance o# the St!y @

1. Sco'e an! Limitations

1.B &e#inition o# terms

C9APTER 2 < RE*E7 =" RELATE& L*TERAT$RE 11

2.1 Mercry 11

2.1.1 Ty'es o# Mercry 12

2.1.1.1 Elemental Mercry 12

2.1.1.2 *nor(anic Mercry 12

2.1.1.; =r(anic Mercry 1;

2.1.2 Sorces an! Rote o# E4'osre o# Mercry 1;

2.1.; inetics an! Metabolism 1


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2.1.;.1 Elemental Mercry 1

2.1.;.2 *nor(anic Mercry 1

2.1.;.; =r(anic Mercry 20

2.1. 9ealth E##ects o# ActeD Sin(le E4'osre 20

2.1.B Coal 2>

2.1.> Coal Minin( ;1

2.1. The /lobal Coal Mar5et ;

2.1.@ Renal &isor!ers 2

C9APTER ;


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.2 Reslts B@

.; ar /ra'hs B

C9APTER B C=CL$S*=

>;

*L*=/RAP9 >

APPE&*CES

A. /antt Chart >@

. E4'ense Re'ort >


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CHAPTER 1

INTRODUCTION

1.1 Backgr!"# $ %&' S%!#(

e'hroto4icity is an in?ry or !ama(e to one or both o# the 5i!neys that reslts

#rom e4'osre to a to4ic chemicals or materials an! me!ications sally ta5en by

moth. 7hen 5i!ney !ama(e occrs, yo are nable to ri! yor bo!y o# e4cess rine

an! 3astes.

e'hroto4icity is also 5no3n as to4ic 5i!ney !isease becase o# the 'resence

o# aristolochic aci! in the bo!y that cases !ama(e to the 5i!ney. There are many

sym'toms that a 'erson can e4'erience i# they ha%e ne'hroto4icity, these are bloo! in

the rine, nasea, !ro3siness, imbalance, #ati(e an! con#sion. =ne (oo! e4am'le

that can contribte to ne'hroto4icity is the lon( term e4'osre to hea%y metals sch as

mercry. FAmerican i!ney "n!, 2010G

Mercry is an element in the earthHs crst. *t is a to4ic metal that has no

biochemical or ntritional #nction. Most o# the to4ic e##ect o# the sbstance is on the

central ner%os system. Mercry is ca'able o# casin( se%ere brain !ama(e in the


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#ets an! mil! tremors, mental !isor!er, emotional !istrbances an! e%en !eath in

e4'ose! a!lts. E4'osre to hi(h le%els o# mercry can 'ermanently !ama(e the

5i!neys. ein( se#l in researches an! laboratory o'erations, mercry is also %ery

!an(eros 3hen not han!le! 'ro'erly. Mercry e4'osre can be #on! thro(h

battery #actory, steel 'ro!ction, castic so!a 'ro!ction, cement 'ro!ction, minin(

in!stry, etc. =ne o# the most common e4'osres to mercry is thro(h combstion

o# coal. 7hen coal is brne! mercry is release! into the en%ironment. FSin(h et al,

2011G

Coal is the !irtiest, most carbon intensi%e o# all #el an! is one o# the lea!in(

contribtors to climate chan(e. Coal brnin( Po3er Plants are lar(est hmancase!

sorce o# mercry emissions on the air. rnin( coal releases massi%e amonts o#

sbstances sch as mercry an! arsenic that are to4ic to hman health. Many 'o3er

'lants in the Phili''ines tili-e coal combstion #or it is one o# the chea'est metho!s

a%ailable. E4'osre to mercry is not ?st a 'roblem #rom the 'ast bt it remains a

'roblem to!ay #or 3or5ers in many in!stries sch as Coal Po3er Plants.

"ili'inos 3ho ha%e 3or5e! #or a lon( time on coal 'o3er 'lants 3ere st!ie!

base! on the ne'hroto4ic e##ects thro(h chronic mercry e4'osre. The st!y can

'ro%i!e im'ortant in#ormation to hel' !etermine 3hether or not there is an association

bet3een health con!itions o# the 'o3er 'lant 3or5ers an! mercry e4'osre.


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1.) O*+'c%-' $ %&' S%!#(

/enerally the researchers 3ol! li5e to assess the ris5 o# !e%elo'in( renal !ama(e in

relation to mercry e4'osre amon( coal 'o3er 'lant 3or5ers.

S'eci#ically, the researchers 3ol! li5e:

1.2.1 To establish the se%erity o# renal !ama(e thro(h %arios rine

'arameters li5e (lcose, 'rotein, cast, mercry an! creatinine.

1.2.2 To associate the !ration o# e4'osre thro(h the ris5 o#

!e%elo'in( renal !ama(e.

1.2.; "or 'ossible correlational #in!in( bet3een mercry e4'osre

an! chronic renal !ama(e

1./ Sg"$ca"c' $ %&' S%!#(

Coal 'o3er 'lants (enerate almost 100I o# mercry emissions, 3hich cases

neroto4icity an! !e%elo'ment e##ect in the #ets. E4'osre to mercry can also case

serios mltior(an !ama(e a##ectin( the ner%os system, 5i!neys, ln(s etc.


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9ealth ris5s o# methyl mercry 3ill be assesse! #rom brnin( coal. The e##ect

o# coal combstion insi!e the 'o3er 'lant 3ill be sho3n thro(h establishin( the

se%erity o# renal !ama(e by sin( !i##erent rinary tests li5e (lcose, 'rotein, cast,

mercry an! creatinine. The !ration o# e4'osre to mercry 3ill also be associate!

thro(h ris5 o# !e%elo'in( renal !ama(e 3hen 3or5in( insi!e the 'o3er 'lant.

*nci!ental correlations o# ne'hroto4ic 'arameters 3ill also be assesse!.

1.0 Sc' a"# L2%a%"

This st!y mainly #ocse! on the to4ic e##ects o# mercry #rom the 'o3er

'lant to the 5i!neys an! not on the res'iratory, nerolo(ic, (astrointestinal, an!

car!io%asclar as'ects. This st!y only co%ere! the elemental ty'e o# mercry.

*nor(anic an! or(anic ty'es o# mercry are ot o# the sco'e o# or st!y.

1.3 D'$"%" $ T'r2

A4*!2" " Ur"'< re#ers to !etection o# albmin

B4# M'rc!r( 5 re#ers to the amont o# mercry Fa sil%er 3hite, 'oisonos,

metallic element se! in thermometers an! other scienti#ic instrmentsG #on!


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in bloo!

Ca4< mineral o# #ossili-e! carbon

C"%r4 gr!< a (ro' o# sb?ects closely resemblin( the e4'ose! (ro' in

many !emo(ra'hic %ariables bt not recei%in( the acti%e me!ication or ris5

#actor n!er st!y an! thereby ser%in( as a com'arison (ro' 3hen treatment

reslts are e%alate!.

Cr'a%""' < a 3hite crystalline stron(ly basic com'on! #orme! #rom

creatine an! #on! es'ecially in mscle, bloo!, an! rine.

Ur"' Cr'a%""' more than 12 years Male 20 < ;0 milli(ram 'er

!eciliter

more than 12 years "emale 20 < ;20 milli(ram 'er !eciliter

E6'# Gr!7r'"#'"%8 the (ro' 3ho satis#ie! the inclsion criteria

H'a-( M'%a4 P""g 5 is the to4ic e##ect o# certain metals in certain #orms

an! !oses on li#e

M'rc!r( 5 is the only metal that is li+i! at stan!ar! con!itions #or

tem'eratre an! 'ressre.

&etection limit < 1. 0 micro(ram 'er liter


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N'&r%6c%(< is a 'osisonos e##ect o# some sbstances, both to4ic

chemicals an! me!ication, on the 5i!neys

Ur"' M'rc!r(< re#ers to the amont o# mercry #on! in rine

CHAPTER )

RE9IEW OF RELATED STUDIES AND LITERATURE

).1 M'rc!r(

Mercry is a metallic element that occrs natrally in the earthKs crst an!

e4ists in the en%ironment as the reslt o# both natral an! anthro'o(enic 'rocesses

FRisher et al. 200G. Mercry in elemental #orm is a sil%ercolore! metal that e4ists as

a thic5 li+i! at room tem'eratre, #amiliar to most 'eo'le as the sil%er li+i! insi!e

mercry thermometers. Mercry can chemically combine 3ith other elements to #orm

or(anic Fcarboncontainin(G an! inor(anic Fnot containin( carbonG com'on!s.

Mercry is a natrallyoccrrin( metal that is se! in manma!e 'ro!cts an!

'rocesses, an! is emitte! into air #rom in!strial sorces. 9man e4'osre to mercry

occrs #rom a %ariety o# sorces, e.(., breathin( mercrycontainin( air, sin(


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commercial 'ro!cts that contain mercry, an! in(estin( some ty'es o# #ish that

contain methyl mercry. &etermination o# mercry is thro(h atomic absor'tion

s'ectrosco'y. *t is an analytic 'roce!re #or the +antitati%e !etermination o#

elements thro(h the absor'tion o# o'tical ra!iation by #ree atoms in the (as 'hase.

The s'ectra o# the atoms are line s'ectra that are s'eci#ic #or the absorbin( elements.

FTEAC9, 200G

).1.1 T(' $ M'rc!r(

).1.1.1 E4'2'"%a4 M'rc!r(

Elemental, or metallic, mercry is the 'rimary #orm o# mercry release! into

the airby natral 'rocesses, sch as %olcanic acti%ity. 7hen bon! to other

chemicals,mercry may ha%e %alence states o# either 1 For mercros mercryG or 2

Formercric mercryG. Many com'on!s o# mercry can he #orme! #rom the

mono%alentan! !i%alent cation #orms. *n the en%ironment, elemental mercry can

combine 3ith chlorine, sl#r, 'hos'horos, an! other elements to #orm inor(anic

com'on!s. *n3ater, inor(anic mercry can be combine! 3ith carbon to #orm or(anic

mercrycom'on!s thro(h the action o# a+atic microor(anisms FRisher et al,

200G.Elemental mercry is#on! in thermometers, #lorescent blbs, !ental amal(am


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).1.1./ Orga"c M'rc!r(

=r(anic mercry, 're!ominantly methyl mercry, is #on! in #oo!s sch as

#ish, an! ethyl mercry #on! in some %accine 'reser%ati%es an! some antise'tics

FTEAC9, 200G.

).1.) S!rc' a"# R!%' $ E6!r' $ M'rc!r(

The main rote o# e4'osre to elemental, inor(anic, an! or(anic mercry is

inhalation, in(estion,an! absor'tion res'ecti%ely FS. ll et al., 200G.

