Human exposure and risk assessment associated with mercury contamination in artisanal gold mining areas in the Brazilian Amazon

Health Risk Assessment for Local Residents from the South China Sea Based on Mercury Concentrations in Marine Fish

The offshore area of the South China Sea is an important fishing ground in China. We used a food frequency questionnaire to determine marine fish consumption by local residents, and we detected mercury concentrations in commonly consumed marine fish species. In total, 127.9 g/day of the marine fish consumed was identified in 178 local residents. THg and MeHg concentrations in 209 samples of 22 fish species ranged from 11.3 to 215.0 µg/kg wt and 2.0 to 160.0 µg/kg wt, respectively. The mean MeHg exposure from marine fish to local residents was 0.099 µg/kg bw, accounting for 43.0% of the provisional tolerated weekly intake (PTWI) (1.6 µg/kg bw/week), suggesting a low health risk. However, a potentially high health risk (202.2% of PTWI) was identified in those with 97.5% MeHg exposure.

Speciation, bioaccessibility and potential risk of chromium in Amazon forest soils

Even though the Amazon region is widely studied, there is still a gap regarding Cr exposure and its risk to human health. The objectives of this study were to 1) determine Cr concentrations in seven chemical fractions and 6 particle sizes in Amazon soils, 2) quantify hexavalent Cr (CrVI) concentrations using an alkaline extraction, 3) determine the oral and lung bioaccessible Cr, and 4) assess Cr exposure risks based on total and bioaccessible Cr in soils. The total Cr in both A (0-20 cm) and B (80-100 cm) horizons was high at 2346 and 1864 mg kg^-1. However, sequential extraction indicated that available Cr fraction was low compared to total Cr, with Cr in the residual fraction being the highest (74-76%). There was little difference in total Cr concentrations among particle sizes. Hexavalent Cr concentration was also low, averaging 0.72 and 2.05 mg kg^-1 in A and B horizon. In addition, both gastrointestinal (21-22 mg kg^-1) and lung (0.95-1.25 mg kg^-1) bioaccessible Cr were low (<1.2%). The low bioavailability of soil Cr and its uniform distribution in different particle sizes indicated that Cr was probably of geogenic origin. Exposure based on total Cr resulted in daily intake > the oral reference dose for children, but not when using CrVI or bioaccessible Cr. The data indicated that it is important to consider both Cr speciation and bioaccessibility when evaluating risk from Cr in Amazon soils.

Assessing exposure to metals using biomonitoring: Achievements and challenges experienced through surveys in low- and middle-income countries

In this narrative account based on a keynote presentation on exposure biomonitoring of metals in low- and middle-income countries (LMIC), we first briefly address practical issues that have arisen from our experience during the conduct of various surveys in LMIC. These have included the statistical handling of multiple pollutants in the same subject, the problem of correctly adjusting for urinary flow in spot samples of urine, and the possible external contamination of samples when doing field surveys in challenging environments. We then review and present selected results from surveys conducted in the mining area of Katanga in the Democratic Republic of Congo (DR Congo), where we documented high urinary levels of cobalt and other trace metals (arsenic, uranium) in people living close (<3 km) to mining or smelting operations (Banza et al., 2009). Consumption of contaminated foodstuffs (maize, legumes, fish) and, especially among children, dust ingestion proved to be the main sources of exposure to cobalt (Cheyns et al., 2014). Urinary biomonitoring studies among artisanal workers involved in mining cobalt, craftsmen working malachite, and workers processing gold ore revealed high to extremely high values of cobalt (largely exceeding the Biological Exposure Index of 15 μg/L), as well as other trace metals such as uranium, manganese, lead or mercury, depending on the type of jobs. This abundant biomonitoring data has been valuable to argue for improved enforcement of legislation to protect workers and citizens against the hazards posed by the mining activities in the area. Epidemiological studies have been undertaken and are ongoing to assess the human health impact of this pollution.

