Background: The prevalence of growth disorders among school-aged children in Indonesia is high (30.7%). Pesticides have been massively used in Indonesian agricultural areas. Objective: To determine if exposure to pesticides is associated with stunting among children in agricultural areas. Methods: This case-control study included 160 children (48 cases and 112 controls) aged 8–12 years. Exposure to pesticides was measured based on the history of the exposure since perinatal period, infancy, and childhood of the participants. Stunting was determined as a height for age z-score (HAZ) < -2 SD. Other variables measured were levels of thyroid stimulating hormone (TSH), insulin-like growth factor-1 (IGF-1), hemoglobin, zinc, albumin, nutrient adequacy level (energy and protein), and history of infection, low-birth weight (LBW), and mother's height. Results: There were no significant difference between the cases and controls in terms of in the baseline characteristics, except for the median IGF-1 level; it was significantly (p<0.001) lower in the cases (66.73 ng/mL) than the controls (112.57 ng/mL). High level of pesticide exposure (p=0.029) and low IGF-1 levels (p<0.001) were significantly associated with stunting. After adjusting for confounding variables, these variables were found to be independent risk factors for stunting in children (aOR 3.90, 95% CI 1.15 to 13.26; and aOR 8.35, 95% CI 3.65 to 19.14, respectively). Conclusion: Pesticide exposure could be a risk factor for the occurrence of growth disorders in children living in agricultural areas. Necessary actions should be taken to protect children living in agricultural areas from exposure to pesticides.

This study was conducted to determine the effect of composite flour (CF) constituents and different extrusion temperatures on the production of analog rice and community perceptions about the produced rice. CF was produced by mixing modified cassava flour (Mocaf) and snakehead fish flour (SF) in the following ratios: 100:0; 97:3; 94:6; 91:9; and 88:12. Analog rice was then extruded from CF at the following temperatures: 50, 70, and 90°C. The analog rice was tested for physical properties (bulk density and cooking time), chemical properties (nutrient content), and organoleptic properties. The results showed that CF and extrusion temperature affect the nutrient content of analog rice. The best analog rice formulation constituted of CF with Mocaf:SF ratio of 91:9 and extrusion temperature of 70°C, and contained 14.34% water, 0.85% ash, 71.83% carbohydrate, 11.24% protein, 1.12%, calcium 1,113 ppm, and 2.43% dietary fiber. This study included 42 respondents aged 20–23 years, including 20 males and 22 females. All the respondents showed acceptance for the analog rice, suggesting that it could substitute ordinary rice as a staple food.

Pesticide Exposure and Thyroid Function in Elementary School Children Living in an Agricultural Area, Brebes District, Indonesia

Introduction: Previous studies found that young children, children, pregnant women, and farmers are at risk of pesticide exposure. Organophosphate pesticides are detected in children’s urine, but other types of pesticides, their toxicity classification, and their toxicity level have not been identified. Hence, this study aims to identify types and toxicity levels of pesticides that are possible causes of health problems in an agricultural area. Methods: The population of the study were 1,017 households in two villages of an agricultural area of Brebes Regency, Indonesia. The data were collected from 166 participants using a cross-sectional design involving questionnaires to identify the characteristics of the respondents and observations to identify the pesticide, pesticide packaging, and pesticide residue in their houses. The toxicity levels of the pesticides were identified based on the pesticide toxicity classification recommended by the World Health Organization (WHO). Potential health problems due to pesticides were subsequently identified based on literature reviews. Results and Discussion: According to the results, organophosphate, carbamate, and pyrethroid pesticides were found in 30.7% of the respondents’ houses. The toxicity levels of the pesticides ranged from highly hazardous (Ib) to unlikely presenting acute hazard (U). The potential health problems due to pesticides varied from poisoning symptoms to genetic disorders and polymorphisms. Conclusion: There were three types of pesticides with toxicity levels ranging from highly hazardous to unlikely presenting acute hazard in the agricultural area in Brebes Regency

Climate and environmental change are currently in the forefront as global development issues due to their economic, societal and health impacts, and the complex ways these interact. Experience and perception play an important role regarding the overall nature and severity of the environmental change, as these shape coping behaviour. Therefore, more insight is needed into local health-related risk perception, knowledge and coping mechanisms. In Semarang, a low-lying coastal city in Indonesia, a concurrent mixed-methods study design was applied using a cross-sectional survey supplemented by six focus group discussions and eight semi-structured key informant interviews with village officers and health-care workers. Respondents exhibited high awareness of environmental change and impact on health, housing and livelihood, and acknowledged the role of human activity, yet insight in underlying disease mechanisms was low. Most coping mechanisms were mainly short-term due to financial limitations and the frequency and intensity of environmental events. Existing health educational programs should be expanded and incorporate local perception and knowledge, to optimise coping behaviour and strengthen population resilience to environmental change. Further research needs to focus on differences regarding perception and desired coping strategies between household members and individual vulnerability to environmental change.