Metallic mercry in li+i! #orm has been a%ailable in homes, schools, o##ices,

an! health care #acilities #or many !eca!es. *ts shiny, sil%ery a''earance, its 'hysical

ability to #orm small bea!s 3hen !istrb, an! its ability to ma5e ol! sil%ercolore!

coins loo5 li5e ne3 ma5e it 'articlarly attracti%e to chil!ren o# all a(es FRisher et al.,

200G. Some tra!itional ses o# this #orm o# mercry, as 3ell as acci!ental s'ills, ha%e

been #on! to reslt in a %ariety o# health e##ects, ran(in( in se%erity #rom relati%ely

beni(n to lethal Fanlen /ottlieb, 11G. E4'osre to elemental mercry occrs

'rimarily thro(h the inhalation o# mercry %a'ors. *n#ants an! yon( chil!ren, 3ith

breathin( -ones closest to the #loor, are at (reater ris5 o# si(ni#icant e4'osre

#ollo3in( s'ills o# elemental mercry, since mercry %a'or is hea%y an! ten!s to #orm

layers close to the #loor FClar5son, Ma(os, Myers, 200;G. *na!%ertent e4'osre to


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mercry %a'or is a recrrin( sorce o# inta5e o# this metal into the bo!y. *n some

cases, e4'osre is com'letely n5no3n an! is only !isco%ere! becase o# the onset o#

sym'toms. Sch cases o#ten in%ol%e mo%in( into a 're%iosly contaminate! resi!ence

or strctre 3ithot 5no3le!(e o# the mercry contaminationF=rlo## el al., 16

Sasso et al., 1>6eates Mortensen, 1G. *n other instances, the na''ro%e!

remo%al o# mercry #rom schools, 3arehoses, or aban!one! in!strial #acilities has

reslte! in si(ni#icant e4'osre, ty'ically o# chil!ren Fa5er Eshenar, 200B6

/eor(e et al., 1>6 Malec5i 9o'5ins, 1B6 Risher, ic5le, Amler, 200;6 Se4ton

et al., 1>G. A recent sorce o# ina!%ertent e4'osre 3as the re'lacement o#

mercrycontainin( (as re(lators in homes, 3ith sbse+ent e4'osre resltin( #rom

s'illa(e o# elemental mercry in the 'rocess F9ryhorc-5 et al., 200>G.

&ental amal(am also constittes a sorce o# e4'osre to elemental mercry

#or some in!i%i!als. Amal(am, or Nsil%er,N #illin(s consist o# a''ro4imately B0

'ercent elemental mercry, ;B 'ercent sil%er, an! a mi4tre o# other metals. *# sch a

#illin( 3ere acci!entally bro5en an! s3allo3e!, it 3ol! 'ass thro(h the

(astrointestinal tract intact an! he eliminate! in the #eces. Some %ery sli(ht

%olatili-ation occrs thro(h normal che3in( 'rocesses, ho3e%er, resltin( in some

absor'tion o# the metal thro(h the ln(s. The 7orl! 9ealth =r(ani-ation

F79=,11G estimates that !entalamal(am #illin(s contribte a''ro4imately to 1

micro(rams o# mercry 'er !ay to hmans 3ho ha%e a si(ni#icant nmber o# !ental


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amal(am #illin(s. *t is im'ortant to note that altho(h !entalamal(am #illin(s are the

ma?or sorce o# mercry e4'osre #or most 'eo'le, there is no cre!ible e%i!ence to

s((est that mercry amal(ams re'resent a health ris5. "rthermore, recent st!ies

ha%e #on! no association bet3een mercry amal(am e4'osre an! nerolo(ic or

renal !ys#nction in chil!ren Fellin(eret al, 200>6&eRoen et al., 200>6 in(man,

Albers, Are--o, /arabrant, Michale5, 200BG, consi!ere! to be the most sensiti%e

hman sb'o'lation.

A lesser 5no3n, yet 3ell!ocmente!, se o# metallic mercry amon( the

(eneral 'o'lation is its se in ethnic or #ol5 me!ical 'ractices FRisher et al., 200G

The oral se o# mercry to treat in!i(estion, or empacho, in some 9is'anic

'o'lations is also a sorce o# e4'osre. Some Caribbean reli(ions, sch as o!o,

Santeria, =beah, an! Es'iritismo, sometimes se mercry ceremonially #or a %ariety

o# 'r'oses F7en!ro##, 200B6 e3, Morris, Aihie, "ysh, Jones, oo5s, 1;G. Sch

ses may incl!e the s'rin5lin( o# metallic mercry aron! the home an! atomobile

to 3ar! o## Ne%il s'irits.N *n some 'ractices, mercry is s'rin5le! in baths or brne!

on !e%otional can!les. All o# these ses can reslt in e4'osre to sers an! #amily

members. Another se o# elemental mercry is its sbctaneos in?ection to 3ar! o##

e%il an! 'rotect a(ainst in#ectionD!isease, an a''arently common 'ractice in se%eral

Central an! Soth American contries FPrasa!, 200G. *ntra%enos in?ection o#

elemental mercry in a nmber o# sici!e attem'ts also has been re'orte! Fayias,


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&rosos, 9a'sasAna#nosto'olo, 200;G.

The JS* Center #or En%ironmental 9ealth St!ies F200;G re'orte! a st!y

con!cte! in Massachsetts, in 3hich @@ 'eo'le, 're!ominantly o# Latino or

Caribbean bac5(ron!, 3ere sr%eye!. *n this st!y, in!i%i!als, or BB 'ercent o#

the st!y 'o'lation, in!icate! that they se! mercry in their homes.=# these, 1

in!i%i!als a!mitte! s3allo3in( a !rin5 containin( mercry 1; a''lie! mercry to

their s5in,1B2 brne! mercry in can!les, an! 10@ s'rin5le! mercry aron! their

homes.The se o# mercry in tra!itional Chinese me!icine can reslt in the in(estion

o# ' to 1.2 (rams F'robably as mercry sl#i!eG !aily FEs'ino-a, Mann, lea!s!el,

1>G.

The =re(on En%ironmental an! =cc'ationalE'i!emiolo(y 7eb site contains

a3arnin( abot mercrycontainin( nec5laces 3orn by some school chil!ren F=re(on

9ealth Ser%ices, 200>G. These nec5laces contain metallic mercry in a (lass 'en!ant

attache! to a chain, cor!, or leather stra'. The 'en!ants are sometimes #ille! 3ith

bri(htly colore! li+i!s to(ether 3ith the mercry an! may come in a %ariety o#

sha'es. rea5a(e o# 'en!ants has reslte! in mercry s'ills.

reast mil5 is also a 'otential sorce o# e4'osre to inor(anic mercry,

3hether the initial sorce o# the mercry is maternal e4'osre to elemental mercry


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%a'or or methylmercrycontaminate! #ish F?ornber(, ahter, er(ln!, i5lasson,

lenno3, San!bor(hEn(ln!, 200B6 =s5arsson, Scht-, S5er#%in(, 9allen, =hiin,

La(er5%ist, 1>G.

).1./ K"'%c a"# M'%a*42

).1./.1 E4'2'"%a4 M'rc!r(

The absor'tion o# mercry is lar(ely !e'en!ent on the #orm. The 're!ominant

rote o# e4'osre #or elemental mercry is inhalation FS. ll et al., 200G. A#ter

inhalation, a''ro4imately @0 I o# mercry %a'or crosses the al%eolar membrane an!

is ra'i!ly absorbe! into the bloo!. Li+i! elemental mercry is 'oorly absorbe!

Fa''ro4imately 0.01 IG #rom the (astrointestinal tract 'robably !e to its con%ersion

to !i%alent mercry an! bin!in( to sl#hy!ryl (ro's. &ermal e4'osre to elemental

mercry %a'or may also occr to some e4tent, contribtin( to a''ro4imately 2.> I

o# the absorbe! !ose. Absor'tion %ia the ol#actory ner%es has also been 'ro'ose!

altho(h +antitati%ely this is a minor 'ath3ay. FS ll, 200G


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Absorbe! elemental mercry is ra'i!ly !istribte! to all tisses, altho(h it

accmlates tothe (reatest e4tent in the 5i!ney, reachin( bet3een B0 an! 0 I o# the

bo!y br!en. *treaches 'ea5 le%els in all tisses 3ithin 2 hors, a'art #rom the brain

3here 'ea5 le%els areonly reache! a#ter 2; !ays. &e to the hi(h li'o'hilicity,

elemental mercry rea!ily 'assesthe bloo!brain barrier an! the 'lacenta.

"ollo3in( inhalation an! absor'tion into the bloo!, elemental mercry %a'or

n!er(oeso4i!ation in the re! bloo! cells to #orm !i%alent mercry, 3hich

're!ominantly e4ists as anon!i##sible #orm an! bin!s to albmin an! (loblins.

=4i!ation may also occr in the li%eran! ln(s, altho(h it may occr in most other

tisses to a lesser e4tent. *n the brain an!#ets, elemental mercry may be o4i!i-e!

an! thereby tra''e! as the !i%alent #orm !oes notcross the bloo!brain barrier or the

'lacenta as rea!ily. FCara%ati, 200@G

Elimination o# elemental mercry 're!ominantly occrs thro(h the rine an!

#eces,altho(h some may be e4crete! in s3eat, e4'ire! air or sali%a, 3ith the hal#li#e

bein(a''ro4imately 12 months. A#ter an acte e4'osre, rinary e4cretion acconts

#ora''ro4imately 1; I o# the total bo!y br!en, this increasin( to a''ro4imately B@

I a#terchronic e4'osre. Elemental mercry may be e4hale! as mercry %a'or or

e4crete! inbreast mil5. FS. ll, 200G


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).1./.) I"rga"c M'rc!r(

"or inor(anic mercry, the 're!ominant rote o# e4'osre is in(estion. *n

hmans, a''ro4imately B < 10 I o# inor(anic mercry in #oo! is absorbe! a#ter

in(estion. "ollo3in( inhalation, the rate o# absor'tion o# inor(anic mercry aerosols

is !e'en!ent on 'article si-e bt on a%era(e, a''ro4imately 10 I is absorbe!, as most

'articles 3ill be !e'osite! in the ''er res'iratory tract. FS. ll. 200G.

The e4tent to 3hich inor(anic mercry is trans'orte! across the intestinal tract

is lar(ely !e'en!ent on its solbility an! its !issociation in the lmen. Mercric

com'on!s are more rea!ily absorbe! than mercros #orms !e to their solbility.

*nor(anic mercry is !istribte! to all tisses #ollo3in( absor'tion, bt !e to

the 'oor li'i!s olbility only a small #raction crosses the bloo!brain barrier an! the

'lacenta.

As is thecase #or elemental mercry, the lar(est systemic !e'osition o# inor(anic

mercry occrs inthe 5i!ney.

The main 'ath3ay o# e4cretion o# inor(anic mercry is %ia the rine an!


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#aeces, 3ith the hal#li#e o# a''ro4imately 12 months. Elimination o# inor(anic

mercry #rom the bloo! an! brain is a bi'hasic 'rocess encom'assin( an initial ra'i!

elimination 'hase #ollo3e! by a slo3er 'hase. *nor(anic mercry may also be

re!ce! to #orm elemental mercry 3hich ise4hale! as elemental mercry %a'or or

e4crete! in the breast mil5. FPar5 et al. 2012G

).1././ Orga"c M'rc!r(

The rotes o# e4'osre o# or(anic mercry is thro(h (astrointestinal Fra'i!

an! com'lete absor'tionG, 'arenteral F100I absorbe!G, an! trans

'lacentalFconcentrate! in cor! bloo!G FMaha##ey R et al., 200G. *t is 3i!ely

!istribte! to all tisses. *t crosses the 'lacenta an! the bloo! brain barrier. *t is

secrete! in breast mil5 < bt in %ery small amonts since most is bon! to re! bloo!

cells. *t is !e(ra!e! slo3ly by the hman bo!y. 9al#li#e in a!lts is B0 !ays.