Vulnerability associated with "symptoms similar to those of mercury poisoning" in communities from Xingu River, Amazon basin

The Brazilian Amazon is known to be a region with high levels of mercury (Hg) in the environment and studies point to an association between high levels of natural mercury in the mother rock and the vast number of clandestine gold mines. Other studies already report the contamination of fish in this region, as well as high levels of Hg in biological material from environmentally exposed populations. On the other hand, this is one of the least developed regions of the planet and it is necessary to understand the vulnerability factors in these populations that may be intoxicated by this element. The purpose of the present study was to investigate the vulnerability factors in communities from Xingu River-Amazon basin probably exposed to Hg. A cross-selection study in two cities localized in Xingu River was conducted, and the sample contained was 268 individuals. sociodemographic questions, lifestyle, diet habits and health conditions were collated. The majority of the sample was female, between 30 and 59 years old, had less than 3 years of educational level and lived in the local of study more than 240 months. There was regular fish consumption (95.9%), principally carnivorous species (80.5%). The visual problem has a highest prevalence (43.3%) between the health problems and about the symptoms of Hg intoxication, memory loss (42.9%), weakness (35.1%), fatigue (34.3%), mood changes (28.7%) and difficulties in concentration (27.2%) was most reported. The female sex, age over 60, educational level below 3 years of study, did not had flush toilet, smoke and least one chronic non-communicable disease represent higher probability to had symptoms of Hg intoxication. Lack of access to health services, low education level and income evidence the susceptibility of this community to diseases and injuries. The vulnerable groups identified in this study should be a priority in public health and environmental health policies.

Human Mercury Exposure in Yanomami Indigenous Villages from the Brazilian Amazon

In the Brazilian Amazon, where the majority of Yanomami villages are settled, mercury (Hg) exposure due to artisanal small-scale gold mining (ASGM) has been reported since the 1980s. This study assessed mercury exposure in the Yanomami reserve and whether the level of contamination was related to the ASGM geographical location. It was conducted using a cross-sectional study of 19 villages. Direct interviews were performed and hair samples were used as a bioindicator of Hg exposure. The Prevalence-Ratio (PR) was estimated as an indicator of association between ASGM geographical locations and human exposure to mercury. Mercury levels (239 hair samples) ranged between 0.4 and 22.1 μg·g-1 and presented substantial differences amongst the villages. In the Waikas-Aracaça region, where current ASGM was reported, we observed the highest Hg concentrations (median = 15.5 μg·g-1). Almost all participants presented with hair-Hg levels >6 μg·g-1 (prevalence = 92.3%). In the Paapiu region, we observed the lowest concentrations (median = 3.2 μg·g-1; prevalence = 6.7%). Our findings showed that the Waikas Ye'kuana and Waikas Aracaca villages presented with 4.4 (PR = 4.4; Confidence Interval (CI) 95% = 2.2⁻9.0) and 14.0 (PR = 14.0; CI 95% = 7.9⁻24.9) times higher prevalence of hair-Hg concentration, respectively, compared with Paapiu. Considering seasonal variation of Hg-exposure, the lowest concentrations were observed during the wet season (June⁻September) and the highest in the dry season (December⁻April). Our study suggests that there is an association between mercury exposure and ASGM geographical locations.

Mercury contamination in selected foodstuffs and potential health risk assessment along the artisanal gold mining, Gilgit-Baltistan, Pakistan

This study investigates the mercury (Hg) contaminations in soil and foodstuffs along the artisanal gold mining areas, Gilgit-Baltistan Province, Pakistan. For this purpose, soils were analyzed for Hg concentrations and evaluated for the enrichment/contamination using enrichment factor or contamination factors (CF). The CF values ranged from 18.9 to 153 showed multifold higher levels of Hg contamination as compared to background or reference site. Foodstuffs including vegetables, seeds or grains and fish muscles showed Hg accumulation. Results revealed that Hg concentrations in foodstuffs were higher than the critical human health value set by European Union. The Hg in foodstuffs was consumed and, therefore, evaluated for the risk assessment indices using the daily intake (DI) and health risk index (HRI) for the exposed human population both children and adults. Results of this study revealed that cumulative HRI values through foodstuffs consumption were <1 (within safe limit), but if the current practices continued, then the Hg contamination could pose potential threat to exposed population in near future.

