Int
ern
at
i
onal
Journ
al of
P
u
bli
c Hea
lt
h S
c
ie
nce (IJPH
S)
Vo
l.
7
, No
.
2
, Jun
e
201
8
, pp.
102~
106
IS
S
N: 22
52
-
8806
,
DOI: 10
.11
591/ij
phs
.
v7
i
2.
1
18
49
102
Journ
al h
om
e
page
:
https:
//
ww
w.i
aesco
re
.c
om
/j
our
nals/
ind
ex.
php/IJP
H
S
The Eff
ect o
f Te
nd
e
r
Co
conu
t Wat
er
on
Free Rad
ical
Due to
M
ercury
Expo
su
re
Siti Tho
mas
Z
ulaikh
ah
,
Jok
o
W
ahyu
Wib
owo
Depa
rtment
o
f
P
ubli
c
Hea
l
th,
Fa
cul
t
y
of
Med
ic
in
e,
Univ
ersitas
Isl
am Sulta
n
Agun
g,
Sem
ara
ng
,
In
donesia
Art
ic
le
In
f
o
ABSTR
A
CT
Art
ic
le
history:
Re
cei
ved
Feb
21
, 201
8
Re
vised
Jun
5
,
201
8
Accepte
d
J
un
30
, 201
8
Merc
ur
y
poll
u
tion
ca
n
result
s
fr
om
gold
m
ini
ng.
Furthermore,
a
cont
inuous
m
erc
ur
y
exposure
ca
n
tr
igg
er
t
he
form
at
ion
of
Rea
c
ti
ve
Ox
y
g
en
Species
(
ROS
)
and
int
er
fer
e
with
the
bo
d
y
'
s
antioxida
n
t
m
et
abol
ism
.
A
h
igh
le
ve
l
of
fre
e
r
adica
ls i
n
t
he
bod
y
ca
n
b
e
c
har
acte
ri
ze
d
b
y
a
low
le
ve
l
of
an
ant
iox
ida
n
t
enzy
m
e.
Preve
nti
on
to
avoi
d
the
impact
s
of
m
erc
ur
y
poisonin
g
is
bet
t
er
th
an
treat
m
ent
.
T
ende
r
co
conut
wate
r
c
an
el
iminate
ROS
and
improve
ant
ioxi
d
ant
st
at
u
s.
Thi
s
stud
y
aim
ed
to
was
to
conf
irm
that
t
en
der
co
conut
wate
r
is
abl
e
to
de
crease
the
fr
ee
r
adic
al
which
is
c
har
acte
ri
ze
d
by
inc
r
ea
sed
anti
oxida
nt
en
z
y
m
e
GP
x
stat
us.
T
his
stud
y
was
designe
d
as
ran
dom
iz
ed
pr
e
-
and
postt
est
con
trol
group
d
esig
n
,
40
tra
di
ti
on
al
gold
m
ini
ng
workers
devi
ded
int
o
2
groups:
the
cont
ro
l
and
tre
a
tment
groups.
After
th
e
pre
t
est
of
GP
x
le
ve
l,
the
work
e
rs
were
e
it
he
r
gi
ven
t
ende
r
coc
o
nut
wat
er
a
t
the
dose
of
450
m
L
or
water
f
or
4
we
eks
ev
er
y
d
a
y
.
Four
wee
ks
aft
er
th
e
pre
-
te
st
,
th
e
le
v
el
of
GP
x
was
a
ss
essed
in
the
la
bora
tor
y
PA
U
-
Gaja
hm
ad
a
Univer
sit
y
.
Th
e
post
te
st
result
s
of
the
con
trol
group
and
tre
a
t
m
ent
s
group
were
compare
d
and
anal
y
ze
d
us
ing
Man
Whi
tney
t
est
.
Th
e
m
ean
le
vel
s
of
GPx
post
-
te
st
in
the
cont
ro
l
gro
up
and
treate
d
group
were
63.
5±1.1
U/m
L
and
79.
9±
8.
8
U/
m
L
respe
ct
iv
ely
.
The
ana
l
y
sis
re
sult
obta
in
ed
p
-
val
ue
0.
0
0
0
<0.
05.
T
ende
r
c
oconut
wate
r
ha
s
an
eff
ec
t
on
fre
e
rad
i
ca
ls
due
t
o
to
m
erc
u
r
y
exposure
.
Te
nd
e
r
coc
onu
t
wat
er
c
an
be
co
nsum
ed
dai
l
y
to
pre
v
ent
dege
ner
at
iv
e
d
isea
ses caused
b
y
m
erc
ur
y
exposur
e
.