There#ore, 'ros'ecti%e mothers can si(ni#icantly re!ce mercry bo!y br!en by

a%oi!in( e4'osre #or >12 months 'rior to 're(nancy. *t is e4crete! in #eces an!

bil!s ' in the brain #or many years. F79=. 200BG

).1.0 H'a4%& E$$'c% $ Ac!%': S"g4' E6!r'


22/86


G'"'ra4 %6c%(

The ma?or tar(et or(ans o# elemental mercryin!ce! to4icity are the central

ner%os system an! the 5i!neys. The car!io%asclar an! res'iratory system, /* tract

an! the s5in are also a##ecte! at hi(her concentrations. Similarly, the tar(et or(ans

#ollo3in( in(estion o# inor(anic mercry are the 5i!neys an! the central ner%os

systemFS. ll et al., 200G.

I"&a4a%"

Most !ata on the to4icity o# mercry #ollo3in( inhalation re#er to elemental

mercry, as other #orms, sch as inor(anic mercry, !o not 'ose a si(ni#icant ris5 %ia

this rote o# e4'osre. "ollo3in( inhalation, the ma?or tar(et or(ans are the central

an! 'eri'heral ner%os system, an! the 5i!neys, altho(h at hi(h concentrations

res'iratory, car!io%asclar an! (astrointestinal e##ects may also occr FS. ll et al.,

200G.

"ollo3in( an acte e4'osre to elemental mercry %a'or, res'iratory e##ects


23/86


sch as co(h, !ys'nea an! chest ti(htness ha%e been re'orte!, as 3ell as bronchitis

an! bronchiolitis 3ith interstitial 'nemonitis, air3ay obstrction, an! !ecrease!

'lmonary #nction. *n se%ere cases 'lmonary e!ema, res'iratory !istress, an!

#ibrosis may occr. Patients commonly !e%elo' res'iratory ins##iciency. Sch e##ects

ha%e been re'orte! #ollo3in( e4'osre to 1.1 < m( m; elemental mercry.

*nor(anic mercry com'on!s ha%e also been re'orte! to case res'iratory e##ects

sch as shortness o# breath or 'lmonary e!ema.

The central ner%os system is one o# the most sensiti%e tar(ets #ollo3in(

e4'osre to elemental mercry %a'or, 3hich may case co(niti%e, 'ersonality,

sensory or motor !istrbances. The e##ects may incl!e tremor, irritability,

ner%osness, memory loss, hallcinations an! neromsclar chan(es sch as mscle

atro'hy an! mscle 3ea5ness, hea!aches an! !ecreases in co(niti%e #nction.

The 5i!neys are a ma?or tar(et or(an #ollo3in( e4'osre to elemental mercry

%a'or !e to the relati%ely hi(h accmlation o# mercry in the 5i!neys. 9i(h

concentrations ha%e been re'orte! to reslt in mil! transient 'roteinria, hematria,

oli(ria, acte renal #ailre an! !e(eneration o# the 'ro4imal con%olte! tbles.

/astrointestinal e##ects ha%e been re'orte! in hmans #ollo3in( acte

inhalation o# elemental mercry %a'or. A classic sym'tom o# mercry to4icity is


24/86


in#lammation o# the oral mcosa, 5no3n as stomatitis, sometimes accom'anie! 3ith

e4cessi%e sali%ation an! !i##iclty in s3allo3in(. =ther (astrointestinal e##ects

incl!in( ab!ominal 'ain, nasea, !iarrhea, sore (ms an! lceration o# the oral

mcosa may also occr #ollo3in( inhalation o# elemental mercry %a'or, altho(h

#e3 st!ies re'ort the concentration o# mercry at 3hich sch sym'toms arise.

9y'ertension an! tachycar!ia ha%e both been re'orte! #ollo3in( inhalation o#

hi(h concentrations o# elemental mercry, as 3ell as he'atocelllar e##ects,

he'atome(aly an! central loblar %acolation. 9y'ertension an! tachycar!ia may also

arise #ollo3in( e4'osreto inor(anic mercry.

Elemental mercry %a'or has been re'orte! to case erythematos an! 'rritic

s5inrashes, re!!enin( an! 'eelin( o# s5in on 'alms o# #eet an! han!s associate! 3ith

acro!ynia, brnin( eyes an! con?ncti%itis.

Acte e4'osre to elemental mercry %a'or may 'ro!ce Ometal #me #e%erH,

3hich is characteri-e! by #ati(e, #e%er an! ele%ate! le5ocyte cont. FS. ll, 200G

I"g'%"

Most !ata on the to4icity o# mercry #ollo3in( in(estion re#er to inor(anic

mercry com'on!s, as elemental mercry %ia in(estion !oes not, in (eneral, case


25/86


serios e##ects.

"ollo3in( in(estion, the ma?or tar(et or(ans are the /* tract, 5i!neys,

car!io%asclar system an! the s5in.

*n(estion o# inor(anic mercry salts sch as mercric chlori!e is hi(hly

irritatin( to the /* tract. =ne o# the earliest sym'toms is a metallic taste, #ollo3e! by

(astric 'ain an! %omitin(. As the com'on! 'asses into the lo3er /* tract ab!ominal

'ain, !iarrhea an! necrosis o# the intestinal mcosa may occr, 'ossibly lea!in( to

circlatory colla'se an! !eath. *n(estion o# mercric chlori!e may also lea! to

blisterin( an! lceration o# the li's an! ton(e, oro'haryn(eal 'ain an! lceration o#

the /* tract. *n contrast, in(estion o#

mercros chlori!e a''ears to case less se%ere /* e##ects, altho(h in!i%i!al case

st!ies ha%e re'orte! nasea, %omitin(, s3ollen (ms, e4cess sali%ation, !iarrhea,

anore4ia an! ab!ominal 'ain #ollo3in( the in(estion o# n5no3n concentrations o#

mercros chlori!e. *n(estion o# elemental mercry reslts in ne(li(ible absor'tion

an! there#ore e4ert little e##ect on the /* tract FS. ll et al., 200G.

The 5i!ney is a critical tar(et or(an #ollo3in( the in(estion o# inor(anic

mercry com'on!s. *# 'atients sr%i%e /* tract !ama(e #ollo3in( e4'osre to

mercry salts, oli(ria, anria, necrosis o# the 'ro4imal tble e'ithelim an! acte


26/86


renal #ailre may occr 3ithin 2 hors o# the in(estion o# mercric chlori!e 'rior to

!eath.

Tachycar!ia an! hy'ertension ha%e been re'orte! #ollo3in( the in(estion o#

mercric chlori!e an! mercros chlori!e. *n a!!ition, tachycar!ia has been re'orte!

secon!ary to se%ere 'nemonitis a#ter acte e4'osre to mercry %a'or.

Limite! !ata are a%ailable re(ar!in( the res'iratory e##ects #ollo3in( in(estion

o# inor(anic mercry. Plmonary e!ema an! shortness o# breath ha%e been re'orte!

#ollo3in( in(estion o# mercric chlori!e.

*n(estion o# elemental mercry may case erythematos an! 'rritic s5in

rashes, re!!enin( an! 'eelin( o# s5in on 'alms o# #eet an! han!s associate! 3ith

acro!ynia, brnin( eyes an! con?ncti%itis.

*n(estion o# mercric chlori!e may case ?an!ice an! ele%ation o# li%er en-ymes. FS.

ll, 200G

D'r2a4 : c!4ar '6!r'

&ermal e4'osre to elemental mercry %a'or may case erythematos an!

'rritic s5inrashes, re!!enin( an! 'eelin( o# s5in on 'alms o# #eet an! han!s


27/86


associate! 3ith acro!ynia,brnin( eyes an! con?ncti%itis

Solble inor(anic mercry com'on!s, in 'articlar mercric chlori!e, are

irritatin( to thes5in an! mcos membranes. E4'osre to 1 < B I may case

irritation, %esiclation, contact!ermatitis an! corrosion o# the s5in. *nsolble

com'on!s are not imme!iately irritatin(bt irritation may slo3ly !e%elo' as the

com'on! is absorbe! an! ioni-e! in tisse.

Amal(am #illin(s ha%e occasionally been sho3n to case !ermatitis on the

#ace. *n a!!ition,!ermatitis case! by aller(y to elemental mercry has been !escribe!

in !ental 'ersonnel.

erolo(ical e##ects ha%e been re'orte! #ollo3in( !ermal e4'osre to

inor(anic mercry. .FLA Rashe!, 200G

).1.3 Ca4

Coal is a #ossil #el. *t is a combstible, se!imentary, or(anic roc5, 3hich is

com'ose! mainly o# carbon, hy!ro(en an! o4y(en. *t is #orme! #rom %e(etation,

3hich has been consoli!ate! bet3een other roc5 strata an! altere! by the combine!


28/86


e##ects o# 'ressre an! heat o%er millions o# years to #orm coal seams. F7orl! Coal

*nstitte, 200G.

Coal is one o# the 3orl!Hs most im'ortant sorces o# ener(y, #ellin( almost

0I o# electricity 3orl!3i!e. *n many contries this #i(re is mch hi(her: Polan!

relies on coal #or o%er I o# its electricity6 Soth A#rica #or 2I6 China #or I6

an! Astralia #or >I. Coal has been the 3orl!Hs #astest (ro3in( ener(y sorce in

years #aster than (as, oil, nclear, hy!ro an! rene3ables. Coal has 'laye! this

im'ortant role #or centries < not only 'ro%i!in( electricity, bt also an essential #el

#or steel an! cement 'ro!ction, an! other in!strial acti%ities F7orl! Coal *nstitte,

200G.

Coal is the altere! remains o# 'rehistoric %e(etation that ori(inally

accmlate! in s3am's an! 'eat bo(s F7orl! Coal *nstitte, 200G.

The bil!' o# silt an! other se!iments, to(ether 3ith mo%ements in the

earthHs crst F5no3n as tectonic mo%ementsG brie! these s3am's an! 'eat bo(s,

o#ten to (reat !e'ths. 7ith brial, the 'lant material 3as sb?ecte! to hi(h

tem'eratres an! 'ressres.

This case! 'hysical an! chemical chan(es in the %e(etation, trans#ormin( it into 'eat

an! then into coal.


29/86


Coal #ormation be(an !rin( the Carboni#eros Perio! < 5no3n as the #irst

coal a(e < 3hich s'anne! ;>0 million to 20 million years a(o.

The +ality o# each coal !e'osit is !etermine! by tem'eratre an! 'ressre

an! by the len(th o# time in #ormation, 3hich is re#erre! to as its Oor(anic matrityH

*nitially the 'eat is con%erte! into li(nite or Obro3n coalH < these are coal ty'es 3ith

lo3 or(anic matrity. *n com'arison to other coals, li(nite is +ite so#t an! its color

can ran(e #rom !ar5 blac5 to %arios sha!es o# bro3n.