Hair as a Biomarker of Long Term Mercury Exposure in Brazilian Amazon: A Systematic Review

Many studies have assessed mercury (Hg) exposure in the Amazonian population. This article performs a literature search of the studies that used hair as a biomarker of Hg exposure in the Brazilian Amazonian population. The search covered the period from 1996 to 2016 and included articles which matched the following criteria: (1) articles related to Hg exposure into Brazilian Amazon; (2) articles that used hair as a biomarker of Hg exposure; (3) articles that used analytical tools to measure the Hg content on hair and (4) articles that presented arithmetic mean and/or minimum and maximum values of Hg. 36 studies were selected. The findings show that most of the studies were performed along margins of important rivers, such as Negro, Tapajós and Madeira. All the population presented mean levels of Hg on hair above 6 µg g^-1 and general population, adults, not determined and men presented levels of Hg on hair above 10 µg g^-1. The results show that most of the studies were performed by Brazilian institutions/researchers and the majority was performed in the State of Pará. The present study identified that Amazonian population has long-term been exposed to Hg. In terms of future perspectives, this study suggests the implementation of a strategic plan for environmental health surveillance in the region in order to promote health and benefit Amazonian population.

Challenges and opportunities for managing aquatic mercury pollution in altered landscapes

The environmental cycling of mercury (Hg) can be affected by natural and anthropogenic perturbations. Of particular concern is how these disruptions increase mobilization of Hg from sites and alter the formation of monomethylmercury (MeHg), a bioaccumulative form of Hg for humans and wildlife. The scientific community has made significant advances in recent years in understanding the processes contributing to the risk of MeHg in the environment. The objective of this paper is to synthesize the scientific understanding of how Hg cycling in the aquatic environment is influenced by landscape perturbations at the local scale, perturbations that include watershed loadings, deforestation, reservoir and wetland creation, rice production, urbanization, mining and industrial point source pollution, and remediation. We focus on the major challenges associated with each type of alteration, as well as management opportunities that could lessen both MeHg levels in biota and exposure to humans. For example, our understanding of approximate response times to changes in Hg inputs from various sources or landscape alterations could lead to policies that prioritize the avoidance of certain activities in the most vulnerable systems and sequestration of Hg in deep soil and sediment pools. The remediation of Hg pollution from historical mining and other industries is shifting towards in situ technologies that could be less disruptive and less costly than conventional approaches. Contemporary artisanal gold mining has well-documented impacts with respect to Hg; however, significant social and political challenges remain in implementing effective policies to minimize Hg use. Much remains to be learned as we strive towards the meaningful application of our understanding for stakeholders, including communities living near Hg-polluted sites, environmental policy makers, and scientists and engineers tasked with developing watershed management solutions. Site-specific assessments of MeHg exposure risk will require new methods to predict the impacts of anthropogenic perturbations and an understanding of the complexity of Hg cycling at the local scale.

Geo-Spatial Characterization of Soil Mercury and Arsenic at a High-Altitude Bolivian Gold Mine

Soil mercury concentrations at a typical small-scale mine site in the Bolivian Andes were elevated (28-737 mg/kg or ppm) in localized areas where mercury amalgams were either formed or vaporized to release gold, but was not detectable beyond approximately 10 m from its sources. Arsenic was measurable, exceeding known background levels throughout the mine site (77-137,022 ppm), and was also measurable through the local village of Ingenio (36-1803 ppm). Although arsenic levels were high at all surveyed locations, its spatial pattern followed mercury, being highest where mercury was high.

Mercury Levels in Fish for Human Consumption from the Southeast Gulf of California: Tissue Distribution and Health Risk Assessment

We assessed human health risk due to mercury (Hg) concentrations in fish from three coastal lagoons (Urías, Huizache, and Teacapán) in the SE Gulf of California. We also determined Hg distribution in muscle and liver of analyzed ichthyofauna and compared the results among studied areas according to tissue, season, and lagoon system by using multivariate analyses. Levels of Hg in most of the analyzed fish followed the sequence liver > muscle. The highest Hg levels in muscle (2.80 µg g^-1 dw) and liver (9.51 µg g^-1 dw) were measured in Cynoscion reticulatus and Pomadasys macracanthus, respectively, although according to the multivariate analyses, statistical differences of Hg concentrations were not found according to the season and the tissue but were found according to the system. It seems that the higher concentrations were associated with areas where the hydrological regime is lower. With respect to health risk assessment, the highest hazard quotients were estimated for Cynoscion reticulatus (0.45) and Stellifer furthii (0.29) from Urías and Pomadasys macracanthus (0.35) from Huizache. None of the studied fish represent a risk for consumers in terms of Hg levels in the edible portion.