Ke
yw
or
d:
Fr
ee
rad
ic
al
s
Glutati
on per
o
x
id
a
se
Me
rcury
Re
act
ive Oxyg
en
S
pecies
(
ROS)
Ten
der
c
oc
onut
w
at
er
Copyright
©
201
8
Instit
ut
e
o
f Ad
vanc
ed
Engi
n
ee
r
ing
and
S
cienc
e
.
Al
l
rights re
serv
ed
.
Corres
pond
in
g
Aut
h
or
:
Sit
i Tho
m
as Zu
la
ikh
a
h
,
Dep
a
rtm
ent o
f Pu
blic Heal
th
,
Faculty
of Me
dicine,
Un
i
ver
sit
as
Isl
a
m
Su
lt
an Agu
ng,
Sem
arang, In
donesia
.
Em
a
il
:
sitit
ho
m
as@u
niss
ula.
ac.id
1.
INTROD
U
CTION
Me
rcury
has
be
en
widely
us
e
d
in
in
dustria
l
processes
s
uch
as
the
rm
o
m
eter
in
dustrie
s,
hy
drom
et
ers
,
barom
et
er,
sph
ygm
o
m
ano
m
eter
,
flu
orosce
nt
s
li
gh
ts,
ba
tt
eries,
pestic
ides
,
plasti
cs,
s
oda
s,
c
hl
or
-
al
kalis
an
d
go
l
d
m
ining
[
1
-
3].
Global
ly
,
the
la
rg
est
so
urce
of
m
erc
ur
y
em
issi
on
s
com
es
fr
om
the
s
m
al
l
scale
go
l
d
m
ining
s
[
3].
I
n
I
ndonesi
a,
t
he
re
ar
e
ar
ou
nd
57.
5%
s
ource
of
m
ercu
ry
em
issi
on
s
al
so
co
m
es
from
s
m
all
scal
e
go
l
d
m
ining
s
with
the
total
e
m
issi
on
s
of
195
to
nn
es/
ye
ar
[4
]
.
Me
rcury
is
a
fr
ee
ra
dic
al
,
this
s
ub
sta
nc
e
will
bind
thi
ol
or
s
ulf
hydr
yl
c
on
t
ai
ned
i
n
a
ntio
xid
a
nt
protei
ns
so
t
he
a
ntiox
i
dan
t
act
ivit
y
will
decr
ease
[5
]
,
[6
]
.
This
co
ndit
ion
will
cause
de
pleti
on
of
glu
t
at
hio
ne
a
nd
an
increa
se
in
H
2
O
2
due
to
i
nh
i
bited
act
ivit
y
of
antioxi
dan
t
en
zym
es
[5
]
.
Defi
ci
ency
of
on
e
of
the
antio
xida
nt
c
om
po
ne
nts
of
t
he
e
nzym
e
le
ads
to
a
c
om
ple
te
reducti
on
in
a
nt
iox
ida
nt
sta
tus
and
will
res
ult
in
wea
k
prote
ct
ion
a
gainst
R
OS
at
ta
cks
[7
]
,
[8
]
.
Eli
m
inatio
n
of
ROS
is ver
y
i
m
po
rtant
to
m
ai
ntain
the
i
nteg
rity
of
cel
l
f
un
ct
ion
a
nd
can
be
done
by
i
ncrea
sing
t
he
a
ntiox
i
dan
t
act
ivit
y
[9
]
.
Gl
utathio
ne
pe
r
oxidase
(GPx
)
a
ct
s
as
a
cat
al
ys
t
in
br
ea
king
dow
n
H
2
O
2
int
o
ox
i
diz
ed
glu
ta
thion
e
(G
S
SH)
us
in
g
glu
ta
thio
ne
(
GSH)
as
a
s
ubstrat
e,
GS
S
H
will
be
re
du
c
ed
to
GSH
by
glu
ta
thi
on
e
re
du
ct
ase
enzym
e
Me
rcu
ry
in
the
body
is
able
t
o
in
hi
bit
m
et
hio
nein
e
syntha
se
(SM
)
in
the
m
eth
io
nin
e
cy
cl
e
and
will
interfe
re w
it
h GS
H
synth
esi
s r
esulti
ng in
a
decr
ease i
n GS
H
(
GRed
)
[10
]
,
[11
]
. Merc
ur
y
in the body i
s ab
le
t
o
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N: 22
52
-
8806
Th
e
Eff
ect
o
f T
end
e
r Coc
onut
Wa
te
r
on Free
Radical
D
ue
t
o
Merc
ur
y
Exposure
(
Siti
T
homa
s
Z
ula
ik
hah
)
103
in
hib
it
m
et
hio
neine
sy
nth
ase (S
M)
,
in
the
m
et
hio
ni
ne
cy
cl
e
and
w
il
l
interf
ere
with G
S
H
synthesis
re
su
l
ti
ng
i
n
a
dec
rease
in
GSH
[12
]
.