=%er many more millions o# years, the continin( e##ects o# tem'eratre an!

'ressre 'ro!ces #rther chan(e in the li(nite, 'ro(ressi%ely increasin( its or(anic

matrity an! trans#ormin( it into the ran(e 5no3n as OsbbitminosH coals.

"rther chemical an! 'hysical chan(es occr ntil these coals became har!er

an! blac5er, #ormin( the ObitminosH or Ohar! coalsH. $n!er the ri(ht con!itions, the

'ro(ressi%e increase in the or(anic matrity can contine, #inally #ormin( anthracite.

F7orl! Coal *nstitte, 200G.

).1.3.1 T(' $ Ca4


30/86


The !e(ree o# chan(e n!er(one by a coal as it matres #rom 'eat to anthracite

< 5no3n as coali#ication < has an im'ortant bearin( on its 'hysical an! chemical

'ro'erties an! is re#erre! to as the Oran5H o# the coal. Lo3 ran5 coals, sch as li(nite

an! sbbitminos coals are ty'ically so#ter, #riable materials 3ith a !ll, earthy

a''earance. They are characteri-e! by hi(h moistre le%els an! lo3 carbon content,

an! there#ore lo3 ener(y content. 9i(her ran5 coals are (enerally har!er an! stron(er

an! o#ten ha%e a blac5, %itreos lstre. They contain more carbon, ha%e lo3er

moistre content, an! 'ro!ce more ener(y. Anthracite is at the to' o# the ran5 scale

an! has a corres'on!in(ly hi(her carbon an! ener(y content an! a lo3er le%el o#

moistre. F7orl! Coal *nstitte, 200G

).1.3.) W&'r' Ca4 F!"#;

*t has been estimate! that there are o%er @ billion tonnes o# 'ro%en coal

reser%es 3orl!3i!e. This means that there is eno(h coal to last s o%er 10 years.

Coal is locate! 3orl!3i!e < it canbe #on! on e%ery continent in o%er 0 contries,

3ith the bi((est reser%es in the $SA, Rssia, China an! *n!ia. F7orl! Coal *nstitte,

200G


31/86


).1.3.).1 R'!rc'

The amont o# coal that may be 'resent in a !e'osit or coal#iel!. This !oes not

ta5e into accont the #easibility o# minin( the coal economically. ot all resorces are

reco%erable sin( crrent technolo(y. F7orl! Coal *nstitte, 200G

).1.3.).) R''r-'

Reser%es can be !e#ine! in terms o# 'ro%e! For measre!G reser%es an!

'robable For in!icate!G reser%es. Probable reser%es ha%e been estimate! 3ith a lo3er

!e(ree o# con#i!ence than 'ro%e! reser%es. F7orl! Coal *nstitte, 200G

).1.3.)./ Pr-'# R''r-'

Reser%es are not only consi!ere! to be reco%erable bt can also be reco%ere!


32/86


economically. This means they ta5e into accont 3hat crrent minin( technolo(y can

achie%e an! the economics o# reco%ery. Pro%e! reser%es 3ill there#ore chan(e

accor!in( tothe 'rice o# coal6 i# the 'rice o# coal is lo3, 'ro%e! reser%es 3ill !ecrease.

7hile it is estimate! that there is eno(h coal to last s 10 years, this col!

e4ten! still #rther thro(h a nmber o# !e%elo'ments, incl!in(: the !isco%ery o#

ne3 reser%es thro(h on(oin( an! im'ro%e! e4'loration acti%ities6 a!%ances in

minin( techni+es, 3hich 3ill allo3 're%iosly inaccessible reser%es to be reache!.

All #ossil #els 3ill e%entally rn ot an! it is essential that 3e se them as

e##iciently as 'ossible. Si(ni#icant im'ro%ements contine to be ma!e in ho3

e##iciently coal is se! so that more ener(y can be (enerate! #rom each ton o# coal

'ro!ce!. F7orl! Coal *nstitte, 200G

).1.3./ F"#"g Ca4

Coal reser%es are !isco%ere! thro(h e4'loration acti%ities F7orl! Coal

*nstitte, 200G. The 'rocess sally in%ol%es creatin( a (eolo(ical ma' o# the area,

then carryin( ot (eochemical an! (eo'hysical sr%eys, #ollo3e! by e4'loration

!rillin(. This allo3s an accrate 'ictre o# the area to be !e%elo'e!.


33/86


The area 3ill only e%er become a mine i# it is lar(e eno(h an! o# s##icient

+ality that the coal can be economically reco%ere!. =nce this has been con#irme!,

minin( o'erations be(in. F7orl! Coal *nstitte, 200G

).1.< Ca4 M""g

Coal is mine! by t3o metho!s < sr#ace or Oo'encastH minin( an!

n!er(ron! or O!ee'H minin(. The choice o# minin( metho! is lar(ely !etermine! by

the (eolo(y o# the coal !e'osit.

$n!er(ron! minin( crrently acconts #or abot >0I o# 3orl! coal

'ro!ction, altho(h in se%eral im'ortant coal 'ro!cin( contries sr#ace minin( is

more common. Sr#ace minin( acconts #or aron! @0I o# 'ro!ction in Astralia,

3hile in the $SA it is se! #or abot >I o# 'ro!ction. F7orl! Coal *nstitte, 200G

).1.


34/86


the mine. These 'illars can be ' to 0I o# the total coal in the seam < altho(h this

coal can sometimes be reco%ere! at a later sta(e. This can be achie%e! in 3hat is

5no3n as Oretreat minin(H, 3here coal is mine! #rom the 'illars as 3or5ers retreat.

The roo# is then allo3e! to colla'se an! the mine is aban!one!.

Lon(3all minin( in%ol%es the #ll e4traction o# coal #rom a section o# the

seam or O#aceH sin( mechanical shearers. A lon(3all #ace re+ires care#l 'lannin(

to ensre #a%orable (eolo(y e4ists thro(hot the section be#ore !e%elo'ment 3or5

be(ins. The coal O#aceH can %ary in len(th #rom 100;B0m. Sel#a!%ancin(,

hy!ralically'o3ere! s''orts tem'orarily hol! ' the roo# 3hile coal is e4tracte!.

7hen coal has been e4tracte! #rom the area, the roo# is allo3e! to colla'se. =%er

BI o# the coal in the !e'osit can be e4tracte! #rom 'anels o# coal that can e4ten!

;5m thro(h the coal seam. The main a!%anta(e o# room


35/86


).1.


36/86


).1.


37/86


(ron! ma(netite. As the coal is li(hter, it #loats an! can be se'arate! o##, 3hile

hea%ier roc5 an! other im'rities sin5 an! are remo%e! as 3aste.

The smaller si-e #ractions are treate! in a nmber o# 3ays, sally base! on

!i##erences in mass, sch as in centri#(es. A centri#(e is a machine 3hich trns a

container aron! %ery +ic5ly, casin( soli!s an! li+i!s insi!e it to se'arate.

Alternati%e metho!s se the !i##erent sr#ace 'ro'erties o# coal an! 3aste. *n O#roth

#lotationH, coal 'articles are remo%e! in a #roth 'ro!ce! by blo3in( air into a 3ater

bath containin( chemical rea(ents. The bbbles attract the coal bt not the 3aste an!

are s5imme! o## to reco%er the coal #ines. Recent technolo(ical !e%elo'ments ha%e

hel'e! increase the reco%ery o# ltra#ine coal material. F7orl! Coal *nstitte, 200G.

).1.


38/86


Shi's are commonly se! #or international trans'ortation, in si-es ran(in(

#rom 9an!yma4 F0>0,000 &7TG, Panama4 Fabot >0@0,000 &7TG to lar(e

Ca'esi-e %essels Fabot @0,000 &7TG. Aron! 00 million tonnes FMtG o# coal 3as

tra!e! internationally in 200; an! aron! 0I o# this 3as seaborne tra!e. Coal

trans'ortation can be %ery e4'ensi%e < in some instances it acconts #or ' to 0I o#

the !eli%ere! cost o# coal. F7orl! Coal *nstitte, 200G.

).1.


39/86


The Chinese (o%ernment is ta5in( ste's to im'ro%e sa#ety le%els, incl!in( the

#orce! closre o# smallscale mines an! those that #ail to meet sa#ety stan!ar!s.


).1.


40/86


con#licts o%er lan! se can be resol%e! by hi(hli(htin( that minin( is only a

tem'orary lan! se. Mine rehabilitation means that the lan! can be se! once a(ain

#or other 'r'oses a#ter mine closre. F7orl! Coal *nstitte, 200G.

).1.= T&' G4*a4 Ca4 Mark'%

The 3orl! crrently consmes o%er 0B0 Mt o# coal. Coal is se! by a %ariety

o# sectors < incl!in( 'o3er (eneration, iron an! steel 'ro!ction, cement

man#actrin( an! as a li+i! #el. The ma?ority o# coal is either tili-e! in 'o3er

(eneration < steam coal or li(nite < oriron an! steel 'ro!ction < coo5in( coal.


).1.=.1 Ca4 Pr#!c%"

=%er 0;0 Mt o# coal is crrently 'ro!ce! < a ;@I increase o%er the 'ast 20

years. Coal 'ro!ction has (ro3n #astest in Asia, 3hile Ero'e has actally seen a

!ecline in 'ro!ction.

The lar(est coal 'ro!cin( contries are not con#ine! to one re(ion < the to'

#i%e 'ro!cers are China, the $SA, *n!ia, Astralia an! Soth A#rica. Mch o# (lobal

coal 'ro!ction is se! in the contry in 3hich it 3as 'ro!ce!. =nly aron! 1@I o#


41/86


har! coal 'ro!ction is !estine! #or the international coal mar5et.

/lobal coal 'ro!ction is e4'ecte! to reach billion tons in 20;0 < 3ith China

accontin( #or aron! hal# the increase o%er this 'erio!. Steam coal 'ro!ction is

'ro?ecte! to ha%e reache! aron! B.2 billion tons6 co5in( coal >2 million tons6 an!

bro3n coal 1.2 billion tons.

).1.=.) Ca4 C"!2%"

Coal 'lays a %ital role in 'o3er (eneration an! this role is set to contine. Coal

crrently #els;I o# the 3orl!Hs electricity an! this 'ro'ortion is e4'ecte! to remain

at similar le%els o%er the ne4t ;0 years.

Consm'tion o# steam coal is 'ro?ecte! to (ro3 by 1.BI 'er year o%er the

'erio! 200220;0. Li(nite, also se! in 'o3er (eneration, 3ill (ro3 by 1I 'er year.

&eman! #or co5in( coal in iron an! steel 'ro!ction is set to increase by 0.I 'er

year o%er this 'erio!.

The bi((est mar5et #or coal is Asia, 3hich crrently acconts #or BI o#

(lobal coal consm'tion < altho(h China is res'onsible #or a si(ni#icant 'ro'ortion


42/86


o# this. Many contries !o not ha%e natral ener(y resorces s##icient to co%er their

ener(y nee!s, an! there#ore nee! to im'ort ener(y to hel' meet their re+irements.

