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Chronic kidney disease of unknown etiology (CKDu) is spreading gradually in Sri Lanka. In the current research, 1,435 well water samples from all 25 districts of Sri Lanka, 91 rice samples, and 84 human urine samples from both CKDu-endemic and non-endemic areas in Sri Lanka were analyzed for arsenic, cadmium, lead, and chromium to detect whether toxic elements could be a cause of CKDu. The liver-type fatty acid binding protein (L-FABP) concentration and arsenic, cadmium, lead, and chromium concentrations of the urine samples were analyzed to determine the relation of L-FABP with arsenic, cadmium, lead, and chromium. High concentrations of arsenic, cadmium, lead, and chromium were not detected in the well water samples from CKDu-endemic areas. Arsenic, cadmium, and lead contents in the rice samples from both CKDu-endemic and non-endemic areas were well below the Codex standard. There were no relationships between the L-FABP concentration and concentrations of arsenic, cadmium, lead, and chromium in urine. In addition, arsenic, cadmium, lead, and chromium concentrations in human urine samples from CKDu-endemic areas were not significantly different from those from non-endemic areas. These findings indicated that arsenic, cadmium, lead, and chromium could not cause CKDu.

Graphical abstract

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In some developing countries, such as Myanmar, mercury used for gold refining in artisanal small-scale gold mining (ASGM) is emitted into the atmosphere and water, causing environmental pollution. In this study, the diffusion of mercury from ASGM in Thabeikkyin Township, Mandalay Division, Myanmar was investigated. Air samples, water samples and hair were collected from the ASGM sites. The mercury concentration in the atmosphere in the gold mining area reached 74,000 ng/m 3 at the maximum concentration, which exceeded the WHO guideline of 1,000 ng/m 3 . The mercury concentration in the Ayeyarwady River and the groundwater pumped from the gold mining tunnel was 4.6 ng/l and 29-35 ng/l, respectively. The limit of mercury in hair is considered to be 50 μg/g, at which concentration nervous symptoms may appear, while 11 μg/g is the concentration at which adverse effects on fetuses could take place. The average mercury concentration in hair was 1.5 μg/g for ASGM workers, while it was 1.1 μg/g for nonworkers. An analysis of hair indicated that the mercury was not at a level that would adversely affect human health, so far.