G
S
H
is
a
substrat
e
for
t
he
a
ntio
xid
a
nt
gl
utathi
on
e
pe
r
ox
i
de
(
GPx)
i
n
br
ea
ki
ng
do
wn
hydro
ge
n
pe
r
oxide,
if
the
gl
utathio
ne
syst
e
m
is
disturbed
it
will
cause
a
decr
e
ase
in
GSH
a
nd
hydr
og
e
n
pero
xid
e
will
accum
ulate
an
d event
ually
w
il
l i
ncr
ease
the
hy
drox
yl
r
a
dical
s m
or
e h
arm
fu
l
to
the
hum
an
body.
GSH
is
a
subst
rate
f
or
the
ant
iox
ida
nt g
lutat
hione p
er
oxide
(
GPx)
i
n
br
ea
king d
ow
n
hydro
ge
n
p
er
ox
i
de
,
if
t
he
glu
ta
thio
ne
sys
tem
is
interfer
r
ed
it
will
cause
a
decr
ea
se
in
GSH
an
d
hydr
og
e
n
pero
xid
e
will
accum
ulate
and
even
t
ually
will
increa
se
the
hy
drox
yl
r
adica
ls
w
hich
ca
n
be
ha
rm
fu
l
to
t
he
hu
m
an
body
.
The
hum
an
body
do
e
s
not
ha
ve
antioxi
dan
t
res
e
rv
es
in
e
xces
s
am
ou
nt,
s
o
i
n
case
of
e
xposure
to
fr
ee
ra
dical
s,
the
bo
dy
will
need
a
ntio
xid
a
nts
that
com
e
from
ou
tsi
de
the
bo
dy
in
or
der
to
el
im
inate
the
eff
ect
s
of
fr
ee
.
L
ow
le
vel
of
antioxi
dan
t
e
nz
ym
es
can
be
us
e
d
as
i
nd
ic
at
or
t
hat
the
re
is
a
hi
gh
le
ve
l
of
f
ree
rad
ic
al
s
i
n
the
bo
dy
[
13
]
,
[14
].
The
body
has
protect
ive
m
ec
han
ism
to
neu
t
rali
ze
fr
ee
rad
i
cal
s
wh
ic
h
is
f
or
m
ed
as
glu
t
hathione
pero
xi
dase
(G
P
x)
[13
]
.
Ten
der
coc
on
ut
water
has
t
her
a
pe
utic
effe
ct
s,
wh
ic
h
con
ta
in
s
var
i
ous
nu
trie
nts
can
be
us
e
d
to
el
i
m
inate
RO
S
an
d
im
pr
ove
a
ntio
xid
a
nts
sta
tus
[
15
]
.
The
re
su
lt
s
on
a
nim
a
l
te
sti
ng
s
i
nd
ic
at
e
d
t
hat
adm
inist
rati
on
of
te
nder
c
oc
onut
wate
r
can
i
m
pr
ov
e
antio
xi
dan
t
sta
tus
a
nd
prov
i
de
protec
ti
on
agai
ns
t
da
m
age
cause
d
by
fr
ee
rad
ic
al
s
[15
]
,
[
16
]
.
This
resea
rch
ai
m
s
to
pro
ve
the
adm
inist
rati
on
of
te
nd
er
coc
onut
wat
er
can
decr
ease
free
r
adical
s which
ind
ic
at
ed
b
y t
he
incr
ease
an
ti
oxidat st
at
us o
f GP
x
e
nzym
es
.
2.
RESEA
R
CH MET
HO
D
The
resea
rc
h
de
sign
us
ed
is
Ra
ndom
iz
ed
pr
e
and
post
te
st
con
t
ro
l
gro
up
de
sign
.
In
this
de
sign,
there
are
f
our
ty
pes
of
obser
vatio
n
gro
up
s
on
rese
arch
var
ia
bles,
the
two
gro
ups
are
f
ro
m
init
ial
resu
lt
s
obse
rvat
io
n
gro
up
s
(O
-
1
a
nd
O
-
3),
an
d
tw
o
final
obse
rv
a
ti
on
s
res
ults
(
O
-
2
an
d
O
-
4)
[
17
]
.