Ja'an, Chinese Tai'ei an! orea, #or e4am'le, im'ort si(ni#icant +antities o# steam

coal #or electricity (eneration an! co5in( coal #or steel 'ro!ction.

*t is not ?st a lac5 o# in!i(enos coal s''lies that 'rom'ts contries to

im'ort coal bt also the im'ortance o# obtainin( s'eci#ic ty'es o# coal. Ma?or coal

'ro!cers sch as China, the $SA an! *n!ia, #or e4am'le, also im'ort +antities o#

coal #or +ality an! lo(istical reasons.

Coal 3ill contine to 'lay a 5ey role in the 3orl!Hs ener(y mi4, 3ith !eman!

in certain re(ions set to (ro3 ra'i!ly. /ro3th in both the steam an! co5in( coal

mar5ets 3ill be stron(est in !e%elo'in( Asian contries, 3here !eman! #or electricity

an! the nee! #or steel in constrction, car 'ro!ction, an! !eman!s #or hosehol!

a''liances 3ill increase as incomes rise. F7orl! Coal *nstitte, 200G.

).1.=./ Ca4 Tra#'

Coal is tra!e! all o%er the 3orl!, 3ith coal shi''e! h(e !istances by sea to

reach mar5ets.

=%er the last t3enty years, seaborne tra!e in steam coal has increase! on


43/86


a%era(e by abot@I each year, 3hile seaborne co5in( coal tra!e has increase! by 2I

a year. =%erall international tra!e in coal reache! 1@ Mt in 200;6 3hile this is a

si(ni#icant amont o# coal it still only acconts #or abot 1@I o# total coal consme!.

Trans'ortation costs accont #or a lar(e share o# the total !eli%ere! 'rice o#

coal, there#ore international tra!e in steam coal is e##ecti%ely !i%i!e! into t3o

re(ional mar5ets < the Atlantic an! the Paci#ic. The Atlantic mar5et is ma!e ' o#

im'ortin( contries in 7estern Ero'e, notably the $, /ermany an! S'ain. The

Paci#ic mar5et consists o# !e%elo'in( an!=EC& Asian im'orters, notably Ja'an,

orea an! Chinese Tai'ei. The Paci#ic mar5etcrrently acconts #or abot >0I o#

3orl! steam coal tra!e. Mar5ets ten! to o%erla' 3hen coal 'rices are hi(h an!

s''lies 'lenti#l. Soth A#rica is a natral 'oint o# con%er(ence bet3een the t3o

mar5ets.

Astralia is the 3orl!Hs lar(est coal e4'orter6 e4'ortin( o%er 20 Mt o# har!

coal in 200;, ot o# its total 'ro!ction o# 2 Mt. Coal is one o# AstraliaHs most

%alable e4'ort commo!ities. Altho(h almost three+arters o# AstraliaHs e4'orts

(o to the Asian mar5et, Astralian coals are se! all o%er the 3orl!, incl!in(

Ero'e, the Americas an! A#rica.

*nternational co5in( coal tra!e is limite!. Astralia is also the lar(est s''lier


44/86


o# co5in( coal, accontin( #or B1I o# 3orl! e4'orts. The $SA an! Cana!a are

si(ni#icant e4'orters an! China is emer(in( as an im'ortant s''lier. Co5in( coal is

more e4'ensi%e than steam coal, 3hich means that Astralia is able to a##or! the hi(h

#rei(ht rates in%ol%e! in e4'ortin( co5in( coal 3orl!3i!e. F7orl! Coal *nstitte,

200G.

).1.=.0 E"'rg( S'c!r%(

Minimi-in( the ris5 o# !isr'tions to or ener(y s''lies is e%er more

im'ortant


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Colombia, Polan!, Rssia, Soth A#rica, an! the $SA, as 3ell as smaller amonts

#rom a nmber o# other contries an! its o3n !omestic s''lies.

Coal there#ore has an im'ortant role to 'lay in maintainin( the secrity o# the

(lobal ener(y mi4. F7orl! Coal *nstitte, 200G.

).1.> R'"a4 Dr#'r

The 5i!neys 'lay a %ery im'ortant role in an in!i%i!alHs health, an! renal

!isease a##ects 'eo'le thro(hot the 3orl!. As 'art o# the !ia(nostic ima(in(

'ro#ession, ra!iolo(ic technolo(ists 'lay a 5ey role in hel'in( 'hysicians !ia(nose

renal !isease. 7ith the in#ormation ac+ire! by technolo(ists, the ne4t corse o#

action is !eci!e! 'on an! treatment can be 'lanne!. Forey et al., 200@G.

).1.>.1 R'"a4 F!"c%"

The 5i!neys are containe! in the retro'eritoneal s'ace an! are 'art o# the

e4cretory system, also 5no3n as the rinary system.1 *ncl!e! in this system are 2

5i!neys, 2 reters lea!in( !o3n to a rinary bla!!er, an! a rethra, 3hich allo3s #or

'assa(e o# rine. Accor!in( to ontra(er, QThe measrements #or an a%era(e a!lt

5i!ney are 10 to 12 cm lon(, B to .B cm 3i!e an! 2.B cm thic5.2 The 5i!neys, each


46/86


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The 5i!neys also maintain the 3ater le%el 3ithin the bo!y by remo%in( e4cess

#li!, 3or5in( to 5ee' the amont o# 3ater in the bo!y at a stea!y %olme #rom one

!ay to another. Thro(h the res'iratory, !i(esti%e an! inte(mentary systems, the

bo!y loses 3ater each !ay as a reslt o# normal bo!y #nctions. The 5i!neys are %ery

a!a'table to !i##erent amonts o# 3ater consm'tion each !ay. /enerally, the amont

o# 3ater a 'erson ta5es in an! 'ro!ces is e+al to the amont that 3ill be lost 3ithin

that !ay. *t is #or this reason that 3hen a 'atient is n!er(oin( treatment #or a

con!ition o# the rinary tract system, nrses 5ee' trac5 o# the 'atientHs #li! inta5e

an! rine ot't to see i# amonts are similar.

ecase aci!s are re(larly 'ro!ce! by !aily cell metabolism, re(lation o#

aci!ity an! al5alinity in the bloo!stream also is %ery im'ortant.; *n a!!ition, certain

#oo!s an! me!ications can !isr't normal aci!base le%els in bo!y #li!s. "or 'ro'er

bo!y #nctionin(, the aci!base le%el nee!s to be maintaine! at a certain balance.

Thro(h care#l elimination or reabsor'tion o# hy!ro(en ions, the 5i!neys stea!ily

re(late the bo!yHs '9 balance Forey et al., 200@G.

Electrolytes normally are #on! in the rine. Electrolytes most im'ortant to

renal #nction incl!e so!im, 'otassim, calcim, 'hos'hate an! chlori!e. So!im is

se! #or ner%e im'lse con!ction an! to maintain #li! %olme an! aci!base


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balance. Potassim also is nee!e! #or ner%e im'lse con!ction, alon( 3ith celllar

en-yme acti%ity an! some chemical reactions. Calcim is nee!e! #or ner%e im'lse

con!ction, as 3ell as bone #ormation an! contraction o# mscles, an! it ai!s in the

clottin( o# bloo!. Phos'hate is nee!e! #or carbohy!rate metabolism an! 'ro!ction o#

bone, an! it ai!s in maintainin( aci!base balance. Chlori!e is %ery im'ortant in the

!i(esti%e system becase it ai!s in the creation o# hy!rochloric aci!, 3hich is se! in

(astric ?ices.

E%ery !ay, electrolytes are lost thro(h the !i(esti%e system as #eces an!

thro(h the inte(mentary system as s3eat. *t is the 5i!neysH res'onsibility to 5ee'

the electrolytesin a 'ro'er balance. They are e4crete! only in certain amonts. *n this

3ay, they are 5e't at 'articlar amonts in the bloo!stream.

*# 5i!ney #nction is im'aire! in any 3ay, there 3ill be an accmlation o#

to4ic 3astes in the bloo!stream an! a !ecrease in essential chemicals a%ailable in the

bloo!stream. *# this im'ortant re(lation is not correcte! +ic5ly, renal #ailre can

occr, 'ossibly lea!in( to !eath.

The 5i!neys 'ro!ce ; im'ortant hormones to hel' 5ee' the bo!yHs systems

rnnin( smoothly. Renin, erythro'oietin an! calcitriol each carry ot their o3n %ery

im'ortant !ties.


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*# the bloo! 'ressre le%el is too lo3 #or 'ro'er #iltration to ta5e 'lace, the

5i!ney is stimlate! to 'ro!ce renin. Renin then acti%ates an(iotensin, a 'rotein that

has a constrictin( e##ect on the bloo! %essels. This constriction o# bloo! %essels in

trn raises the bloo! 'ressre.=nce the bloo! 'ressre is bac5 at a normal rate, 5i!ney

#iltration 'rocesses be(in once a(ain.

The 5i!neys also hel' re(late 'ro!ction o# re! bloo! cells. *n a sitation in

3hich the 5i!neys are not recei%in( eno(h o4y(en, they 3ill be(in to 'ro!ce

erythro'oietin to correct the sitation. Erythro'oietin is a hormone that stimlates

bone marro3 to ma5e more re! bloo! cells. *n this #ashion, the 5i!neys maintain the

correct bloo! %olme nee!e! #or 'ro'er bo!y #nctionin(.

*n a!!ition to the 're%iosly mentione! hormones, the bo!y ses calcitriol,

3hich also is 'ro!ce! in the 5i!ney. Calcitriol stimlates the absor'tion o# calcim

in the intestinal tract, 3hich in trn increases the reabsor'tion o# calcim in the

5i!neys. *t is im'ortant that the correct amont o# calcim is absorbe! #rom the !aily

inta5e o# #oo!. 7hen a healthy calcim le%el e4ists, the bo!y is able to se calcim to

maintain bone stren(th. Forey et al., 200@G


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).1.>.) R'"a4 D'a' S%a%%c

More than 20 million Americans ha%e 5i!ney 'roblems, an! nearly 1 ot o# >

a!lts has chronic 5i!ney !isease.B,> The to' 2 cases o# renal !isease are !iabetes

an! hy'ertension. A''ro4imately 0 000 'eo'le rely on !ialysis or 5i!ney

trans'lants to 5ee' them ali%e, an! more than 0 000 'atients are on the 3aitin( list

#or a 5i!ney trans'lant6 ho3e%er, only abot 1 000 in!i%i!als 3ill (et a ne3 5i!ney

this year. =# those a##ecte! 3ith 5i!ney !isease, more than @2 000 'eo'le 3ith 5i!ney

#ailre !ie each year. FAlra--a5, 201;G

).1.>./ Ca!' $ R'"a4 D'a'

Renal !isease is case! by a %ariety o# #actors. *n!i%i!als ol!er than >0 years

ten! to be at hi(her ris5 o# !e%elo'in( the !isease. *n a!!ition, !isor!ers o# the renal

system are here!itary6 ths, ris5 o# 5i!ney !isease contines #rom 1 (eneration to the

ne4t. Some ethnicities Fe(, A#rican American, ati%e American, Asian American an!

9is'anicG also are at hi(her ris5. Patients !ia(nose! 3ith car!io%asclar !isease also

maybe at hi(her ris5 o# !e%elo'in( renal !isease.