Dietary human exposure to mercury in two artisanal small-scale gold mining communities of northwestern Colombia

Artisanal and small-scale gold mining (ASGM) is the largest anthropogenic source of mercury pollution worldwide, posing a grave threat to human health. The present study identifies current levels of mercury in the human population from mining areas of the Chocó Department, Colombia, through total mercury (THg) and methylmercury (MeHg) measurements in human hair. Mercury exposure of the local population was assessed in two towns affected by ASGM and was related to different variables of interest. Concentrations of THg in human hair ranged from 0.06 to 17.54ppm and the mean value for the subjects under study was 2.48ppm. Men had significantly higher levels than women in both towns (3.29ppm vs. 0.77ppm). Fish consumption was related to a marked increase of THg in hair, with mean values close to five times higher in frequent fish consumers (5-7 times/week) than in non-fish consumers (4.80ppm vs. 0.90ppm). A multiple linear regression model was fitted successfully (R=0.671) and reveals that gender, fish consumption and location of residence were significant indicators of Hg levels in hair, while no significant relationship was found for age. Approximately 60% of subjects tested had THg levels that exceeded the U.S. Environmental Protection Agency reference dose of 1.0ppm, while 25% surpassed that of the World Health Organization (2.2ppm).

Endophytic fungal communities of Polygonum acuminatum and Aeschynomene fluminensis are influenced by soil mercury contamination

The endophytic fungal communities of Polygonum acuminatum and Aeschynomene fluminensis were examined with respect to soil mercury (Hg) contamination. Plants were collected in places with and without Hg+2 for isolation and identification of their endophytic root fungi. We evaluated frequency of colonization, number of isolates and richness, indices of diversity and similarity, functional traits (hydrolytic enzymes, siderophores, indoleacetic acid, antibiosis and metal tolerance) and growth promotion of Aeschynomene fluminensis inoculated with endophytic fungi on soil with mercury. The frequency of colonization, structure and community function, as well as the abundant distribution of taxa of endophytic fungi were influenced by mercury contamination, with higher endophytic fungi in hosts in soil with mercury. The presence or absence of mercury in the soil changes the profile of the functional characteristics of the endophytic fungal community. On the other hand, tolerance of lineages to multiple metals is not associated with contamination. A. fluminensis depends on its endophytic fungi, since plants free of endophytic fungi grew less than expected due to mercury toxicity. In contrast plants containing certain endophytic fungi showed good growth in soil containing mercury, even exceeding growth of plants cultivated in soil without mercury. The data obtained confirm the hypothesis that soil contamination by mercury alters community structure of root endophytic fungi in terms of composition, abundance and species richness. The inoculation of A. fluminensis with certain strains of stress tolerant endophytic fungi contribute to colonization and establishment of the host and may be used in processes that aim to improve phytoremediation of soils with toxic concentrations of mercury.

Mercury exposure, serum antinuclear antibodies, and serum cytokine levels in the Long Island Study of Seafood Consumption: A cross-sectional study in NY, USA

Mercury (Hg) is a well-known neurotoxin, and has been more recently studied specifically as an immunotoxin. In experimental and a few epidemiologic studies, Hg has been associated with distinct cytokine profiles and antinuclear antibody (ANA) positivity, though patterns at lower levels of exposure, typical of seafood consumers with a western diet, are not well characterized. Seafood consumers (n=287) recruited on Long Island, NY completed food frequency and health questionnaires and provided blood for analysis of Hg, poly-unsaturated fatty acids (omega-3 and omega-6 fatty acids), selenium (Se), ANA, and several cytokines (IL-1β, IL-4, IL-10, TNF-α, IL-17, IFN-γ, and IL-1ra). Logistic and linear regression analyses were conducted to evaluate associations between serum Hg and cytokines and ANA. Adjusted models accounted for gender, age, ethnicity, income, education, smoking, BMI, selenium, omega-3 fatty acids, omega-6 fatty acids, omega-6/omega-3 ratio, and fish intake. Sex-stratified models were also generated with the expectation that immune profiles would differ between women and men. Median blood Hg was 4.58µg/L with 90th %ile =19.8µg/L. Nine individuals displayed ANA positivity at serum titers above 1:80; many of the cytokines were below detection limits, and the ability to detect was used in the logistic regression analyses. In linear and logistic regression analyses, Hg was not significantly associated with any of the seven investigated cytokines or with ANA-positivity. Therefore, Hg was not associated with altered immune profiles in this population of seafood consumers.