T
he
desi
gn
schem
e
as
sh
own
in
Figure
1.
Figure
1. Ra
nd
om
iz
ed
pr
e a
nd
po
st
d
esi
gn test
contro
l
gro
up d
e
sig
n
Descr
i
ption
:
R
: R
andom
iz
ation
(X)
: adm
inist
rati
on
of ten
der
c
oc
onut
water
of 450 m
L/day
f
or
30 d
ay
s
(
inte
rvanti
on)
(
-
)
:
adm
inist
rati
on
of w
at
er
45
0 m
L
/
day for 30
days
(c
ontr
ol)
O
-
1
: In
it
ia
l O
bs
er
va
ti
on
Res
ult
(
G
Px
Level)
in t
r
eatm
ent g
r
oup
(pretest
)
O
-
2
: Final
Obse
rvat
ion
Res
ult
(
G
Px
Level)
in t
r
eatm
ent g
r
oup
(postest
)
O
-
3
: In
it
ia
l O
bs
er
va
ti
on
resu
lt
(GPx Level
)
in
co
ntr
ol grou
p
(pr
et
est
)
O
-
4
: Final
obse
rv
a
ti
on
resu
lt
(GP
x
Le
vel)
i
n
c
on
trol
group
(
po
s
te
st)
Inde
pende
nt
va
riable
f
or
thi
s
stud
y
was
a
dm
inist
rati
on
of
te
nder
c
oc
onut
wate
r
40m
l/
day
fo
r
30
days,
the
de
pe
nd
e
nt
var
ia
ble
s
wer
e
bloo
d
GPx
le
vels,
w
her
eas
the
c
onfou
nd
i
ng
va
ria
bles
inclu
de
ed
ucati
on,
age,
durati
o
ns
of
co
ntact
,
peri
od
s
of
w
ork,
BM
I,
per
s
onal
protect
ive
eq
uip
m
ent
(P
P
E)
an
d
bloo
d
m
e
rcur
y
le
vels.
I
n
orde
r
to o
btain
certa
inty
that
the
c
ha
ng
e
s o
ccu
rr
i
ng o
n
the
m
easu
red
de
pe
nd
e
nt v
aria
ble
are
act
ually
cause
d
by
the ad
m
inist
rati
on
o
f
450
m
L/
day
of
te
nder
coc
onut w
at
er
f
or
30 d
ay
s,
it
is ne
cessary
to cont
ro
l
t
he
arisi
ng con
fou
nd
i
ng v
a
riables
, thro
ugh restri
ct
ion
a
nd r
a
nd
om
iz
a
ti
on
.
To
e
ns
ure
th
a
t
the
co
ntr
ol
and
t
he
treat
m
ent
groups
befor
e
inter
ve
ntion
ha
d
the
sam
e
su
bj
ect
char
act
e
risti
cs
distrib
ution,
t
he
com
par
at
ive
te
st
analy
ze
s
wer
e
pe
rfo
rm
e
d
in
bo
t
h
gro
ups
.
E
du
cat
io
n,
age,
durati
on
of
co
nt
act
with
m
ercu
ry, u
se o
f
P
P
E,
w
ork
per
io
d
and
nutrit
ion
al
sta
tus
(BMI)
wer
e
a
naly
zed b
y
Chi
sq
ua
re
te
st
bec
ause
t
he
scal
e
of
the
data
we
re
cat
eg
ori
cal
data,
w
hile
m
e
rcury
w
as
a
nal
yz
ed
by
in
depend
e
nt
t
-
te
st beca
us
e t
he data
scale
w
as r
at
io
a
nd
norm
ally dist
ribute
d.
The
Sub
j
ect
s
wer
e
tra
diti
on
a
l
go
l
d
m
iner’
s
w
orkers
in
W
onogiri
with
t
he
f
ollow
i
ng
cri
te
ria:
m
al
e,
age
20
-
60
ye
a
rs
ol
d,
per
i
ods
of
w
orkin
g
a
s
m
iner
f
or
at
le
ast
5
ye
ars,
norm
al
nu
trit
ion
al
sta
tus
(
BM
I)
.
Subj
ect
s
w
ho
m
et
sel
ect
ion
c
rite
ria
we
re
ra
ndom
iz
ed
(R),
so
the
t
reatm
e
nt
an
d
co
ntr
ol
gro
up
s
we
re
f
orm
ed,
the
bias
factors
can
be
con
t
ro
l
le
d
eff
ect
ively
because
the
co
nfo
unding
va
riabl
es
wer
e
di
vi
ded
e
ven
ly
bet
ween
two
s
ubj
ect
groups
[17
]
.