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&iabetes

&iabetes mellits is the lea!in( case o# 5i!ney #ailre Forey et al., 200@G. A

!ia(nosis o# !iabetes mellits means that the bo!y is no lon(er ca'able o# 'ro!cin(

eno(h inslin, 3hich is 'ro!ce! in the 'ancreas, to re(late the amont o# (lcose

in the bloo!stream. Ths, the bo!yHs (lcose le%el rises to an nsa#e le%el an! many

com'lications can arise. =r(ans an! systems sch as the heart, bloo! %essels, eyes,

ner%es an! 5i!neys can be a!%ersely a##ecte! 3hen the bloo! (lcose le%el is not

re(late!. Conse+ently, 3hen the small bloo! %essels in the 5i!neys are !ama(e! by

hi(h bloo! (lcose le%els, the 5i!neys cannot clean bloo! 'ro'erly. er%es also can

become !ama(e! !e to !iabetes, 3hich in trn can a##ect the bla!!erHs ability to

em'ty 'ro'erly. This can case rine to bac5 ' into the 5i!neys, thereby !ama(in(

them.

Patients 3ith !iabetes mi(ht not notice any 'roblems 3ith their renal system

#or many years. *n some 'atients, the 5i!neys actally can carry ot their #iltration

#nctions at a hi(her rate than normal in the early sta(es, 3hich is 5no3n as

hy'er#iltration. As the !iabetic !isease 'ro(resses, an increase in the amont o#

albmin content in rine, 5no3n as microalbminria, mi(ht be the #irst si(n o#

5i!ney mal#nction.

7hen microalbminria #irst a''ears in a rine test, the 5i!neys still may be


52/86


#nctionin( at a normal rate. =%er time, ho3e%er, 5i!ney !isease 3ill !e%elo' an!

hi(her amonts o# albmin 3ill be notice! in the rine.This sta(e, 5no3n as macro

albminria, is 3hen the 5i!neysH ability to carry ot #iltration #nctions be(ins to

!iminish. *t is also at this sta(e that the laboratory %ales #or bloo! rea nitro(en

F$G an! creatinine 3ill be(in to be abnormal. These abnormal %ales can be se!

to hel' !etermine ho3 #ar 5i!ney !isease has 'ro(resse!. *t is o# the tmost

im'ortance that 'atients 3ith !iabetes ha%e their bloo! an! rine teste! 3hen or!ere!

by their 'hysician becase this !isease can reslt in serios con!itions 3ithin the renal

system 3ithot the 'atient e%en reali-in( that anythin( is 3ron( an! e%en i# 'atients

ha%e their !iabetes n!er control. FSacco et al, 200>G

9y'ertension

9y'ertension, also 5no3n as hi(h bloo! 'ressre, is the secon! most common

case o# 5i!ney !isease. =%er time, hy'ertension 3ill case !ama(e to bloo! %essels

thro(hot the bo!y. 7hen the bloo! %essels o# the 5i!neys are im'aire!, the

ne'hrons cannot #nction 'ro'erly. This can lea! to im'ro'er #iltration an! #li!

bil!' 3ithin the bo!y, conse+ently resltin( in hi(her bloo! 'ressre, 3hich then

col! lea! to e%en more !ama(e to 5i!ney #nction.


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Mch li5e renal !isease, hy'ertension can be asym'tomatic in its be(innin(

sta(es. 7hen 'atients (o to their 'hysician #or a yearly 'hysical e4am, their bloo!

'ressre 3ill be chec5e! an! laboratory tests 3ill be or!ere! to ma5e sre the bo!y is

#nctionin( 'ro'erly. *t sally is at this time that hi(h bloo! 'ressre an! renal

system !ys#nction are notice!. An abnormally hi(h amont o# creatinine in the bloo!

or 'rotein in the rine F'roteinriaG s((ests that the renal system is not #nctionin(

'ro'erly.

ecase the bo!y nee!s 'roteins to hel' it #i(ht a(ainst in#ections, ai! the

bloo! in clottin( an! hel' circlate the correct amont o# #li!s thro(h the bo!y, the

5i!neys !o not #ilter ot 'roteins 3ith 3aste materials. 9o3e%er, i# the 5i!neys are

not #nctionin( 'ro'erly, the 'roteins 3ill ma5e their 3ay into the rine an! be

e4crete! by the bo!y. There#ore, rine tests in!icatin( the 'resence o# 'roteins are a

hel'#l measre o# 5i!ney #nction.

The most common 'rotein to ma5e its 3ay into the rine is albmin. The

'resence o# albmin in the rine is re#erre! to as albminria. An im'ortant #nction

o# albmin is to soa5 ' #li! #rom bo!y tisses to hel' retain #li! in the

bloo!stream. 7ithot this im'ortant #nction, the 'atient may notice s3ellin( in the

han!s, #eet, ab!omen or #ace becase the bo!y can no lon(er soa5 ' #li! e##iciently.


54/86


y limitin( so!im inta5e, (ettin( a mo!erate amont o# e4ercise, re!cin(

ca##eine inta5e an! maintainin( a healthy !iet an! 3ei(ht, 'atients can hel' re!ce the

amont o# #li! bil!'. These (i!elines, alon( 3ith close monitorin( by a

'hysician, can hel' re(late hy'ertension an! re!ce a!%erse e##ects to the renal

system. Forey et al., 200@G.

).1.>.0 R'"a4 F!"c%" A'2'"%

Physicians #re+ently se contrast me!ia to hel' ma5e !ia(noses in%ol%in( the

rinary system. e#ore contrast me!ia is (i%en, the 'hysician mst chec5$ an!

creatinine le%els to ensre they are 3ithin the sa#e ran(e. *# these le%els are not 3ithin

normal ran(e, the 'atient 3ill be nable to 'rocess an! e4crete the contrast #rom the

bo!y. More s'eci#ically, i# these le%els are not in the correct ran(e, this col! in!icate

a 'roblem 3ith renal #nction an! contrast me!ia shol! not be a!ministere!.

The $ le%el is a measre o# the rea nitro(en in the bloo!, an in!ication o#

ho3 3ell the 5i!ney is able to e4crete rea.; Accor!in( to ontra(er, QThe normal

a!lt ran(e #or $ is bet3een @ to 2B m(D100 ml.

Creatinine is a nitro(enos 3aste #rom mscle metabolism. Creatinine is


55/86


#iltere! #rom the bloo! an! then e4crete! by the 5i!neys.; Accor!in( to ontra(er,

QThe normal a!lt ran(e #or creatinine is bet3een 0.> to 1.B m(D!l.

Patients 3ho ha%e ele%ate! $ or creatinine bloo! le%els are at hi(her ris5

o# ha%in( an a!%erse e##ect #rom the contrast me!ia becase they are not able to

'rocess an! e4crete contrast me!ia 'ro'erly Forey et al., 200@G. Conse+ently, their

renal system col! be !ama(e! by the contrast me!ia.

Physicians sometimes or!er a ro(ra'hy e4am to obser%e renal system

#nctionality. &rin( this e4am, an io!inate! contrast me!ia 3ill be (i%en to enhance

the anatomy o# the renal system. 9o3e%er, contrast me!ia can case an a!%erse

reaction in 'atients ta5in( /lco'ha(e Fmet#orminG, 3hich sometimes is (i%en to

'atients 3ith noninslin!e'en!ent !iabetes. The technolo(ist mst as5 the 'atient

3hether he or she is ta5in( this me!ication 'rior to 'er#ormin( the st!y becase o#

the ris5 o# contrast me!iain!ce! acte renal #ailre."or the @ hors 'rece!in( an!

#ollo3in( the ro(ra'hy st!y, the 'atient nee!s to sto' ta5in( /lco'ha(e. e#ore

the 'atient can resme the me!ication, the 'hysician 3ill or!er laboratory tests to

!etermine 3hether the 5i!neys are #nctionin( normally. Forey et al., 200@G.

CHAPTER /


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METHODOLOGY

/.1 RESEARCH DESIGN

S'eci#ically, the i!enti#ie! e4'osre is e4'osre o# mercry in a coal 'o3er 'lant

settin(. The researchers (athere! in#ormation #rom the $ni%ersity o# Santo Tomas

Mi(el !e ena%i!es Library an! #rom reliable eresorces sch as ESC= an!

Science &irect.

This st!y 3as 'er#orme! on an e4'erimental an! control (ro'. The e4'erimental

(ro' 3as !i%i!e! into three cate(ories ha%in( !i##erent !ration o# e4'osre. The

e4'erimental (ro' 3ere coal 'o3er 'lant 3or5ers that 3ere a##iliate! in the ash

!is'osal !e'artment. The control (ro' se! in the st!y 3as in!i%i!als that 3ere

ne%er e4'ose! #rom elemental mercry an! ha%e no history o# renal !ama(e. Prior to

this st!y, a''ro%al o# coal minin( !e'artment chairman an! the baran((ay secretary

3ere obtaine!. A consent to share in the st!y an! an a''ro%al to (i%e rine sam'les

#rom each in!i%i!al 3ere obtaine! a#ter e4'lainin( to them the aim an! im'ortance

o# the st!y. Strict con#i!entiality 3as obser%e! thro(hot sam'le collection, co!in(,

testin(, an! recor!in( o# the reslts. Partici'ants 3ere allo3e! to obtain co'ies o# the

reslts.

/.) RESPONDENTS OF THE STUDY


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The e4'erimental (ro' se! in the st!y 3as !i%i!e! into three cate(ories

that ha%e been e4'ose! to elemental mercry #rom less than #i%e years, si4 to ten

years an! ele%en to #i#teen years. The e4'erimental (ro' 3ere assesse! by the se o#

+estionnaires to ma5e sre that the res'on!ents ha%e 3or5e! #rom the 'o3er 'lant

an! also ha%e no history o# renal !ama(e. The res'on!ents #rom the 'o3er 'lant 3ere

also con#irme! to ha%e been statione! at the ash !is'osal !e'artment o# the 'o3er

'lant.

/./ SAMPLING TECHNI?UE

Ran!om sam'lin( techni+e 3as em'loye!.

/.0 PROCEDURE

C=MM$*CAT*= A& C=SET7*T9 C=AL P=7ER PLAT

C=MP$TAT*= =" SAMPLES*E

PREPARAT*= A& C=LLECT*==" $R*E SAMPLES

&*STR*$T*= ="$EST*=A*RE

E8P=SE& /R=$PC=TR=L /R=$P


58/86


Fg!r' 0. Prc'#!r' #"' " %&' %!#(

/.0.1 SPECIMEN COLLECTION

$rine sam'les 3ere collecte! sin( a sterile container an! store! in an icebo4

!rin( tra%el. At least 20 mL o# rine 3ere collecte! to ensre a!e+ate amont o#

sam'les #or the !i##erent tests !one.