Semiquantitative determination of total mercury in Pygocentrus nattereri Kner, 1858 and sediment at the plateau of Upper Paraguai River, Brazil

In this study an environmental assessment of contamination by total mercury (THg) was carried out at the Plateau of the Upper Paraguai River. Total mercury was evaluated in sediment and muscle of the red piranha Pygocentrus nattereri Kner, 1858, a piscivorous species at the top of the food chain consumed for subsistence and commercially. THg concentrations were below national guidelines established by WHO for sediments (100 ng g^-1) and fish (100-600 ng g^-1) for most of the sampled sites. Two sites located downstream of artisanal diamond and gold mines had THg concentrations in fish equal or greater than 600 ng g^-1.

Biomarkers of mercury toxicity: Past, present, and future trends

Mercury (Hg) toxicity continues to represent a global health concern. Given that human populations are mostly exposed to low chronic levels of mercurial compounds (methylmercury through fish, mercury vapor from dental amalgams, and ethylmercury from vaccines), the need for more sensitive and refined tools to assess the effects and/or susceptibility to adverse metal-mediated health risks remains. Traditional biomarkers, such as hair or blood Hg levels, are practical and provide a reliable measure of exposure, but given intra-population variability, it is difficult to establish accurate cause-effect relationships. It is therefore important to identify and validate biomarkers that are predictive of early adverse effects prior to adverse health outcomes becoming irreversible. This review describes the predominant biomarkers used by toxicologists and epidemiologists to evaluate exposure, effect and susceptibility to Hg compounds, weighing on their advantages and disadvantages. Most importantly, and in light of recent findings on the molecular mechanisms underlying Hg-mediated toxicity, potential novel biomarkers that might be predictive of toxic effect are presented, and the applicability of these parameters in risk assessment is examined.

Assessment of risk to human health from simultaneous exposure to multiple contaminants in an artisanal gold mine in Serra Pelada, Pará, Brazil

Contamination of soil, water and plants caused by gold mining is of great societal concern because of the risk of environmental pollution and risk to human health. The aim of the present study was to evaluate the risk to human health from ingestion of As, Ba, Co, Cu, Cd, Cr, Ni, Pb, Se and Ni present in soil, sterile and mineralized waste, and water and plants at a gold mine in Serra Pelada, Pará, Brazil. Samples of soil, sterile and mineralized waste, water and plants were collected around an artisanal gold mine located in Serra Pelada. The mean concentrations of potentially toxic elements in the soil were higher than the soil quality reference values as defined in the legislation, which may be attributeable to past mining activities. Water from the area close to the mine exhibited As, Ba and Pb concentrations exceeding the reference values established by the World Health Organization, deemed unfit for human consumption. Plants exhibited high Pb concentrations, representing a food safety risk to the population. The mean hazard index (HI) values were below the acceptable limit (1.0) established by the United States Environmental Protection Agency, although the highest HI values observed for adults and children were higher than the respective acceptable limits. Environmental contamination and risk to human health were heterogeneous in the surroundings of the mine. Mitigation strategies need to be adopted to decrease the risks of contamination to the environment and to the local population.

Human exposure and risk assessment associated with mercury pollution in the Caqueta River, Colombian Amazon

Mercury (Hg) is a global contaminant posing severe risks to human health worldwide. The aim of this study was to assess the levels of total Hg (T-Hg) in human hair and fish in the Caqueta River, at the Colombian Amazon, as well as to determine fish consumption-based risks for T-Hg ingestion. T-Hg levels were measured using a direct mercury analyzer. The overall mean T-Hg level in hair for humans in the Caqueta River sample (n = 200) was 17.29 ± 0.61 μg/g (1.2 to 47.0 μg/g). Ninety-four percent of the individuals had hair T-Hg concentrations greater than the WHO threshold level (5 μg/g), and 79 % displayed levels higher than 10 μg/g. Average Hg concentrations in fish varied between 0.10-0.15 μg/g and 0.10-1.60 μg/g, for noncarnivorous and carnivorous species, respectively. Based on the maximum allowable fish consumption rate for adults, most carnivorous species should be avoided in the diet, as their target hazard quotient ranged from 2.96 up to 31.05, representing a risk for Hg-related health problems. In the light of existing evidence for elevated Hg levels in the indigenous population of the Colombian Amazon, carnivorous fish should be restricted as part of the diet, and breastfeeding should be reduced to protect children health. Most importantly, gold mining activities directly on rivers demand immediate attention from the national government to avoid extensive damage on the environment and human health.