T
he
nu
m
ber
of
sa
m
ple
of
40
ra
ndom
ly
div
ided
into
2
gr
oups
,
wh
ic
h
are
co
nt
ro
l
a
nd
treatm
ent
gr
ou
p.
T
he
treat
m
e
nt
gro
up
was
gi
ven
te
nder
c
oc
onut
water
450
m
L/day
fo
r
30
days,
an
d
c
on
t
ro
l
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2252
-
8806
IJPHS
V
ol.
7
,
No.
2
,
J
une
20
18
:
10
2
–
106
104
gro
up
was
give
n
water
for
450
m
L/day
fo
r
30
days
.
The
su
bject
s
as
wel
l
as
the
researc
her
do
no
t
kn
ow
into
wh
ic
h
gro
ups
the
subj
ect
s
a
r
e
al
locat
ed
(do
ub
le
bli
nd).
T
he
first
wa
s
co
nductin
g
pre
te
st
by
m
easur
ing
th
e
workers
bloo
d
pr
ess
ure
to
t
he
ir
GPx
le
vels
,
f
our
week
s
aft
e
r
pre
te
st
,
post
te
st
was
co
nd
ucted
i
n
both
s
a
m
ple
gro
up
s
by
m
ea
su
ri
ng
thei
r
G
Px
le
vels.
T
he
GP
x
le
vels
w
ere
exam
ined
in
the
PAU
la
borat
or
y
-
Ga
j
ah
Ma
da
Un
i
ver
sit
y
(UGM)
by
usi
ng
RANSEL
Gl
utathion
e
.
The
first
te
st
per
f
orm
ed
was
te
st
fo
r
data
norm
ality
sinc
e
the
data
scal
e
was
rasi
o.
T
he
resu
lt
of
norm
al
it
y
te
st
us
ing
Sh
a
piro
-
W
il
k
resu
lt
ed
t
hat
th
e
distrib
ution
of
data
in
bo
t
h
gro
ups
wer
e
not
nor
m
al
l
y
distribu
te
d
(p
<
0.
05)
,
so
the
Ma
nn
W
hitn
ey
te
st
will
be
us
e
to
anal
yz
e
the
diff
e
re
nce
between t
he GP
x
l
evels
afte
r
inte
rv
e
ntio
n
(
poste
st
)
in c
ontr
ol a
nd treat
m
ent g
r
oups
[
18
].
3.
RESU
LT
S
A
ND AN
ALYSIS
3.1. C
ha
r
ac
te
ri
stics of
th
e
S
ubj
ec
t
The
res
ult
of
the
analy
sis
in
dicat
ed
that
th
e
distrib
ution
of
c
har
act
e
risti
cs
of
t
he
sub
j
e
ct
s
betwee
n
treatm
ent
gr
ou
p
an
d
co
ntr
o
l
gro
up
wer
e
no
si
gn
ific
a
nt
dif
fer
e
nce
(
p
val
ue
>0
.
05)
.
Thi
s
sit
uation
in
dicat
e
d
that
the
char
ac
te
risti
cs
of
the
su
bject
s
bet
w
een
the
co
ntr
ol
group
an
d
tre
atm
ent
gr
oup
wer
e
e
ven.
All
of
the
su
bject
s
ha
ve
the
bl
ood
m
ercu
ry
le
vels
ex
ceedin
g
the
WH
O
al
lowa
ble
tresh
old
(<
10
µg/L)
as
well
as
by
Directo
rate
of
Me
dical
Su
pport
Serv
ic
e
Dire
ct
or
at
e
Ge
ner
a
l
of
Me
dical
C
are
-
Dep
a
rtm
ent
of
Healt
h
R
epublic
of Indo
nesia in
2008 (≤
8
µ
g/L
).
T
he
c
om
plete
r
es
ult are il
lu
strat
ed
in
Ta
ble 1
.
Table
1.
Distri
bu
ti
on
C
har
a
ct
e
risti
cs o
f
the
Subj
ect
s
betwee
n
T
reat
m
ent G
r
oups a
nd
Co
ntr
ol
G
r
oups
No
Ch
arac
teristics
Tr
eat
m
en
t
Co
n
trol
p
-
v
alu
e
1.
Edu
catio
n
Ele
m
en
ta
ry Sch
o
o
l
Pri
m
a
r
y
Scho
o
l
Seco
n
d
ary
Scho
o
l
1
(5%
)
1
3
(65
%)
6
(30
%)
1
(35
%)
1
2
(
3
0
%)
7
(35
%)
0
.94
3
*#
2.