MEAS$RE $R*E MERC$RT9R=$/9 C=L& AP=R AT=M*C

AS=RPT*= TEC9*$E

MEAS$RE $R*AR PR=TE* T=ASSESS REAL "$CT*= $S*/ M$LT*ST*8 $R*AR

PARAMETERS

C=MPARE E8P=SE& /R=$P A&C=TR=L /R=$P

U Byrs

>10yrs

111B

yrs

STAT*ST*CALTREATMET ="

&ATA /AT9ERE&

MEAS$RE $R*E CREAT**E EMPL=*/ T9E PR*C*PLES ="

JA""E REACT*=

C=TR=L /R=$PE8P=SE& /R=$P


59/86


/.0.) MEASUREMENT OF MERCURY LE9ELS IN URINE

The rine sam'les 3ere sent to Chem'ro #or measrin( rine mercry le%els.

The rine sam'les 3ere 3et !i(este! 3ith nitric an! 'erchloric aci!s at 2B;BVC.

Then the sam'les 3ere #iltere! thro(h 7hatman Ashless "ilter Pa'er, an! a!!e! to

bi!istille! 3ater to total amont o# 10mL. The mercry content 3as !etermine! in

3et !i(este! sam'les by a col! %a'or atomic absor'tion techni+e sin( mercry

e%a'oration 5it.

/.0./ MEASUREMENT OF CREATININE LE9ELS IN URINE

$rine sam'les 3ere sent to the laboratory in East A%ene Me!ical center.

$rinary creatinine 3as measre! by sin( architect ci@200 ha%in( em'loye! the

'rinci'les o# Ja##e reaction. *n this reaction, creatinine reacts 3ith 'icric aci! in

al5aline soltion to #orm a re!oran(e chromo(en.

/.0.0 MEASURING URINARY PARAMETERS AND MICROSCOPIC

ELEMENTS

$rinary (lcose an! 'rotein 3ere measre! manally by sin( QMltisti4.

The 'rinci'les o# Q!oble se+ential en-yme reaction #or (lcose an! Q'rotein error

o# in!icators #or 'rotein 3ere em'loye!. $rinary microsco'ic elements 3ere

i!enti#ie! insi!e East A%e Me!ical center by a re(istere! me!ical technolo(ist.


60/86


/.0.3 SAMPLE SI@E COMPUTATION

To !etect a !i##erence o# B.2@ $9( in the mercry le%els in rine,

bet3een the e4'ose! an! control (ro', at least t3o sam'les in each

(ro' collecte!. This 'ro%i!e! at least @0I 'o3er o# the

statistical test at t3osi!e! BI le%el o# si(n#icance. Com'tation o#

sam'le si-e is base! on the st!y o# Samir an! Are# F2011G that rine

sam'les o# !ental sta## ha%e a mean mercry le%el o# 10.02 FS&1.;>G,

3hile rine sam'les o# !ental sta## ha%e a mean mercry le%el o# .

FS&0.@G.

Calclation is 'er#orme! sin( Me!Calc 12..2.


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CHAPTER 0

RESULTS AND DISCUSSION

0.1 STATISTICAL ANALYSES

Mean an! its stan!ar! error FSEMG 3ere se! to smmari-e the rine mercry

an! creatinine le%els o# the 3or5ers. The nmber o# 3or5ers 3ith (lcose, 'rotein,

casts ele%ate! mercry an! creatinine le%els 3ere conte! an! e4'resse! in

'ercenta(es. Sin(le#actor analysis o# %ariance 3as se! to com'are the means 3hile

"isherHs e4act test 3as se! to com'are the conts or 'ercenta(es. =!!s ratio, 3ere

#rther, calclate!.

All the statistical tests 3ere 'er#orme! sin( SPSS %er 20.0 an! R %er ;.0.2.


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0.) RESULTS

Ta*4' 1.Laboratory Reslts o# the Coal Po3er Plant 7or5ers

ales e4'resse! as conts FIG, or mean W SEM, n 10.*n (lcose an! 'rotein, %ales are e4'resse! as conts o# traces6 *n casts, %ales e4'resse! as a 'ositi%e reslt.Ele%ate! rine mercry le%els is set to X1 Y(DL an! ele%ate! rine creatinine le%el is set to X;0 m(D!L.

As sho3n in the table, rinary (lcose Fp 0.2;1G an! casts Fp 1.000G are

not si(ni#icantly !i##erent accor!in( to the len(th o# mercry e4'osre.

The nmber o# 'o3er 'lant 3or5ers 3ith traces o# 'rotein si(ni#icantly !i##er

Zp 0.016 Control 1 to B years U F> to 10 years 11 to 1B yearsG[, in!icatin( that

the control (ro' an! those e4'ose! #rom 1 to B years !o not !i##er Fp 1.000G. Those

3ho are e4'ose! #rom si4 to ten years an! 11 to 1B years !o not !i##er Fp 1.000G bt

ha%e si(ni#icantly (reater nmber o# rine sam'les 3ith 'rotein traces as com'are! to

the control an! those ha%e one to #i%e years e4'osre. This in!icates that those 3ith

Ur"' Para2'%'r

L'"g%& $ M'rc!r( E6!r' 7(r8p

-a4!' P% &cAC"%r4 B1 % 3 C< % 1 D11 % 13

/lcose 0 F0IG 0 F0IG 0 F0IG 2 F20IG 0.2;1

Protein 0 F0IG 0 F0IG F0IG ; F;0IG 0.01 FA G U FC &G

Casts 0 F0IG 1 F10IG 0 F0IG 0 F0IG 1.000

Mercry FY(DLG 1.00 W

0.00

;.2> W

0.

.;> W

1.1

.2 W

1.20

U0.001 FA G U C

U & Ele%ate! 0 F0IG 10 F100IG 10 F100IG 10 F100IG U0.001 A U F C

&GCreatinine Fm(D!LG .B1 W

.12.00 W

10.;1@. W

2.;22B.;; W

1@[email protected] FA G U C

U & Ele%ate! 0 F0IG 0 F0IG 1 F10IG 0 F100IG 1.000


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si4 to ten an! 11 to 1B years o# mercry e4'osre are 1B F=R 1.BG an! 10 F=R

.@G times, res'ecti%ely, more li5ely to ha%e traces o# 'rotein as com'are! to those

3ho are not e4'ose! or ha%e e4'osre o# one to #i%e years.

The mean amont o# rine mercry si(ni#icantly !i##er Z";,;> 1.1;1,

pU0.0016 Post hoc: FYcontrol Y1 to BG U Y> to 10U Y11 to 1B[ accor!in( to len(th o# mercry

e4'osre. Post hoc analysis in!icates that those 3ith 11 to 1B years o# e4'osre ha%e

si(ni#icantly the hi(hest mean rine mercry le%el, #ollo3e! by those 3ith si4 to ten

years o# e4'osre. Those 3ith one to #i%e years o# e4'osre !o not !i##er 3ith the

control Fp 0.;2BG. Those 3ith si4 to ten years o# e4'osre are hi(her by >.;B Y(DL


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FC*BI: ;.> to .0G, 3hile those 3ith 11 to 1B years o# e4'osre are hi(her by @.2

Y(DL FC*BI: B.> to 11.1BG, as com'are! 3ith the control.

The mean amont o# rine creatinine si(ni#icantly !i##er Z";,;> 1B.;,

pU0.0016 Post hoc: FYcontrol Y1 to BG U Y> to 10U Y11 to 1B[ accor!in( to len(th o# mercry

e4'osre. Li5e their rine mercry le%el, 'ost hoc analysis in!icate that those 3ith 11

to 1B years o# e4'osre ha%e si(ni#icantly the hi(hest mean rine creatinine le%el,

#ollo3e! by those 3ith si4 to ten years o# e4'osre. Those 3ith one to #i%e years o#

e4'osre !o not !i##er 3ith the control Fp 0.1@G. Those 3ith si4 to ten years o#

e4'osre are hi(her by 10. m(D!L FC*BI: B. to 1>.;G, 3hile those 3ith 11 to


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1B years o# e4'osre are hi(her by 1B0.@2 Y(DL FC*BI: 10>.2; to 1.2G, as

com'are! 3ith the control. 9o3e%er, only one 3or5er, 3ith si4 to 10 years o#

mercry e4'osre, ha%e ele%ate! rine creatinine. The nmber o# 3or5ers 3ith

ele%ate! rine creatinine !o not !i##er Fp 1.000G accor!in( to len(th o# mercry

e4'osre.


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The table sho3s that #or e%ery increase o# one micro(ram 'er liter in rine mercry,

rine creatinine 3ill also increase by .11 W 2.> m(D!L.

Correlation et3een $rine mercry an! $rine creatinine.


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CHAPTER 3

SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS

B.1 Smmary o# "in!in(s

$rine mercry le%el an! t3o renal #nction tests 3ere teste! an! relationshi's

amon( them 3ere !etermine! sin( a''ro'riate statistical analysis. estionnaire 3as

also (i%en to !etermine li#estyle #actors an! 3or5relate! #actors 3hich can be

attribte! to 'ossible renal 'roblem an! mercry e4'osre res'ecti%ely. The

res'onses o# the 3or5ers 3ere correlate! an! associate! 3ith the other 'arameters

incl!e! in the st!y. $rine sam'les 3ere teste! #or rine mercry le%el sin( Col!

a'or Atomic Absor'tion S'ectrosco'y.

Reslts sho3e! that there is a si(ni#icant hi(her inci!ence o# mercry

e4'osre amon( coal 'o3er 'lant 3or5ers. $rine mercry le%el bet3een the e4'ose!

an! control (ro' 3as com'are! an! reslts sho3e! that the mean rine mercry

le%el o# the e4'ose! (ro' 3as si(ni#icantly hi(her than the control (ro'. *t is also

#on! ot that the rine mercry le%el is associate! 3ith occ'ational coal e4'osre.

"rthermore, all the 3or5ers 3ith at least one year o# e4'osre 3ere #on! to

ha%e ele%ate! rine mercry le%el. This in!icate that coal 'o3er 'lant 3or5ers, 3ith


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at least one year o# mercry e4'osre, are 1 times Fo!!s ratio 1.0G more li5ely

to ha%e ele%ate! rine mercry le%el as com'are! to those 3ho are not e4'ose!. Renal

#nction 'arameters 3ere associate! an! correlate!. Reslts sho3e! that rine

creatinine is si(ni#icantly hi(her amon( the coal 'o3er 'lant 3or5ers com'are! to the

control (ro'.

&ration o# e4'osre in the 3or5'lace 3as also consi!ere! an! reslts sho3e!

that their 'erio! o# 3or5 in the 'o3er 'lant is associate! 3ith the li5elihoo! o# them

ha%in( mercry or not in the rine. The years o# em'loyment in the in!stry is

statistically correlate! to rine mercry le%el.

Pre%ios 3or5 o# the 3or5ers 3as also analy-e! 3ith re(ar!s to the mean

mercry le%el. Reslts sho3e! that the mean mercry rine le%els o# the #or (ro's

are si(ni#icantly !i##erent.

*nci!entally, it 3as #on! that rine mercry an! rine creatinine are

si(ni#icantly correlate! Fr 0.00,p 0.011G, in!icatin( that #or e%ery increase o# one

Y(DL, an increase o# .11 W 2.> m(D!L in the rine creatinine #ollo3s.