Essential Indicators Identifying Chronic Inorganic Mercury Intoxication: Pooled Analysis across Multiple Cross-Sectional Studies

Background

The continuous exposure to inorganic mercury vapour in artisanal small-scale gold mining (ASGM) areas leads to chronic health problems. It is therefore essential to have a quick, but reliable risk assessing tool to diagnose chronic inorganic mercury intoxication. This study re-evaluates the state-of-the-art toolkit to diagnose chronic inorganic mercury intoxication by analysing data from multiple pooled cross-sectional studies. The primary research question aims to reduce the currently used set of indicators without affecting essentially the capability to diagnose chronic inorganic mercury intoxication. In addition, a sensitivity analysis is performed on established biomonitoring exposure limits for mercury in blood, hair, urine and urine adjusted by creatinine, where the biomonitoring exposure limits are compared to thresholds most associated with chronic inorganic mercury intoxication in artisanal small-scale gold mining.

Methods

Health data from miners and community members in Indonesia, Tanzania and Zimbabwe were obtained as part of the Global Mercury Project and pooled into one dataset together with their biomarkers mercury in urine, blood and hair. The individual prognostic impact of the indicators on the diagnosis of mercury intoxication is quantified using logistic regression models. The selection is performed by a stepwise forward/backward selection. Different models are compared based on the Bayesian information criterion (BIC) and Cohen`s kappa is used to evaluate the level of agreement between the diagnosis of mercury intoxication based on the currently used set of indicators and the result based on our reduced set of indicators. The sensitivity analysis of biomarker exposure limits of mercury is based on a sequence of chi square tests.

Results

The variable selection in logistic regression reduced the number of medical indicators from thirteen to ten in addition to the biomarkers. The estimated level of agreement using ten of thirteen medical indicators and all four biomarkers to diagnose chronic inorganic mercury intoxication yields a Cohen`s Kappa of 0.87. While in an additional stepwise selection the biomarker blood was not selected, the level of agreement based on ten medical indicators and only the three biomarkers urine, urine/creatinine and hair reduced Cohen`s Kappa to 0.46. The optimal cut-point for the biomarkers blood, hair, urine and urine/creatinine were estimated at 11. 6 μg/l, 3.84 μg/g, 24.4 μg/l and 4.26 μg/g, respectively.

Conclusion

The results show that a reduction down to only ten indicators still allows a reliable diagnosis of chronic inorganic mercury intoxication. This reduction of indicators will simplify health assessments in artisanal small-scale gold mining areas.

[Recent Epidemiological Studies on Methylmercury, Mercury and Selenium]

More than sixty years has passed since the outbreak of Minamata disease, and high-level methylmercury contaminations now seem nonexistent in Japan. However, mercury has been continuously discharged from natural sources and industrial activities, and the health effects on children susceptible to methylmercury exposure at low levels, in addition to mercury contamination from mercury or gold mining areas in developing countries, become a worldwide concern. In this article, we provide a recent overview of epidemiological studies regarding methylmercury and mercury. The following findings were obtained. (1) Many papers on exposure assessment of methylmercury/mercury have been published since the Minamata Convention on Mercury was adopted in 2013. (2) The most crucial problem is child developmental neurotoxicity resulting from prenatal exposure to methylmercury, but its precise assessment seems to be difficult because most of such effects are neither severe nor specific. (3) Several problems raised in birth cohort studies (e.g., whether IQ deficits due to prenatal methylmercury exposure remain when the children become adults, or whether the postnatal exposure at low levels also causes such adverse effects in children) remain unsolved. (4) Concurrent exposure models of methylmercury, lead, polychlorinated biphenyls, aresenic, and organochlorine pesticides, as well as possible antagonists such as polyunsaturated fatty acids and selenium, should be considered in the study design because the exposure levels of methylmercury are extremely low in developed countries. (5) Further animal experiments and molecular biological studies, in addition to human studies, are required to clarify the mechanism of methylmercury toxicity.