Ag
e (
Yea
rs)
Av
erage
±
SD
Min
–
Max
(years)
39
.
9
±1
0
.5
24
-
60
4
1
.8 ±8
.4
29
-
60
0
.53
2
*
#
3.
Co
n
tact Duration
(
h
o
u
rs/d
ay
)
≥1
ho
u
rs/d
ay
< 1 h
o
u
r
1
7
(85
%)
3
(15
%)
2
0
(10
0
%)
0
.
072
*#
4.
PPE
Nev
er
So
m
eti
m
e
s
1
5
(75
%)
5
(25
%)
2
0
(10
0
%)
0
.05
7
*#
5.
Period
of
W
o
rk (Y
ear)
Av
erage ±
SD
Min
–
Max
(years)
12
.
8
5
±5
.
5
6
-
22
14
.
8
±5
.
5
6
-
25
0
.
248
*#
6.
Nu
trition
al Status
(
BMI)
No
r
m
al
2
0
(10
0
%)
2
0
(10
0
%)
--
-
-
7.
Av
erage M
ercur
y
Levels
±
S
D
56
.
5
±3
7
.
6
74
.
6
±5
2
.
4
0
.
217
*
#
#
*
No sig
n
if
ican
t di
f
f
erence (
p
>0
,05
)
#
Ch
i sq
u
a
re test
##
Ind
ep
en
d
en
t
t
-
t
est
3.2. A
verage
Analysis
for
GPx l
evels
of
Contr
ol Gr
oup and Tre
atm
ent Gro
up
The
ave
rage
le
vel
of
P
re
G
Px
in
treat
m
ent
gr
ou
p
wer
e
69.8±
13.
4
U/m
L
and
co
ntr
ol
gro
up
wer
e
69.7±
14.
2
U/m
L,
w
hile
the
a
ver
a
ge
of
P
os
t
GPx
le
vels
in
treatm
ent
group
we
re
79.9±8.
8
U/m
L
and
c
on
t
ro
l
gro
up
we
re
63.
5±1
,
0
U/m
L.
The
a
ver
a
ge
le
vels
of
GPx
i
n
the
c
on
t
ro
l
group
a
nd
treat
m
ent
gr
oup
befo
re
t
he
interve
ntio
n
w
ere
p=
0.3
24
,
th
is
m
eans
that
there
was
no
di
ff
e
ren
ce
of
GPx
le
vels
befor
e
interve
ntio
n
in
bot
h
gro
up
s
.
T
he
re
su
l
t
of
analy
sis
for
a
ver
a
ge
G
Px
le
vels
after
interve
ntio
n
in
co
ntro
l
gr
oup
and
treat
m
ent
gro
up
was
p=0.
000
¸
it
m
eans
that
there
we
re
di
fference
on
GPx
le
vels
after
in
te
rv
e
ntion
in
both
gro
ups,
in
oth
e
r
words
the
adm
inist
rati
on
of
te
nd
e
r
c
oc
onut
water
ca
n
inc
r
ease
GPx
le
vels
on
tra
diti
on
al
gold
m
iners
e
xpos
e
d
to m
ercu
ry. T
he
co
m
plete
r
es
ults are il
lust
ra
te
d
in
Table
2.
Table
2.
Res
ult o
f
A
ve
rag
e
Analy
sis f
or
GPx levels
of C
ontrol
Group
a
nd
Treatm
ent G
roup
Variable
Av
erage±SD
p
-
v
alu
e
Tr
eat
m
en
t G
rou
p
(
n
:
20
)
Co
n
trol Grou
p
(
n
:
20
)
Pre
GPx
Levels
69.
8±
13
.
4
69
.
7
±1
4
.
2
0
.
3
2
4
>0
.
0
5
*
Po
st GPx
L
ev
els
79
.
9
±
8
.
8
63
.
5
±
1
.
1
0
.
0
0
0
<0
.
0
5
*
Evaluation Warning : The document was created with Spire.PDF for Python.
IJPHS
IS
S
N: 22
52
-
8806
Th
e
Eff
ect
o
f T
end
e
r Coc
onut
Wa
te
r
on Free
Radical
D
ue
t
o
Merc
ur
y
Exposure
(
Siti
T
homa
s
Z
ula
ik
hah
)
105
The
ave
rage
re
su
lt
of
G
Px
le
ve
ls
after
interv
ention
in
th
e
con
t
ro
l
gro
u
p
and
the
treat
m
e
nt
gro
up
wa
s
p=
0.