B.2 Conclsions

*n conclsion, there is a si(ni#icant hi(her rine mercry le%el amon( the coal

'o3er 'lant 3or5ers com'are! to the control (ro'. These #in!in(s coinci!e 3ith the

#in!in(s o# /ome- et al F200G 3herein he state! that the e4'osre o# coal 'o3er


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'lant 3or5ers is hi(her to the e4'ose! (ro' than the control (ro'.

Also statistics sho3e! that there is a si(ni#icantly increase! chance o#

ac+irin( mercry in coal 'o3er 'lant, re(ar!less o# role in the 'rocess, than in

en%ironmental e4'osre.

Moreo%er, there is si(ni#icant increase in rine creatinine. Proteinria an!

cylin!ria is not associate! 3ith rine mercry le%el.

Pre%ios occ'ations 3ith 'ossible mercry e4'osre contribte to the crrent

mercry br!en in the bo!y. "rthermore, years o# em'loyment 'lays an im'ortant

role in assessin( mercry e4'osre o# coal 'o3er 'lant 3or5ers 'rior to mercry

testin(. *t is statistically correlate! 3ith rine mercry le%el an! 'oses a yearly

increase in rine mercry le%el o# the 3or5ers.

ears o# em'loyment can be se! as an in!icator o# increase rine mercry

le%el br!en amon( the 3or5ers 'ro%i!e! they are 3or5in( in the same con!ition o#

these 3or5ersH 3or5'lace. Li5e3ise, ha%in( 're%ios 3or5 that has e4'osre to

mercry can also be se! as a 're!ictor o# increase! rine mercry. More im'ortantly,

bein( in the coal 'o3er 'lant in!stry, re(ar!less o# 'osition, 'oses a ris5 o# ha%in(

rine mercry.

B.; Recommen!ations

The researchers recommen! 'er#ormin( #ollo3 ' st!y in the same 'o3er


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'lant a year a#ter this st!y 3as con!cte! as to 'ro%i!e more e%i!ence 3ith re(ar!s

to the #in!in(s that this st!y 3as able to #on! ot. loo! mercry le%els may also

be !one to those 3or5ers to assess the lon( term br!en o# the 3or5ers. Per#ormance

o# en%ironmental mercry may also be !one in or!er to ascertain the mercry

e4'osre in the 3or5'lace.

Asi!e #rom these, #tre st!ies re(ar!in( the e##ects o# lea! to the other bo!y

systems o# the sai! 3or5ers may be consi!ere!. As to hel' establish 3hich bo!y

system is (reatly a##ecte! in this 5in! o# occ'ation. This may 'ro%i!e se#l

in#ormation to researchers in the area o# occ'ational me!icine an! en%ironmental

me!icine.


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BIBLIOGRAPHY

Z1[ Risher, John ". F200@G. *nor(anic: The =ther Mercry . Jornal o# En%ironmental

9ealth

Z2[ A(ency #or To4ic Sbstances an! &isease Re(istry. F200@G. Toxicological

profile for mercury (Update). Atlanta, /A: &e'artment o#

9ealth an! 9man Sciences

Z;[ AlSaleh, *., Al&osh, *. F200G. Mercry content in s5inli(htenin(

creams an! 'otential ha-ar!s to the health o# Sa!i 3omen..

Z[ A, A.M., o, R.=., oo, E=., 9s, R., Pere-, /., an(, . F200G. Screenin(

metho!s #or !r(s an! hea%y metals in Chinese 'atent me!icines.

ZB[ a(enstose, L.M., S\l(ame, P, r Monestier, M. F200@G. Mrine mercry

in!ce! atoimmnity: A mo!el o# chemically relate! atoimmnity

in hmans.

Z>[ Samir, Aisha M. F2011G. *m'act o# =cc'ational E4'osre to Elemental Mercry

on Some Antio4i!ati%e En-ymes Amon( &ental Sta##


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APPENDICES

APPENDIX A

E8PESE REP=RT

S!rc' $

E6'"'

U"% Prc' 'r U"% T%a4

Ur"'

M'rc!r(

T'%

0 00D'erson /F; timesG 1B00D'erson )=,

Gra"# T%a4 =0,/


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APPENDIX

SP=T MAP =" T9E P=7ER PLAT


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APPENDIX C

$EST*=A*RE SAMPLE

AME:

A&&RESS:

*RT9&ATE:

A/E:

/E&ER:

1. Ano 'o an( inyon( trabahao] Anano 'o an( m(a (am'anin na nasasa5la3a

n( inyon( trabaho]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

2. *lan( oras 'o an( trabaho ninyo sa isan( ara3]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

;. Maaari ninyo 'o ban( ilara3an an( inyon( 5arani3an( ara3 sa trabaho]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

. /aano na 'o 5ayo 5ata(al na na(trabaho sa 'a(a3aan( ito]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^

B. Mayroon 'o ba 5ayon( na((in( iban( trabaho noon] n( mayroon, ano 'o

ito at (aano 5ayo 5ata(al na(trabaho noon]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^


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>. Mayroon 'o ba 5ayon( F'a5ila(yan n( chec5G

^^^^^ !iabetes ^^^^alta'resyon

^^^^^ sa5it sa bato ^^^^^ 5anser

. May iniinom 'o ba 5ayon( (amot] n( mayroon, ano 'oi to at (aano niyo

na 'o 5ata(al iton( iniinom]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

@. ma5ain 'o ba 5ayo n(_] /aano 'o 5a!alas]

^^^^^^mn((o ^^^^^^^^^^^^^^^^

^^^^^^ !ilis ^^^^^^^^^^^^^^^^^^^

^^^^^ mani ^^^^^^^^^^^^^^^^^^^

^^^^^ oatmeal ^^^^^^^^^^^^^^^^^

^^^^^ beans ^^^^^^^^^^^^^^^^^^^

. *lara3an an( l(ar na inyon( 'ina(tratrabahan]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

^^^^^^^^^^^^^^^^^^^^^^^^^^^

10. a(ssot ba 5ayo n( PPE sa trabaho]

^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^

An( im'ormasyon( a5in( bini(ay sa +estionnaire na ito ay totoo at tama atnaiintin!ihan 5o na an( m(a im'ormasyon( a5in( inila(ay !ito ay mananatilin('riba!o at (a(amitin laman( sa 'a(ssri n( m(a ta(a'an(asi3a n( 'ananali5si5 naito.


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______________________ ___________Lagda sa ibabaw ng pangalan Petsa

I"$r2'# C"'"%

A5o si ^^^^^^^^^^^^^^^^^^^^, at a5o ay na'a(bi(yan 5aalaman na..

5hanan n( Q$rine sam'le o ihi

An( reslta n( urinalysisna ito ay mananatilin( 'riba!o at (a(amitin laman(

sa 'a(ssri n( ta(a'an(asi3a n( 'ananali5si5 na ito.

A5o ay 'ma'aya( na ma'asama sa 'ananali5si5 na ito.

____________________________ ______________________Lagda sa ibabaw ng pangalan Petsa


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APPRO9AL SHEET

This Thesis is entitle!

NEPHROTOXIC EFFECTS OF ELEMENTAL MERCURY AMONG

COAL POWERPLANT WORKERS IN PANGASINAN

're'are! an! sbmitte! by

FERNANDE@, CHRISTIAN NOEL., GARCIA, ROMUALD O@EP D.,

GASAPO, SIMON IBERT G.,GUBALLA, KESTER IMER S., LORETO,

ALLEN STEPHEN B ., 9ILLALOBOS, MARIA HOGIELYN A.

has been a''ro%e! an! acce'te! as 'artial #l#illment o# the re+irements #or the

&e(ree o# achelor o# Science in Me!ical Technolo(y.

A%. Pr$. R" S", RMT, MPHA!%iser

PANEL MEMBERS

This thesis has been a''ro%e! by the Committee on =ral E4amination on March

1, 201.

Pr$. Ma. Fr'#a @. Haa", RMT, MSMT,P&D

Chair

A%. Pr$. Fr'#'rck R. L4a"'ra, MD, FPSPMr. R" C&r%a" G. S", RMT, MPH

Member Member

Pr$. Ma. Fr'#a @. Haa", RMT, MSMT,P&D.Pr$. Prc44a Ma"a"a4a P&D.

Chair, &e'artment o# Me!ical Technolo(y &ean, "aclty o# Pharmacy


78/86


CERTIFICATE OF STATISTICIAN

This Thesis is entitle!

NEPHROTOXIC EFFECTS OF ELEMENTAL MERCURY AMONG

COAL POWERPLANT WORKERS IN PANGASINAN

're'are! an! sbmitte! by

FERNANDE@, CHRISTIAN NOEL., GARCIA, ROMUALD O@EP D.,

GASAPO, SIMON IBERT G ., GUBALLA, KESTER IMER S., LORETO,

ALLEN STEPHEN B ., 9ILLALOBOS, MARIA HOGIELYN A.

has been conslte!, re%ie3e! an! a''ro%e! #or statistical analysis nee!e! #or

the st!y as a 'artial #l#illment o# the re+irements #or the !e(ree o# achelor

o# Science in Me!ical Technolo(y.

A%. Pr$. Xa"#r A4'6 A. N'%

STAT*ST*C*A


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CERTIFICATE OF ORIGINALITY

7e hereby a##irm that this sbmission in the researchers o3n 3or5 an!

that, to the best o# their 5no3le!(e an! belie#, it contains no materials

're%iosly 'blishe! or 3ritten by another 'erson nor material 3hich to a

sbstantial e4tent has been acce'te! #or a3ar! or any other !e(ree o# !i'loma

o# a ni%ersity or other institte o# hi(her learnin(, that 3here !e

ac5no3le!(ement is ma!e in the te4t.

The researchers also a##irms that the intellectal content o# this thesis is the

'ro!ct o# their 3or5 e%en tho(h they may ha%e recei%e! assistance #rom others on

style, 'resentation, an! lan(a(e e4'ression.

Can!i!ates:

"ernan!e-, Christian oel






A%. Pr$. R" S", RMT, MPH

Thesis A!%iser

ote! by:

Pr$. Ma. Fr'#a @. Haa", RMT, MSMT,P&D.

Chair, &e'artment o# Me!ical Technolo(y


80/86


81/86


CURRICULUM 9ITAE

Na2'Christian oel &ela "ente "ernan!e-

Da%' $ Br%& May 22, 1

P4ac' $ *r%& e-on City

E#!ca%"a4 Backgr!"#

C44'g' $ni%ersity o# Santo Tomas F.S. Me!ical Technolo(yG

Es'ana, Manila

2010201

S'c"#ar( =cci!ental Min!oro State Colle(e

=cci!ental Min!oro

200>2010

Pr2ar( =cci!ental Min!oro ational Colle(e

=cci!ental Min!oro

2000200>


82/86


83/86


Na2'Simon *bert /arcia /asa'o

Da%' $ Br%&May2;, 12

P4ac' $ *r%&Tacloban City, Leyte

E#!ca%"a4 Backgr!"#

C44'g' $ni%ersity o# Santo Tomas F.S. Me!ical Technolo(yG

Es'ana, Manila

2010201

S'c"#ar( ethel *nternational School an! /race o# She5inah School

Tacloban City, Leyte

200>2010

Pr2ar( ethel *nternational School

Tacloban City, Leyte

2000200>

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