000
¸
the
re
was
a
diff
e
rence
of
GPx
le
ve
ls
after
the
interve
ntio
n
in
both
gr
oups
,
m
e
anin
g
that
the
bloo
d
GPx
le
vel
of
tr
aditi
on
al
gold
m
iners
ex
pose
d
to
m
ercu
ry
wer
e
evi
den
tl
y
increase
d
afte
r
the
adm
inist
rati
on
of
te
nd
e
r
coc
onut
water 450
m
L
ever
y day
f
or
30
da
ys.
T
his
re
su
lt
is
in
acc
or
dan
ce
with
B
ha
gya
et
al
'
s
research,
Anurag
a
nd
R
ajam
oh
an
w
ho
sta
te
d
that
ad
m
inist
rati
on
of
te
nd
e
r
coc
on
ut
water
ca
n
i
ncr
ease
t
he
le
vels
of
SOD
an
d
GPx
antioxi
da
nts
in
ex
pe
rim
ental
anim
al
s
[15
]
,
[16
]
.
T
his
res
ult
is
al
so
li
ne
ar
with
Zulai
khah'
s
researc
h,
et
al
.
wh
ic
h
sta
te
s
that
te
nd
er
coc
onut
water
is
able
to
increase
le
ve
ls
of
SOD
an
d
GPx
in
tradit
ion
al
go
l
d
m
iners
ex
po
s
ed
to
m
ercu
ry
[
19
]
.
T
he
diff
e
re
nce
bet
ween
this
stu
dy
and
previ
ou
s
researc
h
co
nducted
by
Zulai
khah
et
a
l.
li
es
in
t
he
t
ype
of
te
nder
cocon
ut
water
us
e
d
duri
ng
the
treat
m
ent,
te
nd
e
r
c
oc
onut
wate
r
or
i
gin
al
ly
der
i
ved
from
or
din
ary
green
c
oc
onut
ori
gin
at
in
g
from
Paci
ta
n
bu
t
this
resea
rch
us
es
the
w
ulun
g
te
nd
e
r
c
ocon
ut
water
ori
gin
at
ing
from
Pu
r
w
or
e
jo
a
nd
it
s
s
urrou
nd
i
ngs,
t
he
a
ge
of
t
he
cocon
ut
f
ru
it
i
s
ab
ou
t
5
-
7
m
on
ths,
a
nd
the
a
ntio
xid
ant
sta
tus
m
e
asur
e
d
is
an
e
nzym
e
antioxid
ant
w
hic
h
is
glu
ta
thio
ne
perox
i
dase
(G
P
x)
[19
].
Ten
der
c
oc
onut
water
c
on
ta
in
s
antio
xid
a
nts
su
c
h
as
vitam
i
n
C,
vitam
in
B1,
vitam
in
B6,
a
m
ino
aci
ds
su
c
h
as
m
et
hi
on
i
ne,
L
-
Arg
in
ine,
sel
eni
um
,
cy
tok
ines
a
nd
m
inerals
that
are
ve
ry
us
e
f
ul
for
pr
otect
ing
body
cel
ls
fr
om
fr
ee
rad
ic
al
at
ta
cks
and
pr
e
ven
ti
ng
e
ff
ect
s
cau
sed
by
m
ercu
r
y
exp
osu
re
[
15]
,
[20]
-
[2
3
]
.
Ten
der
cocon
ut
water
is
a
source
of
m
et
hio
nin
e
an
d
vitam
in
B6
[23
]
.
Me
t
hioni
ne
act
s
as
a
pr
ecu
rsor
for
the
form
ation
of
c
yst
ei
ne
wh
ic
h
i
s
the
m
ai
n
com
pound
i
n
the
s
ynthesis
of
glut
at
hio
ne
(GSH
).
Me
thi
on
i
ne
will
be
synthesiz
ed
to
S
-
a
de
nosylm
et
hio
ni
n
(SA
M)
wit
h
the
ai
d
of
a
m
eth
io
nin
e
ade
no
syl
transfrease
enzym
e
cat
al
yst
.
Fu
rth
erm
or
e
,
S
-
a
de
no
sil
m
et
hio
nin
(SAM)
will
be
c
onver
te
d
t
o
S
-
ade
nosil
hom
ocyst
ei
ne
(S
A
H),
SAH
will
be
c
onve
rted
to
ho
m
ocyst
e
ine
with
the
help
of
e
nzym
e
aden
os
i
lho
m
os
ist
ei
nase
and
by
m
et
hi
on
i
ne
synthase
(MS
)
ho
m
ocyst
ei
ne
can
be
conve
rted
bac
k
into
m
et
hio
nin
e.
I
n
cy
ste
ine
synthesis,
hom
ocyst
ei
ne
will
be
conver
t
ed
to
cy
sta
ti
onin
with
the
hel
p
of
cy
sta
thioni
ne
β
synthase
(CBS)
enzym
e
and
vitam
in
B
6
an
d
then
co
nverte
d
to
cy
ste
ine
with
the
help
of
the
enzym
e
sis
t
at
ion
in
li
ase
and
vitam
in
B6,
finall
y
cy
ste
in
e
will
be
synthes
iz
e
d
into
glu
ta
thio
ne
(GSH
)
[
12
]
,
[2
4],
[
25]
.
Tend
e
r
coc
onut
water
co
ntains
sel
enium
,
wh
ic
h
play
s
an
i
m
po
rta
nt
r
ole
in
protei
n
synthesis
an
d
GPx
act
ivit
y,
t
he
la
ck
of
sel
enium
in
the
body
can
dec
reas
e
GP
x
act
ivit
y
by
up
to
90%
[
26]
.
Me
rcury
has
a
strong
bi
ndin
g
f
or
ce
a
ga
inst
sel
enium
[5
]
,
a
nd
both
ar
e
antag
on
ist
ic
[
27]
.
Givi
ng
yo
ung
c
ocon
ut
wa
te
r
to
work
e
rs
expose
d
to
m
ercury
can
be
us
e
d
as
a
so
ur
ce
of
sel
enium
in
or
der to i
ncr
ease
GPx acti
vity
.
4.
CONCL
US
I
O
N
The
a
ver
a
ge
of
GPx
le
vels
after
inte
rv
e
ntion
in
t
he
con
t
ro
l
gro
up
an
d
trea
tm
ent
group
wa
s
p
value=
0.000
¸
there
was
dif
f
eren
ce
on
GPx
le
vels
after
in
te
rv
e
ntion
in
both
gro
ups
w
hi
ch
m
eans
the
blood
GPx
le
vels
of
tradit
ion
al
gol
d
m
iners
e
xpose
d
t
o
m
ercu
ry
was
pro
ve
n
t
o
increa
se
afte
r
the
a
dm
inist
rat
ion
of
te
nd
e
r
c
ocon
ut w
at
er
of
450 m
L ev
ery day f
or 30
days.
ACKN
OWLE
DGE
MENTS
The
resea
rch
e
r
s
w
ould
li
ke
to
tha
nk
F
K
Un
i
ssu
la
for
f
undi
ng
this
resea
rc
h,
PAU
-
U
GM
Y
ogya
ka
rta,
Won
og
i
ri
Re
ge
nt,
S
ub
-
distri
ct
Selog
i
ri,
Je
ndi
Vill
age
Chi
ef
a
nd
tra
diti
on
al
gold
m
iners
w
ho
wer
e
wi
ll
ing
to
be resp
onde
nts
.
REFERE
NCE
S
[1]
D.
Mergler
e
t
al.
,
“
Meth
y
lmer
cu
r
y
Exposure
and
Hea
l
th
Ef
fects
i
n
Hum
ans:
A
W
orldwide
Con
ce
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n
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t
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B
y
N
-
Ac
ety
l
c
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st
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n
e
and
Gall
ic
Acid
on
Kidne
y
T
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id
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ti
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e El
imina
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cur
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n
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014
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"
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e
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ti
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e
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erc
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v
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gen
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'
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hemistr
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“
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i
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t
hei
r
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ent
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e
rad
ic
a
l
c
atche
rs
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ut
i
k
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e
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te
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coc
on
ut
wate
r
on
ox
id
at
iv
e
stress
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uct
osa
fed
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n
resista
nt
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ra
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“
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a
l
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te
nd
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con
ut
wat
er
ag
ai
nst
isoprote
r
enol
in
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ce
d
toxi
c
ity
o
n
hea
rt
m
it
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ria
l
activit
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m
oro,
"F
undam
ent
a
ls of
Cl
inica
l
Rese
arc
h
Meth
odolog
y
"
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g
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[18]
Dahla
n
MS
,
"T
he
gatewa
y
und
ersta
nds
statistics
,
m
et
hodolog
y
and
epi
d
emiolo
g
y
(
in
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asa
)",
Jaka
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Sagun
g
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S.
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ah
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A.
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“
Eff
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A
nti
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n
t
En
z
ym
at
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Superoxi
da
Dism
uta
se
(
S
O
D
),
CATALASE
(
CAT
),
Gluta
thi
o
n
e
Peroxid
ase
(GP
x)
and
Li
pid
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at
i
on
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u
r
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